________________ CM . . . . Volume XXIV Number 41 . . . . June 22, 2018


Dr. Jo: How Sara Josephine Baker Saved the Lives of America's Children.

Monica Kulling. Illustrated by Julianna Swaney.
Toronto, ON: Tundra, October, 2018.
32 pp., hardcover & EPUB, $21.99 (hc.).
ISBN 978-1-101-91789-3 (hc.), ISBN 978-1-101-91791-6 (EPUB).

Subject Headings:
Baker, S. Josephine (Sara Josephine), 1873-1945-Juvenile literature.
Health officers-New York (State)-New York-Biography-Juvenile literature.

Kindergarten-grade 2 / Ages 5-7.

Review by Ellen Wu.

***½ /4



Each morning Dr. Jo put on her sturdy walking shoes, picked up her medical bag and headed for Hell's Kitchen.

She was making her way to work one morning when a frantic man stopped her.

"Please come quick!" he said. "My baby is dying!"

Dr. Jo entered a gloomy room. When she saw three hungry children staring at her, she brought out her lunch. She split a hunk of cornbread into three parts.

The screaming baby was tightly wrapped in a blanket. Many mothers believed that this practice, called swaddling, kept newborns quiet. But summer's severe heat could be deadly.

As Dr. Jo unwound the blanket, she said, "This is not good."

And it wasn't. This baby, like many others, would die of heatstroke.

In the same building, Dr. Jo examined another baby with eye problems. The retinoscope shone a light into the retina, or back of the eye, to see if the eye was working.

"I'm so sorry," said Dr. Jo, sadly.

Silver nitrate drops used to clean bacteria from a newborn's eyes had instead made this baby blind.

Dr. Jo shared the stories of her day with Dr. Florence. While her friend listened, Jo ticked off the things every newborn needed.

"The eye drops must be an exact measure. Too often the solution evaporates or the glass container is dirty. The result? Damaged eyes.

"Newborns also need clothes that let them move. They need fresh air and clean milk. Children need a safe place to play, not streets that are filled with garbage and manure. In short, Hell's Kitchen has earned its name!"

Jo did her best thinking while walking. On a rare day off, she walked to the bottom of Manhattan Island. She looked out at the statue that welcomed newcomers from other countries.

Jo was seeing firsthand how grateful immigrants were to live in America, but also how hard that new life could be if you were poor.

Dr. Jo desperately wanted to help, and she had a few ideas.

This beautifully illustrated account of Dr. S. Josephine Baker's work in New York City is an excellent introduction to an inspiring woman whose public health reforms in New York City saved the lives of 90 000 children and formed the basis for public health programs across the United States.

      The book first takes readers back to the 1870s in Poughkeepsie, NY, where Sara Josephine Baker was born. Those who knew young Sara "called [her] a tomboy" because she "did things that the quiet and polite girls of her day did not do. She played baseball. She climbed trees. She was strong and adventurous." Jo lost her beloved brother Robbie and her father in quick succession due to an outbreak of typhoid caused by contaminated river water. Since she had from a young age harboured a desire to become a doctor, 16-year old Jo, determined more than ever after the death of her family members, enrolled in the Women's Medical College of the New York Infirmary after she graduated high school.

      As Kulling points out, the prejudices against women practicing medicine included its being considered "too grisly" or "too gruesome" for women to withstand. Kulling gently precludes other reasons, including that of gender discrimination and the fact that men did not consider women competent enough to tackle the study of medicine. Arguments against women included the fact that women were biologically ill-equipped to handle the study of medicine, and they would indeed develop a pathology that would lead to ill health in themselves. Thankfully, such ideas were already being proven wrong by women such as Emily and Elizabeth Blackwell who had founded the college from which Dr. Jo would graduate in 1898.

      Due to the lack of patients, Dr. Jo's brief stint in private practice ended in 1901, the point at which she became a public health inspector for New York City. Perhaps due to the fact that she was a woman (a point not mentioned in the text but suggested in the sources referred to by Kulling in her bibliography), she was given the thankless task of monitoring the welfare of Hell's Kitchen, an area of the city stricken by poverty. There, Dr. Jo encountered the situations excerpted above and came up with sensible, ingenious solutions to them.

      She first examined how home births, common amongst immigrant women, resulted in many infant deaths. Midwives helped during labour, but they did not have the skills to cope with unforeseen circumstances. Therefore, Dr. Jo required midwives to take courses to earn a license, and she also sent nurses to help new mothers in their first days at home with their babies. Dr. Jo also addressed the malnutrition she witnessed by setting up milk stations to distribute clean, healthy milk for children. She next turned her mind to addressing the unsanitary glass containers for dispensing silver nitrate drops into babies' eyes, and she discovered the "antibacterial, anti fungal, antiseptic, and even antiviral" properties of beeswax–"everything the doctor ordered!" The last reform described by Kulling was that of baby swaddling, a practice which had led to heat stroke-related deaths in so many babies. She designed baby clothes which opened down the front, allowing for ease of movement, temperature control, and easier access for frequent diaper changes. The patterns were purchased by McCall's, a pattern company, so that they could be mass-produced, and this led to mothers making safer baby clothes. The book ends with a statement that Dr. Jo "understood the connection between poverty and illness. Throughout her life she worked tirelessly to improve the health of woman and their children in New York and other big cities. By the end of her career, Dr. Sara Josephine Baker had saved the lives of 90,000 inner-city children across America. People were always happy to see Dr. Jo coming their way!"

      Given that it is a picture-book biography aimed for primary students, the informational content does not aim to be rigorous. There are no sidebars so ubiquitous in children's nonfiction, no historical photographs or maps of Hell's Kitchen in relation to the rest of New York City. Some terms would need to be explained to children, such as the properties of beeswax being "antimicrobial, antifungal, even antiviral", what a retinisocope is (though its meaning could be derived from context) and perhaps even "inner-city" might need some clarification. A one-page "More about Dr. Jo" is included as well, with more information about her career. It is curious that one of Dr. Jo's health ideas, that of the Little Mothers' League, in which girls aged 12 and older "were trained in basic infant care, such as feeding a baby, care of milk in the home, and what to do if a baby is teething", was not included in the main text. Depicting this program would have highlighted young girls' roles in helping raise their siblings and supporting their parents in increasing their household's finance by providing childcare during the day. It would also have been interesting to hear Dr. Jo's voice more, perhaps from her autobiography, as there is a lot of 'telling' in the narrative, and the only direct quotes are short, aside from her impassioned outburst to her friend, Dr. Florence, also quoted above.

      Swaney's homely, charming illustrations appear to be in watercolour, with more muted colour palette. The figure of Dr. Jo is reassuringly strong, confident, and professional, while being maternal and caring at the same time. She wears her dark auburn hair neatly pinned in a demure bun, small round spectacles, a neat bowtie or tie paired with crisp white shirts, and serviceable dark skirts. The tenements depicted are a somewhat sanitized version of the conditions of Hell's Kitchen at the time Dr. Jo worked there, with the suggestion rather than the depiction of squalor and despair. Human figures receive most detail, with an illustrative style slightly reminiscent of Lois Lenski and the felt figures found in Jack and Holman Wang's "Cozy Classics". When Dr. Jo boards the train bound for New York City, the background is mostly left blank, but a half spread of Hell's Kitchen includes broken windows, laundry drying outside, and children playing barefoot with animals in the streets beside barrels, mucky puddles, and decrepit wagon wheels.

      I read some of the sources consulted by Kulling, and I discovered Dr. Jo was also so much more than just a doctor, being a suffragist and champion for feminism, who spent the remainder of her life after retirement with her life partner, the novelist Ida Wylie. She also chose to become a doctor not because she had always wanted to be one as a child, but because she essentially became the breadwinner of her family after her father's death, and she chose medicine as the path to financial stability. Another highlight in her career as a health inspector were her two apprehensions of Typhoid Mary who had unwittingly caused typhoid outbreaks wherever she had worked as a cook. Dr. Jo published prolifically in her lifetime, penning hundreds of articles for both public and scholarly audiences, and she wrote books on infant and child health, hygiene, guidebooks for mothers, and a posthumously published biography called Fighting for Life which was just reissued in 2013. She also was the first woman to receive a doctorate in public health from the NYU-Bellevue Hospital Medical School, and she was a consultant to the federal Children's Bureau as well as a representative on child health issues to the League of Nations. The Division of Child Hygiene was developed with Dr. Baker as its head, and was the first bureau of its kind in the world devoted to the promotion of children's health. This is all to say that the scope of one person's life was narrowed down to focus on the main idea encapsulated in the title of the book–she saved America's children–and there is absolutely nothing wrong with that as the alternative would have been a much more bloated account.

      It's hoped that children, after reading Dr. Jo: How Sara Josephine Baker Saved the Lives of America's Children will ask more questions about Dr. Jo whose indomitable spirit, intelligence, compassion, and good sense not only saved lives, but set the groundwork for public health policy, preventive medicine, and women's and children's health for years to come.

Highly Recommended.

Ellen Wu has worked as a teen services librarian at Surrey Libraries since 2012 and resides in Vancouver, BC.

To comment on this title or this review, contact cm@umanitoba.ca.

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