And to all of you for showing up. So we are not able to host events in our store spaces, our community of authors and reader is still here. Were grateful for your support and for the chance to make this space for conversation and connection. In our webinar tonight you can see and hear the speakers but they cannot see or hear you. They can see youre here, though and you can see a count of your fellow listeners at the top of your zoom screen. A couple of functions that well be using throughout the event you can find at the bottom of your zoom window. One is an icon labeled chat win one speech bubble. Youre welcome to post comments and thoughts in the chat. Thats great way to show your appreciation for the author and to enter act with fellow attendees. If you have a specific question youd like to have answered by the author, please post that in the q a module. You can fine it by clicking on the icon label q a that looks like two speech bubbles. Well be pulling questions only from the q a to be aned later. To be answered later. Were rerecord thing event so look for video or audio versions of our channels later on, and importantly, tonights featured book a good time to be born is available for sale from greenlight book store. We excited to offer actual shopping at our book store location, noon to to 7 00 p. M. Every day of the week, and you can purchase perris book and many others onsite or order online at greenlightbookstore dorm dorm to pick up at the store or shipping. If you care about support thing careers of authors and the ongoing existence of independent book stores, find tonights featured book is a great way to show your support. And now to introduce tonights speaker, our interviewer is andrew solomon. He is a writer and lecturer on politics, cultural and psychology. A professor of Clinical Psychology at Columbia University medical center. And the former president of pen america. Most recently he made an audio series called a new family values, an awardwinning film. Far them to tree received the award for nonfiction and 25 other national and international awards. Also the author of far and away, a National Book award winner and Pulitzer Prize finalist. The irony tower and a novel, stone boat, and activist and lgbtq rights, health, education and the arts, a founder of she sol lohman Research Fellowship at lgbt studies and served on the board of the national lgbtq task force, the president museum of art, the number Public Library and many others. Andrew will be speaking with our author, perri klass. She is a professor of journalism and pediatrics at new york university, codirector onyu florence, and National Medical director of reachout and read. She writes the week column the checkup for the new york times. Her new become a good time to be born, is about the fight against Child Mortality that transformed parenting, fostering and the way we live. Weaving her own experiences as a medical student and doctor, klass pays tribe but to Ground Breaking women and doctors like rebecca columnber, mary put numb and josephinebacker and the nurses and scientists who brought new approaches and scientific ideas about sanitation and vaccination to families. Perri will start us off with a reading from the book and then shell be talking with andrew and with all of you. Per y, please take it away. Thank you. Our grandparents and great grandparents and all of the parents before, throughout history, expected that children would die. It was a known and predictable recollection that went with being a patient. Now we expect children innovate to die. We are the luckiest parents in history. We wore part of this wave over the past 75 years or so, because we are the first parents ever who have been able to enter into parenthood in the hopeful expectation of seeing all our children survive and thrive, and we are also the luckiest children in history, born into an eastern a era when we could expect to group along with all our sisters and brothers. Driving down Child Mortality in the late 19th in and 20th center was not a single product but a unified human accomplishment, maybe our greates human fleshment, at least for pediatricians and parents. The entire world has relearned with some something and great sorrow how vulnerable or precious human beings are to the microorganizisms that find ways to take advantage how we live, eat, travel, parents have taken some comfort in knowing that for the most part children have been less severely affected by covid19, but all through Human History babies and children have been a particularly vulnerable group, and parents have lived with the fear of con day judge, infection and death. Children used to die regularly and insurprise log i barbing died a birth because they were premature or weak, pause they were born with congenital anomalies, got infections, older infants and oneyearold died of summer dieee remarks caused by mine crop cristobals in the water or cows milk they started drinking. Threeyearolds and fiveyearolds and five and six and seven and eightyearolds died of scar let fever and dip theira, pneumonia, measles and Skin Infections or influence should that turned into pneumonia. At line at the late 19th and earliest 20th century, almost every family and every ethnic group and eave country, rich or poor, was touch in some way by the deaths of children. Childhood death was always there in the shadows at the edge of the family landscape in prayers and religious ceremonies and religion portraits on the wall in poems and stories and dramas and paintings, pause they figured so consistently in childhood and family life, child deaths figured in the art and literature and songs and stories of childhood and family life, from a century ago as they had all through Human History. I am a lover of babies and yet i cant seem to have them, wrote mrs. D. From brooklyn in 1917. I am married 11 years last july and would have six children and about to become a mother which i had almost feared ha two out of six, one boy nine years, and one six years work who of the them died some years ago, she didnt say how. But then within a year she had two babies and lost both of them. I gave birth to a beautiful fat boy and it lived but three days. The doctor told her the baby had a leaking heart. Three months later she was pregnant again, son lived to be a year old and then she awoke and found him dead alongside of me. Now pregnant again she worried constantly but the terrible long labor he would have and what would become of the baby. I try and live a good honest life and my home is my heaven and babies are my idol. I love them. But i am afraid something will happen to this one again. She whereas writing the letter to the United States government, to the childrens bureau, established in 1912. This new federal Office Published a pamphlet prenatal care and infant care in 1913 and 1914. Immediately popular, they were at first distributed free of charge and provided by politicians to their constituents, later available for purchase, by 1929 the government estimated these writings touched the parents of half the babies born in in the. She said i cried night and day for any big fat baby, taken from me like that. Mrs. Wd was not living in middle age orders the victorian ear ramp she was live informing 1917 when my grandmother lived and in new york city where any grandmother lived, ten years before my open parents were born. And at that time in 1917, when mrs. Wd wrote her letter, near lay quarter of the children born alive in the out died before their fifth birthday. Those mothers wrote in the early decade odd the 20th century with a certain home for medical solutions, for at vice that it might protect the next baby, even with a desire to extend that protection to all babies and children to join in the larger project of chirps bureau represented. I only wish i could take up the work of promoting baby welfare wrote a woman who lost their child. Hers from women would struggled with writing writing and otherse privileged. No part of society where childrens lives were secure. The statistical evidence has been complete, infant and Child Mortality in europe and america was extremely high, through the 17th and early 18th 18th centuries with a third of all children or some cases even 40 or more, dying before the clout drew childhood. In the first decade of the 20th century, when my grandmother was growing up, and out of every thousand live birth in United States more than 100 baby is did nod live to the first birthdays and mow at that time rates were higher among the rural, poor, micks and africanamericans. By comparison the infant mortality rate for the United States in 2017 was 5. 8 deaths per thousand live births. The majority of thieves deaths before the first birthday actually occurred the first month of life due either to con general anomalies, birth disease effects or maturity. A good time prematurity. A good time to live is a fusion of science and Public Health and medicine that transformed ore families, our emotional landscapes and our souls. All threw Human History many babies died at birth and this was true the middle ages and the renaissance, colonial america and victorian england and it was still true in the early 20th century. If where wont around any table anyone would have lost a sibling the childhood, lost a friend to death at a young age, lost a child. Infant and Child Mortality was a fact of life for almost every family, rich or poor, john. Rockefeller founded the Rockefeller Institute when his grandson died of scar let fever. Mortality was higher in 19th century, disadvantaged populations including enslaved children and the michigan poor. Let me star there. Thank you for that love live reading. Let me begin this conversation by saying this quite a remarkable book. Just had a rave review in times. Its written in an engaging and even enenthralling style. She is she brings together abstract information put she tells an neck totes and stories like the story of mrs. Wd and many other stories. Both of the people who lost children, ranging across the entire social spectrum and people who figure out how to save children. Its a very sobering study as a parent might well i was very struck over and over guy what it must have been like to have to form a more college attachment to your children. And i thought it looked forward to many of the questions of helicopter parenting that are current. What its your sense of how people responded psychologically and emotionally to these losses . Do you think that because they were common, people were better protected against them . Or too you think the quality of their despair was the same as the quality of disspare in someone who loses a child to sids which you write about today. I think quality of despair was the same but in a strange way they were less isolated, because it was so common, because it was discussed, because it was an experience everyone had had. I dont think that i think that when you read the conditions that parents write, you can see they loved their children just as much in and the same ways you can see they remembered them and grieved. You can see they went over and over the question of, could i have if we hadnt moved to the city, if i hadnt done this, if you hadnt done that. They did all of that but they did it sort of in company. We have three children but only two are living. That stops the conversation. That is not something that can easily be discussed. In the past there was ways because it was so common you can at least acknowledge the child anacknowledge the grief talk a little bit in that contexabout some of the losses where it clearly cuts so deep and where the quality of accusation cuts so deep. Particularly of Eugene Oneills mother and the story you tell about the death of his what would have been his older brother. Was actually writing about measles and looking for examples in art and literature of measles. Measles was a disease that every single child got before there was a vaccine because it was an incredibly infectious disease. Its a fairly miserable disease, in a disease which hits every single child when there are relatively rare complications its a relatively rare complication times all the children in the world so you lose a fair number of children. Even so, when i looked for references in literature, what many of them were abthe disease you get big spots. And most children recover. Then i was actually watching a performance of long days journey, Eugene Oneill play, so strongly autobiographical in which we think of as a play about addiction, the mother is addicted to opiates and the father and the sons drink too much. At the center of the plague is this tragedy of a baby lost to measles. My mother who went away to be on the road with her actor husband and leaves with her own mother, her sixyearold son and her baby. The sixyearold gets measles, the older child gets measles and he goes into the room where the baby is and the baby gets measles, the child recovers, the baby dies. The mother never forgive herself for having left the children and she never forgives the son who went into the room and infected his younger brother and she thinks he did it on purpose because he was jealous of the baby. That common childhood disease basically comes into this family and devaates the family. Right. And it was all true. Eugene aEugene Oneills mother hes the reconciliation baby born later to more or less take the place of the boy who dies. Talk a little bit, i think all of us know there was enormous medical progress and that the development of vaccine has made an extraordinary difference in the lives of children but the Public Health story is less well known. How is the information not only about getting vaccines but other measures helpful to children, how is it disseminated, who were the visionaries that led the process of dissemination . I feel a little guilty. I feel that there are probably heroic names and sanitation that i probably dont know because im looking at this through a medical side. You start by going back certainly to the 19th century thinking about cities building sewer systems and cleaning up their water. Thats tremendously important. Then when you get to abone of the things happening in the 19th century as people are figuring out the importance of microbes, the importance of bacteria, later developing this technique pasteurization which makes milk safety stop all of that is tremendously important but just as you say, has to get to the individual household. Parents have to understand the dangers of letting milk spoil, using water you dont know whether its pure. One of the reasons thats important because especially in the summers, especially in the cities around the turnofthecentury there is this understanding that in the summer, something they call colorado in phantom, its not really cholera, its just upset stomach, diarrhea. It kills thousands of babies every month in the summer. Theres not a full understanding on the part of parents or medical people where that comes from. Is it bad smells, poor ventilation . What it is is its all that whole range of microbes that causes children to get stomach upset and then its the fact that babies are so vulnerable to dehydration. Get still true if youve ever brought a sick baby with a stomach bug and, your pediatrician probably told you the infection is not, do any harm, is to dehydration. Youve got to go out and buy rehydration solution, youve got to buy popsicles, keep putting the fluid back in. Absolutely. Then talk about the subject i think hasnt received abwhat was the relationship between the people who develop the vaccines and help to control or at least address so many of these problems. In the early stirrings of the Eugenics Movement and the notion that somehow where the children lived and it was unworthy children who were dying in such large numbers . Thats a really interesting question. Right around the beginning of the 19th abbeginning of the 20th century people started counting dead babies. I think the truth is that if you go back much further than that, early infant mortality, children who dont make it out of delivery, stillborn babies, babies who dont breathe, a common fact of life that nobody even necessarily really counted. Then at the beginning of the 20th century 1906, british doctor publishes a book called infant mortality social problem in which he basically says we should not be losing all of these children under a year of age and the united kingdom. We are losing a regiment of small beings. But he says some children are just going to be born we can theres nothing we can do about that. Thinks the problem one out of every 10 may just lose because they are sort of the unfit. One of the things thats really interesting about the movement against import mortality is that people who are trying to bring down infant mortality especially newborn mortality are regularly being asked, if you save all the week babies whats going to happen . Arent they meant to die . Are they really able to live . There are quite a few who say the founder of american pediatrics doctor abraham jacoby was a very weak and sickly baby himself when he was born in germany and he repeatedly references the fact that just because somebody is weak and sickly baby doesnt predict who that person is going to grow up to be. But there are other people and overlap with the Eugenics Movement in which you have people explaining very seriously that at the same time as you are saving babies, you also have to discourage certain people from marrying or reproducing. Because they are very worried about people with epilepsy, for example, some of them. Or whatever people are on their list. This is true of everybody involved in bringing down infant mortality but its a question which keeps being addressed. Will we actually weaken our population if we save these babies . On the other hand, its also very clear to everybody that even the people of the top of the social pyramid are losing babies. And losing babs frequently. Talk a little bit about abraham and Mary Todd Lincolns loss of their baby and the very extraordinary way that they responded and the audit simultaneity of