Deliver Me from Pain: Anesthesia and Birth in America

2 Twilight Sleep: The Question of Professional Respect, 1890s through 1930s

c h a p t e r t w o Twilight Sleep The Question of Professional Respect, 1890s through 1930s I n 1912 Mrs. Cecil Stewart left the United States to give birth to her second child in Freiburg, Germany, under the auspices of physicians Bernhard Krönig and C. J. Gauss. Stewart’s sister accompanied her. Word of Krönig’s and Gauss’s work on Dämmerschlaf, an injectable combination of scopolamine and morphine, motivated the two women to make the long journey. As news of Dämmerschlaf (twilight sleep) crossed the Atlantic, the prospect of painless childbirth had become a topic of conversation in upper-class American social circles , turning Krönig’s and Gauss’s Frauenklinik (women’s clinic) into a mecca for select pregnant Americans. Before embarking on the trip to Freiburg, Stewart had asked Mrs. C. Temple Emmet, the first American to give birth under Dämmerschlaf, for more information on the Frauenklinik and its novel treatment. Information from Emmet was not forthcoming, however. Instead, she responded to each of Stewart’s entreaties with the same terse statement: “The Head Nurse will tell you everything.” Despite the lack of detailed information, Stewart headed to Germany with her sister. Finally arriving in Freiburg after an extended stay in London, Stewart checked into a hotel one “cold, wet, dismal October night,” sent her English doctor ’s letter of introduction to the Frauenklinik, and then settled in, anticipating an imminent visit from Krönig. Days passed and he never came. Eventually, Krönig’s head nurse arrived to answer Stewart’s questions, just as Emmet had promised. The nurse told Stewart that to see Dr. Krönig she would have to go to the clinic. He would not come to her. Incredulous at being ordered to go to the doctor rather than being visited by him, Stewart remained at the hotel. A few days later, one of the younger clinic physicians came to see her and immediately put her at ease: “He did not bother me with questions, nor ask me when I thought the baby would come, nor how I felt, nor any of the disagreeable things doctors usually say to one in these circum- stances.” Instead, the young physician took her hand and assured her, “I have come to comfort you.” The next day Stewart went to see Krönig. Krönig examined her, and because her baby was breech and he did not trust the taxi service to get her to the clinic after dark, he ordered her to sleep each night at the clinic.When Stewart balked, the nurse suggested she continue spending her days at the hotel. Mollified, Stewart went back to the hotel for dinner. Upon returning to the clinic later that evening with her sister, she anticipated “a whole staff to meet us.” The two women were stunned to discover that they had to let themselves into the building, find their way to Stewart’s room alone, and turn down her bed without assistance. Three weeks later, when Stewart was asleep in her “big and high-ceilinged [room] with beautiful white tiles,” a sharp pain awoke her. She sat up and rang the bell next to the bed. The head nurse rushed in and, learning of Stewart’s pain, injected her with scopolamine-morphine, readied the room for the birth, and later administered a second injection. When Dr. Gauss came to examine Stewart, she told him what she had told the nurse earlier: “I have an awfully bad pain.” Gauss responded,“Yes, you have a very bad pain.”Stewart was pleased:“It was the first time a doctor had ever admitted that I had a bad pain when I had one. Before , they had always known better than I had, and they had told me,‘Oh, no, you have not got any pain at all; that is nothing; you’ll have to have much worse pains than that.’ Just Dr. Gauss’s admitting that my pain was pain made me feel comforted and happy.” Under the influence of twilight sleep, Stewart slept. The next morning, three “chambermaids . . . making a fearful racket”woke her. Terribly annoyed at the intrusion , Stewart wondered how clinic doctors could permit such an irritant when she was about to give birth. Just then the door opened and the head nurse came in triumphantly carrying Stewart’s baby. Stewart was stunned.“I can’t believe it; it is a fairy tale! It isn’t true...