Book Review

Raising Children in America

Dr. Spock: An American life

N Engl J Med 1999; 340:68January 7, 1999

Article

Dr. Spock: An American life
By Thomas Maier. 520 pp., illustrated. New York, Harcourt Brace, 1998. $30. ISBN: 0-15-100203-7

Over the years pediatricians have made important contributions to our understanding of such areas as infectious disease, genetics, and immunology, but as a group they seldom acquire the academic and scientific prestige achieved by many other members of the medical profession. They become neither rich nor famous. Benjamin Spock is the exception; in 1946, with the publication of his book The Common Sense Book of Baby and Child Care (New York: Duell, Sloan and Pearce), this patrician Connecticut Yankee became the most famous pediatrician in this country, if not the world. With the exception of the Bible, Baby and Child Care, as it was later titled, in its various editions has sold more copies than any other book. And since its publication it has been a veritable bible for middle-class American parents desperate for practical advice about simple and complicated problems for children.

Baby and Child Care, written in clear and simple prose, has taught generations of parents about breast-feeding, what to do when the baby has hiccups, and especially, when not to worry, when to trust their own instincts, and when to call the doctor. Through the 1950s and much of the 1960s the collective image of Dr. Spock was of a gentle avuncular man with a wonderful ability to relate to worried middle-class parents. This image changed as in the late 1960s and throughout the 1970s this oracle of child rearing became an unlikely political activist at the center of the tumult and shouting produced by civil rights, Vietnam, and Watergate.

Thomas Maier has provided a narrative of the life of this remarkable man, who died at the age of 94 in early 1998. Both Spock and his second wife, Mary Morgan, cooperated fully with the author. Maier also had access to Spock's papers and conducted extensive interviews with his family, friends, and colleagues.

Although Maier clearly respects Benjamin Spock and his accomplishments, he does not flinch from revealing how much the reality of Spock's life differed from his public persona as a kindly, comforting, and wise baby doctor. Maier traces in great detail Spock's life from his childhood at the hands of a stern, dominant mother to the Gold Medal he earned at the 1924 Olympics as part of the Yale rowing team, his marriage to an upper-middle-class woman, his training in pediatrics and psychoanalysis, and the writing of his famous book. More startling is the account of Spock's family life, his first wife's mental illness and alcoholism, his stern and distant treatment of his two sons, his divorce after more than 45 years of marriage, and his remarriage in his early 70s to a woman 40 years his junior.

Benjamin Spock's position in history is predominantly tied to his book. Its influence on the child-rearing patterns of middle-class American parents of the mid-20th century remains unclear, but Spock's genius is clear. As a product of the clinical fascination with Freud's psychoanalytic theories so prevalent in the 1920s and 1930s, especially in New York City, Spock managed without invoking Freud's name to translate Freudian theories into a practical primer on the nature of children and child-rearing practices, all in a calm and comforting manner. As Maier explains, the content and emphasis of the book changed over time to reflect cultural changes as well as Spock's revisions of his own views. Nevertheless, Baby and Child Care remains as it began, a tool for middle-class parents. It has never had any great relevance for or direct influence on poor parents.

Since this biography was written for the general public, it has a clear but conversational, almost chatty style. Maier provides a factual and informative account of the life of this interesting figure in American medicine. Although he seems to like the man he knew, he provides little in the way of final judgments about either the private or the public man. Perhaps that is wise. Time and more formal historical analysis will be necessary for any final judgment. Certainly, this book will be indispensable to all who are interested in Benjamin Spock as well as those who are interested in the 20th-century cultural norms of child rearing.

Margaret Heagarty, M.D.
College of Physicians and Surgeons of Columbia University, New York, NY 10032