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CHAPTER 2

The History of SBS

Many believe that shaking as a form of child abuse began in the 1970s, as the term is frequently referenced as having been “coined” during this era. However, shaking and the confessions of caregivers who performed this abuse began much earlier. Their accounts are key to understanding that shaking an infant or young child can be deadly. The media did not make shaking a household name until the 1950s, when the daughter of a Connecticut state senator confessed to shaking three infants to death and injuring many more. Let’s look at some earlier stories.

The first reference to an abusive shaking that made headlines occurred in Kansas City, Missouri, in 1905. John David Stewart came home after work one evening and accused his wife of keeping their ten-month-old daughter quiet during the day and allowing her to cry at night. He was tired of it, so he “shook her hard and slammed her on the bed,” and told his wife to take care of her. She later died. Stewart was arrested, convicted of fourth degree manslaughter and given a two-year prison sentence.¹

The next account of a shaking incident occurred in Oneonta, New York, in 1937. Young Thomas Hinkley, Jr., age fifteen months, was shaken to death by Clyde Proctor, an unemployed truck driver who lived with the boy’s mother. Proctor originally stated that the boy had fallen from a highchair (one of the first noted perpetrator excuses for an injury), which was accepted as fact by the Otsego County coroner. But further investigation by the District Attorney and Chief of Police found discrepancies in Proctor’s story. Proctor stated that he witnessed the boy fall from the highchair as he looked through a window from the yard and that Mrs. Hinkley was out of the room for a moment, when, in fact, she was in town during the time of the “accident.” Investigators brought these inconsistencies to Proctor’s attention, and he ultimately confessed to shaking the boy, because the child had bitten him on the hand. Proctor was then arrested. He later pled guilty to first-degree manslaughter and was sentenced to ten years in prison.²

In 1938, James McCoy violently shook his five-month-old son, George, which landed the infant in the hospital in “poor condition with a broken neck.” This was before CT scans and MRIs existed. A fractured neck was an assumption of the medical providers, as studies on the physiology of young children were in the early stages in those days.³

Shaken Baby Syndrome wasn’t the original name of this form of child abuse that would kill 25 percent of its victims and leave another 60 percent with lifelong disabilities. In 1971, Dr. Norman Guthkelch, a British pediatric neurosurgeon, postulated that a number of infants and children that he operated on who had bleeding on the brain might have been shaken. It was customary in Britain to say, “Give him a good shake,” so Guthkelch wondered if such a mechanism could be the cause of brain bleed, or subdural hematomas, to put it clinically. In his paper, “Infantile Subdural Hematoma and Its Relationship to Whiplash Injuries,” Guthkelch laid out his hypothesis cleanly.⁴

He reflected on his visit to an American neurosurgeon, Ayub Ommaya, who was studying the effects of rapid acceleration and deceleration whiplash injuries in car accidents for the auto safety industry. Ommaya anesthetized rhesus monkeys and placed the primates in a contoured chair on moving sleds, securing them with a strap. He also cut a section off their skulls, placed see-through windows in their places and used film to capture images of the brain as the sleds raced forward on a twenty-foot long track at a high speed and suddenly braked to simulate a car crash. He was able to see on film the damage on a monkey’s brain—how the blood vessels would pull and snap in response to the high velocity movement and seep out to fill a section of the brain with blood. This study resulted in the article “Whiplash Injury and Brain Damage: An Experimental Study” being published in the prestigious publication Journal of the American Medical Association (JAMA).⁵

The experiments, supported in part by the U.S. Navy, led Ommaya to conclude that whiplash, resulting from shaking, can cause cerebral concussions and brain injury, including bleeding on the surface of the brains of these monkeys who had been used in scientific research.

Guthkelch also made his own simple experiment by filling a flask with a solution of paraffin wax and coconut flakes. He shook the flask and noted that the coconut swirled about. When he struck it against a hard table, he then noted that the coconut didn’t move. He also recounted a story from a fellow neurosurgeon who told him of a time that he developed a subdural hematoma from being on a bobsled ride at a local carnival. Finally, Guthkelch spoke with a social worker at his hospital who told him tales of parents coming into the emergency room with spite in their voices about their young children whom they brought in. He knew about the dark side of parenting, but hadn’t put the pieces of shaking as a mechanism together. His article on the subject received modest, lukewarm attention in the medical field. It was another syndrome that wasn’t named or given notoriety until a different clinician picked up the ball and ran with it—into the record books.

John Caffey, MD, was a successful radiologist in Pittsburgh, Pennsylvania in the 1940s. His contribution to the world of child welfare began when he wrote a journal article about long-bone fractures in young children. Caffey reviewed the cases of many children that he saw and described the unusual findings of periosteal reactions in arms and legs coupled with subdural hematomas (“Multiple Fractures in Long Bones of Infants Suffering from Chronic Subdural Hematoma”).⁶ As for the manner in which these injuries occurred, Caffey opened the proverbial abuse box in his article, only to shut it quickly. He implied that in some cases of long-bone injuries in children, parents possibly could be the culprits. He did not explicitly blame this condition on the shaking and twisting of young bones, he only hinted at it. The issue was revisited twenty years later when Henry Kempe’s “The Battered Child” was published in the pages of JAMA.⁷

Dr. Caffey attempted to create his own child abuse coinage with the publication of his article “Parent-Infant Traumatic Stress Syndrome,” or PITS for short.⁸ The year after Guthkelch’s article on shaking was published, Caffey finally received recognition. He incorporated Guthkelch’s treatise and created his own—“On the Theory and Practice of Shaking Infants,” which was published in The American Journal of Diseases in Children in 1972.⁹ Caffey offered keen insight into a dangerous form of child abuse that had never been described in such detail before. It was an “ah ha” moment in the field of pediatrics and clinicians could put a name to a condition they had seen for years and to the act that caused the condition. Two years later, Caffey wrote a “Part II” follow-up to his whiplash shaking article.¹⁰ Here he chronicled the deadly spree of violence that a baby nurse from New Haven, Connecticut had unleashed on her tiny victims in the 1940s and 50s. Her name? Virginia Belle Jaspers. She had confessed to killing infants by shaking them to death. Caffey thus sealed his name as the creator of what would be called Shaken Baby Syndrome (or SBS). This recognition lasted another forty years, until credit returned to Dr. Guthkelch as the first clinician to describe the syndrome as it is known today.

Virginia Jaspers was the daughter of a successful Connecticut state senator. She had aspirations to work with children in the homes of new parents in and around New Haven beginning in the early 1940s. Though qualified to do so, having recently completed high school and attending a basic pediatric nursing program at a nearby nunnery, she had a physical presence that caused people to be taken aback. Jaspers stood six feet tall and weighed two hundred and twenty pounds. She was extremely talkative and overcompensated for her appearance by being excessively pleasant to her clients. She became well-respected in her chosen field; her name was even added to the list that local pediatricians kept to recommend baby nurses to new parents. It was during these years of caregiving that her lethal side came out. The first baby she shook to death was three-week-old Cynthia Hubbard. Alone with the baby, who was crying excessively, Jaspers became highly volatile. Cynthia’s parents never knew what killed their infant, but her death certificate listed her cause of death as “congenital malformation,” like something let loose inside the girl and she died.¹¹

Jaspers’s temper continued to get the best of her. She shook and killed Jennifer Malkan in 1950 and then Abbe Kapsinow six years later. The nurse also inflicted injuries on twelve other infants and children during her tenure as a caregiver. She slapped babies, shook them and broke bones. This was her modus operandi for handling crying, bottle refusal and other normal behaviors of the young.

Though suspicions about Jaspers surfaced over the years, there were only two action-takers. One was Marvin Schaeffer, the father of three-month-old Bruce, whose leg was broken by Jaspers while Marvin and his wife were out at a party. He convinced one area pediatrician, Robert Salinger, to strike Jaspers from his list of preferred nurses and asked him for help in getting justice for his son. But it wasn’t until 1956, when the nurse caused the death of twelve-day-old Abbe Kapsinow, that Dr. Salinger and others went to authorities with their concerns and let them know they didn’t believe it to be accidental.

When Virginia Jaspers was finally interviewed about the deaths, she broke down and confessed. This was vital to our understanding of perpetrators and Shaken Baby Syndrome today, because Jaspers was one of the first in history to confess to shaking an infant to death. No one guided her or suggested to her that shaking was a lethal form of abuse—she said this herself. The act of violently shaking tiny infants will not only do irreparable harm, but can kill them as well. This was her tactic to put infants under her control when they became out of control. One boy was “lucky.” He was shaken but lived through it. Yet he was left permanently handicapped from the act. As Jaspers confessed and as word got out, people all across the U.S. were shocked about the “Killer Baby Nurse from New Haven.” She fits today’s criteria of a serial killer but didn’t shoot, stab or poison adults; instead, she brutally shook babies and they died.

Jaspers was sentenced to ten to twenty years in prison for manslaughter but only served a few short years in jail. She was never allowed to care for children again and later led a quiet life.

Once Guthkelch and Caffey opened the door to shaking as a mechanism for abuse, others followed. Over the years, thousands of journal articles, research papers and presentations have been featured in the pages of respected medical periodicals. Yet there have been unscrupulous authors as well—those who have set out to dispute the very nature of SBS and have sought to deny its existence. Because of these individuals, many court cases have been lost and perpetrators set free. This is the dark side of the clinical aspect of SBS.