Content area
Full Text
Most fertilized human embryos die before birth. Some seemingly lethal genes, like those for juvenile-onset diabetes, may persist by helping us past that risk of miscarriage
My maternal grandmother died when I was seven years old--old enough to remember her but still to young to understand her life story. I recall my surprise on being told that Grandma had been so grief-stricken on the death of an infant daughter (one of my mother's older sisters) that she scarcely smiled for a year afterward. Why, I wondered as a child, was someone with eight surviving children so devastated by the death of a ninth?
Forty years later, the answer became obvious to me when I nearly lost one of my own children. Of course Grandma could never forget, any more than can any other parent who outlives a child. Decades later, the bereaved parent still wonders, what would my lost ghost be like now, if he or she had survived?
Such questioning must have pervaded life in past centuries, when infant mortality was high. Of Johann Sebastian Bach's many children, ten died in infancy, as did ten of Schubert's thirteen siblings. As has often been pointed out, Bach's frequent bereavements may have contributed to the preoccupation with death in so much of his music. Four of Bach's surviving children became composers, although none quite matched their father's genius. Was there a potentially greater musical genius among those of Bach's children and Schubert's siblings who died as infants?
Today, when most of us survive to old age, premature death is considered an exceptional tragedy. In reality, that's true only if you define "us" as "those of us who survive to be born." In fact, the combined risk of all postnatal premature human deaths pales before the risk of death through miscarriage. Of pregnancies clearly recognized by the mother, only 15 percent end in miscarriage. However, modern hormonal tests can detect many other pregnancies that terminate within a couple of weeks, indicating a total miscarriage rate of about 50 percent rather than 15 percent. Such early miscarriages either escape the mother's attention entirely or express themselves only as a slightly strange sensation or slightly late menstrual period. Outcomes of attempted artificial fertilizations of ova within the fallopian tubes...