Wednesday, August 5, 2020

The Blessed Paper Babies of the Karens

In today's episode I will tell you a story from a medical report in 1999 [McGready, Rose, ‘Meet My Uncle’, The Lancet, 353.9150 (1999), 414], of how people in an Asian society treats some dead, mummified babies as living family members.

Now as usual for strange medical conditions, I won't show the real pictures, since they are… NOPE! but you know how to find them if you don't want to sleep tonight!

Pregnancy is hard

So before we get to the story we first need to understand a bit about pregnancy. The first thing you need to know is that pregnancy is hard, not only for the mothers, but much more for the fetuses. 

Now it's one of those awkward little details that might be better left unnoticed, but it's actually not easy to get pregnant. Even under "ideal situations", a fertile woman would take on average three months to get pregnant. Now, what happened to the other two?

The answer turns out to be rather terrifying. For every ten embryos, six die in the first ten weeks of pregnancy, usually from deadly deformities, and they get quietly reabsorbed without anybody noticing, not even the mothers.

Let's make it personal: on average, every one of you has two dead siblings. Granted, they were barely more than a blob of a hundred cells, but still…

From ‘Fate of Fertilized Human Oocytes’, Reproductive BioMedicine Online, 21.6 (2010), 732–41:
under ideal conditions, the greatest probability of achieving a clinical pregnancy per cycle is around 30–40% 
the group led by the embryologist Hertig (Adams et al., 1956, Hertig et al., 1959) who collected 34 human embryos aged between 1 and 17 days; eight were considered to be in the preimplantation stage and the remainder derived from the first 2 weeks post-implantation. Hertig and his group were surprised to observe that 50% of the eight preimplantation embryos had severe anomalies leading them to conclude that pregnancy could not have proceeded to term. Six (23%) of the 26 remaining embryos also had major anomalies incompatible with normal development. The study provided the first strong evidence that spontaneous loss of early human embryos by far exceeded clinically evident pregnancy losses. 
Twenty years later, Hustin et al. (1994) using techniques of histochemical staining, confirmed the observations of Hertig and colleagues 
Considering these data together, one must conclude that early embryonic wastage is in the order of 50%.

Now, usually when a fetus dies in the womb, it either gets reabsorbed if it's small enough, or expelled if it's too big. However, if the fetus happens to die when it's around 10 weeks old, so that it has just grown some little bones, and it has a healthy twin, then the dead fetus would be compressed by its sibling into a bony, flat, dry thing, just like making a piece of papyrus. This is why such babies are also called "fetus papyraceus".

From ‘Fetus Papyraceus: A Rare Case Report’, Journal of Patan Academy of Health Sciences, 7.1 (2020), 113–116:
a mummified fetus occurring in multiple gestations where one fetus dies in utero and is incorperated between the uterine wall and the membranes of living fetus. Intrauterine fetal demise after eight weeks gestational age in a twin pregnancy, with retention of the fetus for more than 10 weeks will result in mechanical compression of the fetus, making it look like a parchment paper. Fetus papraceus is usually discovered among the placenta and membranes of its well-developed twin.
Rest of the article is based on Meet My Uncle.

The Karens and their dry babies

Paper babies are found only once every 10000 births, and they usually come out stuck on the placenta of its healthy twin, but among the Karen people, it seems paper babies are more common, to the point that they have a whole mythology around this phenomenon, which they call "dry babies".

Now Internet memes aside, the Karens is a real ethnic group in Southeast Asia, in the border between Thailand and Burma,  and in a 1999 letter to The Lancet, which, take note, is a very trustworthy source, Dr Rose McGready reported meeting two Karen families with dry babies.

Case 1

In the first case, an 18-year-old mother gave birth for the first time, which happened to be two dry babies. They were named Aye Shwe and Ing Whey, meaning "cold gold" and "cold silver". They were put in a hammock, and local children were encouraged to talk to and play with them. 

Beside the hammock, they put a small dish holding grains of rice and spices for them to eat. Their mother later explained that they had to eat solid food, because she had no breast milk. Which… is a convenient excuse since dry babies can't actually suckle.

When Dr McGready saw the paper brothers, they were 8 months old, living in a biscuit tin. They were still dry, with no odor. According to their mother, in her dreams, her twin boys looked normal, but were too young to speak.

Before the doctor left, The mother mentioned that after they become old enough, she needed to find two dry baby girls so that they could marry, and presumably, start a family of dry babies...? It's kinda sweet, in a creepy sad way. [Dr McGready didn't explain how dry baby marriages were supposed to work.]

Case 2

In the second case, a 28-year-old gave birth to a healthy male baby and his "dry brother". When Dr McGready visited them three months later, she saw them lying together in a hammock. 

[The following scene is imagined]
"Look at them, they are both eating well. They'll grow up so nicely… Say, would you like to meet their uncle?" 
"I would be honored to." 
The woman went back, then returned with another dry baby in her hands, "Here he is, my twin brother."
The doctor just nodded silently, and took her leave, away from the 28-year-old dry uncle and his dry niece.

Notes on Dr McGready

Dr McGready, has, a, Twitter, page! And she is an Oxford professor! Like, whooah. This makes this story so much more than just a "creepy true story"!

In fact, earlier today, I got an email reply from Dr McGready herself!! She confirmed the story, but noted that there are no more published results on this Karen tradition.

The email conversation was like this:
Me: I read your 1999 letter to the Lancet about the dry babies of the Karen people with great interest. I would like to know if there are other published references (medical, anthropological, etc) to this phenomenon? 
Dr Rose McGready: Not that I know of. Also with ultrasound we see less of them, sincerely Rose.

Boring copyright information


Pictures, unless otherwise stated, are from Wikimedia Commons.

Pictures of papyrus making are from wikiHow.

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