Cambridge University Press is publishing a textbook I have co-edited with five colleagues, Shaken Baby Syndrome, Investigating the Abusive Head Trauma Controversy, by Findley et al. With contributions by 32 authors, this book provides a thorough analysis of an interdisciplinary subject lying at the intersection of medicine, science, and law, and covering topics in pediatrics, neuropathology, biomechanics, statistics, psychology, criminal law, and many others. This is also a truly international issue, and our book explores the similarities and differences in 20 different countries across all continents. This project, which may qualify as the hardest I’ve ever completed so far, actually started with a personal drama.

Seven years ago, I was in a small room of a children’s hospital, anxiously waiting for the ER pediatrician to come back with my 5-month-old’s brain CT scan results. I was on vacation with my wife and son in the South of France. Our baby David had been fussy for a month. My mother, a general practitioner, had also noticed a rapid increase of David’s head circumference for the past weeks. She feared a neurological condition.

She was right.

The ER physician came back, shocked. “Sir, your son has blood around the brain, a so-called subdural hemorrhage. I’m afraid to tell you that your baby has been shaken.”

That my own son could be a victim of shaken baby syndrome (SBS), also known as abusive head trauma (AHT), was the most devastating thing I ever heard. Babies who are victims of this severe form of child abuse are known to die or suffer from life-long disabilities after violent shaking, and my very first thoughts concerned his health. Fortunately, the MRI scan was reassuring. David successfully underwent two neurosurgical operations and he fully recovered.

My next question was obvious: who could have ever done something so horrific to my own baby? I knew for a fact that neither my wife nor I, nor anyone in our respective families could ever do something like this. David had been cared for by a nanny for the past couple of months, and we had a hard time believing she could have done it, even if his symptoms had occurred while she was caring for him — twice. David cried very infrequently and we knew no one who had cared for him could lose their temper to such a degree. Yet, fundoscopy revealed bilateral retinal hemorrhage. The doctors at the hospital were absolutely, unconditionally 100% certain that no other cause than violent shaking could ever explain blood around the brain and at the back of the eyes. Why wouldn’t I believe them? They’re the experts.

There was one exception, though. The hospital neuropediatrician mentioned that our baby could have had a relatively rare medical condition called benign external hydrocephalus, an excess of fluid around the brain sometimes associated with subdural and retinal hemorrhage. He was not fully convinced that David had been shaken, especially given the total lack of bruises, fractures, neck injury, or any other evidence of trauma. We were totally confused.

I couldn’t live with this uncertainty any longer. But first, I had to get my son back. As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures. I would discover much later that we actually had been lucky to be allowed to do this, as most parents are abruptly separated from their babies for months after reporting takes place.

With my baby back, my next objective was clear: to understand what actually happened to David. At this point, our nanny was being prosecuted for the shaking – but she denied and I was still not certain. Had our baby really been violently shaken by a person who failed us and him – or had he simply suffered from a treatable medical condition? I asked for a second opinion from many specialists around the world, and found that they were evenly split between SBS and external hydrocephalus. This was definitely not helpful.

I came to realize that there was a long-standing scientific controversy in the field, and I felt that I had no choice but to get to the bottom of things myself. Although I am not a medical doctor, I hold a PhD in neuroscience and am familiar with critically reading scientific literature. I decided that I would invest as much time as necessary to learn everything I possibly could on the subject. At that point, there was nothing in my life more important than finding out what had really happened to my son.

That quest soon took an unexpected turn. After reading more than 500 medical articles within a few months, I managed to obtain a relatively clear answer for my son, but that turned out to be only the very beginning of a long, perhaps even a life-long journey.

What happened is that during my literature review, I disturbingly realized that what I had been told at the hospital, namely that subdural and retinal hemorrhage in infants are almost always caused by violent shaking even in the absence of external evidence of trauma, was an assertion based on very weak scientific foundations. And yet, this “shaking hypothesis” (sometimes referred to as the theory of the “triad”, since encephalopathy is frequently associated with the other two signs, subdural and retinal hemorrhage)