Polio Wars

by Rogers, Naomi

  Before heading to Copenhagen Kenny spent time with her American friends. She was greeted at the airport by Russell and her husband and spent 5 days at the El Monte Kenny Hospital resting at her special cottage. On her flight from Australia to California she had traveled with Jack Hall, a Pan-American pilot who had spent 3 months in an iron lung in Melbourne. In a typically dramatic gesture she described Hall’s experience and noted that he was now seeking proper care at El Monte.230 In New York Kenny stayed at her favorite Delmonico Hotel and told reporters that a third volume on her work was necessary as she had not had “sufficient opportunities to explain her theories to medical men.”231

  While reporters in Los Angeles and New York still came to Kenny’s press conferences and repeated her pronouncements, their reporting was now more dutiful than eager. Debates around Kenny’s work no longer sparked professional fire and its newness had been tamed through 10 years of clinical adoption. Scientists still debated just how the polio virus traveled around the body, but despite the work of a few innovative virologists the scientific understanding of polio had not altered significantly. Although John Enders’ 1948 work suggested that Kenny’s insistence that scientists must look beyond damaged or destroyed neurons might not be so unscientific, the idea of polio as a non-neurological disease was largely ignored by most clinicians and laboratory researchers. Indeed Kenny’s claim that polio was a muscle or skin disease sounded ridiculous. This was partly a reaction to Kenny as a nurse and an exaggerator but it also reflected a wider neglect of Enders’ work. Until 1952 the ability to grow the polio virus in nonneurological tissue was considered by most of Enders’ peers to be just another intriguing experimental finding.232 A discussion of the pathogenesis of the polio virus in Modern Trends in Pediatrics (1951), for example, failed to mention Enders’ work, and the author stated confidently that the virus multiplied in the walls of air passages and the alimentary canal and then “passes readily along the nerves to the central nervous system.”233 Nor did O’Connor refer to Enders’ work in a fundraising appeal at the Waldorf-Astoria, although he did boast about other NFIP-funded research projects that had led to the isolation of at least 3 types of polio virus.234

  In September 1951 the NFIP, in cooperation with the Danish National Foundation for Infantile Paralysis, held its second international conference in Copenhagen. Five hundred delegates from 38 countries attended the 5-day conference, which was jointly hosted by the Nobel Prize winning Danish physicist Niles Bohr and Basil O’Connor.235 Along with 32 American polio experts sponsored by the NFIP, the conference also attracted a number of physical therapists who came to attend both the polio conference and the first World Confederation of Physical Therapy, which was meeting concurrently.236

  University of Pittsburgh virologist Jonas Salk discussed not the vaccine experiments he was pursuing semicovertly, but the far less exciting conclusion of a 3-year NFIP project that established that there were only 3 distinct types of polio virus. Delegates were particularly interested in a report by virologists at the Rockefeller Institute about a new complement fixation test, which, although tested only on monkeys, held the potential to solve the problem of polio diagnosis.237 John Enders gave a paper on “the multiplication and properties of poliomyelitis viruses in culture of human tissue,” but science writers and other reporters did not see his work as especially remarkable. Dazzled by the modern abstract design of exhibits and by the closed circuit television programs that showed some of the presentations, delegates and reporters were far more intrigued by reports of a drug that might prevent the growth of polio virus in nerve cells and had been tested on patients with mumps and influenza.238 Amid reports on pathology, physiology, and surgical techniques, there was some talk about a polio vaccine. O’Connor said publicly but vaguely, “I won’t say when, but I believe a serum will be found against the polio virus during my lifetime.”239

  For Kenny the Copenhagen conference confirmed her sense that a few scientists were rethinking polio’s pathology in the direction she had long propagated. She “had the pleasure of hearing my theory concerning the disease process in the human body once more confirmed in a paper read by Professor Enders,” and, she later claimed, “it was my privilege to shake hands with this gentleman, who informed me that my discoveries had inspired his investigation.”240 In a courteous letter to Brisbane health official Abe Fryberg Enders later explained that he had not said this. His research had shown that the virus could propagate in “a variety of types of tissue from human beings.” But “it would be hazardous … to draw conclusions from our observations that the virus attacks skin fascia in the living animal or in man.”241 When Kenny encountered O’Connor at a reception line at the conference he refused to greet her, a snub that both of them felt properly expressed their relationship.

  Kenny returned to Los Angeles after the conference to dedicate a new wing at the El Monte hospital, and then traveled to Minneapolis where she celebrated her birthday (the chimes of city hall played her favorite song “Danny Boy”) and took part in the dedication of a new 75-bed wing at the Institute. A few months earlier “souvenir-hunting crows” had jammed her former home at 24-46 Park Avenue, which had been put up for sale by the city.242

  Her beloved Institute continued to harbor skeptics. A few physicians there said that they agreed “with my theories and practices,” but overall she felt that the treatment and teaching were not “satisfactory.” Wallace Cole, she learned, was no longer working as an Institute consultant and the 2 young orthopedic surgeons who had replaced him had “no knowledge of the concept of the disease.”243 John Pohl was also no longer connected with the KF or the Institute. Now a consultant to the Dowling School for Crippled Children he remained a strong supporter of Kenny and her work but had a new interest: children with cerebral palsy. His new textbook Cerebral Palsy (1950) represented a growing focus in postwar pediatrics and neurology, and his therapies sounded eerily like Kenny’s polio methods, with descriptions of developing “voluntary control” of muscles and establishing muscle consciousness as specially trained therapists helped to direct “the thought of the patient to a specific area.”244 There had been a time when she was eager to see her work extended to the treatment of cerebral palsy, but now this was a topic in which Kenny was no longer especially interested.245

  Other unsympathetic physicians remained influential. Huenkens continued to direct the Institute, and Miland Knapp, Kenny was “much disgusted” to hear, had received a KF grant of $1,000 for research in spinal deformity “when it was a well known fact that the only person with the knowledge concerning the materialization of spinal deformity was myself.”246 She enjoyed far more her brief stop in Centralia, where, although her clinic had been closed for more than 2 years, the mayor and the local medical society gave her a warm welcome, school children were given a half-day holiday, and streets were lined with thousands of people. That was the kind of reception she had become used to, but now it seemed bittersweet, as she was forced to rely on close friends to be able to walk steadily, and she kept her right arm and shoulder well covered to conceal their tremors.247

  After Centralia Kenny traveled to New York City where she organized a meeting in New York with representatives from Kenny centers in Los Angeles, Pontiac, Jersey City, and the outpatient clinic in New York City. This was part of her effort to form a national KF Council, an idea KF officials had long discouraged. Although she hoped that the meeting would prevent the “jealousies and misunderstandings that unfortunately have become a part of [the] philanthropic movement,” nothing came of it.248 Kline was in New York but refused to attend. Nonetheless, he sought out her help: the New York City’s Department of Welfare had denied the KF’s application for a license to collect funds based on its “poor financial picture” and warned that KF “fund raising and operating expenses have been out of proportion to the amount of money spent for aid to polio patients,” a problem city officials had noted for several years. The KF’s legitimacy in New York was also contested by the group of influe
ntial women led by Mrs. Madden who claimed they had an exclusive right to raise funds under a charter granted by Kenny in 1950. Kline now asked Kenny to use her influence to try to get the application accepted.249 Kenny had long been aware that Kline often tried to manipulate her, telling one friend that he had given her “a lot of palaver about what a wonderful person I was.”250 But this assessment of him could not overcome her joy at being appealed to as a power player. She convinced New York officials to issue a license allowing the KF to raise money in New York City, although, she warned the KF Board, she and the New York Women’s Committee remained unsatisfied with the KF’s financial dealings.251

  Kenny flew back to Australia, planning to work on captions for a new film so that certain polio conditions could be “properly explained.” This “new and important campaign film,” she assured Kline, would soon be available for the KF “with very little expense.”252 Although tired and sick, she welcomed celebratory occasions that reminded her of America. She made a special trip to Townsville where the local press lauded the visit as “A Gracious Gesture by a Noble Woman.” An impressive figure in a black dinner gown, she gave a public address at the Theatre Royal referring to specialists at universities in Vienna, Prague, and London who had described her treatment as a “splendid new weapon.” Amid prolonged applause, her longstanding ally Tom Aikens praised her as “the noblest Australian woman of her generation.” The city mayor, the head of the local CWA, and members of the Sister Kenny Memorial Committee showed her the playground named in her honor, which had been opened 2 years earlier, and she met many of her former patients from the clinic she had established in the town during the 1930s. At her request “Danny Boy” was played and sung at the end of the reception.253 It was beginning to sound like a funeral song.

  THE GRAYING WOMAN

  In January 1952 a Gallup Poll asked American women “which of these famous women comes closest to your ideal of what, you, yourself, would like to be?” For the first time in a poll like this, Kenny was ranked first, above Eleanor Roosevelt. No other woman had been ranked above the former First Lady in a Gallup poll.254 “Now, I’m really happy,” Kenny supposedly told friends.255

  Perhaps this unprecedented jump to first place was influenced by public knowledge of her serious illness. Still, Kenny’s celebrity did not extend to her native country. Her name did not appear on Australia’s annual Honours List, which recognizes outstanding service to humanity. Yet Kenny seemed content. She told Brisbane reporters she would decline an honor in any case, for she was as known “throughout the entire world as Sister Elizabeth Kenny [and]… the title of ‘Sister’ to the world is the one, in my opinion, that cannot be excelled.”256 Such a comment, despite its familiar tone of sentimental self-deprecation, had a new note. Kenny was beginning to recognize that despite her efforts during these last years of her life to shore up her legacy as a prescient scientific innovator, her international renown was based on her persona as a compassionate nurse-clinician. She was “Sister to the world,” and all her angry outbursts could be feminized as the responses of someone who cared so profoundly that she could not help being frustrated at any efforts to hamper her work—just the tone she had successfully used during her “Meet the Press” interview in 1950.

  The growing paralysis of her body gave her familiar story a new and poignant twist. She made her illness central in an article published by the Hearst newspaper Sunday supplement American Weekly with the arch title “Doctors, I Salute You.” Kenny was shown looking through a window in her Australian home, saying “I’m a patient myself for a change.” Parkinson’s disease, Kenny explained carefully, was not fatal in itself but was “inclined to be rather abrupt with anyone who has a bad heart history.” Her pride in her life’s work enabled her to “help me forget the irony of becoming slowly incapacitated by a paralysis for which [there is]… no remedy.” Doctors would one day find a cure, for “they’re wonderful, wonderful men, most of them. I guess you have to fight them to appreciate them.”257 Here was a nurse who had once argued with physicians, demanding to be accepted on their level as both a clinician and as a scientific researcher. Now she was a woman, a nurse, and a patient, recalling former triumphs.

  A NEW CONCEPT

  In early 1952 a major turning point in polio science reinvigorated Kenny’s sense that her ideas were leading scientists to victory over the disease. Although epidemiologists confidently used serological techniques to assess exposure to the polio virus, the bloodstream had not been considered important in explaining polio’s pathology. When the NFIP’s advisory committee decided to fund trials of gamma globulin (a protein fraction of blood plasma containing many antibodies) as a possible preventative in 1951, the decision was based on the older (although discarded) idea of passive immunization (which had supported the use of convalescent serum decades earlier) and on new evidence that antibodies concentrated in blood plasma could provide brief protection against polio.258

  Suddenly blood captured the public and scientific imaginations in a new way. In April 1952 came the announcement by virologists Dorothy Horstmann of Yale and David Bodian of Johns Hopkins that they had identified the polio virus in the bloodstream of monkeys, suggesting there was a preliminary stage of “viremia” before the virus reached the nervous system.259 This “surprising discovery,” said the New York Times, which had “exploded” the “old theory” of polio suggested a “new concept of polio” that was now “generally accepted” by immunologists. Perhaps if antibodies are injected into a patient before the virus reaches the nervous system “we can kill the disease before it paralyzes its victims,” the article opined. Conflating the gamma globulin trials with this announcement, the press reported that physicians would be testing “new polio theories on thousands of children” now that “it appears polio should be easily prevented by immunization.”260

  A polio discovery that “exploded” a mainstream theory delighted Kenny and her allies. Marvin Stevens, director of Kenny’s Jersey City clinic, immediately told the press that Horstmann and Bodian’s research was “scientific confirmation of Sister Kenny’s deductions of many years ago.” “We are on the verge of a great change in treatment,” Stevens declared, that will end the “fanatical insistence in certain medical quarters” that polio was solely a disease of the central nervous system. Not only had Kenny’s own clinical observations led her to conclude that polio is a systemic disease but KF-funded researchers had “been reporting increasing evidence in the last four years that the polio virus is blood-borne.”261 The NFIP has “scoffed at the theory presented to the medical world by myself for the past 40 years that the primary invasion of the virus is not in the central nervous system,” Kenny reiterated to reporters in Toowoomba. Now that this announcement had confirmed her theories, she expected to be returning to America “by invitation.”262 She wrote to the federal minister of health to draw his attention “to the complete somersault” made by the NFIP and other groups throughout the world as researchers at Yale and Hopkins had “exploded” the “old theory.”263

  In May, only a few weeks later, Kenny, accompanied by a companion, left for the United States although, she admitted to her friends, “the visit will be a tremendous physical effort on my part.”264 She joined the annual fundraising drive for the El Monte Kenny Hospital and took part in a parade. She also appeared as part of El Monte’s TV campaign, which included an hour-long telethon hosted by character actor Eddie Albert as Kenny technicians explained how to become a Kenny therapist and demonstrated the Kenny treatment.265

  In a new lecture on the “Cause and Prevention of Deformities in Poliomyelitis,” which she also had printed as a 29-page pamphlet, Kenny used the announcement of Horstmann and Bodian’s work to mock Roland Berg’s 1948 claim that her treatment would have gained earlier and wider acceptance if she had not demanded that physicians accept her theories. Now, she said, “it has been acknowledged and published throughout the world that the orthodox theory has been exploded” and a contrasting theory of polio “whi
ch in all humility I can say I had the privilege of discovering forty-one years ago—does in truth exist.”266 This visit, she confided to Rosalind Russell a few weeks later, was “most profitable in the interests of my work in the Country and abroad.”267

  Although sick and exhausted when she again returned home, Kenny was unable to keep away from the United States, where she could see the impact her work had made on clinical practice and American life. Polio epidemics were now a constant part of American life; indeed 1952 would be America’s worst year since 1916.268 At the end of June, only a few weeks later, Kenny appeared again looking, the Los Angeles Times remarked, “in better health.”269 This visit, like the previous ones, was filled with farewell dinners. She rested at her cottage in El Monte, and tried to monitor the hospital’s standard of patient care. But while she was still quick to criticize, now she would often apologize, saying “I’m an old woman and I sometimes say things I don’t mean.” The physicians, nurses, and administrators listened to her patiently and then continued their work.270 She brought with her Poliomyelitis A Systemic Disease, a new lecture accompanied by a 15-page pamphlet, in which she reaffirmed the importance of Horstmann and Bodian’s work in confirming her theory, and made a jibe at their refusal to believe that a KF-funded researcher had already made this discovery.271 In an odd presentation of herself as a celebrity figure, she appeared on TV again, this time as the mystery guest on “What’s My Line.”272