Polio Wars

by Rogers, Naomi

  In New York she met with Jungeblut and discussed plans for a European Poliomyelitis Research Laboratory, which Jungeblut believed would be supported by the new semi-official Western European polio organization headed by Leon Laruelle. Eager to be this laboratory’s director, Jungeblut offered to leave his position at Columbia, but explained that he would need around $50,000 for an initial 3 years to cover salaries for himself and his assistants and for the purchase and maintenance of experimental animals.273 Kenny’s wealthy women allies in New York assured her that $50,000 could be obtained for Jungeblut’s “outstanding” work and listened sympathetically when Kenny repeated a story Jungeblut had told her about Horstmann and Bodian who had “ridiculed” his work at the Copenhagen conference and had “stooped to allow their photographs to appear in the papers as the scientists responsible for the viremia discovery.”274 Kenny hoped that this focus on polio’s pathology would alter professional and public perceptions of her own contribution. But she was mistaken.

  KENNY MODIFIED

  With growing numbers of patients in this epidemic year both the Medical Journal of Australia and the British Medical Journal began discussing polio therapies, including Kenny’s work. In an article on “Early Treatment of Poliomyelitis” a young Oxford orthopedist described efforts to ensure continuity of care for patients moving after 3 weeks in an infectious disease hospital to an orthopedic hospital. In a confusing mélange he warned against using muscle testing in the early stage but also against any “over-zealous application of hot packs,” which would be mentally as well as physically exhausting for the patient and necessary only if there was “persistent muscular tenderness or pain” after the fever had subsided. Most children got great comfort from an ordinary hot bath, which “will usually overcome ‘muscle spasm’ and consequent deforming tendencies” by the time the patient left the infectious disease hospital.275 Here were therapies to treat both pain and spasm, even if the latter still had textual quotation marks around it.

  Even more enthusiastic about Kenny’s methods were physicians at the Newcastle Hospital, around 95 miles north of Sydney. During Newcastle’s polio epidemic of 1950–1951, as 2 of the hospital’s physicians reported in the Medical Journal of Australia, patients at the hospital were treated without the use of any restraining splints; hot packs were given to as many patients as possible “especially those in whom the muscular spasm and pain were pronounced symptoms”; muscles were stretched although not “in a forcible manner”; and joints were put through their full range several times a day. After the acute stage, patients were given muscle reeducation without routine muscle testing. This treatment was coordinated by a trained physical therapist who “was receptive to the ideas prevailing in the clinic” and who taught this method to the hospital’s nursing staff. Strikingly, the physicians agreed with Kenny that iron lungs were frequently unnecessary, even for bulbar patients. Their use of heat clearly relied on modes other than hot packs, and they suggested that during a polio epidemic “it would be of greater benefit to humanity to rush a water bath rather than a respirator.”276 In response, Melbourne orthopedist Jean Macnamara urged, as she had years earlier, that splinting be applied very early to ensure straight alignment. There was a school of thought, she noted, that questioned the utility of any splinting and she attributed this to Kenny’s “teaching and influence.” In her view Kenny had in fact used splints but pretended not to. Kenny’s American staff was large enough to police the position of the patient and his limbs; in Australia “we have used more robot police staff called splints to attain the same objective.”277

  Away from the passion of the 1948 NFIP polio conference Oxford orthopedist Herbert Seddon had begun to offer a more mellow view of Kenny’s contribution to polio care. In his British Medical Journal review of the 1951 edition of Kenny’s autobiography he described her theorizing as rash, but praised her attention to the harmfulness of immobilization—“so long a sacred tenet of the Liverpool school of orthopaedics”—as an important contribution to polio treatment.278 Brisbane orthopedist John Lahz, a leader in Australian physical medicine, was appalled to read Seddon’s praise. In the British Medical Journal Lahz protested that Kenny had not successfully challenged “the truth that a paralysed muscle is damaged by unopposed continuous gravitation pull.” Lahz was convinced that ignoring this “truth” could have “possibly caused many reversibly paralysed muscles to go unsplinted and so have their weak fibres stretched and their paralyses prolonged.”279 Orthopedist Lancelot Walton, in contrast, who had spent some months in the United States observing Kenny’s work, wrote to commend Seddon, but reminded him that without a proper understanding of spasm many British physicians had left “hundreds of patients” with unrelieved spasm and contributed to their “deformity.”280 Thus, British and Australian physicians used Kenny’s terms to disagree about polio care, especially the pros and cons of splinting. They accepted parts of Kenny’s work but managed to avoid any acceptance of her conceptual understanding of the disease.

  KENNY’S LAST MONTHS

  In September 1952 Kenny returned to Australia. Once there she poured her energies into completing a new autobiography, which she recognized would be her last book. In My Battle and Victory (published a few years after her death) Kenny sought to defend her awkward professional standing. She presented herself as an obscure contributor to scientific progress who was nonetheless clinically skilled. Those “with mind and heart of the true physician,” she argued, do not “scorn … the offerings of the obscure” but seek “to gather all proven truths and make the world of pain and crippling a little happier.” She also reflected on the possible conquest of polio, which some scientists said would occur within this next decade and reduce polio “to the ashes of a memory.”281 The idea of a polio vaccine had long fascinated Kenny, and in 1950 she had urged the KF Board “to obtain a preventive vaccine” which would be “a crown of glory to the Kenny Foundation.”282 In early 1952 she had been quick to notify MacFarlane Burnet when Yale virologist John Paul was reported in the Brisbane Courier Mail commenting on the idea of a polio infection “independent” of the central nervous system.283 Now she proudly claimed that new vaccine research was based on the idea that “polio is a systemic disease attacking blood and tissues,” a statement that was reported by the New York Times.284 But neither Jungeblut nor her other scientific allies were working on such a topic and as NFIP-funded virologists moved closer to testing a vaccine Kenny’s work seemed to have less and less to do with science.

  In Australia her flashes of temper and sharp tongue continued to abrade allies and critics alike. After a sympathetic Labor Party physician urged the government to appoint a “brilliant physiotherapist to investigate future claims by Sister Kenny” Kenny retorted that the physical therapists at the Toowoomba General Hospital were brilliant and intelligent but nonetheless many symptoms and conditions were “unknown to them” and “apparently unknown” to their medical supervisors.285

  Kenny also failed to gain political support for institutionalizing her work in the Australian hospital system. In 1951 the federal minister of health, Sir Earle Page, a surgeon turned politician, had praised Kenny’s “personal drive, magnetism and enthusiasm” in Parliament but noted that he had learned that her American clinics were closing because their patients were leaving to attend orthodox hospitals. In any case, he claimed, her methods of early movement had “now been adopted as policy throughout the whole medical profession.”286 Rebuffed by Page after her offer to meet him, Kenny began to rely on her local allies, particularly Pearl Baldock, who signed a series of letters sent to Page and the Prime Minister, which, officials noted, were “almost certainly written by Miss Kenny.”287 In early November 1952 Baldock finally received a formal response from the Prime Minister’s office, stating that as the Director-General of Health had advised that as both systems of polio care were “in many particulars identical,” the government “would not be justified in actively supporting the adoption of her curative treatment in preference to
orthodox methods.”288

  Kenny continued to act as if she was a major player in global affairs and refused to see herself as the frail, monotonous, and defensive figure she had become. She urged KF officials to invite physicians from South Africa, India, and Egypt to the Institute, as therapists from these countries were studying at the Institute and “otherwise the training shall be lost and the opportunity of a further link of friendship also lost.”289 A group of polio survivors had founded a Kenny Association in England, and she was confident that this was a sign of further global expansion.290 Feeling that the time was ripe for the KF to apply for WHO membership, she sent copies of her recent pamphlets to Anthony Payne, head of the WHO’s Communicable Diseases Division, who thanked her and agreed diplomatically that there were “definite symptoms which lead one to suspect the presence of poliomyelitis, and that a wide dissemination of their nature is useful.”291

  In early November Kenny began to plan another visit to America “to straighten things out a bit” and make sure the WHO would help “get the book written.”292 She sensed a political turning point after the election of a Republican to the White House for the first time since 1928. She sent Dwight Eisenhower a congratulatory cable and was planning to have her personal representatives “make some approach to the new Government.” It was time, she remarked to her friend James Henry, for “a policy change” in the NFIP as well.293 Her Republican friends might well have organized some kind of formal recognition, but by the third week of November Kenny was too sick to travel.

  Kenny declined precipitously. She had a stroke and fought what her doctor John Ogden described as “her last battle.” Ogden and Betty Brennan, Kenny’s secretary, issued regular bulletins, which were publicized across the United States in headlines such as “Sister Kenny Fights For Life” and “Sister Kenny’s Condition Takes Turn for Worse.”294 There were a series of dramatic vignettes: Charles Carson, the American Vice-Consul, drove 85 miles from Brisbane to Toowoomba where Kenny managed her first smile in days for, according to Brennan, “hearing Carson’s American accent was a real tonic for her.” There was a telegram from Rosalind Russell saying “we hope our Waltzing Matilda will soon be up and at them again.”295 Then, with the flavor of a Hollywood drama, her physician contacted New York pathologist Irving Innerfield who had begun using trypsin, a pancreatic enzyme, as a blood-thinning drug, and a special parcel was rushed from New York across the Pacific. The plane was detoured from its normal Sydney landing to Brisbane’s Eagle Farm airport, and the package was then sent by car under police escort for the 2-hour drive. The drug did not seem to make any difference but, Ogden told reporters, it had not had “a fair clinical trial” as Kenny’s condition “had been too far advanced.”296 Kenny, Ogden said, had “a very strong will to live” and “fought hard for her life. But it needs more than the will to live to beat this illness.”297

  On November 30, 1952 Elizabeth Kenny died, surrounded by a niece, 2 sisters, and Mary Kenny McCracken.298 She was buried beside her mother at the Nobby Cemetery after a church service at Toowoomba’s Neil Street Methodist Church. The church was full of people, many weeping openly. Charles Carson and his wife were there as were Kenny’s Brisbane allies Abraham Fryberg, Aubrey Pye, Jarvis Nye, and Herbert Wilkinson. Even those who had disagreed with Kenny, the minister declared during the church service, which was broadcast by the Australian Broadcasting Commission, “nevertheless recognized the honesty and sincerity with which she pursued what was a God-given work.” In what would become the first of many efforts to assess her significance, he declared that “the value of her work will become more apparent to future generations than it has been to men of our age.”299

  Her funeral was observed in celebrity fashion, which would have delighted her. Hundreds of people stood in silent groups along the funeral route as the 8-car funeral cortege traveled from the Toowoomba church to the cemetery. At the graveside her coffin was covered with the Union Jack (the British flag that traditionally covered the coffins of Australia’s war dead) and the United States flag (the Australian Blue Ensign was not formally designated the national flag until 1953). There were wreaths of chrysanthemums, red roses, and other floral tributes around the coffin, including a wreath designed by Kenny’s Toowoomba housekeeper in the shape of outstretched arms with a card that read “from your garden.”300 Pearl Baldock, who attended the funeral, sent a laurel wreath on behalf of the QCWA. Wreaths also came from the staff of the Jersey City clinic and from the Minneapolis Institute.301 Members of the Returned Servicemen’s League and the Australian Army laid poppies—the flower of remembrance that was used to raise money for veterans—at the graveside.302 The Brisbane Courier-Mail had 3 photographs of the funeral: giant gum trees “as sentinels” above her grave surrounded by mourners, the British and American flags on her coffin, and children from Nobby State School in their summer uniforms standing in 2 lines as the hearse passed.303 Her tombstone was inscribed with the false birth date she had popularized: 1886 instead of 1880.

  Then the obituaries appeared. Some were short, like the one in Newsweek, which noted in only 8 lines that she had “fought many years to have the medical fraternity accept her method of treating polio” but that finally the Mayo Clinic and the University of Minnesota “gave her the support she needed.”304 Some were long. The New York Times began her obituary on its front page and continued for 2 more columns inside.305 JAMA had 4 short lines but other medical journals allowed more space. The Lancet used two-thirds of a column, the Medical Journal of Australia used 2 columns, and the British Medical Journal devoted 2 pages.306

  Most major Australian newspapers reported on her death. The Sydney Morning Herald retold her life and career, pointing out that, unlike America and Europe, Australia had never valued her properly.307 Sir Arthur Fadden, the Acting Prime Minister, called her “a great Queenslander who had become a great Australian and a great international figure.”308 Health minister Earle Page, who had been a prominent opponent, awkwardly described his admiration for her “wonderful energy and enthusiasm” and her “extraordinary and dynamic character.”309 Abraham Fryberg, now Queensland’s Director-General of Health, declared that during the past 16 years “though I have not always agreed with her views, I have always respected her idealism and aims.”310 Less tactfully and with some bitterness, Pearl Baldock declared that “Australia has lost the greatest citizen that we have produced.”311

  In America Hollywood star Rosalind Russell said “I have lost a great friend and the world has lost a great, great benefactor,” and she added dramatically that she “could not give up my Kenny work even if it means giving up my career.”312 In Minnesota obituaries and commemorations continued for some months. Whatever their differences, local papers reminded readers, American physicians recognized Kenny’s contribution and there was universal acceptance today of the Kenny method or some modification of it. “The former Australian bush nurse was one of the great women of this century,” according to the Minneapolis Star, and the Minneapolis Tribune praised her contributions to American medicine as “a revolutionary treatment” and “a new explanation of the way polio acts.”313

  Concrete forms of memorializing Kenny began that December. The Minneapolis Board of Education named a new million dollar elementary school after Kenny.314 After a memorial service at El Monte attended by nurses, officials, employees, and around a hundred other supporters, the community began renovating her cottage, which opened in 1953 as the Sister Kenny Memorial Annex, expanding the number of inpatient beds.315 Mary Kenny McCracken began planning a trip to California and Minnesota to present Kenny’s medals and try to heal any institutional divisions.316 But Kenny’s legacy would prove much more fragile than any of her allies had anticipated.

  NOTES

  1. Paul A History, 373–381; Kenny “This Report Was Presented to The Honorable The Premier of the State of Queensland E. M. Hanlon, M.L.A. and to Doctors Pye, Nye, Lee, Arden, Wilkinson, and Fryberg of the City of Brisbane, Queensland, Australia Concerning the Di
sease Poliomyelitis [1950],” Kenny Collection, Box 1, Fryer Library, 3. See also John F. Enders, Thomas H. Weller, and Frederick C. Robbins “Cultivation of the Lansing Strain of Poliomyelitis Virus in Cultures of Various Human Embryonic Tissues” Science (January 28 1949) 109: 85–87.

  2. On polio epidemics in Japan 1938–1942, Malta 1942–1943, El Salvador 1943, South Africa 1944–1945, Mauritius 1945, London 1947, and Berlin 1947 see Albert B. Sabin “Epidemiologic Patterns of Poliomyelitis in Different Parts of the World” in Poliomyelitis: Papers and Discussions Presented at the First International Poliomyelitis Conference (Philadelphia: J.B. Lippincott, 1949), 4–13.

  3. Kenny to Mr. President, Mrs. Webber and Gentlemen, May 24 1948, Board of Directors, MHS-K.

  4. Kenny “Report of My Activities In Switzerland” [1950], European Trip 1950, MHS-K; Kenny “Report of My Activities” [1950], Minnesota-Hospitals 1944–1961, Judd Papers, MHS.

  5. C. J. McSweeney “A Visit to Poliomyelitis Centers in U.S.A.” Irish Journal of Medical Science (February 1951) 302: 63–73. The hospital was known as the Cork Street Fever Hospital or the House of Recovery and Fever Hospital.

  6. W. J. Treanor and F. H. Krusen “Poliomyelitis: Modern Treatment and Rehabilitation” Irish Journal of Medical Science (June 1950) 294: 257–269, 257. This paper was presented to the Medical Society of University College Dublin in May 1950. Kenny had heard that Krusen had told the audience that her contribution was “little or nothing”; Kenny “Report of My Activities” [1950]; Kenny “Report of My Activities In Ireland” [1950], European Trip 1950, MHS-K.

  7. Kenny “Report of My Activities” [1950]; Kenny “Report of My Activities In Ireland” [1950].