Polio Wars (110 page)

These maneuvers helped to refocus the picture of polio away from the bedside to the laboratory. Boosted by NFIP publicity, a new symbol of the defeat of polio was emerging: not a woman surrounded by grateful child patients but a man in a white coat holding a test tube. During the 1950s and early 1960s polio's history was remade into the story of virus hunters; physical therapists, nurses, and even doctors, when they appeared, were portrayed as grateful for the insights of scientists who knew, as the authors of
Polio Pioneers
argued, “how to hunt a germ.”
⁵
The forgetting of Sister Kenny reflected a wider cultural neglect of the pioneers of clinical care compared to the designers of preventive and curative techniques.

The NFIP encouraged science writers to see polio as a triumphant story of medical science, even when a batch of the Salk vaccine produced by the Cutter laboratory proved deadly and the federal government had to step in to monitor vaccine production more closely. By the late 1950s the making of a new vaccine by Albert Sabin similarly captured public attention, especially the purported rivalry between Sabin and Salk. The 2 polio vaccines, indeed, became the exemplar of Americans' ability to control disease, a high tech solution to a messy, frightening plague now gone forever. They were another emblem, like penicillin, of American medicine's Golden Age.
⁶
While the NFIP's publicity department continued to remind the public of the importance of making sure children received 3 separate injections of the Salk vaccine, the NFIP began to expand its mission beyond polio, focusing on “crippling” diseases such as arthritis before finally settling on birth defects. The term “infantile paralysis” had already lost its meaning; the organization renamed itself first the National Foundation (1958) and then the March of Dimes. In 1960 its poster child had spina bifida.
⁷

During her lifetime, admirers had placed Kenny in a pantheon of great scientists like Louis Pasteur, Paul Ehrlich, and Marie Curie—all subjects of Hollywood movies, which had depicted them as scientific figures who had battled conservative antagonists and had “shared their secrets with all mankind.”
⁸
But most physicians were unwilling to go as far to put Kenny in the same category as double-Nobel-Prize-winner Marie Curie or another great contributor to medical science.

Kenny's gender, training, and claims to discovery were made central in the numerous obituaries published after her death where the act of memorializing offered an opportunity to settle scores. Kenny's story—bush nurse becomes medical celebrity—was too good not to retell. Indeed, the
Chicago Tribune
phrased her life much as the
Sister Kenny
movie had done, praising her “zeal” and arguing that it had prevented her from attaining a husband and family. Making it clear to readers that Kenny—a single woman and a crusading professional—had once had a sweetheart was especially important in an era in which American women were expected to embrace a life of marriage and domesticity.
⁹

In a long unsympathetic obituary, the
New York Times
noted “the extraordinary character of Sister Kenny” whose “stubbornness” had allowed her “to revolutionize the methods of treating poliomyelitis” and to rise “from the status of an obscure Australian nurse
to a personage of international importance in the medical world.” Her personal characteristics were, however, “the primary cause of a deplorable conflict with physicians who disagreed with her concept of poliomyelitis.” “Medical opinion has been against Sister Kenny for years” but physicians did acknowledge “her great service in introducing methods of treatment that are now standard.” When her theories were “repudiated” she had lost the support of the NFIP, although it continued to fund the teaching of her techniques. Ignoring Kenny's argument that her work showed that the polio virus affected nonnervous tissues, the
Times
oversimplified her theory and said that Kenny saw polio not as a nervous disorder but as “an affliction of the muscles and skin,” ideas that were the unsurprising result of one whose medical knowledge and grasp of anatomy “were those acquired by a nurse.” By contrast, physicians who “had studied the damaged brains of monkeys that had been infected with polio and of fatal human cases … saw plainly that the nerves were affected, for all Sister Kenny's denials.” “The technical arguments, the personal recriminations … are at an end,” the
Times
concluded with relief, adding with an insincere-sounding reference to her patients, “there remains the figure of a strong-minded woman whose name will invoke blessings from thousands who would have been crippled for life had it not been for her courage, her forthrightness.”
¹⁰

This attack on Kenny's character and on her poor understanding of polio's pathology outraged Columbia University virologist Claus Jungeblut who wrote an angry letter to the
Times
. The
Times
obituary, Jungeblut complained to KF head Marvin Kline, had probably been written “some two or more years ago … in readiness for this occasion.” Its accusations would make it difficult to organize an effective KF campaign, for now KF promoters would have to try “to memorialize someone whose work was made to appear professionally unsound and whose claim to honor was a stubborn courage and an unshaken but unshared belief in her own ideas.”
¹¹

Jungeblut's letter to the
Times
protesting the portrayal of Kenny's scientific contribution was passed on to Waldemar Kaempffert, the paper's science editor. Jungeblut argued that the obituary failed “to do justice to the meaning of the ‘Kenny concept' and [had confused] … existing scientific facts.” A new viewpoint, Jungeblut pointed out, showed that the polio virus traveled through the bloodstream and could perhaps cause “a widespread involvement of peripheral areas, including skeletal and cardiac muscles.”
¹²
Kaempffert wrote back to Jungeblut, defending the obituary as written “only after we had consulted clinicians and virologists whose opinion we respect.”
¹³
But Jungeblut replied firmly that his claims were “based on recorded facts and not on personal opinion” and cited specific research studies, including Dorothy Horstmann's viremia studies and work by John Enders showing that the polio virus could grow in nonneurological tissue. “Many of the earlier differences of opinion have been resolved,” he wrote, and “at last a concept of the systemic nature of the disease emerges on which there is general agreement.”
¹⁴

Jungeblut's own career spiraled downward. He continued for a few years to seek evidence of a genetic factor to explain susceptibility to paralytic polio, but his research plans were rejected by the National Institutes of Health.
¹⁵
His reputation as an idiosyncratic scientist who had rejected the NFIP was recognized by other neglected researchers who hoped that his support by the KF could help break up “this Polio Foundation Control System.”
¹⁶
Appearing before Congress in 1953, he reiterated his belief that the paralytic process in polio was both central and “peripheral” and that his Columbia team had been “some of the first ones to sponsor the viewpoint that the bloodstream was one way of
disseminating the virus.”
¹⁷
Jungeblut retired from Columbia in 1962 and died in 1976. In his
New York Times
obituary he was described as a bacteriologist who was well known for his research on transferring the polio virus from monkeys to mice, which led to a “changed virus that protected monkeys and prevented their paralysis if used in time.”
¹⁸
The obituary made no mention of his support by the KF or his alliance with Kenny.

Kenny's death also offered physicians the opportunity to get in the last word on her contributions. In a pointed juxtaposition
JAMA
paired its 4 line obituary with a 4 page study of follow-up examinations of 346 Kenny-treated patients from the Minneapolis General Hospital written by Miland Knapp and 2 younger physicians from Minneapolis. Knapp's study found that 69.1% of the patients were now “essentially normal” and that early treatment decreased “the necessity for operation and the incidence of scoliosis” but also detailed the various orthopedic operations and apparatus 8.3% of the patients required. The
Journal
's “Poliomyelitis” items in its subject index for the first 3 months of 1953 had only 20% on treatment and around 35% on preventive research such as gamma globulin and immunization.
¹⁹
In contrast, the
British Medical Journal
published 2 separate full obituaries. The first noted that the controversy over Kenny's unorthodox methods had filled “many pages of this and other journals.” In a character assessment that probably pleased neither her allies nor her critics, the
Journal
called her “a shrewd, combative woman, intolerant of opinions which conflicted with her own [but also]… a woman of deep compassion and one who sought no great reward for herself.”
²⁰
In an unusual separate obituary in the same issue, Oxford orthopedist Herbert Seddon argued that Kenny had gone astray when she had elevated muscle spasm “into an important aspect of the pathology of the disease.” The hot packs used to ameliorate “this so-called spasm” were too often used in “a drill … that was elaborate, extensive, and tiresome.” Her theory of mental alienation, further, was just a new name for a variety of functional disorders, which, despite her protests, had no “permanent influence in the designing of remedial exercises.” In Seddon's view Kenny's “initial small store of knowledge” had been expanded as the result of “increasing contact with able medical people.” Had she been content “to talk about treatment without embarking on speculations about pathology” and “had she been a little kindlier [sic] and more tolerant,” Seddon concluded, “she might now be regarded as the Florence Nightingale of orthopaedics, or at any rate of that part of it concerned with poliomyelitis.”
²¹

Seddon's reference to “the Florence Nightingale of orthopaedics” reflected a consciously gendered notion of what made an appropriate female contribution to medical science. Seddon had elsewhere compared Kenny unfavorably to 2 “other great humane women of our time” Dame Agnes Hunt and Lady Marjory Allen. Hunt, a disabled nurse, had collaborated with British orthopedist Sir Robert Jones and worked with tubercular children and disabled veterans; Allen, a landscape architect, had founded an international organization for early childhood education and was working with UNICEF and UNESCO. These 2 women, Seddon believed, were “every bit as tenacious, every bit as impatient of red tape and professional complacency” as Kenny had been. But they had finally got their way by “cheerful persistence and by inspiring that greatest of all reforming forces—affection.” Kenny, in contrast, was never content to let an idea “sink in and do its work.” She “hammered everybody with the whole powerful apparatus of modern propaganda” and, worse, claimed “she never made a mistake.”
²²
It was Kenny's stubborn demand for
scientific legitimacy, Seddon believed, that had alienated potential male allies who preferred insightful women contemporaries who were cheerful, patient, and humble.

Kenny's stubbornness and impatience were highlighted in many obituaries. “She never won for her methods or theories the unconditional approval that she and her many supporters believed them to deserve,” the
Lancet
pointed out, and “she did not realize that her own enthusiasm could go against her.” Still she had whipped up a global interest in polio treatment, and her ideas “aroused discussion and controversy all over the world.”
²³
In the
Medical Journal of Australia
Kenny's antagonist Jean Macnamara argued that progress in medicine came from the efforts of 2 types of people: those who “patiently observe and record” like physical therapists Florence and Henry Kendall and others who “battle for the application of knowledge to the individual patient.” Kenny's “forceful personality” may have helped to destroy complacency but, Macnamara believed, her contribution would have been greater if she had shared “her gifts of patience, pertinacity and attention to detail” with those working for the same objectives. Still, Macnamara was not surprised Kenny had chosen the path of a celebrity. “Fame, travel, press interviews, her book, the film controversy were her choice, and perhaps suited her temperament better.” Macnamara conceded that publicity around Kenny's work had led to a welcome “loosening of purse strings” for physical therapy and rehabilitation facilities. As for her contribution to polio science, Kenny had “provided a stimulus to research workers to abandon the servile adherence to the theory of essential neurotropism of the virus.”
²⁴

Kenny's clinical skills as well as her sense of humor were featured in the few obituaries that defined her primarily as a nurse. The
British Journal of Nursing
praised her as one of nursing's “most brilliant colleagues.”
²⁵
Mildred Elson's obituary of Kenny in the
Physical Therapy Review
was pointedly upbeat, giving a sense that Elson had known Kenny as a person as well as a clinician. Kenny had been “a very warm person [with]… a delightful and, at times, mischievous sense of humor.” Elson was sure that “the controversy and furor” that Kenny had aroused would be forgotten. In any case it had “stimulated everyone to do a better job and the patient [had] benefited.” Her visit to Minneapolis, along with the Kendalls and other therapists in January 1941, had been “thought provoking.” True, there were differences of opinion, but it was just the “good give-and-take which is enjoyed between professional colleagues.” The therapists had found Kenny “a charming and dedicated person” and had been intrigued by her hats. For Elson the central issue was patient care and patient perspective. Patients loved Kenny, she recalled, and appreciated “her kindness, reassuring manner, and skillful hands.” “Her name will continue to be associated with the treatment of polio throughout the world [and] … for her courage and devotion to the polio patient.”
²⁶
Few of the physicians who memorialized Kenny after her death commented on patients at all, but for physical therapists the changes that Kenny's work had made to the routine care of patients were impressive and worth remembering. What Elson could not imagine in 1953 was that attention to polio's clinical care would almost totally disappear for at least 3 decades.
²⁷