Polio Wars (9 page)

Kenny intended to demonstrate her professional respectability through her dignified appearance, her unusual accent, and written testimonials from Australian doctors and politicians. Her letters of introduction stated that she had made a distinctive “contribution” to polio care and that she had “given her services entirely voluntarily” and did not “seek personal gain.”
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They were mostly, however, written by unknown physicians, including government health officials who in both Australia and America were seen as partisan appointees. Kenny wanted a chance to demonstrate her method on paralyzed patients in order to convince American experts to try them, recognize their value, and call for the transformation of polio care everywhere. In seeking out NFIP officials and Mayo Clinic physicians Kenny sought formal, official approval of her work, something she assumed she would never get from leaders of the organized American profession if they were anything like the elite physicians she had encountered in Australia. She hoped that a polio philanthropy would be less beholden to the medical establishment and that her Brisbane allies' personal connections to Mayo specialists would give her an opportunity to show her methods in a more welcoming atmosphere than Australian specialists had provided.

Kenny's appeal also drew on a popular notion of the open-minded American. Just as science popularizer Paul De Kruif imagined scientists
hunting
microbes and
fighting
hunger and death, so Kenny saw the American physician as a kind of frontiersman.
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This stereotype drew on the antielitist heroes she had seen in Hollywood movies at the Brisbane cinema, where she had often escaped from professional tensions during the 1930s. Cinematic heroes were courteous to ladies, strangers, and even friendly Indians; they were receptive to challenge and quick to adapt unusual technological means to achieve their mastery of nature and fight against evil. They laughed at orthodox conservatism, and achieved love and riches by ignoring or conquering it. Doctors in this distinctive culture, Kenny believed, had that “quality which has put the United States in the forefront in almost every department of science—that is, an eagerness to know what it is really all about, in order that he may not be the one left behind if there is something to it.”
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Kenny was an innovator; this new audience valued—perhaps even preferred—the new and improved.

Kenny had been certain that in the United States, as in Australia and Britain, there was a polio orthodoxy she would need to identify and challenge. Before O'Connor returned to New York, she was invited to the NFIP headquarters at 120 Broadway to meet Peter Cusack, the NFIP's executive secretary. Greeting her “with the utmost courtesy” Cusack “showed interest” in the material Kenny gave him and in return gave her
Bulletin No. 242
, a Public Health Service pamphlet on polio care written by physical therapists Henry Kendall and Florence Kendall. This pamphlet, which Kenny studied “carefully,” had, as she saw it, the combined formal approval both of the nation's medical establishment and its federal government. The Kendalls argued that weak muscles must be protected from fatigue, shortening, and overstretching by the use of splinting and rest to maintain joints in a neutral position.
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In approaching American physicians, Kenny faced a fundamental strategic decision. Should she present her work simply as an improvement to rehabilitative therapy, or should she claim that orthodox polio care was based on a flawed understanding of the disease? In 1940 Kenny did not really have a well-developed
theory
of polio. She spoke of distinctive clinical signs that only she had recognized, and warned that if they were not treated patients would be left deformed. She knew her method was distinctive, indeed opposed to elements of standard care.
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Recalling conservative Australian physicians who saw her as an ignorant upstart she came to believe that only the boldest approach would allow her to open eyes and change minds.

Kenny's sense that there was a single, approved method of polio care in the United States was intensified at another meeting with physicians at the Ruptured and Crippled. As she read a paper on her work, “the look of something like boredom” spread over their faces. Some of the men, she recalled later, took naps as she talked, and “one member of the group with a cartoonist kink amused himself by drawing an outline of my features on his cuff.”
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This kind of disdain and ridicule was familiar to her; it had occurred during her demonstration at the Brisbane General Hospital in 1933. Her suspicion that minor NFIP officials were trying to get rid of her before O'Connor returned was reinforced when Cusack urged her to leave New York and go to Chicago to speak to the head of the AMA's Council on Physical Therapy. Reflecting on her many antagonistic experiences with Australian physicians, Kenny had planned to avoid the headquarters of the AMA and turned down Cusack's proposal.
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She was, however, willing to test the openness of New York's scientific establishment, and using a letter of introduction she began explaining her ideas on the phone to a prominent research worker. She had not gone far when this man (probably Thomas Rivers, a prominent virologist at the Rockefeller Institute who was the head of the NFIP's advisory committee on scientific research) advised her to follow Cusack's advice, adding, “I do not think I wish to meet you.” Unable to curb her “nerves and temper” Kenny retorted “I do not only
think
I have no wish to meet
you
. I am sure of it.” So, she reflected later, “ended my first effort to make contact with a research institution in the United States.”
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Kenny now had an introduction from the NFIP to a Chicago specialist in physical medicine as well as introductory letters from Australia to physicians at the Mayo Clinic. In New York she had faced disdain, condescension, and dismissal. But nonetheless she stayed there instead of traveling west. What was she waiting for?

The NFIP, as Kenny shrewdly recognized, was becoming a crucial institution in funding polio care. Formally incorporated only 2 years earlier, it was in the midst of reshaping itself into what became a model for all voluntary health agencies: a sophisticated disease philanthropy committed to funding research, professional training, and patient care on a national scale. Yet it had already had to weather accusations of corruption and dangerous experimentation. Roosevelt had bought the Warm Springs resort in 1926 and established the Georgia Warm Springs Foundation (GWSF), a nonprofit corporation to help him raise funds for it. Both the GWSF and the resort had been accused of corruption and racism, and had been tied too closely to Roosevelt's own political fortunes. The GWSF, further,
had become a forum for activist polio survivors who, inspired by their community at Warm Springs, attacked the widespread neglect of patients with polio and other disabled Americans. Calling themselves the Polio Crusaders, the group had called for expanding the rights of the disabled. By 1933, however, Roosevelt's presidential advisors realized that disabled children were more appealing and far less dangerous than vocal adult subjects. A new fundraising organization based around the president's birthday subsumed the GWSF and removed disability rights from its national agenda. Despite efforts by the newly established Birthday Ball Committee to encourage local communities to expand their own centers, Warm Springs continued to be considered a national center for polio rehabilitation.

An even more dramatic setback occurred in 1935 when a polio vaccine supported by the Birthday Ball Committee led to the paralysis and death of 11 children. The vaccine disaster followed by disappointing trials of a zinc sulfate nasal spray convinced O'Connor that the NFIP must stop funding what a science writer later called “trial-and-error ‘miracle cures.' ”
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By 1940 a reorganized NFIP had developed a new strategy of providing grants for mostly basic science research approved by elite “known” scientists and clinicians. The NFIP's major aim was paying for medical care for patients with polio who could not afford it and it was structured around a sophisticated fundraising program based on the efforts of local and regional chapters run by volunteers but including influential physicians and welfare officials. An invigorated professionally trained public relations staff continued to market hope along with fear, stressing the likelihood that anyone's child could be a victim, the pathetic disabled polio survivor, and the civic virtue of giving.

Although the NFIP claimed it was not in the business of judging polio therapies, that was not quite true. It had to define best polio care when it funded training in the latest methods of diagnosis, treatment, and prevention. The pamphlets it distributed similarly laid out therapies reflecting a particular vision of polio's pathology. Thus,
The Nursing Care of Patients with Infantile Paralysis
emphasized the need for rest during polio's early stage and the usefulness of “orthopedic appliances” such as frames and splints to protect muscles from overstretching.
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The NFIP also sponsored polio exhibits at national conferences such as the National Congress of Physiotherapy and the American Academy of Orthopedic Surgeons.
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While the NFIP never resolved how to define best practice, by the early 1940s it followed the least partisan policy possible, agreeing to pay for any form of therapy recommended by a physician who was legally recognized by a state's licensing laws. The NFIP's research policies, however, became far stricter and more centralized: local and state chapters were forbidden to use any of their funds for research and grants were offered only to individuals or groups based at an institution that the NFIP recognized as equipped to pursue scientific work.

NFIP officials expected Kenny to be another kook but were hesitant to dismiss someone recommended by physicians, however unknown. Kenny's reiteration of the many letters after their names—M.S., F.R.C.S., F.R.A.C.P.—was powerful in a country without Royal Colleges and with diverse medical standards. Her claim to be a “representative” of the Australian government was even more impressive. NFIP officials contacted officials in Washington to verify this claim. Unknown to Kenny as she waited in New York, Richard Casey at the Australian embassy (then known as the Legation) sent a telegram to Canberra to ask whether Kenny was in fact “sponsored by the Australian Government.”
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An Australian federal health official based in Brisbane had a “long talk” with Raphael
Cilento, now both Queensland's health director-general and head of the state's medical society. Cilento, no friend of Kenny's, claimed that “Sister Kenny had herself decided to go to America” and showed the official a copy of Forgan Smith's letter to the NFIP, pointing out its “non-committal” tone.
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In a less antagonistic manner, the Canberra office informed Casey that although the Australian government had not sponsored Kenny, the Queensland government had given her £300 and a letter of introduction to the NFIP.
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NFIP officials did not confront Kenny with this information, but it may well have influenced their cautious dealings with her and their care to have her assessed by eminent American physicians.

Officials at the NFIP had long experience with people who demanded money for their polio “cure.” Even more than tuberculosis or cancer, polio had gained public prominence. Roosevelt's experience suggested that anyone could potentially become a victim of polio paralysis, and the frequency and unpredictability of polio epidemics further frightened the public. Before the late 1940s the federal government played only a limited role in funding medical research, so disease-oriented charities along with major foundations such as Rockefeller, Carnegie, Russell Sage, and Kellogg as well as some municipal and state health departments were the major sources of research funds.

Roosevelt was frequently sent letters with ideas about preventing and curing polio, and these were now forwarded to the NFIP. In February 1940, a few months before Kenny appeared, O'Connor had been sent 2 letters addressed to the President. One was from a nurse with a “cure” for polio called “Via Pak” who wanted an opportunity to “demonstrate its effectiveness.”
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The second was from a wealthy woman who, impressed by the work of a Dr. John van Paing of Washington D.C., offered to give the government 30 acres including 2 large warm water pools in order to set up a polio institution like Warm Springs where medical experts from the NFIP could investigate van Paing's treatment.
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The man in charge of the NFIP was a tough-minded Irish Catholic in an era when Catholics faced widespread social discrimination. Basil O'Connor had grown up in a working-class family in Taunton, Massachusetts. He had studied at Dartmouth College, playing violin in a dance band to support himself, and found a sponsor to help him attend Harvard Law School, one of the few ways the rare Catholic or Jewish graduate could then gain a position in a prominent law firm. O'Connor moved to New York City in 1919 where he worked as a lawyer for oil companies and became a wealthy Wall Street lawyer as well as a donor to Catholic charities. Irish Catholics were a crucial part of the Democratic Party's organization. Not only was Basil's brother John a New York City Congressman but in the early 1920s Basil O'Connor chose Franklin Roosevelt as his legal partner. Roosevelt, despite his paralysis, was determined to return to political life and O'Connor could see how useful Roosevelt's name and connections would be for their law firm. O'Connor became one of Roosevelt's confidants and was one of the few people invited to Warm Springs where Roosevelt could relax in an openly disabled world.
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