Polio Wars (96 page)

But Kenny still had the power of the pen, the ear of newspaper reporters, and a network of allies. To buttress her argument that clinical care could not progress without a correct theoretical understanding of the disease, she organized a series of physician testimonials. Kenny's work had, orthopedists Robert Bingham and Alfred Deacon argued, “practically abolished the use of plaster casts and splints” and had significantly reduced “the amount of corrective surgery.” They praised her “new concepts of the clinical picture and pathology of acute poliomyelitis” that had enabled doctors to diagnose many early
and mild patients “previously unrecognized until deformities or paralysis developed.”
⁷⁸
Michigan physician Ethel Calhoun, who had been using the Kenny method at the infectious disease hospital in Pontiac since the early 1940s, praised Kenny's “amazing powers of observation” and the “remarkable improvement” she saw among her own patients.
⁷⁹
Although Kenny tried to make much of the devastating impact on clinical practice when it was not informed by correct scientific theory, few of her testimonials mentioned this.

Kenny's claim that if laboratory research were not combined with a clinical understanding of polio in living human patients there could be no progress in polio science did not convince skeptical scientists. After a meeting with Australian virologist Francis MacFarlane Burnet, she noted that he believed “that the disease localized its activities to the central nervous system.” Such a view of polio, Kenny was convinced, was the result of Burnet's limited clinical knowledge, for he “informed me he had seen very few, possibly only three, acute cases.”
⁸⁰
For his part Burnet, the director of the Walter and Eliza Hall Institute in Melbourne, found Kenny memorable but completely unconvincing. In his later autobiography Burnet recalled “a long two-hour interview” with Kenny, a “large white-haired, slow-moving woman dressed like old-fashioned royalty in purple with a large wide-brimmed hat.” He found her ideas about polio's pathology and physiology “highly individual, heretical and, unless all reputable research men were grossly deceiving themselves, completely untenable,” and was not impressed by her testimonials written by a “few not-very-well-known pathologists.”
⁸¹

When Kenny sought testimonials from laboratory scientists who did believe in her theory of polio, she had, as Burnet noted, few familiar names. Jungeblut sent her a Christmas letter in 1949, thanking her for her friendship and continued interest in his work, which had enabled his laboratory “to make a number of scientific contributions which provide direct evidence in favor of your concept of the peripheral origins of poliomyelitis.” In words that Kenny subsequently quoted many times, Jungeblut said he firmly believed “that no intelligent approach to the control of poliomyelitis is thinkable without a clear understanding of these fundamental phenomena.”
⁸²
Neurologist Leon Laruelle, her major European ally, was, she reported, “completely convinced” that her concept was correct and the young British orthopedist Lancelot Walton, who had spent a few months at the Institute funded by the KF, similarly agreed “that the peripheral structures are primarily affected.”
⁸³
She also forced Huenkens to write a To Whom It May Concern letter stating that for the previous 8 years the medical staff of the Minneapolis General Hospital and the Kenny Institute had taught that polio “is a complex systemic disease, presenting many clinical manifestations, and that it attacks the peripheral system.”
⁸⁴

As much as Kenny valued Jungeblut, she placed even greater faith in her European connections. She had come to see Europe as a promising site for leading clinical and research work that would be unfettered by the influence of the NFIP or the AMA. Although she had long spoken grandly of the Kenny treatment practiced around the world, before 1945 her work had been fully institutionalized only in the wards of the Queen Mary's Hospital in Carshalton by nurses and physical therapists she had trained in the 1930s. During the war doctors, nurses, and physical therapists from South America and Canada and
a few from elsewhere had come to Minneapolis to study her methods and returned to their home countries, but such practice was individualized and fragmented. After the war prominent visitors included activist Krishna Nehru Hutheesing, the sister of India's first Prime Minister, who reminded Kenny that she had promised to send “a film for our Clinic in Bombay.”
⁸⁵
But a single Kenny technician accompanied by Kenny's technical film, even boosted by community goodwill, was unlikely to be able to transform polio care in a hospital or region, much less a nation.

At the end of the war as polio epidemics spread across Europe Kenny could see the possibility of expansion into communities where the NFIP did not reach and where scientists might be more willing to explore new ways of thinking. She began to travel regularly across the Atlantic with funding from the KF. Her reputation and her connections—as well as the RKO
Sister Kenny
film—opened doors for her.
⁸⁶
Reflecting war-torn Europe's eagerness to “catch up” in medicine, science, and technology, and a wider gratitude toward Americans who had helped to win the war, Kenny was treated as an honored guest. When she stayed at the Hotel Metropole in Brussels, the Belgian flag was brought down and the Union Jack raised up. When she visited Prague and heard a band playing a song of welcome she wondered whether Stalin or some other Soviet leader had arrived. Realizing the band was honoring her, she “felt a little bit small and foolish but, however, it was nice of them to pay such homage to an alien.”
⁸⁷

During these trips she tried to shore up medical respect and counter antagonistic publicity. Officials in Rome assured her they would be sending a doctor and 2 nurses to study at the Institute, but a skeptical Italian pediatric professor asked her why her procedures were not mentioned in an NFIP booklet. Kenny explained that the pamphlet “had been compiled in the very earliest days of my visit to America and was not authentic.”
⁸⁸
In Athens, the Minister of Hygiene thanked her for the film and pamphlets she had donated and said he would be grateful to learn of “further developments made in your Institute in the field of research and treatment of this disease.”
⁸⁹
In Spain the prominent orthopedic surgeon Vincente Sanchis-Olmos praised her for drawing attention to lesions in skin and cellular tissue and quoted virologist Julian Sanz Ibanez of the Ramon Y. Cajal Institute whose work showed that all problems in polio did not “result from lesions of the central nervous system.” To her European audiences Kenny spoke freely of her battles with the NFIP and the AMA. “We know that there are political problems in America,” Sanchis-Olmos declared in his own interpretation, “because this method is not American and Sister Kenny is not a doctor but a nurse.” While the KF was trying to push Kenny aside, the board did reward these words of support with $3,000 to the Cajal Institute.
⁹⁰

A symbolic moment came in the summer of 1950 when Richard Metcalfe, the senior orthopedic consultant at the Queen Mary's Hospital, “shook my hand, congratulated me upon my great discovery and presented me with a copy of that very conservative medical journal,
The Lancet
, wherein it is stated that both my pathology and therapy had been proven correct.” This “red letter day” reminded Kenny when, 13 years earlier, “in the very same ward, my theories were met with repudiation and rebuff.”
⁹¹
Metcalfe had become a consultant at the hospital in the mid-1940s and had been impressed with its patients. Learning about Kenny's methods from the hospital's physical therapists, he had convinced other physicians to allow this work to continue. When he first met Kenny in 1948 she had struck him as “a battleship in full steam,” but he had grown fond of her and
championed her work.
⁹²

While Metcalfe may have spoken fulsomely to Kenny, in fact the
Lancet
reference was neither an editorial nor a research article, but a description of a recent symposium on polio held by the Society of Medical Officers of Health. Although the report was hardly an endorsement by the journal itself, it did show significant interest in her theories among English health officials. At this symposium Metcalfe had praised her ideas on pathology and therapy, pointing out that polio was not “the localized disease it was once thought to be” but in fact “involved not only nerves but also nerve end-plates, muscles, fascia and skin.”
⁹³
Without mentioning Kenny's name, one of Metcalfe's colleagues at Carshalton also praised the condition of patients who had received hot packs.
⁹⁴
Kenny's treatment had first been condemned as of “no importance” and her “osteopathic” pathology dismissed, remarked another official. But now both her methods and her ideas were accepted.
⁹⁵
Calling Kenny's ideas osteopathic reminded listeners that polio rehabilitation frequently attracted unorthodox practitioners, and such faint praise barely raised Kenny out of this despised crowd. Despite the cautious praise by individual European physicians, Kenny's work was never established as a fully institutionalized global enterprise. But there were 2 places where enterprising Kenny technicians were able to set down strong roots, at least for a time: Belgium and Czechoslovakia. The possibility for establishing a European center in Belgium came during a polio epidemic in the summer of 1945, when Kenny had visited a small Brussels polio clinic, which was part of a neurological institute directed by Leon Laruelle. Kenny and her technicians had treated some of the patients and she showed her technical film. Laruelle was impressed both with the clinical results and the film, which he compared to “a great interesting book which he could read many times.”
⁹⁶
He agreed to allow Dorothy Curtis and Nora Housden, Kenny technicians fluent in French, to work at the clinic from the summer of 1945 to February 1946.
⁹⁷

In 1948, Curtis and Housden, funded by the KF, returned to work with Laruelle to establish what Kenny believed would become a European training center and research institute. Like Kenny in her early years in Minneapolis, the technicians hoped that the bodies of their patients would stand as powerful evidence of the efficacy and validity of Kenny's work. At first they were allowed to treat only chronic patients, as local physicians were reluctant to allow them to care for patients in the acute stage “out of fear that the hot packs would strain the heart.” The work was exhausting; the technicians had to do all the hot packing themselves “with very inadequate equipment.” “The days are never long enough,” they reported. But by the end of 1948 they were treating two-thirds of the clinic's patients and beginning to train 2 packers.
⁹⁸

Patients began to arrive from Israel, Spain, Turkey, North Africa, the Congo, France, Luxembourg, England, and Ireland.
⁹⁹
By 1950 the technicians were teaching 5 students: nurses from France, Denmark, and Belgium, and a Romanian woman doctor. The Brussels clinic, a converted nursing home, was not large enough and its physical plant was awkward: 5 stories and no elevators, halls too narrow for carts, and bathrooms on stair landings. But it grew to 40 beds—most of them filled by private patients—and gained a significant reputation across Europe.
¹⁰⁰

Convincing Belgian physicians, even those who worked in the clinic, was, however, not easy. In November 1948, a Dr. Schwarz was appointed as the new medical supervisor of the polio wards. Although he had “hardly grasped the full Kenny concept,” Curtis and Housden reported to Kenny, he appeared to be “favorably impressed by the results.” He read the literature with interest and asked for more, “especially anything published
in official medical journals.”
¹⁰¹
Yet Curtis and Housden found that without their close supervision Kenny methods were easily modified. In the fall of 1949 Curtis left briefly to attend a private patient and Housden went to the Jersey City center for a working vacation. Although they had left explicit instructions as to how their patients should be treated, Housden was disturbed on her return to find her Brussels patients had been given “additional ‘short wave' treatment” prescribed by Schwarz who “feels strongly the benefit of the increased blood supply to a limb, and is making charts to record his findings.” She had a heart to heart talk with Laruelle, arguing that “our patients needed to have ‘unmodified Kenny Treatment.' ” Laruelle recognized that he was being called on to defend the technicians' sense of what was proper care against the interests of other members of staff. He responded quite well, Housden told Kenny, and agreed that “none of our new cases” would have this treatment. Housden had been “amicable about the matter,” she assured her mentor, “but had to be amicably firm!” Schwarz, she added, “can do what he likes with his own old cases.”
¹⁰²

Still, any gains in their efforts to disperse knowledge of Kenny's work around Europe remained precarious. Laruelle, for example, frequently lauded the Kenny treatment when he showed medical visitors through the clinic as a technique that was “physiologically rational, and has beneficial effects all its own.” The method could show “its useful effects,” he believed, only if it were applied “by technicians possessing a profound knowledge of anatomy, … the gift of observation, an innate intuition and a high moral conception of their mission.”
¹⁰³
But when the technicians asked him to let them teach local nurses, they were told either that no nurses were interested or that it was impossible to spare any.
¹⁰⁴