Polio Wars (97 page)

Laruelle was privately supportive of Kenny but he was not willing to make his views public. He gave Kenny a number of “micro-photographs and documentary papers” that she told reporters after returning to New York from a visit to Brussels in 1950, “prove what I have been teaching all these years.”
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But he refused to publish either clinical or pathological findings. His research laboratory studied “peripheral tissues” that he believed showed significant viral alteration, and also “peripheral lesions” in pigs, chickens, and cattle with a disease that clinically resembled human polio. He became convinced that Kenny's methods were “physiologically justified,” and he praised the way her methods could reduce the intensity and duration of pain, improve circulation and the condition of the skin, and allow patients a remarkable ability to walk “in spite of marked muscle deficiency.”
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But these remarks appeared only in private reports to the KF, and he put off requests from other Belgium hospitals for Curtis and Housden to demonstrate their work.

“I have been disappointed in Dr. Laruelle,” Curtis admitted to Kenny. “It seems to me he is definitely keeping the Kenny light under a bushel here.”
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Curtis became convinced that Laruelle's reticence was the result of a cautious proprietary stance. “If the Kenny treatment was good it was to be exclusively this doctor's,” she concluded later, “and if it was not good, he was not going to be criticized by fellow doctors for endorsing it.”
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Laruelle did hope that the KF would enable him to establish a technician training school in “this European daughter-clinic of your Institute” that could mobilize its specially trained nurses to provide international aid for regions across Europe attacked by polio, “the necessity of which the World Health Organization has just confirmed.”
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This was exactly the model that Kenny herself envisioned. But Laruelle's small center was unable to play a major role in polio care, even in its immediate region, and the KF did not provide
any additional funds. By the early 1950s Belgium government officials faced with growing polio outbreaks put resources instead into building a new polio wing at the Hospital Brugmann.
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Ironically in these fraught days of the early Cold War, the place that provided the most promising site for expanding Kenny's work was Czechoslovakia, on the other side of the Iron Curtain. In August 1949 Kenny had been invited to Prague by the Czech ministry of health, an invitation organized by Professor Marianna Vetterova-Pastrnkova, a well-connected former teacher of English. Vetterova skillfully promoted Kenny's work by aligning herself with František Pokorny, a physician who directed the well-known Janské Lázně (Warm Springs) spa and had begun to use the Kenny method after a severe polio epidemic in 1948. After meeting Kenny, Pokorny became an even more fervent proponent. He used the gray and red books Kenny left behind as the basis for treating his patients and described his work in a local medical journal.
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Vetterova urged Kenny to send one of her technicians to Czechoslovakia to give lectures and clinical demonstrations, and the vice-minister of health promised that his officials would fit the film with Czech subtitles and organize a 4-month course on the principles of the Kenny method as long as Kenny sent an experienced teacher to direct the course.
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The combination of Vetterova, Pokorny, and the distinctive context of postwar Czechoslovakia led to an unusual opportunity to institutionalize Kenny's work.

Dorothy Curtis was the obvious choice to lead the enterprise. As a graduate of Oberlin College followed by a nursing degree from the University of Minnesota, she had a richer academic background than most American nurses of her generation. During the war she was a lieutenant in the Army Nurse Corps and then worked in public relations in the Office of the Chief Surgeon of the European Theater of Operations.
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After the war Curtis, described by reporters as a “black-haired, energetic therapist,” became a member of Kenny's inner circle.
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Frustrated by her work in Brussels, Curtis told Kenny she was “intensely interested” in the opportunity “to further the distribution of your work” in Czechoslovakia, whatever the “risks that may be incurred in fulfilling this request.”
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She accompanied Kenny to Prague in 1949 and met Vetterova, whom Curtis identified as a woman with “many prominent and influential friends [who was]… really the power behind of this work here.”
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Czechoslovakia had been reestablished as a republic immediately after the war, but by 1948 it was under the control of the Soviet Union. The country had experienced its first large polio epidemic in 1939, and during the 1940s Czech physicians had turned to the latest medical technologies such as the convalescent serum and the preventive nasal spray, and incorporated additional rehabilitation therapies such as hydrotherapy.
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When Curtis arrived in October 1949 Czech health officials offered Curtis the use of a 150-bed hospital in Prague that had been cleared of all patients other than patients with polio. In addition to treating patients, Curtis gave courses in the Kenny method, which were attended by more than 50 nurses and therapists. She also gave lectures and clinical demonstrations to physicians, returning twice in 1950. One 2-week course was attended by around 50 physicians, including the medical directors of 2 prominent thermal spas, representatives from the national ministry of health, neurologists, pediatricians, and members of the medical faculty of Charles and Plzen universities.
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Not only did Vetterova's influence open the doors of hospitals and spas, but Pokorvny's professional enthusiasm also led senior physicians to let their junior associates attend
these courses. Emil Gutmann, a physiologist and senior anatomist at Charles University, allowed one of his assistants to give anatomy lectures to Curtis's students and made sure the assistant consulted with Curtis “to harmonize his lectures with mine.” The assistant also invited Curtis and her students to view the university's anatomy department where he showed them the anatomy museum and then played a film of a “Muscle Man” who could contract any muscle of his body at will and make each stand out individually.
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Her physicians' classes were too large, Curtis admitted, “but they learned enough to know how restoration of function is done” and what their nurses “are doing when they do it,” and she was delighted when a senior neurologist supplied a “neurologic explanation and scientific support to K. concept.”
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After teaching a 2-week physicians' course in May 1950, Curtis spent 4 additional weeks lecturing to groups of doctors and nurses as she visited her former students, now loyal followers, in hospitals in Prague, Pardubice, Bratislava, and Kroc.
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Although Curtis praised Czech physicians as mostly open minded and eager to learn, they sometimes challenged her. At one meeting before an audience of 70, a physician who had not attended her course declared “I've read all the literature. Sister Kenny had not been accepted by Australia or America. Why should we go farther than they? Orthodox or Kenny treatment, the results are all the same.” An orthopedic surgeon then warned the audience that “five years from now your K. patients will all be coming to me for operations.” Nor, Curtis found, did her lectures about the concepts behind Kenny's work convince all members of her audience. Senior neurologists and other specialists told Curtis that “they wanted to see, not hear.”
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But even giving them a clinical demonstration was not enough. Curtis was only a therapist, and the doctors could not accept scientific explanations from someone who did not have their formal training. Sympathetic physicians pressed her to give them articles in recent medical journals “by virologists, epidemiologists, or other scientists advancing our knowledge of polio & supporting the Kenny concept.”
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But this material was difficult to come by. Kenny had been gathering this kind of material since the early 1940s, but the 1944 AMA report had led American physicians to publish further criticisms of her work. Despite the widespread acceptance of much of her work in the United States by the late 1940s, most American physicians who used her methods did so without fanfare.

Still, Curtis found that most of the physicians she met “treat me with a respect and deference that is touching (and almost embarrassing).” After she described the “rubbery symptom”—Kenny's early diagnostic sign that American physicians had largely ignored—she was asked to attend admission examinations at the Prague children's hospital. “This is a heavy and ticklish responsibility,” she told Kenny. “I try hard not to overstep my position, and still give them the benefit of what I have been taught, and seen in experience.” She was gratified to see the hospital physicians “try to see the signs as I point them out. In other words, the door is open for teaching; I am trying to do my best with the opportunity.”
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Curtis also proved open to constructive criticism. When her students complained that the film
The Kenny Concept
did not clearly show how to restore muscle function, she agreed to make another film showing the full treatment including points “not well covered in the documentary film.” “I think myself it was skillfully done,” she reported to Kenny about her new film. “I look fat and double chinned, but what matter if the work is correct.”
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She was especially pleased to learn that a pediatric professor had warned his students to ignore his own article on polio published in a local medical journal
because it had been written the previous year, and “with what we are learning and seeing in the new treatment, we will have to revise all our thinking.”
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By the time Kenny visited for the second time in June 1950, the Ministry of Health announced that every regional infectious disease hospital would be supplied with the appropriate equipment and personnel to treat all acute patients with the Kenny method, and that there would also be 4 special centers to provide Kenny treatment for up to 2 years. Kenny met many of Curtis's former students who praised their teacher as a “brilliant ambassador” and she was delighted when 2 professors told her that in the European medical press “she had been very much misrepresented, both personally and professionally.”
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In Czechoslovakia Kenny was, Curtis noted, “welcomed with deference and honor everywhere” and “cars and chauffeurs were always at hand.” Most of all she was part of the discussions with senior physicians who asked her opinion about both theory and practice, and after her visit sent her an effusive letter of thanks. Her technical film, now translated into Czech, was shown during her visit. Officials talked with her about the use of the Kenny method for “spastic” patients and those with other muscular diseases. The Ministry of Health announced that orthopedic surgeons were “to hold off operations for two years.”
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Curtis kept a detailed record of Kenny's 1950 visit, but when Kenny turned the record into her Official Report she left out the times when she became ill or spent the afternoon resting.
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This was not an image of herself that Kenny wanted to project.

Cold War politics, however, prevented Kenny from achieving her goal of cementing relations between these enthusiastic Czech professionals and her allies in Western Europe and the United States. She invited Pokorny, the spa director, to Minneapolis. But, although he was recommended by the American Consul in Prague, his application was rejected by the State Department as he was a member of the Communist Party, which, Curtis reminded Kenny in frustration, was the “road to advancement in government jobs here.” Curtis was not surprised to find global medical progress undermined by Cold War politics. “This is really the best grounds and the best opening we have found in Europe,” she reflected. “It is a pity that the Iron Curtain stands in the way of its [the Czech hospital] becoming
the
Kenny center for all Europe.”
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To try to enhance the institutionalization of her teaching, Curtis ordered a hundred copies of
Physical Medicine
(the gray book) to be sent to Czech medical libraries and to the 20 hospitals where her former students worked. Vetterova promised to translate selections from both the gray book and the red book and to add statements by prominent Czech doctors endorsing Kenny's method.
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Curtis had hoped that after she told Laruelle that the Czech doctors were writing up their clinical experiences it would “stimulate him to do something.” “A word from him,” she was convinced, “will really carry great weight in all the European medical world.”
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But prospects in Brussels seemed little improved, and she was disheartened but not surprised to hear from Helen Sare, the Kenny technician now based at the Brussels clinic, that patients had begun to develop “contractures and deformities.”
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Sare continued to train a small number of physical therapists but found that local physicians showed little interest in learning about the Kenny method. Satisfied that the results will be good, they “leave me alone to get on with it,” she told Kenny's secretary, but “it would be SO much more satisfactory … to have them co-operate with me.”
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Curtis's final opportunity to establish Kenny's work in Europe occurred when a German physician invited her to treat his acute patients at the Augsburg city hospital, and the
head of the local children's hospital agreed she could work with patients there also.
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Curtis became convinced that Kenny's work could expand in a country that was part of Western Europe rather than Eastern Europe. She allied herself with the newly established German Pfennig Parade, a kind of March of Dimes organized by the German-American Men's Club.
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Using the KF's familiar promotional technique, Curtis made sure Kenny visited that summer and took part in a Pfennig Parade, held a clinical demonstration, and showed her film. Feted as a celebrity, presented with numerous bouquets, and serenaded by singing children, Kenny spoke delightedly of establishing a “training school … where all may share this knowledge,” reminding her German audiences that “the Science of Medicine knows no frontiers.”
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