Polio Wars (103 page)

In a new lecture on the “Cause and Prevention of Deformities in Poliomyelitis,” which she also had printed as a 29-page pamphlet, Kenny used the announcement of Horstmann and Bodian's work to mock Roland Berg's 1948 claim that her treatment would have gained earlier and wider acceptance if she had not demanded that physicians accept her theories. Now, she said, “it has been acknowledged and published throughout the world that the orthodox theory has been exploded” and a contrasting theory of polio “which in all humility I can say I had the privilege of discovering forty-one years ago—does in truth exist.”
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This visit, she confided to Rosalind Russell a few weeks later, was “most profitable in the interests of my work in the Country and abroad.”
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Although sick and exhausted when she again returned home, Kenny was unable to keep away from the United States, where she could see the impact her work had made on clinical practice and American life. Polio epidemics were now a constant part of American life; indeed 1952 would be America's worst year since 1916.
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At the end of June, only a few weeks later, Kenny appeared again looking, the
Los Angeles Times
remarked, “in better health.”
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This visit, like the previous ones, was filled with farewell dinners. She rested at her cottage in El Monte, and tried to monitor the hospital's standard of patient care. But while she was still quick to criticize, now she would often apologize, saying “I'm an old woman and I sometimes say things I don't mean.” The physicians, nurses, and administrators listened to her patiently and then continued their work.
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She brought with her
Poliomyelitis A Systemic Disease
, a new lecture accompanied by a 15-page pamphlet, in which she reaffirmed the importance of Horstmann and Bodian's work in confirming her theory, and made a jibe at their refusal to believe that a KF-funded researcher had already made this discovery.
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In an odd presentation of herself as a celebrity figure, she appeared on TV again, this time as the mystery guest on “What's My Line.”
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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.
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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.”
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Kenny hoped that this focus on polio's pathology would alter professional and public perceptions of her own contribution. But she was mistaken.

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.
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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.”
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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.”
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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.
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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.”
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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.”
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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.

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.”
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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.”
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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.
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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
.
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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.
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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.”
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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.”
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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.”
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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.”
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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.
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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.”
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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.”
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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.
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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.”
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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.”
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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.”
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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.”
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