Polio Wars (112 page)

In the early 1950s Kline had become involved with Empire Industries of Chicago, a professional fundraising company owned by Abraham and David Koolish. Board member James Henry, Kenny's friend, suspected that Kline had been using KF funds to pay for his own golf club memberships and vacations and noticed that some of the Koolishes' solicitation appeals had not been approved by the board. When Henry spoke up he was asked to leave the board.
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The Koolishes were indicted for mail fraud in 1955, but Kline assured the board (falsely) that New Century, the company with which the KF now worked, was not run by the Koolishes.

Kline also had the board approve substantial raises for himself: his salary during the 1950s increased from $25,000 to $48,000. As rumors of fiscal improprieties intensified, Minnesota's attorney general Miles Lord began to investigate Kline and the KF, and when Lord became U.S. district attorney the investigation was taken over by Walter Mondale, the state's new attorney general.
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When the investigation became public in March 1960 Kline resigned and was replaced by Edgar Huenkens, formerly the KF's medical director.
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Local citizens began to protest this “betrayal of public confidence and debauchery by trusted officials” and argued that claims by KF board members that they did not know what was going on were no excuse.
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In vain did an editorial in the
Minneapolis Tribune
remind the public of the KF's “vastly important and beneficial work.”
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Soon the story was appearing in the Chicago press and then the
New York Times
.
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Kline was indicted for grand larceny by a local jury who recommended that all KF board members resign as they had been neglectful and shown “a grave lack of responsibility.”
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The scandal continued to reverberate through the local and national press. With headlines like “Kline Gets 10 Years In Kenny Fund Fraud,” Kenny's name was linked to signs of greed and corruption. Each time reporters noted the “lavish gifts” that KF officials had accepted—including paid trips to the World Series, fishing vacations, television sets, and luggage—the implication was clear that these officials had deprived disabled children and adults of medical care and betrayed the trust of patients and the public.
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District and federal judges spoke harshly of KF board directors' neglect and indifference, and the issue became part of a wider debate about voluntary health and welfare agencies that duplicated services and fundraising.
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As a result of the scandal, the Minnesota legislature required charities to make full annual reports to the state's attorney general.

In September 1960 the KF board announced a further reorganization with the appointment of a new KF head: Frank Krusen, now senior consultant at the Mayo Clinic.
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Taking a leave of absence from the Mayo Clinic, Krusen closed down the KF offices in the Foshay tower and hired a respected accounting firm to audit the KF books. His success in shoring up the KF's reputation was demonstrated in December 1961 when the federal Office of Vocational Rehabilitation located one of the nation's first federally funded rehabilitation centers at the Institute.
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After 3 years Krusen retired.
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His successor was Paul M. Ellwood, Jr. who had been appointed head of the Institute's inpatient services in 1953. Ellwood was eager to help turn the Institute from a polio hospital into a rehabilitation center. In his view Kenny's work had been “too much a cult,” and he had particularly disliked the Kenny technicians' resistance against the use of tracheotomies and iron lungs. When the “Blue Girls” went
home in the evening, he recalled, the interns gave some patients tracheotomies and placed others in iron lungs.
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In 1965 the KF changed its name to the American Rehabilitation Foundation, and the remnants of Kenny's connection to it were sloughed off. Ellwood assured reporters that the 1960 scandal had figured only partly in the name change. If KF officials had changed the name in 1960, he explained, “it might have appeared we were doing nothing more than putting a false front on the old structure.”
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During the late 1960s a few memoirs mentioned Kenny. In his 1969 autobiography Morris Fishbein pointed out that Kenny had no formal education and had never become “what is called a registered or graduate nurse,” although she had tried domestic work and had worked as a governess. She had been unable to establish her ideas in Australia, he claimed, and speculated that perhaps this was due to her personality or perhaps her “disregard for medical custom.” Her work, Fishbein admitted vaguely, led to further intensive studies of polio's “pathological changes.” He did not mention any of Kenny's theories; in his view she was an untrained empiric who “knew nothing really of anatomy, physiology, pathology or any other of the basic sciences on which scientific medicine rests.” “Confronted with an emergency … she tried what she thought would help, and it did, but she never did know why it helped.” He made much of her character and body. She was a big woman who wore a 3-cornered hat and “came to luncheons and dinners invariably late so as to make a grand entrance.” Fishbein made himself a central figure in Kenny's career. Kenny had stopped to see him any time she passed through Chicago and never hesitated to call him long distance “at whatever time of the day or night, to recount her resentment at some actual or fancied slight or difference of opinion.” Unlike his statement to Cohn in 1953, Fishbein now felt that her work had
not
been properly evaluated. Repeating a widely held belief among many physicians about the hysteria around polio epidemics, Fishbein argued that “the psychological effects of those so burdened by emotion were such as to make further controlled evaluation of her techniques difficult if not impossible.” As a medical popularizer who no longer had the power to control the portrayal of medical professionals in any media, Fishbein blamed both Kenny and the press for the adulation around her. Her celebrity reputation in the 1940s was a typical example of how “most of the press liked to portray … another unprofessional investigator and discoverer being denied and overwhelmed by medical authority.”
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In 1967, historian Saul Benison published a study of virologist Thomas Rivers, a book that was honored with the American Association for the History of Medicine's William Welch medal the following year.
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Rivers, who had died in 1962, was a leading virologist at the Rockefeller Institute for Medical Research. He had been an NFIP advisor since the late 1930s, and was later the foundation's medical director and then Vice President for Medical Affairs. He was also one of the 1958 Polio Hall of Fame scientists.
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Rivers was uncompromising in his assessment of Kenny, whom he saw as an ignorant woman who pretended to understand complex medical science. He admitted to Benison, “I couldn't stand her … She had no notion of the nature of poliomyelitis as a virus disease and certainly knew nothing about its pathology. For example, she thought it was a disease of the muscle. The kindest thing I can say about her ideas of physiology and anatomy is that
they best be forgotten.” Rivers had lived through America's polio epidemics and knew he had to say something about the efficacy of her methods. Reluctantly he told Benison “there is no denying, however, that she got effects, and I think that on the whole she did some good.”
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In his 1968 autobiography Melbourne virologist Francis MacFarlane Burnet recalled that “being an Australian I had heard much of Sister Elizabeth Kenny.” He had met Kenny about a year before her death and he described the tremor in her right arm and her “heavy-fleshed Irish face” that had looked tired. Kenny was now almost forgotten by the world, Burnet admitted, but “there was an air of greatness about her and I shall never forget that meeting.” She had been “strong-willed and persuasive enough” to have many of her ideas adopted in a Queensland hospital; in the United States she “became an increasingly influential figure … as well as a gadfly to the medical profession … removing medical apathy and defeatism about the residual effects of polio.” Her most important contributions, Burnet wrote, had been to show paralyzed children how to make the best use of what functional muscles they had, to demonstrate to their parents that something active was being done, and to destroy “the orthodox superstition of immobilization by splinting.” He had disliked her extreme claims, recalling that she had told him that a primary site of viral infection could be the skin and offering the example of a patient who she had known would die within 48 hours as his skin was “contracting all over.”
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John Pohl did not write about Kenny after her death. During the 1960s he was interviewed by Victor Cohn a number of times and also read and commented on a draft of Cohn's manuscript. Pohl called one draft “a superb piece of work” and praised Cohn for capturing what he saw as the main theme: that “this was a battle of concepts: The Kenny vs. the orthodox.” After all, he reminded Cohn, Kenny had “frankly stated she did not know the cause of spasm.” In a letter to Cohn in 1967 Pohl claimed that Kenny had got the idea of peripheral disease from himself. While her hope of “scientific interest or investigation” had been sincere, when none had developed “she knew she was doomed.”
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This was a strange rethinking of the fierce debates around Kenny's ideas, but perhaps Pohl could tell that Cohn had already made up his mind about the scientific validity of Kenny's ideas.

Yale epidemiologist John Paul's
A History of Poliomyelitis
was published in 1971, the year he died. Paul's Yale Polio Unit, funded by the NFIP since the 1930s, had produced crucial serological studies of polio, and like Rivers, Paul was one of the NFIP's Hall of Fame scientists. His
History
dealt awkwardly with polio's clinical care, ignoring the work of nurses and physical therapists.
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Primarily a virology researcher, Paul believed that most orthopedic care—splints, braces, corrective surgery, and electrical treatments—lacked “real efficacy” and impressed patients mainly “from a psychological point of view.” Kenny was fortunately able to break through the “the slough into which it [polio care] had sunk in the 1930s,” he said. Paul described the 1944 AMA report as an attempt by “prominent American orthopedic surgeons … to discredit Miss Kenny's reputation—almost, it would seem, out of professional jealousy.”
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Kenny, Paul noted sadly, had attracted fanatic allies among “both lay and professional people” who believed “there was something magical in her personality as well as in her treatment.” Kenny herself had exacerbated this situation, for the aggressive way she had presented her ideas had been “calculated to antagonize physicians.” She had also forsaken her appropriate role as nurse and clinical assistant: “instead of sticking to her daily work
in the hospital wards, caring for and rehabilitating her patients, work for which she was eminently qualified, she became busy with all the paraphernalia of public campaigns and press agents, who, needless to say, loved a fight.” Uncomfortable with the way the NFIP had forced scientists to participate in its propaganda efforts, Paul argued that the reputation of physicians was apt to become tarnished when they engaged in “medical polemics”; thus, he concluded, “how much more tarnished is the image of a nurse who, forsaking her natural duties, becomes similarly embroiled.”
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Physical medicine physicians also sought to lay Kenny to rest. In a special 1969 commemorative issue of the
Archives of Physical Medicine and Rehabilitation
entitled “Our Experience With Poliomyelitis,” Robert Bennett recalled “this controversial woman, [who] through the sheer force of her personality and her words, made us defend and reconsider methods of treatment popular at that time and, by so doing, changed some of our ideas regarding early care.” Bennett was convinced, however, that “the ‘Kenny method' … reflected more the effect of our clinicians upon Sister Kenny than her effect upon them,” especially the influence of the physiatrist Miland Knapp.
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Bennett's article was followed by a reprint of a 1932 article by Walter Galland, a little known orthopedist. Galland, the journal's editor noted, had used terms like “spasm” and warned that treating spasm with splints would increase a patient's pain “tremendously.” Thus, the editor pointed out delightedly, “long before Sister Elizabeth Kenny arrived in America … and began espousing the ideas which created quite a national uproar, Dr. Walter Galland's enlightened views … appeared in our journal.”
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The
Archives
also reprinted 2 more articles: the AMA committee's “Evaluation of the Kenny Treatment of Infantile Paralysis” from
JAMA
in 1944 and Knapp's article “The Contribution of Sister Elizabeth Kenny to the Treatment of Poliomyelitis,” which had been first published in the
Archives
in 1955. Knapp sought to establish the proper distance between Kenny's work (and his own early enthusiasm for it) and the view of a reputable physical medicine expert. Kenny's “background in pathology and medical training left much to be desired,” Knapp acknowledged, but “she was an excellent clinical observer with keen perception and… an intimate knowledge of muscle function.” He praised her “well thought-out logical and physiological treatment” that had been appropriate “for the symptoms as she saw them.” The enthusiasm of the general public had been spurred by her zeal, but her efforts to convert the medical profession to her way of thinking had been “a difficult and often an impossible task.” She loved a fight—probably as a result of “her Irish temperament”—and she could not see “any point of view other than her own.” Unfortunately, Knapp continued, newspapers had reported many of these arguments. Kenny had remained frustrated by what she saw as “her snail-like progress,” but Knapp felt that “very few medical ideas have gained such rapid momentum and prestige and have affected the general treatment of a disease as completely as did hers.”
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