Polio Wars (113 page)

Finally, Kenny was remembered and commemorated in Congress. In the early 1970s Minnesota Senator Walter Mondale chaired congressional hearings on the mismanagement of charities and formally commemorated Kenny's birthday in the
Senate Record
praising “a very great lady of this century” who at first had been “dismissed rather coldly by our medical leaders, but then won them over and became an international heroine.” Kenny deserved to be remembered, he told Congress: she was “a dynamic backwoods nurse” and her “spirit and philosophy” lived on at the Institute in Minneapolis, which, he added, was one of nation's leading rehabilitation centers.
⁸³

Cohn's book
Sister Kenny: The Woman Who Challenged the Doctors
finally appeared in 1975. Published by the University of Minnesota,
Sister Kenny
was a well-produced book, with 260 pages of text, many photographs, endnotes, and a 6 page bibliography. It was no feminist text. While its focus on a woman protagonist was distinctive, Cohn's portrayal fell into familiar tropes. Kenny had grown up in a matriarchy and her father had been quiet and dreamy. Irritatingly, Cohn chose to call Kenny “Liza” throughout (a name that he claimed her relatives used and she disliked), although he admitted that her closest friends and relatives had called her “Sister.”
⁸⁴

Cohn recognized that many of his readers would no longer remember Kenny from popular magazines or the rarely shown movie. He tried to convey how impressive she had been: “in her prime … overpowering … five feet, eight inches tall, about 170 solid pounds … large, open brown eyes and a direct gaze that could turn to sharp steel.” It was not only her physical appearance that had made her such an effective crusader. She had modeled herself, he believed, on “a sort of turn-of-the-century combination of Emmeline Pankhurst, Sarah Bernhardt, and Joan of Arc.” The combination of a suffragist, a celebrated actor, and a religious crusader who had been burnt to death suggested a confusing mélange of feminist advocacy, dramatized acting, and evangelical fervor. She battled with men and enjoyed it, he wrote, and quoted her as saying “I won't let any man boss me.”
⁸⁵

Cohn made much of what he thought of as his own great discovery: the fact that Kenny had lied about having graduated from a nursing school. This fact, Cohn claimed (incorrectly), was never uncovered by “even her worst enemies in the United States.” It explained what he identified as a deep seated insecurity, leading Kenny to move “through life with the air of a duchess, half-cloaking the uncertainty of a self-trained outback nurse.” While he considered her an innovator whose “one-woman revolution [had] helped start modern medical rehabilitation,” he noted that her “honeymoon with the doctors” had been brief. In part this had been her fault, for, despite their making great changes in polio treatment, she had “demanded more change, in some cases justifiably, in some not.” “In her own way,” he argued, she was “a questioner like a Kepler or a Freud, a rebel whose life casts light on all times,” and she “helped turn medicine toward a new aggressive approach to all injury.”
⁸⁶
Cohn remained unsure about how to explain the heights of adulation and the depths of hatred that Kenny inspired. He decided, finally, that a combination of her gender and her personality was the answer.

Cohn's
Sister Kenny
was reviewed in the national press, in history journals, and in
JAMA
. Audrey Davis, historian and curator at the Smithsonian, enjoyed Cohn's depiction of the controversial figure who had been “a celebrity of the highest rank” and suggested that Kenny's reception by the medical community “reveals much about the standards of American medicine in the 20th century.” Davis wished Cohn had reflected more on the sources of clinical change and the role of scientific theory. “Empiricism,” she argued, could not have been “sufficient to change medical procedures.” Physicians would have expected “a theory to explain the results,” but when Kenny's “theoretical rationale was unsatisfactory, the practice was shunned as unacceptable.” Only Kenny's “incessant appeal[s],” according to Davis, had led her methods to be “incorporated into modern medical practice.”
⁸⁷

In the mid-1970s women's history was only just emerging as a separate discipline. Another woman historian, Glenda Riley, praised Cohn's book as well researched and pleasantly written but complained that nowhere did Cohn “demonstrate that Kenny understood or advocated the philosophy of feminism.” She felt that Cohn lacked “a feminist perspective,” noting his “vaguely patronizing tone” and his use of “Liza” rather than “Kenny.”
⁸⁸

The medical and popular press acclaimed Cohn's stories of Kenny and, like history journals, chose women to review it. “Today, her name is seldom mentioned,” Marjorie Mehan, the
JAMA
reviewer, noted, but because “the emotions she aroused [had]… subsided … a relatively unbiased biography and evaluation is possible.” Her method had directly opposed standard treatment, and her explanations “conflicted with accepted beliefs.” But the American public was “panicky” and therefore “enthusiastic for any approach that offered new hope” and most physicians “gradually … modified their therapy to resemble hers.”
⁸⁹

In the
Washington Post
Sonya Rudikoff argued that Kenny's “revolutionary treatment of polio [had] conquered medical skepticism.” The reviewer compared the modern postvaccine era to the years before antisepsis, antibiotics, modern surgery, and vaccines when what mattered were speed, proper nursing, diagnostic skill, and “exact obedience to prescribed regimens.” A lack of formal training had not been crucial in such an old-fashioned era, and Kenny had learned to help patients with “intuition, swift care and meager knowledge.” After the polio vaccines were developed Kenny's methods “and their inventor's dedication became antediluvian.” Rudikoff was shocked by Cohn's description of the “incredible indifference, resistance and even active opposition to her methods by the medical establishment of her day.” Such “cruelty, suspicion and hostility” among physicians, she concluded, had been “extreme and unworthy.”
⁹⁰

Kenny's harshest critics saw Cohn's book as too mild. Jay Myers, for example, who had retired from the University of Minnesota in 1957 after over 40 years on the faculty, had written a “little review of the Kenny episode” that by 1971 had become a manuscript of around 70 pages. But after the publication of Cohn's book Myers grew discouraged, as he admitted to his friend and colleague Maurice Visscher.
⁹¹
During the KF scandal in 1960 he had gleefully offered a talk to his local medical society entitled “How Could It Happen” to explain how his and Visscher's “investigation” had revealed that Kenny was not a nurse and did not deserve the title Sister.
⁹²
But the directors of the Hennepin County medical society had declined his offer, and although Myers was convinced that the KF's new board should learn that Kenny was “an impostor pure and simple,” no local paper was willing to publish his material.
⁹³
In Myers' longer manuscript, which he continued to work on during the 1970s, he castigated “the uninformed and misinformed public” that had been impressed by Kenny's propaganda. He remained frustrated by the limited impact of his and Visscher's anti-Kenny campaign, which he defended by explaining that he and his colleagues had sought to understand why Kenny “manifested no understanding of the mechanism” of polio and why she lacked the “knowledge, finesse and other well known qualities of a graduate nurse.”
⁹⁴

In 1977 Myers sent a short version of his manuscript to Leonard Wilson, an historian of medicine at the University of Minnesota who was the editor of the
Journal of the History of Medicine and Allied Sciences
. He doubted whether Wilson and his editorial board would accept it, “especially after reading Vic Cohn's book,” but hoped that if it
was rejected perhaps the
Journal of Bone and Joint Surgery
might accept it.
⁹⁵
Neither journal published his work, but Visscher continued to encourage Myers, reminding him that his material on “the Sister Kenny episode [must] be preserved for future scholars” and urging him to hold onto Wilson's letter of rejection to illustrate “the difficulty in getting matter like this published.” Visscher suspected that timing might be another reason that this topic had not yet intrigued historians, telling Myers “I doubt that present day medical historians are as interested in the Kenny story as some may be a hundred years from now.”
⁹⁶
Myers died in 1978.
⁹⁷
His Kenny manuscript was never published.

By the time Cohn's book appeared, Kenny, as the author had suspected, was fully forgotten. The RKO movie was shown only occasionally on late night TV. Because the Salk and Sabin vaccines had dramatically decreased the number of America's polio cases, the El Monte Kenny hospital, among others, had closed.
⁹⁸
When the disease was discussed at all, it was mainly as an historical artifact. In 1973 the second season of the TV show “The Waltons,” which dramatized the life of a family in Virginia during the Great Depression, opened with a special 2-hour episode in which Olivia, the mother, was paralyzed by polio. Her children sought out an alternative therapy to help her walk again, in this case the Kenny method, which was presented as a kind of folk remedy promoted by a doctor, or as the
New York Times
described it in its review of the episode, “unorthodox treatments developed by a Sister Kenny in Australia.”
⁹⁹
In this episode, the paper noted, “polio is defanged, an occasion for family solidarity as the children, grandparents and father work together to bring hot packs to the bedridden mother.”
¹⁰⁰

Aaron Klein's
Trial By Fury: The Polio Vaccine Controversy
(1972) did not discuss the care of polio patients at all. His chapter on “The End of Orthodoxy” was a study not of polio therapies but of polio science. The work of insightful epidemiologists and pathologists, Klein argued, should have overthrown some of the dearly cherished polio orthodoxies but was initially unsuccessful because “orthodoxies have a way of growing long roots.” Klein also pointed out that during the 1940s “the ‘significant breakthroughs' upon which the foundation fundraisers relied to inspire the public to greater giving were non-existent.”
¹⁰¹

The story of polio as a vaccine victory was solidified with the death of Basil O'Connor in 1972. The
Washington Post
depicted him as the man who had made the polio vaccines possible, and the
New York Times
called him “a singleminded and ingenious fund-raiser.”
¹⁰²
O'Connor, who remained head of the March of Dimes after the Salk and Sabin vaccines were developed, was still considered a shrewd philanthropic organizer, but after the death of Roosevelt and the rise of the Republican Party during the 1950s he was no longer a power broker. In 1965, his claim to have sacrificed his potential earnings as a Wall Street lawyer to take on the voluntary March of Dimes position as director was undermined when the
New York Times
revealed that since 1959 he had been receiving a salary of around $50,000, plus expenses, for the job.
¹⁰³
His memorial service was attended by leading polio scientists; Jonas Salk declared that O'Connor had “made history happen.”
¹⁰⁴
But his legacy as a sacrificial administrator continued to be buffeted by reports of his love of the good life. Only a few months after his death a
Washington Post
commentator
described O'Connor as “a dapper man who lived lavishly at his charity's expense and dealt lavishly with other people's money.”
¹⁰⁵

Florence Kendall never forgot Kenny. She and her husband Henry remained the bulwark of the anti-Kenny movement, and in 1956 Kristian Hansson praised them for having “opposed Sister Kenny's questionable idea of the pathology and the therapeutics of poliomyelitis.”
¹⁰⁶
Their textbooks
Muscles: Testing and Function
(1949) and
Posture and Pain
(1952) became the gold standard for musculoskeletal evaluation and treatment. The books were translated into many languages and were in print through 5 editions into the early twenty-first century.
¹⁰⁷
After Henry died in 1979, Florence became a prominent lecturer and received 4 honorary doctorates. In 2002 she was chosen as a member of the Maryland Women's Hall of Fame, and the Maryland American Physical Therapy Association chapter named her “Physical Therapist of the Century.”
¹⁰⁸
She had always been suspicious of Kenny's bold claims and her florid style of self-promotion. Florence, by contrast, was known as “a drill sergeant [and] … perfectionist,” quick to say “if you weren't taking the time to do it correctly, you were wasting your time—and the patient's time.”
¹⁰⁹

In 1997 Kendall took the opportunity as the John Stanley Coulter Lecturer at the American Congress of Rehabilitation Medicine's annual meeting to revisit Kenny. The search for the best polio treatment, Kendall declared, had been hampered by politics and by the press. Recalling the 1941 meeting with Kenny in Minneapolis, Kendall did not mention the critical report she and her husband had written or the notes she had carefully taken at the end of each day, saying simply that “Henry and I had a brief, not uneventful, personal meeting with her.” During the 1940s, which Kendall termed the Kenny Era, the press had praised Kenny lavishly, ignoring many problems with her work as well as more promising conservative work by orthopedic surgeons and physical therapists in Boston, Baltimore, Los Angeles, and Warm Springs. Her hot packs, for example, were usually so hot that a nurse or therapist needed tongs to pick them up. Although “adverse reactions” were seldom discussed, Kendall knew of a boy with a temperature of 108 who had been hot packed regardless and had “succumbed” (probably a reference to the patient described by Hansson in 1942). As Kenny condemned muscle testing there were no proper statistics to be able to assess her work, but a few studies had shown that her much vaulted recovery rates were no different from those of orthodox care. Kendall compared Kenny's work to that of her husband and herself who had “made continuous efforts to keep records that would provide meaningful information.” Their therapy, sometimes called “traditional, conventional, or orthodox,” had included the use of “moist foments” but also heat lamps, warm baths, half-shell (bivalve) plaster casts, foot boards, sand bags, pillows, rolled blankets, massage “used judiciously,” and immobilization “in rare instances.” “The combined power of politics, the press, and public passion that enveloped the controversy over Sister Kenny and her theories … nearly succeeded in blinding the truth,” Kendall concluded, for “reason, perspective, and judgment can be sidetracked by the hysteria, helplessness, fear and anxiety caused by a devastating disease such as polio.” After all, she reminded her audience of physical medicine experts, “we must hold fast to the sound principles that
have been developed through years of scientific research.”
¹¹⁰
In an era when polio care was barely remembered Kendall sought to turn Kenny into a misguided, unscientific innovator whose methods had fortunately been abandoned.