Polio Wars (114 page)

By the early 1980s polio epidemics in the United States were a thing of the past. Polio survivors had largely accepted the idea that their individualized physical therapy had enabled them to “conquer” polio or at least that their remaining disabilities would not get worse. Most specialized polio centers had closed, and physical medicine specialists now worked with conditions such as multiple sclerosis and cerebral palsy. Some adult survivors in visible apparatus such as wheelchairs or iron lungs published institutional newsletters, which satirized rehabilitation institutions and berated the “A.B.” (able-bodied) world, advocating for full access to public facilities.
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But outside of these few newsletters, polio survivors tended not to identify as a community.

Only in the mid-1980s, with the emergence of Post-Polio Syndrome (PPS), did polio gain a new cultural prominence. Frustrated at the growing weakness in muscles they had “normalized” through hard work—along with other symptoms such as joint pain, sensitivity to cold, and extreme fatigue—survivors began to seek medical advice. Physicians, they discovered, had rarely if ever treated a case of polio and did not see these symptoms as indicating anything other than the familiar signs of aging. Identifying this emerging syndrome and fighting for its proper diagnosis and treatment brought together polio survivors who had rarely thought of themselves as a distinctive community before. Dissatisfied survivors created a new specialty with a new set of experts, a few of them polio survivors themselves such as rehabilitation physician Lauro Halstead who organized the first international PPS conference at Warm Springs in 1984.
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Survivors also began to develop a counternarrative about their previous polio care. The lessons taught by nurses, physical therapists, and physicians during the epidemic years, PPS activists now argued, had been counterproductive, for “pushing through” did not, as promised, bring stable physical achievements. New medical research suggested that polio survivors may have originally recovered muscle function through a process of branching or regeneration whereby surviving nerve cells developed extra branches (axonal sprouts) that reattached themselves to orphaned muscle fibers. Survivors developed PPS because these branches had been under heavy usage for some years and therefore were likely to age especially rapidly.
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It was a devastating new science of muscle physiology.

As weakness forced many PPS survivors to move to crutches and wheelchairs, some became disability rights activists. Survivors turned newsletters into activist organizing tools. One, the
Toomeyville j. Gazette
, was named after a critic and rival of Kenny's. Ideas such as rights and citizenship buoyed this community whose members had previously been isolated not in institutions but in the self-perception of being “cured.”
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Polio survivors were key lobbyists for the Americans with Disability Act of 1990 and joined other activists to protest the proposed 1997 Roosevelt memorial that gave no indication of his disability, leading National Park Service officials to agree reluctantly to add a statue of Roosevelt seated in his wheelchair.
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As stories of Kenny resurfaced in PPS newsletters and memoirs, a newly harsh memorialization emerged. Survivors remembered the messiness and pain of hot packs and the careless and brutal way they had sometimes been applied. As one survivor recalled, “two times every day the therapists took hot packs out of the boiling water. The wool was too hot for them to touch so they used tongs. Every time they threw them on my bare legs I screamed.” Others reported “they still feel fear when they smell wet wool.”
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In his memoir, Robert Hall, who had been a patient in an Omaha county hospital in 1949, described how the treatment cart, a shiny cylinder for heating the hot packs, emitted steam with such “an acrid, nauseating smell” that he had gagged. The packs were greased with a “jelly like substance, to keep you from burning” and then the “steaming and stinking” flannel pieces were placed on the skin. In his memory “the packs sapped my strength more than my polio did.”
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Dorothea Nudelman recalled other children on her polio ward screaming during hot pack treatment, and when she herself was burned she “sobbed out loud, wore myself out with it. The shock was as bad as the pain. I knew it could happen again.”
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Although Kenny claimed to take pain seriously as a crucial symptom that must be relieved, pain was a constant part of polio therapy, whatever method was used, even Kenny's. Robert Hall's memory of pain came with the use of a footboard, which the Kenny method used to anchor the patients' feet, stretch the leg muscles, and “re-establish and … stimulate the normal standing reflexes.”
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“My hamstrings hurt more and more the tighter they became,” Hall recalled. Kenny had instructed her technicians not to use the footboard until the leg muscles were no longer in spasm, but the distance between Kenny's prescriptive directions and routine hospital practice can be seen by the horrific example Hall reported of 2 men in his hospital ward who writhed in pain “back and forth across their beds with their feet anchored to their footboards.”
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In 2002 psychophysiologist Richard Bruno published
The Polio Paradox
, which sought to explain why polio survivors had been reluctant to link their new symptoms to their former experience with polio. Among other factors, Bruno drew attention to examples of abusive care suffered by survivors years earlier. In shocking vignettes he quoted survivors who recalled nurses who slapped them and turned off an iron lung to punish them for crying and physical therapists who lay on a patient's knee to stretch the muscles in the leg while the patient screamed and who hit patients with rubber truncheons to make them stand up in their braces.
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Not all mistreatment, of course, took place on wards using the Kenny method, but some was a specific result of her treatment.

According to Bruno, some of Kenny's techniques “to identify alienated muscles and … to get polio patients to ‘take up their beds and walk' were painful, terrifying, and also dangerous.” On occasion polio survivors recalled Kenny herself as one of the abusers; in one recollection in Bruno's book Kenny “slapped me on the face several times as a means of ‘defining my reflex response.' ”
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This sounds quite different from the frequent descriptions of Kenny's gentle hands and her reminders to technicians that “the handling of the patient should always be so gentle that pain is never caused as this arouses fear in the mind of the patient and defeats efforts to get his cooperation.”
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In Australia in the 1980s both PPS communities and feminist scholars rediscovered Kenny. In 1983 feminist writers added Kenny to their list of Significant Australian
Women, drawing with relish a picture of a “boastful and tactless” nurse who “rebelled against so-called respectability” and sought acceptance “on her own terms.” Her lack of formal education and her limited knowledge of anatomy had meant that some of her claims were “untrue and based on ignorance,” and she antagonized the medical profession “by exaggerating her success.” Unlike Australian physicians who had treated her with hostility, American physicians had “followed the lead of this self-taught, elderly nurse from outback Queensland,” and as a result “polio treatment in the United States changed almost overnight.” She had invented “a ‘respectable' education and nurses' training course,” but she had also “persevered against great odds to prove that ‘experts' are not always right” and “brought about a revolution in medical treatment and relief and hope to people all over the world.”
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The authors also quoted Hollywood star Alan Alda who tried to make Kenny a feminist example, telling an Australian women's magazine in 1980 about his experience as a boy paralyzed by polio: “If it weren't for an Australian woman, Sister Kenny, I might not have lived … I got the Sister Kenny treatment—it was a very rough treatment with hot packs, but it kept me from becoming crippled. I might not have lived if Sister Kenny had not been inventive, creative and exploratory—all those things that men are supposed to be.” What this interview did not mention, but appeared in his later memoirs, was that this Kenny treatment had been designed and practiced by his mother who had been inspired by Kenny's work as it was described in newspaper and magazine articles.
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In 1995, writing as a nurse activist and a historical sociologist, John Wilson provided a scholarly examination of Kenny's work, arguing that many of her clinical insights were crucial for today's nurses.
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In 2004, drawing on material provided by a polio survivor, a biographer, a psychologist, a cultural historian, and Mary Kenny McCracken, the Australian Broadcasting Commission produced a radio show entitled “Sister Kenny: Saint or Charlatan?” Hers was “a name that rings few bells these days” historian Michelle Arrow acknowledged. She was “a self-trained Aussie bush nurse” who “claimed she had the answer to polio, and Americans believed her.” On one side Betty Newell, daughter of Charles Thelander (chair of the 1938 Queensland Royal Commission), unsympathetically declared that “Kenny's egotism was incredible … I think she actually believed her own propaganda to a huge degree.” Kenny had once sat at her father's dinner table, Newell recounted, and told the family “I put my hands on the little withered limb and I feel my power going into it,” a statement that was followed by “silence at the dinner table.” In a quite different tone Mary McCracken recalled that Kenny would say “Oh, it's useless to try and convince these blockheads,” and Mavis Bosswell, a former patient at the Townsville clinic, praised Kenny's work, while admitting that in her case her muscles were too badly damaged to allow her to able to walk again. McCracken's effort to defend Kenny's significance could not overcome Arrow's presentation of Kenny as part charlatan, part messiah, and a “great self-publicist.” University of Sydney psychologist Mary Westbrook, a polio survivor who had studied PPS, claimed that Kenny's theory of polio “was just medically, anatomically, physiologically so unsound.” But like Cohn, Arrow was not interested in debating the scientific issues. She noted that while Kenny had never found a “cure” she had given patients “hope.”
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Despite her dream of a lasting legacy Kenny has only a few memorials in Australia or the United States. In Warialda, her birthplace, the local Baptist church has a memorial stained glass window that was a gift from the KF. In Townsville, where she had her first government clinic, there is an Elizabeth Kenny playground and also a memorial sundial.
In Nobby, where she lived and later died, the town council and the Nobby branch of the Queensland Country Women's Association established a memorial park, and the house where she lived with her mother and Mary has been opened as a museum with a Kenny mural nearby.
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To honor the fiftieth anniversary of her death, donors to the Australian Sister Kenny Memorial Fund, which has provided scholarships to nursing students with an interest in remote and rural nursing, established the Sister Elizabeth Kenny Chair in Rural and Remote Nursing at the University of Southern Queensland.
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There is no special museum in Minneapolis, although Kenny is still important for the city. In 1986 the Kenny Institute celebrated Kenny's 100th birthday, discovering too late her true 1880 birth date. During the celebration Institute employees wore “Kenny” clothes as they showed children an iron lung, an odd choice considering Kenny's longstanding dislike of that technology. Institute medical director Richard Owen, a polio survivor, recalled the time in the 1940s when Kenny had visited the Indiana hospital where he had been a teenage patient; she was “an awesome lady, large physically and in aura.” Her ideas about early mobility and reeducation were still part of current therapies for spinal cord and head injuries, Owen said. While “she did not know the technical language of medical doctors” she made accurate observations, which others had missed, “that were totally correct.”
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Kenny's place in the region's history was cemented in 1989 when Leonard Wilson, who had rejected Myers' article on Kenny for the
Journal of the History of Medicine and Allied Sciences
in the late 1970s, devoted 8 pages to her in his book on the history of the University of Minnesota's medical school. Wilson portrayed Minnesota faculty members as hospitable and open-minded, especially dean Harold Diehl, who was “remarkably open to new ideas” and “a perceptive judge of character.” In Wilson's assessment, “although her training was that of a nurse, Sister Kenny acted toward poliomyelitis as a Hippocratic physician” and university physicians “gave Elizabeth Kenny's methods a full and fair trial when no one else would, to the immeasurable benefit of poliomyelitis patients during the fifteen years or so before the introduction of polio vaccines.” While noting that “many medical men were never reconciled to Sister Kenny, and attacked her repeatedly,” he did not name Visscher or Myers.
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Healing Warrior
, a children's book about Kenny published in Minneapolis at the same time, defended Kenny's invention of professional credentials because she believed “doctors wouldn't listen to her if they knew she was not an educated, certified nurse.”
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In 1992, Owen and other administrators organized a celebration of the 50th Anniversary of the Institute, calling on former patients and their families to offer their memories and honor “a pioneer in changing the way the world viewed polio treatment.” The Institute featured an exhibit on Kenny, a portrait of Kenny at the Institute was restored, students at the city's Kenny School studied the Kenny story, and the state's governor declared December 17 Sister Kenny Day. The city hosted an Indoor Wheelchair Tennis Tournament along with the International Art Show by Disabled Artists, an annual event partly sponsored by the Institute.
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In a local newspaper Henry Haverstock, Kenny's former patient, reminded readers that “doctors could never quite understand or accept her theories, but they could not dispute the evidence of their own eyes.”
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