Polio Wars (29 page)

Kenny also took her work to the people. In 1942 she traveled several times to Chicago and New York and also visited Wilmington, Cincinnati, Columbus, New Orleans, and Boston. When polio outbreaks appeared in Memphis and Little Rock she went there where a
Life Magazine
photographer caught her glistening face and unruly hair, and
Time
praised the way her technicians were showing Arkansas doctors and nurses how to use
“her gentle, natural exercises” that helped muscles regain their normal coordination “before dangerous new behavior patterns can be set up.”
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Wealthy parents, worried that a journey to Minnesota would harm their paralyzed child, begged her to visit their home or local hospital. Kenny used these opportunities to speak to new audiences. “Mary and I had our hotel expenses at the Medical Society meeting paid for us by the father of a little girl from West Virginia who had benefited [sic] by our treatment,” Kenny noted in May 1942, “so the only expense was our return fare.”
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In an era when commercial flights were rare, Kenny flew whenever she could, explaining that traveling by air enabled her to “limit the time away from my classes as much as possible.”
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FIGURE 3.1
Photograph of Kenny and a child patient during the LittleRock, Arkansas, epidemic in 1942, featured in
Life
; “Sister Kenny: Australian Nurse Demonstrates Her Treatment for Infantile Paralysis”
Life
(September 28 1942) 13: 73. Courtesy of Time & Life Pictures/Getty Images.

Courses in the Kenny method were formally institutionalized after Gudakunst and O'Connor came to Minneapolis in February 1942 where they met with university officials and local physicians.
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Drawing on the model of postgraduate courses already in place at the university, the new program was directed by Knapp and financed by the NFIP. There were 1 week courses for doctors, 3–4 month courses for physical therapists, and 6 month courses for nurses.
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Kenny was pleased that her ideas and techniques were being taken seriously by exactly the experts she had hoped to impress, but she could see that others were trying to take control of her teaching. While O'Connor had “asked me to present some scheme about instructing people,” she complained to Dean Diehl a few weeks later, “it is evident that that had already been arranged before he saw me.”
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The NFIP had indeed, as Kenny guessed, begun to discuss how to institutionalize her work not just at the University of
Minnesota but at a variety of centers.
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At O'Connor's urging Robert Bennett, the medical director of Warm Springs, visited Minneapolis where he “talked at great length with the medical and technical personnel working with Miss Kenny.”
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Like Kenny, Bennett recognized the power relations in polio care. Most patients with polio were cared for by hospital nurses and physical therapists who practiced under the supervision of physicians in institutions with set routines. Patients in polio's acute stage—the stage at which Kenny insisted her work must begin—were sent first to infectious disease hospitals where there were strict contagion rules. To alter clinical practice Kenny technicians had to be admitted to these hospitals and then be able to continue their work during a patient's convalescent stage whether in a hospital or a child's own home. Such changes required the support of supervising physicians, professionals who were the lynchpin between Kenny's teaching and hospital routine.

Bennett believed that the most important immediate need was “to acquaint the medical profession with all available scientific proof supporting the concepts of this system and to outline to them the treatment in their own language.” Physicians who directed physical therapy schools should be sent to Minnesota so this system could be quickly incorporated into physical therapy teaching programs. Although Bennett clearly saw Kenny's work more as a clinical innovation than a radical reinterpretation of polio's pathology, he did agree that there was a need for fundamental research that would “be the basis upon which all long range estimations of the system could be evaluated.” In a frank letter to O'Connor he admitted that, considering the skepticism of many of his peers, it would be “wise at present that all research should be designed to prove the merits of the system rather than to disprove them.”
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Here then was a deliberate plan to institutionalize clinical change, with an emphasis on physicians as supervisors and potential researchers. In addition to the Kenny courses at the University of Minnesota, the NFIP began funding courses at other medical and nursing schools around the country including Stanford, the University of Southern California, Northwestern, New York University, the D. T. Watson Home in Pittsburgh, and Warm Springs.
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Kenny's pedagogic philosophy was based on changing the minds of physicians and retraining the hands of nurses and physical therapists. She was careful to make her technician courses as formal as possible. Students attended lectures and demonstrations, worked with patients under the supervision of her Australian staff, and after experience with acute patients (something that depended on the erratic nature of polio outbreaks) sat an examination. Only then were they awarded what was called a certificate of efficiency.
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By early 1943 more than 100 had become Kenny technicians.
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This teaching, Kenny believed, was and should be a struggle, for her students “are taught symptoms and condition of a disease … they had no idea exists.”
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She had little sympathy when students complained about her teaching style. The Webber scholarship nurses, she reflected in 1943, “rebelled and wept and thought they were being requested to learn too much” but later came to “thank me for the knowledge given them and the way it was given.”
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Kenny was well aware of the pragmatic difficulties of introducing her work in institutions with antagonistic health professionals. Every technician, she explained to O'Connor, should have a “duly qualified medical practitioner” who could understand the method and supervise it. Still, she added, even if her technicians were only partly trained “no doubt, whatever they did it would be an improvement on previous treatment.”
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Kenny shortened this idea to “poor Kenny is better than the best orthodoxy,” and her students
shortened it further to “P.K. is better than B.O.”
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With her technicians' medical supervisors, however, she argued that the complexity of her work required full training. She had hoped to be invited to Warm Springs, but instead Robert Bennett sent 3 of his physical therapists to Minnesota, assuring her that they were “particularly keen individuals who have excellent knowledge of applied anatomy and who are very sympathetic with your work.” When Bennett recalled his therapists to Georgia after only 3 weeks, Kenny warned him that it had been “impossible for them to learn the work during their short stay” for, in an argument she used frequently, “the time has been so short that the ideas have not had any time to sink in and, therefore, will not be permanent.”
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Later she was annoyed to hear that Warm Springs was offering courses in the Kenny technique.
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For their part her graduates reveled in a method they saw as a break from older unsatisfactory practices. One New York City therapist—who described herself as still “green”—told Kenny there were “hundreds of Physiotherapists who are grateful to you for enriching their profession with your knowledge.” Kenny's training had given her a sense “of Anatomy and Body Mechanics, far clearer and with a deeper foundation than all the books, lectures, and 200 hours of dissection I have had.”
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For physical therapists and nurses familiar with the careful, repetitive work necessary to rehabilitate disabled bodies, Kenny's method seemed fresh and modern, an attack on medical orthodoxy in a safe way. This treatment “has added new zest to a job I was already crazy about,” one graduate admitted, “it is fun to be doing polio work when there are such bright prospects for the patients.”
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Technicians returned to their home institutions armed with fervor, new skills, and the promise of impressive results. For some, this training made them minor celebrities; for many it provided an opportunity to become teachers in their own hospitals, instructing not only their peers but also their supervisors. At the Children's Hospital in Los Angeles Dorothy Behlow was confident that she had proved to the medical staff at her hospital that “there is a great deal more to the Kenny Treatment than just packing” and that it was “far superior to any other form of treatment.” She proudly described how her clinical results had countered pessimistic prognoses. With one patient “the tendon work-up is wonderful. At first, no anterior tibial; ‘Gone,' cried the doctors and other physiotherapists, but hear them now when it appears when working up the tendons! It is the most exciting and thrilling work I have ever done.” In a postscript Behlow added that “If I lived to be 100 yrs. old I could not begin to repay you for [the] knowledge you have given me. Thank you Sister, from the bottom of my heart.”
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FIGURE 3.2
Kenny technician Valerie Harvey demonstrating a muscle to a group of physical therapists, flanked by Sister Kenny (left) and Mary Kenny (far right) [perhaps 1942 or 1943]. Box 11, Elizabeth Kenny Papers, Minnesota Historical Society, St Paul.

Taking Kenny's course in Minnesota was also exhilarating. A cult of personality emerged, especially among the first generation of Kenny technicians. “You are the first truly great woman I have ever known personally,” Adelaide Smith of Pittsburgh gushed.
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With their minds full of the stories Kenny had told them about antagonists and converts, her students saw their own struggles to convince other professionals as part of the same narrative. One therapist was treating 27 patients and “at night, after hours and hours of work, I return home discouraged and tired, ready to quit but I seem to get a lift as I glance at your photograph and think how brave and courageous you were thru [sic] all the years with barriers all along the way.”
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The personal loyalty among Kenny technicians to their teacher occasionally pitted therapists against their supervisors. Thus, after NFIP medical director Don Gudakunst visited the Kenny technicians working in Little Rock during the 1942 epidemic and told them that there were “too many of us down here” and he would send some to other places, Ethel Gardner, one of the Webber scholarship students, let Kenny know that she and the other technicians had replied flatly that “you sent us here and here we stay until you tell us to come home. We don't pay any attention to him and will not do a thing for him without orders from you.”
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Technicians told Kenny about their successes and failures. My “whole community is thrilled over the Kenny Method,” Emily Griffin wrote from the Monmouth Memorial Hospital in Long Branch, New Jersey. Administrators at her hospital had been “wonderfully cooperative” and had turned an isolation ward into a Kenny Ward. Griffin was teaching hot pack classes to other therapists and nurses who were all enthusiastic.
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Other graduates grew discouraged. Lorraine Paulson had come from the D. T. Watson Home in Pittsburgh to study with Kenny for 6 weeks and she left vowing “she would prefer not to treat a patient at all if she had to resort to the old method.” But Paulson was not able to change polio practices in her institution, and within a few weeks Kenny received letters from the parents of patients complaining that splints had been reapplied.
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A single physical therapist or nurse could not alter the entire routine of a hospital's entrenched practices or the views of medical skeptics. A New York therapist became so frustrated by one mocking physician that she “burst out, hurt the gentle doctor's ego” and then was reprimanded and asked to resign. In her experience physicians were inherently resistant to change. “I am surprised you are still sane after the trouble you have had dealing with the most jealous, egotistic and blind profession,” she told Kenny bitterly.
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