Polio Wars (30 page)

Kenny and her technicians fought to ensure that Kenny training remained on a strictly professional level, available only to respectable professionals and used solely for altruistic purposes. After studying with Kenny and returning to San Diego, Ruth Giaciolli complained that a local woman osteopath “thinks I will teach her your method in two easy lessons [but] … I have no intention of trying to teach your method to any persons likely to use it for personal gain. It should remain on the sound ethical basis upon which you began it.”
⁶¹
Giaciolli was not the only technician to note that “many unscrupulous
practitioners of massage & Chiropractory [sic] are only too willing to accept money for treating chronic polio with Kenny Hot packs.”
⁶²

In Honolulu technician Charlotte Anderson, working at an Emergency Poliomyelitis Hospital run by the Office of Civilian Defense, was pressured to offer short training courses by her hospital's medical director who, Anderson told Kenny, was “
very
anxious to have us teach other technicians.” But Anderson resisted, believing “the only place to get proper training is with you.” She asked Kenny to explain to her hospital director the necessity of a formal course with high standards. He was planning to visit Minneapolis and “perhaps you can make him realize it would not be right for us to do” this training, without, she hoped, “mentioning our names.”
⁶³

These experiences left both Kenny and her technicians more than ever convinced that supervising physicians must visit Minneapolis to learn to understand and respect the Kenny method. Miland Knapp shared this view. “It is obviously impossible for a technician to treat a case under the supervision of the doctor who knows nothing about the method being used,” he reflected after a year as director of the Kenny courses. In his experience “one of the most satisfactory ways for the Kenny treatment to be established is to have the doctor come to a class first and become so enthusiastic about the method that he arranges to have a technician and nurse trained.” Aware of the tensions inherent when a subordinate hospital staff member tried to institute change not understood or appreciated by senior staff, Knapp had on occasion “considered refusing the application of technicians where a physician has not agreed to take the course also.”
⁶⁴

Physicians may have been wary of the purple prose in popular magazines but they were impressed by reports in
JAMA
and other medical journals indicating that old-fashioned polio therapy was being modernized. So many researchers now admit that immobilizing limbs causes “destruction of muscle fibers as well as irreparable joint changes,” one physician remarked in January 1942, that “it is hardly necessary to devote much time to the benefits derived by discarding immobilization.”
⁶⁵

The first formal course for physicians began in March 1942. Led by Pohl and Knapp, with a number of lectures and demonstrations by Kenny, the courses were intended to turn the curious into converts, and to inspire them to send their nurses and physical therapists to Minneapolis for full training. Knapp's lectures on pathology and physiology were very good, one physician commented, impressed by Knapp's comments that “there has been no research yet which refuted Miss Kenny's ideas on the pathology in Infantile Paralysis” and that her work was “opening up a field of research to you doctors unafraid to face new ideas.”
⁶⁶
With funding from local NFIP chapters class size ranged from 10 to 34 physicians. Although Kenny and NFIP officials hoped to attract supervisors in infectious disease hospitals where acute stage patients were treated, most physicians in the classes supervised convalescent care: pediatricians, orthopedic surgeons, and physical medicine specialists.
⁶⁷
By early 1943 around 200 physicians had attended.
⁶⁸
A number of other physicians who could not travel to Minnesota began to use a version of Kenny's methods after reading about them.
⁶⁹

In an era when nurses were expected to defer to physicians and when women rarely taught medical or science subjects to men, it must have been a shock for these physicians to see and hear Kenny. With a style perhaps closest to the matron of a nursing school, she was uncompromising in asserting the truth and logic of her own ideas. Not interested in a middle ground, she refused to present her ideas as a development of established standards or to alter her distinctive and sometimes confusing terminology by making analogies to more familiar terms. She told the physicians in her courses, as she recalled it in 1943: “if they wished to learn what I had to teach them, they must begin by understanding that the disease they were so familiar with simply did not exist.” On the other hand, “if they wished to continue treating for symptoms with which they were familiar, then my lectures and demonstrations were a waste of time.”
⁷⁰
She understood that she was overwhelming men and women not used to being overwhelmed.

Kenny saw doctors as supplicants who needed to be converted and many did become believers. One epidemiologist told her that “after seeing from day to day your work and results I had to admit that we were wrong and you were right. I thank you all very much for the ‘conversion of ideas.' ”
⁷¹
Even suspicious physicians were eager to hear from those who had seen Kenny in action. Floyd Clarke, a member of the June 1942 class, gave a talk on the Kenny treatment for the Omaha-Midwest Clinical Society to an audience of around 700.
⁷²
Some of the doctors who attended the courses were amused; most were intrigued; and many left determined to convince their own colleagues and hospital directors that patients needed these new methods and properly trained technicians.

Still, many physicians who praised her work's clinical applications distanced themselves from her theories. Thus, pediatrician Irvine McQuarrie told everyone that although he was not convinced by most of Kenny's ideas, if his own child had polio he would want to have Kenny's method used.
⁷³
Perhaps, Kenny hoped, this sort of endorsement was only the first step and gradually physicians would want to seek out explanations for the efficacy of her methods.

Other physicians who publicly identified themselves in favor of these new clinical practices were nonetheless careful to present their change of heart as the result of scientific skepticism.
⁷⁴
Mayo physician medicine expert Frank Krusen knew he would be taken more seriously when he hesitated to affirm his belief in Kenny's work. In his “Observations on the Kenny Treatment of Poliomyelitis” published in the
Proceedings of the Staff Meetings of the Mayo Clinic
in August 1942 Krusen reminded his colleagues of how skeptical he had been from the outset. When he had been asked by O'Connor to serve on a committee to evaluate Kenny's work and had protested that he was skeptical about the whole procedure, O'Connor had assured him that “my skepticism eminently qualified me for membership on the committee.” Only after he had finally visited Minneapolis himself and examined Kenny's patients did he acknowledge how impressed he was with her clinical results.
⁷⁵
Kenny similarly saw that characterizing her medical allies as initially skeptical helped to demonstrate their credibility as scientific professionals. Krusen, she often pointed out, had “thought I was unbalanced when I arrived in the United States and presented my ideas.”
⁷⁶

The enthusiasm of Cole, Knapp, and Pohl continued to trouble their colleagues in orthopedics and physical medicine, especially when the NFIP published their June 1942 article in
Archives of Physical Therapy
as a separate pamphlet. To prove it was not the result of being swayed by Kenny's personality all 3 physicians began to stress how skeptical they had initially been and how only the objectivity of close clinical
observation had led them to change their minds. “Nothing occult is involved in her methods,” they assured their peers; indeed her complex therapies required “an intimate knowledge” of anatomy and the neuromuscular system.
⁷⁷
Pohl had been so skeptical of the work at first, Krusen claimed, that he had refused to have his name appear on the first publication in
JAMA
although he was now “a most enthusiastic advocate of the procedure.”
⁷⁸

Another skeptical convert was prominent Chicago orthopedist Philip Lewin, who taught at Northwestern's medical school and was the chair of the NFIP's Aftereffects Committee. His 1941 polio textbook had called Kenny's methods “of questionable practical value” and Kenny had named Lewin's book as an example of mistaken old-style polio care.
⁷⁹
But after Lewin came to Minneapolis to see her work in person, he “completely changed his views,” as the
Saturday Evening Post
put it.
⁸⁰
At the annual meeting of the Illinois State Medical Society in May 1942 Lewin argued that Kenny “has jarred the medical and allied professions out of their complacency into an immediate offensive attack on the local condition which she has proved exists.” Continuous rigid splinting “is not only ‘on its way out' but … it is ‘out.' ” Kenny's patients, he declared, were “in better condition than any similar group I have seen anywhere in the world.”
⁸¹
Kenny delighted in this admission of conversion and called Lewin her first American disciple.
⁸²

Pediatrician Philip Stimson became another Kenny convert. Stimson came from a patrician family and had graduated from Yale (1910) and Cornell's medical school (1914).
⁸³
An excellent public speaker, he was frequently sent by the NFIP to regional medical societies to talk about polio care.

Even before meeting Kenny in person, Stimson had begun to refer to her ideas in lectures, admitting that after reading about her work he had altered his own hospital practice by doing a little less immobilization and by putting heat on “a cramped muscle … to keep it from getting stiff.”
⁸⁴
Stimson first met Kenny when she visited the Willard Parker Hospital, the city's infectious disease hospital, in September 1941. Thereafter he began to use her methods systematically and with the urging of the NFIP gave numerous talks to local medical societies using her terms
spasm
,
incoordination
, and
alienation
. After offering a detailed description of her methods, he concluded (and this final line in his notes for one talk was underlined) “
A little Kenny is better than none.
”
⁸⁵

By the time Stimson reported on his own Willard Parker patients at an NFIP meeting in December 1941 he had become a skilled presenter who dramatized Kenny's methods using a model. He preferred “a pretty nurse … in a bathing suit of the bra and panties type [or] … a gym suit costume.” On one occasion when “a male orderly in bathing trunks was provided … the audience was not half as interested in the actual demonstration.”
⁸⁶
In early 1942 Stimson invited Kenny to lecture to the New York Physical Therapy Society where several orthopedic surgeons agreed during the discussion that immobilization could be harmful, damaging, and crippling, that spasm was a significant symptom, and that surgeons had “concentrated … too much on the diseased nerve cells [and been] … afraid to stretch the muscles.”
⁸⁷
While Kenny saw such occasions as opportunities to defend her work, Stimson said privately that he had invited her mostly for entertainment. “She is a terrible talker,” he admitted to a friend, “and really not worth hearing, but she is well worth seeing.”
⁸⁸

As Stimson became identified as a Kenny convert, he was confronted by antagonistic opponents. After hearing him give a radio talk that seemed to be endorsing her views, one physician sent him a reprint of his own prize-winning essay on polio that had warned of “numerous quacks who thrive upon the ignorance of the unfortunate people” and proposed the use of a light corset or a well-padded splint along with massage, heat, electricity, muscle training, and hydrotherapy.
⁸⁹
Charles Zacharie, another physician who heard Stimson's radio talk, felt that Stimson's training and hospital connections showed that he was educated and intelligent, which made his praise of Kenny all the worse. Zacharie was convinced that Kenny had “never studied Pathology, Histology, nor Anatomy nor Diagnosis, nor Symptoms.” Mocking the doctors who had “all jumped on the Kinney [sic] Wagon,” he argued that her methods could not “cure or prevent atrophy of muscles & the deformity that goes with it,” and that, in any case, hot packs “were known & used way back in 1600 in many diseases before you and Kinney [sic] were born.”
⁹⁰
Stimson replied courteously that while he agreed that Kenny “knows nothing of histology, and very little about the central nervous system,” nonetheless “she has a greater knowledge of muscle anatomy and muscle function than most doctors, obtained by many hours of study.” “On the speakers' platform” she was “more apt to antagonize doctors than win them over,” Stimson admitted. “But at the bedside, she is an entirely different proposition” for “practically every doctor who has seen her at work [agreed] … that at the present time, her methods of treatment are the best we have for minimizing the after-effects of the disease.”
⁹¹

It is difficult to say how much of the opposition to Kenny's treatment was based on actual clinical disagreement and how much was the result of resistance to change and the feeling of being under attack. “It is interesting, and if one can take it, stimulating to have one's life-long theories and teachings completely reversed,” a Philadelphia orthopedist remarked to a medical audience.
⁹²