Polio Wars (47 page)

A determination to conquer paralysis and to ignore the pessimism of doctors pervaded the letters Kenny received. In 1934 doctors had told Dorothy Meissner that she was a hopeless case and would never walk again. Eleven years later Meissner, now a high school student in Morristown, New Jersey, wrote to Kenny. After the doctors gave up on her, she and her mother had devised special exercises even though “the hospital which I attended every day did not know I was doing this.” She then demonstrated her new-found strength to the hospital staff who “were greatly pleased and thought it wonderful but warned me not to try and stand.” She ignored this advice, “thinking that if I did not ever walk again I would not want to live.” After a year and a half Meissner walked into the hospital “and all the doctors gathered around and, Sister, they couldn't believe their own eyes.” Her picture and story were in the newspapers. She was now one of the best tennis players in her school, and could also swim, ice skate, roller skate, and ride horses.
⁷⁰

Others wrote asking advice after they listed in detail what they had done for themselves. Charlotte Birch, a 23- year-old woman from Brooklyn, had spent almost 2 weeks when she was 19 years old in the Kings County Hospital with the left side of her body paralyzed. “I begged to be taken home and at home my parents had a nurse give me massage and hot applications to my hand and foot.” She also “practiced walking when no one was watching.” Within a year she had been able to return to work and was satisfied that now “few people can tell that there is anything wrong with any part of my body,” although her hand was “still not right.” For Birch, her search for therapeutic help made Kenny's expertise crucial. “I was determined to walk and I did and I have the same determination for my hand but I can't remedy it with just determination.”
⁷¹

Kenny's version of polio care—with cheerful, comfortable and active patients—was an inversion of standard institutional care. It also challenged the pervasive fear of polio infection. In dramatic stances she stood next to her patients, usually without any mask, touching their bodies, completely unafraid.
⁷²
Patients with polio and their families were used to being stigmatized. Some neighbors were so frightened that they would not raise the windows on the side of their house next to the home of a stricken patient; people living in the same block would walk on the other side of street to avoid passing close to a patient's house, even after the patient had been taken to the hospital. Many rooming houses and hotels refused to rent rooms to anyone who had been exposed to polio.
⁷³
“Years after I had polio,” a survivor recalled, “when adults saw me coming they would say out loud to their children to stay away from me because they could ‘catch' it.”
⁷⁴

Inside hospitals the staff also stayed away from those who worked with polio patients. One hot packer learned she was “in the ‘dread ward' ” when she went into the hospital's kitchen and “the negro woman almost swooned in terror, saying that so long as I wore that robe, I mustn't go near anyone, nor into any part of the hospital, other than the rooms where the polio was confined.”
⁷⁵
During an epidemic in Florence, Alabama, polio nurses at the Eliza Coffee Memorial Hospital, sitting in the hospital's dining hall, were shunned initially, and “ate hurriedly feeling as miserable as a person who has failed to don a conspicuously necessary article of wearing apparel.”
⁷⁶
By the late 1940s, however, the courage of Kenny technicians as well as a substantial increase in the numbers of patients led to a decline in such strict contagion rules, and even masks were not used on many polio services.

Kenny's work, unlike standard care, made much of the pain of polio—its clinical significance as well as its emotional toll, and the relief that hot packs could provide. For Kenny pain was central to the disease, not an unfortunate side effect of best care, and she spoke of the “tragedy” of orthodox care that left patients with “a look of pain and fear.”
⁷⁷
This pain, which she argued most doctors could not explain, suggested to her that supposedly normal muscles were in fact directly affected by the polio virus and must be treated. For her pain was a diagnostic sign. She began treatment almost at once “while the patient was still in great pain,” arguing that if technicians waited until the end of the 3-week isolation period, stiffness would have started, “deformities have begun to develop, [and] precious time has been lost.”
⁷⁸
Skeptical orthopedists mocked her highlighting of this symptom, arguing that this was the kind of thing an emotional, poorly trained woman would do.
⁷⁹

The popular press loved this debate. The “old treatment” was “painful” and “produced miserable results,”
Colliers
reported, but with Kenny's methods, “pain disappeared in two to three days—instead of lingering for as many weeks.”
⁸⁰
A Buffalo supporter described the faces of the children: “I saw no eyes deeply gouged with pain; I saw no foreheads lined with agony; I saw no lips thinned with suffering. Everywhere was a spirit of optimism, confidence, cheerfulness.”
⁸¹

Some physicians, such as the editor of the
British Medical Journal
, admitted that they had frequently denied the significance of pain in polio, and it was a “matter of reproach that we have so long evaded the questions raised by this striking symptom.”
⁸²
Those physicians who already disliked Kenny and her claims to have transformed the management of polio, however, discounted this emphasis on pain. “In spite of the fact that Sister Kenny harps on the idea that the disease is accompanied by excruciating muscle pain, this
has never in the experience of most of us been an outstanding symptom,” Virginia orthopedist Robert Funsten declared in 1944. Pain was usually present only “when movement is a factor” and was always relieved by immobilization.
⁸³

Kenny and her patients saw the neglect of polio pain as a sign that physicians did not listen to their patients. Many of her medical opponents, Kenny argued, believed that “pain is not an important feature of the disease [but] … this is not the opinion of the patients.”
⁸⁴
Mary Lou Drosten, who “endured four weeks of hell on earth” during her hospital stay, recalled that the staff did nothing to relieve her “pain and discomfort.” She had “no hope in my heart until I learned of the Kenny treatment.”
⁸⁵
William Foote Whyte recalled his “constant and intense pain” in his paralyzed legs in the early 1940s, and the hot packs used at the Massachusetts General Hospital, which “relieved my pain and helped me relax, at least temporarily.”
⁸⁶

Doctors, nurses, and physical therapists found that the use of Kenny methods made the task of maintaining their patients' morale much easier. Kenny's attention to ameliorating pain also led patients to be more cooperative in muscle training. Indeed many child patients saw muscle reeducation as a game. If Kenny's methods were more “generally employed,” one New York physician argued, “there will not occur so many of the emotional and physical wrecks that we see even now, in spite of much of the expensive orthodox treatment.”
⁸⁷
Kenny's focus on alleviating physical pain was also linked to physiological health. Patients who had not had Kenny treatment, according to Ethel Calhoun, a Michigan physician who was a strong Kenny ally, “had severe atrophy and impaired circulation, with blue extremities, dripping with perspiration, and often with ulcers present,” while the skin of Kenny-treated patients was “soft and pliable” with good circulation and “very little atrophy.” Such clinical signs meant that patients could hope for a kind of visible normality. “These patients often remark that they are very thankful they do not look deformed.”
⁸⁸

In both the Kenny treatment and in orthodox polio care, however, muscle stretching to try to achieve full motion was still required, and even with muscles relaxed by heat it was still painful. Polio care had long been based on a fear of stretching muscles improperly, but Kenny was confident that “no muscle is being stretched as long as it is within its normal arc of motion.” In one of Kenny's bold analogies, she argued that to overstretch a deltoid, “a hole would have to be made in the side of the body and thigh and the arm drawn into the hole toward the center of the body.”
⁸⁹
“Most people find the stretching very painful,” Kenny told Ray Gullickson, a Minneapolis patient, but he could manage this pain by recognizing that “pain is just a signal from your body that something is wrong. Once you recognize why it is happening, you don't need to feel the pain anymore.” Her advice “sounded really sensible” to Gullickson, who recalled thinking “ ‘Hey, if it means I'm making progress, I don't need to feel the pain.' And that's really how I felt about it. I've been able to manage persistent pain ever since that day.”
⁹⁰

Kenny's techniques demanded that patients themselves, even toddlers, be active and knowledgeable participants in muscle exercises and learn the location of muscles and “the resultant action of the joint and parts when the insertion of a muscle is pulled upon by the contraction of the muscle.”
⁹¹
Orthopedist Wallace Cole said that Kenny's patients were
given a simple course in muscle anatomy and shown “with the aid of medical illustrations, the position of the muscle and how it works.”
⁹²
“Sister Kenny explained to me exactly what they were going to do and how they were going to accomplish it,” one patient recalled. “She took my right hand in hers and pointed to a muscle in my wrist. As she tapped the muscle with her finger tip, she told me that muscle was the one we were going to start with, and when that muscle started to work, we'd do another and another until we got them all working … she told me to repeat the exercise until I was too tired to continue.”
⁹³

Making a patient “muscle conscious” was quite contrary to standard rehabilitative work with children.
⁹⁴
Indeed Kenny and her technicians exhibited child patients to show the efficacy of the techniques. “Boy how I hated being wheeled out in front of a bunch of poking and prodding doctors,” Clemson Griggs wrote to Kenny, recalling his experience in the early 1940s as a patient for 9 months in the university hospital in Minneapolis. Kenny would tell the audience “ ‘Now, Mr. Griggs you tell your story!' You don't realize how hard it is to make a speech with no clothes on when you are lying flat on your back and looking at the ceiling … I consider that 9AM performance my small contribution to your work.” He remembered that he had learned “a lot of about muscles and their work. I can still rattle off quite a few of them, but they are getting hazier all the time.” Griggs was now the head of a hacksaw factory in Middletown, New Jersey, had 3 children, and enjoyed ice skating, and concluded “I bless you and your ‘quack treatment' more and more every day of my life.”
⁹⁵

Warm Springs physical therapist Alice Lou Plastridge had been “very much impressed with the way Sister Kenny teaches the exercises.” Patients were made “muscle-conscious” to such a degree that “even little six year old children would put their fingers on the outside of their hip if you asked them what pushed the leg sideways.”
⁹⁶
Even 2- and 3-year-old children were taught the Latin terms for their muscles. A favorite story during Kenny's early years in Minneapolis—repeated by Lois Miller in the
Reader's Digest
—concerned Suzy, a 3-year-old girl who named each individual muscle of her thighs and calves “by its long Latin name.”
⁹⁷
A New York physician mocked the idea that paralysis could be improved “by hot packs and finger manipulation, or by educating 4 or 5 yr old children by talking.” In particular, the idea of telling Suzy, identified by the
Reader's Digest
as a “colored girl,” to “flex her Gluteus Maximus & she did” was “absurd.”
⁹⁸
In reply pediatrician Philip Stimson protested that this element of Kenny's work was effective and rational. “As for teaching little children to know the names of muscles, I myself have heard the four year old colored girl name and flex 8 or 10 of her muscles.”
⁹⁹
That Kenny's methods gave even young patients the psychological confidence to talk back to skeptics was a delightful example of Kenny's lack of deference to medical authority; that the girl in question was identified as “colored” made it for contemporaries even more shocking.

FIGURE 4.2
Jack Delano, a New Deal photographer, depicted Kenny demonstrating an acrobatic move by an Institute patient during a class for nurses and physicians, February 1943. Courtesy of the Library of Congress, Prints & Photographs Division, FSA/OWI Collection, LC-USW3- 017586-D [P&P] LOT 768.