Polio Wars (48 page)

Her muscle exercises worked, Kenny argued, because they helped patients reconnect a “physiologic block.” Initially even sympathetic medical observers assumed that she was simply using different language to talk about ways to teach patients to avoid muscle substitution (the use of a strong muscle to substitute for a weak or paralyzed one). Winnipeg orthopedist Alfred Deacon, for example, praised the way patients were taught the normal action of muscles to prevent “attempts at muscle substitution.” Deacon was not sure that Kenny's methods really enabled patients to reestablish a pathway between nerves and muscles, but he did find that teaching patients “to think of and gradually to achieve motion in the affected muscles” showed impressive results, whatever the mechanism.
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The connection between mind and body, and the faith that the mind could—with proper training—address faulty neurological connections was, however, fully accepted by many of Kenny's patients. Haverstock recalled in 1942 that Kenny had showed him “exactly what a muscle does.” “Miss Kenny would ask me to concentrate while she trained a muscle, and after a lot of training, I could move it myself.”
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Kenny's treatment depended on patient participation. She had trouble dealing with a patient who “was not cooperating with his treatment and just lying in bed, feeling sorry for himself,” another patient recalled. “I could tell that she had very little patience left [for] … it was obvious that she'd rather work with people who were willing to try and get well.”
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Professionals unwilling to believe that Kenny's methods had any neurological effect argued that teaching patients muscle knowledge and giving them an active role in physical therapy was simply a useful psychological tool. After Toinette Balkema, head physical therapist of the Children's Orthopedic Hospital in Seattle, returned home at the end of her Kenny course, she reflected “your method of reeducation is completely reasonable, very satisfying and successful. The children express great liking for the stimulation, probably because it tends to release tension. They also show interest in the passive exercises and are pleased when their cooperation warrants active work.”
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Army psychiatrist Charles Bohnengel saw Kenny's muscle training methods as “chiefly a psychotherapeutic measure” based on reassurance and suggestion, which were “well-established methods of psychotherapy.” In “An Evaluation of Psychobiologic Factors in the Re-Education Phase of the Kenny Treatment for Infantile Paralysis” published in
Psychosomatic Medicine
, Bohnengel argued that the “cheerful, hopeful, confident atmosphere” of hospital wards using Kenny's methods exerted “a strong influence over emotional forces within the individual,” especially compared to the “general environmental and sociologic attitude of gloom and dread” typical of hospitals practicing “older methods of treatment.” Patients who “learn to identify by name and physiologic action all of the important muscles of the body … derive pleasure from this accomplishment.” Unlike surgery and splinting in which patients were expected to subject themselves “passively to mechanical manipulation,” here the patient played “an intrinsic and active role in the treatment.” Bohnengel was also
impressed by Kenny's attention to the grace of muscular activity, which he compared to older methods which often resulted in “awkward and ungraceful muscular movement.”
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As newspapers and popular magazines described—in exaggerated ways—this new polio therapy that promised so much and depended on a patient's active participation, polio survivors, especially teenagers and young adults, began to criticize the institutions that did not offer this kind of care. After graduating from the Johns Hopkins nursing school, Kathryn Holman joined the Army and, while waiting for her call, worked with patients at the Baltimore Children's Hospital-School during a polio epidemic. When Holman herself was struck by polio—an unusual but not unknown consequence of caring for patients with polio—she became a patient at the Hospital-School under the care of Henry and Florence Kendall. “Fed up” with the way she was being treated, Holman wrote to the
Washington Times-Herald
, saying, according to the newspaper, “I know that Sister Kenny will be able to cure me … I want to get well so that I can devote my life to fighting this dire disease.”
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She arrived in Minneapolis a month later, and, as a reporter's purple prose phrased it, “the doors of the Kenny Institute in Minneapolis and the arms of the white-haired crusader will open as a healing haven for the stricken young girl.”
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A few weeks later Holman's father told Kenny that “Kathryn's improvement since she has been under your care has been so great as to be almost unbelievable.” He added that he wished “our own government [would] endow the Kenny Institute with millions, and set up branches all over the country to take their training from you before you went back to Australia.”
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Holman's mother added that her daughter “is so happy and writes often of what an inspiration you are to her.”
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Embolded by Kenny's work, polio survivors spoke out, defining what they considered best care and reasonable expectations as a disabled person. But another group, usually the most articulate and authoritarian in polio care, was increasingly demonized and silenced. Orthopedic surgeons, especially in the letters that Kenny received, were disliked and feared. Perhaps it was their stock in trade—the operation and the knife.
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Kenny herself frequently argued that her work would prevent the necessity for surgical operations.
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Many times parents wrote to Kenny telling her how they had refused to allow their child to undergo surgery, and, against the orthopedist's advice, had removed leg braces, stomach corsets, or other apparatus. Jean Renel of Detroit had spent 2 weeks in the hospital with casts on both legs. The hospital doctors then took the casts off and gave her braces for the next 16 months and a few “lamp treatments.” Her family doctor told her parents she needed surgery “but we refused an operation and then the doctor said [it was] no use [to] give her lamp treatments any more because that will not help her.” At home Jean's parents removed the braces and took her to a chiropractor. Jean now had “no deformation” of her legs and could walk, but her parents hoped that Kenny's methods would stop her from being “a toe walker.”
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When Kenny removed braces and stomach corsets it was dramatic because she did it in a clinical setting, in front of physicians and nurses, as a public show of rejecting the machinery of orthodoxy. Parents' quiet removal of such apparatus in their own home was no less of a rejection.

To show the extent of her patients' recoveries, Kenny developed a dramatic final demonstration. Her recovered patients were taught a series of acrobatic techniques, showing
not only physical flexibility but impressive strength and balance. “These are no merely acrobatic stunts,” Kenny and Pohl's 1943 textbook explained, “but an examination of paramount importance in safeguarding the future welfare of the patient.”
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It was regrettable, Kenny told one Associated Press reporter, that a short film produced for the 1943 March of Dimes campaign had shown children walking with crutches. “If the picture had been presented from the Institute we could have shown cases who were helpless in bed, unable to lift their heads, could not sit up, stand or walk [and] … months later could turn somersaults backwards.”
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When Alice Plastridge saw such a demonstration she was amazed. The children were asked to walk on tip toes and on their heels, hop on each foot, squat on one foot and come to standing without touching the other foot to the floor, come to a sitting position lying on a table without using their arms, bend forward putting their foreheads on their knees, and lying on their backs bring both legs over their heads to let their toes touch the table. The exercises, Plastridge thought, “seemed pretty drastic and severe … but surely proved there could be no stiffness or spasm there.”
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The Kendalls had also noted examples of “extraordinary flexibility” among Kenny's patients. Their notes listed the exercises Kenny asked one boy to do:

1–Legs over head

2–Trunk rais[e] & legs supported

3–Knees to nose—sit on bottom

4–S[i]t—Knees legs

5–S[i]t on toes, on heels

6–Ly—Turn ft in—all

7–Face lying—rocking on abdomen.
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This kind of flexibility and strength was dramatic, but it did not always inspire the kind of awe Kenny hoped for. After their visit to Minnesota, for example, the Kendalls began a series of studies to see whether such acts were developmentally normal for young children.
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In evaluating results of polio therapy, Cleveland pediatrician John Toomey observed dourly, a patient “does not have to have acrobatic litheness, and his muscles do not have to be trained to the point where he doubles himself into a knot, for he is a plantigrade animal [and] as soon as he start[s] to walk again he begins to have some contraction of his muscle arcs and some slight limitations.”
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Orthopedist Albert Key similarly agreed that Kenny's patients were “very limber and are able to do certain gymnastics which normal patients would have difficulty carrying out [but that] … this is merely a matter of training and practice.”
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Most of all, physicians were uncomfortable about the ways that Kenny used her patients' bodies to reinforce her claims about the harm that “orthodox” treatment could cause. Assessing progress was considered the province of the supervising orthopedist, although physical therapists were the daily judges of muscle strength. Kenny looked at the bodies of polio survivors and saw not destroyed neurons or patients who had not followed the instructions of professional supervisors but improper care by medical professionals. Of course the context mattered: Kenny made these statements in front of patients and their families. Key was therefore outraged that Kenny had announced in front of 4 patients she had called “hopeless cripples” that “had they had the Kenny treatment they would now be normal.” “This was a cruel statement to make before the patients,” Key remarked, “and
there was no evidence that it was true.”
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“The remark made by me would have had no effect upon the patient,” Kenny retorted after she read Key's complaints, for “as, unfortunately he had been painfully aware of the truth. He was also aware of the improvement that change of treatment had brought about.”
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Patients, she claimed, well understood the limitations of their bodies and the kinds of therapy they hoped would transform them.

Her frank prognoses disturbed professionals trained to hide not only diagnoses they considered too psychologically difficult for patients to handle—like the likelihood of a lifelong disability or a terminal illness—but also the incompetence of a fellow professional or their disagreement with a colleague. Patients and their families frequently shopped among physicians, but they usually heard dissension only from practitioners outside orthodoxy, reinforcing the sense of physicians as members of an exclusive club. Polio experts frequently refused to admit the extent and permanence of a patient's disability. Miland Knapp, for example, said that he “always withheld a poor prognosis. Such information depressed the patient and usually discouraged cooperation with the program of rehabilitation.”
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“On my husband's insistence,” Marjorie Lawrence recalled in 1949, “the verdict [diagnosis] was kept from me.” When Lawrence was finally told, she became, just as many physicians feared she would, very depressed.
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Toomey was also appalled by Kenny's cavalier optimism. “The public unfortunately has come to believe that certain methods will definitely cure paralysis despite the fact that each patient is an individual problem,” he told a meeting of physicians. She claimed that if patients had been treated a certain way “they would have made a better recovery.” “It is cruel to encourage the patient or his family in such a thought because it is utter nonsense … Why not be honest and face the unpleasant, yet obvious fact that some people will be paralyzed despite any type of treatment?”
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Yet here was Kenny in the ward of a hospital in Minneapolis or Little Rock or Wilmington, talking about hope and the possibility of change. Truth-telling to patients—even in the context of therapeutic optimism—was a striking break from mainstream medical norms, and, like Kenny's physical examinations, felt authentic to many patients and their families who disliked the evasion common in therapeutic encounters.

For many disabled Americans and their families Kenny became a hero. “She is worshipped by former paralysis victims who owe their recovery to her courage and selfless devotion,” said one Los Angeles journalist with typical hyperbole.
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Polio survivors and their families were impressed not just with the results of her work but also its provocative challenge to standard medical assessments. Kenny “miracles” were usually performed in front of reporters and parents along with medical staff and members of hospital trustees. In such performances she was shown teaching doctors things they did not know. At Brooklyn's Adelphi Hospital, while reporters and the medical staff watched, 8-year-old Jerry Silverman “smiling confidently, climbed upon the clinic table.” Doctors had said his leg would always remain paralyzed. “Under the soothing hands of the nurse the child relaxed. Slowly she manipulated the child's thin, left leg. In a few minutes it began to twitch. She turned to the boy's doctor and advised him to continue the procedure.”
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