Polio Wars (49 page)

As a source of inspiration, Kenny stood as a complicated lesson. “I am a crippled girl, only one of the many who are cripples today because the American Medical Association would not recognize your method when you first started it 32 years ago,” Clara Hulberg of North Dakota wrote in April 1943. She was going to frame Kenny's picture “as you deserve that much honor from any Cripple,” and she would remind the head of the AMA “never again to make a similar mistake in regards to other ailments now considered incurable but which may someday be cured by a simple method found by someone like you.”
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“This great woman,” an Iowa mother declared, “has given to the world a new concept of this much dreaded disease.” She wished every polio survivor “could see me use my ‘paralyzed' legs to keep my house and go to market, or see me use my ‘paralyzed' arm to hoe tomatoes and spank my babies.”
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It is striking that absent from all the letters, memoirs, and articles written in the 1940s and 1950s by and about polio victims treated by Sister Kenny and the Kenny method are negative comments about the treatment patients received.

In its early stages acute polio was a painful disease, and the hot packs and exercises used by Kenny, even in the hands of the best trained technicians, must have increased this pain. The packs were made of pieces of woolen blanket cut to size, boiled in a sterilizer, picked up with forceps, and passed through a tight wringer twice to get rid of every drop of water to avoid burning the patient. They were supposed to be covered with a piece of a rubber sheet, then a dry piece of blanket and another dry towel to preserve the heat of the hot packs. It was complicated and exhausting work, and initially the NFIP had paid for nurses to take a special short course in “hot packing.” But later much Kenny treatment was delivered by untrained volunteers supervised by often overworked technicians, especially during epidemics, and by parents who had only a sketchy knowledge of how the treatments should be given. The Los Angeles Orthopaedic Hospital had a shortage of packers, Kenny technician Ruby Green reported in 1943, “and those we have aren't too good, Sister, but they have been very cooperative with me in my wishes and are becoming more observing and conscientious.”
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What is clear, as Daniel Wilson has shown in his recent analysis of polio survivor memoirs, is that there were also many sadistic therapists and nurses. It took skill and care to apply hot packs in a way that did not hurt or burn a patient, and sometimes there was neither skill nor care.
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Sometimes even kindly packers applied packs carelessly and without awareness of clinical counterindications. In the early 1940s a New York physician mentioned during a discussion of polio therapy that he had heard about a patient “with a temperature of 106 F. being treated with fomentation. They about burned him to death and he died.”
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In light of all this and the painful graphic memories recounted in the memoirs of polio survivors published in the 1980s and 1990s it is amazing that virtually all of the accounts by polio survivors written in the 1940s and 1950s as well as letters to newspapers and magazines articles were so positive. Psychiatrist Charles Bohnengel spoke of wards of smiling children, and reporters described children “laughing and treating their exercises as a game.”
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Many polio survivors clearly tried to forget or explain away their bad experiences with polio therapies. If they mentioned discomfort, they blamed themselves for not having adjusted to the problems of paralysis or not having the mental and physical stamina to work hard enough to gain the necessary muscle strength.

It was not until the 1980s and 1990s that survivors began to recount painful graphic memories of their months of treatment. The only records from the 1940s we have that describe the negative side of Kenny's method are the complaints of overworked nurses. A pediatric nurse at Mount Sinai Hospital in the 1940s recalled a visit from Kenny when “we had no air conditioning. To use hot, steam packs on a hot, steamy day was very trying. We had to run those hot packs through those wringers and then wrap them in a waterproof covering so that that [the] bed wouldn't get too wet.”
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When families avoided doctors or ignored their advice, St. Louis surgeons McCarroll and Crego referred to the result as “no treatment.” But, in fact, families seeking polio care chose from a range of treatments outside the orthodox health system. Alternative practitioners ran health spas and other facilities that offered services that orthodox medicine provided poorly, such as care for chronic and disabling conditions. The character of these practitioners varied considerably. Some, like chiropractors, osteopaths, and naturopaths, identified themselves as members of an alternative profession critical of orthodox medicine. Some were medical entrepreneurs who directed private rehabilitation centers that accepted referrals from hospitals and private physicians, some promoted a particular medical system or technique, and others were outright health profiteers. Indeed, the growing visibility of polio epidemics along with “the wide publicity of your birthday parties,” as one alternative therapist told Roosevelt, had “brought into being a new vocation” as many patients fell “into the hands of inexpert persons … with semi-medical experience.”
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Techniques such as hydropathy, manipulation, and massage, as orthopedists, physical medicine physicians, and physical therapists recognized unhappily, were “exploited by poorly educated technicians or adherents of cults.”
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All were practitioners who, one orthopedist admitted ruefully at an AMA annual meeting in 1944, “the man in the street” often confused with the orthopedic specialist.
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Beyond debates about medical practice and professional legitimacy were even more destabilizing issues around what constituted proper evidence to drive medical progress. Naturopaths, antivivisectionists, and other long-standing critics of medical science hailed Kenny as one of their own. When she spoke of doing clinical research at the Institute, antivivisectionists heard her promote research outside the experimental laboratory, a “medicine without monkeys.” When she spoke of hot packs and muscle exercises developed in the isolated Australian bush, naturopaths heard her talking about natural, drugless healing that should be available to every man and woman.

Kenny sought to tread a narrow path. She continued to attack elements of medical orthodoxy, including leaders of organized medicine who, she claimed, sought to hinder the expansion of her work. But she also argued that her work was scientific and deserved the respect of elite scientists. She complained that the NFIP, the U.S. Public Health Service, and the Rockefeller Foundation had not sent a research man to the Institute and she began to call her work (awkwardly) “the newer science of dermo-neuro-muscular therapy.” Her proposal to make the Institute a research center was intended to attract basic scientists such as her old ally Queensland anatomist Herbert Wilkinson. At the same time she was careful not to attack unorthodox healers. When she refused to ally herself publicly with particular groups who sought her allegiance, she explained that she had promised her
Australian mentor that she would “stick to the orthodox path.” This sounded like a choice made as a personal vow rather than a decision to denigrate practitioners outside organized medicine. The letters she received from naturopaths, chiropractors, and others suggested that many did not see her as antagonistic to the alternative path, just politically savvy.

The best known alternative polio therapist in the 1920s and 1930s was Milton H. Berry, director of the Berry School for Paralysis and Spastic Correction. Born in San Francisco in the 1880s, Berry had worked as a newspaper and shoe-shine boy, a “rub-down” assistant for college football players, the manager of a Turkish bath, and began working as a paralysis specialist in the 1920s.
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Located on 2 acres in Encino, California, the Berry School was “completely surrounded by orange, lemon and walnut groves,” a secluded location “ideally adapted to the concentration necessary in the work.” The School, which Berry promoted as “the most famous paralytic correction center in the world,” was intended to be “a clinic as famous in its way as the Mayo Brothers' sanitarium [sic] in Rochester, Minn.”
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Its practice was based on Berry's “unique field of Patho-kinesiology,” a distinctive method of muscle re-education. Berry claimed distinctive professional ethics to distinguish him from other kinds of healers for he was willing to turn away prospective patients who he felt he could not “cure.”
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Although Berry did not work solely with polio survivors, his institution, clinical practice, and attitude to orthodox medicine were strikingly similar to Kenny's. “Patho-Kinesiology,” a term Berry said he had coined, was “the science of bodily motion and locomotion as it concerns the individual who is physically sub-normal.” Like Kenny's work, it involved a special way of reading the body that linked muscle action and brain function, it claimed scientific accuracy, and it relied on careful muscle training and the active participation of patients. The school's use of systematized rehabilitation in a beautiful setting set it apart from most children's homes and orthopedic hospitals. His patients were “not ill,” he said, “only physically handicapped. They should be taught, not treated.” Almost all his patients, Berry estimated, had been seen by orthopedists or other doctors, and been told that nothing more could be done for them.
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Well versed in California's strict medical practice laws, he used no drugs and performed no surgery, but instead “locates the trouble with his fingers, parts adhesions of the muscles, freeing cords and nerves and veins, then brings the power of the patient's mind into play.” Like Kenny he emphasized functionality. He promised his patients they would “walk better, farther, faster, with less limp and gait conspicuousness, with more ease and assurance, and with less crutch apparatus” and that the use of such devices as a single-bar leg brace, “from a front or side view almost completely hides the brace from the calf down … [and] can hardly be seen on older girls who wear the proper skirt length.”
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Berry's fundamental principles were, he claimed, “not understood or taught by any one other than myself,” and his methods were “radically different and superior to any of the orthodox methods used by orthopedic hospitals or by orthopedic surgeons.” Like Kenny, Berry sought not to market or patent his work but to have it integrated into mainstream medical practice so that “the extensive teaching of my methods” could lead to “a very grave and lasting benefit to the world.” And, he also claimed, his work was “no secret” and “no doctors or scientific men have been denied the privilege of witnessing my work.”
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He wrote to President Roosevelt several times asking that his method of treatment “be embraced” by the newly established NFIP and reminding him that besides research the NFIP's chief aim was “to combat the after effects of polio.”
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Berry also began a campaign “to enlist the support of the physical education departments of universities of America.” His 1939 pamphlet
A Challenge on Behalf of Crippled Children to the Universities of America: Victims of Infantile Paralysis Need Not Hospitals … But Muscle Training; Not Doctors … But Trained Teachers
asked for “an unprejudiced committee of the heads of the Physical Education Department [to] … investigate my method and my records, and compare them with the record of Orthopaedic Institutions.” Doctors, he explained, unlike physical educators, were not taught “kinesiology (bodily movement)” and therefore did not understand the action of muscles in live bodies.
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Recognizing that he had to demonstrate that his methods did not depend on himself, Berry pointed out that he had trained his 2 sons, which proved “that the work can be transferred to others.” Any man or woman with a full knowledge of anatomy could “acquire proficiency in the use of my methods, under my instructions in a term of, say, two years.”
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The most powerful source of evidence proving the value of this work was, Berry believed, its efficacy. He had worked “personally upon the bodies of some three thousand crippled victims.” Three-quarters had returned to normal and more than 20 percent of the remaining group “returned to physical independence.”
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The dramatic effect of his clinical skills allowed him in 9 seconds to diagnose one boy's foot in which “muscles had adhered, grown together. The cord was imprisoned, and tightened. It had drawn the foot up on one side, twisted it grotesquely.” Telling the boy, “ ‘this may hurt you a little, but it will make a new boy out of you,' ” Berry “parted” the muscles with “a loud ‘pop' that could be heard in the next room,” and the following day the child was able to place his foot flat on the floor. Comparing the “forty years of failure of orthopedic doctors” to “my forty years of success,” Berry was confident that “there can be no other method except the one I use that can bring about these results.”
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In December 1939 Milton Berry died and his son Milton Berry, Jr. took over the direction of the Berry School.
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Berry Jr. considered Kenny an interloper and a competitor. He and members of his school's board of directors contacted her several times during the 1940s. At first he wished her success, noting that “the Berry Organization … had pioneered in a somewhat similar method as early as 1915” and agreed with most of her principles “in dealing with Poliomyelitis in its early stages.” Kenny's reply, in Berry Jr.'s view, was “rather caustic.” She stated that she “alone had pioneered this theory” and declined a series of invitations to visit the Berry school.
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He began to warn Kenny that publicity around her work, including newspaper articles stating that “you have a cure for Spastic Paralysis” and that “you made it possible for a veteran to walk alone, without crutches, after only one Kenny treatment,” were instilling “false hope into the hearts of paralyzed individuals.” As president and national medical director “of the largest paralysis correction … organization in the world,” Berry Jr. challenged Kenny “to a demonstration of your technique in the correction of post-polio and Spastic Paralysis conditions.” “If you can prove that you have a method of paralysis correction superior to ours” then the hundreds of his patients “should have the opportunity of knowing about it.” He proposed that members of the press should be present “so that thousands of others may know of the results of this demonstration.”
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Kenny ignored this offer.