Polio Wars (57 page)

The popular press took sides. Albert Deutsch in
PM
found what he called the AMA's “scathing attack” on Kenny's work “a strangely unconvincing document, charged with emotional bias against Miss Kenny and her claims.” He guessed that at the base of the disagreement was money. He sharply contrasted “private orthopedic specialists who might be cut off from a lucrative source of income if Miss Kenny's method should be generally adopted” to public health officials with “no axe to grind” who found her work valuable despite “some serious flaws in her concept.”
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“Paralysis Method Held Overpraised” argued the
New York Times
in contrast, quoting with approval the NFIP's 1943 annual report that expressed regret at the “unprecedented publicity” given to the Kenny method, which had led to “exaggeration.”
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On the first page of that month's
National Foundation News
NFIP officials placed a special notice saying that the report “by a group of distinguished orthopedic surgeons” had resulted in “numerous inquires regarding the National Foundation policy.” Cautiously treading a path between Kenny and the AMA, the NFIP argued that “the somewhat controversial situation as to the exact merit of each phase of the Kenny method”
did not alter the NFIP's policy “in any way.” Many physicians “feel that a contribution has been made in the Kenny method and use various phases of the technique in their practice.” “The National Foundation is interested in only one thing—determining the value of the various phases of this technique by scientific study in laboratories of physiology and in clinics with a view to retaining such merit as it may possess.”
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Recognizing the upheaval this report had caused, O'Connor also began an extensive tour visiting chapters in 12 states and 21 cities in the West and Northwest to try to calm the waters and to present a rational, unflustered face to a philanthropy under siege.
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Wily enough to know that the report would work best left on its own, Fishbein offered a brief editorial comment in
JAMA
, drawing on a study by Kabat and Knapp that argued that muscle spasm was “a reflex phenomenon” and that “there appears to be no direct relation between it and motor paralysis.”
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His editorial in
Hygeia
fulsomely praised the work of this “distinguished committee” whose members had “nothing to gain personally by their report,” and reiterated that continuous hot packs were of “questionable value” and “a waste of manpower and hospital beds.” “Unfortunately people in general do not read as carefully as they should the reports that appear in the press regarding medical technics,” Fishbein added, and it was best to “get a competent doctors and to leave to his decision the method of treatment to be followed.” He praised Kenny's “enthusiasm” and concluded that “she has acted like an enzyme or a ferment to hasten study and to encourage the earlier appearance of important facts.”
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Surgeon General Thomas Parran refused to get involved, explaining to Kenny by telegram that no action by the United States Public Health Service (USPHS) was indicated since the AMA report “points out [how] important your contribution [is] in stimulating scientific re-evaluation of various known methods of treatment.”
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The report, as its authors had hoped, provided a vocabulary and way of thinking that helped physicians distance mainstream medicine from Kenny's work. A doctor at Chicago's Michael Reese Hospital, one Kenny supporter noted, said to patients “we aren't calling it the Kenny system any more. We have made a few changes and have our own system.”
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Similarly a prominent physician at Northwestern's medical school claimed Kenny “hasn't shown doctors anything that they didn't know before. These nurses who get ideas over-value themselves because they don't know the whole picture.”
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In Minnesota Diehl's effort to find a quiet middle ground was undermined by antagonists within his medical school led by physiologist Maurice Visscher who had been at the University of Minnesota since the 1920s. A researcher with a national reputation, Visscher was the recipient of several large research grants from the NFIP.
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In June 1944 he helped to organize a “Symposium on the Management of Infantile Paralysis” that, as one of the editors of the
Journal-Lancet
, he then published as a special issue the following month.
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Along with articles by neurologists and physiologists from the university, the July issue contained an editorial on “The Present Status of Poliomyelitis Management” written by Visscher and 3 other faculty members.
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The editors praised the “energetic use of hot packs” as certainly better than “rigid immobilization” and the “highly expert” use of physical therapy that had brought attention to “an altogether too frequently neglected aspect of poliomyelitis after-care.” But in pointed but not vitriolic prose, they argued that medical research had not demonstrated that any single polio therapy had “superiority over all others,” so physicians had to “continue to search for better ones.” More sharply, they stated that there was no proof to justify Kenny's theory of the centrality of muscles in polio pathology or that her methods minimized early paralytic damage. Further, her
terms spasm and alienation were “ill-defined” and “awkward” and her attention to these clinical signs was probably not original.
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The
Journal-Lancet
issue received strong praise from neurologists and physiologists around the country who particularly liked the editorial for having, as one man saw it, “the courage to bring out the good side of the Kenny method … against certain belligerent and reactionary groups who have acted as if their precincts in medicine were being taken from them.”
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Members of the public in Minneapolis were not convinced. Many saw the AMA report as further evidence of jealous physicians trying to hinder the expansion of Kenny's work. A small group of Minneapolis businessmen assured Kenny that “the People on the street” were “going to bat for you.”
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The owner of the Emrich Baking Company of Minneapolis excoriated “the ridiculous and monstrously unfair attack made on you by Dr. Ghormley” and assured her that “your many admirers, including myself, are aware of the splendid contributions you have made to medical science.”
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A lumber company official was “disgusted … that an intelligent group of men, such as A.M.A. is made up of, should under rate and make such statements about one who is giving so much to Humanity.”
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Another local supporter reminded Kenny of “the secret opposition and jealousy and pride of the ‘established' order.”
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Kenny needed no such reminder.

At first Kenny fought this new level of the polio wars with familiar weapons: telegrams, letters, reports, and interviews with reporters and science writers. She told Diehl that as her work had been “discredited” she and her staff would stop participating in the University's teaching courses, but after Diehl's tactful negotiation, she agreed to continue teaching the physicians' classes and the 20 technicians who were already enrolled in her courses.
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The public continued to support Kenny passionately. That summer Washington experienced a serious polio epidemic. With the backing of the
Washington Times-Herald
, Kenny and the local health department decided to transfer a small group of children to the Institute, despite protests by pediatricians that sending patients to Minnesota was a “wasteful, unnecessary expenditure of time, money and manpower.” With funding from Eleanor Patterson, the owner and publisher of the
Times-Herald
and a controversial socialite, Kenny traveled 3 times to the nation's capital between July and October 1944, meeting civic leaders, local physicians, diplomats including Australian ambassador Sir Owen Dixon, and a sprinkling of Congressmen and senators.
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When parents begged to see Kenny for advice about their paralyzed children, city health officials, warning that “miracles must not be expected,” organized a special event at the Statler Hotel, which they called a Forum Against Fear, a reference to one of the 4 freedoms Roosevelt had proposed as fundamental in his 1941 State of the Union address: freedom of speech, freedom of religion, freedom from want, and freedom from fear. One mother wept saying, according to the
Times-Herald
, “I just know something good will come … that she has come at all is a miracle.”
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To some members of the public, the upheaval around the polio wars looked like the making of a new movement. The word itself was used by a Georgia Congressman who told reporters in October 1944 of his “intense interest in the Kenny movement.”
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James Hulett, a young sociologist at the University of Illinois, suggested that “the campaign carried on by Miss Elizabeth Kenny and her supporters [had] … begun to assume the
proportions of a cult.” “Of course,” Hulett assured NFIP officials, “I use the word ‘cult' objectively as a name for a particular type of social movement, and not as an epithet.”
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In this movement, the usual power relationships between physician and parent were disrupted. Would this movement engage with national medical politics as well? Would Kenny's attack on organized medicine become a battle about the inadequacies of New Deal welfare services? Would it be a spiteful populist crusade like Father Charles Coughlin's attack on Roosevelt, Jews, capitalists, and Communists?

Kenny had only limited control over the character and direction of this nascent movement. She enthusiastically joined with politicians who expressed their sympathy with her fight, but when anyone began to talk about coordinating Kenny centers or setting up other funding groups, she clung fiercely to her Institute. Her advisors in Minneapolis, similarly, sought to ensure that all coordination came from the Institute's board. The board began to plan a regional fundraising drive. Drawing on the March of Dimes campaigns, they also began to set up a new pro-Kenny philanthropy. Instead of the March of Dimes posters showing children in braces, making their way awkwardly out of wheelchairs, Kenny's campaign would feature children joyously walking and playing.

Kenny sought to make this new populist movement less explicitly anti-doctor. A Chicago public relations man urged her to “avoid any sweeping criticism of the American Medical Association, the Warm Springs Foundation, groups of doctors, etc, to avoid alienating physicians who can be won to our side.”
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Kenny was already aware of the dangers of being the figurehead of an anti-doctor movement. Her own medical allies, she frequently declared, were all “members of the American Medical Association,” and the AMA report, therefore, represented only the views of a few antagonists.
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In her 16-page response to the AMA report addressed to the Institute's board, she pointed out that the same
JAMA
issue had published a “favorable” paper on her work “given by Doctors who had listened and learned.” As for the AMA committee's complaint that she had told patients “who had received treatment at other Centers that disability would not have occurred if they had received the Kenny treatment,” the Committee members were acting “like a group of petulant school boys rather than a scientific body.” These patients “were well aware of this fact without me telling them.” All nuance disappeared when she expressed her outrage at the claim that she had made a “deliberate misrepresentation.” Such statements, she declared, were motivated by “[a] deliberate intention to belittle me and accuse me in the eyes of the public.”
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In dramatic theater a few days after the AMA report reached the newspapers, Kenny invited a group of reporters and around 50 visiting physicians to the Institute. She showed a short film of a young paralyzed patient who “had been given up by doctors and was expected to die.” Then the girl was presented to the audience alongside a boy who had been treated by orthodox methods. “The contrast was appalling,” said the
Minneapolis Star-Journal
.
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To an audience in Washington a few months later she offered the same demonstration but entirely on film. Telling the crowd “my picture will speak for itself,” she showed patients transformed by care at her Institute, standing straight and sturdy beside 4 children treated by the orthodox method and “hopelessly crippled for life.” While it was certainly dramatic, this scenario also posed an uncomfortable ethical dilemma: had some children been left disabled so as to stand as exemplars of bad treatment? No, Kenny assured her audience, these 4 had “volunteered” their services, and in return she had provided them with scholarships and medical assistance.
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Despite her efforts not to attack the entire medical community, the polio wars began to unravel some of Kenny's medical friendships, including her prized alliances with
orthopedic surgeons. Her patients' families had frequently told her how they hoped that her methods would obviate the need for a surgical operation, and Kenny had often said that surgery was usually unnecessary if her methods were used early enough. Now she developed a more forceful antisurgery stance. Relations between Kenny and Chicago orthopedist Edward Compere deteriorated when the press quoted Kenny as saying that orthopedists disliked her work because if patients were treated by her methods the surgeons would lose 40 percent of their practice.
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This “rather strong statement is completely untrue and I am sure you know it is not true,” Compere told Kenny in exasperation, and he deplored her attack on the integrity of physicians whose motives for helping polio sufferers were “quite similar to your own.” The AMA report, he argued, “was in no sense intended as either an attack on you or upon your methods as some of the newspapers, and I think you yourself, interpreted it to be.” Compere reminded Kenny of the ways he himself had taken her work seriously, including the separate unit for acute patients he had just organized at the Wesley Memorial Hospital to enable his Kenny-trained staff to treat patients “from the time that the diagnosis can be made.” At the end of his letter he announced that he would no longer engage in private debate with her. “I have refused to accept long distance telephone calls from you because I have become convinced that nothing can be accomplished by them except perhaps further misunderstandings.”
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