Polio Wars (95 page)

Kenny's ouster as Institute director was followed by another upheaval—the defrocking of Morris Fishbein as AMA general secretary and
JAMA
editor. At the June 1949 annual meeting he was attacked again on the floor of the AMA's House of Delegates by members resentful at his opposition to group practice and perhaps envious of his celebrity reputation. His relationship with the National Physicians Committee, a right-wing lobby group, also left him vulnerable.
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This time his enemies had the numbers. A professional advertising firm took over his AMA public relations work and the AMA's trustees pointedly announced that he must cease speaking on “controversial subjects.” Basil O'Connor, Fishbein later recalled, was “fuming with anger” when he learned of the coup.
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No longer
JAMA
editor, he continued to work as a consulting writer and editor for other medical journals, but his was no longer the single voice for American medicine and there was now no single powerful AMA censor looking over newspaper articles and radio and movie scripts.
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It was the end of an era for America's organized profession.

During the war thousands of civilians migrated to California, and after the war the migration continued with the return of soldiers. Many families with young children lived in congested conditions, a good environment for the emergence of polio outbreaks. Polio continued to threaten every kind of family; even Governor Earl Warren's 17-year-old daughter Nina “Honey Bear” was paralyzed by polio in November 1950.
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By the late 1940s Kenny treatment was provided in most of the state's municipal and county infectious disease hospitals, and the KF was represented by 2 state chapters, the Northern and Southern. The expansion of the KF as an alternative philanthropy and the institutionalization of Kenny's work consistently faced 3 major problems: ensuring the cooperation of hospital staff, establishing congenial relations between the state chapters and the Minneapolis KF Board, and making certain that the chapters' campaigns were directed by honest men. Chaos ensued in 1949 as Kenny technicians protested that their patients who were to be transferred from Santa Monica's Harbor General Hospital to the Kabat Kaiser center would no longer receive proper Kenny treatment.
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The technicians were fired for insubordination, but orthopedist Harvey Billig, who was a member of the Southern KF chapter and directed his own Kenny outpatient clinic, found them other positions.
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The Minneapolis Board was frustrated by this sign of disloyalty, and tried unsuccessfully to rescind the Southern Chapter's charter.
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Kenny had supported the technicians' decision to leave and decided to grant the original Southern KF chapter “self-government” with full power to campaign independently for “the promotion of my work.”
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Prominent Kenny proponents such as Billig and Superior Court Judge George Dockweiler retained their standing as KF representatives and ignored the Minneapolis Board's posturing.

Meanwhile, in San Francisco, members of the Northern KF chapter had long faced “personal dispute[s]” with KF executive director Marvin Kline and other Board members. As a result no Kenny clinics were ever established in northern California. Most disturbing were rumors of financial mismanagement by the chapter's executive director, Henry Von Morpurgo, a San Francisco public relations man. By the end of 1949 the chapter had collapsed, and Von Morpurgo had become the target of a fraud suit brought by the state of California for misappropriating $93,000.
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Kenny had initially tried act as conciliator but realizing this scandal threatened the reputation of both the KF and her own name, she argued that the Northern KF officers had “failed in their custody of public monies.” When Von Morpurgo and his local defenders later approached her she refused to meet with them.
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Her extensive network kept her well informed of public dissatisfaction with KF officials, and she began to keep a close watch on both foundations, especially “all foundations bearing my name.”
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The mess in California threatened Kenny's hope of establishing a West Coast center to provide Kenny care. She was further frustrated to find that the KF Board was not enthusiastic about the efforts of other Kenny promoters.
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Yet even with the backing of the KF Board, state and federal bureaucracy made KF expansion difficult. State Crippled Children's Bureaus set up during the New Deal had developed an extensive list of requirements for the formal approval of rehabilitative hospitals, and, piggybacking on this bureaucratic barrier, the NFIP adopted a policy in 1948 of refusing to pay for convalescent care provided in any facility not approved by a state's bureau.
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These bureaus were usually directed by civic leaders or members of the state medical society who were friends of the governor, thereby transforming bureaucratic hurdles into political ones. The struggles around the Centralia clinic had demonstrated that even with the support of a mayor and a governor, the KF Board still had to find permanent specialists to staff its clinics.

The most powerful way to protect the KF from poor publicity and organizational chaos, Kenny came to believe, was to emphasize its commitment to funding research. Kenny noted frequently that the NFIP had spent 11 million dollars on scientific research without any “advance concerning the knowledge of the disease.”
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Meetings organized by the KF to showcase its contribution to the progress of polio science began to feature Kenny and virologist Claus Jungeblut, whom Kenny proudly called “our scientist.”
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For Kenny these were opportunities to shore up her legacy, a goal made more pressing by her growing sense of mortality. She continued to pretend that she was in her early 60s rather than about to turn 70, but she did like to remind her allies of her heart condition, which had been identified many years earlier. “Contrary to my doctor's advice” and “at a great physical sacrifice,” she told the KF Board, she had “endeavored to improve the financial situation of this Foundation upon many occasions.”
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Well aware that the Kenny method or some adaptation of it was used in hospitals and clinics across the nation, Kenny's complaints now focused on the lack of attention to her work as a scientific contribution. She warned that polio clinicians who denied or ignored the Kenny concept could not achieve proper efficacy of her methods, for if polio was treated “from the viewpoint of a central nervous system infection alone, only deformities develop in
spite of best efforts.”
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News from her network of Kenny technicians had shown her the importance of working within a supportive hospital hierarchy; technicians without physician support were often left isolated and impotent. Teaching physicians to understand the ideas behind the method was critical for any hope of global expansion, especially with a number of international students training to be Kenny technicians at the Institute.
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Yet these arguments, Kenny found, did not alter hospital care or medical training policies. When she warned New York City officials that local hospitals “doing Kenny work” were not practicing the work “intelligently” for “the theory upon which the work is based is unknown,” the city's commissioner of hospitals, she noted uneasily, “smiled and remarked: ‘What odds about the theory so long as they get results?' ” Surely, Kenny argued, it was impossible to teach a treatment “unless the theory upon which the treatment is based is understood.” While the commissioner did not argue further, it was clear that for him and other officials a concern with theory and pedagogy was secondary to the provision of demonstrably efficacious clinical care.
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The medical school deans at New York University and Columbia University were willing to allow her to lecture and show her technical film but these occasions did not alter the teaching of medical students.
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Kenny consistently hailed Jungeblut's work at all of these occasions. Jungeblut disliked Kenny's evangelical tone. Still, he acknowledged his KF grant had been “secured through Miss Kenny's personal efforts.” He consistently asked that “there be no non-professional reports of these discussions, in the press or elsewhere,” for only under such conditions could he “carry on my experimentation at Columbia.” But these pleas were in vain. He was made central in KF publicity, and Kenny considered that his research had proven her concept of the disease.
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Jungeblut had established himself as a scientific outsider during the 1948 Congressional hearings and he was eager to show that his work was on the cutting edge. In June 1949, during an informal report of his work at a public meeting, he highlighted recent epidemiological and virological evidence that suggested that the polio virus produced “paralysis only as a complication, as complications occur in mumps or measles” and that, like these familiar infections, polio was also “a systemic disease.” “It is possible,” he speculated, that “we are dealing with a uniform disease which is essentially peripheral, with the early lesion involving only the peripheral muscles.”
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Jungeblut then cited what he called “a very classical experiment” by Boston virologist John Enders who had grown the Lansing strain of the virus in human embryo tissue. While some commentators disparaged this work, arguing that embryonic material was “not a good guide, that it has a different nervous and non-nervous tissue so the experiment was not of much importance,” Jungeblut disagreed. He saw Enders' work and his own as providing “a clear demonstration that the poliomyelitis virus is not a neurotropic virus only.”
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It is likely that only Jungeblut, of all the participants at this and other KF meetings, had any inkling that these insights would become virological orthodoxy within the next couple of years and provide the intellectual and technical basis for the production of Jonas Salk's polio vaccine. In 1954 Enders and his Boston team received the Nobel Prize for just the experiments that Jungeblut was describing here.
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KF director Edgar Huenkens tried hard to rein Kenny in. He agreed that polio might indeed be “a peripheral disease as well as a central nervous system disease,” but, he commented at a meeting in Jersey City after Kenny had spoken, “we should be awfully careful we do not make statements that are exaggerated and that cannot stand up.” Hasty
declarations made “a bad impression on physicians and scientific people,” and statements by those not working in a laboratory might be seen as “proof [by]…a group of laymen [but not by]… a group of scientists.” In his estimation, the KF should be concerned with “making the doctors believe … not in just making a bare announcement for the record.”
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Never known for subtlety, Kenny retorted that “doctors are upbraiding me for not letting them know what I have discovered about this disease and what has been proven scientifically about this disease.” She had heard all these arguments many times before, and in her experience, cautious presentations did not lead doctors to “believe.” Evaluation, experimentation, proof—these were all obscurant techniques to delay expanding the scope of her work and her ideas. Thus, she declared dramatically, “if we wait for the finality of knowledge in all of these things, we will wait until thousands of children are crippled.”
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Like Huenkens, Jungeblut urged Kenny to accept that “the medical profession is a peculiar profession [which] … likes to see the improvements come from its own ranks.”
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Kenny was able to have the last word, though, when she described children screaming “because their poor inflamed muscles have been stretched instead of scientifically treated.”
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To these horrific pictures Huenkens and Jungeblut had no reply.

What Huenkens was able to do was to keep Kenny at a distance from the Institute. He refused Kenny's request for regular meetings with members of the medical staff “to present to them from time to time all my knowledge and material, and bring them up to the same standard as Doctor Pohl.”
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The Institute now rarely screened
The Kenny Concept of Infantile Paralysis
or its lay equivalent
The Value of a Life
.
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Nor was Kenny able to place her technicians where she believed they should go. When she proposed that Ethel Burns, one of her original students, replace another technician, the KF board warned both technicians that if they moved positions they “would be fired from the Kenny Foundation, and so would any other technicians.”
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Huenkens also made sure that Kenny was no longer the major speaker at medical meetings and did not control their agenda. At one conference in Minneapolis, her participation was limited to 30 minutes on the first day and another hour on the second day.
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To another, Kenny discovered, she was not even invited. This attempt by the KF “to forbid me communicating with the medical world,” she complained to the head of the KF board, was “the exact replica of the National Foundation.”
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Kenny's constant demands, no longer tempered by Mary Kenny, began to alienate her allies on the KF Board, especially Minneapolis businessman Donald Dayton and lawyer Henry Haverstock, whose loyalty she had captured by treating their sons. Both men began to hope that Kenny would go home to Australia and become a beloved, distant figurehead. She was becoming more impatient, more inflexible, and more domineering. “There wasn't any way to work with Sister Kenny as such, you worked for her, she was constantly imposing her will,” one KF public relations man recalled.
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In fact, although Kenny denied this, the organization was not hers, and even the Institute was slipping from her control.