Polio Wars: Sister Kenny and the Golden Age of American Medicine

727 Pages·2013·4.8 MB·English

by  Naomi Rogers

POLIO WARS
Polio Wars
SISTER ELIZABETH KENNY AND THE GOLDEN
AGE OF AMERICAN MEDICINE
Naomi Rogers
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Library of Congress Cataloging-in-Publication Data
Rogers, Naomi, 1958–
Polio wars: Sister Elizabeth Kenny and the golden age of American
medicine/Naomi Rogers.
p. ; cm.
Includes bibliographical references.
ISBN 978–0–19–538059–0 (hardback: alk. paper)—ISBN 978–0–19–970146–9
(updf ebook)—
ISBN 978–0–19–933413–1 (epub ebook)
I. Title.
[DNLM: 1. Kenny, Elizabeth, 1886–1952. 2. Nurses—Australia—
Biography.
3. Poliomyelitis—history—Australia. WZ 100]
RA644.P9
614.5′49—dc23 2013011373
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
For Nat, Dory, and JH
Contents
Introduction
Acknowledgments
List of Archives
PART ONE
1. A Bush Nurse in America
2. The Battle Begins
3. Changing Clinical Care
PART TWO
4. Polio and Disability Politics
5. The Polio Wars
6. Celluloid
PART THREE
7. Kenny Goes to Washington
8. Fading Glory
9. I Knew Sister Kenny
Index
Introduction
STANDING ON MY bookshelf is a coin container in an outrageous bright orange that
was popular in the 1940s. Under white letters urging me to “Sock Polio” are 3
figures: a toddler in a loin cloth standing awkwardly but steadily; singer Bing
Crosby, with a pipe and a jaunty hat; and a white-haired woman in a black dress
and pearls, her hands reaching up toward the child with a look of intense pride.
“Please Give to the Sister Elizabeth Kenny Foundation,” the container pleads.
Crosby was the national chairman of the foundation’s 1945 appeal, but who was
Sister Kenny? When this can was passed down the aisle at movie theaters, no
one in America needed to ask. She was so familiar and iconic a figure that Holly
Golightly in Breakfast at Tiffany’s declared that she would not testify against a
friend, “not if they can prove he doped Sister Kenny.”1
Sister Elizabeth Kenny, an Australian nurse, came to the United States in
1940 to seek medical approval for her new methods of treating patients
paralyzed by polio. (“Sister” was a British designation for senior nurse, not a
religious title.) Despite the skepticism and even hostility of American
physicians, she succeeded. With the sometimes grudging support of the National
Foundation for Infantile Paralysis (NFIP), a polio philanthropy committed to
funding patient care, research, and professional training, her methods were made
standard polio care by the mid-1940s. Kenny became one of the most prominent
women of her era: the subject of a Hollywood movie Sister Kenny (RKO 1946)
starring Rosalind Russell; an expert witness at Congressional hearings on the
founding of the National Science Foundation; and in 1952, not long before her
death, chosen in a Gallup poll as America’s most admired woman, outranking
former first lady Eleanor Roosevelt. Yet by the mid-1950s she was almost
forgotten. Crosby’s 1953 autobiography Call Me Lucky never mentioned her.2
Kenny’s was a life of passionate outrage. She spent years defending her work,
inspiring her patients, and attacking prejudice. She knew how to stir up
controversy and how to play medical politics using the media, the public, and
politicians. Challenging established medical knowledge on its weak points and
inconsistencies, Kenny was a quick study, adopting insights pointed out by her
critics and making them integral to her work. Her feisty style mocked the
deference nurses were expected to show physicians but she could also make fun
of herself as a middle-aged woman. With what was called her Irish humor she
thanked one group of doctors who greeted her at an airport carrying roses, telling
them it was gratifying to receive flowers from doctors while she was “still here
to smell them.”3
This book tells the story of Sister Kenny and the Kenny method. Kenny’s
battles with American medical professionals illuminate the medical politics that
lay at the heart of American medicine, even during its Golden Age. After her
struggles with government bureaucrats and medical professionals in Australia
Kenny was neither shocked nor fazed by the need to pull strings and gain
influential allies in order to alter clinical care in the United States. Polio was a
high-profile disease, and responsibility for its prevention and treatment rested on
diverse authorities: local and state health officials and the U.S. Public Health
Service; individual physicians, nurses, and physical therapists; civic and charity
groups that ran hospitals and “crippled children’s homes,” did surveys, and set
up services for families with disabled members; and the NFIP, which supported
its activities through an annual national fundraising campaign known as the
March of Dimes and numerous regional campaigns organized by its local and
state chapters. Kenny’s heated battles with the NFIP and organized medicine
captured the public imagination. Standing outside the elite scientific community,
she sought to gain its respect through clinical and laboratory confirmation of her
theories of polio. Simultaneously, however, she resented being held to standards
of scientific rigor that she suspected were imposed more strictly on her because
she was a woman and a nurse and because she dared to question the expertise of
male orthopedic surgeons.
This book also focuses on the limber, healthy child patient featured on the
1945 container. Here is a dramatic, if sentimentalized, depiction of the results of
a special kind of clinical care, yet the container does not show any doctor,
hospital bed, syringe, or other symbol of medical science. For the American
public the most powerful omission may have been the familiar picture of a polio
patient: the crying child in a hospital bed with arms or legs in plaster casts; the
fearful child waiting for an orthopedic operation; or the “recovered” child
discharged with crutches or braces, all images typical in March of Dimes
campaigns. On this “Sock Polio” container, health has been achieved in another
way, through compassion and care based on a distinctive understanding of the
body shared by Kenny and her staff but not by other professionals.
In an era when nurses were seen as the recipients of medical science rather
than its designers, Kenny knew that her claims to a new understanding of polio
were controversial before their content was even known. At first she presented
herself as a supplicant to scientists, seeking their assistance to explain the
meaning of the new symptoms she had identified and the reasons her methods
worked. Her 1941 textbook had the temperate title Treatment of Infantile
Paralysis in the Acute Stage. But as the Institute prospered and Kenny was feted
as a savior, she began to argue that her work embodied a new concept of polio
drawn from a close reading of the body. Polio, she said, was not solely a
neurological disease but also a disease of muscles and “peripheral structures.”
By the time Kenny published her 1943 textbook The Kenny Concept of Infantile
Paralysis she had begun to argue that it was impossible to teach anyone to treat
the symptoms she had identified if they did not understand her concept of the
disease. Indeed, she frequently added, the prognosis for a patient treated without
this new knowledge would always be far poorer than for a patient treated by
professionals who fully understood the Kenny concept of polio.
Kenny knew to speak of “improvement” rather than “cure,” but she often did
exaggerate her results. As early as the 1930s she learned the power of the press
and the importance of a good story. She was accused by her critics of being a
publicity hound, of practicing mistaken and perhaps even harmful methods, and
of making unrealistic promises to disabled patients and their families. At times
she boasted of her distance from the medical establishment; at other times she
made much of her medical allies. She found strong public support when she
attacked the elitism of the medical profession in both Australia and North
America, but she also sought out and relied on the financial and social assistance
from the elite in business and society. She said she chose to follow only
“orthodox” physicians, but her clinical practice and its values drew on
alternative attitudes toward medical science, toward the disabled, and toward
chronic care. Her patients as well as the nurses and physical therapists she
trained to become Kenny technicians were central to the functioning of her
work. Her students saw her life as one of struggle and sacrifice, a story that was
central to the image she projected and one they frequently retold as a way to
keep their own spirits up as they battled for clinical autonomy and professional