Polio Wars (115 page)

It was during this anniversary that I first came to the Twin Cities to begin my research on Kenny. Like most Australians born in the late 1950s, I had not heard of her while I was growing up in Melbourne, but as a doctoral student in the United States working on the history of polio I became intrigued by the story of a woman from Australia who made
her mark in America. In 1992 I had begun an academic position at Monash University in Melbourne and become committed to this project after a friend told me that Mary Kenny McCracken was alive, living in Queensland, and willing to be interviewed. I went up to see Mary and her husband Stuart and found them hospitable, a bit wary, and willing to show me papers and photographs that they had not yet given to the University of Queensland. The 5 years Mary had spent in the United States had left a profound impression on her; my dual background (born and raised in Australia but trained in American history in the United States) intrigued her.
¹³⁵
Other informants such as Richard Owen and Margaret Opdahl Ernst, Kenny's first secretary in Minnesota, invited me to attend the Institute's celebrations. I was asked to interview the former patients who spoke warmly of their memories of being treated by Kenny and her technicians and described in matter-of-fact ways their experiences of living with PPS.

As the Twin Cities reclaimed Kenny as part of their heritage I became part of a small group of scholars and informants. I was interviewed in 2002 by Minnesota Public Radio for a program on Kenny in which Richard Owen, now retired from the Institute, remembered being horrified when Kenny undid the strings of his loin cloth in front of reporters.
¹³⁶

Civic boosters in Minnesota also found a place for Kenny. A 2007 pamphlet celebrating the state's 150th year anniversary described Kenny as “a force to be reckoned with—a statuesque woman with snow-white hair who did not suffer fools gladly” but also as someone whose “ideas are still in use around the world and in Minneapolis at the Sister Kenny Institute.”
¹³⁷
A special issue of
Daedalus
on Minnesota described Kenny as “one of the most prominent and popular people in Minnesota in the 1940s.” “She invented her nursing credentials along with her nurse's costume,” one commentator noted casually, and “affected an intimidating public presence, dramatic hats and all.” “She was not a Minnesotan … but we claim her as partly ours.”
¹³⁸

In 2010 Minnesota's History Theater put on the world premiere of “Sister Kenny's Children,” sponsored partly by the Institute. Playwright Doris Baizley based her play on patient letters from the Minnesota Historical Society as well as Cohn's biography and Kenny's autobiography. Reviewers found the play inspiring and touching, but wondered about Kenny's fame: “Was she a publicity hound, or a private person who reluctantly used her celebrity status to further the cause of her treatment centers?”
¹³⁹

In her final autobiography
My Battle and Victory
, Kenny suggested that “in the history of medicine … it is not always the great scientist or the learned doctor who goes forward to discover new fields, new avenues, new ideas”; rather progress was sometimes sparked by God's “weakest minister.”
¹⁴⁰
Her contemporaries knew that she did not see herself this way at all. She wanted to be remembered as a major contributor to medical progress, as a world renowned scientist like Marie Curie. But by and large, that was a failed project. She was always an outsider with an exotic background, an Australian bush nurse who became an American celebrity. As an unmarried, middle-aged woman who fought unapologetically with male physicians and hospital administrators, Kenny did not fit neatly into any available cultural scripts. After her death, as in her life, she was often evaluated harshly,
and she was largely written out of polio history along with disabled patients and clinical care. When she was remembered by polio survivors who experienced a reappearance of their symptoms, it was often with bitterness.

I have sought to present Kenny not as a heroic figure but as someone worth remembering. I hope this book adds another layer to the stories about Kenny: as a woman, a nurse, a clinician, and a scientific innovator. When historians seek to highlight a forgotten figure they are frequently accused of hagiography. I am uncomfortable with the notion of a commemorative biography, which tends to eschew ambiguity and to present the past from a single committed perspective.

This retelling of the story of Kenny and her work is framed as a way of understanding how American medicine was practiced in the 1940s and 1950s. Kenny's struggle to gain respect forced both professionals and the public to debate how to assess clinical practices and medical evidence. Clinical authority, the public knew, was considered a matter of social status and institutional affiliation. Yet Kenny loomed large, in every way. She demanded an upheaval of polio care and the gendered power relations in medical practice and its institutional structure. She insisted that her distinctive understanding of polio was the result of clinical research, a field she saw as the integration of clinical observations with laboratory evidence. She borrowed scientific terms she heard around her and peppered her lectures with them. But she cared little for nuance. Her skill was as an integrative thinker rather than as a theorist. She developed her theories in a kind of collage, where the pattern as a whole was more important than the intricate strands; she did not try to assess their intellectual coherency. Battered by skepticism and patronizing dismissal, she developed a professional persona in which the distinctions between her work and medical orthodoxy were crucial. She heard remarks that similarities between the old and the new implied a lack of originality, perhaps even the result of borrowing of others' ideas. Her defense of her work was sometimes illogical, but her arguments—irrational-sounding or not—were always placed behind the supple, strong bodies of her patients.

She also claimed a distinct way of assessing efficacy that threatened standard techniques. Thus, while orthodox practitioners saw muscle testing as a way to measure her patients' improvements and assess her claims of recovery, Kenny saw such testing as inaccurate and harmful to the patient. In a time before modern evidence-based medicine, she called for fair comparisons of her work with the methods of others, yet she rejected standard testing techniques in favor of demonstrations and testimonials and warned that she would not allow a single child to be subjected to the pain and suffering that the poor care of a controlled test would surely bring.

She demanded formal recognition for the changes she brought to the workings of polio institutions, and trained her technicians to see themselves as special experts deserving popular and professional respect. As one popular work in 1958 argued, in some hospitals the Kenny method “entered with a flourish through the front doors and with the official sanction of the board of governors”; in others her work was “admitted surreptitiously through the service door … in the rear, and the governing staff pretend[ed] to have no official knowledge of it.”
¹⁴¹
Kenny's work helped to ensure that clinical care captured the public imagination—at least until the NFIP was finally able in the late 1950s to turn the polio story into a new story of men in white coats, saving children through carefully prepared scientific vaccines—and the American public demanded her methods be used to
treat their children, and were not satisfied when physicians claimed to have “improved” it. In short, her legacy was complex at best and at times completely paradoxical.

Like her colleagues, patients, and critics Kenny shared a deep respect for the power and prestige of medical science. She relied on the expanding government investment in biomedical institutions; indeed she sometimes tried to redirect such investments when she believed they were made incorrectly. Yet she also found she was not alone when she excoriated antagonistic and patronizing physicians and attacked the ways that disabled patients were dismissed as troubling or clinically uninteresting and therefore as proper subjects for institutionalization. Kenny was no microbe hunter but she claimed insight into polio science through her understanding of the bodies of her patients. Bodies were central to her work and central to the extraordinary publicity around it. Until the Salk polio vaccine, images of a Kenny-treated fully recovered child overshadowed NFIP posters depicting children awkwardly leaving their crutches or wheelchairs.

It is difficult but I think crucial to explore the experience of polio in an era before the polio vaccines. Kenny's successes and failures tell us much about what was supposed to constitute good science and medical expertise in the 1940s and 1950s. The touching of bodies, the healing of pain, and the softening of twisted limbs were all elements in a familiar picture: a female clinician whose special nurturing skills enable her to devise methods to rehabilitate a suffering patient. But Kenny claimed professional authority in a distinctive vision of medical science where clinical observation could lead to scientific insight. Thus, she said she could look inside the paralyzed body and recognize the path of a deadly virus. No virologist considered these claims scientific. Yet in unclear and unacknowledged ways her claim that polio was not a neurotropic but a “systemic” disease became part of a complicated new picture of polio that emerged in the early 1950s and provided the foundation for the production of safe and effective polio vaccines. With the polio virus now understood as traveling through the bloodstream and lingering in the intestines, other versions of polio science have faded and with them the memory of the fierce battles over how this disease had been understood and why it had mattered.

Before the 1950s the care of disabled patients was seen as extraneous to the daily workings of most health facilities, other than “crippled children's homes.” Children and adults with disabling conditions were often neglected or given orthopedic operations and then returned home to domestic supervision or sometimes to alternative healers. If their condition worsened it was usually blamed on careless or apathetic parents or on meddling therapists who practiced outside the orthodox profession. Kenny's attack on elite professionals and harmful medical therapies resonated with patients and families long suspicious of the standard care of polio and other disabling conditions, especially the sometimes horrific results of orthopedic surgery. Her refusal to fear what was considered the “infectious” acute stage or to avoid touching and trying to heal polio patients helped to ease the stigma of people with the disease. For children with birth injuries or cerebral palsy her work offered a source of hope, one that disappeared as she faded from American memory.

Finally, the story of Sister Kenny illustrates the fragility of memory. Forgetting is sometimes seen as a passive process rather than as an active one, but both remembering and forgetting are responses to the present. Recent studies of memorials have shown that communities were convinced that the choice of the moment to be memorialized must be informed by a moral message. The continuing popularity of documentaries, memoirs, and
truth commissions evidences an unabated public interest in the production of memorials. Yet Kenny's legacy in many ways has been one of forgetting rather than memorializing. The scattered memorials to Kenny in Australia appear in small rural towns: Toowoomba, Townsville, and Nobby, not in Brisbane or Melbourne. In North America there are a few signs in Minneapolis, but not in Winnipeg, Los Angeles, New York City, or Washington, D.C. There was never a federal Kenny clinic, directed by a board of Kenny-inspired professionals and former patients, as Senator William Langer had envisioned.

Polio is an old person's disease now in North America; only in parts of the developing world, in countries with inadequate or disrupted vaccine programs, are children paralyzed today. How they are treated for their paralysis is simply not news. The eradication of polio in the Western world has served to make Kenny's contributions largely irrelevant to modern practitioners.

Exploring the history of clinical care has meant addressing the tricky issue of efficacy. I have often been asked if Kenny was right or wrong.
¹⁴²
The many ways in which her story was continually reinvented by herself and others make it impossible to answer this question. In the story I tell here I emphasize the ways clinical practice has been pushed to the side, especially in histories of polio; the vaccine story has rendered disabled polio survivors and clinical therapy almost invisible. Clinical practices and clinical research, especially during the twentieth century, have not attracted many historians.
¹⁴³
Without a comfortable niche and with the help of her many enemies Kenny has slipped out of public memory.

It was perhaps in response to his sense that this was happening that in October 1953 at a Congressional hearing on “causes, control, and remedies of the principal diseases of mankind,” Charles Wolverton, still the powerful chair of the House Committee on Interstate and Foreign Commerce, returned to the issue of Kenny and her work. Wolverton assumed that most other Congressmen would remember her as he did from her appearance before his committee in 1948 where she had “made an indelible impression on all who were present … both as to her sincerity and her conviction and her ability.” She was, Wolverton added, “a great character [who deserved] … all the honors that have been paid to her.”
¹⁴⁴

Others, including epidemiologist Gaylord Anderson who was the dean of the University of Minnesota's recently established School of Public Health, were more critical. Anderson made clear in his testimony before Wolverton's committee that he did not “accept her explanation as to why it worked and [did] … not think many people today accept her explanation.” And he brought up all the old arguments that nothing about her technique was really new. But, in conclusion, he spoke as a father, not a doctor: “If my daughter had polio, she would have the Kenny treatment.”
¹⁴⁵
It was the kind of conclusion Kenny would have liked.