O’Connor began to hear troubling reports that the demands of wealthy families for private care were diverting Mary Kenny and Gardner from their teaching work. He told Gudakunst to explain to Kenny that the technicians must return to the United States. Gudakunst reminded her of “language problems” and “some hospital quarrels” and warned that “the political situation in the Argentine” was unstable.189 At first Kenny agreed that “with regard to Miss Gardner’s and Mary’s return from the Argentine, that is a matter for the Foundation to decide. They sent them down, and I think Mr. O’Connor would know more about the inside affairs than I do. If he thinks it wiser for them to return, that is all right.”190
But she changed her mind a week or so later. “The work they are doing and the friendships they have formed through this work is [sic] doing much for the U.S.A.,” she told Gudakunst in what he admitted to O’Connor was “a rather heated conversation.”191 The quarrels, she had learned, “were between the Doctor from the United States and my own technicians,” and John had threatened to “have them returned to the United States before their time was up.” In any case, neither technician wished “to leave an unfinished job.”192 As Kenny recollected it a few months later, Mary had asked to be allowed to stay, “as the children were so very sick and there was no one to attend to them. She also informed me that the doctors were very interested and that she was giving them lectures three times per week.” Mary also described “the tears of gratitude in the eyes of the mothers.”193 Kenny’s obstinate stance was fueled by her sense that John had not properly valued her work. To explain how wrong Gudakunst had been to defend John, Kenny sent him a copy of a lecture John had given to local orthopedists that she characterized as “a gross misrepresentation of my work and primarily a lecture on the value of orthopedic surgery.”194 In reassuring Argentine orthopedists about the power relations inherent in adopting the Kenny method, John had said that Kenny technicians were all “trained under orthopedic surgeons and the mechanism of the treatment itself is basically orthopedic,” and that Kenny’s work was a useful “adjunct to orthopedic surgery.”195 “[He] does not know how terribly sick these patients are and how much general care they need apart from orthopedic attention,” Kenny retorted, adding that “my contribution is not a treatment or adjunct to anything but a new concept of the disease and treatment for this concept.”196
Kenny responded, in effect, as the director of the technicians, ignoring what she saw as misguided advice from the NFIP. Gudakunst warned her that the NFIP would no longer fund the technicians if they remained, but, she assured him, “I shall personally take steps to see they are afforded the financial support and protection they may need.”197 She then organized a series of telegrams to the secretary of Argentina’s Infantile Paralysis Commission and to the American Consul in Buenos Aires.198
In early June the Argentine army led by General Arturo Rawson and General Pedro Ramirez marched on the federal capital and ousted President Ramon Castillo. Kenny paid little attention to this hazardous political situation. A day after the June coup was reported in American newspapers, she sent a telegram to the technicians formally granting them 2 months extension. Finally, on June 4, Gudakunst sent Mary Kenny an explicit telegram—with a copy to Kenny—warning of the dangers of staying and making it clear that the NFIP was no longer accepting any responsibility for their safety.199 The 2 technicians stayed in Argentina for an additional 2 months, in part so that Kenny could make the point that providing medical care could and should trump politics. A few weeks after the coup Kenny urged the secretary of Argentina’s Infantile Paralysis Commission to send doctors and nurses to be trained at the Institute in order to “make Buenos Aires a center to give assistance to the rest of Spanish-speaking America,” for “I presume the change of government shall not interfere with this project.”200 Gardner later recalled that during the revolution she and Mary had gone downtown and saw a mob of people, buses tipped over, and bullets whizzing around, but they had not seen the upheaval as any reason to return home.201
Relations between Kenny and the NFIP began to deteriorate after O’Connor withdrew the NFIP’s sponsorship of the technicians. In June she met with O’Connor in his office in New York City and was shocked when he defended his actions, saying his desk was full of complaints from American doctors.202 Kenny was outraged by what she felt was a disrespectful act, and that it was directed at Mary, her beloved ward, made it a personal attack. Mary, she pointed out in long letters to Minnesota’s medical dean, “ran the risk of infection in one of the most deadly diseases where death, or worse than death, can be reasonably expected.” Kenny had read the telegram as an abandonment of Mary, not an effort to get her to return to safety. “To be cast off in a foreign country that has just experienced a revolutionary change in government and told that no effort would be put forth for her safe return is, to me, an act of barbarism than even Hitler could not exceed,” she argued.203 In Kenny’s opinion, the telegram had even insinuated that “the patients suffering from the disease infantile paralysis in the Argentine would be better served if she left them.” Yet, she protested, the American Consul, the Argentine Ambassador, the secretary of the Infantile Paralysis Commission, and a representative of the parents were all grateful and had “thanked me most cordially for my splendid cooperation.” Thus, this statement was “untruthful and malicious.”204
The Argentina fiasco was, in her mind, a turning point, separating the NFIP leadership from her American supporters. Kenny told dean Diehl that she was unwilling to accept any further money from the NFIP, and that when Mary returned from Argentina she would not be accepting any more either.205 In early July Kenny returned a $415 check with a letter to Diehl, noting that “the reason has already been explained to you.”206 Diehl replied quickly that he was “indeed sorry that you feel that your relations with the National Foundation for Infantile Paralysis are such that you are unwilling to accept any further support from funds supplied by them,” but he was happy to hear her say that her difficulties with the NFIP would not interfere with her cooperation with the University of Minnesota.207 That summer Kenny did not publicize her dissatisfaction with O’Connor. As she completed the last pages of her autobiography, she described the Argentina trip in glowing terms and said nothing about the telegram, noting only “how sweet the thought that the plane carrying them to this new and distant county did not bear bombs to spread death and disaster even to innocent childhood, but a message of hope and comfort to all!”208 And that August in a radio talk she praised the assistance of C. C. Webber, the NFIP, and the Reader’s Digest in helping “this message of healing … spread throughout the continent of the Americas.”209 Similarly, Gardner expressed no hint of antagonism when she submitted her expenses to O’Connor in August. It had been “a wonderful experience,” Gardner said. “We were quite successful in setting up a Kenny unit in Buenos Aires” and “the people of Argentina will be ever grateful to the National Foundation and Sister Kenny for what was done for them.”210
By the fall, however, local newspapers were announcing “U.S. Polio Foundation, Kenny Split.” She could no longer accept support from an organization, Kenny told reporters, that “can administer or withdraw funds at the will of a few people.”211 The Argentina story became a powerful weapon in her growing arsenal. Hoping this would soon blow over, NFIP officials responded by quoting the $230,000 the NFIP had spent “evaluating and teaching” the Kenny method, pointing out that the organization was the “sole financial supporter of Sister Kenny’s work” and (unwisely) terming the Argentina dispute “a local controversy over the establishment of a local clinic.”212 Later, and in vain, O’Connor’s staff showed reporters copies of the letter from Kenny telling Gudakunst “that if Mr. O’Connor thought it wiser for them to return, that is all right.”213
In Minneapolis Kenny’s sense of community support was deepened when, in August 1943, the city council announced that it was buying her a house. “ ‘I think it is about time we did something for Sister Kenny so
she will have a direct connection with the city,’ ” explained an alderman.214 Marvin Kline, the new mayor of Minneapolis, arranged for the city council to thank Kenny formally for having “graciously chosen Minneapolis as the place to carry on her work and the City’s reputation as a center of healing has been increased thereby not only in this country but throughout the world.”215 Kenny was delighted with the “beautiful home” whose “spacious, well-furnished rooms, … green lawns and flowering lilacs and window boxes” allowed her to feel “as if I had reached a secure haven at last.”216 Her friend businessman James Henry turned to one of his civic clubs to help her financially, and in August 1943 the Exchange Club began to pay an allowance to Mary and Kenny; the club’s monthly checks were, she noted, “issued promptly.”217
IMPATIENT INNOVATOR
Kenny was beginning to see herself not as an NFIP-sponsored clinician and teacher but as a scientific innovator with a national reputation whose patience with narrow-minded critics was coming to an end. In a long letter that she sent to Gill, the Orthopaedic Correspondence Club, and the NFIP, she denied that the value of her work had been established by newspaper publicity rather than by serious professionals. Indeed, she claimed, the press had made “poor presentations” of her work compared to “the signed statements of medical men of unquestionable ability and many of international repute.” Most of her letter was filled with short testimonials from a mixture of pediatricians, health officials, physical medicine experts, and orthopedists, all of whose ability to change their mind took “courage” and showed “the mind and heart of the true physician.”218
Kenny did not try to address the physiological debates, other than remarking that “paralysis occurs from causes other than destruction of parts of the central nervous system” and that the significance of spasm was “one of the things I came to the United States to find out.” Gill’s references to Lovett were easy to combat. Many doctors in Minneapolis “had been Lovett trained and were just as strong disciples as yourself prior to being presented with the true symptoms.” Mental alienation and incoordination were “damaging symptoms over which Lovett or anyone else could not have any control.” Defending the attack on her character, she explained she did not seek fame or fortune. Indeed her national reputation had provided her increasing opportunities for both, which made her restraint even more honorable. “I have patiently, intelligently, humanely, and voluntarily presented this evidence to the medical world whom I consider are the keepers of the nation’s health and well-being, denying myself the opportunity to capitalize the results of my own research, steadfastly refusing to associate myself with any of the minor branches of medicine—such as, osteopathy, neuropathy, etc.—although repeatedly invited to do so.” She urged Gill and other skeptics to come to Minneapolis where “you will see and agree with all other medical men that the concept is the opposite and the treatment is the opposite.”219
THE RED BOOK
Kenny’s most powerful weapon was her new textbook, whose advertising had so incensed Gill. Boldly defending her techniques and her theories it was co-written with her ally John Pohl and framed by 2 forewords—one by Harvard orthopedist Frank Ober and the other by Basil O’Connor—and ended with a commentary by Miland Knapp, representing physical medicine. Wallace Cole, the senior orthopedist at the University of Minnesota, had no part in this effort but the text was dedicated, rather pointedly, to him “in recognition of his efforts to investigate, test and finally approve of the Kenny concept and treatment of the disease anterior poliomyelitis.”220 With its striking crimson cover and gold lettering, The Kenny Concept of Infantile Paralysis and Its Treatment became known as the Red Book.
Both forewords were cautiously positive. Ober, as president of the American Orthopedic Association, praised this “well-received plan” for the relief of pain and muscle spasm and “for the re-education of the neuromuscular system.” He said nothing about any possible physiological explanation for spasm, remarking instead on the method’s continuous superb nursing that helped patients “gain the maximum amount of recovery more quickly and much more satisfactorily than by the techniques previously employed.” Moist heat, he noted, had been used by Lovett, but not in the acute stage and not for the relief of spasm. Spasm was not mentioned in textbooks yet there was “no doubt that it is present and is a great factor in the production of early deformities unless relieved.”221
O’Connor tried to promote Kenny’s work without further antagonizing orthopedists or other professionals. With the support of America’s “progressive and sympathetic medical profession” and the NFIP to lead the fight against polio, Kenny was working “side by side with clinicians, scientists, [and] research workers, preparing a complete and connected picture of her ideas and methods” in order to develop a technique that could be taught to others. With an implicit critique of the dramatic demonstrations the press and Kenny loved, he noted that “in medicine it is not well to believe the eye alone.” Both American physicians and the American public needed to have many questions answered before they could “be certain this was not legerdemain or mere chance.” Fortunately, “those who work in the laboratories with problems on histopathology, anatomy, and physiology claim that the major concept is reasonable and rational.” These researchers, he declared in a statement that awkwardly separated her techniques from her ideas, were convinced that Kenny “presents an entirely new concept and a satisfactory treatment for this concept.”222 But O’Connor’s effort to dampen debate around Kenny’s work and to present the controversial issues as resolved fooled no one. O’Connor’s statement, especially his “reference to the sympathetic and progressive medical profession,” Chuter joked to Kenny after reading the foreword, “is a corker.”223
In her preface, Kenny told the now familiar story of the lone worker in the bush of Australia who saw painful muscles “being subjected to contraction in some way affected by the disease” and realized that “the muscle was sick and needed nursing.” After her methods had relaxed the muscles she saw “the muscle which had been pulled from its normal resting length had forgotten how to contract and must be taught over again.” In telling the story of her discovery of alienation Kenny dived into the murky depths of mind and memory. “Remembering that consciousness is born from the subconscious, I endeavored to bring consciousness about by attempting to bombard this area with impulses from the surrounding muscles.” But as “the normal flow of impulses” had been interrupted “the patient could not visualize in space the exact area from which an attempt to contract should [be] materialized, and the impulses ran riot as it were.” The social organization of the body’s neuroelectrical functioning was out of harmony, and awareness and regularity of muscle movement had to be reestablished. After she described these new symptoms she reiterated that “the treatment evolved by me is not for symptoms previously recognized, but for a different concept altogether.” Despite ridicule from Australian physicians, studies by American physiologists like Schwartz had upheld her work and “proved my concept correct.” Reflecting her growing uneasiness that the teaching of her work outside the Institute was being diluted, she reminded her readers of the Institute featured as the book’s frontispiece. This “noble building” had been established by Minneapolis’s Board of Public Welfare and “will, I hope, provide a further means of distributing this work throughout the world.”224
In his introduction Pohl had the difficult task of both confronting and convincing his wary peers. He began with an attack on orthodox polio therapy pointing out that immobilizing techniques that allowed weakened muscles to rest had made sense, based on the orthodox concept of polio, and yet, as he and other orthopedists knew well, “deformities too frequently occurred.” The Kenny concept explained why immobilization was so often unsuccessful. Orthodox therapy had ignored the possibility that “loss of control of muscle could be due to disorganization and disruption of the nerve cell connections.” As a result, Pohl declared, “orthodoxy has erred both in the recognition as well as in the interpre
tation of the physical findings in the disease.” Indeed the new concept introduced by Kenny was “so radically opposed to the old as to almost warrant considering the entity as a new disease.” He speculated briefly on the physiological and pathological etiology of these new symptoms, concluding that the polio virus probably “affects muscle as well as nerve tissue.”225
In frustratingly repetitive prose Kenny and Pohl’s main text explained how to identify and treat spasm, alienation, and incoordination. Unlike the kinds of spasm seen in “other disorders of the neuromuscular or skeletal system of the body,” polio spasm did not completely relax under general anesthesia and could be relieved by moist heat “treating the specific area of involvement,” suggesting that a “local process is taking place in the muscle.” The exact mechanism of the process of alienation was not clear, but it was possibly the result of “disturbance of the physiological continuity of the motor tracts between the conscious voluntary brain and the muscle.” Incoordination was the result of “a disorganization of the regulating motor centers of the nervous system” that disrupted the “natural rhythmic and cooperative action of associated muscles.”226 Here, the body’s neurological functioning had become disordered like the middle of a war or a badly organized hospital. Kenny’s method could restore physiological order by bringing body memory to the conscious mind.
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