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.”94 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.”95 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.”96 Another local supporter reminded Kenny of “the secret opposition and jealousy and pride of the ‘established’ order.”97 Kenny needed no such reminder.
A NEW MOVEMENT?
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.98
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.99 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.”100
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.”101 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.”102
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.”103 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.104 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.”105
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.106 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.107
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.108 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 b
e accomplished by them except perhaps further misunderstandings.”109
Kenny had no patience with obscuration. In sorrow and anger she agreed that the AMA report did not represent Compere’s own opinion for “you are too honest, I hope, to be a double-dealer.” But she was “surprised to think you signed your name to it,” especially as it “accused me of perjury,” which was “poor thanks to give to one who came from afar to give to you the greatest gift you and your people have yet received with regard to this disease and many others.” Compere should be well aware that the committee had not “made a close study of this work for two years” but instead had wasted time “visiting other Centers where a crude, mongrelized treatment is given.” As for her claim that orthopedists resented losing surgical patients, “an Orthopedic Surgeon from Kansas City informed me that the average work of the Orthopedic Surgeon was 40 per cent the after-effects of infantile paralysis. Whether it is correct or not I do not know.”110 She did not comment on the ethical implications of her statement, which had angered Compere, but defended herself from what she saw as accusations of fraud and deception. This was not a letter that could be answered in any calm way and Compere did not try. Instead he quietly moved away from his prominent stance as a Kenny ally and began to rebuild allegiances with his specialist peers. “My interest in any particular method for the treatment of infantile paralysis, has been over-estimated,” Compere told a man seeking his support for an invention to standardize heating hot packs a few months later; “I have used hot packs, as recommended by Miss Kenny, but have found them far less curative than Miss Kenny herself.”111 Compere continued as the chair of the orthopedics department of Northwestern’s medical school until 1949 and in the 1950s edited a well-known volume on orthopedics and traumatic surgery, but—perhaps as the price he paid for supporting Kenny in the early 1940s—he was never elected to a senior position in any national orthopedic society.112
By comparison Robert Funsten and Charles Frankel, his junior associate at the University of Virginia, remained important orthopedic authorities, speaking frequently about the dangers of Kenny’s version of polio care. At the Southern Medical Association in 1945, for example, they warned that a “rigid” use of the Kenny method, which they had tried in 1943, had been “expensive, illogical and unsatisfactory.” Perhaps Kenny had “stimulated a great deal of investigative work,” but much research had now “disproven many of her statements and claims.” They also condemned her “bitter determination … to force her theories upon the medical profession and the public regardless of pathological data.”113
SEND IN THE NATIONAL RESEARCH COUNCIL
In July 1944, Marvin Kline, as head of the Institute’s board of directors, wrote to O’Connor to apply for a 3-year $840,000 grant. In what was clearly another move in the polio wars Kline said boldly that this large NFIP grant would be used to continue funding the Institute’s technician teaching programs in the Kenny method—“the only treatment based on sound physical medicine”—and to establish a clinical research center at the Institute to be “devoted to clinical investigation of the disease of infantile paralysis and the application of the Kenny principles to other neuro-muscular diseases” including arthritis, cerebral palsy, and postoperative care.114 Gudakunst asked Diehl to find out more about this request. Diehl checked but found that neither Knapp nor the current coordinator of the Kenny courses at the medical school knew “anything about it.”115
The NFIP wanted to handle this grant application as carefully as possible. The decision to turn the Institute into a center for clinical research would represent a major shift in power relations between the NFIP and Kenny’s supporters. The NFIP, further, had consistently argued that the Institute was an inappropriate site for polio research. Twelve months earlier Kline and 2 city aldermen had traveled to New York to discuss the Institute’s budget and had promised O’Connor “that the purpose of the Kenny Institute was for the teaching of the Kenny method” and that NFIP funding for the Institute was to be handled between Diehl and O’Connor.116 But now a group of Institute officials was acting without having consulted Diehl or even most of the physicians in its own facility.
It was here that John Pohl, superintendent of the Kenny Institute, made a decisive move away from other Institute physicians. He had written the grant application in consultation with Kline and other members of the Institute’s board, and he recognized that calling the Institute a potential research site was a defining step. Krusen at the Mayo Clinic and Lewin in Chicago may have been able to express their support of Kenny while holding onto the respect of their specialist peers, but Pohl was working in the eye of the storm without a senior teaching position at the medical school.117 His polio work had rapidly become an inseparable part of Kenny’s sphere.
Pohl was a shy man, uncomfortable with the cocktail parties and formal dinners that Kenny adored. Yet he had increasingly linked his own career to Kenny. He admitted that she could be difficult but he began to feel that his contribution was translating her ideas for other doctors to understand.118 Kenny’s work with Henry Haverstock had impressed him mightily, and in 1942 this patient (H.H.) was the first of a series of 26 patients he described in a report on the Kenny method published in JAMA.119
Kenny saw Pohl as one of her most attentive and helpful supporters. He had, she noted in early 1942, “attended every session and was present at the bedside of every acute case when examined by me and took particular care to watch all phases of the signs and symptoms and the especial treatment for each sign and symptom.”120 Pohl’s promotion of Kenny, however, made him less reliable as an objective medical observer.121 But he deeply believed that the worth of her work should stand above petty politics, whether among city officials, the Institute’s staff and directors, or the medical school faculty. Immediately after the AMA report he had told the local newspapers that her work was “the finest and best treatment known at the present time” and that “antiquated methods which allow children to suffer deformities from infantile paralysis should be abolished.”122 University physicians, in Pohl’s view, had allied themselves with the NFIP ostensibly for scientific reasons but really because the NFIP was one of the nation’s richest sources for medical research funding. It was an expression of his personal and professional faith in Kenny’s work that led him to take this provocative new step of trying to expand the Institute’s mission.
O’Connor decided that the opinion of a group outside the NFIP was needed to assess this new grant application and turned to the National Research Council (NRC) to advise the NFIP on whether to fund it or, more accurately, how least problematically to reject it. Founded during World War I as a scientific advisory body for the military, the NRC had taken on this function again during World War II, establishing a series of committees offering expertise on topics ranging from foot fungus to dengue fever.123
In August 1944, in response to O’Connor’s request, the NRC’s Division of Medical Sciences set up a special subcommittee to investigate the Institute’s grant application.124 The coordinators of the subcommittee, George Darling, the vice-chairman of the Division, and O. H. (Perry) Pepper, head of the Division’s Committee on Medicine, were careful to frame this investigation as the arbitration of what constituted an appropriate place to conduct scientific research and professional training based on national standards and the NFIP’s already established policies. The new subcommittee, they reiterated, was not going to “get drawn into any of the pros and cons concerning the Kenny treatment itself.”125
Pepper was a senior faculty member at the University of Pennsylvania and a member of a socially prominent Philadelphia family.126 The rest of the NRC subcommittee consisted of 2 medical school deans (Milton Winternitz of Yale and Wilbur C. Davison of Duke), a physiologist (Philip Bard of Johns Hopkins), a virologist-epidemiologist (Thomas Francis Jr. of the University of Michigan), an orthopedist (Guy Whitman Leadbetter from George Washington’s medical school), a physical medicine expert (George Morris Piersol of the University of Pennsylvania),
and George Darling himself.127 Francis, who later coordinated the Salk vaccine trials, was the only member with research expertise in polio. Neither Piersol nor Leadbetter, the 2 clinicians interested in polio therapy, had been to Minnesota or played any part in the polio wars.
Polio Wars Page 41