Charles Wolverton heard the testimony by Kenny and Jungeblut with great sympathy. Wolverton had been a member of Congress since 1927, and chaired the House Interstate and Foreign Commerce committee during the 80th and 81st Congresses. He supported the distinctive kind of research populism Kenny was promoting, and had told Surgeon General Leonard Scheele at the hearings that he was very strongly convinced that much knowledge necessary for “the proper functioning of research and research foundations is not reposed in doctors, with all due respect to doctors … much can be gained by the presence on these councils of lay members.”78 To Kenny, Wolverton expressed his committee’s “very great appreciation for your attendance here today.” He praised her film and her marvelous work, and said he was impressed by “the disdain you apparently have for any financial reward.” His committee was “anxious … to assist you in the great work you are doing,” he assured her, for “you are doing a great service for humanity [and] … are entitled to the respect and the support of all who are in [a] position to give it to you.”79
As a New Jersey representative, Wolverton made much of Kenny’s newly established clinic in Jersey City. He held up the front page of Camden’s Courier Post showing a picture of Kenny at the Jersey City center with a patient who hailed from a town “about three miles from my home.” He paid tribute to Irish-Catholic Democratic boss Frank Hague who had, Wolverton admitted, “not always been spoken of in the highest terms.” Yet Hague’s support of the Jersey City center “will stand as a monument for as long as he should live, and will remain long after he has gone.” Hague’s recognition of the importance of Kenny’s treatment by making it “a part of his Medical Center” was a gesture Wolverton wished more local officials would emulate in their own communities and thus “make possible the teaching of this new concept that Sister Kenny has developed with such wonderful results.”80
NSF DEFEAT
Despite the appearances of Kenny and Jungeblut and the support of many Republicans on the committee, the version of the NSF bill they were debating was defeated. In June 1948 only weeks after Kenny’s appearance in Washington the NSF bill passed the Senate but was held up in the House Rules Committee long enough to miss being put on the House calendar so it could not be voted on before Congress adjourned.81 Truman was beginning his presidential campaign, and the bill floundered over the issue of governance and over the highly charged inclusion of disease commissions. While the American Cancer Society and the American Heart Association welcomed federal funding of “cure-oriented research” through a government agency, the NFIP rejected any agency that included a special commission on polio. Behind the scenes, the NFIP made sure that any version of the NSF bill that included polio research would fail, assuring Congress that such a provision was part of a “ ‘Communistic’ un-American … scheme.”82
With the unexpected election of Truman in November 1948 the politicization of organized medicine intensified. For the first time the AMA established an office in Washington, D.C. and a new Council on Medical Service and Public Relations, whose job was to lobby both politicians and physicians. The transformation of relations among universities, business, and the government in scientific research begun during the war continued, but Truman’s national health insurance plan was firmly and effectively defeated by some of the most sophisticated activist AMA-directed campaigns the nation had ever seen.83
It was not until 1950 after the Democrats regained control of Congress that Truman finally signed a watered-down version of the NSF bill. The President appointed its director, but the director shared power with a board made up of academic and industrial scientists. And there was no polio commission. By this time the funding of medical research was clearly shifting from private to government organizations, and the NIH’s emerging empire expanded with the new National Institute of Mental Health, National Heart Institute, and National Institute of Dental Research.84
Kenny was unable to muster enough support to establish a government research agency that targeted polio, much less one that supported her distinctive theory of the disease, and the NFIP was able to make sure that no National Polio Institute was ever established. The 1948 hearings nonetheless brought populism into the politics of science research, and the new Institutes were overseen by councils that included a few lay community representatives. In June 1948, despite AMA protests that “it may be questioned whether a leader in the field of public affairs will be particularly equipped to make very much of a contribution to the promotion of [that] kind of research,” the surgeon general appointed wealthy lobbyist Mary Lasker, wife of advertising executive Albert Lasker, as the first lay member of the National Heart Institute’s advisory council. Lasker had already rejuvenated the American Cancer Society and had lobbied for laymen to serve on the Heart Institute’s advisory council.85 Naturopath critics wondered sardonically whether she would be willing to attack “enterprises that [had] helped to make her husband rich [such as] … the white flour industry, the alcohol industry, the soft drinks industry, and other evil industries that spend billions yearly in advertising?”86 Lasker’s appointment was a reminder that lay representation did not mean class or regional diversity; indeed “public” could easily be interpreted to mean “patron.”
THE INTERNATIONAL CONFERENCE
On the defensive, the NFIP turned the First International Poliomyelitis Conference into a public relations project. Held at New York’s Waldorf-Astoria Hotel, amid banquets, films, and poster exhibits, the conference program was filled with Kenny’s work––although mostly uncredited. The July 1948 conference had 10 sessions, 3 official languages, and was attended by over a thousand representatives from around 40 countries.87
The conference provided an exciting opportunity to bring together American and European researchers who had been kept apart by the war. Polio had only just become a significant problem in Europe, and physicians were looking across the Atlantic for expertise. Making polio research an international issue showed the American public as well as Congress that NFIP policies went beyond parochial medical politics. Indeed, the word international was a coded Cold War term, indicating American allegiances with other “free” nations.88
Kenny’s appearance at the Congressional hearings had not gained her access to the international conference as a scientific participant. But she was able to attend as a reporter with a press card from the American Newspaper Guild.89 While she could not formally participate during the sessions, she did attend press conferences amid the country’s leading science writers where she stood out in her distinctive, elegant attire. Newsweek described her as a “majestic, white-haired woman in a long black frock, large plumed hat, and heavy ropes of pearls.”90 To the press corps Kenny complained frequently of her exclusion. She made sure her fellow reporters learned that she had not been invited as a scientific participant as a result of “the personal attitude and ambition of Mr. Basil O’Connor [who refused] … to recognize the merit of anything connected with polio treatment that cannot be identified in some way with his name.”91 Her sense of conspiracy was reflected in her private detective escort who accompanied her to these public events along with a man who she claimed was a reporter but, according to a pro-NFIP commentator, was in fact “her own personal press agent who tried to conceal his identity at the Conference.”92
While Kenny’s name was avoided by most of the speakers, her ideas were not. Many of the exhibits and technical films showed aspects of her treatment and featured some of the physical therapists she had trained, and, following Kenny’s lead, speakers sought to link clinical signs to pathology.93 Both spasm and pain were now recognized symptoms, although some presenters argued that spasm was rare, and others argued that its presence did not indicate a new pathology.94 Virologist David Bodian of Johns Hopkins agreed that an “important component of muscle weakness in the acute stage may be a partial and temporary loss of function of some motor units.” He believed that “the origin of muscle pain in poliomyelitis also requires further exploration” and referred vaguel
y to “the re-routing of neuron-chain discharge pathways from interrupted primary paths to secondary alternative paths.”95 Fritz Buchthal, a physiologist from Copenhagen, noted that “the occurrence of ‘spasm’ ” had been “the subject of intensive discussions and controversies,” although in his research spasm rarely occurred unless “passive therapies” were employed too vigorously.96 During the discussion following Buchthal’s paper, Lewis Pollock, a Chicago neurologist, declared dramatically that 11 neurologists assigned to Chicago’s city hospitals had conducted around 9,000 examinations of individual muscles and could not find a single instance of spasm.97 Oxford orthopedist W. Ritchie Russell, the author of a textbook on polio which Kenny had read in the 1930s, said firmly that patients must have “physiologic rest” for any “so-called spasm” could be a muscle’s “response to stretch if nothing else, and perhaps a defense against pain.”98 While the cause of pain in polio, commemorators admitted, was still obscure, most continued to argue that the pathology of polio was without doubt based on affected nerve cells. Stanford pediatrician Harold Faber was sure that the polio virus was “strictly neurotropic.”99 Bodian—a neurobiologist and not a clinician—was one of the few who wondered out loud about “the possibility … that a peripheral disease may exist in the absence of central infection.”100
Kenny did not pay much attention to this kind of debate. She was upset when someone asked a question about the cause of spinal deformities, which members of the panel on stage could not answer. Some of her physician allies asked her to explain this symptom, but when this request was sent to the session’s moderator Robert Bennett he did not recognize her as an appropriate respondent.101
Kenny did respond dramatically after a session in which Herbert Seddon, a respected British orthopedist, criticized her method by name. Seddon may not have noticed that the American participants were avoiding Kenny’s name, or he may not have cared. Speaking as a specialist still reeling from the reorganization of the British health system and without the backing of a major polio philanthropy, he called on physicians to seek more economical treatments, arguing that the public “should get value for money.” He was one of the few participants to discuss the cost of medical care openly. “Everyone agrees that the Kenny treatment is expensive,” he said, quoting an estimate from Nicholas Ransohoff that Kenny treatment was around 5 times as expensive as orthodox care. According to the views of “dispassionate critics,” Seddon declared, this expenditure was not justified. He was unsparing in his attacks on his own colleagues as well. “It is not sufficient to dismiss Miss Kenny’s work as an expensive nine days’ wonder; we must ask ourselves whether our own methods of treatment are altogether rational. Maybe we are, in fact, wasting money in prolonging treatment beyond the point when it is of the slightest use to the patient.” He also noted what he called “curious inconsistencies” in current polio practice, urging his peers to “abandon the notion that denervated muscle is in a peculiarly delicate state [for] … it does not degenerate; it atrophies.”102 Physicians, Seddon argued during the discussion of his paper, needed better studies of recovery based on “carefully controlled clinical experiment[s].”103 While he was uncomfortable with Ransohoff’s promotion of curare, he did praise Ransohoff’s arguments in favor of early ambulation compared to the “slavish enforcement of bed-rest that most of us had practised [sic].”104
Kenny then demanded a news conference with Seddon and Ransohoff. She had contested Seddon’s views before, assuring her Australian critics that his claim in 1947 that spasm was rare in his own patients was because “Professor Seddon is viewing the disease from the orthodox point of view.”105 Now she and “a corps of assistants began feeding statements into a mimeograph machine and within a few hours she had a batch of handout[s] for other members of the press.” Seddon and Ransohoff attended this press conference as did Fishbein. Wearing a royal purple dress and large garden-party hat, Kenny challenged Seddon’s calculations and his critique. Kenny treatment at both the Minneapolis Institute and at the Jersey City center, she argued, cost between $9.12 and $12.50 a patient daily, while Ransohoff had previously told her that in his hospital such care cost $17 a day. In any case, the comparison was inappropriate, for it was comparing good care to poor care and therefore any discussion “was a waste of time.” As for the “dispassionate critics”—who she guessed were the members of the 1944 AMA committee—she gave Seddon copies of a telegram showing their refusal to give out the names of the cities or hospitals they visited and one from Alfred Deacon noting that at the end of a 2-year period his Kenny-treated patients were “ten times better.”106
Ransohoff refused to back down, and while Seddon responded politely, he also did not yield. He thanked her publicly “for methods which you have given me that are advantageous to my patients. You got rid of braces. But I do not agree with you on everything. I have to treat the very poor. And for them, when speaking on economic grounds, I cannot recommend the Kenny treatment on account of expense.”107 Kenny technician Amy Lindsey recalled later that Seddon came back into the meeting room after the reporters had left and shook Kenny’s hand saying he admired her although they didn’t agree on everything.108 In contrast, Fishbein recalled that Seddon had said to him after this press conference “I think the old girl is potty.”109
Reporters were split between admiring Kenny’s bravado and finding her amusing and embarrassing. NFIP publicist Roland Berg reported in an internal note that when “Miss Kenny attempted to voice her pseudo-scientific facts … the press was not at all impressed and reported nothing of her claims.”110 But science journalist Albert Deutsch disagreed. In his article “Sister Kenny and the Foundation” he wrote that Kenny had “made a greater contribution to its treatment than any other personality of our generation” and for 30 years “had to fight the bigoted opposition of medical groups who were outraged by the notion that a nurse could teach them anything.” Deutsch castigated NFIP officials who had deliberately ignored her and “apparently have allowed personal peeves and prejudices to get in the way of scientific duty and humanitarian consideration.” Like “many great medical pioneers,” he admitted, Kenny could be difficult and placed too high a value on her work, but she had “beyond all doubt, made a most valuable contribution to the understanding and treatment of polio.” “Under no circumstances,” he cautioned, “should personal feuding be allowed to stand between children fighting off the crippling after-effects of polio and the best possible means of helping them get well.”111
In a deliberate rebuttal to the film Kenny had shown Congress 2 months earlier, University of Illinois’s Division of Services for Crippled Children, funded by the NFIP, presented a new technical film called Nursing Care of Poliomyelitis at the international conference. It was 4 reels and in sound and color. Kenny’s methods appeared throughout, without her name and once again in a modified version. Thus, the first reel, The Acute Stage, showed the use of footboards and hot packs (both Kenny hallmarks); the second reel, Treatment of Spasm, demonstrated details of administering hot packs as well as how to use baths as a substitute; the third reel dealt with the iron lung; and the fourth, on the convalescent stage, showed ways of applying splints “to prevent deformity” and various muscle tests. A JAMA reviewer thought the film was likely to be useful in training physicians, advanced medical students, nurses, and physical therapists, “who may not always appreciate how elaborate the procedure must be if the patient is to have the best possible care and [be] spared unnecessary suffering.”112 Humane polio care, this film suggested, could be obtained by mixing old and new methods, not by slavish adherence to a single program.
AFTER THE HEARINGS
By December 1948 2 main changes in polio treatment, research, and funding were in place. The first was a new organizational structure for the KF. Donald Dayton, a Minneapolis businessman whose son had been paralyzed by polio and treated by Kenny, now headed its Board, and pediatrician Edgar Huenkens directed the Institute. The second change occurred far from Minnesota with the organizat
ion of a Citizen’s Polio Research League, a lay group inspired by the Congressional hearings, based in California’s San Fernando Valley.
In Minnesota Huenkens, who had come to local prominence as the head of the state’s polio commission during the 1946 epidemic, reorganized the Institute’s medical staff, appointing Miland Knapp, who was already in charge of polio technicians at the University hospital, as head of a new physical medicine unit with authority over the Institute’s technicians. Huenkens was eager to reestablish relations with the University of Minnesota and with the NFIP, but he recognized the delicate balance between maintaining Kenny’s trust and working with those she considered her enemies. “I firmly believe in the value of her treatment,” he declared in the formal announcement of his new position, and “we hope to do away with the antagonism that exists between Sister Kenny and the medical profession, which has caused both to be misunderstood by the public.” Once these misunderstandings were resolved he believed that “physicians will be able to judge the Kenny method objectively,” and he invited every doctor to the Institute “to observe for themselves the treatment and its results.”113 In a statement reported in local Minneapolis papers Kenny declared, “I quite agree with the procedures of members of the medical profession for their caution in not embracing new ideas that may from time to time be presented, including my own, until they are satisfied they are effective.”114 Huenkens had helped to craft this statement, and he boasted to Van Riper that “this is the most forward statement she has made yet and I got her to make it.” The Institute under his direction was now successful in “getting the doctors to adopt her methods and ignore her.”115 Van Riper did feel that “for the moment that the Kenny situation in Minneapolis is under control,” but he remained suspicious. Huenkens urged him to come out to the Institute, but Van Riper refused, adding he “would come out if I was sure I would not have to encounter her—the only way I can remain something of a gentleman is to avoid meeting her.”116
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