THE HOPE OF EUROPE
As much as Kenny valued Jungeblut, she placed even greater faith in her European connections. She had come to see Europe as a promising site for leading clinical and research work that would be unfettered by the influence of the NFIP or the AMA. Although she had long spoken grandly of the Kenny treatment practiced around the world, before 1945 her work had been fully institutionalized only in the wards of the Queen Mary’s Hospital in Carshalton by nurses and physical therapists she had trained in the 1930s. During the war doctors, nurses, and physical therapists from South America and Canada and a few from elsewhere had come to Minneapolis to study her methods and returned to their home countries, but such practice was individualized and fragmented. After the war prominent visitors included activist Krishna Nehru Hutheesing, the sister of India’s first Prime Minister, who reminded Kenny that she had promised to send “a film for our Clinic in Bombay.”85 But a single Kenny technician accompanied by Kenny’s technical film, even boosted by community goodwill, was unlikely to be able to transform polio care in a hospital or region, much less a nation.
At the end of the war as polio epidemics spread across Europe Kenny could see the possibility of expansion into communities where the NFIP did not reach and where scientists might be more willing to explore new ways of thinking. She began to travel regularly across the Atlantic with funding from the KF. Her reputation and her connections—as well as the RKO Sister Kenny film—opened doors for her.86 Reflecting war-torn Europe’s eagerness to “catch up” in medicine, science, and technology, and a wider gratitude toward Americans who had helped to win the war, Kenny was treated as an honored guest. When she stayed at the Hotel Metropole in Brussels, the Belgian flag was brought down and the Union Jack raised up. When she visited Prague and heard a band playing a song of welcome she wondered whether Stalin or some other Soviet leader had arrived. Realizing the band was honoring her, she “felt a little bit small and foolish but, however, it was nice of them to pay such homage to an alien.”87
During these trips she tried to shore up medical respect and counter antagonistic publicity. Officials in Rome assured her they would be sending a doctor and 2 nurses to study at the Institute, but a skeptical Italian pediatric professor asked her why her procedures were not mentioned in an NFIP booklet. Kenny explained that the pamphlet “had been compiled in the very earliest days of my visit to America and was not authentic.”88 In Athens, the Minister of Hygiene thanked her for the film and pamphlets she had donated and said he would be grateful to learn of “further developments made in your Institute in the field of research and treatment of this disease.”89 In Spain the prominent orthopedic surgeon Vincente Sanchis-Olmos praised her for drawing attention to lesions in skin and cellular tissue and quoted virologist Julian Sanz Ibanez of the Ramon Y. Cajal Institute whose work showed that all problems in polio did not “result from lesions of the central nervous system.” To her European audiences Kenny spoke freely of her battles with the NFIP and the AMA. “We know that there are political problems in America,” Sanchis-Olmos declared in his own interpretation, “because this method is not American and Sister Kenny is not a doctor but a nurse.” While the KF was trying to push Kenny aside, the board did reward these words of support with $3,000 to the Cajal Institute.90
A symbolic moment came in the summer of 1950 when Richard Metcalfe, the senior orthopedic consultant at the Queen Mary’s Hospital, “shook my hand, congratulated me upon my great discovery and presented me with a copy of that very conservative medical journal, The Lancet, wherein it is stated that both my pathology and therapy had been proven correct.” This “red letter day” reminded Kenny when, 13 years earlier, “in the very same ward, my theories were met with repudiation and rebuff.”91 Metcalfe had become a consultant at the hospital in the mid-1940s and had been impressed with its patients. Learning about Kenny’s methods from the hospital’s physical therapists, he had convinced other physicians to allow this work to continue. When he first met Kenny in 1948 she had struck him as “a battleship in full steam,” but he had grown fond of her and championed her work.92
While Metcalfe may have spoken fulsomely to Kenny, in fact the Lancet reference was neither an editorial nor a research article, but a description of a recent symposium on polio held by the Society of Medical Officers of Health. Although the report was hardly an endorsement by the journal itself, it did show significant interest in her theories among English health officials. At this symposium Metcalfe had praised her ideas on pathology and therapy, pointing out that polio was not “the localized disease it was once thought to be” but in fact “involved not only nerves but also nerve end-plates, muscles, fascia and skin.”93 Without mentioning Kenny’s name, one of Metcalfe’s colleagues at Carshalton also praised the condition of patients who had received hot packs.94 Kenny’s treatment had first been condemned as of “no importance” and her “osteopathic” pathology dismissed, remarked another official. But now both her methods and her ideas were accepted.95 Calling Kenny’s ideas osteopathic reminded listeners that polio rehabilitation frequently attracted unorthodox practitioners, and such faint praise barely raised Kenny out of this despised crowd. Despite the cautious praise by individual European physicians, Kenny’s work was never established as a fully institutionalized global enterprise. But there were 2 places where enterprising Kenny technicians were able to set down strong roots, at least for a time: Belgium and Czechoslovakia. The possibility for establishing a European center in Belgium came during a polio epidemic in the summer of 1945, when Kenny had visited a small Brussels polio clinic, which was part of a neurological institute directed by Leon Laruelle. Kenny and her technicians had treated some of the patients and she showed her technical film. Laruelle was impressed both with the clinical results and the film, which he compared to “a great interesting book which he could read many times.”96 He agreed to allow Dorothy Curtis and Nora Housden, Kenny technicians fluent in French, to work at the clinic from the summer of 1945 to February 1946.97
In 1948, Curtis and Housden, funded by the KF, returned to work with Laruelle to establish what Kenny believed would become a European training center and research institute. Like Kenny in her early years in Minneapolis, the technicians hoped that the bodies of their patients would stand as powerful evidence of the efficacy and validity of Kenny’s work. At first they were allowed to treat only chronic patients, as local physicians were reluctant to allow them to care for patients in the acute stage “out of fear that the hot packs would strain the heart.” The work was exhausting; the technicians had to do all the hot packing themselves “with very inadequate equipment.” “The days are never long enough,” they reported. But by the end of 1948 they were treating two-thirds of the clinic’s patients and beginning to train 2 packers.98
Patients began to arrive from Israel, Spain, Turkey, North Africa, the Congo, France, Luxembourg, England, and Ireland.99 By 1950 the technicians were teaching 5 students: nurses from France, Denmark, and Belgium, and a Romanian woman doctor. The Brussels clinic, a converted nursing home, was not large enough and its physical plant was awkward: 5 stories and no elevators, halls too narrow for carts, and bathrooms on stair landings. But it grew to 40 beds—most of them filled by private patients—and gained a significant reputation across Europe.100
Convincing Belgian physicians, even those who worked in the clinic, was, however, not easy. In November 1948, a Dr. Schwarz was appointed as the new medical supervisor of the polio wards. Although he had “hardly grasped the full Kenny concept,” Curtis and Housden reported to Kenny, he appeared to be “favorably impressed by the results.” He read the literature with interest and asked for more, “especially anything published in official medical journals.”101 Yet Curtis and Housden found that without their close supervision Kenny methods were easily modified. In the fall of 1949 Curtis left briefly to attend a private patient and Housden went to the Jersey City center for a working vacation. Although they had left explicit instructions as to how their patie
nts should be treated, Housden was disturbed on her return to find her Brussels patients had been given “additional ‘short wave’ treatment” prescribed by Schwarz who “feels strongly the benefit of the increased blood supply to a limb, and is making charts to record his findings.” She had a heart to heart talk with Laruelle, arguing that “our patients needed to have ‘unmodified Kenny Treatment.’ ” Laruelle recognized that he was being called on to defend the technicians’ sense of what was proper care against the interests of other members of staff. He responded quite well, Housden told Kenny, and agreed that “none of our new cases” would have this treatment. Housden had been “amicable about the matter,” she assured her mentor, “but had to be amicably firm!” Schwarz, she added, “can do what he likes with his own old cases.”102
Still, any gains in their efforts to disperse knowledge of Kenny’s work around Europe remained precarious. Laruelle, for example, frequently lauded the Kenny treatment when he showed medical visitors through the clinic as a technique that was “physiologically rational, and has beneficial effects all its own.” The method could show “its useful effects,” he believed, only if it were applied “by technicians possessing a profound knowledge of anatomy, … the gift of observation, an innate intuition and a high moral conception of their mission.”103 But when the technicians asked him to let them teach local nurses, they were told either that no nurses were interested or that it was impossible to spare any.104
Laruelle was privately supportive of Kenny but he was not willing to make his views public. He gave Kenny a number of “micro-photographs and documentary papers” that she told reporters after returning to New York from a visit to Brussels in 1950, “prove what I have been teaching all these years.”105 But he refused to publish either clinical or pathological findings. His research laboratory studied “peripheral tissues” that he believed showed significant viral alteration, and also “peripheral lesions” in pigs, chickens, and cattle with a disease that clinically resembled human polio. He became convinced that Kenny’s methods were “physiologically justified,” and he praised the way her methods could reduce the intensity and duration of pain, improve circulation and the condition of the skin, and allow patients a remarkable ability to walk “in spite of marked muscle deficiency.”106 But these remarks appeared only in private reports to the KF, and he put off requests from other Belgium hospitals for Curtis and Housden to demonstrate their work.
“I have been disappointed in Dr. Laruelle,” Curtis admitted to Kenny. “It seems to me he is definitely keeping the Kenny light under a bushel here.”107 Curtis became convinced that Laruelle’s reticence was the result of a cautious proprietary stance. “If the Kenny treatment was good it was to be exclusively this doctor’s,” she concluded later, “and if it was not good, he was not going to be criticized by fellow doctors for endorsing it.”108 Laruelle did hope that the KF would enable him to establish a technician training school in “this European daughter-clinic of your Institute” that could mobilize its specially trained nurses to provide international aid for regions across Europe attacked by polio, “the necessity of which the World Health Organization has just confirmed.”109 This was exactly the model that Kenny herself envisioned. But Laruelle’s small center was unable to play a major role in polio care, even in its immediate region, and the KF did not provide any additional funds. By the early 1950s Belgium government officials faced with growing polio outbreaks put resources instead into building a new polio wing at the Hospital Brugmann.110
Ironically in these fraught days of the early Cold War, the place that provided the most promising site for expanding Kenny’s work was Czechoslovakia, on the other side of the Iron Curtain. In August 1949 Kenny had been invited to Prague by the Czech ministry of health, an invitation organized by Professor Marianna Vetterova-Pastrnkova, a well-connected former teacher of English. Vetterova skillfully promoted Kenny’s work by aligning herself with František Pokorny, a physician who directed the well-known Janské Lázně (Warm Springs) spa and had begun to use the Kenny method after a severe polio epidemic in 1948. After meeting Kenny, Pokorny became an even more fervent proponent. He used the gray and red books Kenny left behind as the basis for treating his patients and described his work in a local medical journal.111 Vetterova urged Kenny to send one of her technicians to Czechoslovakia to give lectures and clinical demonstrations, and the vice-minister of health promised that his officials would fit the film with Czech subtitles and organize a 4-month course on the principles of the Kenny method as long as Kenny sent an experienced teacher to direct the course.112 The combination of Vetterova, Pokorny, and the distinctive context of postwar Czechoslovakia led to an unusual opportunity to institutionalize Kenny’s work.
Dorothy Curtis was the obvious choice to lead the enterprise. As a graduate of Oberlin College followed by a nursing degree from the University of Minnesota, she had a richer academic background than most American nurses of her generation. During the war she was a lieutenant in the Army Nurse Corps and then worked in public relations in the Office of the Chief Surgeon of the European Theater of Operations.113 After the war Curtis, described by reporters as a “black-haired, energetic therapist,” became a member of Kenny’s inner circle.114 Frustrated by her work in Brussels, Curtis told Kenny she was “intensely interested” in the opportunity “to further the distribution of your work” in Czechoslovakia, whatever the “risks that may be incurred in fulfilling this request.”115 She accompanied Kenny to Prague in 1949 and met Vetterova, whom Curtis identified as a woman with “many prominent and influential friends [who was]… really the power behind of this work here.”116
Czechoslovakia had been reestablished as a republic immediately after the war, but by 1948 it was under the control of the Soviet Union. The country had experienced its first large polio epidemic in 1939, and during the 1940s Czech physicians had turned to the latest medical technologies such as the convalescent serum and the preventive nasal spray, and incorporated additional rehabilitation therapies such as hydrotherapy.117 When Curtis arrived in October 1949 Czech health officials offered Curtis the use of a 150-bed hospital in Prague that had been cleared of all patients other than patients with polio. In addition to treating patients, Curtis gave courses in the Kenny method, which were attended by more than 50 nurses and therapists. She also gave lectures and clinical demonstrations to physicians, returning twice in 1950. One 2-week course was attended by around 50 physicians, including the medical directors of 2 prominent thermal spas, representatives from the national ministry of health, neurologists, pediatricians, and members of the medical faculty of Charles and Plzen universities.118
Not only did Vetterova’s influence open the doors of hospitals and spas, but Pokorvny’s professional enthusiasm also led senior physicians to let their junior associates attend these courses. Emil Gutmann, a physiologist and senior anatomist at Charles University, allowed one of his assistants to give anatomy lectures to Curtis’s students and made sure the assistant consulted with Curtis “to harmonize his lectures with mine.” The assistant also invited Curtis and her students to view the university’s anatomy department where he showed them the anatomy museum and then played a film of a “Muscle Man” who could contract any muscle of his body at will and make each stand out individually.119 Her physicians’ classes were too large, Curtis admitted, “but they learned enough to know how restoration of function is done” and what their nurses “are doing when they do it,” and she was delighted when a senior neurologist supplied a “neurologic explanation and scientific support to K. concept.”120 After teaching a 2-week physicians’ course in May 1950, Curtis spent 4 additional weeks lecturing to groups of doctors and nurses as she visited her former students, now loyal followers, in hospitals in Prague, Pardubice, Bratislava, and Kroc.121
Although Curtis praised Czech physicians as mostly open minded and eager to learn, they sometimes challenged her. At one meeting before an audience of 70, a physician who had not attended her course declared “I’ve read
all the literature. Sister Kenny had not been accepted by Australia or America. Why should we go farther than they? Orthodox or Kenny treatment, the results are all the same.” An orthopedic surgeon then warned the audience that “five years from now your K. patients will all be coming to me for operations.” Nor, Curtis found, did her lectures about the concepts behind Kenny’s work convince all members of her audience. Senior neurologists and other specialists told Curtis that “they wanted to see, not hear.”122 But even giving them a clinical demonstration was not enough. Curtis was only a therapist, and the doctors could not accept scientific explanations from someone who did not have their formal training. Sympathetic physicians pressed her to give them articles in recent medical journals “by virologists, epidemiologists, or other scientists advancing our knowledge of polio & supporting the Kenny concept.”123 But this material was difficult to come by. Kenny had been gathering this kind of material since the early 1940s, but the 1944 AMA report had led American physicians to publish further criticisms of her work. Despite the widespread acceptance of much of her work in the United States by the late 1940s, most American physicians who used her methods did so without fanfare.
Still, Curtis found that most of the physicians she met “treat me with a respect and deference that is touching (and almost embarrassing).” After she described the “rubbery symptom”—Kenny’s early diagnostic sign that American physicians had largely ignored—she was asked to attend admission examinations at the Prague children’s hospital. “This is a heavy and ticklish responsibility,” she told Kenny. “I try hard not to overstep my position, and still give them the benefit of what I have been taught, and seen in experience.” She was gratified to see the hospital physicians “try to see the signs as I point them out. In other words, the door is open for teaching; I am trying to do my best with the opportunity.”124 Curtis also proved open to constructive criticism. When her students complained that the film The Kenny Concept did not clearly show how to restore muscle function, she agreed to make another film showing the full treatment including points “not well covered in the documentary film.” “I think myself it was skillfully done,” she reported to Kenny about her new film. “I look fat and double chinned, but what matter if the work is correct.”125 She was especially pleased to learn that a pediatric professor had warned his students to ignore his own article on polio published in a local medical journal because it had been written the previous year, and “with what we are learning and seeing in the new treatment, we will have to revise all our thinking.”126
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