Polio Wars
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This attack on Kenny’s character and on her poor understanding of polio’s pathology outraged Columbia University virologist Claus Jungeblut who wrote an angry letter to the Times. The Times obituary, Jungeblut complained to KF head Marvin Kline, had probably been written “some two or more years ago … in readiness for this occasion.” Its accusations would make it difficult to organize an effective KF campaign, for now KF promoters would have to try “to memorialize someone whose work was made to appear professionally unsound and whose claim to honor was a stubborn courage and an unshaken but unshared belief in her own ideas.”11
Jungeblut’s letter to the Times protesting the portrayal of Kenny’s scientific contribution was passed on to Waldemar Kaempffert, the paper’s science editor. Jungeblut argued that the obituary failed “to do justice to the meaning of the ‘Kenny concept’ and [had confused] … existing scientific facts.” A new viewpoint, Jungeblut pointed out, showed that the polio virus traveled through the bloodstream and could perhaps cause “a widespread involvement of peripheral areas, including skeletal and cardiac muscles.”12 Kaempffert wrote back to Jungeblut, defending the obituary as written “only after we had consulted clinicians and virologists whose opinion we respect.”13 But Jungeblut replied firmly that his claims were “based on recorded facts and not on personal opinion” and cited specific research studies, including Dorothy Horstmann’s viremia studies and work by John Enders showing that the polio virus could grow in nonneurological tissue. “Many of the earlier differences of opinion have been resolved,” he wrote, and “at last a concept of the systemic nature of the disease emerges on which there is general agreement.”14
Jungeblut’s own career spiraled downward. He continued for a few years to seek evidence of a genetic factor to explain susceptibility to paralytic polio, but his research plans were rejected by the National Institutes of Health.15 His reputation as an idiosyncratic scientist who had rejected the NFIP was recognized by other neglected researchers who hoped that his support by the KF could help break up “this Polio Foundation Control System.”16 Appearing before Congress in 1953, he reiterated his belief that the paralytic process in polio was both central and “peripheral” and that his Columbia team had been “some of the first ones to sponsor the viewpoint that the bloodstream was one way of disseminating the virus.”17 Jungeblut retired from Columbia in 1962 and died in 1976. In his New York Times obituary he was described as a bacteriologist who was well known for his research on transferring the polio virus from monkeys to mice, which led to a “changed virus that protected monkeys and prevented their paralysis if used in time.”18 The obituary made no mention of his support by the KF or his alliance with Kenny.
Kenny’s death also offered physicians the opportunity to get in the last word on her contributions. In a pointed juxtaposition JAMA paired its 4 line obituary with a 4 page study of follow-up examinations of 346 Kenny-treated patients from the Minneapolis General Hospital written by Miland Knapp and 2 younger physicians from Minneapolis. Knapp’s study found that 69.1% of the patients were now “essentially normal” and that early treatment decreased “the necessity for operation and the incidence of scoliosis” but also detailed the various orthopedic operations and apparatus 8.3% of the patients required. The Journal’s “Poliomyelitis” items in its subject index for the first 3 months of 1953 had only 20% on treatment and around 35% on preventive research such as gamma globulin and immunization.19 In contrast, the British Medical Journal published 2 separate full obituaries. The first noted that the controversy over Kenny’s unorthodox methods had filled “many pages of this and other journals.” In a character assessment that probably pleased neither her allies nor her critics, the Journal called her “a shrewd, combative woman, intolerant of opinions which conflicted with her own [but also]… a woman of deep compassion and one who sought no great reward for herself.”20 In an unusual separate obituary in the same issue, Oxford orthopedist Herbert Seddon argued that Kenny had gone astray when she had elevated muscle spasm “into an important aspect of the pathology of the disease.” The hot packs used to ameliorate “this so-called spasm” were too often used in “a drill … that was elaborate, extensive, and tiresome.” Her theory of mental alienation, further, was just a new name for a variety of functional disorders, which, despite her protests, had no “permanent influence in the designing of remedial exercises.” In Seddon’s view Kenny’s “initial small store of knowledge” had been expanded as the result of “increasing contact with able medical people.” Had she been content “to talk about treatment without embarking on speculations about pathology” and “had she been a little kindlier [sic] and more tolerant,” Seddon concluded, “she might now be regarded as the Florence Nightingale of orthopaedics, or at any rate of that part of it concerned with poliomyelitis.”21
Seddon’s reference to “the Florence Nightingale of orthopaedics” reflected a consciously gendered notion of what made an appropriate female contribution to medical science. Seddon had elsewhere compared Kenny unfavorably to 2 “other great humane women of our time” Dame Agnes Hunt and Lady Marjory Allen. Hunt, a disabled nurse, had collaborated with British orthopedist Sir Robert Jones and worked with tubercular children and disabled veterans; Allen, a landscape architect, had founded an international organization for early childhood education and was working with UNICEF and UNESCO. These 2 women, Seddon believed, were “every bit as tenacious, every bit as impatient of red tape and professional complacency” as Kenny had been. But they had finally got their way by “cheerful persistence and by inspiring that greatest of all reforming forces—affection.” Kenny, in contrast, was never content to let an idea “sink in and do its work.” She “hammered everybody with the whole powerful apparatus of modern propaganda” and, worse, claimed “she never made a mistake.”22 It was Kenny’s stubborn demand for scientific legitimacy, Seddon believed, that had alienated potential male allies who preferred insightful women contemporaries who were cheerful, patient, and humble.
Kenny’s stubbornness and impatience were highlighted in many obituaries. “She never won for her methods or theories the unconditional approval that she and her many supporters believed them to deserve,” the Lancet pointed out, and “she did not realize that her own enthusiasm could go against her.” Still she had whipped up a global interest in polio treatment, and her ideas “aroused discussion and controversy all over the world.”23 In the Medical Journal of Australia Kenny’s antagonist Jean Macnamara argued that progress in medicine came from the efforts of 2 types of people: those who “patiently observe and record” like physical therapists Florence and Henry Kendall and others who “battle for the application of knowledge to the individual patient.” Kenny’s “forceful personality” may have helped to destroy complacency but, Macnamara believed, her contribution would have been greater if she had shared “her gifts of patience, pertinacity and attention to detail” with those working for the same objectives. Still, Macnamara was not surprised Kenny had chosen the path of a celebrity. “Fame, travel, press interviews, her book, the film controversy were her choice, and perhaps suited her temperament better.” Macnamara conceded that publicity around Kenny’s work had led to a welcome “loosening of purse strings” for physical therapy and rehabilitation facilities. As for her contribution to polio science, Kenny had “provided a stimulus to research workers to abandon the servile adherence to the theory of essential neurotropism of the virus.”24
Kenny’s clinical skills as well as her sense of humor were featured in the few obituaries that defined her primarily as a nurse. The British Journal of Nursing praised her as one of nursing’s “most brilliant colleagues.”25 Mildred Elson’s obituary of Kenny in the Physical Therapy Review was pointedly upbeat, giving a sense that Elson had known Kenny as a person as well as a clinician. Kenny had been “a very warm person [with]… a delightful and, at times, mischievous sense of humor.” Elson was sure that “the controversy and furor” that Kenny had aroused would be forgotten. In any case it had “sti
mulated everyone to do a better job and the patient [had] benefited.” Her visit to Minneapolis, along with the Kendalls and other therapists in January 1941, had been “thought provoking.” True, there were differences of opinion, but it was just the “good give-and-take which is enjoyed between professional colleagues.” The therapists had found Kenny “a charming and dedicated person” and had been intrigued by her hats. For Elson the central issue was patient care and patient perspective. Patients loved Kenny, she recalled, and appreciated “her kindness, reassuring manner, and skillful hands.” “Her name will continue to be associated with the treatment of polio throughout the world [and] … for her courage and devotion to the polio patient.”26 Few of the physicians who memorialized Kenny after her death commented on patients at all, but for physical therapists the changes that Kenny’s work had made to the routine care of patients were impressive and worth remembering. What Elson could not imagine in 1953 was that attention to polio’s clinical care would almost totally disappear for at least 3 decades.27
FADED CELEBRITY
Kenny’s status as a celebrity, admired and feted by movie stars, largely disappeared with her death as well. Buffeted by the disruption of the Hollywood studio system and the growing popularity of television, movie attendance dropped significantly.28 McCarthyism also convulsed the Hollywood community with attacks on politically and sexually suspect people. As allegiances made decades earlier were used to insinuate political suspicions, movie stars were wary of the controversy surrounding Kenny and her work. Thus, screenwriter Mary McCarthy assured a journalist in 1953 that while Kenny had been a liberal and supported the Labor Party in Australia she had always “hated Communism.”29
During the 1950s Rosalind Russell was still a member of the KF board, but a second stage of her career in which she moved from Hollywood to Broadway allowed her to move away from Kenny-related activities.30 Although Russell spoke of Kenny’s importance to American and global medicine immediately after Kenny’s death, she waited until the end of her life to discuss her own support of Kenny’s work in any detail. Her autobiography Life Is a Banquet appeared in 1977, a year after her death from breast cancer. In a brief but not apologetic section on Kenny, Russell fondly recalled meeting her for the first time at an airport in California as she “stepped off that plane wearing that Aussie hat and a sad-looking black dress, which was half of her wardrobe.” Russell had never forgotten the ways that some jealous and suspicious doctors had tried to trick her, although, she maintained, “good doctors liked Sister Kenny.” Like the other commentators in this period Russell linked Kenny to the Salk vaccine: “If she hadn’t gone stamping through the world, stirring people up, we’d have been a whole lot longer getting the Salk vaccine.”31
KENNY AS A CHILDREN’S HERO
Fittingly, Kenny’s legacy fared best in the literature of the group she devoted herself to most: children. “Just before she died she prayed … first, that her treatment might spread throughout the world; and second, that someone might find a vaccine to abolish polio forever,” wrote the author of Lives to Remember (1958), a children’s series that included Louis Pasteur and Helen Keller.32 She lived on in other children’s books as well. In The Girl Book of Modern Adventures as “The Nurse from Australia” Kenny proudly recalls the moment when President Roosevelt (still the most celebrated polio survivor) invited her to lunch at the White House and thinks “If only I could have treated him … he need never have suffered!”33 Her oddity as not exactly a nurse meant that some children’s writers ignored her. Nurses Who Led the Way (1957) featured Edith Cavell, Mary Breckenridge, and Lillian Wald, but not Kenny.34 But she stayed visible in books such as Six Great Nurses (1962) and Heroic Nurses (1966) in which she appeared along with Florence Nightingale, Mary Breckenridge, Clara Barton, and Edith Cavell.35
TRUTH SEEKING: WHO WAS KENNY?
A few years after Kenny’s death, science writer Victor Cohn, who had covered Kenny’s story many times when she lived in Minneapolis, decided that he would write a book about her. A 1941 graduate of the University of Minnesota and a war veteran fascinated by science and its possibilities, Cohn felt that he knew her story well. In 1953 he wrote “Angry Angel,” a series about Kenny for the Minneapolis Tribune, which was widely syndicated.36 Then, like other science writers of his time, Cohn got caught up in one of the biggest science stories of the 1950s: the Salk polio vaccine. In 1955 he wrote a series of articles on the March of Dimes leading to its funding of the Salk vaccine. The Tribune published the series under the title Four Billion Dimes.37 The response to both series convinced Cohn that a full-length study of Kenny would engage a wide audience.
Cohn had already interviewed 2 of the leading figures in this story: Morris Fishbein and Basil O’Connor. Fishbein, no longer the general secretary of the American Medical Association (AMA) or the editor of JAMA, had become a productive editor, writer, and lecturer. He was eager to put Kenny in her proper place as a fraud. One of his file cabinets, he wrote in a letter to O’Connor with whom he remained friends, had “a big fat special folder dealing only with Sister Kenny.”38 Fishbein told Cohn that most of Kenny’s claims were “pure poppycock.” Her methods had been given “a thorough trial” and been rejected. Fishbein had long experience fighting antivivisectionists, cancer entrepreneurs, and left-wing physicians who promoted government health insurance. Women, in Fishbein’s view, were the worst of these: sentimental about animals and children, dramatic in their horror of the routine work of the laboratory and the clinic, and hysterical enough to be able to sway public opinion for patently false causes. Thus, he dismissed Kenny as having “the drive and the enthusiasm of a woman like [Christian Science founder] Mary Baker Eddy,” an analogy he considered a serious insult.39
O’Connor bluntly described Kenny to Cohn as a publicity seeker. In his opinion, “she had no more use for the crippled children than for a broken-down elephant.” Her constant use of the term Sister, he believed, had created the impression that she was a Catholic. And her gender had fooled otherwise hard-boiled commentators. Early on, O’Connor recalled, he had asked Basil “Stuffy” Walters, the executive editor of the Minneapolis Tribune, why he was so easy on her. In the earthy slang of a newspaper man, Walters had replied that “she’s a skirt and we’re afraid of a skirt.” In the 1940s the March of Dimes had tried in vain to evaluate her method; now, O’Connor said, “we know not to evaluate anybody’s method.” Asked whether he had snubbed Kenny at a reception at the 1951 Copenhagen polio conference, O’Connor admitted he had and added “and I’m proud of it.”40
Cohn took a leave of absence from the Tribune in 1955 to give himself time, as he told potential informants, “to be set straight on any points that were wrong in my previous articles.”41 He first traveled to California where he talked to lay supporters and sympathetic physicians who had established the El Monte Kenny Hospital. Orthopedist Robert Bingham assured Cohn that he had always accepted Kenny’s theory that polio was a systemic disease and that the virus “affected all tissues.” Bingham had “never known a physician anywhere in the world” who had understood polio so thoroughly. With her keen observation Kenny could tell just by watching a child breathe how much paralysis there would be in the chest wall and how much in the neck and throat. She could predict whether a child would recover without use of an iron lung and was “very, very seldom wrong.” She had “a tremendous native intelligence” and was independent and resourceful. Her ideas, Bingham stressed, had been based on what was “probably the most careful examination” of patients in the history of polio.42 While Cohn was somewhat interested in clinical issues he was already convinced that Kenny had made no sense scientifically. He confirmed his belief by conducting a phone interview with John Enders who assured Cohn that no researcher had shown that the polio virus attacked the muscles or had “any local action of any sort.” Enders also denied that he had been influenced by Kenny’s theories, declaring that her statements “certainly had no effect on the work in my laboratory.”43
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p; John Pohl, whom Cohn considered “strong looking” with a Yankee face and “deep good manners,” tried to place his own loyalty to Kenny in a wider medical and cultural context. Her concept of polio, he told Cohn, made sense to her and to physicians in Minneapolis, but she “just couldn’t get it across to anyone else.” There was much she did not know, he conceded; when she said that spasm came from the spinal cord, “that was wrong.” Cohn tried to push his argument that Kenny was not properly trained, but Pohl was not convinced. He agreed Kenny had probably not been a graduate nurse, reflecting that when she talked about her past she “never got down to cases” and never talked about her training “as a nurse will.” But, Pohl stressed, the most crucial issue was her clinical acumen: Kenny “saw the spasm, the doctors did not.” She was a fine diagnostician, clever enough to see whether a muscle “was or [was] not in spasm.” If she could see a little movement in a muscle she could get a child to use his or her belly muscles and sit up, which Pohl felt was how she had first impressed Miland Knapp.44
Then Cohn organized a 5-week trip to Australia. With an eye to history he warned Mary and Stuart McCracken that the topic of Kenny might soon lose public interest for “polio, as a disease, is on the way out.” While he did not mean to minimize the current problems with paralyzed children, in his opinion “the next few years is the time when the history of polio is going to be written.”45
Cohn’s “Angry Angel” series had alienated Julia Farquarson, one of Kenny’s sisters, who warned Cohn that she had advised her relatives not to cooperate with him.46 In vain did Cohn protest that he believed Kenny “was a great woman” who had made a great contribution. When he tried to convince Farquarson that his “impartial” investigation would show the “human” side of Kenny in contrast to the Sister Kenny movie “which presented only the sugar-coated side,” he found himself in another morass.47 The movie, Farquarson retorted, had “very truthfully portrayed the Sister Kenny of those earlier years,” and neither Cohn nor any other American had “the slightest knowledge of … [the] charming personality of the Sister Kenny of those days,” for she had been “loved and trusted by all whom she ministered for.”48