Polio Wars (63 page)

The New Jersey campaign was especially vicious. The NFIP's headquarters began receiving frantic phone calls from chapter chairman, reporting rumors. Supposedly, during a recent Mercer County epidemic the NFIP had not provided either Kenny technicians or equipment; the Catholic Church was going to “fully support Sister Kenny because she was a nun”; and all the funds collected by the NFIP in New Jersey were “sent out of the state to the Georgia Warm Springs Foundation.”
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NFIP organizers were appalled when former Governor Harry Moore, a Democrat, announced that he would act as state KF chair.
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Some of the NFIP's New Jersey allies assured the New York office that they would try to make Moore see reason.
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Dr. George O'Hanlon, the director of the Jersey City Medical Center who also led the Hudson County NFIP chapter, refused to direct the KF's medical advisory committee.
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Many local politicians tried valiantly to express broad charitable loyalties. “I like both foundations,” a Republican state senator from Paterson announced during the KF campaign. But he was “particularly fond of the Kenny Appeal” for the Kenny method had created “great advances in medical science for the cure or aid of polio cases.”
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The most disturbing revolt was by the women. The NFIP had relied on women volunteers as fundraisers since the 1930s, and in 1944 officials had responded quickly after Mary Pickford, then head of the NFIP's Women's Division, warned that many of her Hollywood women friends were uneasy about attacks on Kenny. During epidemics NFIP women volunteers collected blankets, safety pins, and electric fans; worked as clerical helpers, chauffeured parents, found lodging for nurses sent to epidemic areas, prepared food for hospital patients and staff, and in some places even accompanied doctors on their rounds, learning to keep medical charts so nurses could stay in hospitals to do their more important work.
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In June 1945 the NFIP had organized these women formally into the Polio Emergency Volunteers.
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But the KF offered women volunteers what the NFIP had never done: power and seniority. Mary Roebling, the campaign director and vice chair of the Mercer County NFIP chapter, accepted the position of chair of the New Jersey state KF campaign. Associated with one of Trenton's outstanding families, Roebling was the first woman president of a major bank and an influential Republican businesswoman and philanthropist. The NFIP chapter head tried to convince her not to accept the position as the KF state chair but Roebling remained adamant.
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In Pennsylvania, Mrs. Edward (Charity) Martin, the wife of the Republican governor, agreed to work as that state's KF chair, and when her husband was elected senator, Martin continued her work as a member of the KF's national executive.
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Clearly the KF's claim that the leaders of the NFIP and the AMA refused to give Kenny proper respect because she was an outspoken woman fell on receptive ears. The turning of the women was an explicit KF campaign strategy. KF officials had urged each county organizer to find “a woman to interest other women and clubs in giving Sister Kenny Teas, Bridge Parties and Fashion Shows.”
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The ability to organize civic events and thereby raise interest and money was not, as Kenny and the KF directors recognized, an insignificant skill.

After the 1945 campaign Kenny organized a conference, inviting public health officials from every state. As well as refuting the accusations of the AMA report, she trod a careful line between praising America's many conscientious technicians and warning that few
of them knew enough about her concept to be able to practice the work “in its entirety.” The lack of this knowledge among physicians and medical students was especially disturbing.
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She also sent a letter warning O'Connor and every NFIP trustee that “an inadequate presentation” of polio's symptoms was likely to “retard research and prevent the conquest of this disease.”
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The NFIP's national office, which had pointedly sent no representatives to the December conference, made sure each trustee received a statement by Gudakunst in response.
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Kenny also began to prepare a new book she provocatively titled
Physical Medicine: the Science of Dermo-Neuro-Muscular Therapy as Applied to Infantile Paralysis
. Although its title suggested she was claiming authority in rehabilitative medicine its content and short length was more modest, and it provided clear, detailed instructions for nurses and physical therapists. Like her 1943 textbook, this book was published by the Bruce Publishing Company and it became known as the Gray Book.
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The 1945 KF campaign did not achieve its stated goal of $5 million, and raised only an estimated $516,000. Its poor showing was, in part, the result of givers' fatigue by Americans who felt worn out by calls for war bonds, Red Cross, the USO, and other wartime charities.
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A confidential report by the National Information Bureau, a watch-dog assessor of charities, warned that the KF campaign had created a competitive and antagonistic relationship between the 2 Foundations. The geographic distribution of the KF board was too narrow, its fundraising costs in 1945 were excessive, and the national office had not adequately supervised the activities of state chapters. Although the KF board began to plan the 1946 campaign with the more modest goal of $2,000,000 and promised to control expenses, it nonetheless signed a contract with the same publicity firm.
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Crosby became a member of the new national executive committee, singer Kate Smith was named national 1946 campaign chairman, and Rosalind Russell became head of the KF's national women's division. Along with Crosby, the executive committee included Governor Frank Lausche of Ohio (the state's first Catholic governor), Governor Earl Warren of California, Charity Martin of Pennsylvania (the wife of Senator Edward Martin), Eleanor Patterson (editor of the
Washington Times-Herald
), and various business owners and union officials.
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The growing uneasiness in Hollywood around the link between the NFIP and the studios was reflected, to O'Connor's dismay, by a decision by the studios in 1946 to end individual theater collections and thus stop showing NFIP trailers. Forced to rethink its fundraising strategies, the NFIP began to promote a new campaign of the poster child, who appeared eager and well-dressed, seeking public support to be assured of a bright future.
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The 1945 campaign helped to clarify a number of new policies. First, the NFIP began to expand its funding of physical therapy, acknowledging physical therapists as crucial professionals in polio care, and producing a number of technical films devoted entirely to this practice.
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Indeed, polio and the Kenny method became crucial parts in the professionalizing of physical therapy in America.

In other ways NFIP policies shifted away from polio therapies. Senior officials no longer sought to assess polio methods of any kind. In a form letter issued to chapters the NFIP announced that it did not “establish standards for medical care or treatment of infantile paralysis” or “interfere in the patient–physician relationship [for] … the type of treatment prescribed is entirely up to the doctor.” The letter added that “as an organization we have no viewpoint toward the Sister Kenny treatment.”
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The NFIP continued to
pay for any system of polio treatment if recommended by a licensed physician, even controversial therapies such as Herman Kabat's use of Prostigmine. The NFIP did boast that it funded what it called “modern treatment,” which exemplified the best in polio care, not a single treatment “bearing the name of one person or one idea.”
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Indeed, officials began to argue, this policy was a sign of a flexible philanthropy, responsive to requests by medical professionals to alter therapies. “The National Foundation, being a progressive organization, is not wedded to any type of treatment.”
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In a continuing effort to delegitimize Kenny as a medical authority, the NFIP also began to remind its own staff, as well as science reporters and others writing about Kenny, to “wherever possible use the title Miss Kenny instead of Sister Kenny.”
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At the same time the 1945 KF campaign had reinforced the importance of making women feel valued as fighters against polio, both as volunteers and as potential donors. Thus, in the 1947 NFIP film
In Daily Battle
women were prominently featured: as mothers, the secretary of a local chapter's medical advisory board who takes notes, nurses and physical therapists, and a chapter official.
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Still, compared to bolder efforts by the KF, such depictions continued to suggest that women were participants in subordinate positions, not philanthropic leaders. It was not until 1951 that the NFIP turned a Mother's March organized by its Phoenix, Arizona, chapter into a national program. According to one historian, “the portrait of mothers marching against polio became one of the indelible images of postwar America.”
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The NFIP relied on science writers such as Roland Berg to reiterate the “many years of careful study” it would take “to evaluate properly [Kenny's] her place in medical history.” While today “physical therapy is used by nearly all doctors … based on Miss Kenny's methods or … modifications,” Berg argued in
The Challenge of Polio
, Kenny's lack of medical knowledge had meant that many physicians rejected her “entirely new concept of the disease” based on ideas with no scientific basis. Kenny, after all, had no training in medical school anatomy and had observed only living patients. Physicians, who had “seen the actual damage in the brains and spinal cords of experimental monkeys and fatal human cases,” knew that polio was “primarily one of the nervous system and that the muscles are only indirectly and symptomatically involved.” Berg also suggested that “had she not demanded that physicians also discard the scientific facts of the pathology of the disease and accept a brand new malady based merely on her observations of certain symptoms,” it was possible that her methods “would have received earlier and wider acceptance.” “Her work has been recognized and supported,” he concluded firmly. “Whatever is good in it has been salvaged and made available to all.”
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A reviewer in the
New Republic
called
The Challenge of Polio
a well-written, honest book with “a sober appraisal of the work of Sister Kenny,” and praised the author's “keen sense of the responsibility so necessary in those who write on medical subjects for the people.”
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Most of all, the NFIP's national office began to articulate clearly “Why Chapters Cannot Sponsor Research.” Chapters were given the sole responsibility for providing for the medical care of patients with polio, the NFIP's director of research reminded an audience at the Hotel Roosevelt in April 1946. To engage in research activities “would serve only to dilute the energies and resources now devoted to medical care.” Further, chapters were directed mostly by volunteers who were “not familiar with problems of research.” To support a research program, an agency needed to be able to say whether the question was important, whether the institution had sufficient staff and equipment, and whether the
research program proposed fit appropriately with the entire scope of the research activities. Only the NFIP's national office, relying on its network of advisory committees, could handle such issues “satisfactorily.”
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By 1947 the KF was one of the nation's 2 polio foundations. Chester La Roche turned down O'Connor's offer to be head of the NFIP's advertising division, explaining that “more and more people of influence and means” were becoming interested in Kenny's work, which had “tremendous popular appeal.”
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The Massachusetts KF field director reported that physicians remained torn in their assessment of Kenny, but antagonists told him “she receives too much publicity and also that a nurse is not supposed to tell a doctor what to do about illness.”
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A New Jersey Kenny supporter asked O'Connor whether Kenny's treatment was going to be discussed at a NFIP symposium to be held at Warm Springs in 1947, and whether Pohl or any other physician connected with the Institute would be invited to attend. “Why is it apparently impossible for the National Foundation, with all of its vast financial resources, to merge [with] the Sister Elizabeth Kenny Institute[?].”
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No one representing the Institute had been invited to participate, O'Connor responded, for the list of speakers had been “selected on the basis of their specific contributions, rather than from the institution which they might represent.” But the papers read at Warm Springs, O'Connor assured the donor later, referred to “Miss Kenny's work” including the use of moist heat, early physical therapy, muscle reeducation, and other measures “endorsed by Miss Kenny.”
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The polio wars exacerbated political and public pressures to expand polio researchers' attention to patient care and decreased believability about claims by orthopedic surgeons that only surgery could fix “deformities.” There was a new focus on questions of efficacy and the authority of expertise. What was the meaning of clinical results? If a treatment worked did it therefore challenge previous theories on which older, less efficacious therapies were based? If not, why not? What was the relationship between therapy and theory? And how could the tools of medical science help to resolve this dispute?

NFIP national officials began to rethink their constant defense of caution when assessing new ideas in polio. Perhaps the many scientists funded by the NFIP were some of the most brilliant scientists in the world who did slow, painstaking work that “eventually … like a slow-moving glacier, will crush and conquer infantile paralysis.”
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But perhaps these scientists needed more direction and coordination, despite their professed desire for professional independence. Unlike the well-publicized model of coordinated research and testing for the new drug penicillin, polio research, Gudakunst reflected, was not achieving any headway because too many scientists were “satisfied to work over and over again those fields of exploration that have been covered by their contemporaries.”
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