Polio Wars by Naomi Rogers Page B

prospered and Kenny was feted as a savior, she began to argue that her work embodied a new concept of polio drawn from a close reading of the body. Polio, she said, was not solely a neurologicaldisease but also a disease of muscles and “peripheral structures.” By the time Kenny published her 1943 textbook
The Kenny Concept of Infantile Paralysis
she had begun to argue that it was impossible to teach anyone to treat the symptoms she had identified if they did not understand her concept of the disease. Indeed, she frequently added, the prognosis for a patient treated without this new knowledge would always be far poorer than for a patient treated by professionals who fully understood the Kenny concept of polio.
    Kenny knew to speak of “improvement” rather than “cure,” but she often did exaggerate her results. As early as the 1930s she learned the power of the press and the importance of a good story. She was accused by her critics of being a publicity hound, of practicing mistaken and perhaps even harmful methods, and of making unrealistic promises to disabled patients and their families. At times she boasted of her distance from the medical establishment; at other times she made much of her medical allies. She found strong public support when she attacked the elitism of the medical profession in both Australia and North America, but she also sought out and relied on the financial and social assistance from the elite in business and society. She said she chose to follow only “orthodox” physicians, but her clinical practice and its values drew on alternative attitudes toward medical science, toward the disabled, and toward chronic care. Her patients as well as the nurses and physical therapists she trained to become Kenny technicians were central to the functioning of her work. Her students saw her life as one of struggle and sacrifice, a story that was central to the image she projected and one they frequently retold as a way to keep their own spirits up as they battled for clinical autonomy and professional respect from skeptical peers and medical supervisors.
    Her critics denigrated her work by drawing on their understanding of medical history, technical innovation, and gender relations. Yet many professionals were frustrated that neither the techniques of modern medical science nor an appeal to medical history enabled them to attack Kenny effectively. Indeed Kenny’s experiences illuminate a side of American medical politics in which claims of nonpartisanship by philanthropies failed and where political and social allegiances defined who was on a hospital’s medical staff, where a patient was cared for, and which patient was seen as suitable for orthopedic surgery and which for home care. In this world, as polio patients ruefully learned, wheelchairs were expensive, ramps nonexistent, and schools and workplaces inaccessible. The lived experience of polio paralysis meant social discrimination as well as physical disability.
    The process of therapeutic change has a disturbingly messy history, as medical historian Erwin Ackerknecht pointed out long ago. 4 At the dawn of the twentieth century, despite emerging laboratory-trained experts preaching rationality and caution, Americans continued to seek out therapeutic panaceas: in the 1920s goat glands for enhanced male virility and in the 1930s sulfa drugs to cure all kinds of infections and vitamins to treat and prevent newly identified “deficiency” diseases. But how could professionals decide what worked and when to change their practice? And how did they know who to trust? Drugs and surgical techniques were concrete, discrete interventions that appeared to have clear effects on the body and could be tested against a placebo in a medical trial. But other clinical methods were more amorphous, resisting any simple test.
    Moreover, the popular and professional understanding of scientific innovation was profoundly gendered. The