Polio Wars Read Free Page A

out its heated mineral springs. He was sufficiently impressed by this treatment to purchase the resort and develop it into a polio rehabilitation center. By 1928 when he was elected governor of New York he was known as the man who had battled and conquered his paralysis, a story that, although not really true, was even more crucial during his successful campaign for the presidency in 1932. 14
    During the 1930s polio care took a conservative turn. Physicians learned not to expect much improvement in their patients’ muscles and were suspicious of those who claimed success. 15 Orthopedic surgeons George Bennett and Robert Johnson and physical therapists Henry and Florence Kendall at the Baltimore Children’s Hospital-School were disheartened to see that some of their patients recovered “to normal with little or no treatment” while others remained “hopelessly crippled even though given the best care.” “No one is justified in making an early prognosis,” they concluded, for “it is impossible to determine the outcome.” 16 The Kendalls were also convinced that patients were harmed by “frequent, improper handling, and over-treatment.” Concerned about muscles that lost their natural reflexes through overstretching they relied on frames, casts, splints, and very mild exercises, rejected underwater exercises, and suggested that some patients might benefit from “complete rest in the bed for several years.” 17 By the early 1940s, muscle exercises were still part of polio care, but there was a consensus that underwater exercises had been overemphasized. Even at Warm Springs, according to its chief surgeon, only a quarter of his patients exercised in the center’s thermal pools. 18
    Tracing the relationship between polio’s clinical symptoms and the pathology of the virus was difficult. Theories to explain the paralysis of muscles abounded, but the standard pathological concept reinforced a faith in immobilization. The polio virus was believed to create lesions in the brain and spinal cord, severing connections between muscles and nerves; a paralyzed limb, therefore, could be expected to regain only limited movement. As physicians saw polio as a neurological disease, they warned that any active movements could exacerbate these lesions and that muscle exercises should not be used until at least 8 weeks after a patient’s fever had subsided, suggesting that the lesions had healed. 19 Reflecting the profound stigma around physical disability and their own skepticism about recovery, physicians used splinting to keep the patient’s body looking straight and “normal” rather than focusing on functionality. 20 Although plaster splints and casts were often painful, clinicians considered them crucial in order to spare patients “the mental and physical pain of a hideous deformity,” as one orthopedic nurse noted. 21
    The most challenging part of polio therapy was the enforced period of rest through immobilization. To ensure that this therapeutic regime was followed hospitals had to rely on the efforts of trained graduate nurses. Indeed, argued one nursing textbook, “the entire success of the treatment depends upon the loyalty of the nurse in maintaining the position effected by splinting.” 22 To dramatize how “a few seconds of nonsupport may do serious harm” orthopedic nurse Jessie Stevenson pointed out that “the nurse would be horrified at the thought of maintaining sterile technic in the operation room for
only part of the time
.” Even when muscle stimulation was allowed, she noted, it must be practiced “very gently” and by a professional who knew “the origin, insertion and action of all the important muscles.” 23 Given the lack of such professionals, however, in practice immobilizing therapy frequently meant therapeutic neglect.
KENNY AS POLIO CLINICIAN
    Elizabeth Kenny gained attention because her