An influential self-trained nurse who discovered a controversial alternative treatment to Polio during the time of outbreak around WW1, Elizabeth Kenny is the focus of today’s article.
The Polio Outbreak
Polio is a disabling and life-threatening disease that spreads from person to person and can infect a person’s spinal cord, causing paralysis. The disease caused more than 15,000 cases of paralysis a year in the U.S. It was the most feared disease of the 20th century that became prevalent exponentially around the time of WW1.
Fortunately, a vaccine was invented and administered in the 1960s. And since then, there has been a 90% reduction in the number of Polio cases worldwide. And no cases of Polio in the U.S. since the 1980s.
The Incredible Elizabeth Kenny
Born in Australia in 1880, Ms. Kenny was a self-taught nurse in rural Australia. Immensely skilled in her job, Ms. Kenny was respected and well liked by many under her care. Once WW1 began, she worked as a British army nurse on troopships. (Due to her exemplary work on these ships, she earned the title of ‘Sister” for her service. Thus, contrary to popular belief, Ms. Kenny was not, in fact, a nun.)
Around the time of WW1, Polio was rising around the world. Most of its victims were children and young adults. Severe cases meant fever and body aches that progressed to varying degrees of paralysis in just hours to days.
5-10% of paralyzed polio victims died, and as many as 50% suffered from persistent, partial paralysis.
The conventional treatment at the time, advocated by doctors and physical therapists, was immobilization. Polio victims were given splints or casts to restrict the affected limbs’ movement and prevent further deformity.
One night, Ms. Kenny received a call to care for a child whose symptoms included contorted limbs and a stiffly curved spine. As a self-taught nurse who practiced most of her career in a rural Australian village, Ms. Kenny had not encountered such symptoms before.
She sent a telegraph to her friend Dr. McDonnell, who lived in a nearby Australian community, for a diagnosis and guidance. Renowned orthopedic surgeon Dr. Brack diagnosed Polio via Dr. McDonnell, who, in his telegram reply, told Kenny to treat the symptoms as best she could. He didn’t provide her with any further direction.
Thus, in doing so, Sister Kenny began wrapping the child’s stiff limbs in hot, woolen sheets, hoping to relieve what she called ‘spasms.’ She sighed with relief when the treatment seemed to work: the child’s limbs straightened. Yet, she soon discovered that the child could not move his legs.
She assumed that the child’s muscles have forgotten how to move on their own. In an attempt to ‘re-educate’ them, she began gently massaging and exercising the child’s paralyzed muscles, enabling passive movement. She also guided him with active coordination. Soon, the child benefitted from her treatment and achieved a miraculous, full recovery.
After this patient encounter, she learned of five other similar cases in her town and administered the same technique to each diseased child. Almost inexplicably, they all recovered to the same extent as the first child. Kenny was able to cure all her cases to the point of the children being able to walk unaided.
Ironically, Sister Kenny was unaware of her immense discovery. It was not until she decided to visit her friend Dr. McDonnell that she learned about the recent Polio outbreak and its ‘proper’ treatment. Polio victims were generally treated by immobilization of the affected muscles, which requires splints, braces, and aids to assist in walking.
Shocked, Ms. Kenny informed her friend of the six Polio-infected children that she had treated to full recovery and how she did so by mobilizing their limbs, not immobilizing them.
Of course, in realizing what Ms. Kenny has accomplished, Dr. McDonnell immediately takes her to see a colleague of his – an orthopedic specialist named Dr. Brack – at a local hospital.
When Brack hears her story, he quickly disregarded it as nonsense, fiction, impossible. He claimed that the children that she ‘cured’ must not have had Polio in the first place. Dr. Brack refuses to allow Elizabeth to demonstrate or treat acute cases in his hospital to fear the patients’ safety and well-being.
Dr. McDonnell began convincing Elizabeth that she has discovered a new, more effective treatment for Polio while at the same time, she begins to butt heads with Dr. Brack. Because Elizabeth is not a physician, let alone not one specializing in orthopedics, Barack was convinced that she is a “quack”.
Dr. Brack ultimately convinced the same to the entire orthopedics community in Australia and Ms. Kenny continued to endure ridicule. Despite this, Sister Kenny fought back. She opened up her clinic to gain notoriety and further prove her point.
Ms. Kenny’s legacy still lives on. Not only was she a nurse questioning physicians’ authority, but she was also a woman – and a very outspoken one, with no problem challenging the overwhelmingly male medical profession.
But most importantly, in my opinion, it was Ms. Kenny’s fierce adherence to what she observed at the bedside that holds the most relevance today.
She thought that she could see and feel muscles improve as she ministered to her patients. She saw her patients recover at rates she believed were much higher than those treated conservatively.
Who needed clinical trials when the proof was right in front of her? Her doctor-friend wrote, “the empirical evidence embodied in her patients’ recovery proved her therapy worked.”
Was Ms. Kenny correct?
It is debatable.
Her emphasis on early mobilization has come to be a mainstay of polio treatment and physical therapy more broadly.
Yet, some of her claims about the nature of the disease and how patients recovered were eventually proved wrong. And the successful development of a polio vaccine in the 1950s made these debates much less pressing.
In an era of evidence-based medicine and reliance on large-scale clinical trials involving thousands of patients, her emphasis on bedside clinical observation flourishes. Ms. Kenny once wrote, “[her opponents] have eyes, but they see not.”
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