Elizabeth Kenny

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Sister Elizabeth Kenny (20 September 1880 - 30 November 1952) was a self-trained Australian bush nurse, who developed an approach to treating polio that was controversial at the time. Her method, promoted internationally while working in Australia, Europe and the United States, differed from the conventional one of placing affected limbs in plaster casts. Instead she applied hot compresses, followed by passive movement of the areas to reduce what she called "spasm"..... Her principles of muscle rehabilitation became the foundation of physical therapy or physiotherapy in such cases.

Her life story was told in a 1946 film, Sister Kenny, portrayed by Rosalind Russell, who was nominated for the Academy Award for Best Actress for her performance.

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{{anchor|Youth}}Early life

Elizabeth Kenny was born in Warialda, New South Wales, on 20 September 1880, to the Australian-born Mary Kenny, née Moore, and Michael Kenny, a farmer from Ireland. She was called Lisa by her family and was home-schooled by her mother before attending schools in Guyra, New South Wales, and Nobby, Queensland. +more At the age of 17, she broke her wrist in a fall from a horse. Her father took her to Aeneas McDonnell, a medical doctor in Toowoomba, where she remained during her convalescence. While there, Kenny studied McDonnell's anatomy books and model skeleton. This began a lifelong association with McDonnell, who became her mentor and advisor. Kenny later confirmed that she became interested in how muscles worked while convalescing from her accident. Instead of using a model skeleton, available for medical students only, she made her own. After her time with McDonnell, Kenny was certified by the Secretary of Public Instruction as a teacher of religious instruction and taught Sunday School in Rockfield. Having become a self-taught pianist, she listed herself as a "teacher of music" and did so a few hours a week.

In 1907, Kenny returned to Guyra, New South Wales, first living with her grandmother and then with her cousin Minnie Bell. She soon became a successful broker of agricultural sales between Guyra farmers and northern markets in Brisbane. +more After that she worked in the kitchen in Scotia, a local midwife's cottage hospital and the local Dr. Harris gave her a letter of recommendation. With some savings from her brokerage work she paid a local seamstress to make her a nurse's uniform. With that and the observations she had made at Scotia and under Dr. Harris, she returned to Nobby to offer her services as a Bush Nurse. By then she was known as Nurse Kenny, earning the title Sister while nursing on cargo ships that carried soldiers to and from Australia and England during the First World War. In Britain and Commonwealth countries, "Sister" as a title of courtesy applies not only to members of a religious order but to a more highly qualified nurse, one grade below "Matron".

Work

After her 1909 return to Nobby, Kenny worked as a bush nurse, reaching her patients on foot or often by horseback. In November 1911 she opened a Cottage Hospital at Clifton which she named St. +more Canice's, where she provided convalescent and midwifery services. In her 1943 autobiography she claimed that in 1911 she treated what McDonnell thought was infantile paralysis under the supervision of Dr Horn, the local Lodge Doctor. The story was romanticized in the 1946 film Sister Kenny, featuring Rosalind Russell. In her autobiography Kenny wrote that she sought McDonnell's opinion. He wired back saying "treat them according to the symptoms as they present themselves. " Sensing that their muscles were tight, she did what mothers around the world did: applied hot compresses made from woollen blankets to their legs. Kenny wrote that a little girl woke up much relieved and said, "Please, I want them rags that well my legs. " Several children recovered with no serious after-effects. The published versions of the story include ones in Victor Cohn's 1975 biography, in Ostenso's, and in Kenny's hand-written autobiography. The most dependable, however, is most likely to be in a letter to Victor Cohn from the Toowoomba journalist T. Thompson. Many years passed before Kenny treated anyone else who might have had polio.

World War I

In 1915, Kenny volunteered to serve as a nurse in the First World War and went to Europe. She was not officially a qualified nurse, but nurses were badly needed and she was assigned to work on "Dark Ships", slow-moving transports that ran with all lights off between Australia and England. +more They carried out war goods and soldiers and wounded soldiers and trade goods on the return voyage. Kenny served on these dangerous missions throughout the war, making 16 round trips (plus one round the world via the Panama Canal). In 1917 she earned the title "Sister", which in the Australian Army Nursing Corps is the equivalent of a First Lieutenant. Kenny used that title for the rest of her life. She was criticized by some for doing so, but Kenny was officially promoted to the rank during her wartime service. During the final months of the war, she served for a few weeks as matron to a soldiers' hospital near Brisbane. By then she was worn down by her wartime duties, honourably discharged and awarded a pension.

Press reports from Australia in the 1930s quote Kenny as saying she developed her method while caring for meningitis patients on troopships during the First World War.

In April 1925, Kenny was elected as the first president of the Nobby branch of the Queensland Country Women's Association .

Return to Queensland

Although exhausted by war service, Kenny set up a temporary hospital in Nobby to care for victims of the 1918 flu pandemic. When the epidemic subsided, Kenny travelled to Guyra to recuperate. +more Still exhausted and sick, she decided to go to Europe, where doctors helped. She then returned to Nobby, but within days was summoned to Guyra by a girlhood friend to care for her daughter Daphne. The girl was disabled with what was known then as cerebral diplegia. Kenny treated her at Cregan's Station west of Guyra for three years and continued her association with her for many years. Treatment of Daphne, plus her wartime nursing of the sick and wounded provided Kenny experience for her later work of rehabilitating polio victims.

Instead of settling at home as a spinster caring for her mother, Kenny continued to work from there as a nurse. Her neighbour Stan Kuhn took her to patients in his motorcycle sidecar or car. +more When his younger sister Sylvia fell into the path of his horse-drawn plough, he carried her home and called Kenny. She quickly improvised a stretcher from a cupboard door, carefully secured Sylvia to it, and rode with her in the local ambulance 26 miles to McDonnell's office. He helped Sylvia recover and credited Kenny for her stretcher and her careful care. She improved the stretcher for use by local ambulance services, and for the next three years marketed it as the Sylvia Stretcher, in Australia, Europe and the United States. She turned the profits of this over to the Country Women's Association, which dealt with its sales and manufacture. At that time Kenny, while travelling to sell the Stretcher, adopted eight-year-old Mary Stewart to be a companion for Sister Kenny. Mary later became one of Sister Kenny's best "technicians".

Polio treatment

As sales of the Sylvia Stretcher declined, Kenny returned to Nobby as a nurse. During one sales journey she had met the Rollinson family, who owned a station west of Townsville. +more Kenny telephoned them in 1931 while on a visit to her brother Will. They promptly asked her to care for their niece Maude, who was disabled by polio. After 18 months under Kenny's care, Maude could walk, return to Townsville, marry and conceive a child. The Townsville newspapers took up the story, naming it as a cure. In 1932, Queensland suffered its highest number of polio cases in 30 years; the following year several local people helped Kenny set up a rudimentary paralysis-treatment facility under canopies behind the Queens Hotel in Townsville. After a few months' further success with local children, she moved to the bottom floor of the hotel. The first official evaluation of her work was made in Townsville in 1934 under the auspices of the Queensland Department of Health. Her success led to Kenny clinics being established in several Australian cities. The Sister Kenny Clinic in the Outpatients Building of the Rockhampton Base Hospital is now listed on the Queensland Heritage Register.

Over the years, Kenny developed her clinical method and gained recognition in Australia. She was strongly opposed to immobilising children's bodies with plaster casts or braces. +more Kenny requested permission to treat children in the acute stage of the disease with hot compresses, as she claimed to have done in Clifton before the war, but doctors would not allow that until after the acute stage of the disease, or until "tightness" (Kenny used the word "spasm" much later) subsided. She instituted a careful regimen of passive "exercises" designed to recall function in unaffected neural pathways, much as she had done with Maude. On her own, she began treating a patient in the acute stage in her George Street Clinic in Brisbane, afterwards transferring her to the Ward 7 Polio Clinic in Brisbane General Hospital. That child and others recovered with fewer after-effects than those placed in braces. In 1937, she published an introductory book on her work and began another, The Treatment of Infantile Paralysis in The Acute Stage, known as The Green Book and later published in the United States. The broadest appraisal of her methods, "The Kenny Concept of Infantile Paralyses And Its Treatment," appeared in collaboration with Dr John Pohl in 1943 and was known as "The Red Book. ".

Between 1935 and 1940, Kenny travelled widely in Australia, helping to establish clinics. She made two trips to England, where she set up a treatment clinic in St Mary's Hospital near Carshalton. +more Kenny's success was controversial; many Australian doctors and the British Medical Association questioned her results and methodology. Raphael Cilento, who was in charge of the QHD evaluation, wrote a report that was somewhat complimentary but mainly critical. Kenny replied publicly, fiercely taking Cilento to task for his criticisms, unheard of then from a self-taught Australian Bush Nurse. This response caused contentious relations between Kenny, Cilento, the BMA and the Australian Massage Association (AMA). Between 1936 and 1938, a Queensland Government Royal Commission evaluated Kenny's work and published its Report of The Queensland Royal Commission on Modern Methods for the Treatment of Infantile Paralysis in 1938. Its most critical comment, on Kenny opposing the use of splints and plaster casts was: "The abandonment of immobilization is a grievous error and fraught with grave danger, especially in very young patients who cannot co-operate in re-education. " However, it stated that her clinic, then in Brisbane, was "admirable". The Commissioners' strongest words were against the Queensland government, then funding Kenny's work, as her clinics were unsupervised by medical practitioners. The Queensland Government rejected the report and continued to support Kenny.

In 2009, during the Q150 celebrations of the institution of Queensland, the Kenny regimen for polio treatment was announced as an outstanding "innovation and invention".

In the US

In 1940, the New South Wales government sent Kenny and her adopted daughter Mary, who had become an expert in Kenny's method, to America to present her clinical method for treating polio victims to doctors. After a sea journey from Sydney to Los Angeles and by rail to San Francisco, Chicago, New York City, back to Chicago and to the Mayo Clinic in Rochester, Minnesota, she was given a chance to show her work in Minneapolis, Minnesota. +more Doctors Miland Knapp and John Pohl, who headed polio treatment centres there, were impressed and told her she should stay. They found an apartment for Kenny and Mary; several years later, the city of Minneapolis gave them a house. The city was Kenny's base in America for 11 years. In a 1943 letter to the British Medical Journal, Kenny noted, "There have been upwards of 300 doctors attending the classes at the University of Minnesota. ".

During this time, several Kenny treatment centres were opened throughout America, the best-known being the Sister Kenny Institute in Minneapolis (opened 17 December 1942; now the Courage Kenny Rehabilitation Institute). Dr Knapp served as director of training at the Minneapolis Sister Kenny Institute after it opened in 1942, and was director of physical medicine and rehabilitation from 1948 to 1964 as well. +more There were also facilities at the New Jersey Medical Center and the Ruth Home in El Monte, California. She received honorary degrees from Rutgers University and the University of Rochester. She joined for lunch US President Roosevelt, whose paralytic illness was believed to be polio, discussing his treatment at Warm Springs. In 1951, Kenny topped Gallup's most admired man and woman poll as the only woman in the first ten years of the annual list to displace Eleanor Roosevelt from the top. The Sister Kenny Foundation was established in Minneapolis to support her and her work throughout the United States.

Some doctors changed their initial professional scepticism when they saw the effects Kenny's method had on her patients, both children and adults. Many magazines covered her work. +more In 1975 Victor Cohn wrote the first detailed biography of her life and work. During her first year in Minneapolis, the National Foundation for Infantile Paralysis (NFIP) paid her personal expenses and financed trials of her work. That support ceased, however, after a series of disagreements with the NFIP Director. Kenny was a determined and outspoken woman, which harmed her relations with the medical profession, but her method continued to be used and helped hundreds of people suffering from polio.

In recognition of her work, in February 1950 President Harry Truman signed a Congressional bill giving Kenny the right to enter and leave the US as she wished without a visa. +more This honour had only been granted once before, to the French Gilbert du Motier, Marquis de Lafayette, a leader in the American War of Independence.

Important

Final years and death

Kenny filled her final years with extensive journeys in America, Europe and Australia in an effort to increase acceptance of her method. She tried, unsuccessfully, to have medical researchers agree with her that polio was a systemic disease. +more She attended the second International Congress about polio in Copenhagen. There she was shunned and unable to participate. Suffering from Parkinson's disease, she stopped on her way home in Melbourne to meet privately with internationally respected virologist Sir Macfarlane Burnet. He wrote of the visit in his autobiography: [wiki_quote=18c1c7f5].

In an attempt to save her life from cerebral thrombosis, Irving Innerfield of New York sent his experimental drug based on the enzyme trypsin by air mail to Brisbane. It was rushed by car to Toowoomba and administered on 29 November 1952, but her doctor found Kenny too close to death to benefit and she died the following day.

Kenny's funeral on 1 December 1952 at Neil Street Methodist Church in Toowoomba was recorded for transmission in other parts of Australia and in the United States. The cortège to Nobby Cemetery was one of the largest seen in Toowoomba. +more Kenny was buried there beside her mother.

Legacy

Between 1934 and her death in 1952, Kenny and her associates cared for thousands of patients, including polio victims throughout the world. Their testimony to Sister Kenny's help is part of her legacy, as is The Kenny Concept of Infantile Paralysis, and Its Treatment, known as the "Red Book".

A Sister Kenny Memorial House was opened in Nobby on 5 October 1997 by Prof John Pearn. This contains many artefacts from Kenny's life and a collection of documents from her private correspondence, papers and newspaper clippings. +more In Toowoomba, the Sister Elizabeth Kenny Memorial Fund provides scholarships to students attending the University of Southern Queensland who dedicate themselves to work in rural and remote areas of Australia. In Townsville, her life was marked in 1949 by the unveiling of a Sister Kenny Memorial and Children's Playground.

Sister Kenny is mentioned in the TV movie An American Christmas Carol, where the Tiny Tim character, Jonathan, is sent for treatment for his disability, never referred to specifically, however, as polio. Her treatments are also suggested to be the basis for Olivia Walton's recovery in The Waltons' first-season episode "An Easter Story". +more Olivia's will to walk again after polio leads her to take the chance that Kenny's methods might work.

The cartoonist and amputee Al Capp was involved with the Sister Kenny Foundation in the 1940s and 1950s. As honorary chairman, Capp made public appearances on its behalf, contributed artwork for its annual fundraising appeals, and entertained disabled children in hospitals with pep talks, humorous stories and sketches.

Alan Alda credits the Sister Kenny treatments he received from his mother as a young boy for his complete recovery from polio, stating in his autobiography Never Have Your Dog Stuffed that he has no question about their efficacy. In an interview with Actors Studio, the actor Martin Sheen recounted that he contracted polio as a child and it was due to his doctor using Sister Kenny's method that he regained use of his legs.

{{anchor|People known to have received treatment}}Polio patients treated with the Sister Kenny method

Joy McKean, singer, recovered from polio after being treated by Sister Kenny. Below are famous people whose polio was treated with the method developed by Kenny, but not by Kenny herself. +more *Alan Alda, American actor *Peg Kehret (née Schulze), American author *Marjorie Lawrence, Australian opera singer, who regained only partial use of her legs *Martin Sheen, American actor *Dinah Shore, American singer *Robert Anton Wilson, American writer.

Bibliography

Elizabeth Kenny, Infantile Paralysis and Cerebral Diplegia: Method of Restoration of Function (Sydney: Angus and Robertson, 1937) *Elizabeth Kenny, The Treatment of Infantile Paralysis in the Acute Stage (Minneapolis-St. Paul, Bruce Publishing Co. +more 1941) *Elizabeth Kenny, My Battle and Victory: History of The Discovery of Poliomyelitis as a Systemic Disease (London: Robert Hale, 1955) *Martha Ostenso and Elizabeth Kenny, And They Shall Walk (Bruce Publishing Co, Minneapolis-St Paul 1943) *John Pohl, MD, and Elizabeth Kenny, The Kenny Concept of Infantile Paralysis and Its Treatment (St. Paul: Bruce Pub. Co. 1943) *Naomi Rogers, Polio Wars: Sister Kenny and The Golden Age of American Medicine (Oxford University Press, N. Y. 2014) *Wade Alexander, Sister Elizabeth Kenny: Maverick Heroine of The Polio Treatment Controversy, (Greystone Press, San Luis Obispo CA 2012). Note: This is an unredacted edition which includes content not in the Outback Press/CQU 2003 Edition which is out of print. The book is now published by the Sister Kenny Memorial House in Nobby QLD, AU. The Greystone 2012 Edition is available in an electronic version from the author.