Kenny, Elizabeth (1880–1952)

Australian-born nurse, without formal medical training, who became known as "Sister" Kenny in World War I and later made a name for herself through her new therapy for polio victims. Name variations: Sister Kenny. Born Elizabeth Kenny on September 20, 1880, in the village of Warialda, in northwestern Australia; died in Brisbane on November 30, 1952; daughter of Michael Kenny and Mary (Moore) Kenny; learned to read and write and took a three-year training course to become a certified nurse; never married, no children.

Completed training course as a certified nurse (1911); volunteered for the Australian Nursing Service (1915); promoted, despite lack of formal nursing training, to rank of "sister," the title used for the rest of her life (1916); after a worldwide outbreak of polio, opened a clinic in Brisbane, using her unorthodox form of treatment (1934); moved to U.S., where she first introduced her therapy in Minneapolis (1940); named "Woman of the Year" by a New York City newspaper (1942); ranked second after Eleanor Roosevelt in a Gallup poll for "Most Admired Woman in America," a position she continued to hold for the next nine years (1943); movie of her life, starring Rosalind Russell, released (1946).

Selected writings:

And They Shall Walk: The Life Story of Sister Elizabeth Kenny (written in collaboration with Martha Ostenso , Dodd, Mead, 1943); The Kenny Concept of Infantile Paralysis and its Treatment (written in collaboration with John F. Pohl, Bruce, 1943); Treatment of Infantile Paralysis in the Acute State (Bruce Press, 1941).

Elizabeth Kenny was born on September 20, 1880, in the village of Warialda, meaning "place of wild honey," in northwestern Australia. Her parents' families had immigrated to the wild new country a couple of decades earlier, and in 1872, Michael Kenny, aged 37, had married Mary Moore , aged 28. Elizabeth, a strong, healthy child, was the fourth of many children born to the couple, though few lived through infancy and childhood.

In the harsh conditions of the Australian outback, as her restless father searched for both security and freedom, Elizabeth soon came to share responsibility for the care and nurture of her younger siblings. Because of her family's nomadic ways, reinforced by the general lack of interest in teaching girls in this frontier society, she received little formal education beyond learning to read and write. Otherwise, she learned mostly from observing nature and human interactions with nature. Her parents were Anglican and Catholic, with her Protestant father exerting more influence by his absence than her Catholic mother did by her presence.

In her adolescent years, a broken wrist led to Elizabeth's first brief acquaintance with "civilization," when she stayed in town with the family of a well-to-do physician, Dr. Aeneas John McDonnell, while he treated her. In McDonnell's home, she became acquainted with his medical anatomy books and also decided to become a missionary. McDonnell advised her that she could be more effective in missionary work if she became a certified nurse. In 1911, having spent most of her life helping her mother and nursing sick neighbors or delivering babies, Kenny completed the three-year training course for becoming a full-fledged certified nurse. She was 31.

As far as can be guessed from her own incomplete autobiographies, Elizabeth Kenny had only one serious romance. She nearly married a man named Dan, or possibly named David and known as Dan because of his fondness for singing the Irish ballad "Danny Boy." According to her, she broke a date to attend an annual picnic with him in order to help deliver a premature baby, causing Dan to demand that she choose between him and her vocation. What Dan lost, the world won.

Poliomyelitis, also known as "polio" and infantile paralysis, was one of the world's most dreaded diseases when Kenny experienced her first exposure to it in the Australian bush. The name comes from the Greek words, polio (gray), myelos (marrow), and itis (inflammation), and its victims are most often children. Oblivious to the conventional medical opinion about treatment, Kenny first applied heat "fomentations" (strips of woolen cloth boiled in a basin) to the tortured, paralyzed limbs, and then prescribed a regimen of exercise to regain mobility. Most of her slightly paralyzed patients recovered completely, and many who were more severely paralyzed regained some use of their limbs. When McDonnell, who had become chief surgeon at a regional hospital in Toowoomba, learned of Elizabeth's successes, he apprised her of the treatment methods of mainstream medical doctors, who prescribed casts and splints to immobilize the limbs. Kenny's response was, "My method works and theirs doesn't."

World War I began in August of 1914, and Australia, as a member of the British Empire, went to war in support of the mother country. Early in 1915, Elizabeth volunteered to serve in the Australian Nursing Service. Informed that she lacked the proper nursing credentials, she went anyway. Thanks partly to the many letters

of recommendation written by McDonnell, and even more to the flood of Australian casualties pouring in from the disastrous British campaign in Turkey at Gallipoli, Kenny was accepted as an army nurse in the field. In 1916, despite her lack of formal nursing training, she was promoted to the rank of "sister," giving her two insignia decorations, or "pips," and the title she was to use the rest of her life.

While her general war experience reinvigorated Sister Kenny's nascent Roman Catholic faith, her more particular medical experience reinforced her conviction that heat packs and exercise cured disease. She treated wartime meningitis patients with exercise, along with splints and crutches retrieved from the shrine to Mary the Virgin at Lourdes. Kenny did not concern herself too much about whether cures came from supernatural or natural sources, so long as they worked.

The war ended in 1918, only to be followed by a massive influenza epidemic that killed more people than had died in combat. Exhausted and sick from overwork and the flu, Elizabeth was mustered out of the military and off the government payroll. In fact, it was her old friend and patron, McDonnell, now a colonel in the Australian army, who pronounced her as suffering acute myocarditis (inflammation of the muscular wall of the heart), rendering her both unfit for further service and ineligible for a government pension.

At age 39, with her morale at its lowest point, Kenny told herself, "If I have only six months to live, I'd better get busy." Back in the Australian bush, she resumed her medical work. After observing that patients were sometimes literally shaken to death during transport to hospitals over terribly bumpy back roads, she perfected a stretcher used to strap patients while they were moved. It was called the "Sylvia Stretcher," for a family friend whose life had been saved by its use.

At age 50, Kenny had recovered her health, but she was still an unknown nurse toiling in the Australian outback when polio swept through the Western world along with the Great Depression. By November 1933, when Americans elected Franklin D. Roosevelt, a polio victim, as president, it was apparent that traditional medicine

could not cope with the disease, and people were seeking help wherever it could be found. Early in 1934, Sister Kenny moved to the city of Brisbane, where she established a clinic using her therapeutic techniques, and by 1935, patients were pouring into Brisbane from the all over the world. A headline in Australia's leading newspaper, The Sydney Morning Herald, read: "PARALYSIS. A New System of Treatment Presented to Nation. Doctors' Praise." By the end of 1936, Sister Kenny was treating 600 patients in clinics throughout Australia, with 600 more on waiting lists.

What was this magic treatment? Sister Kenny's diagnosis focused on the muscles and mind, not cells and bones. According to her interpretation, the symptoms of polio were caused by the "spasm" of the muscles. In her terminology, this "spasm" caused the patient involuntarily to do three bad things. The disease caused the patient to pull the opposite muscles from their normal position and distorted the skeleton; the resulting tenseness, tenderness, and pain caused the second symptom, of "mental alienation," in which the patient was unwilling and eventually unable, i.e. would actually "forget," how to move the muscles even though the nerve paths were intact. This situation led to the third condition, the jerky grotesque body movements Kenny called "incoordination." Here the patient used the wrong muscles in jerky and grotesque motion. According to her prognosis, if muscles "in spasm" were left untreated, their alienated opposites eventually atrophied, while the ones in spasm became hard, fibrous, and inelastic, pulling the skeleton into permanent deformities.

Sister Kenny's prescribed treatment was to exercise and arouse the live but dormant muscles. Stripping away casts, splints, and all the other devices immobilizing her patients, she forced them into various stretching motions. On the psychological level, she commanded the patient to learn the names of the muscles and to exercise will-power in relearning to move them.

Criticism of such a radical approach soon emerged. In the area of traditional medicine, doctors and nurses were not impressed by Sister Kenny's theoretical explanations of what she was doing. Distrusting and even resenting her lack of scientific education, they ridiculed her use of vague terms and seized upon the fact that she was not conversant enough with prevailing medical language to be able to articulate her theories in a clear and convincing way. Moreover, she did not cure everybody. There were many patients in her care who were not relieved of their tragic paralysis, and some who died.

In the second place, the effectiveness of Sister Kenny's treatment was oversold, and she allowed her success to go to her head. Never shy or smooth, and not even especially likeable, she lacked the temperament to cope with the extremes of adulation and criticism. As is the case with many people of humble origin who find themselves pushed into the public spotlight, she was not equipped with the social graces to disguise her own weaknesses. As her fame soared, she became less tolerant of criticism and more inclined to claim that her treatment was the only viable one. When she met medical resistance, she resorted to promoting her convictions through media campaigns. Just as the medical profession resented her zealous self-promotion, so disillusioned patients and their loved ones, and even potential supporters were offended by her brusque behavior.

Nevertheless, her therapy did work better than anybody else's, and her fame did soar. On April 16, 1940, Sister Kenny arrived in San Francisco and was greeted by polio-conscious Americans as a messiah. Touring across the United States, she visited hospital after hospital, where she jeered at the sight of patients plastered up in casts and splints, and promised to revolutionize the situation. Initially attracted to the famous Mayo Clinic in Rochester, Minnesota, she settled in Minneapolis, 90 miles to the northwest, because there were many polio patients in the Twin Cities hospitals.

One case converted many Minnesota physicians to her methods. Dr. John Pohl, at age 36, was a rising star in the Minnesota medical establishment, and he remained skeptical as he presented Henry Haverstock, Jr., 18-year-old son of a prominent attorney, for treatment by Sister Kenny. After Henry was struck by polio in 1939, he had been sent to Warm Springs, Georgia, for the standard treatment, which involved being fitted with two steel leg braces, a steel-and-canvas body corset, and an arm splint. A year later, Henry had a curved spine, a paralyzed right leg, a paralyzed left leg that was all but useless, a weak arm, and weak muscles of the chest, back, and abdomen. Told he would never walk again, he was confined to a bed where he could not even sit up.

Discarding the corset and braces, Sister Kenny proceeded with her heat treatment and began teaching Henry to use the muscles that the real paralysis had not rendered useless. Within a week, he could straighten one contracted leg; before the end of the year, he walked out of his room using hand crutches. He continued his treatment for more than a year, and by the spring of 1942, he started attending the University of Minnesota. Although his movement never became normal, he was able with the aid of hand sticks to walk up 21 flights of steps every day. He became a lawyer and lived a productive life, and Dr. Pohl became Sister Kenny's most active supporter.

Although the conversion of Minnesota doctors was accomplished, the leaders of the American Medical Association remained suspicious and vigilant against the exaggeration of Sister Kenny's success. In fact, however, she had initiated a revolution in polio treatment that conquered the United States. For example, the demand for splints and frames which numbered nearly 15,000 in the Manhattan area of New York City in 1941 had dropped by 1943 to only three.

She was no scientist; she was a crusader. … Her concept of polio and therefore the kind of treatment that was needed was new and different and made [the medical profession] focus on how the neuromuscular system really functions.

—Victor Cohn

In 1942, less than two years after her departure from Australia, Sister Kenny was named "Woman of the Year" by a New York newspaper; in 1943, she was ranked second after Eleanor Roosevelt as the "Most Admired Woman in America" by the Gallup poll, a ranking she kept for nine consecutive years. With this kind of fame, Hollywood came next. On September 27, 1946, the movie Sister Kenny opened in New York, with Rosalind Russell in the starring role for which she received an Oscar nomination. Kenny's life now seemed cast in Hollywood terms. In the film, she was characterized as a saint who had rejected love for medicine; Kenny clinics opened around the world, becoming shrines that seemed to replicate the healing powers of the religious shrine at Lourdes in France; and medical doctors in Australia and America, with few exceptions, were portrayed as medieval clerics, either bone-headed skeptics or cruel inquisitors. All this intensified both the adulation of Sister Kenny, which was not good for her on the personal level, and the criticism of her, which was not good for her professional work.

Just as President Roosevelt became the prime mover in the National Foundation for Infantile Paralysis and its March of Dimes campaign, Sister Kenny herself became an institution dedicated to raising money and promoting medical research and public education. Together, the most famous victim of polio and the most famous crusader for its treatment laid the foundation for funding medical research in the disease for the second half of the 20th century. The Sister Elizabeth Kenny Foundation marked both the highest and lowest points in the life of its founder.

Unfortunately, the independent-minded Australian bush nurse was neither a good administrator, nor a good judge of character. As the symbolic leader of the national organization, she allowed her name to be used in raising vast amounts of money to finance what was being advertised as a medical miracle. With the massive publicity campaigns came enormous amounts of charitable donations and huge opportunities for corruption. Kenny became the organizational figurehead, a stalking-horse for people using her name to line their own pockets. Fortunately for her peace of mind, the fund-raising scandal that wrecked the Kenny Foundation was not uncovered until after her death back home in Brisbane, on November 30, 1952.

Trimmed back and reorganized, the Kenny Foundation is now a respectable supporter of training for rehabilitation workers, while the "institutionalization of Sister Kenny," meaning the transformation of a crusader into a corporation to raise money for charity, has entered the language as a cautionary tale against the danger of corruption lurking in every charitable enterprise. Nevertheless, it is impossible to imagine the subsequent conquest of polio through the vaccines of Drs. Jonas Salk and Albert Sabine without appreciating the massive financial support provided by the organizations created by the president and the nurse. And just as it is probably better to remember the personal courage of Franklin Roosevelt in living a rich life after he was crippled by polio, it is certainly better for us to remember the personal courage of the outback nurse without even the training of a Registered Nurse (R.N.), whose convictions about a therapy that worked helped to open the way for the transformation of medical and nursing approaches throughout the world, especially the rigorous use of exercise in recovery from assorted forms of disease and surgery.

sources:

Cohn, Victor. Sister Kenny: The Woman Who Challenged the Doctors. University of Minnesota Press, 1975. [There have been an enormous number of pamphlet and magazine articles written about Kenny; they are divided between the popular culture magazines which with few exceptions glorify her and the medical association journals which with few exceptions vilify her. Cohn's biography is the best, and in fact the only reasonably objective study which covers her personal life and career and attempts to evaluate her professional achievement; it also contains an excellent bibliography.]

Crofford, Emily. Healing Warrior: A Story About Sister Elizabeth Kenny. Carolrohda Books, 1989.

Fritz, Karen Kay. "A History of the Concept of Creativity in Western Nursing: A Cultural Feminist Perspective," D.N.Sc. dissertation, University of San Diego, 1995.

O'Kiersey, Niamh. "Muscle Woman …Elizabeth Kenny," in Nursing Times. Vol. 92, no. 2, 1996, pp. 38–39.

Wilson, J. "The Sister Kenny Clinics: What Endures?," in Australian Journal of Advanced Nursing. Vol. 3, no. 2. December, 1985–February, 1986, pp. 13–21.

related media:

Sister Kenny, film based on the book And They Shall Walk, with screenplay by Dudley Nichols, Alexander Knox, and Mary McCarthy , was produced by RKO and starred Rosalind Russell, 1946.

David R. Stevenson , Professor of History, University of Nebraska at Kearney, Nebraska