S • I • X

Sister Elizabeth Kenny: Conviction and Controversy

Mary Kamienski

Sister Elizabeth Kenny 1952 “Fight Against Polio” seal, issued in 1952.

These words were uttered by a young child who was stricken with polio and treated using the Elizabeth Kenny method. Elizabeth Kenny (1880–1952) was a remarkable woman who challenged the entire medical community as well as the social customs of her time. She was an Australian bush nurse with a vision, or perhaps an obsession about the care and treatment of poliomyelitis victims. She became world famous for her innovative approach to the treatment of these patients. Although she was well loved and respected by patients and families, her approach to treating polio patients was contrary to the medical community’s beliefs and she battled much resistance to advance her methods. In spite of this, she persevered throughout her entire career in teaching what would eventually become known as the “Kenny method.” In doing so, she achieved great success in preventing deformity and paralysis in children, as well as adults, who were stricken with this devastating disease.

In spite of the fact that Sister Kenny was never a licensed nurse, she eventually became one of the most prominent women of her time. By the mid-1940s, her methods became the standard for polio care. Yet, her impact on health care extended well beyond the treatment of polio.

Before she was 30 years old, she had traveled throughout the Australian countryside for several years helping families and caring for sick neighbors. She also traveled with a nurse, Miss Sutherland, and learned nursing and midwifery. Over the years, Sister Kenny offered several versions of stories about her education and training. These included a story about being educated in a private hospital that had ceased to exist or had burned down. She admitted to one individual that training was too expensive, so she went into nursing with a friend in Sydney. Whatever her educational background and despite her apparent lack of credentials, her reputation as a nurse began to grow. She was always willing to try even when the prognosis for her patients was poor. She was never afraid to give her opinion to a physician, or anyone else for that matter. Her patients always came first. She was considered by her colleagues to be a good and caring nurse and she was remembered for her beautiful and gentle nursing hands (Cohn, 1975, p. 60).

NATURE VERSUS NURTURE

Nature versus nurture is not a question often used when discussing leadership. Are good leaders born or can they be taught and developed over time with experience? A look at Sister Elizabeth Kenny’s early life suggests she was born with strong characteristics that would lead to success in her career. The circumstances of her early life, however, definitely played a role in creating this nurse leader who challenged the medical establishment in many areas, the most prominent being the treatment of polio.

Elizabeth Kenny was born of Irish immigrants who came to Australia as a last resort after losing their home owing to the fact that her great-grandfather guaranteed a loan for a friend who later defaulted (Cohn, 1975). Her great-grandfather Richard Pearson was from County Donegal and he headed for Australia in 1841 with his wife and children in tow. One of his daughters, Elizabeth, later became Sister Kenny’s maternal grandmother (Yoder, 1942).

The Kenny family name is Gaelic for “sprung from fire” (Cohn, 1975, p. 14). Those who knew Elizabeth Kenny would attest to the fact that she seemed to have a fire burning inside that allowed her to accomplish great things. The Kenny family clan lived in County Kilkenny, where the Kilkenny men had a fierce reputation for being independent. They were described as being contentious and contrary (Cohn, 1975).

Bravery, courage, and a fiery spirit were integral parts of Sister Kenny’s personality. Her father, Michael, was born in Ireland. He was a farmer until age 27, when he took advantage of an unexpected opportunity to immigrate to Australia. When Michael Kenny met Mary Moore, daughter of Jim Moore and Elizabeth Pearson Moore, they married and moved onto a new homestead. Michael later moved his family many times and finally settled outside the town of Warialda where Elizabeth was born on September 20, 1880. She was the fifth child although an earlier sibling, the “first” Elizabeth had died of bronchial pneumonia prior to Eliza’s birth (Cohn, 1975).

Over the years, the family moved many more times, and five more children were born to the Kennys. Elizabeth was rarely called by her given name. Her family called her Liza or Eliza (Cohn, 1975). She had traits of her father and became a wanderer at a very young age (Cohn, 1975). Her mother had to tie her to a stump at the early age of 9 months to keep her safe. When she was 4, she tried to fly. When she fell, she seemed to have learned a lesson for a time (Cohn, 1975). Eliza and her sister Julia wandered about and saw the Aboriginal corroboree, a festival of the Aborigines, who are also famous wanderers (at the time, the term “Abos” was frequently used and the term “Aborigine” was also used; Cohn, 1975). In spite of her fear of being captured by these “Abos,” she continued to explore her world.

The Kennys were very poor and the girls’ dolls were usually dressed-up bottles or rags. When one of the dolls developed pneumonia, Eliza decided the dolls needed a hospital. She organized her first hospital and put poultices on her doll “patients” (Cohn, 1975).

Eliza’s interest in and knowledge of human anatomy was piqued when she was a child and fell and broke her arm. She stayed with Dr. Aenas McConnell, who treated the complex fracture in his home. He had a wonderful library that contained a skeleton. She played with the skeleton for hours and learned how to trace muscle from origin to insertion. Dr. McConnell became a lifelong mentor and friend to Eliza (Cohn, 1975).

Shortly after her long recovery, Eliza asked Dr. McConnell how to help her brother Willy improve his physique, which she considered skinny and frail. He prescribed a program of calisthenics, which Eliza supervised. Eventually, Willy was able to isolate his principal muscles through voluntary contraction and he developed biceps so well defined they looked like fruit (Cohn, 1975). So, in spite of her lack of a formal education, Eliza had become very knowledgeable about the actions of muscles.

THE VISION

Although Eliza was never formally trained as a nurse, in 1911 she decided to ride her horse into the outback and treat those in need. There is no mention anywhere regarding her desire to be a nurse. She was, however, always eager to reach out and help wherever there was a need. There were few physicians in the area. Sister Kenny was self-appointed and she did not bother to apply for a formal nursing job, as she did not have the required qualifications. The need for health care in the bush was so great that many were not concerned that she did not have a certificate to practice nursing and many did not even know what a “certificate” was (Cohn, 1975). They were simply grateful to have someone to care for them.

Elizabeth’s decision to join the military in 1915 was instrumental in enhancing her reputation as a legitimate nurse. She did not have the credentials necessary to join the Australian Army Nursing Service. She did obtain references and testimonials from her long-time mentor, Dr. Aneas John McDonnell. He stated she was a capable nurse, but even this this did not get her into the military. As usual, Elizabeth was unstoppable. She simply boarded a ship and sailed to England where she found a bed in a nurses’ club. She reported for duty to a general who ordered her to France for special duty (Cohn, 1975). After this, she was to help transport Australian casualties back home. There is controversy over exactly how this happened. There are no records indicating anything about her training or licensure as a nurse. At the time, there were ships full of severely wounded soldiers and sick civilians being returned home. Elizabeth was popularly known as “Eliza” and wore the drab gray nurse’s uniform and a cape with a red lining. She watched; she learned. She became officially known as “staff nurse Kenny.”

Her next assignment was on a “dark” ship carrying 600 wounded and sick Australians (Cohn, 1975; Fairley, 2008; Rogers, 2014). Dark ships sailed with no lights in order to avoid submarine attacks. It was during this 4-week journey that she performed another of her “muscle miracles” (McKinnon, 1935). A soldier had been shot through both shoulders and was completely paralyzed in his arms; yet he was able to walk off the ship in Melbourne carrying his own pack. He credited a nursing sister with working with him in “reeducating” his muscles. The nursing sister was Elizabeth Kenny. That soldier later returned and reenlisted.

In 1916, Elizabeth was promoted from staff nurse to sister, which was equivalent to first lieutenant (Cohn, 1975). She used this title for the rest of her life. She continued to serve in many areas both on board ships and in Australian hospitals. During these assignments, she remembered the first polio patients she encountered in 1911 when she started her career as a bush nurse (Cohn, 1974). She started to watch the meningitis patients who moved through the acute phase of the disease but continued to remain paralyzed and deformed. She had only a vague knowledge of meningitis, but she did know about muscle rehabilitation. It was reported that she made the men think about their muscles and got them up and walking. She worked hard to position and reposition her patients at regular intervals (Cohn, 1975; Rogers, 2014). She was convinced of the need to reeducate both the mind and the muscles.

Sister Kenny served more time in danger zones that any other nurse of her time. In 1918, the influenza epidemic was rampant. All measures to treat these patients were futile and the men on board ships died. At one point, she and another nurse were left to care for 500 ill and wounded patients. After this ordeal, she was given a furlough and the armistice was signed. But she remained in the military and became a head nurse in a hospital in Brisbane.

When she became ill in 1919, Kenny was discharged with a pension. She had been diagnosed with pericarditis and was told that she had a short time to live. When given this prognosis, she got up out of bed, dressed, and said, “If I only have a short time to live, I better get busy” (Cohn, 1975, p. 64).

This prognosis led her to seek advice about her condition from a specialist in Stuttgart. She traveled to Ireland first, where her Catholic relatives convinced her to travel to Lourdes, where she spent 6 weeks. Later she saw the specialist who had nothing to offer, so she returned home. She had now used 4 months of her “allotted” time. She still suffered from poor health but was determined to return to work.

Sister Elizabeth started working with a young girl who had cerebral palsy. Working with this child, using her muscle-training regimen, brought her serious criticism from physicians. The child progressed and was finally able to walk. Dr. McDonnell agreed the child had improved and encouraged Eliza to continue her treatments with warm water and massage. She worked with this child for 3 1/2 years until she could walk with a stick, ride horseback, and write letters. To some, her walking looked like painful hobbling, but to those who knew the child before the treatments, it was a miracle. Eliza continued her country nursing during these years. As a rule, she took no money because she had her war pension.

COMMITMENT TO THE VISION

Sister Kenny’s passion was her work. She knew how to stir controversy and was expert at using the politics of medicine through the media to challenge the establishment. Elizabeth Kenny spent her entire life challenging the process. She battled mostly with men and appeared to enjoy these encounters. On more than one occasion, she stated, “I won’t let any man boss me” (Cohn, 1975, p. 100). She embraced chances to question the status quo and to think creatively. She had the ability to learn quickly through observation and her experiences. Although nurses were expected to show deference to physicians, Eliza’s style was in direct opposition to this practice. She was quick to question the expertise of any physician.

Elizabeth Kenny was never naïve about the need to use influence in order to change the care for polio victims in Australia and in the United States. She was determined to eradicate what she referred to as an attitude of medical laissez-faire.

Elizabeth Kenny became famous for her contentious nature. She simply did not back down. On one occasion, a physician wanted to operate on a child for appendicitis in the hospital where Elizabeth was working, an old, one-story wooden house. She advised the physician that she did not believe the diagnosis was accurate. When the doctor replied, “Who are you to say?” she responded by telling him, “I’m sorry. This is my hospital” (Cohn, 1975, p. 49). She refused to prepare for the surgery. She felt that if the child died, she would be responsible. Believing this physician incompetent, she had the child transferred for treatment by her mentor, Dr. McDonnell. The child did not have appendicitis (Cohn, 1975).

BEYOND POLIO

In 1926, Sister Kenny was called to care for a severely injured child named Sylvia and was to accompany Sylvia on the trip to the hospital. The Nobby motor ambulance had been engaged to make the 30-mile trip to the Toowoomba hospital. As a military nurse, Sister Kenny had witnessed the death of many soldiers while being transported over rough terrain. When the Nobby ambulance arrived and prepared to transport this child on a canvas stretcher, Elizabeth said she wanted to use her own stretcher. Eliza’s creativity and imagination allowed her to adapt to the situation. She had a heavy door removed from a linen cupboard and placed the child on this door. She immobilized Sylvia with strips of sheeting and packed hot water bottles around her to reduce shock. The child fell asleep within a few miles and they continued on until they were about 7 miles from their destination where they were involved in a head-on collision with an oncoming vehicle. Although Sister Kenny injured her shoulder in this crash, the child was not hurt. When the child recovered completely after 6 weeks, Dr. McDonnell was impressed and stated, “I think you saved your patient’s life” (Cohn, 1975, p. 78). He suggested that Sister Kenny get a patent for her stretcher.

She immediately drew up a design of this stretcher and had a friend’s son build a full-size version. Her completed invention had a firm base to keep the spine straight, coil springs, a mattress, a canopy, hot water containers, and rubber-tired wheels. She called it the “Sylvia” stretcher. It was patented and manufactured, but total sales were only 30 after more than a year’s efforts to market the invention. She firmly believed, however, that her stretcher was effective and offered the best care for transporting sick and injured patients. She refused to take it off the market. By 1930, the stretchers were in general use throughout Australia, although many ambulance companies found them to be large and cumbersome. Eliza continued to collect her self-negotiated guaranteed fee from the manufacturers. Between this fee and her military pension, she had gained some financial security and much experience in living, selling, arguing, and cajoling. This experience served her well as her career continued on its path, focusing more and more on the care and treatment of patients with polio.

Sister Kenny relied heavily on intuition, coupled with science, to develop her ideas about effective treatment for polio victims, as well as in her other endeavors. Her creation of the Sylvia stretcher, the first backboard for transport, stemmed from her understanding of the physiological stress placed on the body of a trauma victim and the need to immobilize the patient during transportation.

SOCIETAL VALUES

Eliza’s inability to conform to public opinion was not restricted to her nursing career. She was proud of her physical size and strength. She disregarded the belief that it is vulgar for women to be robust and that they should be ladylike and delicate (Rogers, 2014). In the early 1900s, Australian women did not leave home unless they married. As a spinster, Elizabeth was expected to remain home and care for her mother. Not so Eliza! She believed nursing was her destiny (Cohn, 1975; Rogers, 2014).

In an effort to conform to societal values, she told several people that she had a relationship with a man named “Dan.” She saw him often and told him she would marry him after she finished her preparations to become a nurse. He wanted her to give up this notion and pressured her to get married. On the last occasion of their courtship, they were preparing to go to a picnic and a dance. A young boy approached her frantically and said his father was away and his mother was about to have a baby. Dan objected, but Eliza was determined to help. He forced her to choose between marriage to him or her vocation. For Eliza, there was no option, no choice. She rode off with the young boy and never looked back (Cohn, 1975).

With Eliza so involved in other activities, her mother, Mary Kenny, became lonely. Eliza heard of an 8-year-old girl from a broken home. The child was named Mary Stewart and she was placed for adoption or a foster home. Eliza made the arrangements, and in 1925, formally adopted her. This was a rare event for a single woman. She now legally had a daughter. Perhaps it was a calculated move as the child remained with Eliza’s mother, Mary, to keep her company while Eliza traveled around the countryside on Country Women’s Association affairs and bush nursing. As little Mary Stewart grew, she later traveled with Sister Kenny and was an active part of Eliza’s polio work.

NOT A NURSE

Registration for nursing became official in New South Wales in 1906 and in Queensland in 1912. There is no evidence that Sister Kenny ever applied to be “grandfathered” as a licensed nurse and she joined no nursing associations. So how did she become a recognized uniformed nurse? It appears she commissioned a tailor to make her a nurse’s outfit. She had a red silk Nightingale cape worn beneath a longer cape of dark velvet. She wore a white uniform with a white belt and a dark velvet nurse’s cap with a stiff crown. She put this on and just became “nurse” Kenny. She displayed confidence and determination. She looked like a nurse, she acted like a nurse—she literally became a nurse. Throughout her career, her education and qualifications were questioned, but she rarely responded to any questions about her early years.

Sister Kenny met her first polio patient in 1911. A 2-year-old named Amy was unable to move and her body was twisted. The child was whimpering in great pain. Eliza did not know what was wrong. She was unable to straighten Amy’s legs. She prayed and waited for an answer from the doctor. During that night, two more children several miles away became ill and could not stand or walk. The physician finally answered with the message that the children had infantile paralysis. She was told there was no treatment and to do the best she could to treat the symptoms. Eliza was devastated. After much prayer and contemplation, she decided to treat the contracted muscles that appeared shortened and tightened with hot packs (Cohn, 1975).

Within a week, there was a polio epidemic afflicting six of the 20 children in the district. Eliza went from house to house putting hot poultices on the children’s painful arms and legs. In each case, after a few days, the pain subsided and Eliza began to gently move the affected limbs. She encouraged the children to remember how to move them. Almost a year passed until she saw Dr. McDonald again. When he asked how the children had fared, he was astounded when Eliza stated that they were all well and without any paralysis or pain. They had all completely recovered. Elizabeth Kenny’s crusade had begun.

Eliza lived in her parents’ home during this part of her career, but many times she stayed in a shack in the bush. She rode many miles on horseback to visit outback areas. She delivered babies and cared for the sick and injured. She did not ask for a fee, but often received payment in the form of a rooster, a leg of lamb, or a cut of beef. Once she even received an armchair from the relative of a grateful patient.

THE REALITY OF POLIO

Polio was a frightening reality during these years. It is a potentially fatal infectious disease. It is a virus transmitted mainly from person to person either from contaminated feces to hand to mouth or from oral secretions. The disease is most common in the summer and fall. During these months, children congregate in groups at swimming pools and playgrounds and physically interact, which increases the threat. The primary nervous system targets are motor cells and the nerve cells that control all voluntary motion. In severe cases, the motor cells in the spinal cord’s anterior horn, which is part of the cord’s vital gray matter, are affected. The name poliomyelitis comes from the Greek polios (gray), myelos (marrow), and itis (inflammation; Cohn, 1975; Rogers, 2014).

The symptoms may progress to a high fever, unrelenting headache, and nausea. This may lead to nuchal rigidity (stiff neck) and back with painful arm and leg muscles. This, may in turn, progress to permanent paralysis and, eventually, muscle wasting (Centers for Disease Control and Prevention [CDC], 2014).

In Kenny’s time, physicians believed the twisted necks, spines, hips, knees, legs, and feet and the flail joints of polio patients were caused by healthy muscles pulling on weak ones. They logically believed prevention of distortion could only be accomplished by splinting the affected parts so they could not become distorted. The common treatment was to strap the affected limbs to wooden or wire splints or place them in plaster casts. Sometimes the entire body would be fastened to a rigid frame with stiff arm and leg pieces. Knees were held in a slightly flexed position, with the legs in plaster. This immobilization would be continued for at least 10 to 14 days. In many cases, however, this was continued for 2 or 3 months, sometimes 6 months or even a year. In some cases, the splints might be removed for part of the day and some exercise might be started. This treatment was inconsistent and exercise regimens ranged from 1 hour to 12 hours. Practices varied widely (Cohn, 1975).

There was a small group of individuals who called for more physical therapy, which, at the time, was an unfamiliar term. Rehabilitation, in a modern sense, simply did not exist. The therapy that did occur was mainly directed at treating paralysis after it occurred and not at preventing it. Only those with ample financial resources were able to receive any long-term treatment.

Eliza had seen this immobilization treatment and considered it a desecration of the body. She said the children looked as if they were being crucified. They moaned in pain and agony and begged for the splints to be removed. Eliza began to work with many of these patients during the acute phase of the illness. This practice was contrary to all medical beliefs about the treatment of polio. She taught patients about their muscles. She told them to concentrate on the muscle. She persisted day after day with her treatment with hot packs and re-educating the muscles to move. One physician said, “She’s a saleswoman. She talks the patient into thinking he’s better when he really isn’t” (Cohn, 1975, p. 83). But other physicians said that she knew that constant, graded exercise could obtain good results, if the paralysis was not irreversible.

Dr. McConnell, who had remained Eliza’s mentor over the years, advised her that the medical community would not be kind to a reformer. He told her that, if she had courage, the time would come when her work would be recognized. He also advised her to never fight with the medical profession or she would make no progress. Sister Kenny did not learn this lesson. As the years passed, she became more and more confrontational and she continued to meet resistance, although her methods were proven over and over to be effective.

One physician said that her methods could never be more than of limited value with chronic paralytics but did agree her treatment should be applied to new patients. This signaled a major change. In her earlier days treating polio victims, she was never allowed by physicians to treat patients in the acute phase of the illness. This physician suggested that a more scientific comparison of old and new methods should be done. This was never done in Australia or anywhere else (Cohn, 1975). In a historical case analysis, however, the author claims Sister Kenny made “bold assertions, obtained scientific validation, learned from experience, used publicity and opposed resistance” (Oppewal, 1997, pp. 83–87).

In 1937, a widespread polio epidemic occurred in Australia. Eliza traveled, treated polio patients, and began to feel sure of her success. In 1938, a crucial report of the Queensland Royal Commission was released. It damned Sister Kenny’s treatment methods. Of 47 cases studied, the majority showed no effective improvement, a few worsened, and a few improved. It proclaimed that her numerous treatments for paralysis were unnecessary. Her response to this report was to demand that the commission produce the deformed patients (Cohn, 1975). Even this did not stop her quest to open more treatment centers. Sister Kenny was relentless in her pursuit to gain acceptance of her treatment method from the medical community.

The governments of Queensland, New South Wales, and Victoria supported her. They stated the government was “satisfied.” The existing clinics would stay open and the new ones would continue to be organized. In Melbourne, because it was polio season, the authorities compromised and said she could have a section of 22 beds in the Children’s Hospital branch. She would be allowed to treat patients coming out of the acute phase of the illness, as long as the parents requested her treatment.

Still, this tenacious woman did not rest. She focused on her treatment and pushed for more and more centers and hospitals. Eight clinics were now operating in Australia. She left for London and waited for a report on the success of her treatment. This report said she claimed to cure poliomyelitis completely, which was not true and this caused her to become angry yet again. The rest of the report was mixed. They agreed that her refusal to splint had not caused the deformities and disaster that orthopedists had predicted. Her next reaction was depression. Finally she thought of her mother’s advice that “he who angers you, conquers you” and “the greater the fight, the greater the victory.” She focused on the fact that the British report admitted that removing splints caused no harm (Cohn, 1975). This was her victory.

The challenges continued. When she heard of a modified Kenny treatment being used in her Newcastle clinic, she rushed there only to realize that, although they were using her name, she had no control over the facilities. They were responsible to their state governments, not to her. Eliza became more depressed but she did not remain discouraged. She constantly sought ways to learn and grow from these experiences (Cohn, 1975).

Eliza decided to concentrate on Brisbane and asked to be assigned to a hospital ward with acute polio cases. She was refused. She defied state law and medical custom by turning one of her treatment rooms into a ward and placing two new polio patients in the room. She was officially told to dismiss the patients, but she ignored the order. The demands that she dismiss these patients continued, but Sister Kenny maintained that these patients could not be safely discharged from hospital supervision. She suggested that they be moved to Brisbane General Hospital where she could supervise their treatment. This request was approved, which was a triumph for Kenny. She had manipulated the system in order to gain what she wanted, the opportunity to care for polio patients in the acute phase of the disease (Cohn, 1975).

Because she was rehabilitating disabled people, Kenny believed the state government should help support her efforts. Several doctors eventually wrote a letter on her behalf to the health minister and asked the government to explore the training of therapists under her direction. When she arrived in Queensland to demonstrate her therapy, she was greeted by Dr. Crawford, president of a branch of the Australian Massage Association, the then physical therapy society. Sister Kenny had not enlisted any physiotherapists because she felt they had too much to unlearn. This angered Dr. Crawford who greeted her in what she considered an unwelcoming manner. She became haughty and suggested they cancel the demonstration (Cohn, 1975).

The demonstration was not canceled; however, an observer said her demonstration was crude and seemed to suggest that she had a charm or gift that traveled from her brain though her arm to the child’s arm and on to the child’s brain. She became incensed at this implication and the meeting ended. The next day, Kenny attempted to lecture to a medical audience and was greeted with stark silence. When she stated she did not believe in casts, splints, or immobilization, one doctor responded that this was criminal. The audience reacted with looks of disgust and jeering laughter and the session was adjourned. These reactions from the medical community continued throughout her life (Cohn, 1975).

Kenny did, however, have some supporters in the medical community. She was able to establish a government clinic on an experimental basis for the training of therapists. Although she had operated small bush hospitals in the past, this was the first government support she had received. The son of the proprietress of the Queen’s Hotel, Dr. James Vivian Guinane, was doing his surgical training in England. When he returned, he brought Sister Kenny physiotherapy texts, taught her some physiology, and improved her knowledge of anatomy (Cohn, 1975) in an attempt to ameliorate criticism of her lack of knowledge and training.

But the fight continued, and although many applauded her success, there were many who were sure that there was trickery involved or misdiagnosis of patients. The commission’s report was quoted for years. The medical community in Australia, as a whole, would not accept her. World War II finished her career in Australia. She was no longer criticized but was largely ignored. The Queensland government had spent substantial money on her clinics but William Smith, Queensland’s premier, felt she was not a political asset and decided she should be dispatched to avoid controversy. The decision to send her to America was made, and she concluded this was perhaps the best solution (Cohn, 1975).

THE AMERICAN FRONTIER

In 1940, Sister Elizabeth Kenny left her home and country and went to America. She brought her daughter, Mary, with her. Mary had become expert in the Kenny method. Eliza’s purpose was to demonstrate her methods to American doctors. She was determined to obtain the approval of the American medical society. During her stay in America, she opened many Kenny treatment centers. Many are still in existence, but with the eradication of polio resulting from the development of the Salk vaccine, these centers now have a different focus. There were centers in Minneapolis, New Jersey (which no longer exists), and her favorite, the Ruth Home in El Monte, California. The Sister Kenny Rehabilitation Associates in Minneapolis is perhaps the best known center and is still in operation. The new name, the Courage Kenny Rehabilitation Institute, is a reflection of the woman after whom it was named. Certainly, Elizabeth displayed remarkable courage throughout her long career. She provoked controversy wherever she traveled, but she was a determined and outspoken woman who believed in herself and had the confidence and courage to persevere.

Kenny may have had her greatest successes in her 11 years in America. She was able to open many clinics, and she lectured to physicians, obtained financial support, and treated many victims of polio. She became a celebrity in her own time. In fact, in 1946 her life story became a movie, Sister Kenny, starring Rosalind Russell. Kenny and Russell became close friends after she treated Russell’s nephew who had contracted polio. Some other celebrities who were treated by Sister Kenny were Alan Alda, actor; Dinah Shore, singer; and Majorie Lawrence, Australian opera singer. Cartoonist Al Capp was an amputee and became involved in the Sister Kenny Foundation during the 1940s and 1950s. She has been referenced in An American Christmas Carol and an episode of The Waltons.

Sister Kenny recognized the high status granted to physicians in American society. She was driven to be accepted by them. She realized that challenging the male-dominated medical establishment meant using a different approach. She was 5′10″ and had a typical Australian Irish sense of humor and she used this effectively most of the time. Although she found it uncomfortable, she developed a feminine persona and dressed in large, dramatic hats and flowers. She often referred to herself as a mixture of Florence Nightingale and Marie Curie (Cohn, 1975). She was never “antiscience,” although her treatment ideas were considered unorthodox. She claimed her clinical work and observations led her to believe that polio was not a neurotropic disease but a systemic one. This theory was debated endlessly, and in 1950, virologists discovered the poliovirus was spread through the body by blood (Rogers, 2014). She was convinced that scientific theory must be based on clinical evidence. She did not trust clinical trials that relied on tissue pathology rather than the living body. This allowed her detractors to state that she lacked an understanding of science (Cohn, 1975).

While in America, Sister Kenny met with President Franklin D. Roosevelt, who was a victim of poliomyelitis as a young boy. He created his own polio treatment center but it was fairly primitive and did not reverse his paralysis. Although he did not actively oppose her, he did not support the Kenny treatment method. Little has been recorded about her encounter with him.

Sister Kenny remained focused on her clinical practice, although she also worked tirelessly to reeducate the medical community. The patients, therapists, and nurses she worked with were a central part of her mission. They often saw her practice as one of constant struggle and sacrifice. They were inspired by her commitment and used her experiences as a way to obtain autonomy and acceptance from physicians.

Sister Kenny was fierce in her determination to provide the care that she believed was optimal for polio patients. She observed patients treated with her method recovering at higher rates than those treated with the traditional methods of splints and braces. She believed that clinical trials were not necessary when the proof was right before her eyes. This is perhaps her greatest legacy. In an era of evidence-based medicine and large-scale clinical trials, a keen clinical observation still has its place. Kenny once wrote about her opponents, “They have eyes, but they see not” (Kenny & Ostenso, 1943, p. 202). She was not a scientist but a crusader.

Charisma is not a term that has been associated with Sister Kenny. She was often caustic and sarcastic but not cruel. She could be intimidating to some because of her height and demeanor. She responded or reacted to the situation at hand in many instances. She was a role model in clinical practice but she was not a good communicator. This, of course, put her at a disadvantage with the medical community. Her constant controversy with physicians became tiresome to many of her supporters. She did not inspire the creation of strong interdisciplinary teams. Some have said that she sometimes lied and often exaggerated. She was never content to let an idea settle but used to hammer at everyone with her beliefs. She often made claims she could not substantiate.

Elizabeth battled, was defeated multiple times, accepted that, and changed her ideas when she had to. When she became depressed over her defeats, she retreated, recovered, and then went onto a fresh start. In the end, she was successful in revolutionizing treatment for poliomyelitis, whereas her impact went far beyond the treatment of polio.

In 1942, TIME magazine reported that her amazing method had an 80% recovery rate, thus forcing doctors to recognize her nonconventional work (Fairley, 2008). A 1943 article in the Journal of Bone and Joint Surgery reported that patients who underwent the Kenny treatment were,

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