‘WE LIVED IN CONSTANT FEAR’
In 1953, we saw the horrors of polio firsthand, treating the afflicted at Royal Alexandra Infirmary, Jean Jenny writes.
It was 1953 and I was a second-year nursing student when I was suddenly sent to do a threemonth stint at the Royal Alexandra Infirmary, Montreal’s isolation hospital. Normally, students rotated to specialty clinical areas during their final year only, but this was the time of the last great poliomyelitis (polio) epidemic.
The city was overwhelmed with cases, and the “Alex” needed help to cope with the influx of patients.
I was given little time to prepare, and soon found myself and my trunk moving into the nurses’ residence. The infirmary was in the Pointe St. Charles area of the city, near the harbour and docks, and the neighbourhood was considered unsavoury, to say the least. If we had to take a trolley into town, a porter from the hospital escorted us to the streetcar stop.
In those days, most cases of serious contagious disease were admitted to the isolation hospital. There was no treatment except supportive care. There was little immunization for childhood diseases.
Polio was a serious disease, and epidemics periodically ravaged North America. As kids, we all knew someone who had been a victim, often stigmatized because of a partial paralysis of a limb or, even worse, doomed to wear a heavy metal and leather brace to support the affected limb. I remember in high school visiting one of my unfortunate classmates who was confined to an iron lung in the local hospital, and who died within the year. After the visit, I couldn’t eat my dinner, horrified by Shirley’s fate, locked up in that tin can until she died.
At the Alex, many of the wards normally devoted to measles, mumps, scarlet fever and pneumonia had been vacated and turned into polio wards for men, women or children. We were given a brief and fearful introduction to the disease, then quickly settled into the most gruelling regime of my nursing education experience.
There was no cure for polio in those days, and a high death rate. The prevailing treatment for the painful spastic limbs characteristic of the disease was the “Sister Kenny” treatment, consisting of the application of hot packs, followed by passive movement and stretching exercises.
This was usually very painful for the patients. In between the schedule of packs, one had to care for the person, who usually had a high fever, was in great pain and scared, and suffering some degree of muscular impairment. We all had far more to do than we had time for, and my days and nights rapidly developed nightmarish overtones — like the dreams in which you are running as fast as you can, but never seem to get anywhere.
The packing therapy itself was exhausting work, consisting of boiling up large heavy flannel cloths in vats, then wringing them out with a pair of wooden stupe wringers, or rolling them through a primitive wringer apparatus. Then the limb was hastily wrapped in the flannels, and covered with rubber sheets to preserve the heat as long as possible. The patients hated the treatment, and grew to dread the sight of us.
The worst cases were the poor souls who had contracted “bulbar” polio, in which the disease affected their ability to swallow, talk, move and breathe. The only way many of these could survive was in a Drinker respirator — the aforementioned iron lung. Invented by Philip Drinker in the 1920s in Britain, the iron lung worked on the principle of intermittent negative pressure ventilation, which replicated the respiratory movements of the patient’s diaphragm and lungs.
The patient was placed inside the sealed metal canister, totally encased except for the head. A soft collar around the neck protected the vacuum in the canister. Along the sides were a series of cuffed portholes, through which the attendants could render nursing care. Suspended over the supine patient’s face was a mirror, through which he or she could glimpse the surrounding environment.
The bellows, which rhythmically pumped in and out to create the vacuum, was powered by electricity, and in the event of a power failure (not uncommon in those days), the bellows had to be pumped by hand until power was restored. Hence, each ventilator had to have its own team of two nurses around the clock, since one nurse could pump for only so long. I remember the terror I felt while pumping for what seemed hours, knowing that my efforts alone were keeping the patient alive.
Inevitably, we came to be very fond of our patients, living with them night and day, and hearing their worst fears and regrets. Each death — and there were many — felt like a personal failure. Our patients were mostly children or young adults, and I can still remember individuals. One was a young woman pregnant with her first child, who needed to be in the respirator. When she went into labour, we took her out of the Drinker and put her on a chest cuirass-type respirator, which encased her torso only. I had not yet been through the maternity rotation, and assisted with the labour and delivery in a fog of fear and confusion. The child survived, but the mother did not. It was a lot to deal with for a 19-year-old, but there was no choice, and we all did what we had to.
We young students lived in constant fear of getting the disease, since it was highly communicable. We knew the symptoms well, and every day or night we went to bed exhausted, with sore throats, elevated pulses or a stiff neck. Upon awakening, the first thing we did was move our heads to see if the stiffness was there. We had few days off, and when we did, it seemed too much effort to go into town, although we badly needed the diversion. None of our boyfriends had cars, and it was a long streetcar ride for even the most ardent suitor.
During my stay, I came down with a severe case of laryngitis and cough, which I think was caused by stress. My friend, Bev, contracted the measles while at the Alex, but we survived unscathed.
That long, hot summer of fear finally ended for me, and the rest of my nursing education seemed a breeze after my stint in polio hell. A few weeks before I graduated, I received a call from the director of the Alexandra, asking me if I would like to come on staff there. I declined with thanks, but felt gratified by the offer.
A year later, the polio vaccine developed by Jonas Salk came on the market, and that was the end of the North American polio epidemics and their fearful toll on the lives of youth.
I remember, in 1956, taking my baby son to the pediatrician for the first of his series of polio shots. I had tears in my eyes, mostly in gratitude that he would forever be spared the threat of polio, I suppose, but partly in grief that it had come too late for so many people.
Jean Jenny, R.N., BSC. N.ED, M.ED, M.SC.N., is a retired professor of nursing, University of Ottawa. She graduated from the school of nursing of the Royal Victoria Hospital in Montreal in 1954, and embarked on long and rewarding nursing career, including clinical, administrative, teaching and research.
We were given a brief and fearful introduction to the disease, then quickly settled into the most gruelling regime of my nursing education experience.