Polio and Historical Inquiry Author(s): Karen L. Wellner Reviewed work(s): Source: OAH Magazine of History, Vol. 19, No. 5, Medicine and History (Sep., 2005), pp. 54-58 Published by: Organization of American Historians Stable URL: http://www.jstor.org/stable/25161982 . Accessed: 19/10/2012 19:48 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. . Organization of American Historians is collaborating with JSTOR to digitize, preserve and extend access to OAH Magazine of History. http://www.jstor.org Lesson Plan Karen Polio It was the robber and a of hope for Historical several generation, L.Wellner generations of children. Inquiry There were ... diseases that were more devastating, more affecting children, more deadly than polio. But polio left kids crippled, and thatwas an image that this big strongpostwar country simply couldn't abide. We had children lining up inwheelchairs, in iron lungs,whose very vitality [was drained] and everyone's hopefor theirfuture was.. .[shaken]right at themost critical time in their childhoods. And that'swhy polio seemed like such a horrible scourge,far more so than any number of other diseases or accidents that, any way you want to measure it,were more deadly and were fatal. And the image of a child in an iron lung is about as tearful and wrenching as we could imagine at that time, and any time certainly in this century. There were many other diseases thatwere badfor America, but polio broke its heart. ?Mark Writing about the teaching of history, Zachary Osofsky suc cinctly captures the purpose of a history classroom by ask ing this question: how is the past different from the present (2)? In the case of polio, medicine, and public health, the answer is: a lot different. Before the arrival of the polio vaccine in the mid-1950s, Americans lived for many years in fear of this dread disease. As sum mer appeared, so too did the specter of polio. And for the most part, for which the virus, are humans in epidemic deliver?sometimes the only natural proportions never host, failed to less so. sometimes and Students todaymay have difficulty comprehending the fear that polio elicited in that era (although AIDS provides a useful analogy). How have we gone from heightened anxiety to complacency in such a brief period of time? Since large polio outbreaks occurred throughout the 1940s and 1950s, students your will have grandparents and older relatives or ac quaintances who are familiar with polio and may have been directly affected by it. Collecting their accounts will familiarize your students with qualitative and quantitative analyses and demonstrate how they can be useful tools in historical inquiry. In addition, this lesson will help establish your classroom as a learning community by providing opportunity for interaction and can success Time This lesson should take two to three class periods, with homework. Student Objectives 1. To draw upon quantitative and qualitative data to formulate gen eralizations about polio in the United States during themid-i900s. 2. To evaluate the implementation of a vaccine study by analyzing 54 OAH Magazine of History September 2005 (i) story. Background The year 2005 marks the fiftieth anniversary of the announce ment that clinical trials of the Salk polio vaccine had proved successful across the United States. Before this discovery, polio knew relatively no boundaries. The March of Dimes's successful poster campaigns of the 1950s made use of clean and wholesome children in braces to drive home the point: polio must be stopped, and itwould be done so with public support. The same citizenry that had been called upon to pitch in to help win World War IIwould be called upon again, only this time was polio. could attack polio slums and immigrants the enemy While lieved even higher such ignored to good health. rates played be many its spread. that affluent suburban dwellers suffered than evidence A backlash at any time, anywhere, a role in significant anyone, evidence Despite mounting often National Standards This activity will fulfill the following standards in the National Stan dardsfor United States History: Standard 4 in Standards in Historical Thinking: Historical Re search Capabilities Era 9: Postwar United States (1945-early 1970s) Standard iB: Demonstrate understanding of how social changes of the postwar period affected various Americans. survivor polio the interests served and ethical dimensions of the study. 3. To recognize that science in the era immediately following the Second World War was seen as a powerful and objective tool, best left in the hands of experts. 4. To identify why the eUmination of polio is considered an Ameri from discourse. Sauer, inner did because city or cleanliness urban, against rural residents, was Eastern poor, people to lead expected im European followed. In Dirt and Disease (1992), Naomi Rogers notes that migrants the power of dirt, and disease, overrode disorder the germ theory of disease; and nothing spoke to those three D's like immigrants (3). In addition, with so little known about how the virus spread, there were those own cold war in the Americans. share era who Never mind of polio saw polio as a communist that the Soviet Union plot against also suffered from its epidemics. The first well-documented polio epidemic in the United States occurred in New York City in 1916. At the time the polio virus was known to be the causative but agent, it remained a mystery as to how one "caught" polio. Did it have something to do with the new method and house of pasteurizing milk? Was it carried by flies, mosquitoes, hold then cats? Was easily the virus transmitted carried on clothes, to humans? Was coal dust, polio or street waterborne, grit, and contribut ing to the likelihood that exposure to pond water, drinking fountains, and tap water ordinary would in polio? result so many since Or, are school so many With fountains, swimming bizarre. Retarded to leave encouraged their children home. Cats, whether household to avoid naps stress (4). And yet, even with and sterilizing, ing, to grow the most in countries and sanitation programs to what contrary Sabin immunization enough, perhaps, for S., children the was had people or polio 50 medical to special In country would with facilities . J????? ill.. V-...,, polio as patients. s approach Salk and Sabin, revolving to vaccine Salk production. favored using a killed virus for polio vaccination while Sabin believed that a weakened, but still live, virus would offer more antibody production and longer-lasting protection. Salk and his University of Pittsburgh on of monkeys served a killed virus vaccine from as Salks as test animals, 1947 team to 1952. to sought identify how many types of poliovirus existed (there are three) and to test the vaccine. At the end of 1951, the NFIP granted Salk approval to begin vaccine testing on humans. But which testing children cohort?isolated and complet incidence about rate?only people, to compared that children many Each jail inmates. from the media, the size must be. sample a tremendous required and logistical support. the larger who group easy can doctors after school county con con as children too, immunization, prin and required to had Support planning. child the vaccine, of parents, state nurses, and officials, siderable tinue efforts teachers, cipals, health receive would in experimental and control groups had to be tracked and community physicians to report needed po suspected lio cases promptly. Costs of the 1954 field trials were funded largely remained were tax dollars used. Jonas Salk was receiving most of the publicity, Albert Sabin While vaccine to the NFIP?no donations public through in the background, the 1950s throughout continuing and 1960s. his research with also was Sabin a weakened funded heavily by the NFIP but once word of the Salk vaccine's success spread, Sabin had to redirect his to locate efforts another where country he could test his work. The Soviet Union provided such an opportunity. Sabirfs live but weakened polio vaccine had an advantage: it could be administered orally, in the form of a sugar cube. vaccine The entered the digestive system in the same manner that the polio virus did. Only a be no single dose was There required. would need rather as was than weeks, Although in the Soviet it seems Union the case with strange during that Sabin the cold war, the Salk was and in days vaccine. allowed he was for boosters antibodies Sabin predicted that the body would begin making to test his given vaccine permission in 1956 to visit and speak with Soviet virologists and health officials. He humans? Traditionally, human testing had been accomplished using institu tionalized ...V-MM a dose of the "dead virus" vaccine to a Jonas Salk administers Division of child. (Image courtesy of the History of Medicine the National Library of Medicine.) polio such V^^U; ;'.:.-... ^MMt A rift subsequently emerged between laboratory Hundreds per the unpaid and to prevention. Enter for polio, attention shifted Jonas Salk, Albert on medical researchers who drew break and a host of other Sabin, as tissue vaccine and flu such culture production techniques throughs to advance their work. help staff worked be testing In addition to the nearly half million the public and accept scientist a low volunteers cure each the large sample amount of planning At first, the NFIP tackled the growing problem of patient care and physical rehabilitation. As it became apparent that there would be no around the that (6). 100,000 dence, The Home for Incurables or The Hospital for the Ruptured and Crippled. As late as 1939, only 300 hospitals in the entire that This for rehabili Those treatment work Salks moreover, publicized, 100,000?required to treat insurance, were often isolated from taken Because of volunteers. highly the incidence of cancer today at 566 per to for unprepared research. and ones be part of the testing. The lower the inci there was little federal money tation vaccine, such had thousands of crippled children and adults. Few in The fact that polio in the United States constituted Foundation and Depression enormous to prove the safety since earlier the tions required ed in one year fantile Paralysis (NFIP) began in 1938, the United States was still deeply mired in the Great was testing vaccine would work and laboratory's Such be quickly available. expecta his of the disease the National children. of so would childhood viral infections. When stim public already had high expectations thereby but leav severity worse?a trait common infancy, often much vaccine in the 1930s had triggered the disease in a to susceptible polio. When at this time of life rath occurred exposure er than was six to nine aged and nationwide. the killed-virus administered number most the group agreed 57,000 clinical efficacy ing them vulnerable as they aged? In the U. school be (5). in infants completely or partially fought off the disease? Were children in the United just too clean and protected, to infant exposure polio reducing testing. both scope and design. A field trial had to Early antibodies States that The to the virus? that maternal authorities recorded?over believed, Did crowded and unsanitary conditions aid in early the ulated high and long-lasting antibody production. Such encouraging findings paved theway for the design of amassive inoculation program with water sound ever to climb. Ironically, it of polio continued seemed S. was in the U. incidence the state Pennsylvania all of this clean resting, of Initial experiments proved that the vaccine did protect against polio and, or stray,were killed by the thousands. Children were forced to take after noon Feeble-Minded. and cases polio during the summer months. Mothers who had to go grocery shopping were to the dangers oblivious testing began in June of 1952, the same year that the highest number of libraries, public were shut down Many theaters and movie pools, strat and preventive avoidance transmitters, suspected if not somewhat numerous, were egies water often and transient, rarely Salk convinced the NFIP that a group of volunteers awaited him at the D.T. Watson Home for Crippled Children and the Polk School for the children suffered from polio, could itbe due to the posture necessitated by bending over their school desks? (4) serve to track as an since "ideal" subjects spent mission ing. one month return in Leningrad, and upon his per requested to the Soviet Union strains of polio virus for test concerns Defense about warfare Department biological to send Despite his OAH Magazine of History September 2005 55 the dangers, State Department approved to the the virus of shipment over vaccine the Salk vaccine. a handful year, however, Every of children contracted polio from the Sabin live vaccine and in 2000 the Centers for Disease Control recommended returning to the Salk vaccine for childhood immunization. answers or tions the after completing to their responses. the mid-i900S. to add occurring during stand the context in which to correct lesson Then ask lowing information tracted; the year It is important feared and for was polio section increased to mass accessibility media. Television, and radio, 2: Post of this new the war was cold war with charged answer" The the As it was such, was science scientists bold the possessed as a viewed and "can-do" of the American triumph and innovative, attitude that American form stronger once generalizations the interview data 1: Interviewing occurs when II technology?a about powerful and War read about polio and post-World merely is something truth in the text. There quite ready-made a person he or she was when tell you where po having point your out "Yes, but that the thaf s not I have each adolescents had students enter not could father text offers the same "You could tell me, for months. the house similar information the be quarantined ..." When students of I reply, scripted, and there is a potential danger with each approach. A loose script beginning with the question "Tellme about polio" can prove rich if the respondent is comfortable talking with students. But if that in or her answers, students may not know how to pursue questioning. A heavily scripted interview may lose insightful information and because the students concentrate to the script sticking I suggest the written questions. role-playing, beyond probe to start the students before you act as an interviewee, allowing do not in which on 56 OAH Magazine of History September 2005 this Then lesson.) a class into data the demographic or ask spreadsheet stu the spreadsheet further in the mapping return the interviews and ask the students part what If this is where the lesson is collected, and returned. ends, graded, to go beyond their own data. For a will never get the chance to know to succeed, students need historical they will inquiry approach thing." at least young two who were interview people one In a interview the mid-^oos. class, per large his Arizona. students at that time knew most and adults the interviewees, teenagers ly affect or will and avoidance remember who had polio of someone strategies or can be either news interview The the vaccine. about loosely heavily is short with in Phoenix, should be done with the collected data. All too often this type of student student works fine. The biggest concern that students initially have is that they will not find anyone who knows anything about polio. From my experience, this problem will not occur. Even if polio did not direct dividual lives work student during now enter either students I have relatives. "question and easier coding dents to do it. (I discuss lio shots became available in 1954 or how polio affected their friends and in their Students follow the same format for all their interviews, which typically are one to three pages long. Collect and review the interviews before using them for the next part of the lesson. At this point you can Jean Piaget, the noted psychological theorist, believed that "a ready made truth is a half-truth" (7).While he generally had the development of logical thinking inmind, I contend this half-truth style of learning also out to write been collected and categorized. Part want may I:What can you tellme about polio? A: Well, when Iwas little we couldn't go swimming at all. The park pool was shut down during the summer andmy mother would not letme and my brother swim in the pond behind our house. life af has He school. ter the Second World War. With this background knowledge, students aremore apt to ask good questions during their interviews. Italso helps them students 1, 2004 September system. American dedicated typified will interviewees Albert is my grandfather who grew up in Chicago, Illinois. He was in sixth grade when the polio shots were given out at his vaccine became an affirmation of American scientific and technological progress. American most experience, Example: An Interview with Albert Smith for a polio search some makes format and prevention. tensions. From my or friends who contracted polio. terviews in paragraph form, I have found the following important was the fact that the scientific atmosphere Perhaps most after treatment for polio developments contracted; Procedures Interview press played a large role in advertising the March of Dimes and report ing was con age when polio gender; and the city and state where the patient: was lesson. typed. While possible, reason One why the spread of polio was halted when it was is due to the rapid growth of science and technology afterWorld War II. Another factor was about that polio I usually give students one week to complete their interviews. At that point, all questions and responses need to be organized and, if to under students combated. to ask to redirect the individual lived at that time. This information is used in themap Part any misconcep what else was students see how and how an interviewee back to the topic of polio. Students should begin their interviews with the statement "What can you tellme about polio?" If the interviewee identifies someone that he or she knew who had polio, the student will need to collect the fol identify family members Before beginning the lesson, ask your students what they know about polio. Keep track of student responses on the board and return can the process, students to probe for answers, By modeling when questions, open-ended ping Procedure to their interviews. their Soviet Union. With Sabin's help, the Soviets produced the vaccine and inoculated tenmillion children during the first five months of 1959. In i960, the incidence of polio in the Soviet Union dropped dramatically. In 1964, the American Medical Association endorsed the Sabin ideas with their share pate in a discussion I suggest each other that you allow groups their data. With highlighters to devise a and that entire the class will partici of the work. or category coding of three to four students to combine and large pieces of paper, they will need to system organize their as information they sift through interviews, looking for key words, events, and pat terns. While the number of categories they will require depends on the questions asked and responses received, I recommend five to six. Categories need to be general enough to subsume but specific enough to tease out different quotes. This process is not easy, and you will be busy facilitating and suggesting at this point in the lesson. come up with at least these students event; categories: My usually use scissors to cut out quo and science. social structure; They strategy, the category and tape them under tations from their interviews heading that they have written on their large pieces of paper. Using students to move the quotations from one category tape allows to another. While I offer examples below, the approach to historical inquiry will be lost if students are not able to sift through their data and come up with their own unique categories. Event Category Students will find quotes addressing who got the disease, how severe the disease ments was, where was the disease treat and contracted, 14 or about losing feeling inmy legs and felt extremely allows lung for several weeks. from the neck down." When iron lyzed he he was recovered para in this work everyone's and differences between wall. Presenting to see commonalities students Part 3:Mapping The "My best friend in high school had a severe case and was put in to a classroom affixed group. to my complaining ill." an be each I remember old. 15 years that Iwas mother can manner offered for polio: "I was The public health history of polio is filled with ironies. The generalizations should be written on large pieces of paper that of purpose data collecting about and year, age, gender, geo graphic location is to plot this information on amap and enter it into a spreadsheet. Iuse a large political map of North America, and each students year's own their plot on data the map. After several the years, map provides students with additional data to use while working on their In this students quotations category place whether enforced by mothers strategies, ance that deal (you will with avoid tiple for sum the whole stickers were die on placed for treatments, Kenny polio "I was a polio pioneer polio .... shots, the virus I remember polio the front itself, when the map can and Jonas Salk: nurses or doctors and as a whole then class. see meaningful Once the became Number paralyzed. For example, data. patterns and themes polio appeared Disease was spread was initially students assump the unknown, these the that images theater Spreadsheet | Yearof Onset male Early 1950s 19 male 1948 *9 female Location LittleRock,AR Needham, MA male 1948 Detroit, MA female 1942 Warren, OH through the March of Dimes and collections, DC Washington, to door door collecting. poster children, The image of a child in braces, facing adversity with dogged determination, motivated to open Americans their wallets Such strategies revolutionized of many power knowledge individual within are and and organized of philanthropy volunteers, concept like pocketbooks never before. the way in which charities raised mon with chapters available local, to everyone, grass-roots no matter how large or small their donation, created a new model of giving in the United States (9). groups the categories and no age Conclusion to it is difficult understand themassive Today they have can lead to the following generalizations: Polio affected everyday life during the 1940s and 1950s and gener ated changes in behavior. How as more erroneous certain then, Why, I Gender Age its cure to Americans ey, recruited This efforts. the cure [amis devised distinct categories and placed quotations in each, theymay be gin making generalizations about polio, backing them up with inter view infant age groups: are adult. The stickers be updated simply spreadsheet, Sample movie must be given time to analyze and discuss their findings, first among themselves and doors." it." "I think Salk got the Nobel Prize for finding taken impression] (8)." their students interviews, By pooling to construct voices. students To enable that can on a spreadsheet patient Map came to the school and lined us up to give us the experimental shot and after that the certificate. It says polio pioneer and I still have three and years; we have? The NFIP focused tremendous attention on polio, marketing sure." Science and Technology Category this category, interviewees discuss iron lungs, the Sister With students undertake the activity. A sample spreadsheet is shown below. taken." quarantine allows numbered and placed on the city or town where the particular individ ual contracted polio. By numbering the stickers you can keep track of "The news in Chicago in the 1950s had a special segment every night about certain infectious diseases. They would talk about how many people were infected that day and where these people were "Yellow to denote color sticker particular seven to years eighteen In using Iwould meant disease It also polio. tions about polio begin to fade. For example, not every polio victim was young. Nor did polio suddenly appear in the 1950s, and not every Social Category This category addresses how interviewees dealt with the threat of polio on a day-by-day basis and how society stigmatized those with polio. polio a to six years; the data of people." against gatherings me made take a nap every day "My mother in the tenth and Iwas mer, grade!" restrictions contracting about generalizations sources. I use a strong find emphasis on the mother's duty to protect the family during in this period) or by local public health officials: "During this time all the public pools were closed along with "... and categories to see that good historical inquiry is often strengthened by using mul Avoidance Category group the announcement companied For most ly been discovered. that an effective of us, the vaccine sigh of relief that ac had final polio vaccine In has always existed. vestigating polio in depth allows students to see that this circumstance was not sources, always students the case. can begin interviews with other historical Combining the process of reaching their own conclu sions about the multifaceted history of polio and where it belongs in the context of the history of public health, non-profit organizations, the funding of scientific enterprises, and the rapid rise of science and technology during and afterWorld War II. immune. severity was inconsistent and treatments varied. Endnotes OAH Magazine of History September 2005 57 A BUILDING LASTING LEGACY FORTHE STUDY OF U.S. HISTORY Since 1907 OAH has promoted U.S. teaching and scholarshipy the broadest possible encouraging while history resources and to historical sive discussion 3. Naomi inclu history. to commemorate. is something Longevity to celebrate what better way than history a for the future? provide legacy And to 4. 9 (i99?): I3"I6. is to Invent: The Future of Education, 7. Jean Piaget, To Understand trans., reprint (New York: Viking Press, 1974,1973), Roberts, 8. Neither Jonas Salk nor Albert Sabin received the Nobel Prize with and Thomas Weiler received polio. John Enders, Frederick Robbins, Prize in Physiology in 1954 for their breakthrough and Medicine growing polio virus in tissue culture. at universities, between 9. Oshinsky, and college university school teachers. public historians, and secondary professors, Promote the dissemination historical research of the best in historical understanding Ensure affordable generation For more and Science program (TEAMS) at Arizona State Her University. Recent Scholarships by the public, treatment membership of historians. information of 0nlin<^ dues for a new <www.oah.org/giving> exclusively Online" to OAH individual is a searchable, citations for articles history-related journals and for books, dissertations, "Recent members, cumulative drawn database from over of 1,100 and CD-ROMs. Include: visit up to receive monthly Updates?sign to the latest scholarship, customized accord you have selected, months ing to the keywords and categories before they appear in the Journal of American History or Saved emails development manager Leslie A. Leasurey e-mail <[email protected]>y CENTENNIAL 1907-2007 phone (812) 855-7311. ORGANIZATION OF AMERICAN HISTORIANS save, and edit your own the entire database Search Interface?search Updated more quickly and with additional options Enhanced print version, September 2005 E-mail of citations Bibliographies?create, for future access bibliographies contact 58 OAH Magazine of History Scholarship Personalized or giving remembering OAH and its many initiatives in your estate plans yplease Available Features on annual Ph.D. degree isfrom the University of Iowa, and her research interests include the history and nature of science and the integration of oral history into to historical respectful and equitable and adjunct faculty. part-time Karen Wellner is coordinator of the Teacher Education for Arizona Math and media. government, in 5. the curriculum. OAH works with the National interpretation. to foster Park Service and other organizations Advocate Polio, interpretation. in and access excellence the colleges, and secondary schools by bridging the gaps Support George-Anne 51. for their work Nobel education and and Disease: Polio Before FDR NJ: (New Brunswick, Press, 1992), 118. Jeffrey Kluger, Splendid Solution: Jonas Salk and the Conquest of Polio (New York: G.P. Putnam's 1; Jeffrey Kluger, Sons, 2004), chapter "Conquering Polio," Smithsonian 36 (April 2005): 82-89. University 5. David M. Oshinsky, Polio: An American Story (New York: Oxford Press, 2005), 6. 6. Paul Meier, "Polio Trial: An Early Efficient Clinical Trial." Statistics inMedicine Your support will help: Improve history Dirt Rogers, Rutgers the most our national of access i. As quoted in Nina Gilden Seavey, Jane S. Smith, and Paul Wagner, A Paralyzing Fear: The Triumph Over Polio in America (New York: TV Books, 1998), 16. 2. Zachary Osofsky, "American History in American Classrooms," History Matters 16 (2003): 1. the online Browsing?view issue and category by <www.oah.org/rs> version just like the om j
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