Master of His Fate by James Tobin (free ebooks for android txt) 📗

survived the attack with no damage at all. They might be ready to take over the work of cells that had died. And still other cells had been sitting still for so long they’d gone to sleep—but they might wake up again.

Which cells were which? Right now, no one could tell. The only way to find out was to get FDR’s legs moving.

It would be best if he could make the muscles move on his own. If he couldn’t, a nurse could grasp his legs, one at a time, and move them.

But there was danger in overdoing it. A patient who rushed recovery from polio might wind up very sorry. Trying too much too soon could kill injured nerves that might have been saved. A patient who became exhausted might have to quit for a while. That would waste time and energy, and it might deflate the person’s hopes.

So … go slow—that’s what Dr. Lovett had learned in his years of treating polio patients in the gloomy months that trickled by after the virus had finally left the body.

Go slow … but watch closely. It was also possible to go too slowly. Paralyzed limbs, if left alone, could bend and twist out of shape and stay that way.

The poliovirus attacks a bundle of muscles the way a tornado attacks a town. A tornado can leave one block of houses untouched, while it plows up a row of houses just one street over. It’s the same with the virus. It leaves the nerves in one bunch of muscle fibers alone while it ruins the nerves in the fibers next door. Then, day after day and little by little, the healthy muscles pull against the dead muscles. After weeks or months, the victim notices—though it seems unbelievable—that the paralyzed limb is actually changing from its normal shape or getting stuck in an extended position. Doctors call this a contracture.

It can happen in the toes, ankles, knees, hips. Even the spine can curve under the pressure of a contracture. A contracture can be prevented, but only by encasing the body part in casts and braces. It’s also possible to reverse a contraction after it develops, but that takes a hard operation—more pain, more time, more suffering.

So go slow and watch closely were Dr. Lovett’s strict instructions—not just to FDR but to Kathleen Lake, the no-nonsense nurse who first knocked on the Roosevelts’ door in early December 1921.

Mrs. Lake had worked for Dr. Lovett and his patients many times before. She knew all about polio, and she practiced the new medical specialty called physiotherapy. This was a method for teaching people with injured limbs to move as well as they possibly could. It was hard, slow, exacting work for the patient and the nurse alike.

Mrs. Lake knew just how to do it. Day after day, dressed in a starched white uniform, she got down to business with her famous new patient.

First, Mrs. Lake and a young woman named Edna Rockey, FDR’s live-in nurse, would lift and haul the patient onto a long wooden board set up in his bedroom. With dark humor, FDR began to call that room “the Morgue.”

During the long weeks when he had been lying and sitting still, some of his unused muscles had started to stick to each other. These points of stickiness are called adhesions. Another man who had polio remembered what it was like to tear adhesions apart, even by so simple a movement as being helped to sit up in his bed. “The least deflection of my limbs from the horizontal produced intense, exquisite pain,” he wrote. “I had not been aware, until I was moved, just how painful and sensitive my body still was, nor did I expect the extreme fatigue that overcame me.”

Now, every day, FDR began to go through that kind of pain.

Once he was in position on the long board, Mrs. Lake would give orders.

Move your left big toe, she would say.

He would try. Nothing would happen.

Try again, she would say. Again, he would strain just to twitch a muscle in the toe. Still nothing.

“Try it again.”

“Try again.”

“Again.”

She wasn’t being cruel. She knew it might take a hundred tries before a sleeping muscle moved, and if it moved once, it might move a second time. Then blood would start to flow through the muscle, and the whole toe might start to revive. If he could move one toe, he might be able to move one foot, and so on, but only with mind-numbing repetition. And there was no guarantee that one bit of progress would lead to more progress.

FDR was hoping for massage. It just seemed natural that rubbing and kneading the muscles would wake them up. But Dr. Lovett had forbidden any massage until the patient was free of pain. Later, massage could do some good. But at this stage, it could overwork and damage muscles just starting to recover.

Day by day, Mrs. Lake studied each of FDR’s limbs as he struggled to do the exercises. She thought his left leg—the weaker of the two since the attack—was getting a bit stronger. But she also thought contractures might be forming in the hamstrings, the big muscles in the back of the thighs. So she and Nurse Rockey bent FDR’s legs at the knees over and over, stretching the hamstrings to keep the legs from curling out of their normal shape.

So it went, testing and watching and working every muscle, not just below the waist but in the arms and hands, too, and in the abdomen and lower back.

Above the waist, Mrs. Lake saw real progress. FDR was doing many pull-ups with his overhead straps every day. While his lower body shriveled, his chest, shoulders, and upper arms were gaining new bulk and new strength. By the first week of January 1922, Mrs. Lake wrote to Dr. Lovett: “A friend of his told me he wouldn’t have believed he was the same man he saw in November.”

“He is a wonderful patient,” Mrs. Lake wrote,