Polio: Our Parents’ Plague

“Your mom walks funny” a friend said one day in elementary school. I had never noticed my mom walking any different than anyone else. Just like I didn’t realize my dad had a Czechoslovakian accent. That is when I found out my mom had polio 40 years earlier. The virus had attacked her gastrocnemius muscle, the calf muscle in her left leg. She had a slight limp. She was one of the lucky ones.

Lorraine (left) Lucille (right) – edited since first published {I got it mixed-up, my sister corrected}

At age 5, the ever popular Eder twins went to a birthday party. My mom contracted the virus at that party. Her identical twin Aunt Lucy remained healthy.

In the first half of the 20th century people lived in fear of summer, “Polio Season”. Pools, fountains and movie theaters were closed. The virus, poliomyelitis, produced inflammation of the spinal cord. Speculations about what caused the illness ranged from bananas injected with tarantula poison to cats to wireless electricity to doctors’ beards. To this day, I never eat the very bottom of a banana, that is where the tarantulas inject! Parents were blamed for tickling their children. Unlike Covid-19, polio targeted children under the age of 5, a horrifying thought. Adults were also at risk.

Unlike Covid-19, polio spread from one person to another by fecal – oral transmission, by way of food, water or poor hygiene. Symptoms ranged from mild (sore throat and fever), to paralysis in about 1 in 200 cases. Although the paralysis was transient in some, many victims were confined to crutches and wheelchairs for life. Prognosis and morbidity depended on which muscles were effected. My mom was lucky that the virus settled in her left calf only.

When the virus attacked the muscles of the chest, often the iron lung was the fate. While the iron lung was primarily for acute illness, there were people that lived in the chamber for decades. The iron lung is the predecessor of todays modern ventilator. Unlike the ventilator, intubation was not required and it utilized negative pressure rather than positive pressure to achieve the same effect. The price was $1500, considered extremely costly at the time. The iron lung covered the body up to the neck. The image of hospitals full of these massive metal cylinders are chilling.

New York was badly affected (sound familiar)? Health officials entered homes and playgrounds and physically removed children thought to be infected. Asymptomatic spread explained why quarantining sick people in New York City could not contain the virus.

In 1952, the peak number of cases in the United States was near 60,000, resulting in 3,145 deaths.

There was no cure. A vaccine needed to be discovered urgently. Franklin Delano Roosevelt, the President at the time, contracted the virus at the relatively late age of 39. Strategic event planning succeeded in keeping his disability from the public eye. Roosevelt started the National Foundation for Infantile Paralysis, later known as the March of Dimes. People were encouraged to send dimes, conveniently slipped into cards.

Jonas Salk was 33 years old when he started working on a vaccine at the University of Pittsburgh, funded by the March of Dimes. Three floors above his lab was a polio ward filled with people encased in iron lungs. His idea was to use killed virus vaccine, rather than a live-attentuated one.

The first vaccine for polio was given to more than 200,000 children. The process used to render the virus inactive was defective. Within days and months, reports of paralysis in 40,000 children and death of ten children forced a stop to its administration. This became known as The Cutter Incident Jonas Salk was well aware of the tragic outcome of that vaccine.

It took Jonas Salk two and a half years to develop the polio vaccine. In 1953 he tested the virus on himself. This vaccine, administered in four separate shots, was tested in a massive placebo-controlled trial and approved.

That vaccine changed the world. An oral live-attentuated vaccine was developed by Albert Sabin several years later, which replaced Salk’s, due to ease of administration and higher efficacy.

Post-polio syndrome can affect 25-40 out of 100 survivors decades after the initial infection. It is not contagious. Muscle weakness, fatigue and joint pain are the primary symptoms. It is not life threatening but can make life challenging depending on severity.

All of this virus-speak is no longer foreign to us. The fear and terror are all too familiar. Thanks to cooperation, persistence and gifted scientists, the United States has been polio-free since 1979. The disease exists in a few countries in Asia and Africa but steps are being taken toward eradication.

This is a story of HOPE. We must be patient waiting for a safe effective vaccine that has gone through vigorous clinical trials. The agonizing story of polio is part of our recent history. The impact of the vaccine is one to be celebrated. My mom made sure we knew about Jonas Salk. He was her hero.

Lia Koplin-Green, 4/2020

Home

Since we are home, and being ordered to stay home, I am re-publishing an article I wrote two years ago.

The first paragraph sounds like a different lifetime but still, read on..

Walking down the narrow corridor between the rows on an airplane, waiting as people delight in finding a space to hoist their large bags into the overhead. I find my row and settle in to my aisle (always aisle!) seat. I tuck my water bottle, iPad and Us Weekly (my little airplane indulgence) into the front seat pocket. I then turn my attention to the stranger beside me and we exchange the usual small talk:

“Economy Plus, so worth it.”
“Is this a full flight?”
“Oh no, a baby near us. I remember those days traveling with a baby.”
At some point in that interaction, I am asked the question “Where is home for you?”

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Soup

There’s a tradition in our family started by Eva, my dad’s wife, to make a big pot of soup and have it ready when someone comes home from a trip. When you are jetlagged, the last thing you want to do is go out to a restaurant or cook. After a shower, opening the refrigerator and seeing a beautiful pot of soup in the fridge is nirvana. Soup made with love – you can taste the difference. 

I made a pot of homemade chicken soup and matzoh balls about two months ago in anticipation of Jeff coming back from Israel. He had been there since January, working in a busy Emergency Department in Ashdod, Israel. Today, I am defrosting the soup made for him. I don’t think I’m going to see him for a while.

I know for some of you it’s tough to quarantine with family. Tempers are short. You don’t have the usual distractions. But quarantining alone is no picnic. Everyone in my family is on lockdown in their prospective countries.  

My brother is staying here. He too, separated from family. And it’s kind of weird to live with your brother for weeks in the house you grew up in. It just adds to the surreality. 

We are both in Milwaukee with our 99 year old father. Even for a Holocaust survivor this current situation “feels like the end of the world”. He watches at a distance, as an outsider. His joie de vivre, social interaction, has been snatched from him. His hospice nurse recommends the two of us “use FaceTime or something” instead of visiting. His apartment is a short walk from my house. Going there makes me anxious but not going is even harder. Isolation and loneliness are leading to a huge decline in his quality of life.

So when I cook he wants Hungarian meals from the old country like Káposztás Tészta (cabbage and noodles), cholent and Toltott Kaposzta (stuffed cabbage). And of course soup.

Make soup for someone you love, they can taste the difference.

Pandemic Pandemonium

These are unprecedented times. Every person in the world has been affected by COVID-19.

How we react is generally in line with our personalties. The anxious become more anxious and the cynics deny, deny, deny until they can’t anymore. Then there are people who have responded in a completely unexpected way. Those who know them are left scratching their heads thinking “I’ve never seen him like that before”.

We are being instructed how to act. We are required to follow rules to keep ourselves, our families and our communities safe. Despite social distancing we are more connected than ever before.

This virus cannot be seen or felt it but it is in the air. Or on that surface you just touched. * note to self – I need to disinfect this keyboard. It is a matter of being in the wrong place at the wrong time. Or maybe there is no right place, it is all wrong. Except home.

We think that suddenly we are living with uncertainty. The truth is the uncertainty is always there. We think we control it by following certain traditions, symbolic dates on the calendar and rituals.

Now our markers – appointments, work, concerts, church, sports, buying what we need at a store – are gone.

This is our challenge as humans. We will make it work – set up home gyms, watch Netflix, work from home, catch up on nagging tasks. Making it work is not enough. We need to make this a meaningful time both mentally and spiritually. We can’t just wait until it’s over – that may be a very long time.

Freedom from Worry

Now that we understand how dangerous it is to worry, readers are asking for answers on how to control it.

Physician, Heal Thyself is an ancient proverb appearing in Luke 4:23. How can a worried psychiatrist treat worried patients? My answer? Better than a psychiatrist that doesn’t know what worry feels like.

While most of us are wary of medication, it may be beneficial, even short-term. Chronic unrelenting anxiety is toxic. Medication may be needed if anxiety is so severe that it interferes with functioning. For 50% of people diagnosed with anxiety the benefit of medication outweighs the risk. Taking medication does not label you. It is you being self aware, educated and taking care of yourself.

What about us “worried well” that worry but not severely enough for conventional medicine?

This is when I take ideas from my readers. From readers’ comments from my very popular article on Worry , I gained insightful feedback I want to share.

10 MAGICAL WAYS TO FREEDOM FROM WORRYING

Write.

Get fresh air.

Talk with someone way older than you.

Love.

Make Art.

Meditate.

Plant something.

Breathe.

Play with a dog.

Get wet.

{Can anyone find a mnemonic here?}

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