Chapter 1

Introduction

The March of Dimes and Historiography

Abstract

The history of the March of Dimes has been studied primarily in the context of its achievements in the prevention of diseases, especially relating to polio and various birth defects. While much has been written on the early period of polio prevention when it was known as The National Foundation for Infantile Paralysis, there has been no definitive study of the Foundation from an organizational perspective covering its entire history. The historiography of the March of Dimes falls into three phases: first, a comprehensive study commissioned by the NFIP resulting in the unpublished History of the National Foundation for Infantile Paralysis in 1957; second, early treatments of the Salk vaccine story and the history of polio; and third, recent scholarship relating to particular aspects of the leadership of the March of Dimes in the eradication of polio.

Keywords

Historiography; In Daily Battle (film); March of Dimes; National Foundation for Infantile Paralysis; Oral history; Polio; Saul Benison; Thomas Milton Rivers
 
In his State of the Union address on January 20, 2015 President Barack Obama announced the launch of a new initiative that he called the “Precision Medicine Initiative” to refine and personalize medical treatment. The initiative is intended to develop a program to coordinate individual genetic, lifestyle, and symptomatological data to personalize diagnosis and treatment with the precision appropriate to specific characteristics of the human individual and not an “average” patient. President Obama stated, “I want the country that eliminated polio and mapped the human genome to lead a new era of medicine—one that delivers the right treatment at the right time.”1 His reference to these two accomplishments—the elimination of a devastating epidemic disease and one of the most prominent milestones in the science of genetics—was made without mention of the organization that played a significant role in the history of both. The March of Dimes, founded in 1938 as The National Foundation for Infantile Paralysis (NFIP), brought the awful tribulations of polio to a close in the United States just after the midcentury, only to renew its battle against disabling diseases by stimulating research into the causes of birth defects through genetics and genomics. The story of polio’s demise is well known thanks to the dramatic aura that clings to the story of a robust politician stricken in the prime of his life and crippled by “infantile paralysis” who then went on to become president of the nation, and to the legacy of the organization that democratized philanthropy by involving ordinary people in the social construction of scientific accomplishment through a continuous multitude of small donations. Less appreciated, and frequently overlooked, in the history of the human genome project are the human gene mapping workshops that were sponsored by the March of Dimes that formed the incremental steps toward the ultimate goal of mapping the entire genome. In fact, Dr. Victor McKusick, fondly known as “the Father of Medical Genetics,” put forward the very idea of the human genome project at a March of Dimes International Birth Defects Conference in 1969, a conceptualization that the March of Dimes then translated into immediate action. President Obama’s call for a new era of “precision medicine” invokes not only the history of the March of Dimes but also its capabilities concerning the efficacy in medicine as it pursues the ultimate goals of putting an end to birth defects and premature birth in our lifetime.
The place of the March of Dimes in American medical history tacitly invoked by President Obama holds a small irony in that accomplishments cited—polio eradication and the genome project—were spearheaded by a small, independent organization as opposed to a vast governmental bureaucracy of entangled departments and agencies. That the detailed history of the March of Dimes as an organization has not been a subject of focused historical research is the question set forth here. Founding by a major US President, eradicating polio, joining the aims of science with the lives of ordinary people, and reinventing itself as a leader in birth defects prevention—all of these are well known and individually treated in disparate media, in print, and online. The story of the eradication of polio as a threat to public health has been explored from several perspectives since it is a signal accomplishment that resonates powerfully in the 21st century with a world initiative on the verge of total global eradication, which involved many organizations and individuals in collaboration with the March of Dimes, without whom the Salk and Sabin polio vaccines may not have been developed so early (1955 and 1962, respectively). While incisive historical and biographical studies such as Daniel Wilson’s Living with Polio, David Oshinsky’s Polio: An American Story, and Charlotte Jacobs’ Jonas Salk: A Life have contextualized the historical particulars of the polio epidemics and the vaccines as an American story, the organizational history of the March of Dimes has remained untouched and curiously out of focus, except insofar as acknowledged as the engine for success. And while the history of polio in America gained closure as an immediate problem, the reorganization of the March of Dimes in 1958 toward the complexities of its multidimensional attack on birth defects and premature birth are well known yet somehow appreciated by historians and film makers only piecemeal, still wanting proper historical synthesis.
This study does not correct this historical discrepancy in a comprehensive overhaul but hopefully provides a benchmark for future organizational history, one that is measured by its original source in historical biography. The friendship and partnership of Franklin D. Roosevelt (FDR) and Basil O’Connor remains central to the creation of the NFIP and its fund-raising campaign known as the “March of Dimes”; their personalities have inflected the history of polio prevention in ways that impart special character to their humanitarian collaboration.2 Besides the enormous breadth of their individual accomplishments, each is a “colorful character” with an indelible impact on American culture, but this study is not a biography proper of either Roosevelt or O’Connor in the sense of a written portrait of a life as a conclusive summing up from birth to death. The field of Rooseveltian biography is ongoing and inexhaustible, to be referenced here primarily as it pertains to the history of his personal relationship with Basil O’Connor; while the portrait of Basil O’Connor here, though tending toward a more traditional biographical portraiture, is scrutinized largely in the circumstances of his association with FDR and the formation of the March of Dimes. Most essential are their interactions, each man’s influence on the other, and the common ground of their careers. As Frank Costigliola has vividly demonstrated in his Lost Alliances: How Personal Politics Helped Start the Cold War (2011) interpersonal relationships and the fluctuating dynamics in the Roosevelt administration did indeed have an authentically world-changing impact in political history. Costigliola did not include Basil O’Connor in his examination of Roosevelt’s ensemble of advisors in the monumental attempt to steer the Soviet dictator Josef Stalin toward mutuality, diplomacy, and tractability to American ends in the concluding year of World War II. However, FDR’s lasting confidence in O’Connor made him privy to momentous secrets even in the arena of global geopolitics, far afield from the daily management of the NFIP. Long after FDR’s death, O’Connor suggested that the President had revealed to him facts about the Yalta Conference the knowledge of which would not outlive either of them.3
The basis of the historiography of the March of Dimes actually begins with projects of FDR and Basil O’Connor themselves. FDR signed the legislation to create the National Archives and Records Administration (NARA) and created the first presidential library, a model followed by all subsequent American presidents. In the course of launching his library, FDR brought Basil O’Connor directly into the endeavor of preserving his presidential and personal papers. O’Connor thus became involved in the establishment of the FDR Library, and later the Harry S. Truman Library as well. These formative and highly visible roles strengthened O’Connor’s already acute historical consciousness, which he brought into play during the years of the Salk polio vaccine field trial in the mid-1950s to preserve the history of the NFIP, formally and professionally. Perhaps amplified by a vain sense of his own historical significance, O’Connor retained the management consulting firm Hackemann & Associates of Madison, Wisconsin in 1953 to research and write a formal history. For four years, Louis Hackemann and his associate Ruth Walrad, authors of a history of the American Red Cross whom O’Connor had met during his stint as president of that organization, orchestrated the project through a newly created Historical Division of the NFIP to chronicle its achievements in its minutest details. The result was a multivolume, 3,000-page account of the NFIP in its several fields of significant endeavor: national administration and policy, fund-raising, medical research, medical services, professional education, and public education. The study encompasses the activities of the Georgia Warm Springs Foundation from the mid-1920s, the emergence of the NFIP, and the first efforts toward a comprehensive program to stop the polio epidemics in the United States. A separate volume on the Salk polio vaccine field trial was planned but never completed. O’Connor and the NFIP sought a publisher at the completion of the project in 1957 but with no success. The unpublished study remains a cornerstone of the collections of the March of Dimes Archives, providing documentation of the earliest years of the foundation and relying entirely on original materials available at the time of writing, some of which are regrettably no longer extant. The History of the National Foundation for Infantile Paralysis remains a singular but ponderous account of a noble experiment in disease prevention that resonated from the presidency to the science establishment through Hollywood and the mass media and that colored American culture and society in ways that were unique in the American experience.4
Angela Creager of Princeton University was the first contemporary historian to utilize this massive historical study in her research, an examination of the work of Wendell Stanley (a grantee of the NFIP) and his path-breaking work on tobacco mosaic virus in The Life of a Virus: Tobacco Mosaic Virus as an Experimental Model, 1930–1965 (2002). Several others have followed her lead. The future historian considering an organizational or narrative history of the March of Dimes will have additional resources: not only the plentitude of original source materials of the foundation’s Archives, but other important publications as well, including the published proceedings of the International Poliomyelitis Conferences (1948–60) followed by the International Birth Defects Conferences (1960–77); the Birth Defects: Original Article Series (1965–95) described below; and the public opinion surveys conducted in the mid-1950s that led to the publication of The Volunteers: Means and Ends in a National Organization (1957), by David Sills, which was the first sociological assessment of the NFIP as a voluntary organization. Once again, it was Basil O’Connor who set all of these projects in motion. The breadth of O’Connor’s intellectual compass as a visionary leader soars far beyond the reductive simplicity of the common stereotype of the man as the head of the NFIP.
Distinctly aware of his own role in the very thick of “history-in-the-making” during the planning of the field trial of polio vaccine developed by Dr. Jonas Salk in 1954, a clinical trial touted by the March of Dimes as the “largest peacetime mobilization of volunteers” in American history, O’Connor also mandated the requirements for change. By 1953 he completely trusted Salk’s vaccine research as the solution to the problem of polio and recruited a former Red Cross associate, Melvin Glasser, to investigate the best opportunities for the future direction of the organization. Thus, just as the Salk vaccine was being developed and tested, the NFIP began a comprehensive analysis of its impact in the field of public health through formal surveys conducted by the Bureau of Applied Social Research and by the American Institute of Public Opinion. These studies solidly confirmed the organizational strength and broad base of public support for the medical program of the NFIP that helped to shape the foundation’s new mission against birth defects in 1958 with the launch of its Expanded Program. According to a Board of Trustees memo, the Gallup and Columbia University polls when completed “…were designed to determine what endeavor, if any, the National Foundation should follow when the problem of poliomyelitis had been completely solved.”5 The privately commissioned Columbia University study, The National Foundation: Its Volunteers and Public Support (1954), which was the first survey of volunteers and supporters of the NFIP, was recapitulated in David Sills’ The Volunteers, an examination of the March of Dimes as a social movement, its organizational structure, the social origins of local chapters, and the nature of voluntarism as a social experiment. The contemporaneous study of the NFIP by George Gallup’s American Institute of Public Opinion also facilitated decision making about the mission change to birth defects. Gallup himself became a member of the NFIP board of trustees in the 1950s, undoubtedly favored by Basil O’Connor’s appreciation of Gallup’s famous success in predicting FDR’s reelection in the 1936 presidential campaign. The March of Dimes has returned to the Gallup poll on many occasions to survey public opinion and attitudes about its programs and initiatives, for example, the National Folic Acid Campaign of 1998 to 2002. In sum, the two surveys, along with Melvin Glasser’s transformational analysis of organization change and Dr. Josef Warkany’s prodding O’Connor with great urgency to choose birth defects prevention as a new mission, all led to the announcement of the so-called Expanded Program. O’Connor, Glasser, and their advisors reached the conclusion that prevention of birth defects and arthritis (which was discontinued in 1963) were achievable mission objectives not because they were “unmet medical needs” but that the NFIP was equipped to meet these needs, as stated explicitly in the Columbia University survey.6 At the same time, the Foundation simplified its name from the NFIP to “the National Foundation.” Basil O’Connor’s continuing confrontation with a widening spectrum of disease became apparent in a new direction: he idealized the foundation as a “flexible force” in the field of public health, an innovative twist in the Rooseveltian notion of “Freedom from Disease.”
The organization of the NFIP as a national civic movement based on a confederated network of local cadres of volunteers gave way to an even more structured hierarchy after the polio years, just as Josef Warkany’s teratological model of birth defects gave way to an understanding of “congenital malformations” based on genetics. The 1960s were not only years of change and reorganization, but also of summing up, with polio a lesser threat than it had been at the founding of the NFIP. Saul Benison’s oral history of virologist Thomas Rivers is the preeminent study in a second wave of historical reconnaissance of how polio came to be defeated. Tom Rivers: Reflections on a Life in Medicine and Science (1967) is an “oral history memoir” and as such is a classic model of its kind. In this memoir, Benison achieves an unparalleled, wide-ranging history of mid-20th-century virology and medicine expressed in the personal reflections of Dr. Tom Rivers, a brilliant but truly cantankerous and feisty decision maker in the momentous events leading up to the Salk vaccine field trial and its aftermath (not to mention NFIP grant making). Thomas Milton Rivers, MD (1887–1963) was an American original, an intellectual powerhouse of the kind that Basil O’Connor needed most to fulfill his vision of the “precision medicine” of his time. Rivers belonged to an age of medicine that knew viruses as “filterable viruses” (because they traveled freely through porcelain filters that otherwise easily trapped bacteria), and he led the Rockefeller Institute as Director when he joined the NFIP. His important role as a leader in NFIP grants administration and key player in planning the 1954 field trial are revealed in painstaking detail in Benison’s oral history.
Saul Benison was one of the original members of the Oral History Research Office of Columbia University with historian Allan Nevins, who founded the office in 1948. Benison was as close as anyone to the professional intellectual source of oral history in the United States, later publishing “Reflections on Oral History” in the American Archivist and acknowledging Nevin’s role in the field with a dedication in his Tom Rivers memoir: “For Professor Allan Nevins/Known to my generation at Columbia as the Little Shepherd/From one of the sheep.”7 Benison became Professor of History at Brandeis University until his retirement in 1990, and he benefitted from a warm relationship with Basil O’Connor, becoming more or less official historian of the National Foundation in the 1960s. Before any other scholar, Benison recognized the world historical significance of the NFIP in the milieu of global war when FDR was yet alive, expressed in a stunning observation that has continuing relevance for the March of Dimes mission in both national and international contexts today. In an unpublished essay, “The National Foundation: 1938–68, A Retrospective View,” later reprised in an article on the history of polio research in the United States, Benison stated:
Benison also authored several articles on the history of polio in addition to the Tom Rivers memoir and an unpublished “retrospective view” of the National Foundation’s first 30 years; and he collected and indexed Basil O’Connor’s speeches, having unique access to an earlier incarnation of the March of Dimes Archives than the existing archival collections of the March of Dimes today. Benison’s meticulous notes on manuscript and bibliographic sources for the Rivers memoir reveal an extensive archival collection of documents, indisputably unique for a private nonprofit foundation of the 1960s, which he describes in part as follows:

The Archives, which are kept at the National Foundation’s headquarters in New York, contain approximately 3,000 linear feet of records, organized into seven major record groups, including legal records, accounting and financial records, medical service records of patients supported by the Foundation, chapter administrative records, administrative records of the national office of the Foundation, public relations records, and grant file records.9

Many of these core collections are still preserved and accessible today in the contemporary March of Dimes Archives, but the discrepancies between the current collection and Benison’s bibliographic snapshot of 1967 leads to the disappointing conclusion that much has been lost over the years. While Benison’s work remains fundamentally important, two other books of that era deserve acknowledgment as participating in the second wave of historical retrospectives on polio and the March of Dimes. John Paul’s History ofPoliomyelitis (1971) is an authoritative account of “the natural history” of this disease, based on Dr. Paul’s long experience as a founding investigator, with James Trask, of the Yale Poliomyelitis Study Unit and a research grantee (the very first) of the NFIP. Compared with Benison’s meticulous citation of sources, Paul’s history lacks such scholarly apparatus; instead, he relied on Benison himself for assistance with areas of history beyond his own direct experience as a polio epidemiologist beginning in the 1930s. Dr. Paul likened the appearance of the NFIP to “the sudden appearance of a fairy godmother of quite mammoth proportions who thrived on publicity,” lending to the polio literature a notorious characterization that has been recycled ad nauseam.10 Finally, Richard Carter’s Breakthrough: The Saga of Jonas Salk (1966) is a journalistic attempt to portray the public drama of the Salk vaccine, and though he benefitted from interviews with Basil O’Connor as well as the assistance of Saul Benison and others close to the story of the vaccine, it is undistinguished by the meticulous objectivity in Benison’s own approach to the same events in his life and of Tom Rivers. Stanley Plotkin, MD, then of the Wistar Institute, who developed the RA27/3 rubella vaccine, pinpointed the rudiments of a simplistic conspiracy theory in Breakthrough, finding a drastic imbalance of perspective in Carter’s favoritism of Jonas Salk as the only polio researcher among his peers who was objective and altruistic. In a book review in Clinical Pediatrics, Dr. Plotkin wasted no words in stating right off: “This is essentially a paranoid book, but like many paranoid productions not without merit or intrinsic truth.”11 Richard Carter’s Breakthrough, written much closer in time to the events it portrays, has been superseded by other fine histories that utilize original source materials rather than an obsolete old boy network of cronies and newsmen.
In 1965, under the editorial leadership of Daniel Bergsma, MD, the March of Dimes launched the Birth Defects: Original Article Series (BDOAS), a periodical publication that became a key component of the foundation’s growing professional education program. Dr. Bergsma was Director of Professional Education from 1959 to 1977 at a time when the foundation’s corporate name was hyphenated as The National Foundation-March of Dimes. He also authored the Birth Defects Atlas and Compendium (1973), a massive encyclopedia of malformation syndromes and genetic diseases. The BDOAS was created “to enhance medical communication in the birth defects field,” and it published original papers on inherited disorders, genetic counseling, immunology, embryonic development, and bioethics by medical specialists in genetics and birth defects research. Also featured were the papers and proceedings of medical symposia sponsored or cosponsored by the March of Dimes beginning with the Symposium on the Placenta in 1965, edited by Dr. Bergsma himself. Robert Good, MD coedited volumes on immunodeficiency diseases as did Victor McKusick, MD with several volumes on the clinical delineation of birth defects. Frank H. Ruddle, MD was involved with Drs. McKusick, Bergsma, and others in the publication of nine international human gene mapping workshops sponsored by the March of Dimes. The BDOAS, along with the proceedings of the International Birth Defects Conferences and the annual March of Dimes Conference on the Clinical Delineation of Birth Defects established in 1968 in association with the Johns Hopkins Medical Institutions, were cornerstones documenting an enormous transformation: the systematic and holistic turn to birth defects prevention. Victor McKusick, chair of the first five of the clinical delineation conferences, equated the study of birth defects with medical genetics, believing that the field was “an effective focus for the March of Dimes, clarifying its mission as a way to unravel the basic problems [of genetics].”12 Dr. McKusick was instrumental in developing the annual Short Course on Medical and Experimental Mammalian Genetics with March of Dimes support at the Jackson Laboratory in Bar Harbor, Maine, claiming of the March of Dimes role in medical genetics that “massive might not be an excessive evaluation.”13 In sum, all of these publications and conference proceedings originating in the 1960s and continuing to the turn of the millennium are published resources to be utilized in conjunction with original source materials of the March of Dimes Archives in future historiography of the foundation.
A resurgence of interest in oral history in the 1980s anticipated the 50th anniversary of the March of Dimes in 1988 with a project “to create an anecdotal account of the March of Dimes based on the personal remembrances of people who had shaped its history.”14 The project was carried out by Albert Rosenfeld, Consultant on Future Programs, and Gabriel Stickle, who served as Statistician for the Salk polio vaccine field trial and later became Executive Assistant to the President, Basil O’Connor, in 1966. The transcribed tape recordings of 57 interviews conducted from 1983 to 1988 were never published, though the reflections of many important figures in March of Dimes history, namely Jonas Salk, Victor McKusick, Elaine Whitelaw, Dorothy Ducas, and other volunteers and staff, were documented. In the meantime, renewed interest in the earlier polio mission of the NFIP was brewing in the 1990s long after the foundation had broadened its birth defects mission to encompass the field of perinatology and the problem of premature birth. Filmmaker Nina Gilden Seavey utilized the March of Dimes audiovisual collection for research on the history of polio; her award-winning documentary, A Paralyzing Fear: The Story of Polio in America, was released in 1998, a stimulus to the founding of the March of Dimes Archives as an institutional repository for the original records of the foundation. Since 1998, a spate of original studies—a third wave of historical reconnaissance—have utilized this collection: The Life of a Virus: Tobacco Mosaic Virus as an Experimental Model, 1930–1965 (2002) by Angela N. H. Creager; Living with Polio: The Epidemic and Its Survivors (2005) by Daniel J. Wilson; Polio: An American Story (2005) by David Oshinsky; The Cutter Incident (2005) by Paul A. Offit, MD; Bracing Accounts: The Literature and Culture of Polio in Postwar America (2008) by Jacqueline Foertsch; The Polio Years in Texas: Battling a Terrifying Unknown (2009) by Heather Green Wooten; The Immortal Life of Henrietta Lacks (2010) by Rebecca Skloot; Genesis of the Salk Institute: The Epic of Its Founders (2013) by Suzanne Bourgeois; Polio Wars: Sister Kenny and the Golden Age of American Medicine (2014) by Naomi Rogers; Jonas Salk: A Life (2015) by Charlotte Jacobs; and Selling Science: Polio and the Promise of Gamma Globulin (2016) by Stephen Mawdsley.
Any of these studies may be destined to become classics in the medical humanities. One of them, Polio: An American Story, has achieved acclaim with a Pulitzer Prize in History in 2006. These and other published articles, dissertations, films, and exhibits amount to a minirenaissance in the discovery that the March of Dimes exists in the firmament of Americana as well as in traditional historiography of science and medicine. And yet there is no institutional history of the March of Dimes as an organization, nor do any of these studies examine the history of the foundation (or even the polio years) from an organizational perspective in a sustained fashion. The reasons for this seeming neglect are paradoxically obscured by the very fact that so many have taken stock of the foundation’s singular achievements in so many areas of endeavor. The complexity and scope of this history is daunting, and the Foundation naturally moves ahead without looking back nostalgically even as it deploys its history of achievement strategically to impel its current mission. The mythologizing of the founder FDR is another factor, but historians are normally adept at decoding any institutional “myth of origins” that smothers the clarity of fact in the fogbank of legend. FDR’s partner Basil O’Connor may be partly responsible as well, which is the crowning irony. O’Connor’s heightened sense of himself as a historical actor on the global stage contradicts his failure to publish The History of the National Foundation for Infantile Paralysis in 1957 just as his role in the preservation of presidential papers contradicts the sad lapse in preserving his own. His public persona belies his reclusive method. And though public controversy attracts attention and makes for good theater, O’Connor’s combativeness in the daily newspapers (eg, with Albert Sabin) tinges the reputation of his final years with an element of unbending stodginess that blends perfectly with the visible trappings of privilege and high style that he flaunted. His personal success was envied, or not understood in relation to his humanitarianism and liberal politics (yet another contradiction), and distortions of interpretation occurred much later in some attempts to portray O’Connor and the NFIP with any semblance of accuracy. One of these relates to the social construction of fear.
The idea that March of Dimes publicity was grounded in fear-mongering, that it preyed on the fears of a vulnerable public, that its success was predicated on fear-based marketing is an unfortunate misconception that demands correction. David Oshinsky alludes to this maladroit gloss on the success of the NFIP in Polio: An American Story, but it crops up time and again with virtually no analysis or substantiation. Paralyzed with Fear: The Story of Polio (2013) by Gareth Williams exemplifies an extreme version of this ill-founded opinion. A gossipy medical history of polio centering on Great Britain (Williams is Professor of Medicine at the University of Bristol) Paralyzed with Fear revels in breezy language that throws any pretention to care about scholarship completely out of kilter: the NFIP is dismissed as a tentacular monopoly fanning the flames of polio hysteria with no standard of accountability; Jonas Salk is accused of pathological “tunnel vision,” and Basil O’Connor is branded as a manipulative “tough-talking, short-fused bully.” Citing Patenting the Sun: Polio and the Salk Vaccine, an earlier telling of the Salk story by Jane Smith, Williams misrepresents the NFIP as “slick, arrogant fear-mongers, raising money through a campaign of terror.” The NFIP “campaign of terror,” he reiterates, “was a classic stick-and-carrot strategy, but with both elements carved from fear” and led by a “thick-skinned, abrasive pirate,” a “pushy businessman.” Williams even questions FDR’s principles: “It is ironic that Roosevelt himself was instrumental in the campaign of terror which deliberately denied Americans [Freedom from Fear], and that he did not live to reassure himself that the end justified the means.” Stereotypical characterizations such as these are inexcusable substitutes for careful research and objective presentation; these are untenable, unwarranted, and patently unfair.15
Then why does this misperception of the NFIP as “fear-monger” persist? The answer lies in the distortions that arose from its own success with polio, its transformation and rebranding in 1958, and its ability to evolve with the evolution of the news media. Indeed, a history of the March of Dimes could be written from the perspective of its creative engagement with communications media, harkening back to FDR’s “fireside chats” on radio (a brilliant exercise in allaying public fears). As Public Relations Director, Dorothy Ducas pointed out that the NFIP had utilized the news media unlike any other public health organization before it, and she, rather than Basil O’Connor or anyone else, was responsible for the engagement of its PR Department with the mass media in the 1940s and 1950s. She stated bluntly: “I ran it like a newspaper or a news service and nobody else had done that.”16 Moreover, Ducas insisted on disseminating dependable information about polio through all available news outlets throughout the year, not just during March of Dimes campaign drives, to keep advances over polio in the public eye and to involve volunteers effectively in solutions to a common, horrendous, national problem. Gareth Williams’ overstatement that there was “no escape from March of Dimes propaganda, as the NFIP’s well-funded and well-connected press office exploited all the media to hammer home the horrors of polio,” entirely disregards the abundant evidence of the prior public alarm over polio-paralyzed children during the first decade or more of the existence of the NFIP.17
image
One of Them Had Polio, 1949.
The NFIP and the Museum of Modern Art in New York sponsored a polio poster contest in 1949, a challenge to artists to represent visually the fight against polio. Herbert Matter, an advertising designer and photographer known for his pioneering use of photomontage in commercial art, won First Prize for his poster “One of Them Had Polio.” Matter’s son, whose image appears on the right, was a polio survivor. The message “skilled teamwork brought recovery” characterizes the polio prevention program of the NFIP. The poster was reproduced on its annual report of 1949, a year of serious polio epidemics throughout the nation.
Another element in this mischaracterization adds a touch of the bizarre to the reputation of NFIP productions: the film In Daily Battle (1947), produced by RKO Pathé, Inc. for the NFIP as an educational film about services available to communities in the grip of polio epidemics, In Daily Battle is better known as “The Crippler,” a name that was a common trope for polio itself. In the film, a short introduction features US Surgeon General Thomas Parran championing the NFIP as a “volunteer army” promoting “the Fifth Freedom—freedom from disease.” The next brief snippet is notoriously famous: a specter of polio emerges in the form of a child’s shadow with a crutch, chuckling with menace I am Virus Poliomyelitis as it roams city and countryside bringing paralysis to all it touches. The remainder of the film portrays the efficient charity of a March of Dimes chapter providing financial aid to families touched by polio, a straightforward scenario with actress Nancy Davis (later First Lady Nancy Reagan) in the role of a prim March of Dimes chapter assistant: “Miss Manning—she represents you!” The message was explicitly clear: “to replace fear with preparedness.”18 NFIP interventions in the epidemics in Hickory, North Carolina (1944) and Jackson, Mississippi (1946) are also depicted, but the emphatic lesson was one of reassurance and dependable care. Even though In Daily Battle falls in line with many educational films that boosted the good work of chapter volunteers and progress over polio, the “crippler” episode has been repeatedly taken out of context as a “scare tactic.” NFIP staff recognized this tinge of grotesquerie and cautioned that the film might not be appropriate for schoolchildren though the film ultimately reached audiences in both schools and movie theaters. One scholar has recently examined this film in the context of the Frankenstein mythos.19 But just as the contemporary March of Dimes approaches the problem of prematurity from every necessary medical, social, and epidemiological perspective, so too did the NFIP treat the problem of polio holistically. One constant consideration of local chapters operating in the public interface to address polio spreading out of control was precisely the reactions of panic and fear.
From the great epidemic of 1916 and the days after FDR was stricken, fear of polio as a parental and public concern was immediate and real, but there were other fears as ubiquitous. Ira Katznelson, in Fear Itself: The New Deal and the Origins of Our Time (2013) has mused that a generalized fear of the future has never been laid to rest since the upheavals of the Great Depression and World War II. Katznelson identifies the roots of three most prominent fears in the era of the New Deal (which he sees running from Roosevelt’s inauguration in 1933 until the end of Harry Truman’s term in office): the spread of totalitarian dictatorships, warfare and global violence as a permanent condition, and the racist structure of American society.20 Add to those the specific dread of nuclear warfare since Hiroshima and the political paranoia of the Joseph McCarthy debacle, and one can begin to contextualize the fear of polio properly in the complexities of the age. While the NFIP was founded not to address these overarching geopolitical and structural problems, it has produced a general lesson that has relevance in every field of human endeavor: to replace fear with action. This was, par excellence, the lesson of FDR’s first inaugural address and Basil O’Connor’s subsequent modus operandi for the NFIP. It was the principle from which O’Connor derived an important corollary to battle polio at the community level: “what have you got and what do you need?” That is to say, what medical resources does the community already have in place, and what does it need from the NFIP to quell an epidemic. This instant form of needs assessment was buttressed by the mass distribution of public health literature designed to explain polio to allay fear, the training of teams of Polio Emergency Volunteers (PEVs) to aid communities in emergencies, and the creation of a nationwide structure of volunteers who organized polio relief and fund-raising in a dependable way year after year. In this way, the NFIP acted as an agent of social change as it formed a moral identity for the organization that in truth expressed the collective identities of hundreds of thousands of volunteers.
In his History of Poliomyelitis, John Paul saw Basil O’Connor as a leader not only of good causes, but of great ones. Paul affirmed that O’Connor “had that loyalty for the good cause that goes with militant magnanimity.”21 The militancy of his magnanimity might be expressed with peremptory impatience with his staff or with the soothing tones of an orator to win over a public audience. It was this Janus-faced persona that has provoked misjudgments that he was little more than a “short-fused bully.” Even though Charles Massey, third President of the March of Dimes, admitted that O’Connor sometimes betrayed an “explosive temper,” this was but the irascible impatience by which he confirmed his “militant magnanimity.” A leader need not always project the soft-spoken humility of a Gandhi to be genuinely humanitarian, but the effectiveness of his administration will always be judged by its resulting achievements. As Massey explained:
Misrepresentations of character aside, there is also the resounding silence of utter neglect: Basil O’Connor has become the “forgotten man” (a phrase that FDR had used in a fireside chat). This is conspicuously evident in recent cinematic treatments of FDR’s struggle with polio, where historical completism is forfeited in preference of dramatic effect. In the HBO television production Warm Springs (2005), FDR’s associates Louis McHenry Howe and Missy LeHand appear on the sidelines, but O’Connor is absent entirely. He does not appear in the frivolous comedy-drama Hyde Park on Hudson (2012) starring Bill Murray as FDR, and in the epic Ken Burns film documentary The Roosevelts—An Intimate History (2014), neither O’Connor nor the NFIP is even mentioned in an otherwise excellent portrayal of Roosevelt’s struggle with polio by biographer Geoffrey Ward. In Polio and Its Aftermath (2005), Harvard literary critic and polio survivor Marc Shell has asked, “What happened to the NFIP itself? Beginning in the 1950s, the NFIP as Roosevelt conceived it—as a real instrument of national health policy and practice—simply disappeared.” Professor Shell concluded, “The bold experiment in medicine and public health pioneered by Roosevelt … was all but forgotten.”23 Professor Shell did not dig deeply enough. What actually happened was that the NFIP as FDR and Basil O’Connor first conceived it reinvented itself and continued with remarkable progress as a leader against birth defects in the 1960s toward its campaign to prevent premature birth in the 21st century. While the pages that follow are not intended to explore the full scope of the history of the NFIP in its finest detail, this monograph will hopefully bring a corrective understanding to lapses and misconceptions described here by examining the life of Basil O’Connor and his connections to FDR with a cold but sympathetic eye in order to situate him in his rightful place for more encompassing projects of historiography to come.