The History of Polio Treatment in Texas: The Southwestern Poliomyelitis Respiratory Center

Throughout the early twentieth century, polio plagued the state of Texas. Between the years of 1948 and 1949 more than 4,000 Texans had polio. Houston and Harris County were especially hard hit and saw 827 people fall victim to polio and fifty-four people die from the disease from 1948 to 1950. In response to this, the Southwestern Poliomyelitis Respiratory Center (SWPRC) was founded in 1950 by physician William A. Spencer. Although the Houston area did have access to polio treatment as a result of the polio ward operated by surgeon Paul Harrington at Jefferson Davis Hospital and a ward run by Nell Schwartz at Hedgecroft Hospital, many agreed that these facilities were not equipped to handle the city’s booming number of polio cases. Dr. Russell Blattner, the chairman of the department of pediatrics at Baylor College of Medicine at the time, urged Kenneth Landauer, the medical director of the National Foundation for Infantile Paralysis (NFIP, established in 1938 to fight against polio and now known as the March of Dimes) to consider implementing a facility solely designated towards polio treatment.

Thus, Houston was chosen by the NFIP to have a polio facility due to the city’s dire need for a proper polio treatment institution and its newly-emerging Texas Medical Center. The SWPRC was initially located on the tenth floor of Jefferson Davis Hospital to revitalize its polio ward and provide learning opportunities for Baylor College of Medicine, as Jefferson Davis was the medical school’s teaching hospital. In addition to serving as the president of SWPRC, William A. Spencer was a pediatrics instructor at Baylor College of Medicine and conducted brain and spinal cord research. Dr. Eve Pfeiffer served as the assistant director. The remaining team members consisted of orthopedic, psychiatric, and pediatric residents as well as otolaryngology, physiology, and internal medicine specialists.

SWPRC was unique in that it served all patients regardless of race. In the era of segregation in Texas, Black patients were barred from treatment, and Black health care professionals were prohibited from employment at all-White hospitals. Facilities, such as the Houston Negro Hospital (now Riverside General Hospital) which hired Black physicians and treated Black patients, lacked the resources of other hospitals, and Black patients, especially those with the complications of polio, were unable to receive proper care. As a result of this and Jefferson Davis Hospital’s integration, Spencer and SWPRC stood by the principle to serve all, and SWPRC became an integrated polio treatment facility in Texas. It joined the few others such as the Gonzales Warm Springs Foundation (see WARM SPRINGS REHABILITATION SYSTEM) and Scottish Rite Hospital for Crippled Children to employ Black nurses and treat Black patients. Along with Jefferson Davis Hospital, the SWPRC hired nurses from Prairie View A&M, a historically black university, fostering employment opportunities for Black health care providers.

In November 1951 patients were moved from the tenth floor at Jefferson Davis Hospital to a new annex with the capacity to treat up to sixty acute polio patients and twenty in convalescence. In 1954 SWPRC opened the Wolff Home Rehabilitation Unit to help patients transition from hospital life to independent living. It received funding from the NFIP and the Cora and Webb Mading Foundation, a pivotal benefactor of the Texas Medical Center. The facility was designed to house twenty patients at a time, optimally a breakdown of twelve adults and eight children. One distinction between the Wolff Home and prior SWPRC facilities is that the Wolff Memorial Foundation, which did not fund prior SWPRC facilities, stipulated that only Black children under the age of fourteen could receive care. A typical day for Wolff Home residents included dressing themselves, attending therapy, taking part in the facility’s schooling if school-aged, eating meals in a family-style dining room, and enjoying free time.

During the years following its founding, the SWPRC received donations from Houston philanthropists and the NFIP. On May 30, 1959, a new facility, constructed in the Texas Medical Center, was dedicated as the Texas Institute for Rehabilitation and Research (TIRR). The new facility had 54 beds, 80,000 square feet, 80 health care professionals, and a total staff of 240 employees. Moreover, the NFIP contributed $200,000 worth of equipment, which included iron lungs, chest respirators, rocking beds, standing beds, and hot pack machines. When patients were admitted, physicians assessed the severity of the patients’ health and had iron lungs ready for acute patients facing prolonged respiratory muscle paralysis. If patients exhibited pharyngeal paralysis, which interfered with coughing and swallowing, physicians also used nasal catheters and performed tracheostomies to help treat them. For those with iron lungs, they would eventually undergo weaning, and if this was successful, then they received physical therapy.

As the need for polio treatments dwindled due to the mass implementation of the polio vaccine and the dramatic drop in polio cases, TIRR eventually shifted efforts towards research and program growth. The organization already had a history with groundbreaking research, as Paul Harrington developed the Harrington Rod, a steel implant designed to stabilize the spine and aid in polio patient spinal stability, in 1953. Likewise, William Spencer, along with other physicians, developed the physiograph which helped record vitals and is regarded as a predecessor to the EKG. The device received recognition in Life magazine in March 1954. TIRR established a spinal cord injury program in 1962 and in 1963 became a research partner with NASA to study the effects of weightlessness and application of centrifuge therapy for astronauts. In 1978 TIRR became known as the Institute for Rehabilitation and Research, signaling its devotion towards rehabilitation beyond polio and movement beyond regional care to “national and international service.”

TIRR has continued to study spinal cord and polio rehabilitation as well as other patient care areas, including brain injury research (the facility launched its inpatient brain injury program in 1984) and specialized inpatient pediatric care. Throughout the 1970s and 1980s, TIRR was named a Model Spinal Injury Treatment System and Model Brain Injury program by the National Institute on Disability and Rehabilitation Research due to TIRR’s inpatient programs. William Spencer served as president of TIRR until his retirement in 1987. In 1990 U.S. News & World Report included TIRR on its first “America’s Best Hospitals” list, and TIRR has been named in this list ever since. The Southwest Disability and Business Technical Assistance Center was established at TIRR in 1992. In 1993 the institution affiliated with McGovern Medical School in addition to its longtime affiliation with Baylor College of Medicine.

In 2006 TIRR joined the Memorial Hermann system. As of 2014 the facility, known as TIRR Memorial Hermann, had expanded to 134 beds and remained a nationally-ranked health care and research facility. Over recent years, TIRR has continued to foster affiliations with nearby medical schools and has created a rehabilitation network providing outreach to various communities in the Houston area. In the 2020s the institute’s research projects, facilities, and research team reflect its motto of “connecting knowledge and enhancing lives.”