Medicine: Bullet Lou Ricochets

When Louis Joseph Kirn was a midshipman, he played halfback for the Navy against Knute Rockne’s iron Notre Dame elevens and, despite a succession of banged-up joints, punched opponents’ lines so hard that he won the nickname of “Bullet Lou.” On Guadalcanal he commanded a dive-bomber squadron and flew missions around the clock. Kirn was not badly hurt when he had to ditch his plane in the Pacific, was unscathed in two torpe-doings of the carrier Saratoga. On Pentagon duty last February, Captain Kirn, 46, was a wiry 168 lbs., and rated himself “the healthiest man in the world.”

One Friday he woke up feeling seedy and decided that he had a touch of influenza. The dispensary gave him some pills. But Monday morning, Bullet Lou’s fingers were so weak that he could not squeeze the toothpaste tube. At the U.S. Naval Hospital in Bethesda, Md., Kirn announced: “I’m a well man who isn’t feel ing well.” While doctors tried to figure out what ailed him, Kirn got worse. By 10 p.m. he was paralyzed from the neck down, could hardly breathe or swallow.

Bullet Lou Kirn had a severe case of a baffling disorder, fortunately uncommon (a big metropolitan hospital will average no more than 20 cases a year), for which doctors have an array of misnomers. The one most often used: Guillain-Barré’s syndrome.* Doctors have no idea what causes the disorder, but know that it usually follows a feverish upper respiratory infection. Mysteriously, some or all of the 31 pairs of nerve bundles that branch from the spinal cord become inflamed around their roots and can no longer control their muscles.

Navy medics put Kirn on a rocking bed to help his breathing. They pumped him full of antibiotics to guard against pneumonia. But in ten days he ran a fever, and breathing and swallowing became so difficult that he was put in an iron lung. His lungs were filling with mucus, so a surgeon slit his windpipe and ran a rubber tube down it to drain them. Then Kirn had to be fed intravenously. Still he got pneumonia, so the Navy got in touch with the nearby National Institutes of Health, and borrowed a “cough machine” (a gadget which fills a patient’s lungs with air, then empties them with explosive decompression more powerful than any human cough). Even this was not enough: the mucus had thickened too much. A hood was put over the patient’s head, and he sweltered at 120° as steam kettles humidified the air. Doctors put detergents into the oxygenated air that Kirn breathed, and took to feeding him by a tube running through his nose to the stomach. Even so, in more than two months on the critical list, Captain Kirn faded away to 90 lbs.

Last week, brought back from the brink of the grave by the teamwork of 15 doctors and countless corpsmen, Kirn navigated his first unaided steps down a Bethesda corridor. Most Guillain-Barré victims, if they survive the first critical weeks, regain full use of their muscles. But not many have such a long and arduous way to come back as Bullet Lou Kirn. It had taken him three months even to wiggle his fingers and toes. Now, on a Spartan daily schedule which includes “walks” in the swimming pool, typing to exercise his fingers, pulling on a block and tackle loaded with weights, and twisting a wrist roller, Captain Kirn is mending fast and hopes to attend the Navy-Columbia game this week.

*Named for French Neurologists Georges Guillain and Jean Barré, and called “syndrome” because it is a set of symptoms, not a specific disease. Other names: Landry’s paralysis, infectious (or postinfectious) polyneuritis, acute idiopathic polyneuritis, and even encephalo-myeloradiculoneuritis.