Small Steps: The Year I Got Polio

Written by Peg Kehret, Small Steps: The Year I Got Polio (1996) is a middle-grade memoir that recounts the year the author first contracted polio. Kehret explains both the physical effects of the virus and the resilience and determination that allowed her to make a miraculous recovery. Small Steps has won several awards, including the Golden Kite Award (1996), the Pen Center USA West Literary Award (1997), the Dorothy Canfield Fisher Children’s Book Award (1998), the Joan Fassler Memorial Book Award (1998), the Mark Twain Readers Award (1998-1999), and the Young Hoosier Book Award (2001).

The memoir is often used in school curricula to educate children on the effects of poliomyelitis and to provide an engaging work through which students can identify with a narrator their own age and engage with complex themes in accessible ways. Kehret provides a glimpse into life as a polio survivor within both hospital and rehabilitation settings throughout the epidemics of the 1940s; to this end, the memoir explores such as The Value of Connection in Recovery, Emotional Turmoil Throughout Recovery, and The Impact of Adversity on Perspective.

A note on the language in this guide: To differentiate between the author’s dual roles as narrator and protagonist in her own story, this guide refers to the narrator as “Kehret” and refers to the author-as-protagonist by her first name only, Peg.

This guide refers to the e-book edition published by Albert Whitman & Company in 1996.

Summary

The Prologue introduces readers to poliomyelitis (more commonly known as polio), a disease that resulted in physical disabilities or killed thousands of people each year throughout the mid-1900s. Peg reflects on her writing process and the emotions the memories bring back of her year fighting polio. She admits to using fictional writing techniques in the narrative yet promises to remain transparent in her recounting of events; most importantly, she resolves to remain true to the emotions she experienced throughout that time of her life.

In early September, 12-year-old Peg, excited for the homecoming parade that afternoon, experiences back pain, headaches, and muscle spasms in her left thigh. She collapses in the hallway before returning home for lunch, where her mother takes her temperature and calls for a doctor. Testing and a spinal tap reveal that Peg has polio. She is brought into isolation at the Sheltering Arms shortly before paralysis sets in. Her temperature persists, and she starts struggling to breathe and swallow. She is transferred to University Hospital for closer access to a respirator, and she soon learns that she has bulbar polio, the rarest and most severe type; this news causes her further distress.

Peg’s parents are allowed to visit her while she is in isolation, and she finds comfort in their presence despite sensing their fear. She is put into an oxygen tent to facilitate her breathing and must endure the indifferent attentions of a callous nurse who refuses to roll her over in bed to ease her pain. She receives a teddy bear from her brother, Art, which brings her some solace during this time. Despite the strict rules against milkshakes for polio patients, Peg’s parents sneak one in because Peg is not able to eat or drink anything else. After consuming the milkshake, Peg’s fever breaks. Peg continues to improve in the following days, and Dr. Bevis authorizes her removal from isolation. Peg meets her new roommate, eight-year-old Tommy, who is in an iron lung. She wishes he were closer to her age but finds comfort in having company for the first time since her diagnosis. Peg develops a crush on Dr. Bevis and promises that she’ll walk for him someday. She begins Sister Kenny treatments, which involve painful hot packs and muscle stretches, and she quickly renames these sessions “Torture Time.” Peg’s physical therapist, whom she nicknames Mrs. Crab, is antagonistic and unsympathetic, and Peg throws tantrums at every session until Dr. Bevis assures her that the sessions will help her to regain her mobility.

After three weeks of paralysis, Peg regains movement in her arms and hands. She rapidly continues to make progress and can eventually sit up and move her legs again. Despite the joy she feels at her recovery, Peg also struggles with the guilt that she is recovering more quickly than other patients. She attempts to stand on her own but falls, an experiment that results in brief disappointment. Meanwhile, she receives another round of letters from friends and family, but upon reading their countless worries about seemingly unimportant things, Peg begins to wonder if she’ll ever have anything in common with these people when she returns home.

By mid-October, Peg is transferred back to the Sheltering Arms for rehabilitation. She is devastated to say goodbye to Dr. Bevis and Tommy but soon meets girls her age at the Sheltering Arms who quickly become her closest friends. Her roommates—Dorothy, Shirley, Renée, and Alice—all have more difficult polio experiences and harder family lives, which eventually makes Peg appreciate what she still has rather than thinking about what she has lost. Peg meets her new physical therapist, Miss Ballard, who is a welcome change to Mrs. Crab, and whose gentle methods make Peg look forward to therapy sessions instead of dreading them. Peg’s recovery continues, and she is eventually able to use a wheelchair. When her family visits every Sunday, Peg learns to be glad to share her family with her roommates, whom she realizes never get visits from their own families.

Peg’s parents throw her 13th birthday party at the Sheltering Arms. While she and her roommates enjoy it immensely, Peg is struck with homesickness. Peg transitions from hot packs to hot baths and starts occupational therapy. Just before Thanksgiving, Peg succeeds in standing on her own. Dr. Bevis visits to remind Peg of her promise, and because she has made such great progress, she believes for the first time that she might actually be able to keep the promise to walk for him. As Peg’s confidence grows, she becomes even more excited at the prospect of returning home, but when she visits her house in December, the trip is more difficult than she expects. Peg returns to the Sheltering Arms exhausted and frustrated, as the trip merely highlighted how far she still has to go in recovery before she is ready to live at home again.

Despite school being of secondary priority to recovery at the Sheltering Arms, Peg continues to prioritize her education, taking it upon herself to keep up with the assignments at her old school. She is determined to pass the final exams at the end of the year and move on to eighth grade with her classmates. Peg researches Sister Elizabeth Kenny, who invented the “Sister Kenny treatments” that, while painful, have resulted in the recovery of countless polio patients. The information Peg learns causes her to be even more grateful for her experience, for the methods were adopted a mere six years prior to her own diagnosis, and if she had contracted polio earlier, her prognosis would have been much bleaker.

Peg says a bittersweet farewell to her wheelchair and transitions to walking sticks. Despite her excitement at her physical progress, Peg feels unhappy and lonely at Christmas. She convinces Miss Ballard to allow her a trip home to see her family. This visit is easier and much more pleasant. While she’s upset that her room has been remodeled during her absence, the unexpected change is the push she needs to accept the fact that life will forever be different than it was prior to her polio.

By late January, Peg can walk short distances without her sticks, and by February, Miss Ballard tells Peg that she can return home permanently. After being discharged, Peg goes with her mother to University Hospital so Peg can keep her promise to Dr. Bevis and walk for him. Peg returns home and adapts to her life there. The visits from her old friends are strained, which worries Peg, who wonders how her return to school will go. Despite her happiness at being home again, Peg grapples with feelings of homesickness for the Sheltering Arms, and she also misses her roommates. These feelings eventually ease as Peg continues to keep in contact with them by exchanging written letters.

In April, Peg returns to school. The narrative ends with Peg returning to chorus class and reflecting on the last time she was in the room. Though her physical strength is not what it used to be, she feels stronger in other more important ways. The Epilogue concludes the memoir with updates about the lives of the doctors and patients who had a role in Peg’s recovery. While Peg keeps up with the fates of Dr. Bevis, Dorothy, Shirley, Alice, and Renée, she inevitably loses contact with Tommy and never learns his fate. Peg concludes by chronicling the major events of her own life after that difficult year. She eventually marries Carl Kehret and became Peg Kehret, has two children, and enjoys writing books for children. Despite these positive developments, she ends on a bittersweet note by admitting that 40 years after her recovery, she now has post-polio syndrome, which causes a return of polio symptoms among survivors. While she does physical therapy to slow the progression of her symptoms, her physical mobility will continue to be impacted as she gets older.