COCOONED in an iron lung for more than 70 years, Paul Alexander still enjoyed a life well lived.
Known as Polio Paul and paralysed from the neck down, he got engaged, worked as a lawyer, was a published author and travelled widely.
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Yet every few hours he would need to return to the ancient contraption he called his faithful “old iron horse” as he gasped for breath.
On Monday, Texan Paul died aged 78. According to reports, his weakened body succumbed to Covid.
Friend Christopher Ulmer described him as “an incredible role model” who “positively influenced people around the world”.
For the Man in the Iron Lung was testament to the strength of the human spirit.
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As a child encased in the 7ft metal tube he remembers doctors saying “he’s going to die today” and “he shouldn’t be alive.” It would only bolster Paul’s resolve.
His ordeal was something from another age when polio was rife and hospital wards could be full of children breathing through the machines.
The last Briton to use such an outdated device died in 2017. In the US Martha Lillard, 74, from Oklahoma, still uses her “dear friend”. There are likely few others.
It was a humid, rainy July day in 1952 when a six-year-old Paul Alexander came in from playing outside the family home in a Dallas suburb feeling feverish.
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His head pounded and his neck ached. Just five days later he could no longer speak, swallow, cough or hold a pen. He had contracted deadly polio.
He was rushed to hospital, where a dedicated ward for the disease was jammed full with other youngsters. Barely breathing, a paralysed Paul was left on a gurney in a hallway.
A doctor eventually performed an emergency tracheotomy — cutting a hole in the boy’s windpipe — to relieve the congestion in his lungs.
When he woke three days later, his tiny body was encased in an iron machine that made rhythmic wheezing then sighing noises.
A vinyl “steam tent” swathed his head, keeping the air there moist to help him breathe.
When it was finally removed he peered around the ward to see other children similarly encased in iron.
Paul would later remember: “As far as you can see, rows and rows of iron lungs. Full of children.”
Paralysed from the neck down, his diaphragm was unable to help him breathe. His iron lung now did the job.
Air was sucked out of the machine by leather bellows connected to a motor, causing his lungs to expand.
Then air was pumped back in, allowing his lungs to deflate.
It meant leaving the artificial lung was impossible. When nursing staff opened it to wash him, he had to hold his breath.
Yet his tracheotomy meant he was unable to talk and alert staff when he needed the toilet. He would often lie for hours in his own filth.
His parents would visit most days but the boredom was soul-destroying.
Lying flat on his back, his head on a pillow, Paul would try to communicate with the other children through facial expressions.
After 18 months in hospital, his parents hired a truck to bring him and the iron lung home.
The breathing device needed a portable generator to keep it working during the nerve-racking journey.
Dad Gus later remembered: “Any minute it looked like that old generator would go off.
“It kept popping. I didn’t know if we would make it home or not.” Despite being home, Paul still lived permanently in the iron lung. If he tried to breathe without it, he would turn blue and pass out.
I knew if I was going to do anything with my life, it was going to have to be a mental thing, I wasn’t going to be a basketball player.
Paul
Then, aged eight, came a lifeline. He was taught a breathing method where you trap air in your mouth then force it down your throat into the lungs.
Nicknamed “frog-breathing” by Paul, he was promised a puppy if he could do it for three minutes. It took him a year to accomplish.
Years later he would call his autobiography Three Minutes For A Dog.
Gradually, he could spend more time out of the iron lung and was able to venture outside.
In an era when disabled people suffered appalling discrimination, Paul forged ahead with his life.
It took a year for his parents to be able to convince the authorities that he should be home-schooled. “I knew if I was going to do anything with my life, it was going to have to be a mental thing,” Paul once said. “I wasn’t going to be a basketball player.”
Meanwhile a vaccine rollout, beginning in the 1950s, stamped out polio across most of the world.
Strip club
And science also came to the aid of those still trapped in their iron lungs in the same decade.
A new device would push air directly into the lungs either through the mouth — through a tube placed down the throat while sedated — or through a hole made in the windpipe.
It meant the last iron lungs were manufactured in the late Sixties and they soon became obsolete.
After his childhood traumas, Paul couldn’t face having a hole cut in his throat again and his life was manageable with his old iron apparatus, so he kept it.
As he got older, friends would push him in his wheelchair to bars, restaurants and the cinema. He even visited a strip club.
Yet, he was frustrated by his lack of independence. His younger brother Phil remembered: “He let his anger out a lot. He had a mouth.
“I completely understand it. He would yell and scream and curse and get it all out, and my parents would just let it happen — because obviously Paul would need a release, he was normal.”
In 1967, aged 21, Paul graduated from high school with straight As apart from a B in biology (because he was unable to dissect a rat).
Yet he was rejected from Southern Methodist University in Dallas. He said years later: “I was too crippled. Broke my heart. I fought for two years, repeatedly called them.”
Eventually, they relented.
Attending his first lecture, Paul said he was “scared to death”, adding: “You have to understand, back then, there were no cripples.
“There was none on campus, I was the only one. Wherever I went, I was the only one. Restaurant, movie theatre — I thought, ‘Wow, there’s nobody else out here. I’ll just pave the way.’ ”
Then he fell in love. He met Claire, and got engaged.
When Paul called her one day, her mother — who had long been unhappy with the relationship — told him never to speak to her again.
Paul would later say: “It took years to heal from that.”
Moving to the University of Texas at Austin to study law, he lived away from home for the first time.
After his carer failed to show, Paul was looked after for the first month — including “the most intimate things” — by the other students in his dormitory.
Close relationship
In 1980 he made headlines with a Texas newspaper trumpeting: “Iron-willed man leaves iron lung, to vote.”
For decades Paul — in a dapper three-piece suit — represented clients in Dallas courts using a modified wheelchair to keep his paralysed body upright.
You can actually do anything, regardless of where you come from, your background, or the challenges you may face.
Paul
At night he would be back inside the iron lung that kept him alive.
Next to his head, a foot-long plastic stick with a pen allowed him to write, type and push buttons on a phone. Although he never found romantic love again, he forged a close relationship with his carer Kathy Gaines who answered a newspaper advert to become his “arms and legs”.
A Type 1 diabetic who is legally blind, Kathy changed his clothes, shaved him, trimmed his hair and his nails and did his paperwork.
Paul said: “Kathy and I grew together.”
His brother Phil added: “Paul’s pretty demanding. But Kathy is more demanding than he is.
“They’ve had their moments, but they always work it out.”
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Old friend and retired nurse Norman Brown added: “Paul’s been 100 per cent dependant on the kindness of others since he was six years old.
“And he’s done it by virtue of his voice and his demeanour and his ability to communicate.” In later years Paul answered questions from his 330,000 followers on TikTok and racked up millions of views.
Remaining resolute to the end, his 72 years in an iron long was a world record.
“You can actually do anything, regardless of where you come from, your background, or the challenges you may face,” Paul once said. “My story is an example of why your past and even obstacles don’t need to define your future.”
WHAT IS POLIO
POLIO kills when the muscles used for breathing are paralysed leading to suffocation.
Highly infectious, the virus is passed from person to person via food and water containing human faeces.
It became an epidemic affecting mostly children in the early 20th Century.
Babies were largely still protected by antibodies from their mother’s womb. Then when older, if they became infected by the virus, their bodies were unprepared.
There are no symptoms for most cases but it can attack motor neurons in the spinal cord causing paralysis.
Once infected, there is no treatment. But the disease can be prevented with the polio vaccine.
What is an iron lung?
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THE iron lung was invented in 1928 by Philip Drinker and Louis Shaw to help polio sufferers to breathe.
A US medical engineer, Philip had gone to fix a faulty air conditioner at a Boston hospital and was haunted by the “small blue faces, the terrible gasping for air” of children in the polio ward.
The 7ft-long device helps those whose muscles used for breathing have become paralysed.
It encloses all the patient’s body bar their head.
It works by changing the air pressure inside the cylinder to help inhalation and exhalation.
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Air was sucked out of the iron lung by leather bellows powered by a motor, forcing a person’s lungs to expand.
Then when air was pumped back in, they deflate.
Source: Sun
