When he was six, Paul Alexander contracted polio and was paralysed for life. Today he is 74, and one of the last people in the world still using an iron lung. But after surviving one deadly outbreak, he did not expect to find himself threatened by another

Instead of being imprisoned by the medical device that keeps him alive, the man in the iron lung has used it as a springboard to thrive. He graduated with honors from high school, then received a scholarship to Southern Methodist University after first being rejected by the school. He attended classes in a wheelchair for the brief moments when he could escape the iron lung, reports Linda Rodriguez McRobbie of the Guardian in a 2020 article.


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The polio plague sickened tens of thousands of people and killed thousands each year during the mid-20th-century. At the peak of the scourge, iron lungs were an absolute necessity for those who suffered paralysis of the diaphragm. The medical device allowed them to breathe by creating negative pressure through a vacuum, which forced the lungs to expand.

Paul Richard "Polio Paul" Alexander (born January 10, 1946) is an American lawyer and paralytic polio survivor. He is the last person living in an iron lung after he contracted polio in 1952 at the age of six.[1][2][3][4]

During a major U.S. outbreak of polio in the early 1950s, hundreds of children around Dallas, Texas, including Alexander, were taken to Parkland Hospital. There, children were treated in a ward of iron lungs. He almost died in the hospital before a doctor noticed he was not breathing and rushed him into an iron lung.[8]Beginning in 1954, with help from the March of Dimes and a physical therapist named Mrs. Sullivan, Alexander taught himself glossopharyngeal breathing which allowed him to leave the iron lung for gradually increasing periods of time.[9]Alexander was one of Dallas Independent School District's first homeschooled students. He learned to memorize instead of taking notes. At 21, he graduated second in his class from W.W. Samuell High in 1967, becoming the first person to graduate from a Dallas high school without physically attending a class.[1]

After working at it for a year, the puppy was his. Breathing on his own meant he could spend hours outside the iron lung. He adapted in other ways as well. His father fashioned a stick that he could put in his mouth to play with his toys. (Today, he uses a similar instrument to dial the phone and type on a keyboard.) He learned how to paint and write with a paintbrush or pencil in his mouth, too.

Paul Alexander was a normal, vibrant and active child until he was paralyzed by polio in Dallas, Texas at 6 years of age. Five days after contracting the disease he was unable to voluntarily move, or even breath, he has miraculously survived, established a law practice and is living a full life. He has lived with critical assistance of an iron lung for over 67 years.

After I got back to the office and was writing the story, I kept thinking about what it would have been like to have lived in the confinement of an iron lung for such a long time. I wondered if VUMC still had an operating iron lung that I could see.

I phoned Respiratory Therapy and the person who answered put me in touch with a young guy who was a respiratory therapist who said that, as a matter of fact, there still was a functioning iron lung at VUMC. It was in a storage room in Medical Center North. He agreed to meet me there.

"A lot of people who had polio and they're dead. What did they do with the iron lung? I've found them in barns. I found them in garages. I've found them in junk shops. Not much, but enough to scrounge [for] parts," Alexander said.

"It was years and years and years before I developed another way of breathing. It's a task that requires a lot of energy. But I was challenged to do it, I did it, and it took me a year to get it up to three minutes," he said.

You can eat in the iron lung because your head is outside but the rest of your body is inside, although since you are flat on your back you really need to be careful when you swallow; you have to swallow in rhythm with the machine because it's pulling your diaphragm in and then pushing it out again. You just wait until it's breathing out and then you swallow. Coughing was a bit more difficult because you don't cough in rhythm with the iron lung. It was something you had to work round. But that was just sort of a down side. You cannot turn over or anything. The iron lung had port holes on the side which came in useful for physiotherapy. They had a rubber seal so you could open them on the down breath and put a hand in, to do physiotherapy or anything inside.

With the iron lung at home it was really accepting that I only slept in it at nights. Once I got the idea that the iron lung was just something that happened at night then I went back to work in about November. Fortunately I could drive. I think my confidence might have been a little bit different if I hadn't been able to drive, because obviously it meant that I was able to get about more. I just went back to work and sleeping in the iron lung at night.

My mother then went into a home, and I used to go and see her every day. I don't mind my own company; I have hobbies and things that I do so it doesn't really worry me. And fortunately with my Nippy breathing machine I am independent. When I had the iron lung I used to think that I would eventually be somewhere where I would have to be looked after.

The Royal Berkshire Hospital is now so big and quite daunting. But the Museum is in a convenient corner and very accessible. It's fascinating to see all the medical equipment, although it seems a bit strange to see something you slept in. I am fairly sure I have slept in that actual machine. Early on I once had a week in the Royal Berks sleeping in the iron lung while my parents were on a holiday. It was very good of the hospital and Dr Price was a very kind man. It is not exactly the best place to have a holiday, in intensive care, but it meant my parents could go away. I used to go home for a little while in the day and come back into the iron lung at night.

In 1959, 1,200 Americans relied on an iron lung to stay alive, but the machines gradually became less common after widespread distribution of the polio vaccine. In 1979, the US was declared polio-free, and by 2014, there were only 10 Americans left using an iron lung.

The iron lung is an airtight capsule that sucks oxygen through negative pressure, allowing the lungs to expand and the patient to breathe, Medscape reports. The contraption is large and cumbersome and requires the person using it to lay fastened inside during operation.

The number of people in iron lungs continues to decrease around the world. In 2018, Missouri woman Mona Randolph was profiled by The Post about her years spent relying on the machine. She died the following year at the age of 82.

The solution came from a team at Harvard University. The 'iron lung', as it was nicknamed, was a huge metal box attached to bellows in which the patient was encased. The continuous suction from the bellows kept the patient breathing.

Philip Drinker and Louis Agassiz Shaw invented the first iron lung at Harvard School of Public Health. It consisted of a huge metal box with a set of bellows attached at one end to pump air in and out. The whole body was enclosed in an airtight chamber, apart from the head. A tight rubber seal supported the neck and ensured that air did not escape.

Before the large scale manufacture of iron lungs, local hospitals had to improvise their own methods to help patients breathe when their lungs failed. This custom-built iron lung at Lansdowne Hospital in Cardiff, Wales was made by hospital engineers in the 1940s.

Therapists used several techniques to help patients regain strength in their chest muscles. By slowly extending the time outside the cabinet the patient could gradually build up the muscles to the point where they could spend most of the day outside the iron lung, returning to it at night to give tired bodies time to rest.

Once an effective polio vaccine was developed in the 1950s, the incidents of polio infection fell dramatically and only a very few machines were needed in hospitals. But for patients dependent on them to breathe, the old iron lungs were gradually replaced with modern ventilators.

John Haven Emerson, of the Emerson iron lung, developed the first mechanical assistor for anaesthesia in 1949. It's still the job of the anaesthetist to operate the ventilator and monitor patient breathing.

Three Minutes For A Dog is the story of Paul's life with Polio and his personal struggle and victory over polio. It is his personal story from childhood to adulthood of his life in an iron lung, as only he can tell it. His voice is unique!

Victims of Polio, their families, friends and communities are struggling to cope with this obscure but still dangerous infectious disease. This book is a testimony to the strength of the human spirit and an affirmation of the need to continue efforts to eradicate the pestilence of Polio from the planet. ( -three-minutes-for-a-dog)

The life of Paul Alexander could easily be viewed as one of tragedy: A man who cannot breathe on his own, paralyzed from the neck down for seven decades due to polio. However, Paul Alexander never let his polio or his iron lung stand in the way of him living his life.

But that only made him want to live all the more. So from the confines of his iron lung, Paul Alexander did what very few people are able to do. He taught himself to breathe a different way. Then, he not only survived, but thrived inside his steel ventilator for the next 70 years.

Alexander made friends once he was out of the hospital and able to leave the iron lung for periods, and on some afternoons they pushed him around the neighborhood in his wheelchair. However, during the day those friends were all busy doing the one thing that he desperately wanted to do: go to school. e24fc04721

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