Paul Alexander, the man in the iron lung, dies at 78: What is polio and how is it prevented?

Polio once afflicted children across the globe, tens of thousands in the United States alone. The worst outbreak in the US occurred in 1952 when it struck Paul Alexander, just six years old at the time. He nearly died then but an emergency operation saved his life but left him paralyzed and unable to breathe for himself and confined to an iron lung.

Two years later, a persistent therapist from the March of Dimes, Mrs Sullivan, made a deal with Paul, if he could learn a technique to breathe for himself, she would give him a puppy that he had wanted. It took him a year, but he managed to “frog-breathe,” as he called it, without the iron lung for three minutes. That episode became the title of his memoir ‘Three Minutes for a Dog’ that he published in 2020.

Paul Alexander, “the man in the iron lung,” dies at 78

Paul would go on to be able to spend hours at a time outside of the seven-foot-long metal cylinder. That allowed him to graduate high school and college, receive a law degree, pass the bar, and opened up a successful practice in Dallas and Fort Worth. He represented clients for three decades before the illness once again confined him to the iron lung full-time.

“It’s a different kind of life that you’re totally restricted,” he told The Dallas Morning News. “Many people would go crazy in it. And I watched them do it in the hospital.”

“But you adapt and you learn to do what you need to do to accomplish your goals and your dreams, with the help of the iron lung,” Alexander added, “The iron lung is home to me now. It’s my friend and my enemy. In the end it keeps me alive.”

“Over the course of his life, he has been on planes and to strip clubs, seen the ocean, prayed in church, fallen in love, lived alone and staged a sit-in for disability rights,” reported the Guardian in a 2020 article about Paul’s life. In 2023, Guinness World Records recognized him as the longest-surviving iron lung patient. On 11 March, Paul Alexander passed away at age 78.

“It was an honor to be part of someone’s life who was as admired as he was. He touched and inspired millions of people and that is no exaggeration,” wrote in a post his brother Philip Alexander. “Paul was an incredible role model that will continue to be remembered,” wrote Christopher Ulmer who organized a GoFundMe page for Alexander after interviewing him in 2022.

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What is polio and how is it prevented?

Polio was once a scourge across the globe and one of the most feared diseases attacking its victims’ muscles, possibly causing paralysis and even death among those who got infected. Polio, or poliomyelitis, mainly affects children under 5 years of age with one in 200 infections leading to paralysis.

While the rate of infection is lower among those who older, the rate of paralysis is higher for those who contract the disease. Between 5% and 10% of those who are paralyzed by Polio die when their breathing muscles become immobilized according to the World Health Organization. The virus, before vaccines were available, caused over 15,000 cases of paralysis a year in the US.

Through a widespread vaccination effort beginning in 1955, wild polio has been eliminated from the US since 1979 and now much of the globe is considered polio free. The virus is still endemic in Afghanistan and Pakistan, the only two countries where wild polio is still endemic, but health officials are on the lookout to make sure there is not a resurgence as happened in Nigeria in 2016.

Even though polio has been eradicated from the US, it has been been brought into the country by travelers and a case was detected two years ago in New York. Until it is completely wiped out globally, like smallpox was in 1980, vaccination is the best way to keep it from gaining a foothold again.