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Health and Medicinemedicine

Paul Alexander: A Successful Lawyer And One Of The Last Iron Lung Users

"I decided I was going to fight this. I was going to have a life."

James Felton

James Felton

Senior Staff Writer

clockAug 5 2022, 14:30 UTC
A large, yellow iron lung, used to assist breathing using pressure applied to the patient.
The obsolete technology is now only used by only a handful of people. Image credit: R Scott James/shutterstock.com

At the age of six, in the summer of 1952, Paul Alexander began to feel unwell. He was experiencing pain in his neck, headaches, and fever. It was pretty clear what was wrong. 

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"Our mother called for us to come in for dinner, and I remember her taking one look at me – hot and wet and feverish – and she cried out, 'Oh my God!' She ripped my clothes off and threw me onto her and my dad's bed and called the doctor," Alexander recalled years later.

"She knew right away that I had polio. I don't know how she knew, but she knew. I remember feeling hot and feverish, and for the next few days, I stayed in the bed and didn't move. I remember I had this coloring book, and I felt this compulsion to color as much as I could, sort of like maybe I wouldn't be able to do it in the future."

That summer, Texas had seen venues, bars, restaurants, cinemas, and churches shut down due to a polio outbreak. His parents rushed him to the hospital after he began to have trouble holding the crayons he was using, as well as talking – but like so many others, he would be paralyzed by the disease, for which there is still no cure.

In hospital – which itself was feeling the strain of too many polio patients to handle – he and his family were informed that nothing could be done for him, and left him on a gurney, barely able to breathe. A better doctor saw him soon afterward and performed an emergency tracheotomy before draining the fluid that was accumulating in his lungs.

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"The next thing I remember, I was inside an iron lung."


Alexander was placed on an iron lung to help him to breathe, perhaps unaware that he would need the machine's assistance to breathe for most of the rest of his life. Now only used by a few patients, of which Alexander is one, iron lungs work by applying negative pressure on the patient inside. To help the patient inhale, air is pumped out of the machine, helping their chest to expand. As air is pumped back into the machine, this makes the patient exhale.

The disease left him unable to move anything except his head, neck, and mouth, making life and his education much more challenging than before.

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"I decided I was going to fight this," he told Health Day of those first 18 months, spent entirely in hospital. "I was going to have a life."

He became one of the state's first entirely home-schooled children, learning to memorize facts rather than take notes, and use a specialized pen his father had made for him, operating it with his mouth. After completing school with good grades, he decided he was going to pass the bar and become a lawyer.

“When I transferred to the University of Texas, they were horrified to think that I was going to bring my iron lung down, but I did, and I put it in the dorm, and I lived in the dorm with my iron lung,” he later recalled.

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“I had a thousand friends before it was over with, who all wanted to find out what’s that guy downstairs with a head sticking out of a machine doing here.”

He passed the bar in 1984 and became a lawyer. With physical therapy and assistance, he could leave the machine for longer periods of time, allowing him to argue his cases in court. He managed to breathe outside the machine via a technique called glossopharyngeal breathing, which he nicknames "frog-breathing".

Paul – along with maybe less than ten other people – continues to use the iron lung, preferring it to other more modern breathing apparatus which could involve a hole in his throat. As nobody makes the machines anymore, it is becoming more and more difficult to repair and replace parts as they age, but so far he has managed. 

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He is still alive and well 70 years after becoming paralyzed. He has even written a book about his life in an iron lung, with the title Three Minutes for a Dog inspired by a physical therapist that offered a puppy as a reward for him glossopharyngeal breathing for three minutes outside the iron lung. The book was dictated to a friend, as well as painstakingly typed out using a plastic rod over the course of eight years.


Health and Medicinemedicine
  • medicine,

  • viruses,

  • paralysis,

  • humans,

  • polio,

  • disability,

  • iron lung

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