Texan Paul Alexander, 70, was unlucky enough to fall victim to an appalling epidemic that raged across the U.S. in 1952 – poliomyelitis, otherwise known as polio. And Alexander, aged six at the time, was one of the small minority of those unfortunates who were affected by the poliovirus and then had to suffer lifelong disability as a result. Sadly his impairment has meant a life sentence trapped horizontally inside a now archaic piece of medical apparatus called an iron lung. But, as we shall see, Alexander did not just lie down and accept his prognosis.
New generations are lucky to have escaped many of the medical horrors that were all too commonplace in human history. Before medical science had accrued its current wealth of knowledge, there were many illnesses that doomed humankind to terrible consequences, from severe, lifelong impediments through to death. And one of the most feared of these merciless diseases was polio, which also had another name – infantile paralysis.
Poliomyelitis only affects humans and is especially cruel in that it largely attacks very young children. Polio has been a scourge of the human race for millennia, and even Ancient Egyptian art portrays its crippling effects. However, the ailment was not clinically defined until the 18th century, when British doctor Michael Underwood wrote a paper on childhood diseases. He described it as “a debility of the lower extremities.”
However, in rare cases poliomyelitis can also affect the head, neck and diaphragm. But, in fact, the vast majority of people who contract polio escape its worst effects. Unnervingly, some 70 percent of those who contract the disease actually experience no symptoms at all. This, alas, makes them unwitting carriers of the virus for an infection time of six weeks. Nevertheless, only as few as one percent of those infected will experience a weakening of the muscles, resulting in paralysis.
This is when the poliovirus attacks the pathways of the central nervous system along the spine and in the brain stem. The virus reproduces itself in motor neurons, laying waste to them in the process. And, tragically, of those children who succumb to polio, some two to five percent will die. Moreover, this figure rockets to 30 percent in affected adults. But, in truth, the majority of people who contract polio will have either no symptoms, or an illness from which they will recover.
This is, of course, little comfort for those unlucky enough to suffer the worst effects of the polio virus. They face a life of painful physical disruption. The weakening of the muscles can result in paralytic poliomyelitis, as the virus travels along the nerve super highways destroying motor neurons. In children like the six-year-old Paul Alexander, only one in every 1,000 will develop paralysis, but for those that do it is a terrible affliction.
The polio virus is largely passed on by the feces of those infected, when the waste matter gets into the water supply or communal bathing areas. Drinking contaminated water is the most common method of infection, although spreading the disease via saliva is also possible. And, as we have seen, those people who are infected but not affected – known as asymptomatic – can spread the virus for up to a month and a half, potentially wreaking devastation.
Even now, there is no cure for polio although treatments are available to diminish the terrible effects of the disease. Antibiotics can prevent infections resulting from the weakening of muscles, modern drugs can lessen pain, and controlled diet and exercise can be helpful in ameliorating the worst effects of the condition. In some cases, surgery may help to improve performance in deformed muscle groups.
Nonetheless, by far and away the most effective medical intervention is prevention achieved through mass vaccination. The first vaccine to combat poliomyelitis was developed by Hilary Koprowski, a Polish virologist working in America, in 1948. His vaccine was taken orally and used a weakened form of the polio virus to develop immunity in the patient’s body.
U.S. scientist Jonas Salk built on Koprowski’s work the following decade. At his lab in Pittsburgh University in 1952, Salk created a polio vaccine that could be administered by injection. After exhaustive testing on about one million subjects – including his own wife and three sons – Salk’s vaccine was proclaimed to be safe in 1955.
Things moved fast after this breakthrough, and by 1957, some 100 million doses of the vaccine had been sent out to medical centers all over the U.S. The fourth ever International Polio Conference held in Geneva that same year reported “remarkably rare” instances of adverse reactions from the medicine. This success was repeated around the world and severe polio epidemics now occurred only where Salk’s vaccine was not yet available.
By the 1960s, mass vaccination had reduced the number of polio cases in the U.S. to fewer than 100 per year, and, by 1979, the disease was declared to be eliminated entirely in America. Once again, a similar story played out in most countries around the planet. In 2016, the World Heath Organization put the global number of reported polio cases at a mere 37.
But this medical success story sadly came too late for the six-year-old Paul Alexander in 1952. In fact, that year saw the worst polio epidemic that the U.S. ever suffered. There were some 52,000 cases reported across the States, with 3,145 fatalities. On top of that, 21,269 people were struck by mild to severe paralysis. Unfortunately, young Alexander found himself in the severe paralysis category.
In a 2014 interview with a reporter from the HealthDay website, Alexander recalled a fateful summer day in his hometown in 1952. He said, “I remember it was really hot and raining, something that is sort of rare for Dallas in August, and my brother and I had been outside playing, running around and getting wet when the rain started.”
Alexander continued, “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. 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.”
Heartbreakingly, within six days, Alexander no longer had the ability to move at all. The boy was also in considerable pain and was struggling to breathe. He told HealthDay, “I had become immobile; I don’t think I could even talk, so the hospital staff put me on a gurney in a long hallway with all the other hopeless polio kids. Most of them were dead.”
Alexander remembered that he blacked out, and when the boy came to after weeks had passed, he was in an iron lung. This is a machine that helps those with paralysis of the lungs to breathe by making the lungs fill and then exhale by applying pressure. The patient would lie on their back in its air-tight drum with their body enclosed and their head poking out. Pumps would then vary air pressure within the cylinder, forcing the occupant to breathe. For many more fortunate polio victims with milder symptoms, the device was used for only a couple of weeks or so until recovery. For Alexander, however, the iron lung was an unwieldy piece of apparatus he would have to depend on for the rest of his life.
Today, only Alexander and less than a handful of others in the U.S. need to use an iron lung to stay alive. That means that Alexander has been dependent on this now archaic piece of machinery for more than 60 years. But he has not allowed that fact to put a stop to his life. Helped by scholarships, Alexander graduated from the Southern Methodist University in Dallas, and then gained a law degree from the University of Texas in Austin. Subsequently, Alexander became an attorney and set up his own practice.
To achieve all of that educational and professional success, Alexander effectively had to re-learn how to breathe first in order to temporarily leave the confines of the iron lung. He explained to HealthDay, “I have to consciously push air into my lungs, something that’s done involuntarily by just about everyone else. It’s hard work, but it allows me to escape this infernal device, if only for a little while.” But as Alexander grew older, he became ever more dependent on the machine. Moreover, his biggest problem now is age; and it is not just the fact that he is advancing in years. The iron lung is now virtually a museum piece – and sourcing spare parts and organizing maintenance are a real problem.
In 2015, a friend posted a video of Alexander in his antiquated life support machine to YouTube. In the clip, the attorney explained the difficulties he was having in keeping his machine going. Luckily, a good Samaritan called Brady Richards came across the uploaded film. Richards runs an equipment testing facility to see how various products stand up to environmental factors. In his spare time, he repairs and reconditions racing cars, hot rods and – bizarrely – iron lungs. Richards has become Alexander’s savior, and the latter said, “It’s a miracle that I found him.” And asked how he has coped in the last 60 years and more, Alexander answered succinctly and with optimism. “It all starts with love,” he told HealthDay. “My parents raised me in love. They taught me never to give up… And you know what? They were right. Anything is possible.”