Imagine living in a yellow metal cylinder for seventy years. It sounds like a horror movie premise. For Paul Alexander, it was just Tuesday. He was six years old when the world changed. One minute he was playing in the rain in a Dallas suburb; the next, he was struggling to swallow. This was 1952. The peak of the polio epidemic. Within days, he was paralyzed from the neck down. Doctors performed an emergency tracheotomy because he literally couldn't draw breath. When he woke up, he was inside a machine that hissed and puffed. That machine, the iron lung, became his constant companion until his death in March 2024.
Honestly, most people look at the photos of Paul and feel a wave of pity. They see the "man in the can." But if you ever listened to him talk or watched his TikTok videos toward the end, you’d realize he was probably more driven than anyone you know. He didn't just survive. He thrived. He went to law school. He represented clients in court while paralyzed. He wrote a book with a pen attached to a stick held in his mouth.
Why Paul Alexander Refused the Modern Ventilator
You’d think he would have swapped that clunky, antique tank for a modern, sleek portable ventilator decades ago. Most polio survivors did. By the 1960s and 70s, positive-pressure ventilators—the kind that push air into the lungs through a tube in the throat—became the standard. But Paul stuck with his yellow tank. Why?
It came down to comfort and habit. The iron lung works on negative pressure. It creates a vacuum to pull the chest up, mimicking natural breathing. Paul hated the feeling of air being forced into him. He called it intrusive. Also, by the time the tech got "better," Paul had already spent twenty years in the cylinder. He was used to it. The machine was his skin.
There was also a technical hurdle. Because he’d lived in the tank so long, his chest muscles and lungs had adapted to that specific rhythm. Moving to a new system wasn't just a matter of "upgrading" a gadget. It was a massive medical risk. He chose the devil he knew.
The Art of "Frog Breathing"
He wasn't actually trapped 24/7. This is the part that blows people's minds. Paul learned a technique called glossopharyngeal breathing. He nicknamed it "frog breathing."
Basically, he used his tongue and throat muscles to gulp down air and force it into his lungs. It’s exhausting. Imagine trying to stay alive by manually swallowing every single breath. He practiced for a year, coached by a physical therapist who promised him a puppy if he could do it for three minutes. He got the puppy. Eventually, he could stay out of the machine for several hours at a time. This allowed him to attend the University of Texas at Austin and later, Southern Methodist University for his law degree. He’d sit in his wheelchair, gulping air, looking like every other student, except for the fact that he was literally working for every second of oxygen.
The Struggle to Maintain an Antique
By the 2010s, Paul faced a terrifying reality: his life-support system was becoming an endangered species. The companies that made the iron lung had long since stopped manufacturing parts. In 2015, his machine began to fail. The seals were leaking. The motor was groaning.
He put out a plea on YouTube. It went viral. Eventually, a local mechanic named Brady Richards saw the video. Richards ran an environmental testing lab and happened to have a spare iron lung in his shop. He refurbished Paul’s machine, machining custom parts that no longer existed in any catalog. It was a DIY rescue mission for a human life.
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Living a Full Life in a Six-Foot Tube
Paul Alexander was a trial lawyer. Think about that. He had to be wheeled into court in a specialized wheelchair while using his frog-breathing technique to argue cases. He traveled. He went to strip clubs. He fell in love and got engaged. He lived a life that was messy, complicated, and incredibly public.
In his later years, he became a social media sensation. He reached a whole new generation on TikTok (@ironlungpaul). He’d answer questions about how he went to the bathroom (a nurse assisted him) or how he kept his spirits up. He never sounded bitter. He sounded like a guy who had won a very long, very difficult game.
The Medical Context of Polio
- The 1952 Outbreak: This was the worst year in U.S. history, with 58,000 cases.
- The Vaccine: Jonas Salk’s vaccine didn't become widely available until 1955, just three years too late for Paul.
- Post-Polio Syndrome: Many survivors face new muscle weakness decades later, making Paul’s longevity even more scientifically significant.
The Legacy of the Man in the Iron Lung
When Paul passed away at age 78, he was one of the last people in the world still using an iron lung. His death marked the end of an era in public health. He was a living bridge between the terrifying days of "the invisible killer" (polio) and the modern era of eradication.
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He wrote his autobiography, Three Minutes for a Dog: My Life in an Iron Lung, over eight years. Every word was typed with a stick in his mouth. He didn't want to be remembered as a victim. He wanted people to see that the human spirit is way more resilient than a 600-pound metal box.
Lessons We Can Actually Use
We shouldn't just read Paul’s story as a "feel-good" anecdote. It’s a case study in adaptation.
If you’re feeling stuck, look at his "three minutes." He didn't start by trying to breathe for three hours. He started with three minutes. Small, agonizing increments of progress.
Also, his story highlights the importance of community. Without the mechanic who fixed his machine, or the nurses who cared for him for decades, or the friends who pushed his wheelchair through law school, Paul wouldn't have made it to 30, let alone 78.
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Next Steps for Deeper Understanding:
Check out the Post-Polio Health International (PHI) archives. They maintain the most comprehensive records on how the few remaining iron lung users managed their equipment in the 21st century. If you're interested in the mechanical side, look up the March of Dimes historical records on the "Emerson" and "Drinker" respirators. They provide the blueprints for the tech that kept Paul alive when the rest of the world had moved on.