In 1952 Texan Paul Alexander was unlucky enough to fall victim to an appalling epidemic that raged across the U.S. Poliomyelitis, otherwise known as polio, swept across the country and left a trail of devastation in its wake. And Alexander – aged just six at the time – contracted the disease that summer and has suffered a lifelong disability as a result. Sadly, his impairment has meant a life 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.
Recent generations are lucky to have escaped many of the medical horrors that were once all too commonplace in human history. Yes, 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.
Also known as infantile paralysis, polio only affects humans and is especially cruel in that it largely attacks very young children. And the disease has been a scourge of the human race for millennia; 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. Underwood described the disease as “a debility of the lower extremities.”
In some rare cases, poliomyelitis can also affect the head, neck and diaphragm. Thankfully, though, the vast majority of people who contract polio escape its worst effects. But unnervingly, some 70 percent of those who contract the disease actually experience no symptoms at all, and this makes them unwitting carriers of the virus for an infection time of six weeks. However, only as few as one percent of those infected will experience a weakening of the muscles, resulting in paralysis.
Paralysis is caused by the disease 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 – while this figure rockets to 30 percent in affected adults. More happily, however, the majority of people who contract polio will either have 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. You see, sufferers of the disease face a life of painful physical disruption – polio can cause a weakening of the muscles, which in turn can result in paralytic poliomyelitis. And while in children only one in every 1,000 will develop paralysis, it is a terrible affliction for those who do.
But how exactly is the disease spread? Well, the poliovirus is largely passed on when the feces of those infected gets into the water supply or communal bathing areas. Indeed, 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. There is, then, potential for widespread devastation.
Yet even after extensive medical research, there is still no cure for polio. Treatments are available to diminish the terrible effects of the disease, though. Antibiotics, for example, can prevent infections resulting from the weakening of muscles, and modern drugs can lessen pain. Controlled diet and exercise, meanwhile, can be helpful in ameliorating the worst effects of the condition. And 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 in 1948 by Hilary Koprowski, a Polish virologist working in America. Koprowski’s remedy 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 then built on Koprowski’s work in the following decade. At his lab in Pittsburgh University in 1952, Salk created a polio vaccine that could be administered by injection. And 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 then moved very fast after Salk’s big breakthrough. By mid-1957, some 100 million doses of the vaccine had been sent out to medical centers all over the U.S. Meanwhile, the fourth ever International Polio Conference – held in Geneva that same year – reported “remarkably rare” instances of adverse reactions from the medicine. And this success was repeated around the world too. In fact, severe polio epidemics now occurred only where Salk’s vaccine was not yet available.
Come the 1960s, mass vaccination had reduced the number of polio cases in the U.S. to fewer than 100 per year. Then in 1979, the disease was declared to be entirely eliminated in America. And a similar story played out in most countries around the planet. Indeed, 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. The young Texan contracted the disease in 1952 – a year that saw the worst polio epidemic that the U.S. has ever suffered. In fact, there were some 52,000 cases of the disease reported across the States. On top of that, 21,269 people were struck by mild to severe paralysis. And unfortunately for Alexander, he found himself in the severe paralysis category.
Alexander has battled the disease ever since, but he still remembers that fateful summer day in 1952. Speaking to HealthDay in 2014, Alexander recalled, “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 just 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 then blacked out. And when the young Texan came to weeks later, he was in an iron lung – a machine that helps those with paralysis of the lungs to breathe. A user of the iron lung lies on their back in its air-tight drum with their body enclosed and their head poking out. Pumps then vary air pressure within the cylinder, forcing the occupant to breathe. For polio victims with milder symptoms, the device was used for only a couple of weeks or so until recovery. But for Alexander, the iron lung was an unwieldy piece of apparatus that he would have to depend on for the rest of his life.
Today, only a handful of people in the U.S. need to use an iron lung to stay alive. Alexander is one of this number, and he has been dependent on the now archaic piece of machinery for more than 60 years. But the Texan 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. And subsequently, Alexander became an attorney and set up his own practice.
To achieve all of that educational and professional success, Alexander effectively had to first re-learn how to breathe in order to temporarily leave the confines of the iron lung. As 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 – though, not his own. The iron lung is now virtually a museum piece, after all, and sourcing spare parts and organizing maintenance are a real problem.
Thankfully, however, the internet would help Alexander find the assistance that he needed. You see, in 2015 a friend posted a video of Alexander and his machine to YouTube, and luckily a good Samaritan called Brady Richards came across the film. Richards runs an equipment testing facility, and in his spare time he repairs and reconditions racing cars, hot rods and – bizarrely – iron lungs. Richards has become Alexander’s savior, and Alexander said, “It’s a miracle that I found him.” Happily, then, the Texan can fight on against polio. But just how has Alexander found the strength to endure for the past 60 years and more? “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.”