Olden Life Tony Gould

The Oldie - - CONTENTS - Tony Gould

On 20th April 1959, at the age of twenty, I was ad­mit­ted to the Kowloon Bri­tish Mil­i­tary Hospi­tal in Hong Kong with a fever. Later in the day, I found my­self fight­ing for breath, sur­rounded by fig­ures in masks and gowns, who seemed to be block­ing out my air. They were in­tent on lift­ing me into a yawn­ing box which, in my deliri­ous state, I mis­took for a cof­fin. En­fee­bled though I was, I did all I could to re­sist them. But I soon gave up the strug­gle and sank into obliv­ion.

It was not a cof­fin, of course, but an iron lung. I had never heard of an iron lung and had no idea what was wrong with me. ‘A tem­po­rary form of paral­y­sis’ was all the doc­tor had said. But the iron lung … This was a long cylin­dri­cal tube with port­holes on ei­ther side. My body was en­cased in it with my head stick­ing out at one end. Above my head was a glass shelf, on which a book could be placed face­down so that I might read if there was some­one to turn the pages. There was also a sort of rear-view mir­ror in which I could watch the world go by.

An iron lung is a ‘neg­a­tive-pres­sure ven­ti­la­tor’. It works by al­ter­nately pump­ing air into the cylin­der and suck­ing it out again, caus­ing your chest to rise and fall in sync with it. It doesn’t in­volve a sur­gi­cal in­ter­ven­tion like a tra­cheotomy, as pos­i­tive-pres­sure ven­ti­la­tors gen­er­ally do. But it is an un­com­fort­able – if lifesaving – beast. To en­sure the cylin­der is air­tight, your neck has to be padded with cot­ton wool; and to this day, if any­one puts a hand around my neck, my first im­pulse is to lash out. I won’t wear polo-necked jumpers, or even a tie if I can avoid it.

Once you get used to the rhyth­mic suck­ing and blow­ing of the ma­chine, it can be a com­fort­ing sound – like the ebb and flow of waves on the beach. But it was not al­ways thus. Fred­er­ick B Snite, a wealthy young Amer­i­can who con­tracted po­lio when trav­el­ling in China in 1936, de­scribed his first iron lung as ‘a thresh­ing ma­chine with a cold’. Yet with­out it he wouldn’t have sur­vived. He was lucky that one of the orig­i­nal six­teen res­pi­ra­tors de­vised in 1928 by Philip Drinker, an en­gi­neer work­ing at the Har­vard School of Pub­lic Health, had found its way to China, cour­tesy of the Rock­e­feller Foun­da­tion, and hap­pened to be just min­utes away from where he fell ill. He was de­pen­dent on iron lungs for the rest of his life but man­aged to travel, get mar­ried and fa­ther three daugh­ters, be­com­ing some­thing of a celebrity – sec­ond only to Franklin D Roo­sevelt among po­lio sur­vivors in the US.

The Na­tional Foun­da­tion for In­fan­tile Paral­y­sis (bet­ter known as the March of Dimes), co-founded by FDR and his for­mer le­gal part­ner Basil O’con­nor in the mid-1930s, came into be­ing at the most op­por­tune mo­ment for the de­vel­op­ment of iron lungs. FDR’S name and O’con­nor’s force­ful per­son­al­ity made this the most ef­fec­tive med­i­cal char­ity, cer­tainly of its time and per­haps ever. Faced with a short­age of res­pi­ra­tors and an in­creas­ing num­ber of res­pi­ra­tory cases in the US po­lio epi­demics of the 1930s, doc­tors had the in­vid­i­ous task of hav­ing to de­cide whose need was great­est. But lo­gis­ti­cal prob­lems were meat and drink to O’con­nor: he es­tab­lished res­pi­ra­tor cen­tres all across the States and for the next twenty years – un­til first the Salk and then the Sabin vac­cines made them re­dun­dant – saved many lives as a re­sult.

In this coun­try, where res­pi­ra­tory po­lio cases also mounted dur­ing epi­demics be­fore and af­ter the Sec­ond World War, the main bene­fac­tor was the mo­tor man­u­fac­turer Lord Nuffield, who used his Mor­ris Cow­ley works in Ox­ford to pro­duce iron lungs which he dis­trib­uted to hospi­tals in Bri­tain and through­out the em­pire – in­clud­ing the one I oc­cu­pied in Hong Kong. Res­pi­ra­tory tech­nol­ogy has now moved on and po­lio epi­demics are a thing of the past. As a re­sult iron lungs are, for the most part, mu­seum pieces.

By no means all po­lio cases re­quired iron lungs; and iron lungs were also used for other res­pi­ra­tory ail­ments. But in peo­ple’s minds the two are in­ex­tri­ca­bly con­nected. A ward with rows and rows of iron lungs is one of the en­dur­ing im­ages of po­lio – which, along with pic­tures of chil­dren with their legs en­cased in calipers, the March of Dimes did not hes­i­tate to use for fund-rais­ing pur­poses.

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