‘Iron lung man’ was a real Texas superhero
His mother knew immediately that something was wrong when he came in after playing on a hot and rainy Texas day. She sent 6-year-old Paul Alexander to bed and began pampering him, giving him his favorite coloring books, the ones featuring cowboys. She prayed the sickness spreading across Dallas would spare her child. Sensing something was amiss, the boy colored page after page like he was running out of time.
Indeed, the boy’s temperature spiked. His back and neck stiffened as the virus attacked his nervous system, but doctors advised his parents to keep him home away from a hospital filled with other sick kids. When the little boy had trouble breathing, though, they rushed him to the hospital where he received an emergency tracheotomy and woke up in an iron lung.
“I figured I’d gone to hell,” Alexander told the Dallas Morning News more than six decades later, all but his head still inside a giant metal tube that artificially compressed and inflated his lungs. Just a few years after he contracted the virus in 1952, the U.S. mounted a massive polio vaccine campaign. By the time of Alexander’s death on Monday last week at 78, he was among the last polio survivors to use an iron lung. The world lost not only a man who overcame tremendous odds but a leading advocate for vaccines during a time when they are under attack.
That he lived so long was unlikely. Doctors told his parents they expected he’d die soon after being transferred home in a special truck with a generator to keep the iron lung going. Instead, Alexander began setting goals for himself. Promised a puppy by his nurse if he learned to breathe on his own, he taught himself to gulp air like a fish using his tongue and throat muscles. It worked and he got the puppy. After a couple of years, he could sustain the effort for a few minutes, eventually building up to hours, allowing him to finish high school second in his class — first if he’d been able to complete the science labs — and then law school at the University of Texas. He wrote by holding a pen in his mouth, and for more than 30 years practiced bankruptcy and family law.
The iron lung, he told the Dallas Morning News in 2018, “is home to me now, it’s my friend and it’s my enemy.” Pausing as the machine filled his lungs back up, he continued, “It keeps me alive.” The machine had no computer or touch screen, only on and off switches, and a hand crank to adjust the respiration rate.
The anachronistic effect of Alexander’s presence was particularly jarring when he posted videos on TikTok as “ironlungman,” talking about his life and taking questions. He’d given numerous interviews over his life and written a memoir, but social media gave him an intimate connection to more than 330,000 followers. Some viewers, for example, reacted with joy to the stickers that decorated his iron lung. Near where his head emerged from the contraption hung a cross with the words “for God so loved the world.”
Alexander was straightforward about the suffering and loneliness he endured, and he urged parents to get their children vaccinated.
“I want to talk to the world about polio and the millions of children not protected against polio,” he said on TikTok. “They have to be before there’s another epidemic.”
He was right to be vigilant. The virus virtually disappeared in the U.S. after 1979 and has nearly been eradicated worldwide, with remaining cases typically occurring in remote and impoverished areas. Yet, in 2022, polio began to show signs of reemerging in the U.S. when the virus was detected in wastewater samples from Rockland County, N.Y.
What could explain the reemergence of a disease so horrifying it could leave young kids unable to even breathe on their own?
“This is happening because of an aggressive antivaccine campaign in the U.S,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and codirector of the Center for Vaccine Development at Texas Children’s Hospital, told the editorial board by email. “If it was up to the Texas antivaccine lobby, polio could one day return, so we must double down and work hard to debunk antivaccine propaganda and rhetoric.”
During the COVID pandemic, both vaccine hesitancy and outright anti-vaccine beliefs among some groups increased. In 2023, the Texas Legislature passed laws prohibiting local governments and private companies from mandating COVID vaccines, but changes to public school requirements did not pass. To be clear, the COVID vaccine was never on the required list for students. On top of that, Texas law allows parents to seek exemptions from the standard ones — polio, diphtheria, tetanus, pertussis and others. The percentage of families taking that exception has been ticking up. Ahead of the 2024 primary election, John Perez, a Spring Branch ISD board member who ran for the Texas House and was backed by Attorney General Ken Paxton, told us he’s against mandates for any kind of vaccine. Perez lost, but his relatively strong showing at the polls should serve as a warning.
With the death of Paul Alexander, we lost one of the best messengers on vaccines. On archived social media, only his bald head is visible, popping out of the velvety collared opening of the iron lung. He looks at the camera from an upside-down position because he’s laying on his back.
The disorientation has the effect of opening us to the simplest of truths: Every breath is precious. Every individual should have a chance to live to their fullest potential. And no more children should go through what he did as a 6-year-old, desperately coloring in cowboys as if he knows it’s his last chance.
The late Dallas attorney was a leading advocate for polio vaccines