Confined to an iron lung after contracting polio as a child, Paul Alexander managed to train himself to breathe on his own for part of the day, earned a law degree, wrote a book about his life, built a big following on social media and inspired people around the globe with his positive outlook.
Alexander died Monday at the age of 78 at a Dallas hospital, said Daniel Spinks, a longtime friend. He said Alexander had recently been hospitalized after being diagnosed with COVID-19, but he did not know the cause of death.
Alexander contracted polio in 1952, when he was 6. He became paralyzed from the neck down and he began using an iron lung -- a cylinder that encased his body as the air pressure in the chamber forced air into and out of his lungs. He had millions of views on his TikTok account.
"He loved to laugh," Spinks said. "He was just one of the bright stars of this world."
In one of his "Conversations With Paul" posts on TikTok, Alexander tells viewers that "being positive is a way of life for me" as his head rests on a pillow and the iron lung can be heard whirring in the background.
Spinks said Alexander's positivity had a profound effect on those around him. "Being around Paul was an enlightenment in so many ways," Spinks said.
Spinks said that Alexander had learned how to "gulp air down his lungs" in order to be out of the iron lung for part of the day. Using a stick in his mouth, Alexander could type on a computer and use the phone, Spinks said.
"As he got older, he had more difficulties in breathing outside the lung for periods of time so, he really just retired back to the lung," Spinks said.
Gary Cox, who has been friends with Alexander since college, said his friend was always smiling. "He was so friendly," Cox said. "He was always happy."
A book Alexander wrote about his life, "Three Minutes for a Dog: My Life in an Iron Lung," was published in 2020. Cox said that the title comes from a promise Alexander's nurse made him when he was a young boy: He'd get a dog if he could teach himself to breathe on his own for 3 minutes.
"That took a good maybe 2 years, 3 years before he was able to stay out for 3 minutes, and then 5 minutes, and then 10 minutes, and then eventually he got the strength to learn to stay out all day," said Cox. And, indeed, Alexander did get that puppy.
Alexander, who earned a bachelor's degree in economics in 1978 from the University of Texas and a law degree from the school in 1984, was a driven man who had a strong faith in God, said Spinks. They became friends in 2000, when Cox took a job as his driver and helper.
He said he would drive Alexander to the courthouse, and then push him to his court proceedings in his wheelchair. At the time, he said, Alexander could spend about 4 to 6 hours outside of an iron lung, and would be in an iron lung when he was at his office or home.
Spinks only worked for Alexander for about a year, though they remained friends, and Spinks said he was among the friends who helped maintain and repair Alexander's iron lungs.
"There were a couple of close calls when his lung would break and I would rush out there and we would have to do some repairs on it," Spinks said.
Cox said that at one point, he and his brother got an iron lung off eBay and drove to Chicago to pick it up, bringing it back to Dallas and refurbishing it.
"They quit making them," Cox said. "They quit supplying the parts for them. You can't even get a collar for them anymore."
Polio was once one of the nation's most feared diseases, with annual outbreaks causing thousands of cases of paralysis. The disease primarily affects children.
Vaccines became available starting in 1955. According to the CDC, a national vaccination campaign cut the annual number of U.S. cases to less than 100 in the 1960s and fewer than 10 in the 1970s. In 1979, polio was declared eliminated in the U.S., meaning it was no longer routinely spread.
Spinks said that Alexander loved being interviewed and had a passion to show that disabled people had a place in society.
Chris Ulmer, founder of Special Books by Special Kids, a social media platform that gives disabled people a way to share their stories, interviewed Alexander in 2022.
"Paul himself really loved inspiring people and letting them know that they are capable of great things," Ulmer said.
"He just had such a vibrant and joyful energy around him that was contagious," he said.
Cox said that over the years, people around the globe sought Alexander out to hear his inspirational story.
"If he set his mind to it, he could do it," Cox said.