Iron lung man Paul Alexander's brother leads tributes to courageous 'flirt and pain in the a**' who 'loved wine, good food and women' who died aged 78 after being admitted to hospital last month

Paul Alexander, the man who lived the majority of his life in an iron lung after being diagnosed with polio at six, was celebrated by his brother as a 'flirt' and as a 'pain in the a**.'

Alexander passed away at the age of 78 on March 11. 

His brother, Philip, led the tributes, writing in a heartbreaking Facebook post that Alexander 'loved wine, good food and women.' 

'It was an honor to be part of someone's life who was as admired as he was. He touched and inspired millions of people and that is no exaggeration,' Philip wrote. 

'To me Paul was just a brother.. same as yours.. loving, giving advice, and scolding when necessary, and also a pain in the a**.. normal brother stuff. He commanded a room.. What a flirt!'

'He loved good food, wine, women, long conversations, and laughing. I will miss him so much,' he concluded. 

Alexander's cousin also wrote a tribute on Facebook calling him her 'true hero.' 

'I know he is loving freedom of not being in an iron lung,' Margaret Moore wrote. 

His life and death have touched many beyond his own family. 

'So sad to hear this. If you don't know who Paul Alexander is, I recommend looking him up. He was an exceptional person who did not let his circumstances of living in an iron lung deter him from achieving things most of us can only aspire to. He will remain an inspiration. RIP,' one fan wrote on X.

'Sad news Paul Alexander was a remarkable man who had much to teach us about personal resilience,' another wrote.

'He and other Iron Lung users are a reminder of the potential life span for medical devices & need to design for longevity. His life & death an illustration of the importance of vaccines,' she added. 

The official Guinness World Records account said it was 'saddened' to learn of the death. 

German journalist Kai Kupferschmidt, who previously interviewed Alexander, called him an 'extraordinary person' who 'lived an extraordinary life by any measure.'

Alexander was one of the millions of childhood victims of a once-epidemic disease that menaced the nation and now left him at the mercy of a mechanical respirator. 

Though unable to move from the neck down, he refused to be limited by his metal prison, finding success in both the classroom and the courtroom. 

He earned his bachelor's and law degrees from the University of Texas at Austin. He specialized in bankruptcy law. 

'Polio was the horror of the day... It was like the Black Plague,' Alexander said in a 2018 interview. It's most famous victim was President Franklin D. Roosevelt. 

Until 1955, when Jonas Salk became a hero by developing the vaccine that would largely eradicate the disease globally, polio reached pandemic levels. 

The worst year was 1952, according to PolioToday.org, with nearly 58,000 reported cases causing 3,100 deaths and leaving more than 21,000 in varying stages of paralysis. 

The disease destroys nerve cells in the spinal cord. It spread silently, explained Steve Cochi, senior adviser at the global immunization division of the Centers for Disease Control and Prevention.

For every one person who contracted paralytic polio, another 200 might display few or no symptoms.  

Writing on Alexander's GoFundMe page, Christopher Ulmer, organizer and disability-rights activist, said on Tuesday: 'Paul Alexander, 'The Man in the Iron Lung', passed away yesterday. 

'After surviving polio as a child, he lived over 70 years inside of an iron lung. In this time Paul went to college, became a lawyer, and a published author. 

'His story traveled wide and far, positively influencing people around the world. 

'Paul was an incredible role model that will continue to be remembered.'

Over an extraordinary life, Alexander's determination saw him achieve a number of remarkable achievements.

At 21, he became the first person to graduate from a high school in Dallas without ever attending class in person.

He was accepted into Southern Methodist University in Dallas, after much difficulty with university administration and then got into law school at the University of Texas, Austin.

He pursued his dreams of becoming a trial lawyer, and represented clients in court in a three-piece suit and a modified wheelchair that held his paralyzed body upright.

He also staged a sit-in for disability rights and published his own memoir, titled 'Three Minutes for a Dog: My Life in an Iron Lung'.

The 155-page memoir was carefully crafted and took five years to complete; Paul wrote each word with a pen attached to a stick in his mouth.

Paul outlived both of his parents, his brother and even his original iron lung, which began leaking air in 2015, but was repaired by a mechanic Brady Richards, which was prompted by a YouTube video of Paul pleading for help. 

The ventilator, a large yellow metal box, requires patients to lie down inside, with the device fastened tightly around their neck.

It works by creating a vacuum to mechanically draw in oxygen to the lungs for patients whose central nervous system and respiratory function were affected by polio.

While in hospital, doctors tried to get Paul to breathe on his own, turning off the machine and forcing him out, but it wouldn't take long for him to turn blue and pass out.

Despite the availability of more modern ventilators, Paul decided to continue using the iron lung machine because he was used to it.

Other devices also require intensive surgery.

Over his lifetime, Alexander never let the device get in the way of what he wanted to achieve, travelling on planes, living independently, praying in church, visiting the ocean, and falling in love.

While at university, Alexander met Claire, who he later became engaged to. He spoke candidly to The Guardian about how her mother forbade him from speaking to her daughter.

'Took years to heal from that,' he told the outlet.

In later life Alexander built a close relationship with Kathy Gaines, who became his caregiver - or 'arms and legs', in his words.

Gaines stepped in to help after Alexander graduated law school, supporting him for more than three decades.

Alexander said the pair 'grew together', Gaines herself legally blind from type-1 diabetes.