Imagine having your breath taken away. Imagine someone telling you that your lungs can no longer be “serviced,” if something goes wrong with them. Well, tough luck, baby.

The letter from Respironics was short, not-so-sweet, and to the point. The company stated that it, “will no longer be able to procure service parts to support or repair” iron lungs.

Did I say iron lung? Are those things still around? Are there really people still living inside huge, monstrous coffin-like structures?

For people growing up in the 1940s and 50s, the specter of getting polio and being trapped in an iron lung was a nightmarish vision, even worse than nuclear war. But as frightening as the device appeared to be, the iron lung was responsible for saving the lives of tens of thousands of polio victims. The device was used to ventilate victims of respiratory paralysis, a common symptom of polio, who otherwise would have died.

Most Americans, including healthcare workers, believe that the iron lung is something that has been relegated to antiquated black and white photographs of hospital polio wards, and is now a footnote is the archives of medical history. But in the U.S. alone, there are about 40 polio survivors who still depend on iron lungs to stay alive. The modern respirators which replaced the iron lung don’t work as well, and attempts to switch have been largely unsuccessful. The iron lung is truly different from other ventilators, say patients, as it works on a negative pressure system that literally takes over the patient’s breathing. Other ventilators work on a positive pressure system that makes it more difficult for polio patients to fill their lungs and keep enough oxygen streaming through their bodies.

But now this small handful of physically frail individuals may have no choice. Each of these polio survivors received the same letter from Respironics, the company responsible for maintaining and servicing their iron lungs, and are now wondering what to do. The letter goes on to recommend that these patients contact their physician to determine what equipment would be “appropriate replacement.” Dr. Richard Bruno, of the International Post Polio Task Force, believes that Respironics’ decision to pull the plug on iron lung patients is symptomatic of a bigger problem, in that polio survivors have largely been forgotten–including the polio survivors who are now suffering from post-polio syndrome.

So who are the people still living on an iron lung? What are their options? Does the government have an obligation to take over when a private company bows out? While unusual in one way, this story correlates to other healthcare dilemmas that older Americans face.

When I first learned about this story, I was rather intrigued. Despite having worked in healthcare (I’m an escapee at large) I really had no idea that iron lungs were still in use. And the idea that a large corporation, such as Respironics, could no longer afford to maintain 40 machines seemed, well, a bit cruel. I decided that it would make a good story, and so did AARP. My article about the undecided fate of iron lung users appears in the September 2004 issue of the AARP Bulletin.

AARP Iron Lung Article: On Borrowed Time