Interview: Larry Becker
Larry Becker’s experience of a feared disease and its aftermath
Larry Becker fell ill with infantile paralysis in summer 1952, when he was 13 years old. Becker spent two and a half years in the hospital undergoing intensive rehabilitation. The March of Dimes paid roughly $20,000 (nearly $155,000 in today’s dollars) toward his rehabilitation, and Becker participated in numerous publicity efforts for the health charity. He grew up to find success in academia. Here, he shares memories of his experience.
In the summer of 1952, I sold ice cream from a pedal cart. At noon on August 22nd I wasn’t feeling well, and my legs gave out as I was pedaling home for lunch. I was sick with flu-like symptoms through the weekend… then I got very ill during Monday evening, developing muscle weakness in both arms and both legs, along with a high fever and a stiff neck. On Tuesday morning I was admitted to the hospital.
About three weeks after I was admitted and diagnosed with polio, I was out of isolation… but still gravely ill, and not able to take even one breath on my own… I was still hoping for a full recovery.
How an Iron Lung Works
The iron lung was a “negative pressure” ventilator. Outward movement of the leather bellows at the foot of the cylinder created a partial vacuum around the patient’s torso inside the “tank.” This would cause the patient’s chest wall and lungs to expand. Because the air pressure in the patient’s lungs would then drop below the ambient air pressure around the patient’s head outside the tank, air would flow into the lungs, given an unobstructed airway. Thus negative pressure inside the tank produced inhalation, and when the bellows reversed and pushed inward into the cylinder, the pressure would change from a partial vacuum back to normal room pressure or a small amount of “positive” pressure, compressing the chest wall and producing exhalation. The respiration rate was adjustable, and mine was usually set at 14 per minute.
An Improved Iron Lung
Emerson ingeniously added a positive pressure dome to its iron lungs in the early Fifties. It made patient care much safer and easier. When the dome was locked in place and the tray was pulled out, air was pumped in and out of the dome by the bellows through a telescoping tube running under the tray. Increased positive pressure under the dome forced air downward into the patient’s lungs; decreased pressure allowed exhalation. Nursing care became much more leisurely, and much less stressful for the patient. The dome essentially reversed the normal action of the iron lung, turning a “negative pressure” respirator into a positive pressure one.
Relearning to Breathe
By the fall of 1952… I could breathe (with great effort) for several hours on my own. My diaphragm was paralyzed, but I had some neck muscles that worked, and I gradually discovered that I could use them to rhythmically lift and lower my shoulders and chest enough to take small breaths. We practiced regularly several times a day, using a stopwatch at first. When I could reliably breathe for one minute I got a new chess set to mark the occasion. Three minutes got me something else, as did five, and 15. Once I got to 30 minutes I reluctantly agreed to spend that time on a hospital bed, and that greatly increased progress because when I lifted my shoulders with my neck muscles, the iron lung didn’t interfere with the effort. But I had no desire to change iron lungs, or to try the dome.
In fact, at the end of one exhausting day, after I was back in the iron lung and getting some rest, I firmly declined to be transferred to the new iron lung given to the hospital by a union local. This was a disappointment to the publicity people, but for me it was driven by fear as much as exhaustion. For one thing, during the first few weeks, I was sure that any change to my machine would be life-threatening. I trusted that machine, and didn’t want to leave it.
Help from Family
A picture was taken sometime in November, and was used on our family Christmas card that year. By that time sister Sharyn (age 8) and brother Mic (age 6) were pretty comfortable around my iron lung — though I am less sure about how comfortable I was with their hands on the locking mechanism. I was feeling a good deal better by then, and was able to spend several hours each day on a hospital bed, breathing on my own. The weight loss was starting to be pretty obvious by this point, but not yet as problematic as it would become by the spring. My mother rarely left my side during the daylight hours, and my father was a daily presence as well — usually early in the morning.
The nurses taught Sharyn how to pump the iron lung by hand in case of a power failure. Although the hospital had emergency generators, Sharyn tells me she was worried about what would happen if the generators failed. She remembers asking a nurse about this and being told “If the power goes out, don’t come running for us. We will already know about it, and we will be running to help you. Your job is to disengage the clutch on the motor, back here. Like this. And then you begin to pump the bellows, like this.” They then rehearsed the procedure.
The Rocking Bed
I was introduced to the rocking bed when I was transferred to the newly opened Respiratory Rehabilitation Center at St. Joseph’s Hospital in Omaha, Nebraska on July 13, 1953 — courtesy of the March of Dimes, which funded the center. It was one of 13 such centers in the United States. I was its third patient, and the plan was for me to stay there as long as I was making substantial progress. The day I arrived in Omaha I was put on a rocking bed to rest from the 160 mile ambulance trip. I liked it a lot. It rested me, and the sense of freedom was compelling…
I was weighed, and given a pulmonary function study. It turned out that my vital capacity was a mere 250 cc and my tidal volume was identical — meaning that each time I breathed on my own, I was taking deepest breath I could take, which was less than 10% of what would be expected for someone my age (14) and height (about 5’6” or so, with the beginnings of a scoliosis). And I weighed 62 pounds — down from about 125 before my illness. Great consternation ensued, and I was put on a routine of 10-hour overnights in the iron lung and 14-hour days out on a rocking bed. The rocking bed was turned off for therapy and various other procedures, but it was turned on for most of the day — and always for meals. That meant that my eating didn’t have to compete with my breathing, and my appetite started to improve.
I was given some foul tasting high calorie supplements each day, which I think I had been getting in Hastings as well, and various kinds of injections. Specialized exercises began to strengthen my breathing. I remember especially several weeks when we were required to blow through a system of glass straws to force a gallon of water from one large bottle into another.
A few months later we were shown a training film about glossopharyngeal breathing (“frog-breathing”) made at Rancho Los Amigos, the rehab center in Los Angeles. I learned how to do it immediately, within hours, and it has become an indispensable supplementary technique.
The polio rehabilitation ethic was relentless, and could be cruel for people who were too sick, or too frightened, or too depressed to cooperate fully. Whining and moping around were not encouraged. Patients and staff were not sympathetic to it. We were all well beyond the initial stages of the disease, and were expected to face forward and get on with recovery.
First Trip Home
Thanksgiving 1954 was my first overnight visit away from the hospital since August 26, 1952. Cumbersome respirators and unaccommodating houses were the problems that delayed this. But on the other hand, there was not much point in getting my hopes up if it was never going to happen for good…
I was fitted out with a portable chest respirator for sleep, since the rocking bed was too cumbersome to transport, and my parents rented a hospital bed (actually, borrowed it, I think, from a mortuary that also ran an ambulance service and a home health supplies store) and set it up downstairs in the dining room of the parsonage.
This trip was a fact-finding mission in preparation for my eventual discharge from the hospital. Finally, my improvement was accelerating. My legs were stronger, my balance was getting better, my vital capacity was improved, and my weight was no longer medically alarming. Managing the respiratory equipment at home was a big problem, since modifying the parsonage was apparently not an option. I was going to have to be able to walk well enough to get up the stairs to my bedroom, and either not need any respiratory assistance at all, or be able to use the chest respirator. The only shower stall in the house was in the basement, off the recreation room. I could take a tub bath upstairs only if someone could lift me in and out of the tub (and in fact it turned out my father could do this, since I still weighed well under 100 pounds). It turned out that I was within striking distance of these goals if I could get strong enough to climb stairs, and not have to rest so much during the days. I went back to the rehab center with a burningly clear agenda for the next few months.
The goal of changing the world so that it accommodated people with various disabilities was still a long way off. Rehabilitation operated on the principle of coping with the world as you found it.
By the time I came home my vital capacity had stabilized in the range of 850 to 1000 cc, depending on body position, tiredness, etc. I could pump up my lungs to triple that number by way of frog breathing. Those two forms of vital capacity have remained the same ever since.
I came home without any respiratory assistance. No rocking bed. No chest respirator. No iron lung. This required a good deal of deception on my part. I knew that my blood gases would be tested during the day, and I hoped they would be good. They were. So I was soon moved to a room without a rocking bed, and convinced myself that I could sleep unassisted. I was discharged without a respirator, but several months later (after I became uncontrollably sleepy during the day and had several episodes of tachycardia), I went back to Omaha for evaluation and was told I would have to use a chest respirator for sleep, indefinitely. (“Indefinitely” turned out to mean the next 40 years. In the summer of 1995, the symptoms of respiratory insufficiency from 1955 returned, and I exchanged the chest respirator for a nasal positive pressure unit called a “BiPap.”)