Paul Alexander, the man who lived in an iron lung for more than 70 years, has died at the age of 78.
A fundraiser for his healthcare confirmed Alexander, of Dallas, Texas, passed away on Monday without providing further details.
Alexander spent an extraordinary lifetime in the iron lung machine after contracting polio in 1952, aged six, which left him paralysed from the neck down.
Unable to breathe by himself, he relied on the machine to breathe for more than seven decades - even as new technologies became available.
But in spite of his physical constraints, Alexander achieved much as a published author, lawyer and avid traveller, remembered worldwide for his enduring positive attitude and smile.
Writing on Alexander's GoFundMe page, Christopher Ulmer, organiser 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.
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'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 paralysed 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.
Polio is an infectious viral disease that affects the central nervous system respiratory function and can cause muscle weakness and paralysis.
It is transmitted through contaminated water and food or contact with an infected person.
It has largely been eradicated around the world after widespread use of the vaccine which came into use in the 1950s.
The disease remains endemic in just four countries today: Nigeria, Pakistan and Afghanistan.
Polio was recently eradicated in India following an extensive campaign over a period of some 20 years, successfully ending the epidemic with sustained oral and injected vaccines.
