History in Hiding

In the summer of 2013, Boston Children's Hospital regained a vital piece of its history, the Iron Lung, after a decades-long search. Invented at Boston Children's in 1928, iron lungs were used to care for polio patients of all ages whose symptoms made it difficult or impossible for them to breathe independently. But in the 1980s, iron were replaced with newer technology and Boston Children's, to make room for other medical devices discarded its supply. Then, in 2013, five intact iron lungs were found in one of the least likely places: an abandoned mental hospital...

A peak inside the iron lung

The hallway is damp and almost completely dark; the only light source is an open doorway leading outside. Broken pieces of machinery under a thick sheet of dust and graffiti line the passageway - the handiwork of teenagers who hunt ghosts in the abandoned facility. Walking inside, it's easy to imagine you've stepped onto the set of a horror movie. It's definitely the last place you would expect to find critical artifacts from Boston Children's Hospital's history: five old iron lungs.

Philip Drinker, the inventor of the iron lungDeveloped in 1928 by Harvard School of Public Health researcher Philip Drinker, PhD, the iron lung treated thousands of polio sufferers for the worst of the disease's ravishes: respiratory paralysis. Well into the 1980s, iron lungs were used to treat polio survivors as well as patients with other neuromuscular diseases like muscular dystrophy. However, innovation never stops moving forward at Boston Children's, and as newer tools for managing respiratory paralysis became feasible, the hospital's iron lungs were discarded.

"At the time, we had no space to store them," Mark Rockoff, MD, vice-chair of the Department of Anesthesiology, Perioperative and Pain Medicine and chair of Boston Children's Archives Committee admits. "We were glad to get rid of them." It's a decision Rockoff and members of the Archive Committee have spent the past four years trying to undo, following up on potential leads across auction houses, eBay and classified ads.

"Dr. Rockoff really put the bug in people's ears to look around," says Alina Morris, MLIS, hospital archivist. Ultimately, new technology helped track down old technology this spring when Morris found a photograph online of five iron lungs in an abandoned state hospital in Lakeville, Mass. "I couldn't believe an image search led us to one, let alone five," Morris says. "We don't want people to forget how important these machines were."

Today - nearly 60 years after the polio vaccine was first developed - it's difficult to remember or imagine the widespread fear the disease sparked, and respiratory paralysis was among the most dreaded of its outcomes. Because it could cause weakness or paralysis in a patient's chest muscles, polio sometimes left patients unable to breathe adequately under their own power. Drinker was inspired to create the first iron lung by his firsthand experience seeing children with polio-induced respiratory paralysis struggling to breathe.

A young Boston Children's patient inside on the first commercial iron lungs

Along with fellow Harvard researcher Louis Agassiz Shaw, Drinker tested a breathing device using little more than an enclosed box and vacuum motors to rhythmically increase and decrease pressure. A much larger metallic version of the machine, capable of forcing the body to inhale and exhale, was a literal breath of welcome relief for many polio sufferers.

Before Drinker and Shaw's breakthrough, there weren't any long-term treatment options for polio patients with this complication. "There wasn't much that could be done besides make patients comfortable," Rockoff says.

That was the likely course of action for one polio victim being treated at Boston Children's the year Drinker and Shaw created their machine. The patient, an 8-year-old girl, was in the grips of respiratory paralysis and near death when she became the first patient to be placed in an iron lung. Within seconds, her breathing was regulated - an improvement so dramatic and so rapid, it earned Drinker and his machine overnight celebrity.

In a short time, the iron lung was in great demand in Boston and across the country. In 1931, inventor John Emerson developed a cheaper and improved version of the machine - one that included a bed and portal windows allowing nurses to care for a patient's limbs and body while the patient was in the device. Soon thereafter, to help meet growing demand, Drinker designed a room-sized respirator capable of housing several patients at once for Boston Children's.

The most commonly produced iron lung, Emerson's model, looks like a tube with a large opening at one end through which a patient could be slid into the chamber. There are several smaller openings along the sides of the body, which is mounted on a rolling cart. At the other end, a motor is affixed under the tube and sucks air in and out to change the pressure inside the airtight chamber.

An iron lung being lifted out of the abandoned state mental hospital in Lakeville, MAThe five units in Lakeville are surprisingly intact despite some obvious wear and tear. They are standing in a neat row against a wall the morning a team of movers arrives to wheel them to the other side of the building, where a forklift waits to carry them one at a time out through the second floor window and onto the bed of a truck that will transport them to Boston Children's Hospital at Peabody.

When they arrive, the machines will need to be inspected, sandblasted and repainted. Their foam and leather components will need to be replaced and new motors installed. Restoring the iron lungs will take months, but for Rockoff and the Archives Committee, that's a worthwhile price to pay to bring a vital piece of hospital history back home. "These machines saved thousands of lives," Morris says, "and having them back is a way for us to honor Boston Children's tradition of innovation and cutting-edge patient care."