![BBC HomepageSkip to contentAccessibility HelpYour accountLiveNotificationsHomeNewsSportWeatheriPlayerSoundsBitesizeMore menuMore menuSearch BBCHomeNewsSportWeatheriPlayerSoundsBitesizeCBBCCBeebiesFoodClose menuBBC NewsMenuHomeIsrael-Gaza warCost of LivingWar in UkraineClimateUKWorldBusinessPoliticsCultureMoreTechScienceHealthFamily & EducationIn PicturesNewsbeatBBC VerifyDisabilityHealthThe man in the iron lung: How Paul Alexander lived life to the fullPublished9 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Philip AlexanderImage caption, Philip Alexander with his brother Paul, in his iron lung machineBy Catherine SnowdonBBC NewsPaul Alexander was six years old when he woke, terrified, to find himself inside a large metal tube, with only his head sticking out.He couldn’t move to feel what was trapping him, and when he tried to call for help, he discovered he couldn’t make a sound.Paul had survived a serious bout of polio, but had been left quadriplegic. After an emergency tracheostomy operation, he was unable to breathe without the iron lung machine that now encased his small body.When he died recently at the age of 78, Paul had spent more than seven decades using his iron lung, longer than anyone else in history. Image source, GoFundMeBut what was it that marked him out from so many of his peers, and kept him going?Polio ran riot in the late 19th and early 20th centuries, killing and maiming scores of children.What is polio and how does it spread?In hospital in Texas in 1952, Paul was surrounded by other children in similar predicaments. According to the World Health Organization, one in 200 polio infections leads to irreversible paralysis. Among those paralysed, 5-10% die when their breathing muscles become immobilised.Uncertain futureAfter two years in hospital, doctors began to cast doubt on Paul’s future.That led his parents to make the brave decision to take him and his iron lung home, to live out his days in peace. But instead of dying, Paul went from strength to strength, once he was home in his parents’ care.The iron lung uses a negative pressure system. Powered by a motor, its bellows suck air out of the cylinder, creating a vacuum around the patient’s body and forcing the lungs to expand and take in air. When the air is let back in, the same process in reverse makes the lungs deflate. The device needs a source of energy to function.During power cuts, the bellows had to be pumped by hand; neighbours would come to help with the job. Paul’s father designed an alarm bell that Paul could ring using his mouth if he needed urgent attention. Over time Paul learnt to consciously breathe by gulping down air, using his throat muscles to force air into his lungs. He called it frog-breathing.His younger brother, Philip, explained to the BBC that the promise of a puppy gave Paul the incentive to be brave, and attempt to spend time out of his iron lung to learn the complicated glossopharyngeal breathing technique, the medical term for frog-breathing.”He was scared of course of choking to death,” says Philip. “They told him if you last three minutes, you’ll get the dog that you want.” And he did.Image source, Rotary Club of Park Cities DallasImage caption, Paul with friend Kathy Gaines shortly after delivering a speech at an eventAs his confidence and strength grew, he was able to spend increasingly longer periods out of the iron lung. This allowed him to begin to experience a bit more of life. He was allowed to venture into the neighbourhood in his wheelchair with childhood friends, returning to the iron lung when he was tired.”He was just a normal brother to me. We fought, we played, we loved, we partied, we went to concerts together – he was just a normal brother,” says Philip.Paul finished school at home and went on to earn a college degree before setting his sights on law school.Image source, University of TexasImage caption, Fellow-students helped care for Paul while he studied lawPhilip recalls Paul’s time at the University of Texas in Austin as being “incredible”. His parents helped Paul move in with his iron lung, and then he was on his own – with limited help at first, after the carer he had hired failed to show up.”He didn’t really have any caregivers. He was in the dorm and different people just took care of him accidentally. They pushed him around campus [in his wheelchair],” says Philip.Paul went on to practise law in downtown Dallas. He had to deal with the surprise of clients on entering his office and seeing him in his iron lung.”It’s not an easy thing to see, just a head sticking out,” says Philip. “People immediately go into shock. I saw that happen a lot.”Paul lived alone for much of his adult life, no mean feat for someone unable to take care of his basic human needs like using the toilet or getting a drink on his own.This video can not be playedTo play this video you need to enable JavaScript in your browser.Media caption, Watch: Philip Alexander remembers his brother, ‘the man in the iron lung’Philip says he became the master of his own domain, helping people to help him.”He needed a unique type of care. Not even professionals are trained to take care of a quadriplegic in an iron lung,” says Philip of the huge responsibility that came with supporting his brother.”Most of the care was basic – shaving and feeding for example. But to move him you needed to be careful not to jam his finger and so on.” There was no instruction manual for those who answered Paul’s adverts for caregivers. “They learned as they went,” says Philip. “And many left after a day or two. I remember going around once and asking a couple of assisted living centres if they could care for him, and the looks on their faces were priceless.”Paul had one carer who was in his life for decades. When Kathy Gaines died, her passing left Paul bereft.Philip says he always saw himself as the back-up carer for his brother, but he admired the support system Paul built: “He had a lot of wonderful friends, some really beautiful people in his life.”Help neededOne of those people came into Paul’s life in a moment of dire need.In 2015, his iron lung began to leak. As the machines were by now extremely rare, it was a race against time to find someone able to carry out the vital repair job to make it airtight once more.After a plea was posted on social media, responses came in from around the world. But the solution turned out to be much closer to home.Ten miles down the road from Paul’s apartment in Dallas, was the mechanical durability business Environmental Testing Laboratory, owned by Brady Richards.Mr Richards had come into possession of two iron lung machines at a building clearance and he recalls how one day a paramedic walked in asking: “Is this the place I can find iron lungs?”The medic had been transporting Paul to and from hospital, as carers fought to keep him alive in the failing iron lung. As the situation became more desperate, word of mouth had brought her to Mr Richards.Image source, Brady RichardsImage caption, Brady Richards at his warehouse with one of Paul’s iron lung machines”I did not have any idea about Paul Alexander at that time,” says Mr Richards. On learning about the emergency, he immediately set about rebuilding one of the broken machines he had in his warehouse. He built some parts from scratch and scavenged others from other devices, learning as he went along: “Iron lungs are very robust machines. They are built to last. “It’s a simple machine so I managed to work it out. You can increase and decrease the breathing rate and the pressure. Paul always liked the settings up high.”Once the refurbished machine was ready, Mr Richards swapped it for the damaged one at Paul’s apartment. He wouldn’t accept any money for his work.But that wasn’t the end of the story. Later that night Mr Richards received a call from Paul’s carer to say the machine wasn’t working.Mr Richards returned to Paul’s apartment and quickly realised the neck collar wasn’t on properly and had come loose.”Paul was saying ‘I’m fine, I’m OK’ as we worked to correct the problem,” recalls Mr Richards. “The truth was, he was turning blue.”In moments of desperation like these, Paul had access to more portable breathing devices, which used a different sort of technology to the iron lung.”Positive pressure respirators can make the patient feel like they have their head stuck out of the car window. Not everyone likes that sensation” explains Dr Patrick Murphy, the clinical lead consultant at the Lane Fox respiratory unit at St Thomas’ Hospital, in London.Paul never moved full-time to these mask-based devices. Another polio survivor, living in York, in northern England, did make the switch.Image source, James PorteousImage caption, James Porteous receiving his MBEJames Porteous, 78, was infected with polio in the same year as Paul. He was initially placed in an iron lung. He recovered to a point where he could live his life without significant breathing support, but as is often the case for polio survivors, as he aged he began to need more help. He now uses a respirator mask for about 17 hours a day: “I don’t remember much about being in the iron lung. I was also placed in a head-to-toe plaster cast initially as the thought was that this would prevent my limbs from becoming deformed,” says Mr Porteous, who is the regional president of the British Polio Fellowship. Mr Porteous had a long career, first in stockbroking and then in various senior roles for Rowntree’s, which became part of Nestlé. He married and has four daughters. He travelled the world and in 2001 he was awarded an MBE for services to the community.Image source, James PorteousImage caption, James Porteous in his specially adapted company car”I could have sat all my life with a rug over my knees, but I decided to just get on with it. I’m tired these days and I don’t get out much any more, but life is good. I have a nice family and good friends. One thing I’d still like to see achieved in my lifetime is the complete eradication of polio around the world,” he says.Ending polio globally was also Paul’s ambition. He wrote about it in his 2020 memoir, which he typed himself, using a pencil attached to a stick gripped in his mouth to reach the computer keyboard.Philip says it was after the book was published that he fully realised what an inspiration his brother was to people around the world: “His personality had a lot to do with how much he was admired. He had that great big smile and he was such a welcoming, warm person. He made people comfortable.”Brady Richards remained involved in Paul’s life over the years. He helped Paul move apartments when needed, and serviced the iron lung regularly: “It was always a pleasure to be around Paul – he had a very upbeat and positive attitude.” Image source, NHSImage caption, Dr Murphy says Paul’s parents and other carers were braveDr Murphy is full of admiration for the people who cared for Paul.”His parents took their son home in a machine that was at the time relatively high-end technology. He also had a tracheostomy, which calls for special care. They will have needed to be engineers, nurses and doctors. “If you speak to lots of trained doctors or nurses they won’t be confident in managing a patient with complex respiratory failure, and yet patients like Paul and their families do it at home on their own. The bravery cannot be underestimated,” says Dr Murphy.World recordLast year Paul was recognised by Guinness World Records as the person who had lived the longest in an iron lung.Philip’s admiration for his brother runs deep: “I saw him go through a lot of struggles in his life. I’m going to miss him. I called him when I needed to talk to someone about any kind of problem I had.”He says that while the rest of the world might be amazed by how long his brother survived in his iron lung, his parents would not have been: “They believed in him. They gave him so much strength and love. They wouldn’t have been shocked.” Related TopicsHealthChild healthMore on this story’Man in the iron lung’ Paul Alexander dies at 78Published13 MarchSuper-engineered vaccines created to help end polioPublished14 June 2023What is polio and how can you protect yourself?Published10 August 2022Top StoriesLive. Hunt: We’ll keep ‘triple lock’ on pension increases if we win electionWilliam and Kate ‘enormously touched’ by public supportPublished2 hours agoRussia marks day of mourning after concert attackPublished1 hour agoFeaturesThe Papers: Kate ‘reassures nation’ and ‘murderous’ Moscow attackThe Brazilian teen who scored winner against EnglandAttributionSportBBC Verify examines how the Moscow attack unfolded. VideoBBC Verify examines how the Moscow attack unfoldedBullets, a crush and panic: Moscow concert that became a massacreKate cancer diagnosis rewrites story of past weeks‘Having a certificate of loss proves my baby existed’Your pictures on the theme of ‘reflections’England kits ‘should connect people’From the desert to the icy waters of WalesElsewhere on the BBCWhy do people behave the way they do on social media?Marianna Spring investigates extraordinary cases of online hate to find out…AttributioniPlayerCritically acclaimed and utterly compelling…Masterful, claustrophobic drama starring Sofie Gråbøl as a troubled prison guardAttributioniPlayerFrom triumph to tragedy…After more than 30 years of service, America’s space shuttle took to the skies for the last timeAttributioniPlayerCan new evidence solve aviation’s greatest mystery?Ten years after the Malaysian Airlines flight disappeared, new technology may explain whyAttributioniPlayerMost Read1The man in the iron lung: How Paul Alexander lived life to the full2Pilgrimage helped Traitors star Amanda say ‘goodbye mum’3Missiles and drones pound Ukraine’s capital4Newspaper headlines: Kate ‘reassures nation’ and ‘murderous’ Moscow attack5William and Kate ‘touched’ by public support6How jealous K-pop super fans try to dictate their idols’ private lives7Russia marks day of mourning after concert attack8Sainz wins in Australia after Verstappen retiresAttributionSport9Abductors release more than 280 Nigerian pupils10’A brutal and timely reminder of England’s problems’AttributionSport](https://newsinsightplus.com/wp-content/uploads/https://ichef.bbci.co.uk/news/1024/branded_news/5D20/production/_132904832_69219225_1667960617285420_r.jpg)
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BBC HomepageSkip to contentAccessibility HelpYour accountLiveNotificationsHomeNewsSportWeatheriPlayerSoundsBitesizeMore menuMore menuSearch BBCHomeNewsSportWeatheriPlayerSoundsBitesizeCBBCCBeebiesFoodClose menuBBC NewsMenuHomeIsrael-Gaza warCost of LivingWar in UkraineClimateUKWorldBusinessPoliticsCultureMoreTechScienceHealthFamily & EducationIn PicturesNewsbeatBBC VerifyDisabilityHealthThe man in the iron lung: How Paul Alexander lived life to the fullPublished9 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Philip AlexanderImage caption, Philip Alexander with his brother Paul, in his iron lung machineBy Catherine SnowdonBBC NewsPaul Alexander was six years old when he woke, terrified, to find himself inside a large metal tube, with only his head sticking out.He couldn’t move to feel what was trapping him, and when he tried to call for help, he discovered he couldn’t make a sound.Paul had survived a serious bout of polio, but had been left quadriplegic. After an emergency tracheostomy operation, he was unable to breathe without the iron lung machine that now encased his small body.When he died recently at the age of 78, Paul had spent more than seven decades using his iron lung, longer than anyone else in history. Image source, GoFundMeBut what was it that marked him out from so many of his peers, and kept him going?Polio ran riot in the late 19th and early 20th centuries, killing and maiming scores of children.What is polio and how does it spread?In hospital in Texas in 1952, Paul was surrounded by other children in similar predicaments. According to the World Health Organization, one in 200 polio infections leads to irreversible paralysis. Among those paralysed, 5-10% die when their breathing muscles become immobilised.Uncertain futureAfter two years in hospital, doctors began to cast doubt on Paul’s future.That led his parents to make the brave decision to take him and his iron lung home, to live out his days in peace. But instead of dying, Paul went from strength to strength, once he was home in his parents’ care.The iron lung uses a negative pressure system. Powered by a motor, its bellows suck air out of the cylinder, creating a vacuum around the patient’s body and forcing the lungs to expand and take in air. When the air is let back in, the same process in reverse makes the lungs deflate. The device needs a source of energy to function.During power cuts, the bellows had to be pumped by hand; neighbours would come to help with the job. Paul’s father designed an alarm bell that Paul could ring using his mouth if he needed urgent attention. Over time Paul learnt to consciously breathe by gulping down air, using his throat muscles to force air into his lungs. He called it frog-breathing.His younger brother, Philip, explained to the BBC that the promise of a puppy gave Paul the incentive to be brave, and attempt to spend time out of his iron lung to learn the complicated glossopharyngeal breathing technique, the medical term for frog-breathing.”He was scared of course of choking to death,” says Philip. “They told him if you last three minutes, you’ll get the dog that you want.” And he did.Image source, Rotary Club of Park Cities DallasImage caption, Paul with friend Kathy Gaines shortly after delivering a speech at an eventAs his confidence and strength grew, he was able to spend increasingly longer periods out of the iron lung. This allowed him to begin to experience a bit more of life. He was allowed to venture into the neighbourhood in his wheelchair with childhood friends, returning to the iron lung when he was tired.”He was just a normal brother to me. We fought, we played, we loved, we partied, we went to concerts together – he was just a normal brother,” says Philip.Paul finished school at home and went on to earn a college degree before setting his sights on law school.Image source, University of TexasImage caption, Fellow-students helped care for Paul while he studied lawPhilip recalls Paul’s time at the University of Texas in Austin as being “incredible”. His parents helped Paul move in with his iron lung, and then he was on his own – with limited help at first, after the carer he had hired failed to show up.”He didn’t really have any caregivers. He was in the dorm and different people just took care of him accidentally. They pushed him around campus [in his wheelchair],” says Philip.Paul went on to practise law in downtown Dallas. He had to deal with the surprise of clients on entering his office and seeing him in his iron lung.”It’s not an easy thing to see, just a head sticking out,” says Philip. “People immediately go into shock. I saw that happen a lot.”Paul lived alone for much of his adult life, no mean feat for someone unable to take care of his basic human needs like using the toilet or getting a drink on his own.This video can not be playedTo play this video you need to enable JavaScript in your browser.Media caption, Watch: Philip Alexander remembers his brother, ‘the man in the iron lung’Philip says he became the master of his own domain, helping people to help him.”He needed a unique type of care. Not even professionals are trained to take care of a quadriplegic in an iron lung,” says Philip of the huge responsibility that came with supporting his brother.”Most of the care was basic – shaving and feeding for example. But to move him you needed to be careful not to jam his finger and so on.” There was no instruction manual for those who answered Paul’s adverts for caregivers. “They learned as they went,” says Philip. “And many left after a day or two. I remember going around once and asking a couple of assisted living centres if they could care for him, and the looks on their faces were priceless.”Paul had one carer who was in his life for decades. When Kathy Gaines died, her passing left Paul bereft.Philip says he always saw himself as the back-up carer for his brother, but he admired the support system Paul built: “He had a lot of wonderful friends, some really beautiful people in his life.”Help neededOne of those people came into Paul’s life in a moment of dire need.In 2015, his iron lung began to leak. As the machines were by now extremely rare, it was a race against time to find someone able to carry out the vital repair job to make it airtight once more.After a plea was posted on social media, responses came in from around the world. But the solution turned out to be much closer to home.Ten miles down the road from Paul’s apartment in Dallas, was the mechanical durability business Environmental Testing Laboratory, owned by Brady Richards.Mr Richards had come into possession of two iron lung machines at a building clearance and he recalls how one day a paramedic walked in asking: “Is this the place I can find iron lungs?”The medic had been transporting Paul to and from hospital, as carers fought to keep him alive in the failing iron lung. As the situation became more desperate, word of mouth had brought her to Mr Richards.Image source, Brady RichardsImage caption, Brady Richards at his warehouse with one of Paul’s iron lung machines”I did not have any idea about Paul Alexander at that time,” says Mr Richards. On learning about the emergency, he immediately set about rebuilding one of the broken machines he had in his warehouse. He built some parts from scratch and scavenged others from other devices, learning as he went along: “Iron lungs are very robust machines. They are built to last. “It’s a simple machine so I managed to work it out. You can increase and decrease the breathing rate and the pressure. Paul always liked the settings up high.”Once the refurbished machine was ready, Mr Richards swapped it for the damaged one at Paul’s apartment. He wouldn’t accept any money for his work.But that wasn’t the end of the story. Later that night Mr Richards received a call from Paul’s carer to say the machine wasn’t working.Mr Richards returned to Paul’s apartment and quickly realised the neck collar wasn’t on properly and had come loose.”Paul was saying ‘I’m fine, I’m OK’ as we worked to correct the problem,” recalls Mr Richards. “The truth was, he was turning blue.”In moments of desperation like these, Paul had access to more portable breathing devices, which used a different sort of technology to the iron lung.”Positive pressure respirators can make the patient feel like they have their head stuck out of the car window. Not everyone likes that sensation” explains Dr Patrick Murphy, the clinical lead consultant at the Lane Fox respiratory unit at St Thomas’ Hospital, in London.Paul never moved full-time to these mask-based devices. Another polio survivor, living in York, in northern England, did make the switch.Image source, James PorteousImage caption, James Porteous receiving his MBEJames Porteous, 78, was infected with polio in the same year as Paul. He was initially placed in an iron lung. He recovered to a point where he could live his life without significant breathing support, but as is often the case for polio survivors, as he aged he began to need more help. He now uses a respirator mask for about 17 hours a day: “I don’t remember much about being in the iron lung. I was also placed in a head-to-toe plaster cast initially as the thought was that this would prevent my limbs from becoming deformed,” says Mr Porteous, who is the regional president of the British Polio Fellowship. Mr Porteous had a long career, first in stockbroking and then in various senior roles for Rowntree’s, which became part of Nestlé. He married and has four daughters. He travelled the world and in 2001 he was awarded an MBE for services to the community.Image source, James PorteousImage caption, James Porteous in his specially adapted company car”I could have sat all my life with a rug over my knees, but I decided to just get on with it. I’m tired these days and I don’t get out much any more, but life is good. I have a nice family and good friends. One thing I’d still like to see achieved in my lifetime is the complete eradication of polio around the world,” he says.Ending polio globally was also Paul’s ambition. He wrote about it in his 2020 memoir, which he typed himself, using a pencil attached to a stick gripped in his mouth to reach the computer keyboard.Philip says it was after the book was published that he fully realised what an inspiration his brother was to people around the world: “His personality had a lot to do with how much he was admired. He had that great big smile and he was such a welcoming, warm person. He made people comfortable.”Brady Richards remained involved in Paul’s life over the years. He helped Paul move apartments when needed, and serviced the iron lung regularly: “It was always a pleasure to be around Paul – he had a very upbeat and positive attitude.” Image source, NHSImage caption, Dr Murphy says Paul’s parents and other carers were braveDr Murphy is full of admiration for the people who cared for Paul.”His parents took their son home in a machine that was at the time relatively high-end technology. He also had a tracheostomy, which calls for special care. They will have needed to be engineers, nurses and doctors. “If you speak to lots of trained doctors or nurses they won’t be confident in managing a patient with complex respiratory failure, and yet patients like Paul and their families do it at home on their own. The bravery cannot be underestimated,” says Dr Murphy.World recordLast year Paul was recognised by Guinness World Records as the person who had lived the longest in an iron lung.Philip’s admiration for his brother runs deep: “I saw him go through a lot of struggles in his life. I’m going to miss him. I called him when I needed to talk to someone about any kind of problem I had.”He says that while the rest of the world might be amazed by how long his brother survived in his iron lung, his parents would not have been: “They believed in him. They gave him so much strength and love. They wouldn’t have been shocked.” Related TopicsHealthChild healthMore on this story’Man in the iron lung’ Paul Alexander dies at 78Published13 MarchSuper-engineered vaccines created to help end polioPublished14 June 2023What is polio and how can you protect yourself?Published10 August 2022Top StoriesLive. Hunt: We’ll keep ‘triple lock’ on pension increases if we win electionWilliam and Kate ‘enormously touched’ by public supportPublished2 hours agoRussia marks day of mourning after concert attackPublished1 hour agoFeaturesThe Papers: Kate ‘reassures nation’ and ‘murderous’ Moscow attackThe Brazilian teen who scored winner against EnglandAttributionSportBBC Verify examines how the Moscow attack unfolded. VideoBBC Verify examines how the Moscow attack unfoldedBullets, a crush and panic: Moscow concert that became a massacreKate cancer diagnosis rewrites story of past weeks‘Having a certificate of loss proves my baby existed’Your pictures on the theme of ‘reflections’England kits ‘should connect people’From the desert to the icy waters of WalesElsewhere on the BBCWhy do people behave the way they do on social media?Marianna Spring investigates extraordinary cases of online hate to find out…AttributioniPlayerCritically acclaimed and utterly compelling…Masterful, claustrophobic drama starring Sofie Gråbøl as a troubled prison guardAttributioniPlayerFrom triumph to tragedy…After more than 30 years of service, America’s space shuttle took to the skies for the last timeAttributioniPlayerCan new evidence solve aviation’s greatest mystery?Ten years after the Malaysian Airlines flight disappeared, new technology may explain whyAttributioniPlayerMost Read1The man in the iron lung: How Paul Alexander lived life to the full2Pilgrimage helped Traitors star Amanda say ‘goodbye mum’3Missiles and drones pound Ukraine’s capital4Newspaper headlines: Kate ‘reassures nation’ and ‘murderous’ Moscow attack5William and Kate ‘touched’ by public support6How jealous K-pop super fans try to dictate their idols’ private lives7Russia marks day of mourning after concert attack8Sainz wins in Australia after Verstappen retiresAttributionSport9Abductors release more than 280 Nigerian pupils10’A brutal and timely reminder of England’s problems’AttributionSport
[ad_1] The iron lung uses a negative pressure system. Powered by a motor, its bellows suck air out of the cylinder, creating a vacuum around the patient’s body and forcing…
![BBC HomepageSkip to contentAccessibility HelpYour accountLiveNotificationsHomeNewsSportWeatheriPlayerSoundsBitesizeMore menuMore menuSearch BBCHomeNewsSportWeatheriPlayerSoundsBitesizeCBBCCBeebiesFoodClose menuBBC NewsMenuHomeIsrael-Gaza warCost of LivingWar in UkraineClimateUKWorldBusinessPoliticsCultureMoreTechScienceHealthFamily & EducationIn PicturesNewsbeatBBC VerifyDisabilityAsiaChinaIndiaK-pop: How jealous ‘super fans’ try to dictate their idols’ private livesPublished6 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesImage caption, Karina (second from left) is the frontwoman of K-pop girl group aespaBy Jake Kwon & Kelly Ngin Seoul and SingaporeWhen K-pop star Karina posted a handwritten apology on Instagram earlier in March, it was both contrite and profuse.”I sincerely apologise for surprising my fans who have supported me,” the frontwoman of the girl group aespa wrote.Her offence? Publicly acknowledging that she was in a relationship with actor Lee Jae-wook. That Karina felt compelled to say sorry for being in a relationship has puzzled many outside the K-pop scene, but it opens a window into the world of the industry’s “super fans”. They stream their favourite stars’ music round the clock – even if on mute while sleeping – to boost chart rankings, organise mass voting sessions during award seasons, and sometimes even sponsor digital billboard ads in places like Times Square, New York. Paying the price of loveWhen news of Karina’s relationship broke, some fans drove a truck to her management agency.”We supported Karina’s bright future, believing in a shared dream, but it was our misconception,” blared an electronic billboard on the vehicle.”Is the love given to you by your fans not enough?” another read. Blackpink’s Jisoo is dating. The K-pop world is stunnedThe dark side of Asia’s pop music industryThis stands in contrast to how celebrities’ romantic lives are often publicised, and sometimes celebrated, in other parts of the world.Take Taylor Swift, for example, whose attendance at last month’s Super Bowl to watch her boyfriend Travis Kelce is said to have singlehandedly boosted TV viewership of the game, making it the most-watched broadcast in the US since the 1969 Moon landing.Polls say one in five Super Bowl viewers were rooting for the Kansas City Chiefs – which eventually won the annual league – because of the pop star’s relationship with Kelce.So why are the attitudes different in K-pop?’A false intimacy'”The fans feel jilted,” said Korean media columnist Jeong Deok-hyeon, adding that K-pop fans often view themselves as being in parasocial relationships with the idols. These refer to one-sided relationships where one party expends an overt amount of time, emotional energy and money on another whom they are fascinated with, but who may not know they exist.”As the industry increasingly encourages fans to express their fandom through consumerism, their desire to be ‘compensated’ [for their investments] grows. This contributed to fans making demands which sometimes border on threats,” Mr Jeong told the BBC.Image source, Getty ImagesImage caption, K-pop star Karina has apologised to her fans after news of her dating actor Lee Jae-wook went publicSome believe the artistes themselves and their management agencies have facilitated a “false intimacy” between idols and fans. Even as recently as 10 years ago, it was common practice for K-pop agencies to ban new stars from dating or even have a personal mobile phone.Agencies have also begun creating social apps for their artists which appear to offer fans a glimpse of their idols’ everyday lives. SM, the K-pop-producing powerhouse behind groups like aespa, introduced an app in 2020 designed to look like a one-on-one messenger app, but is in fact a group chat where the idol drops messages for thousands of fans at once.Some stars have also bought gifts for fans or offered them one-on-one calls.”K-pop agencies have been telling fans that they have the power to create stars,” said Areum Jeong, who lectures on Korean culture at Arizona State University.Cedarbough Saeji from Pusan National University called the Karina incident “a classic case of the fans trying to ‘discipline’ the stars”. “They were angry about the dating, and then they got angry that she apologised in the ‘wrong way’,” said Saeji, an assistant professor in Korean and East Asian Studies, referring to how some fans felt Karina should have posted her apology in a fans-only forum – rather than on a public platform.”In 2024, privacy for K-pop stars, who live in this tiny country and are so widely recognized, is virtually impossible,” she said.Ms Jeong, who considers herself a dedicated K-pop fan, also takes part in “fan labour” by streaming the music of her favourite boyband NCT 127 and paying to vote for them on music platforms and award shows. There are a dozen different digital music platforms for K-pop, each with its own Top 100 chart based on the number of people streaming and downloading songs. Super fans divide and conquer by organising themselves into teams to navigate the rules for each platform. “Fans put in labour to ensure the group’s success. They consider the idol a product. And if you want to see the product on the stage for a long time, the artistes, the fans, and the management will all have to put in hard work,” Ms Jeong said. Some even share voting schedules and streaming guides with “regular fans”, she added, so they can contribute to propelling their idols to the top of the charts.The BBC browsed a “streaming guide” written up by fans of the boyband Seventeen, which includes reminders such as, “Watch two or three other Seventeen music videos that totals to at least seven to 10 minutes. Then repeat the process”, and “Do not pause, forward or rewind”.Large fan groups organise themselves so that different members take on different roles. ARMY, the millions-strong fan group for the world’s biggest boyband BTS, has taken on philanthropic projects on behalf of the band, and also operate X accounts that translate all BTS-related content, from song lyrics to members’ social media posts.Image source, Getty Images”The superfans fundraise, they campaign to vote… Some police comments online to make sure negative comments about their idols are reported and conduct coordinated searches to remove ‘bad’ search terms.”That’s all money and time. The industry profits off of it,” Ms Jeong said.Another hallmark of K-pop fandom are the birthday celebrations held for the idols who themselves are not present. Some fans rent out entire cafes for such events, which will also feature merchandise related to the idol.Changing attitudesK-pop columnist Jeff Benjamin said some idols may feel “obliged to keep their fans happy” because of the fragility of their careers. “The groups are typically quite short-lived at about four to five years… I think a big part of why Karina published her apology was because she has a leadership responsibility in aespa, and she wanted to assure her fans that she will continue to work hard with her music,” he said.”It’s ironic that these artists sing about love but dating is frowned upon. I feel for them,” he added.But as K-pop widens its global footprint, attitudes in the industry could be opening up too.Image source, Getty ImagesImage caption, BTS was invited to speak at the annual UN General Assembly in September 2021Many of Karina’s international fans took to social media to express their outrage that she had been compelled to apologise. “She doesn’t deserve this type of treatment” read one comment on X (formerly Twitter), while another said “Karina apologising for LIKING someone has to be one the craziest things in the world”.Some Korean fans also pointed to the international coverage of her apology, saying it was embarrassing. “It’s been so long since K-pop became global but they still don’t seem to grasp the fact that when something like this happens, it immediately disgraces the country” one person wrote. The global K-pop events market was valued at $8.1bn in 2021 and is projected to reach $20bn by 2031, according to Allied Market Research. Groups have also been invited to perform at international events. Seventeen, for example, will become the first K-pop group to perform at the Glastonbury Festival this year. BTS, who have been named special envoys by the UN, was invited to perform at its New York headquarters in 2021. K-pop albums raked in a record $243.8m overseas from January to October last year. Japan, the United States and China were the top three buyers.”Things are changing as the number of international K-pop fans grows. I am hopeful that the fan bases will become more supportive and open-minded… And that the industry can be less dependent on traditional norms,” Mr Benjamin said.The K-pop girl group with no Korean membersThe world’s most controversial K-pop bandSome of Karina’s fans in South Korea have continued to vouch for her.”There was nothing to apologise for…Whether you are a celebrity or a regular person, you need close friends. It’s natural for her to have a lover,” said Jeong So-yeon, a 33-year-old fan based in Seoul. “Other top stars do fine even after dating ‘scandals’. I look forward to her next albums,” she said.Related TopicsAsiaK-popSouth KoreaMusicMore on this storyBTS go into the army – what now for K-pop’s kings?Published12 December 2023Blackpink renew contract ensuring group’s futurePublished6 December 2023The K-pop girl group with no Korean membersPublished27 August 2023Blackpink star addresses ‘low energy’ performancesPublished14 July 2023The woman who defied the world of K-popPublished18 October 2019The dark side of Asia’s pop music industryPublished26 January 2016Top StoriesWilliam and Kate ‘enormously touched’ by public supportPublished1 hour agoFour suspected gunmen arrested after 133 killed in Moscow attackPublished6 hours agoBBC Verify examines how Moscow attack unfolded. 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