Martha Lillard had just turned 5 when she was diagnosed with polio and depended on an iron lung to live. He died June 26 in Oklahoma and was the last polio patient in the United States to use the machine, his sister said. She was 78 years old.

“They told him he wasn’t supposed to live past 20 years,” Lillard’s younger sister, Cindy McVey, told The Associated Press on Friday. “He had the enthusiasm and drive to keep living and make the best of his life.”

McVey attributes his sister’s death to the effects of long-term COVID-19. A death certificate lists causes as chronic lung failure and post-polio syndrome, McVey said.

Lillard slept in the iron lung cylinder that covered his body as the air pressure in the chamber forced air in and out of his lungs. As a child, I went to elementary school for two hours a day and received tutoring the rest of the time. He attended Shawnee High School using a telephone system that allowed him to interact with his teachers and classmates via an intercom in their classrooms.

His family took road trips to Missouri thanks to a custom trailer, and his father called hotels to see if they had doors wide enough to accommodate the machine Lillard slept on. Lillard was even able to drive for a while.

“To me it was just normal,” McVey, 75, recalls.

Polio was once one of the country’s most feared diseases, with annual outbreaks causing thousands of cases of paralysis. The disease mainly affects children.

Vaccines became available beginning in 1955. According to the federal Centers for Disease Control and Prevention, a national vaccination campaign reduced the annual number of cases in the United States to fewer than 100 in the 1960s and fewer than 10 in the 1970s. In 1979, polio was declared eliminated in the United States, meaning it was no longer routinely spread.

The Internet would later help Lillard stay informed and learn about all kinds of topics, including her illness, which paralyzed her from the neck down.

With therapy he was able to regain partial use of his left arm and legs. But he could only move his left arm from side to side at the height of his waist. Although she couldn’t reach it, she spent many years living alone and preparing her own meals.

The Internet also allowed Lillard to meet her future husband. After the terrorist attacks of September 11, 2001, Lillard wanted to understand more about what happened. In a chat room, she met a man in Egypt and communicated with him online for more than 20 years, McVey said.

Lillard married Baha Salh in February after he was finally able to obtain a visa to travel to Oklahoma.

“They were really soulmates,” McVey said. “He is extremely heartbroken.”

During the coronavirus pandemic, Lillard contracted COVID-19 twice. Before contracting COVID-19, I had less than 25% lung capacity. For the last five years of his life, he couldn’t leave the house because it was harder for him to breathe. For the past two years, he was in the iron lung almost 24 hours a day, McVey said.

McVey described his sister as artistic and creative. He wrote poems and composed songs. She wrote her own obituary, which is now posted online by a funeral home. She described volunteering for the Humane Society. “She was an avid Beagle lover and helped in animal rescue as a cross poster on Facebook,” Lillard wrote.

He later updated his obituary to say that he “died of long-term Covid 19,” but McVey added the date of his death.

In recent years, McVey and Lillard were desperate to find someone who could repair the iron lung, one of several he had throughout his life.

“But since she’s the last one, we don’t need her anymore,” McVey said through tears.