Radiolab - The Man Behind the Maneuver

Episode Date: March 5, 2013

In the 1970s, choking became national news: thousands were choking to death, leading to more accidental deaths than guns. Nobody knew what to do. Until a man named Henry Heimlich came along with a big idea. Since then, thousands and thousands -- maybe even millions -- have been rescued by the Heimlich maneuver. Yet the story of the man who invented it may not have such a happy ending.

Wait, you're listening. Okay. All right. Okay. All right. You're listening to Radio Lab. Radio Lab. Shorts.

From. W. N. Y. C. See? Yes. And NPR. Hey, I'm Chad Abumrah. I'm Robert Krollwich.

This is Radio Lab. This is our podcast. And we're going to be, we're going to tell you a tale. It's actually about a person that we think. we deeply admire, if, by the way, you even pause long enough to admire him at all. Yeah. And the story comes from our own Pat Walters. This one is kind of weird.

I'm going to start with just talking about myself. Okay. I think this is the closest I've ever come to dying. Really? It happened when I was 11, so I was in sixth grade. I was at lunch in the cafeteria, lots of kids, milling about, and I was sitting at the table with my best friend eating my little packed lunch that my mom had made for me. And I was eating an apple.

And all of a sudden, I couldn't breathe. You were choking? Yeah. And I put my hand up in the air. None of the cafeteria ladies came over, and I put both my hands in the air. And they finally came over and dragged me across the hall to the nurse's office. You're choking all the way to the nurse's office? Yeah.

gasping for air kind of choking? No, just totally clogged up. Clogged up. And I get over there and someone calls the paramedics. Wait, how much time has passed since you've breathed? Like two, two and a half minutes, I think. That long? Yeah.

Wow. But then the nurse grabs me, wraps her arms around me, jerks me really hard under the rib cage, and this apple peel shoots right across the room. Nice. Like a projection. projectile kind of p phew kind of thing? Yeah, it was like a cartoon. I mean, I don't actually remember. I have a terrible memory, but I piece this

together from, you know, talking to my mom. And the story is just this thing that's been around. You know, I've told it a million times. It comes up at family gatherings. And I don't know, maybe a year ago, I was reading some things online about the Heimlich maneuver. I don't even know how I ended up there. And I realized I didn't know

who actually is Heimlich. I didn't know anything about him. Like, who is this guy who invented this maneuver that saved my life. And that's when I discovered a story I totally did not expect. Hello. Hello, it's Patrick.

You downstairs? I am. Who's that? That's Dr. Heimlich. What? How far as you went and take the elevator to four and turn left. He's alive?

Yeah. I just would have assumed he died like 100 years ago. Yeah, so he lives in Cincinnati and I went to see him because... You went to see... Does that happen to you every time you like, if I told you... This is what's cool about our job, right?

I guess. Oh, I've heard of him. I guess I'll go meet him. I kind of wanted to say thanks. Hello. Quite a trip. Good to meet you. And I wanted to find out, you know, the story of how he came up with this thing.

Can you just say who you are, so we have it on tape? Dr. Henry Heimlich of the Heimlich maneuver. And many other things. We'll talk about. And each of them is saving many, many lives. That's a matter of some debate. But let's just start the story at the beginning. And for our purposes, the story starts in the summer of 1941.

Yes. Hemlik was 21 years old, and he was on a train heading back to New York City from a summer camp that he worked at upstate. And as the train is going along the shore of this lake, the front end of it jumped the tracks. The whole engine jumped into the middle of the lake. I jumped off and walked up the front to see if anyone was hurt. And as he approached the front of the train, which was sort of sticking in the water, water. He saw this guy, trapped. Under the water with his feet under the train wheel. Like his feet were

stuck and he was kind of hanging down into the water? Correct. The guy's head was bobbing up and down. He was desperately trying to keep it above the water. So I jumped in the water and I held them up. Kind of hooked his arms under the guy's armpits and lifted his head and shoulders. Out of the water. And I held him for a long time. For an hour or so. And by the time the paramedics arrived and freed the man a crowd had formed. Yeah. And as Heimlich crawled out of the water. We got a couple of them yelled.

You saved a life. You saved a life. That was the first time. After college, Heimuk went to medical school and became a thoracic surgeon, a chest surgeon. Started saving lives for living. Then he joined the military. I was in the Navy. Navy surgeon.

Because I like ships in the sea. Where he saved more lives. And while he was overseas, he noticed that many times soldiers who got shot died not necessarily because they bled out but because the bleeding from the wound would fill their chest and crush their lungs. I'm thinking. There must be a way to solve this. And one day...

It hit him. Why not a valve? So I ran to the five and ten cents store. Bought a few simple parts and actually made this tube device that you could slip into a wound that takes the air out and blood and lets nothing in. It's called the high- I'm like chest drain valve. This is a tube and this is the photo valve.

He showed me one of them. It's just a small six-inch tube with a little plastic flap that only lets air go one way. Really simple. But during Vietnam, the U.S. Army bought 20,000 of these valves, distributed them to infantrymen. When your buddy got shot in the chest, you slipped the tube into the chest and it saved his life. And they're still around today. I called the company that makes them, and they told me that 4 million have sold since the 1970s, which translates to, like, who knows how many lives saved.

Wow, this dude's amazing. Wait, we haven't even gotten to the good part yet. One morning, in the winter of 1972, set the scene for me, so you were at that time you were living here? Yes, I was living here. Heimlich is drinking his coffee, reading the paper, and he happens upon this one article about people who die in restaurants. In those days, many people who died in restaurants, they were thought to be having heart

attacks until an autopsy was done. And the article quoted a coroner who'd done a bunch of these autopsies and had found that, actually, no, these people had choked. The article went on to explain that more than 2,500 people... Thousands of people were dying. Every year from choking. Yes, I think it was the sixth leading cause of accidental death. Higher on the list than guns.

And the worst thing was that the great majority were in children. And nobody knew what to do about it. You could, like, thump a person on the back, but some doctors warned that if you hit them on the back, the choking object would go deeper into the airway. Do you remember if there were people trying to come up with, like, devices? I feel like I read something about... Yes. There was one who had a, like...

Like, a pair of plastic pliers. You would jam that in. Alaw down to my throat? Apparently. Another guy invented a sort of vacuum that you'd use to suck the food out. Not surprisingly, these things... Just weren't effective. People were getting desperate.

I found this little clip from the New York Times, which described this guy whose wife choked on a piece of food in a restaurant. And not knowing what else to do, this guy, who happened to be a surgeon, grabbed a steak knife off the table and tried to perform an emergency tracheotomy. On her neck? Yeah. Oh. And what happened? She died in the restaurant. Wow.

So Hamlick was reading about all this, and being a thoracic surgeon... A chest surgeon. He had an idea. I realized that there was enough air in the lungs if you could compress that air. Push it up against whatever was clogging the windpipe. You could carry the object out of the mouth. So he gets a dog. He got a dog?

Yes. Where did you get it? Oh, we had a laboratory that had some dogs there. This wasn't like Fido, the Heimlich family pet. No, no. Lay the dog down on the operating table, and then he jams this piece of meat. Probably beef. Down the dog's throat.

Did he at least sedate the dog before this? Dog is anesthetized. And he ties a piece of string around the beef in case he needs to pull it out. Okay, that's... Oh. But anyway, the clock is ticking. He gets behind the dog... Took my fist just above the belly button and pressed it there.

Nothing. So he tried again. Repeated it. nothing. And then, on the third try, that beefball... Flew right across the room. I knew we had it. So, in 1974, Heimlich wrote up a little description of its maneuver and sent it to a medical journal.

Pretty soon that got picked up by a national paper. The Chicago Daily News, and not quite a week later. A retiree named Isaac Peeha, who had just read about the Heimlich maneuver in the paper... Came out on his porch, and his neighbor started screaming for him. help. A guy runs over to his neighbor's house, finds his neighbor's wife with her face down in the food. Just like he'd read in the newspaper. He did the method and a big piece of meat flew out of her mouth and she fully recovered. And so he was recorded as the first one to use the procedure. Pretty soon. Stories from around the country begin pouring into Hyman's mailbox.

Los Angeles, California, Fresno, California. And it got out very quickly. It's one about a babysitter saving the kids she was looking after. To the whole country. Bangor Maine. Clearwater, Florida. Here's one about a custodian who saved an eighth grader choking on a ravioli. You know, they just kept coming in.

There were stories about celebrities being saved by the Hamlet maneuver. Different actors and actresses. Cher, Goldie Hawn, Walter Mathau, Carrie Fisher, and Ronald Reagan. Okay, I am in... This is the symbol that you're choking, right? Right. This is Heimlich teaching. Johnny Carson, how to do the maneuver.

I'm going to put my arms around your way. Oh, yes. Come on over here, and I guess you're going to demonstrate. He taught Letterman, too. How to do it. I just want to read you, Dr. Heimlich. One letter that you got from a third grader in Kentucky. This is him on Geraldo.

Dear Dr. Heimlich, roses are red, violets are blue. I might be dead if it wasn't for you. Third grader saved from Chokey on an apple. And for most of us, I think, like, that's where the story seemed to end. with Heimlich as sort of a national hero. But the story goes on and gets kind of murkier.

But he mean? Like at the height of his fame, Heimlich starts going to medical conferences and claiming that the Heimlich maneuver can be used for more than just choking. Now we have a new use for the Heimlich maneuver, and that's its use to stop an asthma attack. Asthma? How? Because...

The way he explained it is that when you have an asthma, your lungs get filled with a lot of excess mucus, and if you do the Heimlich maneuver, it will expel the mucus and stop the asthma attack. In addition, you can prevent an asthma attack by using the maneuver to keep the mucus out of the lungs. You use it maybe once every week or two. I live with someone who suffers from bad asthma.

I'm supposed to give her the Heimlich maneuver once a week to help her with her asthma? That just seems weird. Yeah. Does that work? No, there's no proof that that works. Huh. And at the time, asthma experts attacked him,

saying the idea was dangerous. And it wasn't just asthma. On TV, Heimlich began to argue... That you can also save drowning victims with the Heimlich maneuver. Math-to-Math resuscitation is not effective when the lungs are flooded with water. The way to save a drowning victim is to do the Heimlich maneuver first. The lungs will clear after four Heimlich maneuvers. The Heimlich maneuver expels the water from the lungs.

Does it work? No. There are a lot of misconceptions about it when someone drowns, that their lungs will be full of water. This is Jonathan Epstein. I'm the Executive Director of Northeast Emergency Medical Services. Also a member of the American Red Cross's Scientific Advisory Board. And he says what actually happens in most drowning cases, I don't know this at all,

is that the back of the throat will kind of spasm or close off and keep water from getting into the lungs. And it is so important to quickly start that CPR process to replace the oxygen that was lost. By giving the Heimlich maneuver, you're not only wasting time that you could be using to put oxygen back into the victim, but you also put them at risk of, like, of vomiting. You do the Heimlich maneuver, they might throw up and inhale their vomit,

which could make things even worse. But did people take this idea seriously? Yeah. Several major companies that train lifeguards started teaching their students to use the Heimlich maneuver before doing CPR. And for years, thousands of lifeguards were taught to do the Heimlich maneuver first. And as the years went on, Heimlich's ideas, got increasingly radical.

In the early 1980s, he announced that he might have found a cure for Lyme disease, cancer, and... I believe that I have a possible cure of AIDS. Age? How do people usually react

when you say you have a cure to AIDS? I don't say it to the wrong people. Because the secret to his cure? Malaria. Kills more than a million people every year. Malaria therapy. This isn't Heimlich's idea originally. He got it from a guy named...

Wagner Yowrig of Austria. Who, in the early 20th century... 1918... ...started treating victims of neurosophilis by giving the malaria. And he cured it. Because the fever was so severe that the fever from the malaria would kill the neurocifilus, but not the person. Correct.

And based on this work, Warrag, the guy who came up with this... In 1927, he won a Nobel Prize. for it. It wasn't long, though, before antibiotics came along and malaria therapy disappeared. But in the early 1980s, Heimlich figured maybe this could work for seemingly intractable diseases like cancer and AIDS. First thing he tried it out on was Lyme disease. He raised some money. Got some volunteers. Went to the University of Mexico or Mexico City. And he ran this small, unregulated clinical trial in which he infected these volunteers with South American malaria. The CDC caught wind of what he was doing, denounced the treatment, called it unsafe,

but that did not stop Heimlich. And through the 90s and into the early 2000s, he ran other unregulated trials on cancer and AIDS patients. In South China. And in Africa. Ethiopia. Dr. Anthony Fauci of the National Institutes of Health says Dr. Heimlich's theory about malaria therapy has been thoroughly debunked by medical science. This is from a report on ABC News that quoted one of the world's leading AIDS researchers saying,

There's no scientific reason to believe malaria therapy would be effective against AIDS. And it does have the fundamental potential of actually killing you. That is a big risk to put a person through in an experiment in which there's no fundamental basis to even imagine that it would work. Uh, what happened with Peter? And the criticism wasn't just coming from medical experts. I have absolutely no idea. Absolutely no idea. This is Heimlich's eldest son, Phil. And he explained to me that several years ago, his little brother, Peter, came out and began publicly condemning his dad's ideas.

He launched a website and started sending emails to reporters, leading eventually to dozens of articles, most of which were critical of his father. Why does a son do that? I have no idea. When I called Peter, he told me that he didn't do it for any personal reasons, but because he felt his dad's ideas were dangerous, that they were putting people's lives at risk. And you told me, repeat for me, what... Phil didn't want him. father to have to deal with questions about Peter. Basically, because of the pain that this has caused my parents, because of their age,

he wouldn't even give us access to his father unless we agreed to that. I just don't want my parents to go through that. Phil also had another condition, that we not include Peter's voice. We thought he'd waived that condition in a subsequent interview, and therefore we did include Peter's voice in the original version of the story. But Phil didn't see it that way. Even though some ambiguity remains, we've decided to resolve the matter by respecting Phil, his understanding of our agreement for accessing his dad and removing Peter's voice from the story.

We should say, though, that even though we removed Peter's voice, this version of the story contains the same facts as the original. Anyway, the whole family drama aside, Hamlick was happy to address his other critics. He said the way he sees it... Creative ideas are often attacked because people oppose change or do not understand new concepts. This is from an article Hamlich wrote about his career for the Encyclopedia Britannica. When a prominent discovery is revealed, particularly if it provides an obvious and simple answer to an important question, experts who have worked for years unsuccessfully on the same problem may lash out at the creator and the idea,

because they themselves do not find the solution. Creativity requires courage. People who have genius and great ideas often have to struggle to get their ideas out. That's Phil again, and he disagrees with his brother Peter when it comes to his dad's work. Yeah. In fact, they don't even really talk anymore. I trust my father's judgment. I trust the way his mind works, and I trust his ability to find simple solutions to very difficult problems.

And everybody seems to agree that his most famous solution, the Heimlich maneuver, itself is an incredibly effective one. But lately, some people have started to question whether it's the best one. In the end of my conversation with John Epstein, the American Red Cross guy that we talked to before, he told me that every five years, all the major life-saving organizations worldwide get together and review their guidelines for all different kinds of rescues. It is an exhaustive scientific research process.

They look over case reports and case studies. controlled experiments on animals and cadavers. And Epstein told me that two reviews ago, in 2005, the report yielded some new information about choking. It was very clear that back slaps or back blows. Just thumping somebody on the back between their shoulder blades appear to be equally effective. As the Heimlich maneuver.

Really? In fact, the Red Cross, upon finding this out, went so far as to change their recommendation for what you should do when you find someone choking from just do the Heimlich maneuver to first hit someone in the back five times, then do the Heimlich maneuver. Yes.

Nonsense. It's unbelievable. And also, the Red Cross no longer calls it the Heimlich maneuver. Whoa. What do they call it? Abdominal thrust. Abdominal thrust. This is wrong.

And as I sat there with Heimlich, I did start to wonder, like, how will we remember this guy? Will we remember this guy? I mean, does do those bad things that he did later in his career in any way put his legacy as a lifesaver in jeopardy? When I told people I was coming here, a lot of people reacted with a wonderment that you're still here. People thought you'd been dead for 100 years. That makes me feel very good.

It makes you feel good. Yes. My name is something that they just know. They just know it so well that it is so fixed established that these handful of people who are trying to do harm really don't mean anything. I mean, to me right now, it's a great pleasure to know my name means saving lives.

and when I'm gone, it's still going to be the Heimlich maneuver and it's still going to be saving lives. I could just pull up by Google Alert with the name Heimlich on it. Yeah, could you? Hemlick has a Google Alert that he checks pretty much every day.

Sycamore Boys saves life of friend choking on atomic fireball. Custadian recognized for a You find dozens, hundreds of these stories of people being saved by the Heimlich maneuver. Off-duty police officer saves neighbors' life. You don't find a lot of stories about the controversy surrounding drowning and malaria therapy, or the Red Cross's new guidelines. Oregon football player performs Heimlich on man at Beef Bowl.

This is just from one week? Yeah. And flipping through these stories, it does give you the sense that this guy and his maneuver have somehow become kind of immortal. Which, on the one hand, I kind of get. Hello. Hello. Is this Mrs. Ennis? Yep.

This is Pat Walters. I don't know if you remember me, but I... Just before I finished making the story, I found Mrs. Ennis, the nurse, who gave me the Hanuk maneuver when I was 11. That was lunchtime, wasn't it? It was lunchtime. Yeah. An apple? It was an apple. Yeah. And after she gave me the Heimlich maneuver, I sent her a thank you note.

And she sent me back this letter. All right. Tell me when to start. Whenever you're ready. Okay. Right now. Dear Patrick, when I accepted a job as a school nurse in the Wilson School District, 33 years ago, I told myself that I would never allow anything to happen to children in my care. To my sorrow, I have watched Whitfield children I loved die of cystic fibrosis, AIDS, accidents, and cancer. I think when you said, I can breathe was one of the happiest moments of my

life. I treasure yours and your parents' letter and the privilege of being your school nurse. Sincerely, and with a big hug, Cindy Ennis, R.N. I get a little, uh, I got a little choked up just listening to you read that to me. I feel I feel it very sincerely, Patrick, I truly

do. It was from the heart. I think what I take away from this is that like I'll always think of that thing I call the Heimlich maneuver as the Heimlich maneuver

and so Mrs. Ennis but when I think about my kids, I don't have any kids but like the kids I might have someday, when they learn this thing it won't be called the Heimlich maneuver.

And based on what I know now, I really don't think that I would tell them to call it that. Even though it saved your life. Yeah. Thank you, Patrick. Thanks, Pat. And we thank you guys for listening. Yeah. Hello, world.

This is Jamie from Glasgow in Scotland. Radio Lab is supported in part by the National Science Foundation and by the Alfred P. Sloan Foundation, enhancing public understanding of science and technology in the modern world. More information about Sloan at www.sloan.org. Thanks.