Dr Henry Heimlich, the American thoracic surgeon who invented the Heimlich maneuver to save a person from choking, died on December 17 at the age of 96. Heimlich was an medical innovator and sometimes described as a “medical maverick”. But, like many mavericks, he was also a man of controversy.
Heimlich developed his famous anti-choking maneuver that has been credited with saving hundreds of thousands of lives in 1974. In the 1970s, choking on food or some other object was a leading cause of death in America with thousands of people, including many children, dying from such accidents every year. An objects wrongly swallowed can get stuck in the windpipe, preventing a victim from breathing or talking and cutting off oxygen supply to the brain, leading to a quick death.
The standard practice if first aid for choking victims at the time was to administer a couple of hard slaps on the victim’s back to dislodge the food particle of object. Heimlich, a thoracic surgeon, believed it would be more effective to use the reserve air in the victims lungs to push the object out of the windpipe and the mouth.
The maneuver he developed after testing it on animal subjects involved holding a choking victim in a bear hug and delivering abdominal thrusts to eject the obstruction.
In 1990, Heimlich explained the technique to TV host Larry King.
“It really got famous by saving lives,” Heimlich said in the interview. But there is more to that story. Since Heimlich’s experiments in the 1970s to develop the technique had been on dogs he could not prove that it would work on humans. Moreover, he published his work and instructions on how to perform the maneuver in a non-peer reviewed journal. Since there was a lack of hard evidence to support Heimlich’s theory, the American Red Cross only endorsed it as a secondary technique to be used it back blows were not successful in helping a choking victim.
Meanwhile, Heimlich sent his paper explaining the technique to a nationally syndicated science writer and a story about the Heimlich manoeuvre made it to the newspapers. Within a week a restaurant owner used the technique to save his choking neighbour and a story about the save was reported in newpapers, triggering off a spiral of positive news about the technique.
But Heimlich was unable to get the National Academy of Sciences or the Red Cross to promote the technique as a primary life-saving measure against choking till he undertook a widespread and sustained campaign supported by his family. As Jason Zengerle writes in New Republic “He barnstormed across the country, appearing on “The Tonight Show” and speaking to non-medical groups about the maneuver. In his dark suits and conservative ties, Heimlich looked the part of a somber doctor. But his presentations were anything but dull. He told stories of miraculous rescues and cracked risqué jokes… his speeches often ended with a massive group hug as he asked everyone in the audience to practice the maneuver on the person sitting next to them.”
Heimlich’s campaign started making the Red Cross look bad, especially after the US Surgeon General advocated in 1985 that the Heimlich maneuver be “the only method” to save choking victims. Soon both the Red Cross and the American Heart Association made it the primary anti-choking treatment.
Controversy continued to dog Heimlich when he advocated the manoeuvre for victims of drowning and it was shown to have destructive results like stomach rupture. He was also involved in a controversy over advocating malariatherapy to try to treat HIV infected people and unethical clinical trial practices around this. Heimlich was such a polarising figure that one of his own sons turned against him and dedicated all his time and effort in trying to expose what he thought were his father’s unwarranted claims to fame and his unethical practices.
But at his death, Heimlich remains firmly in the medical pantheon for creating a simple effective manouvre that could be used by person without training, with no tools to save the life of someone choking as Heimlich himself did for the first time at age 96.