When Patty Ris, 87, choked on a piece of hamburger in the dining room of Deupree House, a Cincinnati nursing home, in May this year, the ideal person was to hand. Henry Heimlich, a fellow resident, had demonstrated his eponymous manoeuvre countless times, but had rarely used it for real. It worked perfectly. “After three compressions this piece of meat came out and she just started breathing,” Heimlich said.
That simple manoeuvre is estimated to have saved tens of thousands of lives since Heimlich first described it in 1974. It works by giving a sharp inward and upward thrust to the abdomen, contracting the lungs and so forcing air up the windpipe at high speed, dislodging objects trapped in the airways. The distinctive pose, which requires the victim to be embraced from behind and jerked vigorously, has made it a favourite in films and comedy sketches.
The idea first came to Heimlich when he was director of surgery at the Jewish Hospital in Cincinnati. In 1973 he had read a magazine article that identified choking as America’s sixth-biggest cause of death. He began experimenting on anaesthetised beagles, blocking their throats with balloons and testing ways of removing the obstruction. The next year he described what he called his “subdiaphragmatic pressure” technique in the journal Emergency Medicine. The editors of the Journal of the American Medical Association soon renamed it “the Heimlich manoeuvre”.
Reports of the manoeuvre’s success began arriving almost immediately, but the medical establishment preferred to wait for detailed studies rather than to accept anecdotal evidence of the technique’s effectiveness. Heimlich found their reluctance rather stuck in his throat. “Most people cannot accept some guy coming in who is not totally involved in the politics of the field, coming up with an idea that they haven’t figured out in 50 years,” he said.
The struggle to have the manoeuvre endorsed became bitter. Heimlich attacked back slaps, the dominant method of treating choking, as potentially fatal, insisting that they could cause obstructions to lodge deeper in the throat, endangering lives. In 1979 the Red Cross recommended the Heimlich manoeuvre as a secondary procedure, to be used if back slaps failed, but this was not enough for Heimlich, who was increasingly being seen as a maverick. Eventually in 1985 the Heimlich manoeuvre was recommended as “the only method that should be used for the treatment of choking” by C Everett Koop, the US surgeon-general (obituary March 5, 2013). The American Red Cross followed suit.
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The effect was dramatic. Use of the manoeuvre helped deaths from choking in America to fall from 5,000 in 1974 to 2,000 in 1987, according to the Washington Post. Heimlich revelled in his fame, enjoying hearing the stories of those saved by his manoeuvre. “I don’t think a week goes by when someone doesn’t send me a newspaper article about someone saved in a drowning or a choking,” he said in 1989. He used the technique himself in 2000 when a man began to choke in a restaurant where he was having lunch.
“‘I can’t tell you how much my own profession beat me down,’ he said
Heimlich’s own talent for self-promotion added to his manoeuvre’s prominence as he eagerly listed celebrities who had been saved by the technique, including Elizabeth Taylor, who choked on a chicken bone in 1978, Carrie Fisher, who choked on a brussels sprout while on a blind date, and Ronald Reagan, who was saved by an aide after choking on a peanut on his campaign aircraft in 1976.
More seriously, though, he now promoted his manoeuvre as almost a panacea for those in danger of drowning or suffering from asthma. He also started doing controversial research into malariotherapy, attempting to treat sufferers of Aids or cancer by injecting them with malaria. The most stinging rebukes came from his younger son, Peter, a textile importer who set up a website accusing his father of peddling “a whole series of discredited experimental dubious medical theories which every medical expert says are either useless, dangerous or crackpot”.
Henry Judah Heimlich was born in Wilmington, Delaware, in 1920, the son of Philip Heimlich, a prison social worker, and Mary (née Epstein). The family moved to New York and he studied at New Rochelle high school and Cornell Medical School, where he was a drum major in the marching band, receiving his MD in 1943. After an internship in a Boston hospital he joined the US navy and was sent to the Gobi desert, in northern China.
After the war he became a thoracic surgeon, specialising in the treatment of chest diseases. He worked at the Mount Sinai and Bellevue hospitals in New York, where he came up with the idea of replacing a damaged oesophagus with tissue from the stomach, but it proved too innovative for senior surgeons. “I can’t tell you how my own profession beat me down,” he said. Frustrated, Heimlich turned up at a meeting of the American Medical Association with a successful patient, making sure that a reporter from Life magazine was on hand. Later a Romanian surgeon claimed that he had devised the procedure and Heimlich had only seen it because he had been invited to Bucharest as a reviewer.
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In 1951 he married Jane Murray, daughter of Arthur Murray, the dance studio entrepreneur. She was a writer about alternative medicine and died in 2012. As well as Peter he is survived by their son Phil, a local politician who became a Christian radio talk-show host, and their daughters Janet, a reporter, and Elisabeth, who is also involved in local politics.
Heimlich’s next big idea came in 1964. In China he had seen soldiers with chest wounds die of collapsed lungs. Going to a convenience store, he bought a tube and flutter valve, much like a whoopee cushion, from which he fashioned a prototype for a chest drain valve. The device quickly proved its effectiveness on soldiers injured in Vietnam. “As I look at it, [the valve was] the one lasting good thing that came out of the Vietnamese war,” he said.
He moved to Ohio in 1969 and in 1981 set up the Heimlich Institute, where he developed the Heimlich MicroTrach, a small tube for delivering oxygen directly into the trachea.
The Heimlich manoeuvre did not always go to plan. In 2002 Jean Reilly, 68, was left with broken ribs when an over-eager first aider came to her rescue after a piece of scampi went down the wrong way while she was eating in a Lancashire pub. “I am sure the man . . . was acting with the best of intentions, but he really did not know what he was doing,” she said.
In America, however, Patty Ris remained a fan. She wrote to the man who saved her. “God put me in that seat next to you, Dr Heimlich, because I was gone, I couldn’t breathe.”
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Henry Heimlich, thoracic surgeon, was born on February 3, 1920. He died after a heart attack on December 17, 2016, aged 96