Why the Heimlich Manoeuvre almost killed as many people as it saved

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In 2016, 96-year-old ex-doctor Henry Heimlich capped off an astonishing medical career. As he sat relaxing in the Deupree House Retirement Home, he spotted that female resident Patty Ris was in grave danger. Her eyes were wide and her lips had turned a deep shade of puce. As she spluttered and gasped for air and residents and staff ran hysterically around the room, Heimlich rose to perform the procedure that had made his name. Approaching the woman from behind, he grabbed her waist and began a series of short, sharp abdominal thrusts. After three pumps, a small piece of meat was sent sailing across the room and the woman could breathe once more. The Heimlich Manoeuvre had saved another life.

On the face of it, few could deny the impact that Henry Heimlich has had on the medical profession. Starting out as a naval surgeon during World War Two, he quickly established himself as an innovative and unorthodox thinker. Early in his career, he came up with an effective remedy for trachoma - a bacterial infection of the eye - and also invented a device that could be used to treat a collapsed lung. Though these accomplishments were certainly significant, it is for his world-famous choking treatment that he will always be remembered.

Heimlich began to turn his attention to the choking question after learning that more than 2,500 Americans were dying every year due to ineffective care. Death was a risk for anyone who enjoyed their food. Tracheostomies, though effective, were dangerous and little understood. He therefore hypothesised about a radical and more physical approach to helping choking victims.

Heimlich first published a paper on the theoretical benefits of a new manoeuvre in 1974, where he laid out the blueprint for the procedure that would bear his name. For a few weeks, the piece failed to make much of an impact. Then, on June 19th, the Seattle Post-Intelligencer reported that a retired restaurant owner had read Heimlich’s article and used the technique he described to save the life of a choking lady. The world went wild.

Thanks to the successful implementation of his theory and a natural flair for the theatrical, Heimlich went overnight from medical obscurity to pop-culture icon. He gave interviews to talk show hosts Johnny Carson and David Letterman, advocating his new approach and raising awareness of the treatment. The Heimlich manoeuvre's mystique grew after celebrities including Carrie Fisher and Ronald Reagan came forward claiming to have been saved by the doctor’s approach. The public soon sat up and took notice. Choking seemed a thing of the past.

To the casual observer, it looked like the Heimlich manoeuvre's popularity was a massive positive. No one was dying and restaurants had become a whole lot safer. However, for all the lives that the Heimlich manoeuvre saved, there is a shadowy secret history that leaves the doctor’s legacy looking a whole lot more questionable. In fact, Heimlich’s success very nearly lead to global disaster.

For all his expertise as a medical professional, Henry Heimlich was surprisingly blind to the potential limitations of the treatment he had invented. As his manoeuvre grew in popularity, he began an aggressive campaign to have it included on the official guidelines of the Red Cross, who were strongly opposed to advocating a seemingly successful, yet still unproven life-saving procedure. This didn’t stop Heimlich. Eventually, thanks in part to public pressure, the American Heart Association elected to replace their existing advice with the Heimlich manoeuvre. Until 2005, the manoeuvre remained the only choking treatment they would endorse.

Heimlich with kids

It might seem that Heimlich’s enthusiasm, though annoying, was essentially harmless. The problems started when he began to turn his attention to areas other than the dinner table. Perhaps the most worrying from a professional healthcare perspective was drowning. Thanks to the success of the manoeuvre in treating unlucky diners, Heimlich was certain that the same principle could also be applied to unfortunate swimmers. Again, he lobbied the National Lifeguard Association to direct their employees to adopt the Heimlich and disregard the widespread practice of CPR. Again, the body buckled under a tide of public pressure.

The result was a disaster for drowning victims everywhere. CPR is essential in replacing the air that our lungs lose when we drown, and every second is precious once a patient has been recovered. Unfortunately, by adopting the Heimlich as the first port of call, first responders were actually delaying essential, potentially life-saving treatment, in favour of a few futile pumps. Though it’s impossible to say how many lives were endangered and possibly lost thanks to Heimlich’s unfounded conviction, what we do know is that it wasn’t until 2005 that the manoeuvre was finally removed from the American Heart Association drowning care guidelines.

By the mid-eighties, it was becoming increasingly clear that fame had gone to Heimlich’s head. He began to posit even more wild claims, such as the belief that his technique could cure asthma. After many years of dubious science, it became clear that glorified tummy thrusts could not match Heimlich’s lofty ambitions. He began to experiment with even more radical and downright dangerous alternatives to conventional medicine.

Without a shadow of a doubt, his most controversial proposals related to the field malariotherapy. This area, which has been widely discredited by most reputable scientists, focuses on the principle that the high temperatures brought on by malarial fever are sufficient to kill most other diseases. Using this theory as a base, Heimlich claimed that he had discovered the cure to cancer, AIDS and lyme disease. To support his statements, he conducted trials on living human patients in Africa and China, deliberately infecting already sick people with malaria to see if they would get better. Unsurprisingly, his work was labelled atrocious by the United States FDA and CDCP. Suddenly the Heimlich wasn’t so harmless.

Given the controversies that dogged his career, it seems astonishing the Heimlich has been able to remain one of the most mentioned names in medical history. Even today, and despite the best efforts of organisations who have attempted to rebrand his signature move, the Heimlich manoeuvre is still seen as life-saving. Though the manoeuvre itself is still as credible, a deeper look into the doctor’s work reveals that it may have inadvertently laid the foundations for something far more sinister. The Heimlich manoeuvre may not have directly killed anyone, but its impact may have ultimately been far more devastating than anyone could have ever imagined.