Starve.Org White Noise Usenet Archive: "The Trouble With Henry"

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The Trouble With Henry

Controversy doesn't deter prominent doctors from hailing the enigmatic Dr.
Heimlich

By Shane Johnson

SINCE CO-DISCOVERING the "sub-diaphragmatic thrust" in 1974, Dr. Henry
Heimlich's namesake maneuver has irrefutably saved the lives of thousands of
choking diners the world over. But despite dogged self-promotion, Heimlich's
subsequent medical maneuvers have been thoroughly panned by the medical
intelligentsia.

Along the way, the 84-year-old Cincinnati-based thoracic surgeon has allied
himself with a small band of respected medical professionals, including the
director of the Salt Lake County Health Department from 1971 to 1993, Dr.
Harry Gibbons. The two met in 1974 when Gibbons, an aerospace physician by
trade, called on Heimlich's tutelage after a rash of high-profile choking
incidents in Salt Lake City. Together they launched the nation's first
citywide Heimlich Maneuver education campaign, laying the groundwork for the
maneuver's eventual canonization in the American Heart Association's
Standards and Guidelines for choking in 1986.

Yet, despite controversy, Gibbons has backed Heimlich's myriad medical
pursuits since then, even as they've been deemed scientifically irrational
and dangerous by experts in the fields of drowning, asthma, AIDS, cancer,
Lyme disease and, ultimately, medical ethics.

Quick on the heels of his triumph with the choking maneuver, Heimlich went
to work on replacing cardiopulmonary resuscitation (CPR) as the
first-response protocol in near-drowning cases. Heimlich contends that
mouth-to-mouth resuscitation is useless without first plying his maneuver to
remove trapped water from drowning victims' lungs. Despite disagreement from
virtually every reputable medical organization in the country, Heimlich
continues to unabashedly assert on his website, www.heimlichinstitute.org,
and elsewhere that the American Heart Association and the American Red Cross
"are endangering lives by advocating CPR before the only method that has
been proven to save lives, the Heimlich Maneuver for drowning."

Citing a concerted "smear campaign" against Heimlich in the press, his
spokesman declined an interview request.

For his part, Gibbons said resistance to Heimlich's drowning protocol is
politically motivated, just as it was when they fought for more than a
decade to get the maneuver approved for choking.

"They're looking for anything they can push you down with," said Gibbons,
who advocates the maneuver for drowning in contravention of national
standards. "A lot of we doctors, if it's something that we didn't invent,
we're envious, and we tend to attack things."

Retired U.S. Coast Guard Rear Adm. Alan Steinman, the Stanford-trained M.D.
who devised the current drowning resuscitation guidelines for the armed
forces, said it's not bad blood but bad science that's done in the Heimlich
for drowning.

"The entire premise of Dr. Heimlich's hypothesis is wrong," Steinman said in
a telephone interview from his home in DuPont, Wash. "The lungs are not
filled up with water in drowning. Any water that gets down into the airway
and lungs is rapidly absorbed.

"There's absolutely no basis whatsoever for advocating the Heimlich maneuver
in resuscitation of near-drowning victims. In fact, it's counterproductive
and dangerous."

Notes Dr. James Orlowski, a drowning expert and chief of pediatrics at
University Community Hospital in Tampa, Fla.: "None of [Heimlich's] cases
have been adequately enough documented for the scientific community to look
at them critically."

Furthermore, Orlowski said he's investigated 30 near-drowning cases where
the maneuver is suspected of causing severe physical harm. The injuries
range from damage to the pancreas and stomach ruptures to documented cases
of aspiration pneumonia-where he said the Heimlich Maneuver induced
vomiting, which was then inhaled into the lungs during resuscitation. And
counter to Heimlich's claims, even if there is fluid in the lungs, it's well
understood that "you can very easily ventilate or breathe through that fluid
with no trouble at all," Orlowski said.

Overt dangers aside, Orlowski said the gravest consequence of using the
Heimlich is that it unnecessarily wastes precious seconds in getting air
into a drowning victim's lungs.

Prevailing science hasn't swayed Dr. Glen C. Griffin, though. A longtime
associate of Drs. Gibbons and Heimlich, Griffin endorsed and published
Heimlich's drowning protocol in two McGraw-Hill medical journals, of which
he was editorial director until 1995.

Of a handful of anecdotal cases presented by Heimlich in Griffin's journals,
and which he still touts, two have since been discredited to varying
degrees. In one case, the man who purportedly revived a near-drowning victim
using the Heimlich in 1981 recently told the Detroit Metro Times that he in
fact resuscitated the victim, his nephew, with CPR alone. Another
questionable case involved Heimlich's one-time colleague and close friend
Dr. Edward Patrick, also the self-reputed co-discoverer of the maneuver. As
recently reported in the Cleveland Scene, Patrick claimed to have been
working as an attending physician in a Lima, Ohio, emergency room when he
purportedly used the maneuver in 1980 to resuscitate a child who nearly
drowned in a nearby lake. However, Patrick has refused reporters' requests
to provide proof that he was employed at Lima Memorial Hospital at the time
of the scantly documented case, in which the 2-year-old girl slipped into a
coma and died some months later.

Since Griffin left McGraw-Hill, both journals have published articles
against use of the maneuver for near-drowning cases. One such article in a
1998 edition of Physician and Sportsmedicine advised that the Heimlich "is
of unproven benefit and should not be used unless obstruction of the airway
is strongly suspected."

Still, Griffin and Gibbons swear by it. "The logic of water going down an
airway and pushing it out is so consistent with what makes sense that I just
cannot imagine anybody not thinking that this is a good idea," Griffin said.
Asked how he can maintain that position in the face of near-universal
opposition within the medical community, he argued that "it might be
universally acceptable, or a good idea to do abortions, or a whole bunch of
other things that medical committees ... or others think is a good idea, and
they're not."

Although Gibbons acknowledges "there's sure a lot that I don't know" with
respect to the science of the drowning maneuver, he notes there was "very
little scientific evidence to back up the [Heimlich Maneuver for] choking,
too, which of course gives you some encouragement."

So confident has Gibbons been in Heimlich's work that in the late '80s he
tapped professional contacts in Mexico City, paving the way for Heimlich's
infamous "malariotherapy" treatments on terminal cancer patients. Heimlich
has postulated for decades that malaria-infected blood can arouse the
immuno-defenses of cancer, Lyme disease and HIV/AIDS sufferers. The Food and
Drug Administration, Centers for Disease Control and World Health
Organization have rejected the science outright. Ethicists have likened
malariotherapy to Nazi-era medicine.

Gibbons concedes that the malariotherapy trials were conducted south of the
border "because you could do it in Mexico." And although he's sat on two
institutional review boards-medical panels that inspect and monitor clinical
research protocols-that he said wouldn't have approved the malaria tests, he
nonetheless "thought it was worth a try," given that the dying patients had
no other options.

Gibbons reported that one woman's rectal tumor showed signs of retreat after
being injected with malarial blood. But the study's potential was never
realized, he said, because Mexican officials "kicked [Heimlich] out" after a
journalist reported that American doctors were using Mexicans as "guinea
pigs."

Undaunted, Heimlich has continued his malariotherapy foray on AIDS patients
in China, and possibly in sub-Saharan Africa, according to published
reports. But it appears that media scrutiny has hushed Heimlich, who was
dis-invited from a 2004 Pan Africa AIDS conference where he was supposed to
discuss the controversial therapy. Additionally, the Heimlich Institute,
which is hosted by Deaconess Hospital in Cincinnati, Ohio, has recently
removed from its website references to Heimlich's ongoing malariotherapy
efforts.

Naysayers haven't stopped Heimlich, or Gibbons for that matter, from touting
the unproven efficacy of the Heimlich Maneuver for yet another ailment.
According to Heimlich's website, the maneuver can also relieve acute asthma
attacks by expelling trapped air and mucous plugs in asthmatics. And as a
preventative tool, administered routinely as "mini-Maneuvers," Heimlich
claims his "cost-effective" treatment reduces the likelihood of acute
attacks, and "often eliminates or diminishes the need for anti-asthma
medications which have serious, even fatal, side effects."

In many ways, Heimlich's asthma pitch is reminiscent of his malariotherapy
promotions. In emails to the Los Angeles Times in 2003, Heimlich claimed
that "malariotherapy offers a safe, promising and inexpensive way to help
the millions of people suffering from AIDS through the underdeveloped
world."

Heimlich, who hasn't held a license to practice medicine in Ohio since 2002,
told a reporter last year that studies are currently under way to
demonstrate the benefits of the maneuver for asthmatics.

In both cases, said medical ethicist Elizabeth Woeckner, a board member of
the national nonprofit group Citizens for Responsible Care and Research,
Heimlich "puts the cart in front of the horse."

"If you're conducting research and you're already telling me the
results-that it is effective and it works-why the hell are you doing the
research?" asks Woeckner, who has investigated the protocols used in
Heimlich's malariotherapy trials, which in 2000 the national Food and Drug
Administration said were "inadequate" and failed to "minimize risks to
subjects."

Woeckner further states that Heimlich's asthma push hasn't even made it to
"first base," ethically speaking, because he has yet to demonstrate that
current asthma treatments are lacking, let alone how his maneuver would fill
the perceived void. "Do the experts in the field have any doubt which of
those two treatments is better?" she said. "They have no doubt.

"This is why you do research, not because you have-excuse me-a bug up your
ass."

Heimlich's poster child for the asthma maneuver-a 12-year-old Kaysville,
Utah, girl featured prominently in a testimonial on his website-happens to
be the granddaughter of a "dear friend" of Dr. Gibbons, who vouches for the
maneuver, and teaches it whenever he has the opportunity.

Gibbons said he's petitioned pulmonolo-gists at Primary Children's Medical
Center to consider testing the Heimlich on asthmatics, but they "would not
even discuss it," he said. "And that's pathetic."

Loren Greenway, administrative director of respiratory and pulmonary
medicine for Intermountain Health Care, and a nationally certified asthma
educator, finds Heimlich's asthma maneuver physiologically unfounded and
dangerous.

"Using the Heimlich maneuver in an acute asthmatic condition ... could
actually kill somebody," said Greenway.

Peter Heimlich, Dr. Heimlich's son, began examining his father's career a
few years ago and, based on what he found, has joined the ranks of those
calling for an end to the elder Heimlich's quixotic medicine.

"My father is enormously charismatic and persuasive," Peter Heimlich says
"People trust him because the maneuver for choking has saved so many lives.
[But] after a 30-year campaign, he hasn't convinced a single drowning
expert," Peter says. "It doesn't seem to bother him that people may be hurt
or killed. The whole thing's tragic and sick."

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From the January 5-11, 2005 issue of Metro, Silicon Valley's Weekly
Newspaper.