Henry Judah Heimlich (1920 – 2016) was an American thoracic surgeon and medical researcher best known as the creator of the eponymous “Heimlich maneuver,” a bear hug technique of abdominal thrusts pushing in above the navel that is applied to a choking person to lift the diaphragm and force air from the lungs to dislodge any object in the windpipe. It has become a national safety icon since its inception, as it is taught in schools, portrayed in movies and displayed on restaurant posters, and it has saved the lives of countless thousands, including the likes of Ronald Reagan, Ed Koch, Elizabeth Taylor, Goldie Hawn, Cher, Walter Matthau, Carrie Fisher, Jack Lemmon, Marlene Dietrich, sportscaster Dick Vitale, and television newsman John Chancellor.
However, while most people have heard about his maneuver, few are aware that he was Jewish.
Heimlich was born into an Ashkenazi Jewish family in Wilmington, Delaware, Mary (Epstein) and Pincus (Philip) Heimlich, who served as director of the Young Men’s Hebrew Association in Wilmington before working as a prison social worker for the Jewish Board of Guardians in New York. Heimlich’s paternal grandparents were Hungarian-Jewish immigrants, and his maternal grandparents were Russian Jews. He credited his parents for teaching him at a very young age that he has “an obligation to give back, to help others in whatever way we can. True happiness comes from giving of oneself,” which is a distinctly Jewish idea.
Although not religiously observant, Heimlich married Jane Murray, the daughter of ballroom-dancing entrepreneur Arthur Murray (born Moses Teichman) and his famous dance partner, Kathryn Kohnfelder. Much as her husband advanced some controversial medical practices (see discussion below on malariotherapy), Kathryn became a champion of chelation therapy – a notorious and medically disdained procedure whose serious side effects can include death, using medications to remove metals like lead, mercury, and iron from the body. She also wrote What Your Doctor Won’t Tell You: The Complete Guide to the Latest in Alternative Medicine and co-wrote Homeopathic Medicine at Home.
Although best known for his “maneuver,” Heimlich held patents for more than 20 medical innovations and devices and made many other significant medical contributions that are not nearly as well-known.For example, while in China during World War II, he developed an innovative treatment for victims of trachoma, a previously incurable bacterial infection of the eyelids that was causing blindness throughout Asia and the Middle East, by pulverizing a recently developed antibiotic and mixing it with shaving cream.
While working as a thoracic surgeon at New York City hospitals, Heimlich developed a procedure for using a section of a patient’s stomach to construct a new esophagus where the organ had sustained serious damage caused, for instance, by cancer or from the ingestion of a caustic chemical, particularly household lye, a common accident before the development of childproof bottles. His procedure, recognized by some as the first complete organ transplant in history, was originally rejected by hospital management, but he ultimately succeeded in securing a $300 grant and laboratory space. After successfully testing the procedure on dogs, he published his findings in Surgery in 1955, and he successfully performed the operation on a human in 1975. He is credited as a prime developer of this “reversed gastric tube” procedure, which became standard in operating rooms across the world.
In 1962, he invented the Heimlich Chest Drain Valve, or “flutter valve,” which drains blood and air out of the chest cavity and permits a collapsed lung to re-expand. Drawing his inspiration from his recollection of watching in futility as a Chinese soldier in Mongolia died in his arms from a bullet wound to the chest during World War II, he fashioned a prototype using a $1.50 Japanese toy from a novelty store, which functioned as a one-way flutter valve when attached to a drainage bottle. The valves – which, unlike other drains, were highly portable – sparked the interest of Navy doctors, who used them in Vietnam and saved the lives of thousands of American soldiers. The Heimlich valve is still used on the battlefield and in hospitals, and when Heimlich visited Vietnam in 1989, he was deeply moved to find that not only was his name still well-known there, but also that the Quakers had supplied Heimlich Valves to North Vietnam, saving additional thousands lives there as well.
Heimlich also invented the Micro Trach portable oxygen system for ambulatory patients, which relieves dyspnea (difficult shortness of breath) and allows normal speech, productive cough, and restoration of appetite. Significantly, it delivers oxygen through the trachea, which delivers it directly to the lungs and eliminates the waste of oxygen through the mouth and nose, making the use of oxygen so efficient that the supply needed is sufficiently small to be carried, thereby restoring the mobility and freedom of housebound patients.
After graduating from Cornell University with a B.A. in 1941 and earning his medical degree from Weill Cornell Medical College in 1943, Heimlich served on a top-secret mission with the United States Navy in China, where he served as chief medical officer and established a medical camp that was designed to treat American soldiers injured during an expected Japanese invasion. Responsible for the well-being of American forces in northern China behind Japanese lines in the Gobi Desert, he often operated in a field hospital without electricity, and he claimed to be the only doctor assigned to a Marine unit helping Chinese allies in Mongolia. As mentioned above, it was during this time that he developed a pioneering treatment for trachoma.
In the 1970s, choking on food or foreign objects was the sixth leading cause of accidental death in the United States and was responsible for about 4,000 annual fatalities, many of them children. Heimlich became interested in the phenomenon after reading an article about America’s epidemic of death by choking, which was known as “beefsteak disease” because it usually involved adults swallowing large pieces of meat that had been insufficiently chewed. (It was also sometimes referred to as the “café coronary” because the act of choking on a mouthful of food, which often took place at restaurants, looked to casual observers like the victim was suffering a heart attack.) He recognized that the standard technique of pounding the back – which he characterized as “death blows” – often shifted the lodged object more firmly down the windpipe. He and his team at the Jewish Hospital in Cincinnati, where he served as chief of surgery, worked for two years using tubes and balloons inserted down the throats of anaesthetized dogs before developing the thrusts to force air from the lungs and to push obstructions back out towards the mouth.
Heimlich always intended his maneuver to be practiced by the public at large rather than exclusively by health professionals and, as such, he sought to broadly disseminate his findings as soon as possible. He first described the procedure in Pop Goes the Cafe Coronary, an informal article published in Emergency Medicine (June 1, 1974), but it was an editorial in the August 12, 1974, issue of the AMA Journal that first referred to it as “the Heimlich maneuver.”When the procedure met with resistance from the medical establishment, he encouraged readers to send him success stories, and publicity rocketed when a restaurant owner in Bellevue, Washington, used the method to save the life of a choking customer.Only a few weeks later, newspapers were reporting on the first successful implementation of the maneuver and he soon had received over 200 accounts of people being saved through the technique.
Heimlich formally described the anti-choking technique in A Life Saving Maneuver to Prevent Choking, an October 27, 1975, peer-reviewed article published in the Journal of the American Medical Association and later in the Annals of Thoracic Surgery. For the next ten years, the choking guidelines of the AMA, the American Heart Association and the American Red Cross instructed rescuers to first perform a series of back blows to remove the foreign body airway obstruction and then to proceed with the Heimlich abdominal thrusts. In 1985, however, U.S. Surgeon General C. Everett Koop declared that the Heimlich maneuver was “the only method” that should be used to help choking victims, and the American Heart Association instructed rescuers to administer the maneuver immediately upon finding a choking victim.
Exhibited here is a rare and early broadside illustrating how to perform the Heimlich maneuver on food-choking victims, signed and inscribed by Heimlich “To Jerry Shoemaker / Best wishes, / Henry Heimlich.” The circular, which featured colorful illustrations and step-by-step instructions, was published in 1976 and was distributed for posting by the Cincinnati Board of Health and Office of Health Education. Although, as discussed above, Heimlich had discussed the ideas behind his life-saving eponymous maneuver as early as June 1974, the technique was not formally described until 1975 in articles published in two medical journals and, as such, this early broadside uses the term “Heimlich maneuver” only with an asterisk, meaning a trademark was still pending at the time of printing.
Although the American Heart Association and the American Red Cross had removed back blows from the protocol for choking victims and rescuers were taught to immediately administer the Heimlich maneuver, the American Red Cross reversed course in 2005 and, pursuant to its new protocol, called “the five and five,” rescuers treating conscious victims were to begin by administering five back blows before proceeding to five abdominal thrusts, repeating the process until the object is forced out, the victim can cough forcibly or breathe, or the victim becomes unconscious.
An outraged Heimlich was horrified by the move because, he insisted, back slaps lodge the object further in the breathing passageway and lead to deaths from choking, and he demanded that the medical establishment produce any research proving that back slaps help choking victims because “as far as I know, none exists.” He demanded that the Red Cross remove his name from its first-aid literature for choking, and the phrase “Heimlich maneuver” was replaced by “abdominal thrusts.”
Heimlich always maintained a shaky relationship with the medical establishment. A medical maverick, he frequently challenged prevailing medical norms, maintaining his faith in his own theories and abilities in the face of strong opposition, and he was colorful and combative when defending his most enduring contributions to medicine. He frequently flaunted established medical practices in relying on anecdotal evidence instead of hard quantitative data and refusing to publish in peer-reviewed journals.
Even with respect to the Heimlich maneuver, the medical establishment originally questioned its effectiveness, and even its propriety, suspecting that it was an unscientific and possibly dangerous stunt too difficult for laymen to perform and which might even cause internal injuries or broken bones in choking victims. Even the great extent to which the maneuver entered the public consciousness did little to end his battles with the medical associations that viewed him as a publicity-seeking self-promotor at best and a crackpot eccentric at worst. The media would sometimes also pile on condemnation; for example, the New Republic described him in 2007 as “the P.T. Barnum of American medicine – his career serving as testament to the fact that even the supposedly fact-based medical realm is susceptible to the phantom powers of personality and salesmanship.”
Some of the scientific criticism may have been legitimate, but some claims were clearly little more than manifestations of jealousy, although I have never found any sources even suggesting that he was subject to antisemitic animus. To cite just one laughable example, some Red Cross doctors at the time accused him of anesthetizing a patient and then forcibly lodging a chunk of meat with a piece of string attached in his trachea to test the procedure. Reacting to a Woody Allen story about a doctor engaged in parallel research, Heimlich, citing the Red Cross allegations against him, wrote that “your story is truer than you could know.” Allen wrote back: ” I loved the part about the chunk of meat with the piece of string tied around it. Only a madman could have thought of that, and I’m sorry I didn’t.”
Notwithstanding all his remarkable contributions, Heimlich is the subject of debate and controversy regarding whether he deserves full credit for his achievements and for some of his ideas that are unverifiable at best and unscientific, or even dangerous, at worst. Some critics maintain that he fraudulently took credit for his “groundbreaking” esophageal procedure when it had been performed years earlier by Romanian Dr. Dan Gavriliu, but Heimlich claimed to be unaware of Gavriliu’s work at the time. Frederick Webster, who served as Heimlich’s medical assistant in China, claims that Heimlich’s story about the Chinese soldier in Mongolia dying in his arms was sheer fabrication. Claims of experimental case fraud have persisted with respect to Heimlich’s promotion of abdominal thrusts for drowning. Some Hollywood stars, such as Richard Dreyfuss, whom Heimlich listed as supporters of a controversial medical assistance procedure, said that they had never met Heimlich and never supported his proposed protocol.
Allegations against Heimlich later emerged by others claiming to have devised the Heimlich procedure; for example, in a 2003 press conference, Edward Patrick, Heimlich’s associate, claimed to be the uncredited co-developer of the maneuver.
Heimlich provided several different accounts regarding the first time he personally used the maneuver. He claimed that he did not use it until May 23, 2016, when, at age 93, he famously rescued a choking resident of his senior living community but, in a 2003 interview with the BBC, he claims to have used it for the first time to save a man choking in a restaurant. However, according to his son, Peter, neither of these rescues ever occurred. Peter, perhaps his father’s greatest critic, maintained a website describing Heimlich as “a spectacular con man and serial liar . . . the only thing my father ever invented was his own mythology,” and he detailed his father’s “wide-ranging, unseen 50-year history of fraud.” (Heimlich’s three other children, however, all stood by their father and defended his work and character.)
Heimlich’s reputation took a hit when he campaigned to have the maneuver adopted as the best method for treating drowning victims. A unified medical establishment insisted that CPR is the proper procedure to remove water from the lungs and maintained that the use of the Heimlich maneuver in drowning cases could be fatal because victims could aspirate on whatever regurgitated water and vomit the thrusts brought up.
Heimlich, determined to plead his case to the public, accused the medical establishment of letting people die while blindly following their bureaucratic and senseless procedures; in a notable 1995 appearance before the U.S. Lifesaving Association, he even used Holocaust imagery to support the use of his maneuver for drowning by recalling that “the Nuremberg trials told the story that no one can be excused for saying, ‘I was ordered to do so or was taught to do so, to kill people.'”Nonetheless, the American Heart Association’s 2005 drowning rescue guidelines warn against using the Heimlich maneuver for drowning victims as dangerous because, among other things, it increases the risk of vomiting and aspiration.
But the campaign that most brought Heimlich’s reputation into disrepute was his promotion in the 1980s of malariotherapy, the intentional infection of a person with benign malaria to treat cancer, Lyme disease, and HIV, arguing that malarial fevers could stimulate the immune system to fight more serious ailments.The medical authorities uniformly considered this treatment to be illegitimate and, when the FDA prohibited testing in the United States, Heimlich, unable to secure domestic funding, conducted malariotherapy trials through the Heimlich Institute in China, Mexico and Ethiopia.
When Heimlich presented his malariotherapy plan in 1993 to a group of Hollywood stars, he collected $600,000 for an experimental medical program from the likes of Bob Hope, Jack Nicholson and Ron Howard, who worked on Happy Days with Heimlich’s nephew, Anson Williams (“Potsie”). The Heimlich Institute adopted a new letterhead that featured a star-studded “Hollywood Support Committee” including Muhammed Ali, Bette Midler, Jon Voight, Ted Danson, Ed Asner and Anjelica Huston. The major frauds section of the U.S. Department of Justice launched an investigation into Heimlich’s fundraising, but the case was closed with no charges being filed – possibly because Heimlich truly believed in the possibilities of this therapy research and had no fraudulent intent to scam anyone.
Heimlich claimed that the initial trials with seven subjects produced positive results and he published results in a Chinese medical journal in 1999, but he refused to provide details; the treatments had been conducted without institutional review or professional oversight; and the entire procedure drew brutal criticism as both scientifically unsound and dangerous.The United States Food and Drug Administration and the Centers for Disease Control and Prevention went even further, characterizing malariotherapy as “atrocious,” and studies in Africa, where both HIV and malaria are common, indicated that malaria/HIV co-infection increases the viral load and that introducing malaria could accelerate the rate of spread of HIV.
One doctor perhaps said it best: “His proposal was giving malaria-infected blood to people who had AIDS. It doesn’t take a genius to know that you don’t give an infectious disease to somebody who has a suppressed immune system.” In 2002, a World Health Organization commission cited Heimlich as part of “a backdrop of atrocities committed by doctors upon vulnerable subjects.”
Nonetheless, in his 2014 memoir, Heimlich discussed the environment in which AIDS was spreading unimpeded: No vaccine was on the horizon and people and their doctors were desperate, and he claimed that the situation justified malariotherapy trials and that he still believed in its effectiveness. Citing studies conducted in Austria in 1922 using malaria as a method to treat patients with neurosyphilis, a horrendous condition where syphilis spreads to the brain and the spinal cord, he compared himself to Julius Wagner-Jauregg, who was awarded the 1927 Nobel Prize in Medicine for the development of malaria therapy for the treatment of neurosyphilis. (Ironically, Wagner-Jauregg was an enthusiastic Nazi sympathizer who advocated “racial cleansing” – which surely would have included Heimlich.)
One of the fiercest critics of using malaria to treat neurosyphilis was one Anthony Fauci – you may have heard of him – who told ABC News in 2007, “There are some Nobels they would like to take back, and I believe that’s one of them.” I can’t help but wonder if the good doctor thinks the same thing about Yasser Arafat’s and Barack Obama’s Nobel Peace Prizes, but that is another story for another day.
Heimlich won an Emmy Award in 1980 for Dr. Henry’s Emergency Lessons for People, a television children’s series; published Dr. Heimlich’s Home Guide to Emergency Medical Situations; received the 1984 Lasker award, America’s top medical citation dubbed “America’s Nobels;” and published his memoir, Heimlich’s Maneuvers: My Seventy Years of Lifesaving Innovations in 2014. Notwithstanding the controversy regarding whether he deserves full credit for the procedure, and questions by some commentators regarding its efficacy, the AMA credits it with saving thousands of lives each year, and it is broadly acknowledged that the maneuver has saved some hundred thousand lives since its inception.
