Heimlich's Maneuvers

by Henry J. Heimlich

  On the second trip, I was invited back to China by one of General Fu’s granddaughters, Xiou Dong. This time, I was taken to Camp Four. All of its buildings were gone and the road had been paved, but the waves of white sand stretching far into the distance were just as I remembered them. I tearfully knelt down and rubbed my hand in the dirt. As I stood up, our hosts motioned us to follow, and we walked across the road to a peasant’s house on a small farm that I remembered from the war.

  Figures 17.1 and 17.2. Returning to a great country: After World War II, I went back to China numerous times. I love the Chinese people.

  Our conversation with the family who lived on the farm was a moving experience for me. The family members told me how they recalled the American soldiers riding their horses, waving to them, and shouting “Hau bu hau!” (“Good, no good?”), the Mandarin salutation for “How are you?” One woman told me that she remembered me treating her for trachoma when she was a child. I met others on that trip who told me I had treated them for trachoma, too. I wondered how many would have gone blind had I not come up with my sulfa-Barbasol treatment.

  Two days later, I was driven to a small apartment house, where I was introduced to an elderly Chinese couple. My guides informed me that the man was blind. After some discussion, I was reminded that he was a doctor who had spent time with me in my clinic in 1945 and had given me a farewell banquet the night before I left the Gobi Desert. Being blind, he was having trouble remembering just who I was, since he had met not only me but also other doctors who had been at Camp Four before I served there.

  I let him know that I was the only one who operated on people. A big smile erupted on his lips. He sat up straight and said through his interpreter, “You’re the one who operated on the girl!” He remembered how I had saved the life of my first patient at Camp Four, the young woman who was brought to me on her father’s back. The old man and I threw our arms around each other and hugged, both of us laughing.

  SIGNS OF PEACE

  As my parents taught me from a young age, we each have an obligation to give back, to help others in whatever way we can. For decades, I have been promoting the idea of what I call “A Caring World.” It would be a program that promotes peace, good health, and goodwill worldwide. Through this program, people would learn what I have learned so well—that true happiness comes from the giving of oneself.

  The first time I thought about the concept of A Caring World was in 1983, when I was giving a talk that was part of the lecture series at the Chautauqua Institution, outside Buffalo, New York.2 Jonas Salk, inventor of the polio vaccine, was also on the program and talked about world peace. I spoke on the Heimlich Maneuver for saving choking and drowning victims, and I, too, concluded with my thoughts on world peace. I thought then that, while we each go on with our busy lives, it’s important we never lose sight of the big picture—that is, to help bring peace to the world.

  Many people today feel that the world is in a terrible state, and I can’t blame them for feeling that way. We see photos of children holding guns or lying dead, and they look like our own kids. Yet I believe that it is more possible than ever to create a caring world. As we increase communication with the Internet, we bring people together in ways we could never have dreamed of when I was a young man. Choices we make here in America affect the environment everywhere else, and vice versa. Countries that used to hate each other are now interdependent; the need to work together toward goals that benefit us all is more apparent than ever.

  History has shown us wonderful examples of this kind of give-and-take relationship in action. For instance, when World War II ended, US Secretary of State George Marshall established the Marshall Plan, the American initiative in which the United States gave economic support to help rebuild European economies to prevent the spread of Communism. The program enhanced the postwar economies of Germany and Japan, thereby enabling those countries to transform into world-friendly democracies.

  In 1956, I passed through the Brandenburg Gate from West Berlin to Communist East Berlin, one city split in two by the Berlin Wall. On June 7, 1987, President Ronald Reagan stood at the gate and spoke of the industrial benefits of freedom, issuing his famous words, “Mr. Gorbachev, tear down this wall.” Two years later, the Soviets did that very thing.

  In the many years that I have been a surgeon, I have had the opportunity to work with some of the finest individuals in the field of medicine and have marveled at the care patients have received from nurses and aids. Some people with whom I have worked have ventured outside their normal fields for the sheer interest in improving the lives of patients. In the 1970s, I worked with astronaut Neil Armstrong on developing an artificial heart-lung system. I was impressed and energized by Neil’s desire to help others when he could have chosen to simply rest on his laurels as the first man to walk on the moon. We remained friends until he passed away on August 25, 2012.

  Figure 17.3. A man who went beyond: I appreciated astronaut Neil Armstrong’s dedication to medical innovation. (Neil Armstrong and Dr. Heimlich [seated], in front of Dr. George Rieveschl [standing]. Photograph courtesy of Archives and Rare Books Library, University of Cincinnati.)

  For about six years, Neil and I met for lunch on a weekly basis in my laboratory at the Jewish Hospital. He had obtained NASA’s last two existing pumps that were used to circulate fluid in space suits to maintain a constant temperature. We worked on modifying those pumps to reduce the hemorrhaging of red blood cells during bypass surgery, a problem that medical pumps at the time were experiencing. We did not get to the point of developing a prototype; however, on March 20, 1975, we presented our findings at the annual meeting of the Association for the Advancement of Medical Instrumentation.3

  Figure 17.4. A devoted wife: From the time that Jane and I were married in 1951, she was supportive of my work.

  I believe I have learned the most about a caring world from my relationships with my children, my father, and my late wife, Jane. Jane devoted her life to caring for others not only as a wife, a mother, and a loyal friend, but also as a writer. As a columnist for the Cincinnati Post in the 1970s, she wrote an article about holistic health, which had not yet hit the mainstream. The article was so popular that Jane began to dig deeper into the subject. In 1980, she collaborated with a holistic-health physician to write a book on homeopathy called Homeopathy at Home, which was translated into seven languages. Then, in 1990, she wrote another book. What Your Doctor Won’t Tell You explained alternative, holistic-health remedies in a way that was clear to the layperson. In this way, Jane’s work helped thousands of patients who were looking for nontraditional healthcare treatments. After sixty-one wonderful years together, Jane passed away on November 10, 2012.

  Figure 17.5. Sixty-one wonderful years: In our later years, Jane and I lived a relatively simple life. We enjoyed traveling to resorts in natural settings such as Wisconsin, North Carolina, and Maine.

  Like their mother, our children are also compassionate, loving individuals. Even when they were younger, I could see how they cared about the wellbeing of others. In fact, back in the 1970s, when I was working with dogs in my laboratory to come up with the Heimlich Maneuver, my young daughter, Elisabeth, who adores animals, asked to come to the lab with me. From that point on, she held the dogs and walked them around the block whenever she had the chance. Both my son Philip and my daughter Janet are devoted parents. I admire the loving and mutually respectful relationships they have with their children, and I treasure the time I spend with my three grandchildren, Henry, Allie, and Maxine.

  Figure 17.6. Daughter and wife: Me with my daughter Elisabeth and Jane in 1990. (Photograph courtesy of Elisabeth Heimlich.)

  Figure 17.7. At Jane’s book signing: My son Philip with his wife, Rebecca, and their children, Henry and Allie. (Photograph courtesy of Philip Heimlich.)

  Figure 17.8. Daughter and granddaughter: My granddaughter Maxine and my daughter Jan. (Photograph courtesy of Janet Heimlich.)

  A REWARDING RELATIONSHIP WI
TH MY FATHER

  As a physician for more than seventy years, I have treated hundreds of elderly patients, but it was only in the last year and a half of my father’s life that I truly learned about aging and how to care for those approaching death. That year, 1986, was the best year of my life. Here was a man I had known and loved longer than any other person, but we became true friends only during that last year together.

  Pop had moved to Cincinnati, and he did his best to live independently, but eventually he needed our help. One evening, I answered the telephone and it was Dad. “Hank, I can’t get up from the chair,” he said. Jane and I jumped into the car and drove to his apartment. When I saw him, I realized he had not been eating enough and was too weak to stand. I debated whether to take him to the hospital or back to our house and decided on the latter. We bundled him in a blanket and drove home.

  Pop’s strength returned after he lived with us, and we were able to enjoy a wonderful year together. I began coming home after lunch and not returning to the office so I could spend more time with him. We had long talks after lunch and dinner. It was great to have a live-in male friend, and I began asking questions and saying things I had avoided for many years.

  I remember one particularly wonderful moment.

  “Dad,” I said, “men of our generation are ashamed to say ‘I love you,’ but my kids taught me to say it. Pop, I love you.”

  “I love you, too,” he responded warmly. We hugged and kissed as never before. Thereafter, on the phone or in person with visitors, with an expression of discovery in his voice, he closed every conversation saying, “You know what? I love you.”

  In his last six months, Pop’s health worsened. His personal-care and medical-care needs required increasing time. Fortunately, a friend shared with me that, when she had had to spend time with her aging mother, she had been annoyed by the demands on her time and effort. Yet after her mother died, she missed performing those tasks.

  Knowing this, I took pleasure in being able to spend more time caring for Pop. We sometimes had a role reversal. I would carry out the medical rituals, tuck him into bed, and give him a hug and a kiss. Sometimes I’d say, without being conscious of it, “Good night, my son.” At other times, Pop would say he thought of me as his father.

  Figure 17.9. Taking in my father: We loved having Pop visit throughout our lives. When he became aged, he lived with us until his death. (Photograph courtesy of Elisabeth Heimlich.)

  A few months later, he told me of certain symptoms I, as a doctor, should have recognized as indicating urine retention. Sometimes when we care for loved ones every day, we don’t see their small declines. When his condition became acute, I had his physician come over to the house. While waiting for the ambulance, Pop lay in his bed while I sat next to him with my arm around him. I knew we had reached a point of complete understanding when he said, matter-of-factly, “Hank, I don’t want to live any longer. I’m just a burden now. I won’t ask you to do anything because you’re a doctor and it would be on your conscience.” A few months earlier, I would have stammered through a denial of his impending death. Instead, I could say honestly, “I can accept your decision, Pop, and I won’t prolong your life unnecessarily.”

  On admission to the hospital, he underwent a minor surgical procedure under general anesthesia, but at his age, it was still a major stressor. Fortunately, he recovered and was able to return home after about a week. Then, one day, he told me, “Hank, I don’t know why I said I was ready to die. I really want to live.” How wonderful to be ninety-nine years old, ill, and want to continue living!

  On December 30, 1986, four months before his one hundredth birthday, Pop died at home. Up until the last week of his life, people were still phoning him for advice. He spent his entire life helping to create a caring world not only as a social worker but also as a humanitarian. His good deeds will remain forever in my heart and in the hearts of the families he touched.

  ALLOWING CHILDREN TO BE SUPERHEROES

  While reporters seem fixated on my past accomplishments, I am still quite active and continue to educate people about lifesaving programs. Today, I do so through the Heimlich Institute, a nonprofit organization that conducts medical research and teaches the public, including schoolchildren, how to save lives with the Heimlich Maneuver.

  In some ways, I see teaching the maneuver as a way for people to connect to each other as thousands of people throughout the world learn to save the lives of friends, relatives, neighbors, and strangers. Recently, we at the Heimlich Institute got to bring that gift to the next generation by initiating a program we call Heimlich Heroes.

  The idea came from Patrick Ward, who headed the Deaconess Associations Foundation (where the Heimlich Institute is housed) in Cincinnati. Pat and I had often spoken about how astonishing it is that young children learn the maneuver and use it to save a life.

  One day, Pat suggested a tremendous idea: he proposed creating a curriculum for school children to teach them how to perform the Heimlich Maneuver. And that’s just what we did. The foundation employed a gifted sixth-grade teacher with a doctorate in chemistry to develop the curriculum. Dr. Michelle Mellea teaches science at the Bethany School, a private Episcopal elementary and middle school in Glendale, Ohio.

  To help instruct sixth graders about the maneuver, teachers use “Heidi Heimlich,” a forty-two-inch doll specially created for hands-on training of the Heimlich Maneuver. The doll is designed and constructed to mimic human anatomy, complete with an internal diaphragm, lungs, a windpipe, and a plastic mouth that expels a peanut-sized foam cushion when the maneuver is demonstrated correctly.

  On April 22, 2012, we rolled out a Heimlich Heroes pilot program involving Dr. Mellea’s sixth-grade science class. The children loved the experience. They learned that they can save the life of a parent, a sibling, a friend, or even their teacher. It was delightful to watch the children master the technique of applying pressure to Heidi’s diaphragm to compress her lungs, force air upward, and expel the peanut.

  The children came away from the demonstration empowered and confident in their ability to react correctly in an actual choking crisis. Becoming a Heimlich Hero taught those kids not only a lifesaving skill but also self-esteem and a responsibility to help others in need. After the lessons were over, Bethany School’s principal, Cheryl Pez, took me aside and told me a tragic story. She shared with me that her brother had died from choking in June of 2005 at the age of thirty-eight. He was at home, alone, when he began to choke on food. Not knowing how to self-administer the maneuver, he went to the house of a neighbor who was not home and collapsed and died in their driveway. For Ms. Pez, having Bethany School be the first to host the Heimlich Heroes program was a way to honor her brother’s memory and spare another family the pain hers had suffered.

  Since that first demonstration, the Heimlich Heroes program has really taken off. As of summer 2013, the program has been presented in ten Cincinnati public and private schools; 523 sixth graders have been instructed on the correct way to perform the Heimlich Maneuver and save a life. We plan to expand the Heimlich Heroes curriculum to elementary-school systems nationwide. The program is priceless because it can help bring down the number of annual choking deaths in the United States today.

  A CARING WORLD ON A GLOBAL SCALE

  We must encourage caring throughout the world. A meaningful sense of values must be established and accepted by all countries and cultures. We should hold up caring individuals as role models for children and adults alike, and the media should publicize caring acts.

  Governments can do their share, too. Just as anyone can perform the Heimlich Maneuver, governments can learn to care, to empathize, to give. Earlier, I discussed how we have seen huge changes take place in certain countries—changes that were unthinkable at one time, yet they happened and improved the lives of many.

  For a long time, I have advocated for countries that have long been at odds with each other to start trading with one another and working together. Why?
Because establishing such economic partnerships can lead to world peace.

  The idea is simple: once countries form economic alliances, they prosper together. But the world can benefit from these alliances in ways we never imagined because countries can band together to reach out to less fortunate, developing countries to help them prosper, too.

  As an example, in the spring of 1998, I was invited by doctors in Iran to lecture in their country. It was at the height of enmity between the United States and Iran. For two weeks, I gave talks at universities, hospitals, and a medical college. Before concluding my trip, I was invited to hold a press conference. One reporter asked, “What do you think of President Khatami?” I explained that I had seen a CNN interview with the president and agreed with his ideas about the United States and Iran working together. The newspaper Iran News covered the press conference with an article carrying the headline, “‘A Caring World’, the Slogan of Heimlich.”4

  But there is one key partnership that can get this movement going on a global scale—that is, the relationship between the United States and China. Having spent time in China during World War II and having visited that country numerous times since then, I have gotten to know many Chinese citizens and have found them to be wonderful people. It pains me that the United States and China have been at such odds for so long.

  But how that has been changing! Now trade is expanding between the two countries, and the economies of both are benefiting as a result. In December 2012, US ambassador to China Gary F. Locke, who is of Chinese descent, spoke optimistically about the relationship between the United States and China. Mr. Locke pointed out that since the Nixon era, both countries have become inextricably tied to one another, and the relationship is bound to grow even more interdependent going forward. “Our economies are so intertwined, and Chinese leaders know that,” Mr. Locke told the media.5