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Dr. Heimlich: the man behind the maneuver.


Part II

"Things don't happen out of the blue. Apples fall on people's heads all the time. And they either say: 'Ouch!' or: 'Hey, an apple! What luck!' But then along comes a Newton and he wonders what caused the apple to fall.

"Twenty-five years ago I was operating on a patient suffering from cancer of the rectum. It was a general surgical case I would have been doing then, not so unusual. To prevent obstruction and to control bleeding, I cauterized it. The surprising thing was that the patient didn't die, as he should have, by every sign I could see.

"But no, he kept coming back every few months and didn't die. Eventually, he was so improved that we felt he was strong enough, and another operation was justified, to remove more of the tumor and see what was going on inside. We operated and found cancer cells imbedded in scar tissue, very little, and all of the spreading had stopped.

"Now this was a curious happening and it struck my interest. Some doctors would have seen a patient cured, and would have been very happy to have rendered the service. But I was intrigued. I wondered if it had happened before. I investigated the literature, checking under 'Cancer' and 'Cauterizing' and moving from one report to another through the cross-references and found it was a routine occurrence. There was plenty of evidence to support that in a number of cases the cauterizing had been more curative than the surgical removal. Something was going on here. This distracted me from my regular practice, of course. I was never a lucrative practitioner.

"Well, I looked for a common thread to it, and considering it, I came up with a logic for why it might work, a concept. Clearly it had something to do with heat against cold. The heat from the cauterizing radiates through the cancer that's left, diminishing as you go further away from the source, and some temperature along that gradient was either modifying the cells in some way or destroying the cells, causing them to excude a substance that destroys other cancer cells.

"Now I happen to love world's fairs. I sold cold drinks at the 1939 New York World's Fair in New York, the year before I entered medical school. The slogan for that fair was 'Peace and Democracy,' and then Italy pulled out and the World War began and I would up in China. But then I worked the stands at the American Jubilee Show. What a show! They had a hundred people on horses, then a hundred on motorcycles, comedians, bands, a fabulous show. I saw it three times a day, knew every note. Anyway, it was at that world's fair, or maybe another, I'm not sure because I've gone to them all, including the one at Knoxville, when I saw my first laser, at an AT&T exhibit. Later, when I was looking up lasers, I knew who the experts were. Because I had this idea of using the laser surgically, to produce the heat.

"I was working as a consultant and adviser for a pharmaceutical company and I had to fly to Chicago to meet with them, and because they were paying for it, I was flying in the first-class section. I got to talking to the man next to me--he was a very interesting man--and I told him what I was doing, all about other things, of course, and he said, 'Here, take this.' And he wrote a note to the chairman of the board of the lab, who was a relative of his. I turned the card over and it read: Wallace DeButts, president of Illinois Bell and vice president of AT&T. 'Hey,' I said, 'you're just the guy I've been looking for. I've got this idea for adapting the laser for surgery.' He listened and he said, 'I'll get back to you.'

"I got a call from the home Bell lab in New Jersey a week later from a man who identified himself as a physicist. I could tell from his tone that he was put out, he'd been told by the Big Boss to call this doctor. Listen, I said, I don't know Mr. DeButts. I met him on a plane and I told him I was interested in the surgical use of the laser. I knew you people were the leaders in the field. Here's what else I've done. And he was very helpful after that.

"We set up a project and worked it out in a year. We were the first to pass a laser beam through a fiber optic and have it show up intact on the other side. I wanted to direct the beam for surgical use through fiber optics. Once they'd done this, though, they had to stop, as far as I was concerned, because the work was no longer related to the business of their company.

"They put me in touch with the Perkin-Elmer Company in Connecticut. They were the first one to shoot a laser beam to the moon and bounce it back. They assigned some physicists to work with me, and I supplied them with fresh cancerous tissue which they cauterized with lasers using the fiber optics, and we'd chart the results. That was in 1969, when I moved to Cincinnati, and it went on the back burner for a while.

"In 1972, I filed for a grant application with the National Cancer Institute, along with Perkin-Elmer, a business-academic application, the first of its kind. I went to Washington and met with the chairman of the NCI and told him about out work, and he was very encouraging. Looks good, looks good, he said. We filled out the applications--it was a lot of work, presenting all our research and data, the statistics, the works, and they said great, great, looks good, and then they turned us down. I vowed then never to apply for another government grant. I know how it works and where the money goes--it's all political. They look at who you're associated with, and that's where the money goes, millions and millions, usually right down the drain. They don't care what you're doing, so long as you're in the right place.

"Five years later I noticed that the people on the review committee were using the laser in surgery, passing it through the fiber optics. Oh, it was a most marvelous breakthrough for them. I suppose it could have been a natural development of their work--I don't care. For me, the next idea is always just around the corner. I don't care if people steal my work, because they can only take the idea as it is, what they see, not the concept. They know nothing about what went into it, so they're unable to develop it any further.

"For instance, the whole concept of the hyperthermia, that it was increased body heat that was affecting the cancer in some way. They came out with that, too, spent millions on it, but all the research reflected their typical stupidity. They tried ovens; they put people into spacesuits and raised their temperature; into hot baths and heated paraffin, coated them with wax; they even took blood out, warned it, and put it back in. It was so ridiculous! And some of this was so painful to the patients that they had to be anesthetized while it was being done.

"When I think of treatment, I try to imitate the function of the body. Instead of trying to heat the body like you'd cook food, imitate the function. If the problem is to heat the body, then why not look at the way the body heats the body? I was thinking that way when I remembered that malaria was used as the treatment for syphilis before the invention of penicillin. I went back to the literature, the old history, and I found they had very good success when they chose the right strain of malaria. Essentially there are four, and two are especially suitable. One is easily curable, and will induce a good fever. It's that fever we think could be effective against cancer. I believe it is so; I believe it myself 100 percent; but I don't want to hold out false hope to people. I have to be very careful, in my position, of my credibility. People now will believe practically anything I say, so I want to wait until the work is done. Already they come to my office, inoperable, terminal cases, and they ask me if they can't offer themselves as test cases. They'll sign anything, because they have no other hope. I have to tell them to wait. We need to do a study. I hope it comes soon."

The Heimlich Response

Dr. Heimlich is speaking with a young Colombian man attending Xavier on an exchange program in order to improve his English. Dr. Heimlich is brushing up on his Spanish and correcting Eduardo's English at the same time. They met in the Atlanta airport; they struck up a conversation and a friendship. Eduardo was on his way to Cincinnati and Henry was returning from Ecuador, where he had attempted to establish a basis for doing his cancer research. Henry loves talking with Eduardo, loves the boy himself for what he represents--a citizen of the world, fellow traveler, expanding his horizons. Eduardo gives Henry a bag of Colombian coffee as a present and promises to see him soon.

The phone rings. It's the mayor's office. They want to know if he'd be willing to be on the mayor's oyster-eating team as part of an Easter Seals benefit. He knows this would be a great occasion for many jokes about the maneuver. He's learned to be good-natured about that. He has to decline--he has already planned to skiing vacation in Utah for that week. There aren't many open dates on the doctor's calendar. He's in demand all over the world. Otherwise, though, he'd have been glad to do it. Please call again, he says, and if there's any way I can lend my support, let me know.

For 16 years, Dr. Heimlich kept a fairly low profile in Cincinnati. Many people thought the guy who invented the maneuver had died a hundred years ago, and he liked it that way. The only real celebrity he had in his life came from his wife's parents, Arthur and Katherine Murray. That was something he was always dodging, and though he was a good dancer, according to Jane, his wife, he stopped because people expected him to be sensational and he also disliked taking lessons of any kind.

Gradually, his own reputation eclipsed the ballroom, but he still avoided the spotlight, at least in Cincinnati, cherishing his privacy. Lately, he's been coming out of that shell. Partly it's because of his desire to communicate his social programs to the public. Also, he believes in lending his support to good causes.

Another reason for becoming more active in the community is that he would like something in return: money. He wants to see if Cincinnati is willing to make a financial commitment to keep him there. He has offers to work elsewhere. He's seeking $2 million in endowment funds for his institute. It's not an unprecedented request. A few years ago another fellow, Pete Rose, considered himself under-valued in the local market and took his services elsewhere. When Dr. Heimlich left Jewish Hospital after eight years as chief of surgery, Ralph Corbett gave him a grant that kept him there. Xavier now gives him a home and his freedom. But he needs the money to do his work.

Eduardo leaves and Dr. Heimlich, shaking his head in admiration, asks a colleague: "Isn't that just great? Isn't that what it's all about?" Then he drives home for lunch, to a large old house off Grandin Road. He eats with his father, Philip, who's 98 years old and quite alert, tending only to remember the events of 40 years ago in sharper detail than what happened yesterday. Dr. Heimlich calls his father pop, as does everyone else who knows him. Pop was trained as an architect but devoted the energy of his life to social work, particularly in the area of correctional reform. The house is filled with Dr. Heimlich's plaques and trophies and awards and oddments from around the world: ancient dueling pistols, Buddhas, Mongolian eating sets, jade and bamboo carvings. Pop's room upstairs is crammed with him mementos too, and he is proudest of all of a plaque from the "Welfare League of Sing-Sing Prison," a group of prisoners who wanted to thank him for caring about them.

Like father, like son: When Phil Heimlich had an idea he thought was right, nothing could persuade him otherwise, and he'd be determined to test it out. One of his theories, radical at the time where juvenile offenders were concerned, was the how you were raised and treated determined how you would turn out. As part of the test for that theory, he shipped his ten-year-old son off for ten weeks at a camp for delinquent boys. Was he afraid he might be wrong? No. But what if he had been, and his son had been harmed? But I was right! he says, laughing. Young Henry and his sister used to roam through the New York State maximum-security prisons freely and untroubled, because they were Phil Heimlich's kids, and Phil Heimlich was known as a man who treated everyone fairly, as an individual. That position was not without its controversy.

Dr. Heimlich's mother, who died in 1968, wanted her young and talented Jewish son to be a doctor. That was entirely natural, the thing to do. He would help his fellow man and never want for money, or prestige. But whether it was because he was his mother's baby boy or because he inherited his father's stubborn, righteous way of doing things, Dr. Heimlich became a physician who went about things in his own way, following up on notions that sparked his intellect, not tracing the well-marked path of a thoracic surgeon's practice.

He is a reserved man, not an extrovert. He says his own children taught him to open up and to say things like "I love you." Only in the past eight years, he says, have he and his father grown close. He's also financially conservative, calling himself a child of the Depression. Only recently has he purchased a car with all the extras, and it's a Honda. On a business trip not long ago, he bought a topcoat in New York, quite a luxury.

But there is a deeper independent streak in the man, something quite aloof that gives him almost a bravura aspect, like a hero in the operas he loves so much, or a character out of The Music Man, whose songs he knows so well. He grew up playing the clarinet and the piano, but while he was attending Cornell, that was not sufficient for him, to be a member of the band. He had to lead it, and so he became the drum major, yes, the high hat, chin strap, whistle, baton, the boots, the works. He says he has led a charmed life. Things had a way of working out for him. Life has been kind. While he was at Cornell, the school fielded a strong football team, its best in years, one that traveled to Columbus to play Ohio State. They beat Ohio State and there in front of 80,000 people, Hank Heimlich was leading his Big Red Band--he calls it, to this day, "my band."

He says he does not understand what "ego" means. He does not seem to be a immodest, arrogant man. But he is inflexible and full of a confidence tempered and honed by his experience. He does consider himself to be exceptional, with a record to prove it. That attitude doesn't go over well with doctors, a rigid peer group, seething with petty gripes and animosities. He is well aware that if his work has won him admirers and made him a folk hero, his personality has not won him many friends.

At Jewish Hospital he was criticized for not performing his share of the routine surgery and for taking controversial stands. He felt that with his experience he should be concentrating on unusual surgical problems, leaving the routine matters to the young doctors, residents, and interns who should be glad for such work. He remembers a time when he could not get any work. And he says: "I have no interest in doing ten hernias in a row. The president of a company does not work on the loading docks."

As for taking controversial positions on topics perhaps not directly related to the practice of medicine, he feels that is his obligation. He owes it to the world and the fame he has achieved to stand up for what he knows is right. It's not grandstanding; it's a duty.

Now the cancer experts are saying he is wrong, and working far afield from his area of expertise; world diplomats say he is excessively naive, commenting on highly complicated affairs he knows nothing about, and maybe a little "off his rocker"; and fellow doctors say he's a vain and self-centered man who got lucky, and now he thinks he's an oracle, the Font of All Wisdom.

The Heimlich Fortune

Dr. Heimlich protested a planned series of experiments at the University of Florida in which 42 dogs were to be purposely drowned. His letter argued that the experiment, subsequently canceled, was cruel and useless. This small battle is part of the larger, ongoing war he is fighting with the Red Cross over the Heimlich maneuver. The Red Cross, like nations in international disputes, doesn't even recognize the maneuver. It does make vague reference to an "upward abdominal thrust," never endorsing it completely. Dr. Heimlich's unswerving position is that the maneuver is the action of choice with both choking and drowning victims. He is alternately amused and infuriated by the infighting and back-stabbing that go on within the medical community over the adoption of his maneuver as the standard lifesaving operation.

But he's used to it, taking people on. He challenged Pan Am when they gave his airline tickets to another customer when he was about to leave on his honeymoon. He wrote a letter to David Rockefeller and threatened to take the Chase Manhattan Bank before the FCC for false advertising--"You've got a friend in Chase Manhattan"--when he was unable to recover funds involved in a check forgery. For years now it's been the Red Cross, and now he's moving up to the international level.

The morning mail also brings him a letter from Bucharest, from a doctor he has not seen since 1956, when he traveled to Rumania to exchange information with the only other doctor in the world performing the replacement esophagus operation, in which the lower part of the stomach, which secretes no acid, is sewn or stapled off, then cut free and raised as a tube, with blood supply still intact, to replace the damaged esophagus.

Dr. Heimlich developed the technique during a meeting. It came to him whole and in detail. He knew immediately it would work. Afterward, he scribbed the basic procedure on a napkin for the chief of surgery at Mount Sinai Hospital, and the man ignored it. Undaunted, Dr. Heimlich, then 30 years old, walked down the street to the New York Medical College and wrangled the use of lab space and a $300 grant to test his theory on dogs. Working alone, he could not keep the animals alive through the surgery. Some interns he was teaching helped him out; when a dog finally did survive, he paid the animal custodian $5 for each week he could keep it alive.

He published a paper on the operation, but it was several years before he got a chance to perform it on a human patient. When he did, he altered his technique, and the man died. That, Dr. Heimlich says, is the true test of how much you believe in yourself and your idea. He did not stop. When he got a second chance at another hospital, the operation went smoothly and the patient, previously terminal, recovered. It became one of Dr. Heimlich's favorite stories:

The man was wheeled into a conference, given bread and coffee and told to eat. "I can't," he said, and the doctors in the room roared with laughter, a laughter of ridicule, Dr. Heimlich says. "Why not?" he asked the man. "You've been eating all week." "Because they didn't bring my teeth out," the man said. And then we all laughed, Dr. Heimlich says, a laugh he still enjoys as much as ever.

This was after he had returned from Rumania and experienced conditions behind the Iron Curtain. He believes that the cooperation between physicians led to a better spirit between the two countries, an experience he uses to motivate his current peace proposals. The doctor he knew then recently heard him speak over the Voice of America, on the Heimlich Maneuver and Patriots for Peace.

Dr. Heimlich breaks for lunch. He's going to his favorite Chinese restaurant in town, the Blue Gibbon in Saint Bernard. On the way, he slips in a Spanish-language cassette and practices his conversation. He passes a billboard that reads: "What would America be without the Red Cross?" He laughs aloud and says, "Boy, I could give them a good answer to that one!"

At the restaurant, he orders egg-drop soup and chicken chow mein in Chinese and converses briefly with the waiter, asking about the family and how things are, all in Chinese. The waiter departs and the doctor thinks about recent developments in his own family. His older son, a local lawyer, has just announced his engagement; one of his twin daughters is holding down two waitressing jobs in San Francisco while she tries to find work as a model. He has a book on emergency home medical techniques, and he's also written a nuclear-war novel he envisions as a movie.

For some reason, his thoughts drift back a few years to when he was working with Neil Armstrong, George Rieveschl, and Ed Patrick on the development of a miniaturized heart-lung machine and the techniques for implanting it. Rieveschl called the group HARP, after their initials. Even that gathering of minds ran into trouble, though. Other professors believed they'd have a monopoly on the grant money, leaving none for the less famous researchers. An institute was formed, but the spirit was gone by then, and nothing came of their work. Still, Dr. Heimlich remembers a couple of wonderful years when they worked together, screaming, yelling, laughing like kids, eating lunch together at the Alumni Club at the University of Cincinnati.

A couple around his age comes over to his table and interrupts his thoughts. "You're Dr. Heimlich, aren't you?" the man says. Dr. Heimlich nods, smiling. "I thought I recognized you from TV." The man introduces himself. "And this is my wife," he says. "I owe her life to you."

The woman blushes and explains. "We were eating in a restaurant several years ago and I choked on a piece of meat. I tried to tell him, but he didn't understand."

"I thought she was having a heart attack."

"That's very common," Dr. Heimlich says.

"I was dying," the woman says. "Lucky for me a nurse was nearby, and she came over, grabbed me from behind, jerked, and out popped that piece of meat. I can't thank you enough."

They try, thanking him profusely. Dr. Heimlich graciously accepts their thanks, and he urges them to send in a detailed description of their experience to his institute at Xavier. They shake hands around and the couple departs. It's a gratifying experience, and it's one that happens to him frequently, not so much in person, but more often through the mail and regularly in the papers. To make a lasting contribution, that has been his goal.

Finished with his meal, Dr. Heimlich signs the bill, takes a sip of water, and opens his fortune cookie. "You are contemplating some action which will bring great credit upon you," it says. He laughs out loud. "That's a safe bet," he says, getting up and walking away.
COPYRIGHT 1986 Saturday Evening Post Society
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Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Dr. Phil Heimlich
Author:McKay, Robert
Publication:Saturday Evening Post
Date:Dec 1, 1986
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