The Heimlich Maneuvers
by Linda Vaccariello
Cincinnati Magazine, December 2005
In August, with Hurricane Katrina bearing down on their suburban Louisiana subdivision, Peter Heimlich and his wife, Karen Shulman, filled their car with box after box of files. Peter, 51, and Karen, 43, have no children or pets to protect, but what they lugged with them was just as precious: three years' worth of research about Peter's famous father, Dr. Henry Heimlich. The material represents a huge project, so consuming that Peter sometimes refers to it wryly as his "Pad thesis." In fact, the couple says, they hope to publish a book. In the meantime, they're using the information in these files in a relentless campaign to discredit virtually every aspect of Henry Heimlich's career.
Peter is not a doctor or a private eye; he hasn't lived in Cincinnati since he moved away in the late 1970s; and he admits that his relationship with his family has never been close. However, it has taken a bizarre turn in the past three years. In 2002, he and Karen began accumulating evidence of what he alleges is his father's history of deception. Among Peter's claims: that Henry Heimlich has used specious cases to promote the use of the Heimlich Maneuver for drowning; that he helped fabricate a medical residency for an associate; and that he's taken credit for the medical work of others. His father disputes all of it.
Much of the results of Peter's
and Karen's research are posted on heimlichinstitute.com (addendum:
now medfraud.info), which
is filled with links to documents and articles that they feel
support their case. The Web site's URL is so similar to that
of Henry Heimlich's own nonprofit organization, the Heimlich
Institute (heimlichinstitute.org),
that virtually anyone searching the Internet to find even the
most basic information on Henry Heimlich is apt to stumble upon
Peter's site, too. Much of the information on the site is intriguing,
though the significance of some of it is baffling - the list
of people who gave wedding gifts to Peter's brother Phil in 2001,
for example. Yet it's because of this site, and Peter's dedication
to disseminating his information and accusations, that he has
had some success in bringing his case to the media - often to
alt-weeklies outside Cincinnati - where there have been a flurry
of unflattering stories about his father's work.
Until this year, he operated under pseudonyms such as "Holly
Martins" - the name of Joseph Cotten's character in the
film The Third Man, a naive writer who uncovers the sordid
history of an old friend. This subterfuge has made some people
question not only the veracity of Peter's accusations but his
mental state as well. Other people - in some cases, reporters
- have listened.
I first encountered Peter and Karen's work two years ago, when Cincinnati Magazine received a fax from someone named David Ionescu, requesting a correction to a story published in 1986. The story was a profile of Henry Heimlich; the inaccuracy, David Ionescu wrote, was Heimlich's claim to have invented a surgical procedure called the Reversed Gastric Tube, which had actually been developed by a Romanian surgeon named Dr. Dan Gavriliu. It was peculiar and mysterious, but what fascinated me was that the letter included a list of 40 publications that had made the same supposed error. The list included everything from The Congressional Record to The New York Times to Hyde Park Living. I couldn't figure out how a Romanian surgeon, or his attorney, or whoever it was, even knew about a story that ran in Cincinnati Magazine in 1986, or why they'd care about setting the record straight in Hyde Park Living.
Some of the mystery was cleared up this past January, when the Cincinnati Business Courier ran a story by Andrea Tortora and Dan Monk titled "Family Ties Unraveling." The story detailed how Peter had been using multiple pseudonyms, cloaked Web sites, and various e-mail addresses to hound his father. Chris Finney, a partner in the Iaw firm Finney, Stagnaro, Saba, & Klusmeier Co., LPA, and Bob Kraft, a public relations counselor with Dan Pinger Public Relations, Inc., both of whom were hired by Dr. Heimlich, outed Peter as the person behind the pseudonyms. Speaking for the family was Peter's younger sister Janet and his older brother Phil, the Hamilton County Commissioner who is running for lieutenant governor alongside Attorney General Jim Petro in a bid for the 2006 Republican gubernatorial ticket. Phil, who is vice president of the board of the Heimlich Institute, was quoted as saying that his brother's behavior "has gotten more and more bizarre over the years."
Reading that, I figured that "David Ionescu" was Peter, too. I had several e-mail exchanges and telephone conversations with Peter in the spring of this year - after the name "Holly Martins" was replaced with his own on the Website - and I became one of the recipients of the many articles, documents, and tips that Peter feels are germane to his cause.
This summer, Peter claimed that the Heimlich Institute, a subsidiary of Deaconess Associations, which operates Deaconess Hospital, had virtually stopped functioning. I reasoned that if I wanted to test the validity of some of Peter's information, the Heimlich Institute would be an easy box to check. But attempting to do that led me down a trail of what can best be described as non-answers. It was just the sort of experience that compels reporters to listen a little harder to Peter. Which is why I traveled to Louisiana in October, to try to understand what he's doing, why he's done it, and how he keeps getting media attention despite the efforts of a skilled team trying to shut him down.
What I learned is that Peter Heimlich has inherited his father's legendary ability to persevere in the face of overwhelming odds. For the legacy of Henry Heimlich, that may not be good news.
Henry Heimlich was a thoracic surgeon in New York when he joined Jewish Hospital as chief of surgery in 1969. With him came his young family: wife Jane, the daughter of ballroom dancing legends Arthur and Katherine (sic) Murray, and their children - Phil, Peter, Janet, and Elizabeth.
He arrived with a track record as an innovator. In 1955, he'd coauthored a paper about a proposed surgery that would eventually come to be known as the Reversed Gastric Tube (RGT). The surgery involves sectioning off a portion of the stomach to make a gastric tube that will allow a person with a damaged esophagus to swallow and eat. The idea was simple - so simple that, as Heimlich told a Cincinnati Enquirer reporter in 2003, he sketched it on a napkin during a hospital meeting. In 1964, he introduced another simple idea: the Heimlich Chest Drain Valve. The device is a one-way flutter valve used to drain blood and air out of the chest cavity after a wound or during surgery. To make his prototype, Heimlich used a noisemaker from a child's toy. His brilliant, simple, and inexpensive device was used on wounded soldiers during the Vietnam War, and is still in service today.
Both the RGT and the chest drain valve brought Heimlich notoriety, but it was in 1974 that he came up with the idea that made him famous. The story is that he read an article that stated that choking on food was one of the leading causes of accidental death. Working with an anesthetized beagle, he discovered that by pressing on the dog's abdomen he could make an obstruction pop out of the animal's throat. Through this experiment, he figured out a procedure that could duplicate the effect on humans. He called it "sub-diaphragmatic pressure"; later, the editors of the Journal of the American Medical Association would dub it the Heimlich Maneuver. In June 1974, Emergency Medicine published his first article about the maneuver entitled "Pop Goes the Cafe Coronary."
It wasn't long before the Heimlich Maneuver was a household name. The 1970s were full of stories about lives the new maneuver had saved. Ronald Reagan, on the stump for the GOP nomination in 1976, was rescued by his aide Michael Deaver when he choked on what the future president described as "a damn peanut." Dan Akroyd (sic) successfully Heimliched Carrie Fisher when she choked on a Brussels sprout while partying with John Belushi. The Heimlich Maneuver works; the evidence was - and still is - everywhere. Even so, Heimlich had to spend years pushing the American Heart Association and the American Red Cross to endorse it. Both organizations continued to recommend backslaps for choking. It wasn't until 1985, when Surgeon General C. Everett Koop endorsed the maneuver over all other methods, that the matter was settled.
When Heimlich left Jewish Hospital in 1977, he stopped being a surgeon but continued to be a public figure-making guest appearances, lecturing, and promoting various research projects in con-junction with the Heimlich Institute. He also became increasingly controversial. Heimlich mounted a campaign to have his maneuver endorsed as the first response for drowning, entering a long battle with the American Heart Association, the American Red Cross, and scores of drowning experts, which he is still fighting today. In 1986, he began to research malariotherapy for cancer - that is, treating patients with cancer by giving them a curable form of malaria - a treatment that the Centers for Disease Control and Prevention has argued against since 1993. Then he pursued malariotherapy for Lyme Disease. Then AIDS.
Henry Heimlich chose not to be interviewed for this story. Fortunately, there are 30-plus years of interviews that demonstrate how he has answered his detractors. Over the years, Heimlich has more than once told reporters, "If all your peers understand what you've done, you haven't been creative." He's also fond of quoting Belgian writer Maurice Maeterlinck: "At every crossway on the road that leads to the future, each progressive spirit is opposed by a thousand men appointed to guard the past."
It's the slogan of a young man - a person who is not heavily invested in yesterday's achievements. But at 85, Heimlich has a past, and now he has to guard it.
Heimlich established the Dysphagia Foundation while he was still practicing in New York. The name of the nonprofit ("dysphagia" means the inability to swallow) was changed to the Heimlich Institute sometime before 1978, when he began an affiliation with Xavier University. A 1978 university press release indicates that $550,000 in grants, including $50,000 from the Corbett Foundation in Cincinnati, supported the work of the institute. Eventually, however, Heimlich wanted the permanence of an endowment. In 1986, he told the press that the institute needed $2 million and said that he might be forced to leave Cincinnati without it. He told the Enquirer that he'd gotten offers from several universities interested in underwriting the cost of his operation. "The question is, does Cincinnati want this?" he asked in the Enquirer. "Can we get the Heimlich Institute supported and endowed as a permanent Cincinnati institution?"
It was showmanship, but there has been showmanship in much that Heimlich has done. In the early '70s, he was part of a research team that included Edward Patrick, his associate at Jewish Hospital; George Rieveschl, the University of Cincinnati's vice president for research; and former astronaut Neil Armstrong. The four worked - unsuccessfully - to develop a miniaturized heart-lung machine. Rieveschl, who is now 89 and considers Heimlich a good friend, talks with amusement about his colleague's approach to research. "He wanted to do everything in the newspaper," Rieveschl chuckles. "Armstrong and I didn't agree with that. Patrick and I didn't agree with that. We were scientists: You put your research out in professional publications and you invite review and criticism. He was much too interested in what the public thought."
The amount of press that Heimlich garnered was in inverse proportion to the size of the Heimlich Institute, which has always had a tiny staff - Heimlich (who has never taken a salary), a research director, and a secretary. Gerson Carr, 65, a retired professor of anatomy and physiology who now lives in Cleveland, was the first research director. Carr who had been a resident under Heimlich in 1972, was hired in 1980 after he'd lost his medical license and served seven months for drug trafficking in New Mexico. (Carr says that he was "a compassionate doctor" assisting addicts who couldn't get clinical help.) He worked for the institute until 1990, when he was forced to resign for what he describes as "personal reasons." Carr explained the circumstances in a bit more detail in an August 2004 article in Cleveland Scene. "There were some personal, family, and sexual problems," he said, "and I was involved with that."
When I spoke to Carr in October, he told me he'd worked on Heimlich's scientific papers and helped promote the MicroTrach, a portable respiratory device that Heimlich developed to deliver oxygen directly through the trachea. The device had to be surgically inserted, and Carr said Heimlich performed the procedure at Deaconess Hospital. "He considered that to be research," Carr said. "He refused to call it surgery." Heimlich and Carr wrote an article about it, but like so many of Heimlich's innovations, this one met resistance. "The medical community considered it anecdotal because we didn't do a study," Carr said.
Controlled studies were never Heimlich's style. "He always felt he should just try a thing clinically and see how it worked out," Carr told me. "His research protocol was just go do it and see what happens." That's not the way scientific research works, of course. But as Carr saw it, Heimlich was always an exception. "He's just so brilliant," he said, "and his intuition is so good."
During the '80s, Heimlich got interested in malariotherapy to treat cancer. Carr said that Heimlich "kept submitting theoretical papers on malariotherapy for cancer, and they kept getting rejected....They were resubmitted 20 more times."
The idea had precedent. In 1927, Julius Wagner-Jauregg, an Austrian psychiatrist, won the Nobel Prize in medicine for using malaria inoculation as a "fever therapy" to treat neurosyphillisinjecting the patient with blood containing a curable form of malaria (Plasmodium vivax) and letting the malaria fever destroy the syphilis spirochete. "It's that fever that we think could he effective against cancer," Heimlich told this magazine in 1986. "I believe it is so; I believe it myself a hundred percent."
In 1990, the institute left the Xavier campus and moved to rented offices, where it remained until 1998, when it moved to Deaconess. During the 1990s, Heimlich expanded his malariotherapy research to Lyme disease and AIDS. Unable to get the malaria-infected blood he needed from the Centers for Disease Control, he worked with researchers in Mexico. In 1993, the CDC came out against malariotherapy on ethical as well as medical grounds. Undeterred, the Heimlich Institute began to collaborate with an experimental AIDS malariotherapy program in China.
In a 1994 story in the Los
Angeles Times, reporter Pamela Warrick detailed Heimlich's
activities with malariotherapy, including his fund-raising in
Hollywood. Warrick reported that a group of physicians and scientists
from the U.S. and Mexico had petitioned "top U.S. regulatory
agencies" asking for an investigation
into Heimlich's fund-raising and his "touted treatment for
HIV." Asked for a reaction, Heimlich said, "It's very
common in my life. Some people think if they attack a famous
person, they can become as famous as the assassin...Just as the
Kennedy assassins became famous."
When I visited Peter and Karen in early October, they were back home in Louisiana. A tree had fallen and took a few roof shingles with it, but other than that their handsome, airy house weathered hurricanes Katrina and Rita well. The smart, hip couple who live here would not seem to be the same people who created the blaring Web site that excoriates Henry Heimlich; the son you meet here is funny and thoughtful and does not seem to be the same man who has rapid-fire phone conversations about alleged cover-ups, fraud, and his father. But they are, and he is.
Peter Heimlich is a Cincinnati kid who got away. He graduated from Cincinnati Country Day School in 1972 and studied communications at Syracuse University. After he graduated, he came home and put together a band called Choke that played one gig at the Contemporary Arts Center before Peter left town for San Francisco in 1977, where he played music for 10 years and eventually got a day job as a headhunter for computer firms. When he met Karen she was a jewelry designer. They married in 1988 and eventually started their own business, importing hand-woven fabrics from South America and Asia.
Through the 1980s and most of the '90s, he says, "I had a cordial but distant relationship with my parents." It didn't help that, in Peter's view, the family kept him at arm's length and gave his wife the cold shoulder; or that when he wrote to his father about problems within the family, his father would avoid the topic. Peter does a spot-on imitation of his father's voice - the mellifluous tones, the steady cadence - as he recalls one letter.
"Everything's under control, Pete," he quotes. "Thanks so much for your concern. Keep moving."
Peter came to see his father as deeply self-involved and his family deeply in denial. The match to the tinder came in 2001, when, as he obliquely explains, "I found out about some very serious, unaddressed medical problems in the family. I tried to involve myself and I was rebuked, and I couldn't understand (why)."
Peter says that he and Karen came to Cincinnati unannounced that October to find out what was going on. He went to his parents' home in Hyde Park, had what he calls a "terrible confrontation" with his mother, and left. On his way out, he took her Rolodex. "Phil and Henry made some big deal about me stealing her Rolodex, as if it were some sort of jewel," Peter says. "I don't know why I took it." The only explanation he can give is that there was a crisis in the family and he needed to get some information. "My father was a doctor and he let these medical conditions develop and didn't seem to care about dealing with (them)," Peter says. It seemed inexplicable, so he decided to learn all he could about his father's career.
He started by reading all the press clippings his father had sent him over the years (he'd saved most of them). But now he was looking at them differently, and he was struck by how often one particular name came up: Edward Patrick.
"I remember Ed Patrick as a guy portrayed to me by Henry as an electrical engineer and computer whiz, who was a professor at Purdue," he says. "(Beginning) around 1972 or '73, when I was 19 or so, he used to come over to the house on Sunday afternoons and would have these long yellow legal pad sessions with Henry on the patio. He had this big Elvis hair and sideburns and was very different from the type of guest that would frequent our house."
Peter says he hadn't heard Patrick's name mentioned for nearly 30 years. "I find out that, one, he has an M.D., which is news to me. Two, he had been my father's closest colleague; they had written papers together and done presentations together." It was also Patrick who, in 1980, claimed to have revived a 2-year-old drowning victim in an emergency room in Lima, Ohio, using the Heimlich Maneuver. Because it took place in a clinical setting, it became the "scientific" case that Dr. Heimlich cited in his aggressive efforts to get the maneuver endorsed for drowning rescue.
"At this point, I'm becoming Encyclopedia Brown," says Peter. "I've got the scent. I said, 'This is interesting.'"
Eventually, all this digging led Peter and Karen to question every aspect of Dr. Heimlich's work. If you visit their website, you'll find the mountain of purported details that the couple have amassed. According to Peter, much of what he and Karen have gathered is evidence that "the Heimlich Maneuver for drowning is a 'poison idea' that my father put into circulation. There was never any science behind it."
For a number of reporters who have come in contact with Peter, this material has sometimes been a blessing, and sometimes a curse.
In 2003, Brad Herzog, Cornell University '90, children's book author, and freelance writer, had an idea for a profile for his alma mater's alumni magazine. He suggested a piece about Henry Heimlich, Cornell '41, M.D. '43. The editors liked the idea, and Herzog embarked upon what he thought would he, as he says, "a nice fluffy piece about an older man who invented a life-saving maneuver."
He'd interviewed Heimlich once and was researching online when he ran into some scientific material that spoke disparagingly of Heimlich's malariotherapy work. "I thought, 'Oh, this has some wrinkles in it'," he says. Then he came across Peter's Web site, which, at the time, was still credited as the work of "Holly Martins." It raised questions that Herzog thought would have to be addressed if he was going to write about Heimlich. He did more research, then contacted Heimlich again to get him to respond to the controversy surrounding malariotherapy and using the maneuver for drowning. Herzog recalls how the tone of the conversation became frosty. "At one point," he says, "(Dr. Heimlich) said, 'Who's the person who has been giving you this incorrect information?'"
Herzog's article, titled "Dr. Eponymous," appeared in the March/April 2004 issue of the Cornell alumni magazine. It was an examination of Heimlich's career, including interviews with his sharpest critics in medicine, who not only took him to task for the science behind some of his work, but for using his name to push his ideas. It was a far more complex story than Herzog anticipated, and certainly not standard alumni magazine fare. But he knew it couldn't be a puff piece. "I felt an obligation to the facts," Herzog says, as well as an obligation to Heimlich's tremendous contributions to medicine. "It was very uncomfortable to write."
Some writers haven't felt so discomfited. Tom Francis was a reporter at Cleveland Scene when Peter first contacted him as "Holly Martins" in the summer of 2004. He says that he checked out the tips, verified the documents, and talked with experts before deciding to pursue his first story. "The way I approached it, this was a whistleblower," he says. "Every whistleblower has to be scrutinized for their ulterior motives." Within the first few phone calls, Francis says he knew the caller was Peter Heimlich. "I did my due diligence that there was no bias," Francis told me. "The article wasn't driven by Peter Heimlich." But it's evident Francis did play along with Peter; he talks about "Holly Martins" and Peter in the same article without acknowledging they are one in the same.
That Peter can be a difficult source to deal with is putting it charitably. One writer, who respects Peter's work and therefore wants to remain anonymous, claims to have been swamped with in-formation. "There's just so much," the writer says. "I just can't take it."
"His material is incredibly well-researched," says another reporter, who requested anonymity to avoid getting involved in the story again. But if you question Peter's evidence, he tells you "you're not doing your job," says the reporter. "I got tired of that stuff."
Certainly the mysterious pseudonyms could make a reporter question the stability of the person behind this campaign. I pointed this out to Peter one of the first times that we spoke and he bristled at the suggestion that the "Holly Martins" ploy damaged his credibility. Later, he explained that in June 2002 he filed confidential complaints about Patrick's residency and the Lima drowning case with the State of Ohio Medical Board under his own name. That got him nowhere. Which is why he took his allegations to the press using a pseudonym. He says that anytime he's started working with an individual reporter, he's dropped the ruse.
"Maybe ...I could have gone down on Fountain Square with a bullhorn and passed out flyers - said 'My father's a crook' and gotten the Enquirer to report on it that way," he says, "But I didn't want that. I wanted the facts to speak for themselves. That was part of the reason for the pseudonyms. I didn't want this to (be seen) as a family feud."
It's a curious position to take. An estranged son uses the Internet to jump-start a media campaign and inveigh against his internationally recognized father - how could that not be seen as a "family feud"? In my conversations with Peter over the months, it was a recurring question. He doesn't see it as a family feud, and so he doesn't understand why other people see it that way. "After we figured out the frauds, what should we have done?" he wrote in an e-mail. "Kept quiet and hoped) that nobody else would do the maneuver on a drowning kid? Some things go beyond family loyalty."
It's bad enough to languish nearly forgotten for years after collaborating on a world-famous first aid procedure. But to then find yourself attacked by the son of your celebrated colleague must feel like a double indignity. So I went to see Dr. Edward Patrick, to ask about his place in the Heimlich saga.
Patrick is 65, but he still has the Elvis hair. He lives in a lovely home in a posh subdivision in Northern Kentucky, and he is, I surmise, not pleased to be Ground Zero in Peter's campaign. I surmise this because he has agreed to talk to me about his work, not about the work of Henry Heimlich, and only in the presence of his attorney.
On his own Web site (patrickinstitute.org), he explains that "I have always viewed that Dr. Heimlich and I worked together to develop what has become known as the Heimlich maneuver just as the Wright brothers worked together to develop the first flying machine." When Brad Herzog interviewed him, Patrick said that he had met Heimlich before the maneuver was introduced. In our interview, he says he cannot discuss when they met. Nor will he discuss "HARP" - his collaboration with Heimlich, Armstrong, and Rieveschl in the 1970s, "It's another area that might merit some discussion sometime, but I don't think it's appropriate right now," he says. His collaboration with Heimlich to develop the MicroTrach is also off-limits. "Again, I am talking to you about Dr. Patrick's work, not Dr. Heimlich," he tells me.
Patrick was instrumental in getting the maneuver accepted for choking. When the American Heart Association and American Red Cross wouldn't accept it, he and Heimlich went on television talk shows, demonstrated it, and asked people to submit cases of choking. "Over 4,000 cases were submitted," he says, "and out of that I was able (to verify) 1,600 cases of children as definite." He used statistical pattern recognition - he literally wrote the book, Fundamentals of Pattern Recognition, in 1972 - to define favorable and unfavorable outcomes in choking incidents. Ultimately the data helped demonstrate that the maneuver was a better remedy than backslaps.
Peter and Karen became absorbed by Patrick's medical residency, which had taken place at Jewish Hospital in 1975-76 under Dr. Heimlich. They dug up employment records and found out that Patrick was working at Purdue as well as conducting engineering research under a National Science Foundation grant at the same time that he was at Jewish Hospital. This, among other things, led them to the conclusion that Peter's father had fabricated a residency for his colleague.
In investigating Peter's allegation, the Business Courier reported that in the fall of 2003 there were two e-trails exchanged between "Holly Martins" and executives at the Health Alliance of Cincinnati, the consortium that includes Jewish Hospital. The first indicated there was no record of Patrick being a resident there; the second said that he did a one-year "flexible" residency in 1975-76.
It seems like a fuzzy arrangement, bur Patrick says he was a special case. He had a Pad in electrical engineering and a teaching appointment at Purdue, and he was doing his residency simultaneously. "I had a vision of marrying the areas of medicine and engineering," he explains. Emergency medicine was the area where he merged his two interests. "I am a board-certified emergency doctor" he says.
Peter and Karen have also focused on Patrick's use of the maneuver in the Lima drowning case. Peter says that he contacted two staffers in the "employment department" at Lima Memorial Hospital who could find no record of Patrick having hospital privileges at the time that the drowning occurred. Peter also noted that when Patrick wrote an article about the case, he failed to mention that the baby suffered brain damage due to lack of oxygen and died months later.
Patrick is adamant about the details of the Lima case. He presents a copy of the emergency room report with nurse's notes, a letter from hospital attorneys attesting that he served there during that period, and a receipt from a Lima hotel for the dates of the incident. He says that the accusation that he didn't report the child's death in his article is a misrepresentation. "I never said I saved her," he protests. "I said I resuscitated her." Other than that, he will not weigh in on Peter's campaign. "The work I have done speaks for itself," he says "Therefore I will talk about Dr. Patrick's work."
I notice that he has a file titled "Holly Martins" on his coffee table. I ask if he is planning any legal action. "I can't answer that one right now," he says.
When I visited Karen and Peter, I told them about my meeting with Patrick and the documents he showed me. Considering the evidence he had, how could they make their claims? They countered with a blizzard of unproven accusations, such as: the endotrachial tube that Patrick used to revive the child was too big for a 2-year-old; the nurse's notes were not initialed; the father's signature on the ER report was forged. How did they know that? I asked. It didn't match his marriage license, they said.
Before he left journalism for public relations, Bob Kraft was a managing editor at The Cincinnati Post, and he still speaks in the speedy, clipped style of a seasoned journalist. It's plain that he would rather not be answering questions about Peter's effort to discredit his father, but since Henry, Jane, and Phil Heimlich chose not to talk with Cincinnati Magazine, it has fallen to him. "I was brought in to deal with some weird, hostile media inquiries," Kraft says. "And instead, I'm helping a family to deal with a heartbreaking situation."
In the spring of 2003, shortly after the Enquirer ran a story by reporter Robert Anglen about Heimlich raking credit for the RGT surgery, Kraft was hired as a PR consultant by the Heimlich Institute. He and Joe Dehner, a long-time friend of the family and a member of the institute's advisory hoard, went to the Enquirer's editorial offices to present Heimlich's side of the story: That Heimlich coauthored an article describing the operation in a 1955 issue of the journal Surgery; that, after it carne out, he learned that Dr. Dan Gavriliu had been doing the same surgery on patients since 1951 in Romania; that Heimlich traveled to Bucharest in 1956, met Gavriliu, and filmed the operation. Kraft had a stack of scientific journal articles from the 1950s to the 1970s that proved Heimlich gave Gavriliu due credit. "We were not looking for a retraction," Kraft says. "We simply said there's some sort of weird internet campaign going on; we think you got taken by a source."
Kraft thought that handling the Gavriliu business was "a slam dunk," and his services would no longer be required. "I think it was about a year later," he recalls, "the summer of 2004, Phil (Heimlich) gave me a call: 'We need to talk to you about Peter.'"
As Kraft understands it, family relations were normal until "five or 10 years ago," when Dr. Heimlich was visiting his son and Peter erupted in a verbally abusive tirade. According to Kraft, there were several of these episodes, and in one telephone conversation, Peter allegedly told his father, "I'm going to destroy you." ("It's false. I never said it," says Peter. "My father and and Mr. Kraft can't respond to the issues, so they're trying to steer the story to personal attacks.") The final break came after Peter's argument with his mother in the fall of 2001. "His mother was frightened, physically frightened," Kraft claims. "As far as I know, that's the last time anybody has seen him or talked to him."
In 2002, one of the first pseudonymous attacks came when a "Dr. Bob Smith" wrote to the University of California at Los Angeles pummeling the university's Office for the Protection of Research Subjects about a faculty member's involvement with AIDS malariotherapy research in China under Heimlich's direction. Or, as "Dr. Smith" called them, "offshore human experiments which have been denounced as medical atrocities." The letter was CC'd to dozens of organizations, including the National Institutes of Health. The campus newspaper began to ask questions about it, then the Los Angeles Times got interested. A university medical oversight board investigated and eventually rebuked faculty microbiologist Dr. John Fahey for evaluating data and specimens brought to UCLA by a Chinese scientist. UCLA also issued a cease and desist order forbidding Heimlich to use the university's name, or Fahey's, in connection with malariotherapy. It was "a slap on the hand," says Kraft.
Around the time Anglen's stories appeared in the Enquirer, Kraft says that Phil was told by either the Ohio attorney general's office or the state medical board that his brother had registered a complaint about Edward Patrick, but Phil didn't make a connection to the Internet-based letter-writing campaign. In order to untie the mystery, Chris Finney - who in addition to working for Henry Heimlich is a friend of Phil's - hired an investigator. "We had three or four different pseudonyms for Peter," says Finney. Plus, the investigator found a New York mailing address, an Illinois phone number, and a Czech e-mail address for Peter Heimlich. "He went to tremendous lengths to hide his identity," Finney says. "It's necessary to understand that when he started this vendetta, it was all cloak-and-dagger."
Kraft is bothered that some reporters haven't been more wary of Peter's motives, and that others have even played along with the aliases. "I knew that (Cleveland Scene reporter) Tom Francis knew that he was dealing with Peter Heimlich," Kraft says. "I happen to think it's unethical to put Holly Martins and Peter Heimlich in a story without letting the reader know about the source's motivations. What's in it for the son? Is there something else going on here?"
Kraft points out that over the years Henry Heimlich has willingly debated in the public forum those who disagree with him, which is quite different from what Kraft describes as Peter's "four-year campaign of harassment and slander, conducted anonymously."
A turning point in this saga came at the end of December 2004, when Joe Dehner nominated Dr. Heimlich for an award in the Business Courier's 2005 Health Care Heroes awards program. Figuring that Peter would react to the award by contacting the paper, Kraft says that he, Finney, and Phil decided that with Dr. Heimlich's permission, they would tell the Courier about Peter. The idea was to "describe this campaign and perhaps that will neutralize it," says Kraft. As it turned out, neither side was happy with the outcome.
On January 21, 2005, the Courier published an "exclusive report" about Peter's attacks on his father, written by managing editor Andrea Tortora and senior staff reporter Dan Monk. The story outlined Peter's pseudonymous attacks on his father and revealed the fight he had with his mother; said that he had cut himself off from the family; and quoted Henry as saying that it was "too painful" to talk about. Phil talked about his brother's mysterious change in behavior and said that he had tried to reach out to him, "hut his behavior was so abusive that it was impossible to build any kind of relationship." The article then went on to summarize several of the disputes, including the Patrick residency, the Lima case, the use of the maneuver for drowning, and the controversy around malariotherapy. For many readers, the intrigue of the family story probably overshadowed the fact that Monk and Tortora did not dismiss Peter's accusations out of hand.
When I spoke with Peter and Karen in Louisiana, they were still angry about the Courier story. Peter said that in the fail of 2004 he sent Tortora (who declined to be interviewed for this article) numerous documents about Patrick's residency, the Heimlich Institute, and Deaconess. He believed that she was working on a story based on this information. But, he said, after his father was nominated for the award, his contact with Tortora changed.
"He gets these questions," said Karen. "They're all about 'Did you have an altercation with your mother where you took her Rolodex?' That kind of thing. What does that have to do with business reporting?"
"And then, the story turns around into 'Family Ties Unraveling,'" Peter said. The way the Courier played up the pseudonymous-source-expose angle was ridiculous, he said, and he had the e-mails to prove that Tortora knew who he was all along. "The whole thing is disingenuous and kind of laughable," he told me.
He and Karen were unhappy that the story didn't report that Dr. Robert Baratz, the president of the National Counsel Against Health Fraud, was protesting the award, going so far as to call Heimlich's malariotherapy work "on a par with the worst of the World War II experiments on humans carried out by the Japanese and the Germans." (Baratz has become quite involved in the couple's research. "Health fraud is promoting things that are unproven and not telling people they are unproven," he pointed out to me in a separate interview. "(Dr. Heimlich is) not doing science. He starts with a conclusion and then tries to find data to prove it.")
The thing that Peter and Karen seemed to be most infuriated about was the way the story made him sound unhinged. "Phil and Robert Kraft and Henry have been propagating the claim that I distanced myself from the family, and that's simply untrue," Peter said. "I made repeated efforts to reach out to other family members and they didn't want to respond to me."
Karen, who wasn't mentioned in the Courier story, was particularly upset by Phil's comments. "When he made the analogy (between his contact with Peter and) violence," she recalled, "I said, 'Oh, I see. We can't say that Pete's violent because he isn't violent. But we'll plant the idea.'"
Peter knows that he can be persistent to the point of annoyance - "a rhinoceros," he says. But as he sees it, the press has embraced Henry Heimlich unquestioningly for years, and he and Karen are trying to rectify that. "It was no pleasure," he says.
Pamela Mills-Senn would agree. Mills-Senn is a freelance writer based in California. In 1999, three years before Peter began his crusade, she got an assignment from Funworld, a trade magazine put out by the International Association of Amusement Parks and Attractions: a 1,500-word story comparing CPR with the Heimlich Maneuver for drowning rescue. "Dr. Heimlich was the first person I talked to," she says. "I came away thinking, 'Wow! Why aren't people using the maneuver for drowning?'"
Heimlich sent her a packet of research-pages taken from a number of different studies with parts highlighted. The American Heart Association sent her research, too - the same studies, "but the complete studies," she says, "with no highlighting," She realized that Heimlich was excerpting data and seemed to be misinterpreting some of it as well. "Sort of fabricating conclusions," Mills-Senn says.
Ellis & Associates, a company that trains lifeguards for many of the nation's waterparks, had based their drowning rescue protocol on the maneuver since 1995. "The implications became very fraught," Mills-Senn says. "Not only because it involved Dr. Heimlich and what appeared to be unethical behavior on his part, but because Ellis & Associates had not only switched to the maneuver, but were marketing the hell out of it."
Realizing the gravity of this, Mills-Senn's editor at Funworld decided the issue was too important to rush and let her work on the story for six months. She called on every researcher involved in the studies, talked with experts about the physiology of drowning, and studied the efforts of the Institute of Medicine at the National Academy of Sciences, which twice assembled committees to study the issue. She even took the details of the Lima Hospital case to a neutral party (Loma Linda University Children's Hospital) for analysis.
Ultimately, Mills-Senn produced a piece that explored why the research, and the vast majority of the experts, were still on the side of using CPR as drowning protocol. Her 10,000-word story was published as a supplement to the regular magazine in March 2000 (under the heading "Funworld Special Report") and mailed to all the association's members. Heimlich was allowed to review the content beforehand and responded in writing. Mills-Senn said his objections were circular, using his own pronouncements to validate his own theories. If, for example, some other doctor had said that it was possible to ventilate a victim through water, she says, "He would say, 'Everyone knows you can't ventilate through water.'" Ellis & Associates was allowed to review it, too - and quietly switched back to CPR.
By laying out the research and the pro and con arguments of various experts, Mills-Senn inadvertently provided Peter with a load of ammunition when he came across it years later. Not surprisingly, there's a link to her report on his Web site.
Kraft says that the debate still overlooks Dr. Heimlich's issues with CPR - especially the failure rate and the difficulty of performing it correctly. And the statistics Ellis & Associates collected from 1995 to 1999, while the maneuver was in use, were impressive: Ninety-seven percent of unconscious, non-breathing drowning victims were success-fully resuscitated. "I know Ellis changed the protocol," Kraft says, "hut I don't think they ever repudiated those statistics."
Mills-Senn says that she never set out to bash Heimlich or the maneuver but she knew that she could not write about the use of the maneuver for drowning in good conscience without exploring all the conflicting data. "It was really unnerving to work on the article)," she says. "I actually kind of cried when I realized what Dr. Heimlich had done. It was painful."
Whether or not Deaconess Associations and Henry Heimlich are in a mad struggle over who controls the institute and its money, as Peter suggested to me, is anyone's guess. After several weeks of attempting to get an interview with Deaconess CEO Anthony Woods and hospital spokesperson Barbara Lohr, Lohr e-mailed me a statement that "acknowledges and respects the fact that (Dr.Heimlich's) work has saved hundreds of thousands of lives world-wide." When I responded with a list of specific questions about the institute's board, assets, and fund-raising, she forwarded my e-mail to Chris Finney.
Finney's response to my questions was brusque. "Frankly, some of this is either none of your business or beyond my knowledge," he said. "Just because they haven't answered your questions doesn't mean there's something sinister."
Indeed, the Heimlich Institute doesn't seem sinister these days. It's comprised of a few locked offices in a rather desultory corridor of a building on Straight Street next to Deaconess Hospital. According to the institute's IRS form 990 from 2003 (the most recent available), it has assets of $650,000. Deaconess no longer employs the institute's most recent research director, Eric Spletzer, and the secretary seems to have been relocated. It is a quiet place.
The Heimlich Institute does have a Web site, however, with a link to a printable donation form. According to the form, which was still posted in early November, you can make a gift to the institute to be used for malariotherapy research for cancer; malariotherapy research for AIDS; educating the public on the use of the Heimlich Maneuver for choking and drowning; or research into the use of the maneuver for asthma.
This raises questions, primarily because, according to Bob Kraft, the institute is not doing any new, independent AIDS/malariotherapy research but simply reviewing research conducted by others. In addition, in my reporting, I was unable to find any evidence that Heimlich's cancer research continued much past the 1980s. Recently, I had an acquaintance send a donation to the institute to support malariotherapy for cancer. The check was deposited and the donation was acknowledged with a thank-you note from Dr. Heimlich.
Why all the interest in an organization that's merely a forum for an aging medical icon? Because this none-of-your-business attitude touches upon matters of medical research, and that should raise concern.
"Hank is a scientist and his research is subject to scrutiny," says Dr. Victoria Wells Wulsin, referring to Henry Heimlich by his nickname. "That's what the scientific method is all about."
Wulsin is probably better known to Cincinnatians as a candidate in last spring's Democratic primary for the Ohio Second Congressional District seat. But she's also a 52-year-old epidemiologist from Indian Hill who has worked for the Centers for Disease Control and Prevention. Three years ago, after working on a public health project in Kenya, she started a nonprofit organization called Soteni that works with women and orphans in Kenya who are affected by AIDS. In 2004, she was approached by Heimlich and the board about becoming the director of the institute. Wulsin felt it would be a good fit for her. "I was very interested in AIDS in Africa, and that was one of the areas that the Heimlich Institute is interested in," she says. But the salary she was offered ($75,000) was low, even for someone accustomed to working in public health. Moreover she felt the salary suggested that she wouldn't really be given the reins. "I'm interested in being a decision-maker, not just an adjunct to Hank," she says. "So I declined the offer."
Instead, the board hired her as a consultant. She says that she was asked to do two things: First, to review the literature on malariotherapy as a treatment for AIDS; second, to suggest alternatives to malariotherapy in terms of how the institute could address the AIDS epidemic.
Heimlich and Spletzer provided Wulsin with articles and research reports, and she gathered material on her own. She says that she went through hundreds of articles on HIV treatment, malaria, and HIV itself, "most of which didn't even address the question of the relationship between malaria and HIV." But a few articles did, and she developed a quantification system for these: If they suggested that having malaria combated HIV, they were a positive; if not, they were a minus. She met with Heimlich each week to keep him up-to-date. "I had pluses and minuses and I would show them to Hank and he would agree or disagree," she says. Time and again, he would refer her to a study published in 1986 - "which in medicine, particularly in HIV/AIDS research, is outdated," she says. Nevertheless, she studied it.
At the end of three months, Wulsin submitted her report, concluding that "the preponderance of evidence indicates that neither malaria nor Immunotherapy (i.e. malariotherapy) will cure HIV/AIDS."
"I wanted to present (the report) to the board; I thought it was important that they know," she says. She didn't get the chance. Wulsin says that the day after she turned in her report, "Hank left me a phone message and said 'We won't be needing your services.' I called back and asked if we could at least talk. He said, 'You can come in and clear out your things.'"
"His passion is malariotherapy," Wulsin says. "I have spoken with him since, and it still is." Admittedly, she went into the assignment skeptical about malariotherapy for HIV/AIDS. But, she says, "I tried for three months to have what in my mind was scientific interaction. I was very open-minded to what he said, not only reading but studying the articles that he led me to. And I didn't feel that was reciprocated."
During her work, Wulsin was given data from a recent research project in East Africa. While Heimlich and Spletzer received data from the project, Wulsin does not believe that money from the Heimlich Institute was used to fund it. She isn't comfortable discussing who sponsored the project, but according to her report, "an American sponsor" initiated a discussion with the institute about malariotherapy for East Africans, and in 2003 began working with "12-13 HIV-positive patients."
Wulsin was shown follow-up data on eight of these patients, and the report notes that "clinically, the patients continue to do well." But, Wulsin says, she was never shown written research protocols for the project. Without seeing the protocols, she says, she "couldn't be impressed" with the data that Spletzer and Heimlich showed her. "And I said that in my report."
She's still frustrated with the way that data was handled. "I have been a PhD level scientist for 20 years, and I've never experienced that level of difficulty in getting information," she says.
In her report, Wulsin outlines the ethical standards for studies of immunology: patients must he informed and understand the risks and benefits; protocols must be approved by local and donor instructional review boards; the public should have access to the information; research protocols should be designed in advance. "'Fishing expeditions' for possible benefits are no longer warranted," the report chides. It would seem to be a rebuke of the East Africa project - Third World research on human subjects wrapped in a cloak of secrecy.
Wulsin knows about the internecine Heimlich tumult and she thinks Peter's covert attacks are inappropriate. But, she says, "I don't think he would do it just to hurt his father; I think there must be some moral outrage in him." And, she adds, "I have to say that if my father were saying or doing some of the things that Hank is doing, l would have to disagree."
In the end, what are Peter and Karen trying to accomplish? What they say, first and foremost, is that they want people to stop using the maneuver for drowning. That's what the obsession is about, Peter insists. "I just want to be understood," he says. "We didn't want anyone else to he hurt. That's why we did it. The family stuff is secondary, or tertiary."
But there's at least one obvious way that Peter is driven by "family stuff." Throughout his career, once he got an idea into his head, Henry Heimlich has never backed down. Indeed, he's actually drawn strength from the number of experts who have lined up to thwart him. It's a conviction summed up in another one of Heimlich's favorite mottoes: "Until they challenge you, you don't know you're right."
Like father, like son.
@ 2005, Cincinnati Magazine