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Heimlich's Audacious Maneuver

Pamela Warrick, Los Angeles Times, October 30, 1994

He proposes curing AIDS by giving patients malaria. Tests draw celebrity money—and researchers' protests. He shrugs off criticism, noting his anti-choking method was also shunned at first.

The famous guests made their way through the rain into the warmth of Joanne Carson's candle-lit Bel-Air home. Just beyond the door, they found a small registration table. Esther Williams, Patti Davis, Jon Voight, Bruce Davison and other luminaries dutifully signed in.

The guest of honor—a tall intense-looking man in his 70s—waited in the kitchen. Everyone had heard about him, but few had met him. As they filed by to shake his hand, Dr. Henry Heimlich nodded and smiled. Thanks for coming. Thank you for your support.

It was spring, 1993, and Heimlich, bold inventor of the anti-choking maneuver, had come to Los Angeles with a bold pitch: To end the scourge AIDS by 1994.
The room fell silent.

We were awe-struck, recalled Carson. We all said, 'This is hot. This could be it!'

Heimlich's prescription for AIDS? Give the patient malaria.

With no shortage of malaria in the world—or of desperate AIDS patients—all he needed was the money. And from Hollywood's best and brightest, he would get it.

People were so moved by his presentations, that at the end of the evening, everybody went home and sent their checks in, recalled Carson, who hosted three fund-raising dinners last year.

Actress Amy Irving gave $50,000. Other major supporters included actress Estelle Getty, high-powered agent Sandy Bresler and ventriloquist Paul Winchell, according to Heimlich's foundation and other sources.

Fueled by hundreds of thousands of dollars from such celebrity donations, Heimlich researchers have begun injecting a small group of HIV-positive men in China with malaria-infected blood.

At best, warn infectious disease experts, the treatment will cause no harm. At worst, they say, it can kill.

Heimlich's life-saving maneuver for people who aspirate food doesn't qualify one as an HIV expert, said leading AIDS researcher Dr. Anthony Fauci, who called malaria therapy quite dangerous and scientifically unsound.

In an interview this month Heimlich dismissed criticism of his plan. He said no one has been harmed by the treatment and that the first two patients were already feeling better. Still, he cautioned against false hopes.

We have a long way to go, said Heimlich, who expects no final results for another year or two. Nevertheless, he added, we could always benefit by having more funds.

This is not the first time the 74-year-old Heimlich's headstrong approach to medicine has shocked, even outraged the Establishment. I don't do ordinary things. I don't follow all the rules if there's a better, faster way to do it, he boasts.

Induced malaria therapy—IMT, as he calls it—consists of inoculating patients with blood teeming with malaria parasites. Citing the use of a similar therapy for neurosyphilis in the 1920s, Heimlich believes malaria induces production of immune substances that could help patients overcome HIV.

The tiny pathogen that causes malaria—the protozoan Plasmodium— flourishes in the human body, growing inside red blood cells until the cells burst. Without enough red cells to carry oxygen, even patients with the most benign strains can suffer severe anemia and die from renal failure or convulsions from 106-degree fevers.

Citing concerns for the safety of human subjects, a group of 20 scientists and physicians from the United States and Mexico have petitioned top U.S. regulatory agencies to investigate Heimlich's Hollywood fund-raising campaign and the touted treatment of HIV.

This exploits the AIDS crisis, exploits the generous and caring entertainment community, and it exploits the good that Heimlich himself has done in the past, said Dr. Paul Bronston, national ethics chair of the American College of Medical Quality and a petition supporter.

(That petition) is an annoying and painful thing, Heimlich said. But this happens. 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.

And our work takes time. Look, it took the Red Cross 12 1/2 years to (endorse) the Heimlich maneuver.

Unproven Therapies

In the absence of a cure for AIDS, underground trafficking in unproven, experimental therapies is thriving here and abroad.

Desperate for even a crumb of hope, patients have ingested photographic chemicals, been sealed in hyperbaric chambers and taken injections of everything from snake venom to hydrogen peroxide.

What stands out about the malaria treatment is that, like the anti-choking maneuver, it carries the imprimatur of Heimlich.

His name carries a lot of weight, said one loyal Hollywood supporter. For many of us in the entertainment industry, meeting him was like meeting Albert Schweitzer. And sure, that affected our generosity.

There's something about making movies that makes you believe in miracles, said actress Esther Williams.

No question he's one of the great geniuses of our time. I expect he will receive a Nobel prize, said Carson, ex-wife of former Tonight show host Johnny Carson.
She invited Heimlich to Los Angeles, she said, because I wanted to help him. I think he is very close to the answer and I wanted to get people together who really cared so Hank could talk to them and raise the money he needed to start the project.

The entertainment community has lost too many of its own to wait any longer, say Carson and other Heimlich supporters.

And if the search for a cure risks lives? Well, Bresler said, that's the way it is. This is not a party. People who have HIV are going to die anyway. If you have volunteers willing to sacrifice themselves for the good of mankind, I'm all for it.

Creative Approach

From the day he picked up his M.D. from Cornell Medical College in 1943, Henry Jay Heimlich has reveled in his knack for doing what others say cannot be done.
I have never had a failure, he says with bracing—if not always accurate—self-regard. It may take a while for the others to see what I see. But eventually, they do. Like I always say, 'If your peers understand what you've done, you are not being creative.'

No question, this man is creative. As a 35-year-old chest surgeon, he devised a way to reconstruct an esophagus from a patient's stomach. He called it the Heimlich Operation—the world's first transplant.

Then came the Heimlich Chest Drainage Valve, first fashioned from a rubber dime-store toy that makes a Bronx cheer when you blow on it: That valve saved lives on both sides of the Vietnam War and is still saving lives today.

He invented the Heimlich Micro Trach to provide portable oxygen for patients with debilitating lung disease. In news reports, patients called it the Heimlich Miracle.

But it is as the creator of the Heimlich Maneuver that the irrepressible inventor is most famous. According to Norman Vincent Peale, I've probably saved more lives than any man living today, Heimlich says. (Officials estimate that 4,000 to 5,000 people are rescued each year by his method, which involves wrapping one's arms around the victim from behind and thrusting a fist between the rib cage and navel.)

But with his unconventional approaches have come controversy.

For more than a decade neither the American Red Cross nor the American Heart Assn. would endorse the maneuver because they said Heimlich could not provide scientific proof that it worked.

Heimlich's response? We used the media. We couldn't wait for more people to die. We went right to the people and we taught them how to do it on TV. We were saving lives while the Red Cross was still telling people to slap choking kids on the back.

I was right, Heimlich said, and they knew it and they risked lives by not going along. Creative thinking begins with not accepting anything that is supposed to be fact.

But over the last 20 years, skeptics say the doctor's work has moved closer and closer to the fringe. In the last decade, he has proposed treatments for AIDS, cancer, asthma, even war.

Heimlich and his nonprofit institute are based in Cincinnati, where he brought his chest surgery practice, his wife and four children nearly 25 years ago.
Jane Murray Heimlich, a daughter of the famed dance team of Arthur and Kathryn Murray, is an advocate of alternative medicine and best-selling author of What Your Doctor Won't Tell You.

According to Heimlich, the work of controversial physician Julian Wagner-Jauregg—who won a Nobel Prize in 1927 for using malaria to treat syphilis of the brain—inspired his early interest.

But the widow of Leonard B. Greentree, a Harvard-trained Ohio physician who published a 1981 paper on malaria therapy, believes her husband's work was equally inspirational to Heimlich.

Nobody courted my husband for his ideas as much as Dr. Heimlich, recalled Edith F. Greentree. In 1982, we met with Dr. Heimlich at his home in Cincinnati for the expressed purpose of discussing my husband's hypothesis that malaria might be a cure for cancer. Dr. Heimlich wanted us to give him money (to) set up a foundation and Dr. Greentree said, 'Wait a minute, this idea is mine. I want a controlled study someplace, not publicity.'

But, his critics say, controlled studies are not Heimlich's style. When he first advocated the anti-choking method his research consisted almost entirely of collecting anecdotes on how the maneuver was saving lives.

Like Greentree, Heimlich first envisioned malaria therapy as a cancer treatment. For that disease as well as for Lyme disease and HIV, Heimlich believes malaria can stimulate immune responses.

In the mid-1980s, Heimlich asked the Centers for Disease Control to help him get malaria-infected blood for his studies. When plans to do the research here collapsed, Heimlich's foundation offered its support to doctors in Mexico, Panama and China.

Although the successes of those cancer experiments are cited in Heimlich's Hollywood appeal for AIDS research funding, no reports on the methods or results have been published for traditional scientific review.

To conduct legitimate research in this country, you need a host of safeguards, said Bronston. The Los Angeles physician joined the petition to investigate Heimlich's research after attending a fund-raiser hosted by Carson, a friend of Heimlich's wife.

You need review by other researchers in the field, you need careful protocols, you need uniform protection for the patients who are entrusting you with their lives.

But much of the Heimlich Foundation's funding appeal consists of references to other scientists' research—research experts say cannot always be verified by outside reviewers.

The funding appeal describes a 1990 study in Zaire that found that a group of children who had malaria and AIDS were living and well after a two-year trial. To Dr. Heimlich, potential donors were advised, the significant result is that none of the malaria- infected AIDS patients died.

But when asked later whether those children were still alive, Heimlich said, You're wondering! What about me ? Nobody tried harder than we did (to find out).

Dr. Frank Sonnenberg, a Rutgers physician who evaluates research proposals for the National Institutes of Health, calls Heimlich's proposal monumentally flawed, and says it would be resoundingly rejected by any credible grant review committee.

Scope Expanded

At the end of the 1980s, Heimlich returned to Mexico to expand his experiments to include sufferers of Lyme disease, an arthritis-like immune disorder caused by a tick bite. Although most cases are easily cured by antibiotics, a small percentage of patients do not recover.

The first American Lyme disease patient to receive the malaria treatment in Mexico was Cyndi Monahan, a 28-year-old New Jersey aerobics instructor so crippled by the disease she was confined to a wheelchair.

Monahan recently recalled the experiments as exciting (and) very clandestine, like a drug deal. We flew down there and went to this hotel. This doctor came to our room and opened a black valise with these little vials of blood. He had (me) lie down on the bed and he injected (me) with the blood. And (I) went back to the States like on the next flight and pretty soon (I) broke out with malaria.

Monahan said she was cured—for almost three weeks. I was pretty much without symptoms. I could walk, I could run, I could even exercise some, she recalled.
But then I started to get sick again, and I can't tell you how disappointed I was. By then, I was out of money, totally bankrupt.

To raise the money for more malaria therapy, Monahan sought help from her local newspaper, which invited readers to make tax-deductible donations. The campaign raised about $15,000 and she returned to Mexico City where, Monahan said, the same doctor gave her another injection of malaria-infected blood. She identified the doctor as Heimlich's friend Oscar Velasco. Although Velasco said he does not recall Monahan specifically, he confirmed that he has worked with Heimlich and has treated Americ an patients with malaria therapy.

Although the second treatment took her to a nicer hotel, Monahan said, it was not as effective. Turns out I developed an immunity to malaria, I guess.

Now 32, Monahan told The Times this spring that she is about 65% as bad as I was before I took Dr. Heimlich's malaria therapy . . . But I still can't live on my own. I need someone to take care of me pretty much all the time.

Heimlich said he has spoken with Monahan often, but she was never under his care. In fact, while the Heimlich Institute supports such research, Heimlich said he has never personally treated anyone with malaria therapy.

Sallie Timpone, a 34-year-old mother of three who was with Monahan in Mexico City, has been speaking out against both Heimlich and malaria therapy for years.
Although she, too, experienced an early remission, Timpone says she is now as sick as ever: I've been hooked up to IVs of antibiotics but nothing really helps. I'm so sick and weak most days I can hardly get out of bed. But if anybody ever asked me about Dr. Heimlich and his supposed cure, I wouldn't hesitate to tell them to run away fast.

When I called him again and again and told him to stop using me as an example of how malaria therapy was the cure for Lyme disease, Timpone said, he never called me back and kept telling people I was fine, when I am definitely not fine.

Heimlich said that he first met Timpone at a medical meeting. She had had a complete remission, I recall, but I know she didn't take the full course of malaria treatment. Other Lyme patients, said Heimlich, have been symptom-free for five years. In certain cases, we've had remarkable results, OK? My God, (what) if I told you about a woman who was crawling for several years on the floor because of Lyme disease and she owns 15 horses now and is riding them!

Heimlich refused to identify the woman or other patients, citing confidentiality.

High Risk Cited

By the spring of 1993, when Heimlich was nibbling hors d'oeuvres with Hollywood celebrities, Dr. Sergio Perez Barrio was preparing to receive the first HIV patients for malaria injections in Mexico.

Among them were to be volunteers from the Los Angeles area—men with the AIDS virus who, Heimlich said, would be cared for before and after their treatments by courageous local physicians.

Perez, a former public health officer for the border towns around Juarez, says he was handpicked by Heimlich to conduct the first malaria trials. But by early this year, Perez said, he told Heimlich that the risk to HIV patients was too high.

We talked about the money it would cost to care for AIDS patients and the risk of exposing them to malaria, Perez said. And I believe that is when he decided not to proceed with the trials here in Mexico.

Heimlich, who says he draws no salary for his role in the research, said Perez's estimate of $18,000 a patient was too high. He added that that the costs increased markedly when it became apparent that Americans would be involved. When the site of the trials was switched to China, U.S. patients were disqualified, he said.

Probes Sought

Hundreds of millions have been spent on government-approved AIDS studies, with no cure or effective treatment to show for it. Many top U.S. scientists have all but lost hope of finding a cure through traditional means.

That made Heimlich's proposal and its relatively modest $591,800 price tag seem well-timed.

Hank's work doesn't involve hundreds of patients and all of that investment, said Heimlich's long-time friend and research consultant, Dr. Harry Gibbons, retired public health director for Salt Lake City. In many ways, he's offering a real bargain.

But Heimlich's cost-cutting does little to advance the search for a cure, according to Dr. Carlos del Rio, director general of Mexico's AIDS prevention and control agency.

Del Rio said he was outraged by the Heimlich proposal and told petition organizers they could count on his cooperation.

Del Rio is among the scientists and physicians who seek state and federal probes of Heimlich's AIDS project.

We are extremely concerned that the IMT proposal may be deceptive and may contain false conclusions, says the petition. We are particularly concerned about the health and safety of those who may subject themselves to this treatment as well as the possible exploitative techniques for fund-raising.

Officials of the National Institutes of Health, the Food and Drug Administration, FBI and IRS—the agencies addressed by the petition—declined comment. But the CDC responded by issuing a public health alert.

In a four-page statement, three top CDC officials repeat the agency's opposition to malaria therapy for Lyme disease and warn against the Heimlich Foundation's proposal to use the treatment on HIV.

No evidence currently exists to indicate that malaria infection would beneficially affect the course of HIV infection, said the CDC, which noted that malaria-infected blood could contain other contaminants.

CDC warned that any human research should undergo thorough ethical review, and said the deliberate infection of humans with malaria cannot be justified.
Unlike traditional research protocols, few Heimlich projects begin in the laboratory, or even with laboratory animals.

Because he is philosophically opposed to animal research, Heimlich's guinea pigs are usually humans.

That and his failure to publish his research, to expose it to the rigors of peer review, have been the source of persistent criticism.

Heimlich told The Times this month that he had agreed to cooperate with the China-based doctors in publishing the AIDS research results as soon as there is solid data to report.

If the results look favorable, Heimlich said, we'll certainly reach out for more volunteers—and more support.

Heimlich said that the nine HIV-positive patients who have been infected with malarial blood are men in their 20s and 30s who have given informed consent. Our protocols meet all the standards—exceed the standards—required in the U.S. I am very strict, he said.

The AIDS project's protocol calls for patients to receive inoculations of malaria parasites and be admitted to a medical facility. After 10 to 14 fevers—spiking near 106 degrees over three to four weeks—the researchers administer anti-malaria medications.

But, Heimlich assures supporters, only the benign form of the disease—the Plasmodium vivax strain—is used.

CDC malaria specialist Peter Bloland agrees that the vivax strain is among the most curable, but cautions that even in the laboratory, great care must be taken to guarantee that that is the only malaria parasite in a sample and that no other blood-borne diseases are present.

Rarely is malaria-infected blood used for such research, said Bloland. We most always rely on mosquitoes specially bred to (harbor) the specific malaria parasite we want to use.

Heimlich insists that the blood injected into the volunteers is thoroughly screened for other diseases.

And the danger to patients? With the malaria, we can stop (the treatment) if the patient is not doing well, Heimlich said. So far, he said, all the patients have tolerated the treatment well and their malaria has been curable.

As Heimlich continues to travel the world to see patients before and after their malaria treatments, he says he is hurt and confused by those who question his work.
It's happened before, he said. It's politics. Or it's financial. Or one scientist knows another. Or somebody is working on a vaccine for Lyme disease or for AIDS or what-have-you and they're afraid we'll get their funding.

But, you know, if I have something I think is good, how can I let (the people) die? Heimlich asked.

He is risking people's lives and he is trading on the life-saving aura of his name to get people to help him, said Dr. John Renner of the National Council Against Health Fraud, which has been tracking the Heimlich project.

After this, he won't go down in history for the Heimlich maneuver. He'll go down in history as a bizarre, mad scientist.

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