How Dr. Heimlich Maneuvered Hollywood Into Backing His Dangerous AIDS "Cure"
This story originally appeared in the Aug. 22 issue of The Hollywood Reporter magazine.
It was the spring of 1993, and AIDS was devastating Hollywood and the world. AZT, the only FDA-approved treatment at the time, could slow but not stop the disease's progress, and life-saving antiretroviral therapies were still several years away. Determined not to lose even one more colleague to the epidemic, a group of concerned showbiz folk -- among them Jon Voight, Estelle Getty and Amy Irving -- gathered at the Bel Air home of Joanne Carson, ex-wife of Johnny, to hear from someone who claimed to have a promising lead on a cure. He was Dr. Henry Heimlich, the man behind the ubiquitous anti-choking maneuver, among other medical innovations which are credited with saving countless lives. The room was soon in thrall to his brazen, cost-effective proposal to eradicate the disease, possibly in as little as one year: Heimlich wanted to inject HIV-positive patients with malaria to induce fevers that would theoretically "stimulate the immune system," according to a copy of his proposal, thereby allowing "for the potential elimination of the HIV virus." Heimlich referred to his treatment, which involved testing on American subjects in Mexico City without peer review, control groups or animal testing -- thereby circumventing protocols established for American scientists by the U.S. Department of Human Health and Services in 1979 -- as "malariotherapy."
Hopeful that an effective AIDS treatment was within reach, all the guests in attendance buzzed, except for one: Dr. Paul Bronston, an ER doctor and chair of a medical ethics board who had tagged along with his friend, actor Bruce Davison, an Oscar nominee for the 1989 AIDS drama Longtime Companion. Bronston says he went to Carson's house that night with the intention of meeting the legendary man behind the Heimlich maneuver, knowing only that the topic was vaguely AIDS-related. But as the guest of honor spoke and video cameras captured every word -- Heimlich had commissioned a documentary about himself, according to correspondence with director Lisa Pelikan in 1993 -- Bronston couldn't believe what he was hearing. (Pelikan declined to comment.)
"I just f--ing hit the ceiling," Bronston, 63, tells THR. "I went f--ing crazy. It was dangerous, it was total bullshit. His proposal was giving malaria-infected blood to people who had AIDS. It doesn't take a genius to know that you don't give an infectious disease to somebody who has a suppressed immune system."
A trove of documents recently made public and turned over to THR now reveal the extent to which Heimlich's medical project -- cited for 13 "deficiencies" by the FDA in 2000, including "failure to have procedures to determine that risks to subjects are minimized" -- seduced the likes of Jack Nicholson, Bob Hope and Ron Howard into contributing to a $600,000 experimental medical program. In this bizarre chapter of Hollywood philanthropy, Heimlich's campaign offers a startling cautionary tale on the potential dangers of giving.
Hemlich was no stranger to Hollywood. The Cincinnati-based thoracic surgeon had been married since 1951 to Jane Heimlich, the daughter of Arthur Murray, the dance-studio king and host of the TV variety show The Arthur Murray Party, which gave the physician access to a wide swath of famous actors, sports figures and musicians. (Jane Heimlich passed away in 2012.) But in 1973, the doctor became a celebrity in his own right after discovering his life-saving procedure, which he stumbled upon while experimenting with airway obstruction on an anesthetized beagle. Four decades later, the Heimlich maneuver, in which a hand is placed over a fist and thrusts to the abdomen are delivered from behind, still is widely accepted as the first line of defense against choking. But it wasn't always so: After Heimlich initially presented his findings, a skeptical Red Cross countered that back blows -- forceful smacks between the shoulder blades -- were more effective. As the medical establishment debated the issue, Heimlich took his innovation directly to Hollywood. He credits another famous relative, first-cousin Anson Williams -- who played the sweetly naive Potsie Weber on Happy Days -- as having hastened its tipping point.
"I was doing The Merv Griffin Show and Uncle Hank came down," recalls Williams, 64, who refers to his elder cousin as his uncle. "I mentioned during the break how he had invented the Heimlich maneuver, and Merv brought him up from the audience." From there, the move caught fire, and the charismatic doctor was soon on The Tonight Show demonstrating it on Johnny Carson. The maneuver lodged itself into the public consciousness. By 1985, when Surgeon General C. Everett Koop declared the maneuver the "only method" for choking, the Red Cross waved the white flag and adopted it as the primary anti-choking treatment. (In 2006, the organization quietly reverted to supporting back blows as the first line of defense.)
In the years that followed, Heimlich embarked on a number of campaigns that cast a shadow on his status as medical media darling. Heimlich aggressively has advocated that his maneuver replace CPR as the primary treatment for near-drowning. The Red Cross counters that could be fatal, causing victims to aspirate on whatever regurgitated water and vomit the thrusts brought up. He faced similar criticism for trumpeting his maneuver as a life-saving procedure in the case of asthma attacks. Perhaps most troublesome was malariotherapy, which the National Institute of Health's Dr. Anthony Fauci, the country's top infectious disease specialist, described as "scientifically unsound and ethically questionable" to 20/20 in 2007.
Heimlich, now 94, tells THR that his proposed "Induced Malaria Therapy" (IMT) program was inspired by the efforts of Austrian psychiatrist Dr. Julius Wagner-Jauregg. In 1917, Wagner-Jauregg devised a treatment for neurosyphilis, a terrifying condition in which untreated syphilis spreads to the brain and spinal cord. He'd introduce P. vivax, the most curable strain of malarial parasite, into a patient's bloodstream. After two weeks of 105-degree fevers -- accompanied by profuse sweating, convulsive shivering, excruciating migraines, severe body pain, vomiting, anemia and hallucinations -- the patient was then given quinine to cure the malaria and placed under observation.
"He cured most of them and it spread around the world," Heimlich tells THR of Wagner-Jauregg's efforts, which were awarded a Nobel Prize in 1927. According to data, while 20 percent of the patients died, the treatment offered some measure of relief for up to 50 percent more. But for "pyrotherapy," as it was called, "controlled studies were never performed … and published reports suggest that clinical response was unpredictable," according to a 1993 public letter from the U.S. Centers for Disease Control. Further tarnishing Wagner-Jauregg's legacy is the fact that he lived out his later years as an enthusiastic Nazi sympathizer who advocated for "racial cleansing."
Heimlich, who grew up in a middle-class Jewish family from New Rochelle, N.Y., chose not to linger on the less-savory aspects of Wagner-Jauregg's background as he addressed the rapt group gathered in Carson's living room. (Carson, now 82, did not respond to a request for an interview.) He focused instead on Wagner-Jauregg's Nobel Prize and the thousands of lives he saved, just as Heimlich himself had done with his maneuver. (The Heimlich Institute claims that 100,000 lives have been saved, and in his memoir, Heimlich's Maneuvers: My Seventy Years of Livesaving Innovation, published earlier this year, he includes those of Cher, Nicole Kidman and Halle Berry among them. Berry has denied being saved by the maneuver; Cher and Kidman didn't respond to inquiries.) He spoke compellingly about the strides he'd already made through his Heimlich Institute Foundation in using malariotherapy to treat cancer and Lyme disease, and how he'd published writings on the topic in The New England Journal of Medicine.
Those strides involved giving malaria to an indeterminate number of Lyme-disease patients -- indeterminate because he provided insufficient data for peer review, according to the CDC. The published findings in The New England Journal of Medicine that Heimlich referred to came in the form of a letter to the editor penned by him, dated April 26, 1990, and titled, "Should We Try Malariotherapy for Lyme Disease?"
Back in Carson's house, Bronston recalls lobbing several pointed questions at Heimlich, instantly sensing that the doctor was on the defensive: "[He] automatically started feeling threatened, that I was the enemy. I said, 'I know about experimental treatment. You have to have a special informed consent, you have to have committees set up, you have to have scientific literature and a program and all this other stuff. Dr. Heimlich, where is your study?' " Heimlich handed him a copy of his proposal, which Bronston decided he would vet and later voice his concerns to Davison in private.
But when he did, Davison "was concerned and seemed embarrassed," according to Bronston. A few days later, he says, Davison attempted to enlist him for the cause: "He and Heimlich said, 'Well, we want you to be involved. We want to film you, record you. Be part of the documentary.' "
Bronston declined, and instead started a campaign to prevent Heimlich from conducting his experiments. "I contacted the medical boards, the FBI, the CDC, The New England Journal of Medicine, all these people that were listed on the proposal [as project staff members] that said allegedly that they supported him. I contacted all of those people and they disavowed themselves from Heimlich." Bronston's efforts at sounding the alarm alerted governmental agencies -- but were not effective enough to derail Heimlich, who made arrangements to relocate his study from Mexico to China after Mexican health authorities stepped in. "I can say that I was outraged by its lack of scientific basis as well as poor ethics," Dr. Carlos Del Rio, Mexico's AIDS czar, said in a 1993 letter to a journalist after reviewing the IMT proposal. "I have no idea why Heimlich has moved to China, but we are delighted by the move."
Around that time, the Department of Health and Human Services issued a statement of position on Heimlich's plans, stating that "any protocol involving the use of humans in research should undergo thorough ethical review and approval by a review board prior to initiation." It concluded that induced malaria in HIV-infected individuals simply "cannot be justified."
Meanwhile, an investigation into Heimlich's fundraising efforts was undertaken by the major frauds section of the U.S. Department of Justice. The case was closed without charges being filed, but during the investigation, Amy Irving was ordered to hand over a $50,000 check that she had made out to the institute. "[An agent] flashed a badge at her," the Yentl star's assistant later said in a phone message left with the Heimlich Institute in January 1994. "He was discrediting the Heimlich Institute."
Davison, 68, now sees that malariotherapy was probably an ineffective HIV treatment, but like several other Heimlich backers interviewed, including Ed Asner and talent agent Sandy Bresler, he still stands by Heimlich. "I firmly believe that Dr. Heimlich believed in the possibilities of this therapy research and never intended to scam anyone," he tells THR in an email. "We understood his theory to be that plunging the human body into immune-system overdrive with an inactive form of malaria could possibly trigger an immune system response to AIDS -- similar in theory to bee venom therapy for victims of MS." Davison sees it as a matter of desperate times requiring desperate measures: "We wanted to save our friends and thought it was worth a try. Time was running out for many, crippled by research bureaucracy and politics. There was nothing of any real merit in sight. Monday morning quarterbacking is easier now."
Also at Carson's house that night was Bresler, longtime gatekeeper to Jack Nicholson. Bresler was so impressed with Heimlich, he personally undertook a fundraising effort to help him reach his $600,000 goal. That meant canvassing deep-pocketed show-business friends like Nicholson and record producer Lou Adler, both of whom received letters of thanks from Heimlich. "Dear Jack, I want to personally thank you for your generous contribution of $25,000," Heimlich wrote in one. In another, he offered gratitude to Bob Hope for his "kind donation," before reminding the comedian of a night the two spent together following an Arthur Murray Party taping: "We all went to the Plaza for dinner after the show. Jayne Mansfield was there with a chihuahua dog peeping out of a pocket in her fur coat collar." Even Ron Howard, then appearing alongside Heimlich's cousin on Happy Days, apparently opened his wallet: "Rec'd $5,––– from Ron Howard and your recent deposits," Heimlich wrote in one letter to Bresler, omitting the number of zeroes in his donation. "Am writing to all donors."
Bresler, 77, views Heimlich not as a villain, but as a slightly off-kilter visionary. "The first phrase that pops into my head is 'Mad Hatter,' " he says of the scientist. "I knew things weren't going through the FDA, but that didn't bother me any because of the passion involved for the product." Bresler maintains that the underlying premise still strikes him as logical: "If malaria triggers temperature, that triggers your immune system. That made perfect sense to me as a layman. So there you are."
Taking a less sympathetic view of Heimlich is his own estranged son, Peter Heimlich (pictured below), a 60-year-old textile importer from the Atlanta area, who, along with wife Karen Shulman, has spent the past 12 years researching and publicizing the less-celebrated aspects of his father's medical legacy. (Dr. Heimlich's other children are attorney Phil, 61, and twins Elisabeth, a Cincinnati politician, and author Janet, both 52.) "My father is skilled at enticing people," he tells THR. "He always had an unquenchable appetite for attention and praise. After he became famous, that need seemed to take over his life. Plus, he always loved rubbing elbows with the rich and famous. Being invited into the homes of well-meaning but naive Hollywood stars must have been a dream come true for him."
As his fundraising machinery hummed along, Dr. Heimlich drew up a new version of his institute letterhead, which now boasted its star-studded "Hollywood Support Committee." Alongside the names of Davison, Voight and Irving were those of Ed Begley Jr., Ted Danson, Anjelica Huston, Muhammad Ali and Bette Midler, none of whom would comment for this story. Richard Dreyfuss, also listed as a committee member, tells THR that he never met Heimlich nor did he ever support his malariotherapy efforts. But Asner, whose name also appears as a backer, does recall Heimlich with fondness: "I respected him as a worthwhile scientist," says Asner. "An adventurer, perhaps, but certainly worthy of support. What a noble effort to pursue that idea of the high fever to burn out AIDS. It was such a frightening time -- the Black Plague revisited."
Bronston says this kind of naivete is all too common in the entertainment business, where he has served as a Hollywood medical consultant. "These people had friends dying. It's horrible for them, traumatic -- but they are artists," he says. "They don't understand science, just like scientists don't understand art, and they have a lot of money, so they are a very vulnerable group of people to be preyed upon."
With the funding in place, Heimlich signaled the green light for human testing to begin in a hospital in Guangzhou, the third largest city in China. According to documents obtained by Peter Heimlich and given to THR, Heimlich's main Chinese contact, Dr. Chen Xiao Ping, requested a wire of $10,000 per patient to cover hospitalization and blood work, plus a "medical workers' reward for contact with HIV." Patients were asked to sign a form of "informed consent" (which the FDA said in a 2000 report "did not meet federal regulations") that warned subjects of "a risk of adverse side effects [which] may include fever, chills, fatigue, nausea, vomiting, headache, flushing, shortness of breath, tightness of the chest, back pain, muscle aches, sweating, fall in blood pressure, rash, joint pain, muscle weakness and acute allergic reaction (which could on rare occasions be fatal)." The form also warned that IMT may "accelerate your HIV disease condition."
By July 1993, with only two HIV-positive patients recruited, Bresler was growing impatient and decided to put his agenting skills to use to produce quicker results. "It is hard to believe that it is now July," Bresler wrote in what would be the first in a series of increasingly frustrated letters. "The entertainment industry is a result-oriented group. … We were going to do our research on a minimum of 10 patients and now we seem to be in a struggle to get two volunteers." (Later, Bresler castigated Heimlich for bypassing him and directly soliciting Hollywood investors: "I am stunned that you have taken this course now. … My name is connected with the project as well as yours [but] mine is with the people who put up the money. You have put me in a very bad situation.")
Heimlich pressed Chen to find more subjects. Success came in July 1994, when Chen located seven HIV-positive and drug-addicted patients in the Yunnan province, as he wrote in letters to Heimlich spanning 1993 through 1996. Chen had them transported via rail and air to Guangzhou for malaria injections.
In Chen's next letter, dated Aug. 26, it's clear that things had come off the wheels: "I suggest that if you certainly visit Guangzhou again, you had better come as early as possible," he pleaded to Heimlich, who politely declined every invitation to visit his patients in person. "It is very difficult to manage them in hospital. Among them some were prisoners, thieves and all are drug addicts. They stole money, articles of other patients and medical workers, and fight with each other and with other patients. They have made a big chaos in the hospital." Another dispatch informed Heimlich that security guards had to be hired to restore order and raised questions about the entire enterprise. "Because it is not allowed to do any research except in Yunnan, we have to keep the research confidential," it read. Heimlich's response, other than repeatedly reminding to have the waivers signed, was: "This is unfortunate. As physicians we must, of course, treat whoever needs our help."
What followed, based on a review of Heimlich's own documents donated by the doctor himself to the University of Cincinnati, was a case study in sloppy documentation (with "vague descriptions of screening the malaria parasite donor for potential pathogens," according to the 2000 FDA report) and haphazard follow-up, the first one occurring 36 months after the beginning of the study. In one chilling report dated Oct. 22, 1996, Chen informed Heimlich that "Case 6 died on July 5, 1996; the cause of his death is unknown. … One month before he died, he got fever, cough with bloody sputum, diarrhea (bloody stool) and emaciation, heavy anorexia. Maybe he died of drug use (overdose or withdrawal?) but we could not get detailed information about his drug use from his family.
"Or he died of AIDS," he wrote. "Nobody knows."
In the years following the China experiments, Heimlich's commitment to human studies of malariotherapy brought him to East Africa, where, according to one report, he oversaw the injection of 13 HIV-positive sex workers with P. vivax. Heimlich presented his findings at the 11th International AIDS Conference in Vancouver in 1996, which he referenced in later fundraising efforts. Says Martin Schechter, the conference's co-chair, "An H. Heimlich did have a poster presentation on malariotherapy at the conference. A poster presentation is not a talk or speech, but rather the findings are displayed on a board that people walk by and look at. Higher-quality scientific papers are selected for oral presentation." Aside from his cool reception within the scientific community, and despite the official denunciations of malariotherapy from the NIH and Centers for Disease Control and Prevention, no disciplinary action has ever been taken against Heimlich -- including by the State Medical Board of Ohio, which still lists him as a retired member on its website.
In his memoirs, Heimlich devotes three pages to promoting his malariotherapy efforts, and in his author's note, acknowledges that his most famous discovery, the Heimlich maneuver, was arrived at through experimentation on dogs. "If I were to conduct a medical experiment today, I would look only to solutions that do not involve animal research," he writes. "I want to make clear that I strongly believe in protecting the health and safety of animals."
Why wasn't the same protection afforded to human medical subjects? That's a question explored by a World Health Organization commission in 2002, which cited "Heimlich et al 1997" as part of a "backdrop of atrocities committed by doctors upon vulnerable subjects."
Heimlich and his supporters see it differently. "People were dying hand over fist," explains Bresler. "I mean, from an ethical standpoint, I think you and I both would have to admit that sometimes 'ethical' is a naughty word for trying to take the bull by the horns and get around a lot of bureaucratic whatever. And that's how I viewed it."
Heimlich would agree. "It was worth the trial," the doctor says. "It didn't hurt anybody."
Aug. 16, 7:47 a.m.: A previous version of this story incorrectly stated Dr. Heimlich's memoir was self-published. It was published by Prometheus Books. The Hollywood Reporter regrets the error.