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Obituaries

Edward A Patrick

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c1314 (Published 11 March 2010) Cite this as: BMJ 2010;340:c1314
  1. Jeanne Lenzer

    Championed the Heimlich manoeuvre, in a life embroiled with scandal

    Much of Edward A Patrick’s life is shrouded in mystery, his actual accomplishments clouded by his tendency to bend and invent the facts of his life. Patrick claimed that he was the co-developer of the Heimlich manoeuvre, which he referred to as the “Patrick-Heimlich manoeuvre.” For nearly 30 years, his career was intimately tied to the equally puzzling career of Henry Heimlich, once dubbed the “most famous physician in the world” for the life saving manoeuvre named after him. The two men worked tirelessly together, promoting the manoeuvre and later working on a cure for AIDS—a “cure” that was denounced by the US Centers for Disease Control and Prevention and the World Health Organization. In recent years both doctors were implicated in a scandal about Patrick’s medical credentials.

    Born in Wheeling, West Virginia, on 7 October 1937, Patrick had a lifelong fascination with technology. As a teenager he became a licensed amateur radio operator and reportedly built a working x ray machine. He attended the Naval Academy in Annapolis from June 1956 to February 1957, when his resignation was accepted. He earned degrees in electrical engineering from the Massachusetts Institute of Technology—BS in 1960 and MS in 1962. He earned a PhD in electrical engineering from Purdue University in 1966 and in 1974 he received his MD from Indiana University.

    Patrick used his engineering and medical degrees to work on twin projects: statistical pattern recognition and the development of a computer program that he thought would revolutionise medical care by integrating computer guided diagnostic and treatment plans into patient care. He worked on a program for more than 30 years with his son, Edward Patrick Junior. He wrote dozens of articles and a book entitled, Artificial Intelligence with Statistical Pattern Recognition, which one critic opined was “long on hype and short on clarity.”

    Long on hype

    Patrick’s hype extended to his credentials as an emergency physician. In 2005 the investigative journalist Thomas Francis published an article that undermined Patrick’s claim that he served a year long residency under Henry Heimlich at the Jewish Hospital in Cincinnati from 1975 to 1976. In the article, entitled “Playing doctor,” Francis cited documents that show that it was virtually impossible for Patrick to have fulfilled his residency requirements. Part of the evidence against him was a statement by the hospital’s chief resident of surgery, who attested that Patrick was never in the residency programme.

    Patrick filed a libel suit against Francis, but the suit was dismissed and the decision was upheld by a federal appellate court. The judge found that there were “many inconsistencies in Dr Patrick’s representations of virtually all aspects of his medical training.”

    The source of the reporter’s information proved to be as newsworthy as the scandal itself: Heimlich’s son, Peter, gave documents to Francis that undermined not only Patrick’s claims and credentials but also important claims made by his world famous father. The younger Heimlich recalls first seeing Patrick visiting his father in the mid-1970s, when they had long working sessions and scrawled extensive notes on yellow legal pads. Patrick’s unusual appearance made the visits memorable. Says Heimlich, “He had this big Elvis [Presley] pompadour, and he wore a green polyester suit with high heeled boots.”

    In 1976, two years after the manoeuvre was first publicised, the American Heart Association issued guidelines to recommend the manoeuvre for choking if blows to the back had failed. This didn’t satisfy either Patrick or Heimlich. They denounced back blows as “deadly” and argued that only the Heimlich manoeuvre should be performed for choking. Not long after the manoeuvre was introduced, the pair began to promote it for near drowning. But the medical community was not convinced on either score.

    In 1981 use of the manoeuvre for drowning was given a boost when Patrick published a report that claimed that he had saved the life of a 2 year old girl in Lima, Ohio, who had been submerged in a lake for 20 minutes. Patrick claimed that he resuscitated the girl by using the Heimlich manoeuvre after lengthy cardiopulmonary resuscitation failed. “The Lima case,” as it became known, became a centrepiece of the men’s promotion of the manoeuvre for near drowning.

    Patrick and Heimlich waged an aggressive campaign to expand the use of the Heimlich manoeuvre, attacking experts who opposed their view. Still, medical experts continued to express doubts about the pair’s claims. That all changed in 1985 when C Everett Koop, then surgeon general of the United States, ended the impasse by endorsing the manoeuvre as best treatment for choking. Koop told the Washington Post that he was motivated to do so after receiving a letter from Patrick describing his choking “research.” In 1986 the American Red Cross recommended the manoeuvre as the preferred intervention for choking and added it as a measure for cases of near drowning when cardiopulmonary resuscitation failed.

    Experts continued to challenge use of the manoeuvre in cases of drowning, and in 2000 the American Heart Association dropped it from guidelines on drowning. In 2004 the reporter Francis published damning information about the oft cited Lima case. The girl, it turned out, remained comatose and died several months after being pulled from the lake. Reporters were unable to obtain proof that Patrick even worked at the hospital in Lima at the time of the girl’s admission to hospital. Although Patrick posted the child’s medical record on his website, the hospital will not confirm whether the chart notes are genuine, saying that her original records have been destroyed.

    After another review of the scientific evidence in 2006, the American Red Cross quietly changed its guidelines for choking, recommending the manoeuvre only when five blows to the back had failed. They also dropped Heimlich’s name from the manoeuvre, now calling it simply “abdominal thrusts.”

    Malaria as “cure”

    Perhaps the most bizarre chapter of the Patrick-Heimlich alliance came when Heimlich became convinced that he could cure cancer, Lyme disease, and AIDS by infecting patients with malaria, known as “malariotherapy.” Heimlich named Patrick the medical director of a research project into malariotherapy for AIDS. When the US Food and Drug Administration refused to allow the research to be conducted in the United States, the men moved the study to China, Ethiopia, and Gabon. Although Heimlich and his colleagues published articles claiming success after they injected some eight patients with AIDS in China with Plasmodium vivax, the Centers for Disease Control and Prevention issued a statement in 1993 cautioning against the treatment. The World Health Organization denounced the study as an example of “clearly unscrupulous and opportune research.”

    Commenting on Patrick’s puffery and his ties to Heimlich, the reporter Francis says, “One thing they had in common was ambition, and Patrick was so ambitious that nothing was going to be good enough for him.”

    He leaves three former wives, Patricia Roy, Susan Soudrette, and Joy Lake Patrick, and four children from his first marriage (one predeceased him) and two from his third.

    Notes

    Cite this as: BMJ 2010;340:c1314

    Footnotes

    • Edward A Patrick, lifelong promoter of the Heimlich manoeuvre (b 1937; q 1974 Indiana University), died 23 December 2009 from complications from a stroke.