Friday, May 5, 2017

Part II of "Drowning in Funworld" by Pamela Mills-Senn, the dramatic backstory of the landmark article that was our Rosetta Stone


Yesterday I published Part I of Drowning in Funworld, a dramatic four-part article by Pamela Mills-Senn that first saw the light 11 years ago this week on the now-defunct Cincinnati Beacon blog.

In it she relates how a routine writing assignment for an amusement park trade magazine unexpectedly turned into a white-knuckle ride on a journalistic roller coaster.

The result?

A landmark March 30, 2000 article that exposed a reckless, unethical campaign by my father and the country's largest private lifeguard training company, Ellis & Associates.

Since 1995, Ellis-trained lifeguards at scores of major waterparks around the country were being taught to resuscitate drowning victims using the Heimlich maneuver (abdominal thrusts).

Leading medical organizations including the Institute of Medicine had already declared the treatment to be useless and potentially deadly because it wastes precious rescue time and might cause vomiting leading to aspiration.

In other words, Ellis lifeguards were apparently using swimmers at their client pools as human guinea pigs to test an experimental medical treatment.

(Why company founder/president Jeff Ellis ever thought this was a good idea may be a question he now asks himself.) 

The fearless, thorough reporting by Mills-Senn (who lives in Long Beach, CA) and her editor Mike Moran exposed this madness and revealed my father to be a scoundrel and a humbug who didn't even understand the basic physiology of drowning.

And her article was effective.

Soon after it was published, per a May 30, 2000 Los Angeles Times article, Ellis dropped the "Heimlich for drowning" protocol.   

A couple of years later when my wife Karen and I found her article posted on the website of the United States Lifesaving Association, little did we know that our lives would never be the same.

It became the Rosetta Stone for our research that resulted in hundreds of mainstream print and broadcast media reports which exposed my father's disgraceful history; his bizarre 30-year colleague, Dr. Edward A. Patrick; the $9 million Save-A-Life Foundation scandal, and more.

And Pamela became a valued friend.

Before proceeding, I recommend that you first read her article that set us on our course, Water Rescue Sequence: The Controversial Role of the Heimlich Maneuver, and then Part I of Drowning in Funworld.  


Part II: The Tides of Research Rising

I didn't receive duplicate research papers from both sides in every case. One such instance involved a study published in a June 1989 issue of Pediatrics that was conducted by Linda Quan, M.D., internationally known for her work in pediatric drowning. Dr. Henry Heimlich had sent me just the first couple of pages of her study; (the American Heart Association's Mary Fran) Hazinski had not included this in her packet of materials.

Quan's research was important to Heimlich because it was from this study (entitled "Ten-Year Study of Pediatric Drownings and Near-Drownings in King County, Washington: Lessons in Injury Prevention") that he derived a shocking figure that the use of CPR to resuscitate children pulled from public pools resulted in a 42% fatality rate. Heimlich further stated in his own materials (in which this figure was used over and over again to demonstrate CPRs ineffectiveness for all populations) that the children in Quan's study had been given CPR by Red Cross-trained guards.

It was Quan's study I held in my hands that early morning and it was this study that contained the red flag that had been flapping - completely overlooked - in my face all this time.

But before going further, here's a little background on me.

I've earned two Bachelor's degrees, one in psychology and one in anthropology. I completed two years of Master's level coursework in anthropology, with a focus on medical anthropology and how culture affects compliance. I opted out of the thesis and instead, wound up at a small magazine publishing company doing research and marketing, an association that lasted about 14 years before I struck out on my own as a freelancer.

Both my majors were heavily research oriented. I spent six years as an undergrad learning the difference between well-constructed research and research that was not up to standard. Throughout the eight years I was at the university I took a variety of classes on research methodology, statistics and the like. I know how to tell good from bad, valid assumptions from invalid and so on, although I'm not an expert - certainly not at the level of say, someone with a PhD or an M.D. behind his or her name.

Looking at the Heimlich-supplied partial copy of Quan's study, and then at his materials where he quotes the 42% death rate associated with the use of CPR, I realized that he had extrapolated from a small, self-contained regional population and translated the data derived from this population as being true across the board for everyone. Nowhere in the papers that he provided to me at that time, nor in the copies of his correspondence that he sent to various folks trying to win support for using the maneuver for drowning resuscitation, did he mention this was a regional study and therefore valid only for that population.

I was stunned that he would commit such a rank error, one that any beginning statistics or research student would be rapped across the knuckles for.

Here's why you can't do what he did. Say for example, you wanted to do a study on the average amount of time that people, unprotected by any sunscreen, could remain in the sun before burning. Now, say you included only redheads in this study, or only African Americans. How valid do you think it would be to extrapolate from these groups to the entire population at large? (Not to mention you would have to take varying levels of pigmentation into account along with a ton of other variables. You get the idea.)

Or, consider the recent revelations around heart attack symptoms. For years, researchers basically studied males and extrapolated from these studies a list of warning signs commonly believed to be true for everyone. But, as it turns out, the warning signs for women are quite different than those for men. If women had been included in these studies, or if researchers had questioned their assumptions that men and women are alike in this respect, a more scientifically accurate picture would have emerged.

What Heimlich did may seem like a small deal, but it wasn't. It was enormous. My first reaction was to question myself; maybe I was wrong about this, maybe this extrapolation was valid. But I knew better. And if I knew better, why didn't Heimlich? Could he have done this in error? Could this have been deliberate? Either way, it didn't look good.

As I tried to wrap my brain around this, I waited for the workday to begin, too unnerved to sleep and for once grateful that my editor was hours ahead of me here in California. Finally, around 7:00 am, I placed the call.

"There seems to be a problem with how Dr. Heimlich is applying his data," the first of countless times I would say this exact phrase.

I explained. He listened in silence. We were both thinking the same thing - oh shit. What could this mean for Ellis & Associates, who also relied on this figure?

The editor agreed we couldn't move forward and gave me a few weeks more to dig around; weeks that turned into months -- six to be exact.

Having only a partial copy of Quan's study, and freaking out about the implications of what I thought I was seeing, I decided to call her. It was easy enough to find the hospitals number where she worked through information. Maybe Quan would tell me that Heimlich's use of her data was correct after all.

The message I left for her was the same as what I told my editor, "There seems to be a problem with how Dr. Heimlich is applying your data."

The message I left for Hazinski was the same: "There seems to be a problem with how Dr. Heimlich is applying his data."

And then I waited. And the phone calls started coming. And papers and documents and research started arriving. And then the bad dream began to take shape.

Part III, The Straw (Man) Argument