Not waving but choking

    27 September 2014

    If anyone ever dares you to take part in an eating competition, I’d recommend you spit in their eye. Because eating contests kill people. Really, they do. Recently the former marine Gary Sims choked to death in a race to down as many of a pub’s pickled eggs as he could. He’s the latest in a long list of speed-eating RIPs.

    Meanwhile, if you are one of those who’ve said, after a few coughs and splutters at the dining table: ‘Blimey, I nearly choked then!’ — trust me, you didn’t. Choking to death is almost an entirely silent affair. I speak from personal experience.

    I was at a family birthday lunch in a pub named, rather appropriately as things turned out, the Blue Strawberry. There were about 20 of us sitting around a long table talking, laughing, arguing. I was in a heated debate with my brother-in-law when, determined to make a point, I swallowed the chunk of beef I’d just forked into my mouth without bothering to chew. It slid down my throat and lodged snugly at the top of my trachea, and before I could cough the thing up, the windpipe had closed tightly around it.

    It’s called the drowning reflex. If you fall into water and go under, any fatal inhalation of H20 is prohibited by the top of the trachea closing, buying you a few minutes to get out of trouble.

    The problem is that the same reflex can kick in if food comes into contact with this spot. The windpipe grips the foreign object with implacable firmness — what I suppose you could call a choke-hold — and forms a perfect seal. Oxygen cannot get in or out of the lungs. That’s why you can’t make a sound — there’s no air to vibrate your larynx with.

    Of course, I’d never heard of the drowning reflex that afternoon in the Blue Strawberry. All I knew was that I’d stopped breathing and nothing I could do could get me started again. My brother-in-law had no idea what had happened. He thought I’d conceded defeat and was sulking in silence. He turned away and began talking to someone else.

    In those early seconds I was, if anything, more embarrassed than frightened. I almost got up from the table to find the gents and ‘sort myself out’. But something whispered to me that this wouldn’t be a great idea, and after a few more attempts to cough the blockage up, I rose and braced my hands against the edge of the table, instinctively thumping it hard, arms rigid, to try to dislodge the beef. I did this several times, but only succeeded in making people turn and stare at me in irritation. ‘What’s Richard up to? Oh no, he’s not going to make a speech is he?’

    It was my brother-in-law who twigged first. ‘What’s the matter with him? He’s looking a bit blue… Christ, he’s choking!’

    Pandemonium. Fists thumping my back. Shouted exhortations to ‘Cough it up man, cough it up!’

    Panic gripped me. The authentic ‘Fuck me, I’m dying’ sort of panic. A good minute had passed since my last breath (increasingly it did look like being my last breath) and black dots like distant crows began to appear in my vision. The bright room around me had become a narrow, darkening tunnel. However, thought and reasoning remained perfectly functional. If part of my mind was drenched in fear, a parallel consciousness was supplying me with an annoyingly insouciant risk assessment. ‘We’re in the middle of the countryside here, Rich, you know. No chance of an ambulance getting here in time. If someone doesn’t try that bloody Heimlich manoeuvre thing soon, you’re a goner.’

    Then the cavalry arrived in the form of my big sister Liz. Liz is a teacher and, thank the stars, she’d been sent on a first-aid refresher course just the week before. She returned from making a phone call in the car park, took in the situation, and ploughed through the mob like a battle-tank. ‘Out of my way, all of you!’ She wrapped her arms around me from behind and formed a fist below my sternum. ‘Stand back! I need room!’

    Liz made a series of hard, sharp compressions to force the obstruction out. You must have seen the Heimlich manoeuvre on TV dramas, where it’s usually depicted as a much less muscular business than it really is. In real life, it’s a pretty violent affair — first-aid experts say you shouldn’t be afraid of cracking some ribs. Ribs can repair themselves. An oxygen-starved brain can’t.

    And it doesn’t always work. However hard Liz heaved away, the chunk of meat refused to budge from my windpipe.

    My sister began to panic. ‘Help! Help! Somebody help us!’

    Oh dear, I thought. If she’s giving up, it’s game over. And suddenly, all the fear and fight left me. I felt perfectly calm and relaxed. So this was dying. Not so bad, really. Had to happen someday. Shame it was unfolding in such a silly way but, well…

    As my knees buckled, Liz gave one last despairing heave. Gravity and a former hockey captain’s muscle power worked in concert and the beef lifted just a little, like a slyly opening trapdoor. I managed to gasp half a lungful of air before it slapped down again, but then, with another heave from Sis, I coughed, retched, and up it came. Not with a satisfying pop, but in a slow, slithery gloop. I spat it out.

    Fifteen seconds later I was right as rain.

    The Café Coronary

    So-called because, like me, a lot of people choke to death in restaurants. When someone starts to choke it can appear as if they’re about to vomit. So people in the vicinity politely avert their gaze. The next thing they hear is the thud of an unconscious body hitting the floor. ‘Oh my God,’ they say to each other, ‘not throwing up — having a heart-attack!’ CPR is administered without anyone thinking to check the victim’s airway.

    Disastrously, when choking, some people head for the toilet so they can cough the obstruction up in private. This is usually a one-way trip. Try not to be alone when you find you can’t breathe.

    A few simple points emerge:
    • Granny was right — always chew your food.
    • If you find yourself choking, do anything you can to attract attention.
    • Learn the Heimlich manoeuvre.