When I was nine, my oldest friend nearly choked to death on a gobstopper. We had snuck out of my back garden to get sweets, a girl gang of four, hopping over a low wall and armed with enough pennies for at least one treat each. In the end, probably copying each other, we had bought gobstoppers – white terrazzo boiled sweets with a chewing-gum centre that took plenty of licking to get to. We were having an excellent time until, halfway home, my friend started to cough – and then choke.
Her face went red, her eyes looked panicked and she started to wheeze. We called for help, but no one was around, apart from some boys we had made fun of on the way to the corner shop. They ignored our cries. Eventually, after we rammed her on the back a few times, she coughed up the monstrous thing into a pot plant. I haven’t had a gobstopper since and I have carried with me a fear of watching someone choke again. Sadly, as I discovered this week, lightning can strike twice.
I was getting off a tube train in London when I noticed a woman coughing. I slowed down, watching her subtly. I had since learned that coughing is rarely a sign that something is terribly wrong. “If a person can cough, they are passing at least some air through their respiratory tract,” says the Oesophageal Patients Association. But shortly after I started watching her, the woman stopped coughing, her eyes started bulging and she bent over.
When I went over to ask if she was OK, she looked up at me, panicked, and gestured to her back. I started smacking her on the back and screaming for help. Despite having watched a few videos, I was terrified that I wouldn’t be able to perform the Heimlich manoeuvre correctly and that I would have to walk away with her death on my conscience. But it was just the two of us, alone in the tunnel of an underground station; if I didn’t try to help, no one would.
The bystander effect has been described as a “diffusion of responsibility”, the idea that, if there are other people around, they will step in to help and so your assistance isn’t necessary. I have seen it play out time and time again in London, especially on the tube.
A terrible recent example (that I didn’t witness) was when a 20-year-old woman was raped in a train carriage in front of other passengers. The tube now displays posters for a “Bystander Awareness Campaign”, which encourages people to intervene sensitively or report it if they see harassment or hate crimes.
But despite the growing awareness, I have seen people ignore – or back away from – passengers facing medical emergencies a worrying number of times. I get it: the fear of making things worse, especially if you have no medical training, is real; research suggests that when a “medically competent” person is presumed to be available during an emergency, direct help from others is far less likely to occur. Sometimes, though, regardless of who else could be in the vicinity, it may be useful to get involved.
So it was with the coughing woman on the tube. Thankfully, much like with my friend, after a few sharp smacks, whatever had been in her throat dislodged. She thanked me, almost embarrassed, and walked up to the escalator. I followed behind her, shaking, with tears in my eyes, muttering about how she had given me the fright of my life.
The incident taught me that the bystander effect is hard to overcome – and that I desperately need to take a first aid class. Nothing can prepare you for the real thing, but, my God, I would have been far more useful to that woman if I had had some medical training.
By the time we reached the top of the escalator, we had both calmed down. She turned around, took my hands in hers, bowed her head and thanked me again, before disappearing. She might have been fine without my hurried bashes to her back – I may not have actually saved her life – but at least she knew that someone, a stranger whom she will never see again, cared.
• Charlie Brinkhurst-Cuff is a freelance journalist
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