Survivor Guilt Follows Recent Choking Incidents

May 20--Fred Y. Sasaki put on a red tie and his gray suit.

He was not a man who typically dressed up, but tonight was special. At 80 years old, Sasaki had built a successful career as a dry cleaner. He had just spent the day with his grandson. And now he was headed to his favorite restaurant, Yoshi's Cafe.

When he sat down at the table, he said: "I feel great."

Across from him was his financial adviser. The two men had known each other for nearly 20 years. And tonight, Sasaki relished the chance to pay for dinner.

He was a frugal man with a sensitive stomach, but tonight he ordered wine and oysters. And, of course, he would have New York strip steak -- his favorite.

The men talked and laughed, enjoying the food and each other.

Suddenly, Sasaki began to choke. He couldn't speak. His friend didn't know what was happening; he told Sasaki to put his hands above his head. Sasaki tried, but it didn't help. He drank water, but it just came up. An attempt was made to administer the Heimlich maneuver. No one was sure if Sasaki was having a stroke or a heart attack.

Sasaki died later at the hospital, one of about 4,000 people who die every year after choking on food or other objects, according to the Centers for Disease Control and Prevention. When Maureen Oleskiewicz, a 28-year-old teacher from Palos Heights, died after choking at Wrigley Field this month, it was heavily covered in the news. Sasaki's death didn't make the papers.

Yet the cases are striking in their similarity. Both occurred in public places, in front of many people. And in both cases, bystanders either didn't realize or weren't sure if Sasaki or Oleskiewicz were choking. Neither of the victims put their hands to their throats to signal they couldn't breathe.

That scenario is far too common, said Dr. Patricia Lee, head of emergency medicine at Illinois Masonic Medical Center, where Oleskiewicz and Sasaki were treated. Even when bystanders do recognize what is happening and attempt to intervene, they often wonder if they could have done more. Lee said too few have undergone training in CPR and the Heimlich maneuver.

"There is a lot of survivor guilt that goes on," Lee said. "People say, 'I meant to take a class.' People say that all the time when they come in with their loved ones."

It is a tragic twist that choking often catches people off guard in moments when they are happy and relaxed. Oleskiewicz, a dedicated Cubs fan, was at Wrigley Field. Sasaki was at his favorite restaurant.

"It's always a little more of a risk when you're having a good time," Lee said. "You're laughing and drinking. You might laugh and take a big breath so that the food goes down your trachea."

That food can act like a plug. "It's very sudden," Lee said. A person will not be able to speak, cough or make a sound. There is just silence and panic. Oxygen is blocked, and without it, a person will quickly lose consciousness and go into cardiac arrest.

"You have minutes," Lee said. "It's not enough time to sit back and wait for the ambulance."

With a head of thick white hair and a face that made him look younger than his 80 years, Sasaki had made a career working six days a week at his busy dry cleaning business in Lakeview. He did not have many close friends. But he was outgoing and friendly, and he would often greet people in the lobby of his apartment building at 3200 N. Lake Shore Drive by raising his hands high and shouting, at the top of his voice: "Gambaru!"

It is a Japanese word that means to persevere in the face of even the toughest obstacles, and it became a slogan of sorts for Sasaki, a Japanese-American who, as a child during World War II, had been interned with his family at the Heart Mountain Relocation Center in Wyoming, one of several camps used to imprison Japanese-Americans during the war.

After the war, the family ended up in Chicago, where Sasaki's mother worked long hours and eventually scraped together money to buy a dry cleaning business. She and her sons turned the cleaners into a thriving enterprise.

Barry-Regent Dry Cleaners, at the corner of Broadway and Wellington Avenue, served an upscale clientele of Gold Coast customers. Fred was a lighthearted presence at the counter who could happily chat up customers, while his brother John was the numbers man, focused on the bottom line.

Sasaki didn't have room in his life for much beyond work. But he lavished attention on his son. "He lived modestly and was very frugal with himself," said son Fred J. Sasaki. "For us, it was, 'Whatever your heart desires.'"

Sasaki drove his son to school daily. He took him to action movies that his wife, had she known, would never have allowed. When his son was learning card tricks, Sasaki let him practice pulling a tablecloth out from under a fully set table.

"That was something about my father, he always gave me magic," his son said. "He let you believe and made you feel good. He helped people see how special they were."

After he retired about 10 years ago, Sasaki became a doting grandfather to August Sasaki, 9. They browsed the offerings at Chicago Comics, rode the Ferris wheel at Navy Pier and dined on Chicken McNuggets.

In recent years, Sasaki collaborated with his son and grandson on a set of pamphlets that doled out quirky self-help advice.

"He finally had an outlet to be this weird, silly person that he was, and that he didn't get the chance to do as a dry cleaner or a father," his son said. "We had gotten closer in the last couple months. The grandchildren brought us close. My wife and I relied on him in these last few years maybe more than I had in my whole life."

Tuesday, April 23, was no different. Sasaki's grandson, August, woke with a cough and had been sent to his grandfather's house to spend the day. They had wiled away the hours exploring Sasaki's stamp collection.

"My father, like so many people, would get depressed. But this was a day that he felt really good, and I think it had a lot to do with spending the day with my son," Fred J. Sasaki said.

That night he had plans for dinner at Yoshi's Cafe. It was an upscale Japanese-American restaurant that reminded Sasaki of his success in life.

"He always talked about the steak at Yoshi's," his son said. "My mother said when she saw him on his way out to dinner that he looked excited, almost like a schoolgirl."

Choking deaths are the fourth-leading cause of accidental deaths in the nation, according to the National Safety Council. Although children under 12 months are vulnerable, it is older adults who are at the greatest risk. Factors that increase a person's vulnerability include an older age, dentures, alcohol consumption and physical disabilities.

For most age groups, however, the risk of choking fatally is low. A 2007 study found that among 513 choking cases reported in California's San Diego County over a 17-month period, only 3 percent were fatal. In most other cases, the Heimlich maneuver was used to treat the victim, with a very high success rate.

Choking "is a common thing that can happen. It can affect a person you know," said Terry Vanden Hoek, who heads the department of emergency medicine at University of Illinois at Chicago. He said people don't need to sit through a four-hour class to learn the Heimlich maneuver. They can watch a video on YouTube. "Knowing what to do is quite simple," he said. "It takes a few minutes to learn."

The mother of Maureen Oleskiewicz, who died at Wrigley Field, hopes her daughter's death will raise awareness about the dangers of choking and perhaps inspire more people to take a class in CPR.

Her daughter had been at a place she loved when she died. "They were throwing balls into the stands," Margaret Oleskiewicz said. "She went (to Wrigley) as often as she could. If she couldn't go, she would sit and watch the games with her friends at home. But what she really loved was being at the field."

As for the family members of Fred Sasaki, they are planning his memorial service for Sunday, which would have been his 81st birthday. His son stood in his apartment recently, going through his father's possessions. "I know how preventable a choking death can be," he said. "But I've tried not to dwell on that."

Instead, he remembers his father. The white-haired man who used to yell "Gambaru" with such force his dentures sometimes would fall out. The man who would give anything to his family.

It has been hard to comprehend he is gone, his son said.

"We loved him so much."

cmastony@tribune.com

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