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The Choking Game

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On March 7, 2007, Huntsville high school sophomore Blake Sandel died playing the game. His mother told The Huntsville Item that, on the day Blake died, he and his brother had plans to go to the Houston Livestock Show and Rodeo. Blake slipped into his bedroom to change clothes, and he never came out. His father found the body about 45 minutes later.

Besides Blake, the GASP site lists 14 deaths and one injury among Texas children playing the game. The average age is 13.

The Harris County Medical Examiner's Office originally ruled one of the cases a suicide, despite the protests of the family. That is another reason, researchers say, that true numbers are hard to find.

In that case, a 14-year-old Spring girl named Haley Kinney took one of the decorative scarves she liked to keep on her door and tied one end around her neck. She looped the other end around a hinge at the top of her bedroom door, kneeled on her beanbag and fell forward. As she asphyxiated, her mother, baby brother and twin brother Kirby went about their business upstairs.

When one of Haley's friends called, Kirby walked the phone downstairs to Haley's room. Coming down the steps, Kirby says, he saw the door creak partway open to reveal a single pale arm. He said she had a call, but there was no response. Once outside Haley's room, Kirby couldn't get the door to budge. He was up against the weight of his sister's dead body. He leaned into the door and then saw it again, the pale arm. Kirby screamed for his mom.

The way Kirby recalls it, the medics pronounced his sister dead on the scene.

"Ma'am," he remembers them telling his mom, "we need you to step away from her because she's dead."

Do not scream, Carrie Draher is telling herself. Do not lose your self-control, or they will take you away from him.

It's a mercifully quick trip to the hospital. In the trauma bay, the doctors let Carrie stand beside Levi for a few minutes. She holds his cold blue foot. But now it's time for them to take Levi, and a doctor leads her away. She knows where she's going. That room with the little couch and nice lighting where no one wants to go. She's going to a room where the only thing she can do is wait. In a moment, Heidi, the drill instructor's wife, is with her. Carrie can't sit still. She picks up the phone and calls family. There's been an accident. With each call, she feels more and more like she's planning a funeral.

The hospital chaplain appears at the door. She knows what that means. In the military, the only reason the chaplain appears is to administer the last rites.

"Is he dead?" Carrie asks. And when the chaplain says she just wanted to see if there's anything Carrie needs, she lets it out. She closes the door and screams.

Heidi grabs her. She tells Carrie not to block them out. The door opens and the chaplain enters. Heidi and the chaplain ask Carrie to pray. They lock hands at first, but then Carrie drops down, tucking her chest to her knees, laying her head on the floor. She's never felt more powerless. She knows she can't ask God to save Levi; that's not her place. But she still talks to God. She asks for peace and the ability to be strong for the family members who will soon be trickling through the hospital doors. And when she returns to her feet, she is bolstered with the most incredible sense of calm.

Finally stable after three hours of seizures, Levi is moved to pediatric ICU. Carrie is allowed to touch him. He's warmer than before, but still slightly blue. He's intubated and on life support. The doctor takes Carrie aside for a debriefing. Levi's lungs are badly damaged. His brain is swelling. His liver is failing. She tells Carrie that they can push all the oxygen in the world into Levi, but if his lungs can't feed his cells, there's nothing they can do except maintain a pulse. Carrie knows she's being prepped for brain death. She knows what's coming next, and she says, when the time comes, she and her husband will sign a do-not-resuscitate order.

Now her calm is tested by a wave of doubt. Had she done the right thing? Did she give Levi just enough breath to bring him back as a vegetable? Did she revive a brain-dead child?

The waiting stretches through the night, into day two, and on the morning of day three, while Carrie is sitting beside him, Levi's eyes open. Carrie calls for the doctors while a frightened Levi shoots up and reaches for the tube that's jammed down his throat. But Carrie tries to reassure him.

"There was an accident," Carrie says. "You're in a hospital. And if you just breathe with this machine that's helping you breathe, they'll take it out."

Levi lies back down, and the doctors remove the tube.

In a raspy whisper, Levi utters his first word since Carrie found him on the floor.

"Water," he says.

Of all the different names the choking game goes by -- space monkey, blackout, California dreaming -- perhaps the most appropriate is “suffocation roulette.”

That was the title of a 2003 report by Israeli doctors in Annals of Emergency Medicine. Their curious patient was a 12-year-old boy who had gone off to play with friends, only to return disoriented, two days in a row. The boy had told his father that he blacked out on both occasions, but he had no memory of the time immediately preceding the blackouts. The boy said he wasn't sniffing, smoking, drinking or shooting anything. He “denied physical abuse by his peers.” Stymied, the doctors ran a battery of tests. The boy finally fessed up when one doctor asked him point-blank if he knew anything about the choking game.

“We believe that this dangerous game should be brought to the attention of parents, physicians, educators and social service personnel,” the physicians wrote. “Recognition of this game as a possible cause of [passing out], together with prompt educative intervention, might prevent adolescent morbidity and mortality.”

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