I leaned him forward, letting his head hang lower than his torso.

With the heel of my other hand, I delivered a sharp, firm blow between his shoulder blades.

Nothing happened.

The room had gone completely silent, save for the mother’s quiet sobbing.

I gave a second back blow.

Then a third.

The boy’s body remained rigid, his small hands still clutching at his neck.

I knew I had to transition to abdominal thrusts.

I stood up, pulling him up with me, and stepped behind him.

I made a fist with my right hand, placing the thumb side against his abdomen, just above his belly button.

I grasped my fist with my left hand.

I pressed into his abdomen with a quick, upward thrust.

I felt the resistance of his small ribs

and delivered another sharp, upward pull.

A wet, solid pop echoed in the quiet room.

A large piece of half-chewed steak flew from his mouth and bounced onto the polished hardwood floor.

The boy gasped, drawing in a loud, ragged breath that turned into a high-pitched cry.