In 1941, four years after standing on principle (both medical and personal) Alfred Blalock was offered the position of surgeon-in-chief by Johns Hopkins, his alma mater. Here he was to find what would turn out to be a permanent home for both him and Thomas. Here is where heart surgery was born. Here is where many contemporary heart surgeons, giants in their fields, received their training under the precise eye of Thomas. And here is where the door hitherto labeled “whites only” was cracked open to an upcoming generation of black doctors.
Disclaimer: Getting a D+ in high school Biology (though I did somehow wing a 4 on the A.P. Exam) hardly qualifies me for what I am about to describe, but know that my heart’s in the right place.
A common cause of heart-related childhood death at this time was termed Blue Baby Syndrome. The heart has pipes that bring non-oxygenated (blue) blood in and then pumps it out to the lungs where it becomes oxygenated (red). From what I can gather, a child with this condition has a hole in one of the heart walls, a hole that siphons off enough of the blood so that it can’t reach the lungs, depriving the child of oxygen, and thus causing the child to appear bluish. Chronic lethargy and death were the order of events.
Helen Taussig, a pediatric cardiologist at Johns Hopkins, came to Blalock and Thomas in 1943 to see if the pipes could somehow be rerouted so as to supply the lungs adequately. Both men, in their studies on shock, had already successfully divided a major artery of a dog’s heart and tied it into the pulmonary artery that supplies the lungs with blood.
Chief among their many concerns about doing this on very young children was scale. Needles of an appropriate size for such a delicate operation did not even exist. Thomas’s solution was to snap the tips off of standard sized needles and hone them to a finer point.
When Eileen Saxon, just nine pounds, was wheeled into the operating room on November 29, 1944, before Thomas had even finished with the finals details of his laboratory experiments, no one was prepared for what they saw when her chest was opened up. “Her blood vessels weren’t even half the size of those in the experimental animals used to develop the procedure, and they were full of the thick, dark, “blue” blood characteristic of cyanotic children.”
At Blalock’s insistence, Thomas stood on a stool just behind and to the right of him because Thomas had, in the lab, performed this “procedure dozens of times, Blalock only once, as Vivien’s assistant.” Under Thomas’s careful supervision, Blalock sewed the divided subclavian artery into the pulmonary artery, and once the clamps were removed to allow blood flow, little Eileen’s color was transfigured from blue to pink. Thomas would later recall in an interview, “You’ve never seen anything so dramatic. It was almost a miracle.” Heart surgery was born.
As one might imagine, parents from around the world were soon bringing their children to Johns Hopkins for this life-saving procedure, the 1000th operation being performed just six years later in 1950. Likewise, leading surgeons from around the world came to Hopkins to observe the procedure, perplexed as to the identity of the person perpetually perched behind Blalock’s right shoulder. Blalock would admonish anyone who drifted into this spot, “Only Vivien is to stand there.”
Thomas looked not only over Blalock’s shoulder but also over those of Blalock’s residents, a crop of surgeons who would go on to run hospitals and chair university departments, spreading the new techniques learned under the gifted hands of Thomas. One of Thomas’s early students, Dr. Denton Cooley, who performed the first human heart transplant and who currently runs the Texas Heart Institute in Houston, remembers Thomas in contrast to Blalock: “Dr. Blalock was a great scientist, a great thinker, a leader, but by no stretch of the imagination could he be considered a great cutting surgeon. Vivien was.” And it was Blalock who, upon examining the healed, virtually invisible incisions of an operation called an atrial septectomy, an operation that Thomas had wholly conceived, commented with marvel, “Well, this looks like something the Lord made.”
Vivien Thomas’s legacy is an awe inspiring blend of both medical and social advancement. One can see how each aspect dovetails nicely through his work with Dr. Levi Watkins, Hopkins’s first black chief resident in cardiac surgery. Watkins invented and implanted the first Automatic Implantable Defibrillator, a small device that monitors the hearts rate and shocks it back into a normal rhythm when it gets out of line: a device that has saved over 100,000 lives. He says, “It was Vivien who helped me to work through the problems of testing this thing in the dog lab.” Thomas also served as a mentor to the young Watkins, the latter receiving advice “from a man who knew what it was like to be the only one.”
In 1976, three years before his retirement and nine years before his death, Vivien Thomas finally became Dr. Vivien Thomas when Johns Hopkins officially recognized his achievements with an honorary doctorate and appointment to the medical-school faculty. The thunderous applause he received from the many great surgeons whom he had trained must have seemed surreal, far removed from the times when in order to attend Blalock’s parties he had to come as a bartender. It must be said, though, that with his absolute insistence on precision in the operating room, he must have made a damn fine martini.
This is the second part of a two-part series. Click here to read Part I.
* HBO released a movie, Something the Lord Made, in 2004 based on Vivien Thomas’s Life.
* Thomas also wrote an autobiography entitled, Partners of the Heart: Vivien Thomas and his Work with Alfred Blalock.
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