On Nov. 29, 1944, Vivien Thomas assisted Dr. Alfred Blalock in performing heart surgery on an infant girl.
Because I want to focus on the work Thomas and Blalock did with heart defects, I have omitted the incredibly beautiful part of the story in which they discover what causes the body to go into shock and how to treat it. It is told at several of the sites linked at the end, including perhaps most usefully the last site, which is the story as it ought to be told. I can do only so much.
Supporting documents given at the end. Just go with me here, hmm? I will try to make the wait worth it.
OK, open-heart surgery. Kind of a big deal now, no? Lose a lung, you can survive. Lose part of your colon, you get a colostomy bag. Lose your spleen, you can survive.
You get one heart, and if it's a ticking time bomb, start saying your goodbyes in case you don't get a transplant.
In 1944, heart transplants did not exist outside of science fiction, if even there. In 1944, there were no bypass surgeries, no artificial hearts, no ... anything.
In 1944, if your heart was damaged, that was it.
Until Vivien Thomas and Drs. Alfred Blalock and Helen Taussig. Taussig, a pediatric cardiologist, was studying and trying to fix congenital heart defects. Very long story made somewhat shorter (really, Taussig deserves her own diary, so forgive me for focusing on Thomas here), she came up with the concept of what to do:
Operate on the human heart.
Which nobody was doing.
Which the medical community discouraged.
So Vivien Thomas spent two years working on dog hearts, making and fixing two of the four problems in the Tetralogy of Fallot in dog hearts.
Only two of four. But the solutions worked. And Blalock, himself a firm believer in the advancement of science through experimentation, realized that the alternative to trying a surgery for the first time and having the patient possibly die on the operating table was to have the child go on living with a fatal heart defect and very certainly dying.
Twenty-five percent within a year of birth. Seventy percent within 10 years. And in the mean time, they were ticking time bombs. They sat there getting sicker.
Really. Just sat. Because if you're not getting enough oxygen, you're not playing tag too much. Not walking too much. You're having enough trouble sitting up straight because your organs aren't getting enough oxygen, and forget about your spinal muscles. Developing those is a luxury.
But for one very sick girl, oxygen was a luxury.
Eileen Saxon, a weak infant girl (sources have her age ranging from 11 to 19 months), is wheeled into the operating room. Waiting for her are Blalock and Thomas.
Blalock has assisted on one similar heart surgery.
On a dog.
He had planned to get several instructional sessions from Thomas before attempting to do this on his own, but there is no time for little Eileen.
There is no time because this blue baby is ... not blue.
She is purple.
Thomas has operated on 200 dogs, but no humans.
Nothing this small. Nine pounds. She is like a little ... purple ... doll.
Nothing like this.
Nothing with at least one of the heart defects she has.
And while Blalock knows Thomas knows every step of what had to be done, there is the minor issue of Thomas going through the steps in the right order, including to repair one heart defect for the first time ever, while standing on a crate and not being allowed to physically assist Blalock.
For posterity, the entire operation is being filmed. The camera is pointed at the operating table.
One more thing.
Blalock is using surgical instruments Thomas had designed himself based on his work with dogs.
The needles for stitching the girl's heart up are half an inch long.
Or ... have they, as one writer attested, actually been fashioned on the fly? Deliberately broken laboratory equipment fashioned into something Thomas and Blalock hoped would work?
Whatever they were, they would have to do. They would have to do for something nobody had ever done, and ...
No pressure. Just the difference between life and death.
Between a new era of surgery and the continued practice of the medical community to leave the heart alone.
Between fixing a defect that killed 70 percent of children before age 10 and ...
The surgery gave the girl three more months of life before she needed a second surgery.
Days after that, she died.
But the groundwork was laid. Inasmuch as they had done the surgery correctly, they performed it on another patient, who lived.
And then another, who lived.
Six months after the first surgery, a paper based on the three cases was published.
The news went national and then international. Blalock and Taussig were famous. People traveled from far and wide to have the surgery performed on their children.
80 percent of the first 70 pediatric heart surgery patients lived. 200 were performed in the first year of the operation.
RAY HEIMBECKER M.D. OC, University of Western Ontario: The Blue Baby operation put Johns Hopkins on the map. We had people coming in from all over North America. Every day there would be license plates from Tennessee, from Quebec, from Alaska. People bringing their sickly children to us for help.
NARRATOR: Not every child could be saved. Eileen Saxon, the first Blue Baby, died from complications within a year after her operation. The new surgery, still experimental, was used only on children with no other hope for survival. Cookie Belkov was now four years old, her condition much worse.
SYLVIA BELKOV: Cookie had 4 spells in one day. I called my doctor. He says we're not putting it off. I'm calling Johns Hopkins. Next thing I knew, he says, pack up, you're getting on a train. You and Cookie.
NARRATOR: Cookie was rushed to Hopkins, her condition so serious that Blalock cancelled a trip to Europe to operate immediately. Her operation lasted two hours, but it would be nine hours before Sylvia Belkov knew the results.
SYLVIA BELKOV: I did not see Dr. Blalock until they brought her into her room. And he says, you want to see your daughter, go ahead. She looked like a little rosebud. She was beautiful when they brought her down, just beautiful. I'll tell you the color pink is prettier than the color blue.
NARRATOR: Cookie Belkov was one of the early success stories. Today, she lives in San Francisco.
The Hopkins Heart room had captured world attention. Michelle Rannou flew from Paris clutching her life-sized doll. One mother hitchhiked with her two year old from Appalachia. American GIs stationed in Germany, raised over $2000 to send a 5 year old from Frankfurt. Under the intense spotlight of the O.R., Blalock and Thomas perfected their procedure. During the first year alone, the team performed over 200 operations.
The procedure was named after the doctors who had developed it: Blalock and Taussig.
Thomas, who had been working tirelessly as Blalock's assistant for 14 years, was not included in the celebration.
He had helped develop the technique.
He had developed the instruments used.
He had guided Blalock through the procedure.
But ... technically, he was a lab janitor. He was paid as one despite the level of work he was doing.
Because Vivien Thomas not only did not have a medical degree, he did not even have a college degree.
He was doing work on the level of a cutting-edge heart surgeon, but he was a college dropout. And he was paid like one.
In 1929, Vivien Thomas was 19 and an aspiring medical student.
In 1929, Vivien Thomas was 19 and a former aspiring medical student now looking for work because his savings had been wiped out when the bank storing the money had collapsed.
In 1930, Blalock hired Thomas as his lab assistant. Together they changed the medical community's knowledge and understanding of blood pressure and traumatic shock.
In 1940, Blalock went to work at Johns Hopkins University. Thomas went with him. That was all there was to it. To have one was to have the other. Nothing else made sense -- separate Blalock and Thomas? Why? They fed off each other. Blalock had the daring and natural ability to match Thomas' meticulous scientific approach.
Thomas would do more than just be the one person to direct Blalock in performing life-saving heart surgeries on children.
He would also train surgical residents.
You may have heard of Dr. Denton Cooley, who is to heart surgery what heart surgery is to heart surgery. (That's not an editing mistake. See the links at the end.)
You probably have not heard of Dr. Levi Watkins Jr. He was the first black chief cardiac surgery resident at Hopkins.
And so it was that Watkins, Hopkins' first black chief cardiac resident, worked with Thomas, Hopkins' first black surgical technician.
While he was busily helping Blalock save lives, two great problems vexed Thomas.
He wanted to be a doctor, and he wanted to be paid enough to support his family.
Not long after the surgery to repair the Tetralogy of Fallot took off and he was advising in surgeries nearly two days out of three, Thomas got a raise. As one account puts it:
[Thomas] was careful but firm when he approached Blalock on the issue. "I told Dr. Blalock ... that for the type of work I was doing, I felt I should be ... put on the pay scale of a technician, which I was pretty sure was higher than janitor pay."
Blalock promised to investigate. After that, "nothing more was ever said about the matter," Thomas recalled. When several paydays later Thomas and his coworker received salary increases, neither knew whether he had been reclassified or just been given more money because Blalock demanded it.
He grew to be the highest-paid black man at Hopkins.
His other wish would not be fulfilled so easily. The historical record seems incomplete on this point, but the story is that Thomas tried to enroll at Morgan State University, but they would not credit him for life experience.
He would have to enter as a freshman. Imagine being his biology teacher.
Teacher: "And in 1944, the first surgery was performed by Dr. Walter Blalock, who --"
Thomas: "Alfred Blalock."
Teacher: "Excuse me?"
Thomas: "Alfred Blalock. Friend of mine."
Teacher: "Very funny. But you're right, his name is Alfred Blalock."
Thomas: "Wasn't joking. We work together."
Teacher: "Oh, is that right?"
Thomas: "It is right. I guided him through the first blue baby surgery at Hopkins in November 1944. He used instruments I designed. He wouldn't start the surgery without me there behind him, standing on a crate and guiding him through it step by step."
Teacher: " ... then what in the bloody blue baby hell are you doing in an intro biology class?"
Thomas: "School wouldn't credit me for time served."
Teacher: "That's the dumbest thing I've heard since a flat earther took my class."
More than 20 years after Thomas had given up on going back to school, he was teaching surgery at Hopkins. He had been teaching surgery at Hopkins for years. And in 1968, some of those surgical students, having become surgical chiefs at various hospitals in the U.S., decided that anyone who entered the building named after the doctor who first corrected the Tetralogy of Fallot should see Blalock's portrait and Thomas' portrait.
Together, just as in surgery.
But this was not enough.
Several years later, Johns Hopkins University had Thomas change his name to better reflect his life experience.
And so on a spring day in 1976, at the university he had worked at for 36 years, saving and changing lives daily, the man who was born Vivien Theodore Thomas changed his name.
Dr. Vivien Theodore Thomas.
Pictures of Dr. Thomas, plus a story similar to the one you read here.
A great source for more information and personal enrichment.
The Vivien Thomas Fund.
Performthe surgery (no pressure).
Dr. Levi Watkins
A picture of a young Dr. Thomas and a story similar to the one you read here.
A medical accounting of the surgery and the day's events.
Page 1 of Dr. Blalock's notes from the surgery, and page 2 of same.
More pictures, more story.
Sometimes you can't get enough pictures and stories.
This is where I got that giant blockquote of tear-inducing doom.
Dr. Denton Cooley.
The best story about Thomas by someone who was not there.