Vivien Thomas

Vivien Theodore Thomas (August 29, 1910–November 26, 1985) was an African-American surgeon who developed the procedures used to treat Blue Baby Syndrome in the 1940s. He was an assistant to Dr. Alfred Blalock at Vanderbilt University in Nashville, Tennessee and later at Johns Hopkins University in Baltimore, Maryland.

Thomas was very intelligent, but only had a high school education. He had attended Pearl High School (now known as Martin Luther King, Jr. Magnet School) in Nashville in the 1920s. Even though it was part of a racially segregated education system, the school provided him with a high-quality education.

Blalock hired Thomas as a janitor in 1930 at age 19. Thomas had hoped to go to college and study to become a doctor, but the Great Depression wiped out the savings he had collected as a carpenter. He had worked at Fisk University in the summer of 1929 doing carpentry, but the stock market crash later that year meant he was soon out of a job. Thomas was happy to get his new job, but found that it only paid a third of his previous position's salary.

Over time, Thomas gained a greater role as Blalock saw Thomas's talents emerge. Thomas helped fabricate some of the surgical tools that Blalock requested while Blalock educated him about proper scientific procedures. The two grew to have a great respect for one another, although they never quite became equal. They still lived in a time when segregation was the norm.

Together they did important research into the causes of medical shock (particularly hypovolemic shock). This work later evolved into research on Crush syndrome.

Blalock was offered the position of Chief of Surgery at Johns Hopkins in 1941, and he requested that Vivien come along. He arrived in Baltimore with his wife, Clara, and their young child in June of that year. At Johns Hopkins, he wore a white lab coat, defying the traditions of that institution. He was eventually convinced to take it off when he went around the hospital.

In 1943, while searching for a new project, Blalock was approached by Dr. Helen Taussig, who had an idea of how to treat blue baby syndrome. She suggested it might be possible to take part of an artery and add another pathway from the heart to the lungs to increase the level of blood flow. This would involve a very complex surgical procedure and would require many new medical instruments to be created.

Thomas was set on the task of first creating a blue baby-like condition in a dog, then correcting the condition with the new artery. Two years and 200 dogs later, a satisfactory procedure was developed. Once the condition could be simulated, it was relatively easy to develop a method to solve it. The first such dog to be successfully treated was named Anna. She is the only animal to have a portrait hanging on the walls at Johns Hopkins.

On November 29, 1944, the procedure was first tried on a human patient, Eileen Saxon. The blue baby syndrome had made her lips and fingers turn blue, with the rest of her skin having a very faint blue tinge. She could only take a few steps before beginning to breathe heavily. During the surgery, Thomas stood behind Blalock and advised him as he performed the procedure, as Thomas had performed the operation on dogs many more times than Blalock had. The surgery, however, was not completely successful, though it did prolong her life for two more months. Blalock and his team operated again on an 11-year-old girl, this time with complete success and the patient was able to leave the hospital three weeks after the surgery. Next, they operated upon a six-year-old boy, who dramatically regained his color at the end of the surgery. The three cases formed the basis for the article which was published in the May 1945 issue of the Journal of the American Medical Association, giving credit to Blalock and Taussig for the procedure — Thomas received no mention.

Almost directly after the article was printed, a medical reporter picked up the story and circulated it around the world via the Associated Press. Newsreels touted the event, greatly raising the status of Johns Hopkins (and Blalock, whose career had been somewhat in jeopardy before this; Thomas's contribution was still absent). Within a year, more than 200 such operations were performed, with parents bringing their suffering children from thousands of miles away.

Thomas eventually began to train others in the procedure, but he was still not well-paid. He sometimes resorted to working as a bartender. This led to situations where he would serve drinks to people he had been teaching earlier in the day. He was, after negotiation with Blalock, the highest paid technician at Johns Hopkins by 1946, and by far the highest paid African-American on the budget (from 1943 to 1947, hospital records show that Blalock earned roughly ten times as much as Thomas).

In 1947, he tried again to get into college to pursue his dream of becoming a doctor. He enrolled as a freshman at Morgan State University, but soon realized that if he went through the entire education process, he would be 50 years old before he entered regular practice. He grudgingly decided to give up the idea.

Blalock's dealings with the issue of Thomas's race were complicated. On the one hand, he would often defend his choice of Thomas and break many racial barriers in his use of a Black technician (something unheard of at the time, and the sight of Thomas in his long white laboratory coat would often cause profound confusion). On the other hand, there were limits to his tolerance, especially when it came to issues of pay, academic acknowledgement, and socialization outside of work. When Blalock celebrated his 60th birthday at the Southern Hotel in Baltimore in April 1960, Thomas was not invited, at Blalock's insistence. The organizers of the party arranged that Thomas could watch the events from behind the curtain, which Thomas found deeply humiliating. Blalock later died at the age of 65, having worked with Thomas for 34 years.

In 1976, Johns Hopkins University presented Thomas with an honorary doctorate. However, because of certain restrictions, he received an Honorary Doctor of Laws, rather than a medical doctorate.

Thomas began work on an autobiography, Partners of the Heart: Vivien Thomas and His Work with Alfred Blalock, ISBN 0812216342. He died at age 75, and the book was published just days later.

References

• (2003). Partners of the Heart. (http://www.pbs.org/wgbh/amex/partners/) American Experience.
• (2003) Stefan Timmermans, "A Black Technician and Blue Babies" in Social Studies of Science 33:2 (April 2003), 197–229.

External link

• (2004). Something the Lord Made. (http://www.hbo.com/films/stlm/) HBO film.