Alfred Blalock (April 5, 1899 – September 15, 1964) was a 20th-century
AmericanThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
surgeon in the field of medical science most noted for his research on the medical condition of shock and the development of the
Blalock-Taussig ShuntThe Blalock-Taussig shunt is a surgical procedure to give palliation to cyanotic heart defects which are common causes of blue baby syndrome...
, surgical relief of the cyanosis from
Tetralogy of FallotTetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities...
—known commonly as the
blue baby syndromeBlue baby syndrome is a layman's term used to describe newborns with cyanotic conditions, such as*Cyanotic heart defects**Tetralogy of Fallot**Dextro-Transposition of the great arteries**Hypoplastic left heart syndrome...
—with
Vivien ThomasDr. Vivien Theodore Thomas was an African-American surgical technician and animal surgeon who developed in the canine model the procedures used to treat blue baby syndrome in the 1940s...
and pediatric cardiologist Helen Taussig.
Birth and early career
Born in
Culloden, GeorgiaCulloden is a city in Monroe County, Georgia, United States. The population was 223 at the 2000 census. It is part of the Macon Metropolitan Statistical Area.-Geography:Culloden is located at ....
, Blalock entered Georgia Military Academy, a preparatory school for the
University of GeorgiaThe University of Georgia is a public research university located in Athens, Georgia, the oldest and largest of the state's institutions of higher learning. Founded in 1785, UGA claims to be the oldest public university in the United States....
, at the age of 14. Blalock attended
GeorgiaThe University of Georgia is a public research university located in Athens, Georgia, the oldest and largest of the state's institutions of higher learning. Founded in 1785, UGA claims to be the oldest public university in the United States....
as an undergraduate, and was a member of the Delta Chapter of the
Sigma ChiSigma Chi is one of the largest and oldest college Greek-letter social fraternities. Sigma Chi was founded on June 28, 1855 at Miami University in Oxford, Ohio when members split from Delta Kappa Epsilon. Sigma Chi has seven founding members: Benjamin Piatt Runkle, Thomas Cowan Bell, William Lewis...
Fraternity. Having graduated from the University of Georgia with an
A.B.Bachelor of Arts , from the Latin artium baccalaureus, is a bachelor's degree awarded for an undergraduate course or program in either the liberal arts, the sciences or both....
in 1918 at the age of 19, Blalock subsequently entered Johns Hopkins Medical School, where he roomed with, became tennis doubles partner to, and began a lifetime friendship with Tinsley Harrison. Blalock earned his medical degree at Johns Hopkins in 1922. Hoping to gain appointment to a surgical residency at Johns Hopkins due to his admiration of William S. Halsted, Blalock remained in
BaltimoreBaltimore is an independent city and the largest city in the state of Maryland. The city is located in central Maryland along the tidal portion of the Patapsco River, an arm of the Chesapeake Bay. Baltimore is sometimes referred to as Baltimore City in order to distinguish it from surrounding...
over the next three years, completing an internship in
urologyUrology is the surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological disorders...
, one year of an assistant residency on the general surgical service (his contract was not renewed), and an externship in ENT. He moved to Boston, Massachusetts, in the summer of 1925 to begin a surgical residency at the Peter Bent Brigham Hospital but left for Vanderbilt "without ever unpacking [his] trunk."
Vanderbilt University
In July 1925, Blalock joined his good friend Harrison at
Vanderbilt UniversityVanderbilt University is a private research university in Nashville, Tennessee, United States. Founded in 1873, the university is named for shipping and rail magnate "Commodore" Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment despite having never been to the South...
in
NashvilleNashville is the capital of the U.S. state of Tennessee and the county seat of Davidson County. It is the second most populous city in the state after Memphis. It is located on the Cumberland River in Davidson County, in the north-central part of the state...
to serve as first chief resident in surgery under
Barney BrooksBarney Brooks , a 20th century U.S. physician and surgeon, was an influential medical educator, particularly in surgical residency training, and was known for his research in orthopedics, intestinal obstruction, and vascular surgery...
, who was Vanderbilt University Hospital's first Professor of Surgery and Chief of the Surgical Service. Blalock was active in teaching third- and fourth-year medical students and, as a result,he was placed in charge of the surgical research laboratory. While at Vanderbilt University he worked on the nature and treatment of hemorrhagic and traumatic shock. Experimenting on dogs, he found that surgical shock resulted from the loss of blood, and he encouraged the use of
blood plasmaBlood plasma is the yellow liquid component of blood, in which the blood cells in whole blood would normally be suspended. It makes up about 55% of the total blood volume. It is mostly water and contains dissolved proteins, glucose, clotting factors, mineral ions, hormones and carbon dioxide...
or whole blood products as treatment following the onset of shock. This research resulted in the saving of many lives during
World War IIWorld War II, or the Second World War , was a global military conflict which involved a majority of the world's nations, including all great powers, organized into two opposing military alliances: the Allies and the Axis...
. Unfortunately, Blalock met with frequent bouts of
tuberculosisTuberculosis is a common and often deadly infectious disease caused by mycobacteria...
during his Vanderbilt years. His first paper on shock, published in 1927, was actually written by his friend Harrison based on the data that Blalock had completed but could not compile due to his illness.
While at Vanderbilt in 1938, Blalock attempted to produce
pulmonary hypertensionIn medicine, pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion...
in experiments joining the left
subclavian arteryIn human anatomy, the subclavian artery is a major artery of the upper thorax that mainly supplies blood to the head and arms. It is located below the clavicle, hence the name...
to the left
pulmonary arteryThe pulmonary arteries carry blood from heart to the lungs. They are the only arteries that carry deoxygenated blood....
. Although these experiments failed in their purpose, years later he returned to this idea.
Johns Hopkins
When Blalock was offered Chief of Surgery at
Johns Hopkins HospitalThe Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...
in 1941, he requested that his assistant,
Vivien ThomasDr. Vivien Theodore Thomas was an African-American surgical technician and animal surgeon who developed in the canine model the procedures used to treat blue baby syndrome in the 1940s...
, come along with him. They formed a very close relationship that would last more than thirty years. Together, they developed a shunt technique to bypass
aorticThe aorta is the largest artery in the body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation....
coarctation. While they were working on this,
Helen TaussigHelen Brooke Taussig was an American cardiologist, working in Baltimore and Boston, who founded the field of pediatric cardiology. Notably, she is credited with developing the concept for a procedure that would extend the lives of children born with Tetrology of Fallot...
presented him with the problem of the blue baby syndrome.
Blue baby
In the normal
heartThe heart is a muscular organ found in all vertebrates that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
, there are four separate chambers; the two top chambers are known as atria and pump blood simultaneously into the two bottom chambers, or
ventricleIn the heart, a ventricle is a heart chamber which collects blood from an atrium and pumps it out of the heart...
s. Blood first enters the heart at the right atrium, which then empties blood into the right ventricle, which pumps the blood into the lungs through the pulmonary artery to get oxygen. From the lungs, the blood enters the left atrium through the pulmonary vein; the left atrium empties into the left ventricle, which pumps the blood into the aorta and from there reaches the rest of the body. Because it is responsible for getting blood to the entire body through the aorta, the left ventricle is usually the biggest and strongest chamber of the heart.
The following is a depiction of normal blood flow through the body. Valves keep the blood from flowing backwards. Capital letters indicate blood that has been oxygenated:
veins → superior or inferior vena cava → right atrium ——
tricuspid valveThe tricuspid valve is on the right side of the heart, between the right atrium and the right ventricle. The normal tricuspid valve usually has three leaflets and three papillary muscles. They are connected to the papillary muscles by the chordae tendineae, which lie in the right ventricle...
→ right ventricle
——
pulmonary valveThe pulmonary valve is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the...
→ pulmonary artery → LUNGS → PULMONARY VEIN →
LEFT ATRIUM ——
mitral valveThe mitral valve is a dual-flap valve in the heart that lies between the left atrium and the left ventricle...
→ LEFT VENTRICLE ——
aortic valveThe aortic valve is one of the valves of the heart. It lies between the left ventricle and the aorta.-Function and physiology:During ventricular systole, pressure rises in the left ventricle. When the pressure in the left ventricle rises above the pressure in the aorta, the aortic valve opens,...
→ AORTA → ARTERIES
After the body uses up the oxygen delivered by the blood flowing through the arteries, then arterioles, then capillaries, the unoxygenated blood returns to the heart by the capillaries, then venules, then veins.
The blue baby syndrome, known as
Tetralogy of FallotTetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities...
(TOF), consists of an incomplete wall between the ventricles (known as a
ventricular septal defectA ventricular septal defect is a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart.The ventricular septum consists of an inferior muscular and superior membranous portion and is extensively innervated with conducting cardiomyocytes...
or VSD), an aorta that sits over this defect so that its blood comes from both ventricles instead of just from the left (
overriding aortaAn overriding aorta is a congenital heart defect where the aorta is positioned directly over a ventricular septal defect, instead of over the left ventricle....
), a defective right ventricular outflow tract near the
pulmonary valveThe pulmonary valve is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the...
that prevents full flow of blood to the lungs, and a muscular right ventricle necessary to accomplish the extra work required to overcome that defect (
right ventricular hypertrophyRight ventricular hypertrophy is a form of ventricular hypertrophy affecting the right ventricle.Blood travels through the right ventricle to the lungs. If conditions occur which decrease pulmonary circulation, meaning blood does not flow well from the heart to the lungs, extra stress can be...
).
The following is a depiction of blood flow in Tetralogy of Fallot. Mixed capital letters indicate partially oxygenated blood.
veins → superior or inferior vena cava → right atrium ——
tricuspid valve→
rIgHt vEnTrIcLe ——
VSD→ LeFt VeNtRiClE or
\__
——
pulmonary valve→ pulmonary artery → LUNGS → PULMONARY VEIN →
LEFT ATRIUM ——
mitral valve→
LeFt VeNtRiClE <—————————————————————————————————————————rIgHt vEnTrIcLe
\__
——
aortic valve→ aOrTa → aRtErIeS
Unoxygenated blood from the right ventricle flows into the aorta preferentially because of the obstructed outflow tract into the lungs. This means less blood has the opportunity to be oxygenated in the lungs. Blood mixes abnormally between the left and right ventricles and into the aorta. Oxygen gives blood dik its reddish color.
CyanosisCyanosis is a blue coloration of the skin and mucous membranes due to the presence of > 5g/dl deoxygenated hemoglobin in blood vessels near the skin surface....
describes the "blueness" in the baby and results from the pumping of mixed oxygenated and unoxygenated blood throughout the body.
.
Films About Blalock and his medical technician Vivien Thomas
In 2003, PBS'
American ExperienceAmerican Experience is a television program airing on the PBS network in the United States. The program airs documentaries, many of which have won awards, about important or interesting events and people in American history...
broadcasted the
Spark MediaSpark Media is an independent multi-media and documentary production house based in Washington D.C.-History:Established in 1989 by award-winning director and producer Andrea Kalin, the non-profit company specializes in creating socially-conscious media used to raise public awareness in America and...
documentary "Partners of the Heart", which was about the collaboration between Alfred Blalock and Vivien Thomas at Vanderbilit and
Johns Hopkins UniversityThe Johns Hopkins University, commonly referred to as Johns Hopkins, JHU, or simply Hopkins, is a private research university located in Baltimore, Maryland, United States. Johns Hopkins also maintains full-time campuses elsewhere in Maryland, Washington, D.C., Italy, China, and Singapore...
. The documentary was directed by Andrea Kalin and written by
Andrea KalinAndrea Kalin is a documentary director, producer and the founder and executive producer of Spark Media.-Biography:Born in Boston, Kalin graduated Cum Laude from American University, and began her journalistic career as a radio reporter in the Middle East...
and Lou Potter, with recreations directed by Bill Duke and narration by
Morgan FreemanMorgan Porterfield Freeman, Jr. is an American actor, film director, and narrator. He is noted for his reserved demeanor and authoritative speaking voice....
. The "Partners of the Heart" documentary went on to win the Organization of American Historians'
Erik BarnouwErik Barnouw was a U.S. historian of radio and television broadcasting.Born in Den Haag in the Netherlands, Barnouw became a professor at Columbia University in New York after emigrating to the United States...
Award for Best History Documentary in 2004. In the
2004The year 2004 in film involved some significant events. Major releases of sequels took place. It included blockbuster films like Shrek 2, Harry Potter and the Prisoner of Azkaban, The Passion of the Christ, Meet the Fockers, Blade: Trinity, Spider-Man 2, Alien vs. Predator, Kill Bill Vol...
HBO
docudramaA docudrama is a dramatization of actual historical events. As a neologism, the term is often confused with docufiction.-Generalities:Docudramas tend to demonstrate some or most of the following characteristics:...
Something the Lord MadeSomething The Lord Made is a biopic about the black cardiac pioneer Vivien Thomas and his complex and volatile partnership with white surgeon Alfred Blalock, the world famous "Blue Baby doctor" who pioneered modern heart surgery...
about the Blalock-Thomas collaboration, Blalock was portrayed by
Alan RickmanAlan Sidney Patrick Rickman is an English actor. Rickman is best known for his performances in film as Hans Gruber in Die Hard and Severus Snape in the Harry Potter film series, as well as extensive stage work...
and Thomas by
Mos DefDante Terrell Smith is an American actor and MC known by the stage name Mos Def. Mos Def started his hip hop career in a group called Urban Thermo Dynamics, after which he appeared on albums by Da Bush Babees and De La Soul. With Talib Kweli, he formed the duo Black Star, who released the album...
. Robert Cort produced the film, which went on to win an Emmy and a Peabody Award for the HBO docudrama.
External links
- http://www.medicalarchives.jhmi.edu/blbio.htm
- http://www.medicalarchives.jhmi.edu/sgml/blalock.html
- http://www.mc.vanderbilt.edu/biolib/hc/biopages/ablalock.html