Alfred Blalock
Encyclopedia
Alfred Blalock was a 20th-century American
surgeon most noted for his research on the medical condition of shock and the development of the Blalock-Taussig Shunt
, surgical relief of the cyanosis from Tetralogy of Fallot
—known commonly as the blue baby syndrome
—with Vivien Thomas
and pediatric cardiologist Helen Taussig.
, Blalock entered Georgia Military Academy, a preparatory school for the University of Georgia
, at the age of 14. Blalock attended Georgia as an undergraduate and was a member of the Delta Chapter of the Sigma Chi
fraternity. After graduating with an A.B.
in 1918 at the age of 19, Blalock entered Johns Hopkins Medical School, where he roomed with 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 Baltimore for the next three years, completing an internship in urology
, 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, 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".
in Nashville
to serve as first chief resident in surgery under Barney Brooks
, 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 put in charge of the surgical research laboratory. While at Vanderbilt, 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 plasma
or whole blood products as treatment following the onset of shock. This research resulted in the saving of many lives during World War II
. Unfortunately, Blalock had frequent bouts of tuberculosis
during his Vanderbilt years. His first paper on shock, published in 1927, was actually written by 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 hypertension
in experiments joining the left subclavian artery
to the left pulmonary artery
. Although these experiments failed in their intended purpose, years later he returned to this idea.
in 1941, he requested that his assistant, Vivien Thomas
, 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 aortic
coarctation. While they were working on this, Helen Taussig
presented him with the problem of the blue baby syndrome. The shunt and operation not only directly saved thousands of lives, it marked the start of the modern era of cardiac surgery, as the first successful surgery on the human heart of the modern medical era. The "Blue Baby" operation pioneered at Johns Hopkins launched the field of cardiac surgery. As of 2004, doctors in the United States alone perform over 1.75 million heart operations annually.
In the normal heart
, there are four separate chambers; the two top chambers, or atria, pump blood simultaneously into the two bottom chambers, or ventricle
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 the left ventricle is responsible for getting blood to the entire body through the aorta, it 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 oxygenated blood:
veins → superior or inferior vena cava → right atrium ——tricuspid valve
→ right ventricle
——pulmonary valve
→ pulmonary artery → LUNGS → PULMONARY VEIN →
LEFT ATRIUM ——mitral valve
→ LEFT VENTRICLE ——aortic valve
→ 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 Fallot
(TOF), consists of an incomplete wall between the ventricles (known as a ventricular septal defect
or VSD), an aorta that sits over this defect so that its blood comes from both ventricles instead of just from the left (overriding aorta
), a defective right ventricular outflow tract near the pulmonary valve
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 hypertrophy
).
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 its reddish color. Cyanosis
describes the "blueness" in the baby and results from the pumping of mixed oxygenated and unoxygenated blood throughout the body.
premiered the Spark Media
documentary "Partners of the Heart", which was about the collaboration between Blalock and Vivien Thomas at Vanderbilt and Johns Hopkins University
. The documentary was directed by Andrea Kalin
and written by Kalin and Lou Potter, with re-creations directed by Bill Duke and narration by Morgan Freeman
. The "Partners of the Heart" went on to win the Organization of American Historians' Erik Barnouw
Award for Best History Documentary in 2004. In the 2004
HBO docudrama
Something the Lord Made
about the Blalock-Thomas collaboration, Blalock was portrayed by Alan Rickman
and Thomas by Mos Def
. Robert Cort produced the film, which went on to win an Emmy and a Peabody Award.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
surgeon most noted for his research on the medical condition of shock and the development of the Blalock-Taussig Shunt
Blalock-Taussig shunt
The 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 Fallot
Tetralogy of Fallot
Tetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities...
—known commonly as the blue baby syndrome
Blue baby syndrome
Blue baby syndrome is a layman's term used to describe newborns with cyanotic heart lesions, such as* Persistent Truncus Arteriosus* Transposition of the great vessels* Tricuspid atresia* Tetralogy of Fallot...
—with Vivien Thomas
Vivien Thomas
Vivien Theodore Thomas was an African-American surgical technician who developed the procedures used to treat blue baby syndrome in the 1940s...
and pediatric cardiologist Helen Taussig.
Early life and career
Born in Culloden, GeorgiaCulloden, Georgia
Culloden 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 Georgia
University of Georgia
The University of Georgia is a public research university located in Athens, Georgia, United States. Founded in 1785, it is the oldest and largest of the state's institutions of higher learning and is one of multiple schools to claim the title of the oldest public university in the United States...
, at the age of 14. Blalock attended Georgia as an undergraduate and was a member of the Delta Chapter of the Sigma Chi
Sigma Chi
Sigma Chi is the largest and one of the oldest college Greek-letter secret and social fraternities in North America with 244 active chapters and more than . Sigma Chi was founded on June 28, 1855 at Miami University in Oxford, Ohio when members split from Delta Kappa Epsilon...
fraternity. After graduating with an A.B.
Bachelor of Arts
A 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 entered Johns Hopkins Medical School, where he roomed with 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 Baltimore for the next three years, completing an internship in urology
Urology
Urology is the medical and 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...
, 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, 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 Harrison at Vanderbilt UniversityVanderbilt University
Vanderbilt University is a private research university located 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...
in Nashville
Nashville, Tennessee
Nashville is the capital of the U.S. state of Tennessee and the county seat of Davidson County. It is located on the Cumberland River in Davidson County, in the north-central part of the state. The city is a center for the health care, publishing, banking and transportation industries, and is home...
to serve as first chief resident in surgery under Barney Brooks
Barney Brooks
Barney 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 put in charge of the surgical research laboratory. While at Vanderbilt, 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 plasma
Blood plasma
Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...
or whole blood products as treatment following the onset of shock. This research resulted in the saving of many lives during World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
. Unfortunately, Blalock had frequent bouts of tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
during his Vanderbilt years. His first paper on shock, published in 1927, was actually written by 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 hypertension
Pulmonary hypertension
In 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 artery
Subclavian artery
In human anatomy, the subclavian arteries are two major arteries of the upper thorax , below the clavicle . They receive blood from the top of the aorta...
to the left pulmonary artery
Pulmonary artery
The pulmonary arteries carry deoxygenated blood from the heart to the lungs. They are the only arteries that carry deoxygenated blood....
. Although these experiments failed in their intended purpose, years later he returned to this idea.
Johns Hopkins
When Blalock was offered Chief of Surgery at Johns Hopkins HospitalJohns Hopkins Hospital
The 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 Thomas
Vivien Thomas
Vivien Theodore Thomas was an African-American surgical technician who developed 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 aortic
Aorta
The aorta is the largest artery in the body, originating from the left ventricle of the heart and extending down to the abdomen, where it branches off into two smaller arteries...
coarctation. While they were working on this, Helen Taussig
Helen B. Taussig
Helen 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. The shunt and operation not only directly saved thousands of lives, it marked the start of the modern era of cardiac surgery, as the first successful surgery on the human heart of the modern medical era. The "Blue Baby" operation pioneered at Johns Hopkins launched the field of cardiac surgery. As of 2004, doctors in the United States alone perform over 1.75 million heart operations annually.
Blue baby
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
, there are four separate chambers; the two top chambers, or atria, pump blood simultaneously into the two bottom chambers, or ventricle
Ventricle (heart)
In the heart, a ventricle is one of two large chambers that collect and expel blood received from an atrium towards the peripheral beds within the body and lungs. The Atria primes the Pump...
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 the left ventricle is responsible for getting blood to the entire body through the aorta, it 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 oxygenated blood:
veins → superior or inferior vena cava → right atrium ——tricuspid valve
Tricuspid valve
The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian 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...
→ right ventricle
——pulmonary valve
Pulmonary valve
The 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 valve
Mitral valve
The mitral valve is a dual-flap valve in the heart that lies between the left atrium and the left ventricle...
→ LEFT VENTRICLE ——aortic valve
Aortic valve
The aortic valve is one of the valves of the heart. It is normally tricuspid , although in 1% of the population it is found to be congenitally bicuspid . It lies between the left ventricle and the aorta....
→ 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 Fallot
Tetralogy of Fallot
Tetralogy 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 defect
Ventricular septal defect
A 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.The membranous...
or VSD), an aorta that sits over this defect so that its blood comes from both ventricles instead of just from the left (overriding aorta
Overriding aorta
An 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 valve
Pulmonary valve
The 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 hypertrophy
Right ventricular hypertrophy
Right ventricular hypertrophy is a form of ventricular hypertrophy affecting the right ventricle.Blood travels through the right ventricle to the lungs via the pulmonary arteries. If conditions occur which decrease pulmonary circulation, meaning blood does not flow well from the heart to the...
).
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 its reddish color. Cyanosis
Cyanosis
Cyanosis is the appearance of a blue or purple coloration of the skin or mucous membranes due to the tissues near the skin surface being low on oxygen. The onset of cyanosis is 2.5 g/dL of deoxyhemoglobin. The bluish color is more readily apparent in those with high hemoglobin counts than it is...
describes the "blueness" in the baby and results from the pumping of mixed oxygenated and unoxygenated blood throughout the body.
Films about Blalock and Thomas
In 2003, the PBS series American ExperienceAmerican Experience
American Experience is a television program airing on the Public Broadcasting Service Public television stations in the United States. The program airs documentaries, many of which have won awards, about important or interesting events and people in American history...
premiered the Spark Media
Spark Media
Spark Media is an independent multi-media and documentary production house based in Washington D.C.-History:Established in 1989 by director and producer Andrea Kalin, the non-profit company specializes in creating socially-conscious media used to raise public awareness in America and throughout the...
documentary "Partners of the Heart", which was about the collaboration between Blalock and Vivien Thomas at Vanderbilt and Johns Hopkins University
Johns Hopkins University
The Johns Hopkins University, commonly referred to as Johns Hopkins, JHU, or simply Hopkins, is a private research university based in Baltimore, Maryland, United States...
. The documentary was directed by Andrea Kalin
Andrea Kalin
Andrea Kalin is an independent American filmmaker . She is also the principal and founder of Spark Media, Inc. and founder and Executive Director of Stone Soup Productions, Inc., a 501c3 non-profit foundation-Personal life:...
and written by Kalin and Lou Potter, with re-creations directed by Bill Duke and narration by Morgan Freeman
Morgan Freeman
Morgan Freeman is an American actor, film director, aviator and narrator. He is noted for his reserved demeanor and authoritative speaking voice. Freeman has received Academy Award nominations for his performances in Street Smart, Driving Miss Daisy, The Shawshank Redemption and Invictus and won...
. The "Partners of the Heart" went on to win the Organization of American Historians' Erik Barnouw
Erik Barnouw
Erik Barnouw was a U.S. historian of radio and television broadcasting.According to the Scribner Encyclopia of American Lives, Erik Barnouw was born in Den Haag in the Netherlands, the son of Adriaan , and Ann Eliza Barnouw...
Award for Best History Documentary in 2004. In the 2004
2004 in film
The 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 docudrama
Docudrama
In film, television programming and staged theatre, docudrama is a documentary-style genre that features dramatized re-enactments of actual historical events. As a neologism, the term is often confused with docufiction....
Something the Lord Made
Something the Lord Made
Something The Lord Made is a film 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 Rickman
Alan Rickman
Alan Sidney Patrick Rickman is an English actor and theatre director. He is a renowned stage actor in modern and classical productions and a former member of the Royal Shakespeare Company...
and Thomas by Mos Def
Mos Def
Dante Terrell Smith is an American actor and Emcee known by the stage names Mos Def and Yasiin Bey. He 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, which...
. Robert Cort produced the film, which went on to win an Emmy and a Peabody Award.
External links
- http://www.medicalarchives.jhmi.edu/blbio.htm
- http://www.medicalarchives.jhmi.edu/papers/blalock.html
- http://www.mc.vanderbilt.edu/biolib/hc/biopages/ablalock.html
- http://www.pbs.org/wgbh/amex/partners/
- http://www.amazon.com/American-Experience-Partners-Morgan-Freeman/dp/B00008G97L
- http://www.neh.gov/news/humanities/2003-01/partners.html
- http://www.oah.org/activities/awards/barnouw/winners.html