Vivien Thomas
Encyclopedia
Vivien Theodore Thomas (August 29, 1910 – November 26, 1985) was an African-American surgical technician who developed the procedures used to treat 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...

 in the 1940s. He was an assistant to surgeon Alfred Blalock
Alfred Blalock
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...

 in Blalock's experimental animal laboratory at Vanderbilt University
Vanderbilt 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, Tennessee
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...

 and later at the 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...

 in Baltimore, Maryland. Without any education past high school, Thomas rose above poverty and racism
Racism
Racism is the belief that inherent different traits in human racial groups justify discrimination. In the modern English language, the term "racism" is used predominantly as a pejorative epithet. It is applied especially to the practice or advocacy of racial discrimination of a pernicious nature...

 to become a cardiac surgery
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...

 pioneer and a teacher of operative techniques to many of the country's most prominent surgeons. Vivien Thomas was the first African American without a doctorate degree to perform open heart surgery on a white patient in the United States.

Early life

Thomas was born in New Iberia, Louisiana
New Iberia, Louisiana
New Iberia is a city in and the parish seat of Iberia Parish, Louisiana, United States, 30 miles southeast of Lafayette. In 1900, 6,815 people lived in New Iberia; in 1910, 7,499; and in 1940, 13,747...

. The grandson of a slave, he attended Pearl High School (named for a Union sympathizer Joshua Fenton Pearl and now known as Pearl Cohn Comprehensive High School
Pearl Cohn Comprehensive High School
Pearl Cohn Comprehensive High School is a public high school located in Nashville, Tennessee.Pearl Cohn includes grades 9-12, and students feed from Bass Middle School. In the 2009-2010 School year, John Early Middle will also feed into the school...

) in Nashville in the 1920s. Thomas had hoped to attend college and become a doctor
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

, but the Great Depression
Great Depression
The Great Depression was a severe worldwide economic depression in the decade preceding World War II. The timing of the Great Depression varied across nations, but in most countries it started in about 1929 and lasted until the late 1930s or early 1940s...

 derailed his plans. He worked at Fisk University
Fisk University
Fisk University is an historically black university founded in 1866 in Nashville, Tennessee, U.S. The world-famous Fisk Jubilee Singers started as a group of students who performed to earn enough money to save the school at a critical time of financial shortages. They toured to raise funds to...

 in the summer of 1929 doing carpentry but was laid off in the fall. In the wake of the stock market crash
Stock market crash
A stock market crash is a sudden dramatic decline of stock prices across a significant cross-section of a stock market, resulting in a significant loss of paper wealth. Crashes are driven by panic as much as by underlying economic factors...

 in October, Thomas put his educational plans on hold, and, through a friend, in February 1930 secured a job as surgical research technician with Dr. Alfred Blalock
Alfred Blalock
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...

 at Vanderbilt University
Vanderbilt 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...

. On his first day of work, Thomas assisted Blalock with a surgical experiment on a dog. At the end of Thomas' first day, Blalock told Thomas they would do another experiment the next morning. Blalock told Thomas to "come in and put the animal to sleep and get it set up". Within a few weeks, Thomas was starting surgery on his own. Thomas was classified and paid as a janitor, despite the fact that by the mid 1930s, he was doing the work of a postdoctoral researcher
Postdoctoral researcher
Postdoctoral research is scholarly research conducted by a person who has recently completed doctoral studies, normally within the previous five years. It is intended to further deepen expertise in a specialist subject, including acquiring novel skills and methods...

 in the lab.

Before meeting Blalock, Thomas married Clara and had two daughters. When Nashville's banks failed nine months after starting his job with Blalock and Thomas' savings were wiped out, he abandoned his plans for college and medical school, relieved to have even a low-paying job as the Great Depression deepened.

Working with Blalock

Thomas and Blalock did groundbreaking research into the causes of hemorrhagic and traumatic shock. This work later evolved into research on Crush syndrome
Crush syndrome
Crush syndrome is a medical condition characterized by major shock and renal failure after a crushing injury to skeletal muscle...

 and saved the lives of thousands of soldiers on the battlefields of World War II. In hundreds of flawlessly executed experiments, the two disproved traditional theories which held that shock was caused by toxins in the blood. Blalock, a highly original scientific thinker and something of an iconoclast, had theorized that shock resulted from fluid loss outside the vascular bed and that the condition could be effectively treated by fluid replacement. Assisted by Thomas, he was able to provide incontrovertible proof of this theory, and in so doing, he gained wide recognition in the medical community by the mid 1930s. At this same time, Blalock and Thomas began experimental work in vascular and cardiac surgery, defying medical taboos against operating upon the heart. It was this work that laid the foundation for the revolutionary lifesaving surgery they were to perform at Johns Hopkins a decade later.

Working at Johns Hopkins

By 1940, the work Blalock had done with Thomas placed him at the forefront of American surgery, and when he was offered the position of Chief of Surgery at his alma mater Johns Hopkins in 1941, he requested that Thomas accompany him. Thomas arrived in Baltimore with his family in June of that year, confronting a severe housing shortage and a level of racism worse than they had endured in Nashville. Hopkins, like the rest of Baltimore, was rigidly segregated, and the only black employees at the institution were janitors. When Thomas walked the halls in his white lab coat, heads turned.

Blue baby syndrome

In 1943, while pursuing his shock research, Blalock was approached by renowned pediatric cardiologist Dr. Helen Taussig, who was seeking a surgical solution to a complex and fatal four-part heart anomaly called Tetralogy of Fallot
Tetralogy of Fallot
Tetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities...

 (also known as 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...

, although other cardiac anomalies produce blueness, or 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...

). In infants born with this defect, blood is shunted past the lungs, thus creating oxygen deprivation and a blue pallor. Having treated many such patients in her work in Hopkins' Harriet Lane Home, Taussig was desperate to find a surgical cure. According to the accounts in Thomas' 1985 autobiography and in a 1967 interview with medical historian Peter Olch, Taussig suggested only that it might be possible to "reconnect the pipes" in some way to increase the level of blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....

 flow to the lungs but did not suggest how this could be accomplished. Blalock and Thomas realized immediately that the answer lay in a procedure they had perfected for a different purpose in their Vanderbilt work, involving the anastomosis
Anastomosis
An anastomosis is the reconnection of two streams that previously branched out, such as blood vessels or leaf veins. The term is used in medicine, biology, mycology and geology....

, or joining, of the subclavian
Subclavian
In general, Subclavian means beneath the clavicle, and it can refer to:* Subclavian vein* Subclavian artery* Subclavian nerve...

 to the 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....

, which had the effect of increasing blood flow to the lungs.

Thomas was charged with the task of first creating a blue baby-like condition in a dog, and then correcting the condition by means of the pulmonary-to-subclavian anastomosis. Among the dogs on whom Thomas operated was one named Anna, who became the first long-term survivor of the operation and the only animal to have her portrait hung on the walls of Johns Hopkins. In nearly two years of laboratory work, involving some 200 dogs, Thomas was ultimately able to replicate only two of the four cardiac anomalies involved in Tetralogy of Fallot
Tetralogy of Fallot
Tetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities...

. He did demonstrate that the corrective procedure was not lethal, thus persuading Blalock that the operation could be safely attempted on a human patient. Even though Thomas knew he was not allowed to operate on patients at that time, he still followed Blalock's rules and assisted him during surgery.

Decisive surgery

On November 29, 1944, the procedure was first tried on an eighteen-month-old infant named Eileen Saxon
Eileen Saxon
Eileen Saxon was an infant known as "The Blue Baby", because of a condition called Tetralogy of Fallot, one of the primary congenital defects that lead to blue baby syndrome. In this condition, defects in the great vessels and wall of the heart lead to a chronic lack of oxygen in the blood...

. 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. Because no instruments for cardiac surgery then existed, Thomas adapted the needles and clamps for the procedure from those in use in the animal lab. During the surgery itself, at Blalock's request, Thomas stood on a step stool at Blalock's shoulder and coached him step by step through the procedure, Thomas having performed the operation hundreds of times on a dog, Blalock only once, as Thomas' assistant. The surgery was not completely successful, though it did prolong the infant's life for several 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 that was published in the May 1945 issue of the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...

, giving credit to Blalock and Taussig for the procedure. Thomas received no mention.

News of this groundbreaking story circulated around the world via the Associated Press
Associated Press
The Associated Press is an American news agency. The AP is a cooperative owned by its contributing newspapers, radio and television stations in the United States, which both contribute stories to the AP and use material written by its staff journalists...

. Newsreels touted the event, greatly enhancing the status of Johns Hopkins and solidifying the reputation of Blalock, who had been regarded as a maverick up until that point by some in the Hopkins old guard. Thomas' contribution remained unacknowledged, both by Blalock and by Hopkins. Within a year, the operation known as 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...

 had been performed on more than 200 patients at Hopkins, with parents bringing their suffering children from thousands of miles away.

Thomas' surgical techniques included one he developed in 1946 for improving circulation in patients whose great vessels (the aorta
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...

 and the 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....

) were transposed. A complex operation called an atrial septectomy, the procedure was executed so flawlessly by Thomas that Blalock, upon examining the nearly undetectable suture line, was prompted to remark, "Vivien, this looks like something the Lord made."

To the host of young surgeons Thomas trained during the 1940s, he became a figure of legend, the model of a dexterous and efficient cutting surgeon. "Even if you'd never seen surgery before, you could do it because Vivien made it look so simple," the renowned surgeon Denton Cooley
Denton Cooley
Denton Arthur Cooley is an American heart surgeon famous for performing the first implantation of a total artificial heart. Cooley is also founder and surgeon in-chief of the Texas Heart Institute, chief of Cardiovascular Surgery at St...

 told Washingtonian
Washingtonian (magazine)
Washingtonian is a monthly magazine distributed in the Washington, DC area since 1965. The magazine describes itself as "the magazine Washington lives by." The magazine's core focuses are local feature journalism, guide book-style articles, and real estate advice.-Editorial Content:Washingtonian...

magazine in 1989. "There wasn't a false move, not a wasted motion, when he operated." Surgeons like Cooley, along with Alex Haller, Frank Spencer, Rowena Spencer, and others credited Thomas with teaching them the surgical technique that placed them at the forefront of medicine in the United States. Despite the deep respect Thomas was accorded by these surgeons and by the many black lab technicians he trained at Hopkins, he was not well paid. He sometimes resorted to working as a bartender
Bartender
A bartender is a person who serves beverages behind a counter in a bar, pub, tavern, or similar establishment. A bartender, in short, "tends the bar". The term barkeeper may carry a connotation of being the bar's owner...

, often at Blalock's parties. This led to the peculiar circumstance of his serving drinks to people he had been teaching earlier in the day. Eventually, after negotiations on his behalf by Blalock, he became the highest paid technician at Johns Hopkins by 1946, and by far the highest paid African-American on the institution's rolls. Although Thomas never wrote or spoke publicly about his ongoing desire to return to college and obtain a medical degree, his widow, the late Clara Flanders Thomas, revealed in a 1987 interview with Washingtonian writer Katie McCabe that her husband had clung to the possibility of further education throughout the Blue Baby period and had only abandoned the idea with great reluctance. Mrs. Thomas stated that in 1947, Thomas had investigated the possibility of enrolling in college and pursuing his dream of becoming a doctor, but had been deterred by the inflexibility of Morgan State University
Morgan State University
Morgan State University, formerly Centenary Biblical Institute , Morgan College and Morgan State College , is a historically black college in Baltimore, Maryland, United States. Morgan is Maryland's designated public urban university and the largest HBCU in the state of Maryland...

, which refused to grant him credit for life experience and insisted that he fulfill the standard freshman requirements. Realizing that he would be 50 years old by the time he completed college and medical school, Thomas decided to give up the idea of further education.

Relations with Blalock

Blalock's approach to the issue of Thomas' race was complicated and contradictory throughout their 34-year partnership. On the one hand, he defended his choice of Thomas to his superiors at Vanderbilt and to Hopkins colleagues, and he insisted that Thomas accompany him in the operating room during the first series of tetralogy operations. On the other hand, there were limits to his tolerance, especially when it came to issues of pay, academic acknowledgment, and his social interaction outside of work.

After Blalock's death from cancer in 1964 at the age of 65, Thomas stayed at Hopkins for 15 more years. In his role as director of Surgical Research Laboratories, he mentored a number of African-American lab technicians as well as Hopkins' first black cardiac resident, Dr. Levi Watkins, Jr., whom Thomas assisted with his groundbreaking work in the use of the Automatic Implantable Defibrillator.

Thomas' nephew, Koco Eaton, graduated from the Johns Hopkins Medical School, trained by many of the same physicians his uncle had trained. Eaton trained in orthopedics and is now the team doctor for the Tampa Bay Rays
Tampa Bay Rays
The Tampa Bay Rays are a Major League Baseball team based in St. Petersburg, Florida. The Rays are a member of the Eastern Division of MLB's American League. Since their inception in , the club has played at Tropicana Field...

.

Institutional acknowledgment

In 1968, the surgeons Thomas trained — who had then become chiefs of surgical departments throughout America — commissioned the painting of his portrait (by Bob Gee, oil on canvas, 1969, The Johns Hopkins Alan Mason Chesney Medical Archives) and arranged to have it hung next to Blalock's in the lobby of the Alfred Blalock Clinical Sciences Building.

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, but it did allow the staff and students of Johns Hopkins Hospital and Johns Hopkins Medical School to call him doctor. Thomas was also appointed to the faculty of Johns Hopkins Medical School as Instructor of Surgery.

Legacy

Following his retirement in 1979, Thomas began work on an autobiography
Autobiography
An autobiography is a book about the life of a person, written by that person.-Origin of the term:...

, Partners of the Heart: Vivien Thomas and his Work with Alfred Blalock, ISBN 0-8122-1634-2. He died on November 26, 1985 of pancreatic cancer
Pancreatic cancer
Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...

, at age 75, and the book was published just days later. Having learned about Thomas on the day of his death, Washingtonian
Washingtonian (magazine)
Washingtonian is a monthly magazine distributed in the Washington, DC area since 1965. The magazine describes itself as "the magazine Washington lives by." The magazine's core focuses are local feature journalism, guide book-style articles, and real estate advice.-Editorial Content:Washingtonian...

 writer Katie McCabe brought his story to public attention for the first time in a 1989 article entitled "Like Something the Lord Made", which won the 1990 National Magazine Award
National Magazine Award
The National Magazine Awards are a series of US awards that honor excellence in the magazine industry. They are administered by the American Society of Magazine Editors and the Columbia University Graduate School of Journalism in New York City...

 for Feature Writing and inspired filmmaker 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:...

 to make the PBS documentary Partners of the Heart", which was broadcast in 2003 on PBS' American Experience
American 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...

 and won 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. McCabe's article, brought to Hollywood by Washington, D.C. dentist Irving Sorkin, formed the basis for the Emmy and Peabody Award
Peabody Award
The George Foster Peabody Awards recognize distinguished and meritorious public service by radio and television stations, networks, producing organizations and individuals. In 1939, the National Association of Broadcasters formed a committee to recognize outstanding achievement in radio broadcasting...

-winning 2004 HBO film 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...

.

Thomas' legacy as an educator and scientist continued with the institution of the Vivien Thomas Young Investigator Awards, given by the Council on Cardiovascular Surgery and Anesthesiology beginning in 1996. In 1993, the Congressional Black Caucus
Congressional Black Caucus
The Congressional Black Caucus is an organization representing the black members of the United States Congress. Membership is exclusive to blacks, and its chair in the 112th Congress is Representative Emanuel Cleaver of Missouri.-Aims:...

 Foundation instituted the Vivien Thomas Scholarship for Medical Science and Research sponsored by GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline plc is a global pharmaceutical, biologics, vaccines and consumer healthcare company headquartered in London, United Kingdom...

. In Fall 2004, the Baltimore City Public School System opened the Vivien T. Thomas Medical Arts Academy, and on January 29, 2008, MedStar Health unveiled the first "Rx for Success" program at the Academy, joining the conventional curriculum with specialized coursework geared to the health care professions. In the halls of the school hangs a replica of Thomas' portrait commissioned by his surgeon-trainees in 1968. The Journal Of Surgical Case Reports (JSCR) announced in January 2010 that their annual prizes for the best case report written by a doctor and best case report written by a medical student would be named after Thomas.

External links

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