Vivien Thomas: Pioneer of Blue Baby Surgery


Vivien Thomas was described as “the most untalked-about, unappreciated, unknown giant in the African American community” by one of his colleagues, Dr. Levi Watkins, an African American surgeon who performed the first human implant of an automatic defibrillator. Though he never attended medical school, Thomas still managed to make an enormous contribution to surgical sciences. Banished to the back halls of the hospital during the height of segregation, his accomplishments were overshadowed by the great Drs. Blalock and Taussig. But make no mistake – this unsung hero was also one of the greats in medicine.

Thomas was born in 1910 and graduated with honors from Pearl High School in Nashville. He began work as a carpenter, his father’s apprentice, but he was saving for medical school. Soon carpentry jobs dried up, and his college savings disappeared when banks failed during the 1929 stock market crash. Through a friend, he found work as a research assistant in Dr. Alfred Blalock’s lab at Vanderbilt University Medical School. Blalock quickly recognized his assistant’s extraordinary talent in the lab, but he didn’t pay much attention to management details, like payroll. When Thomas learned he was classified as a janitor – the only job available to blacks – he demanded and received a raise. After all, he was only making $12/week and was putting in 16-hour days to develop cutting edge surgical techniques.

In 1941 Blalock was offered Chief of Surgery at Johns Hopkins, and he insisted that Thomas move to Maryland to be on his team. They made a dynamic duo; Thomas put in painstaking hours of tedious research, and Blalock contributed breakthrough ideas and had the clout and courage to practice Thomas’ techniques in human patients. After they revolutionized treatment for traumatic shock, Blalock looked for the next surgical innovation. The idea came from Dr. Helen Taussig.

Taussig was a pediatric cardiologist who had seen far too many children die from a congenital defect called Tetralogy of Fallot, better known as blue baby syndrome. She convinced Blalock to take up the cause and create a surgery on what was then considered the inoperable heart. Working with Taussig and Blalock, Thomas did most of the behind-the-scenes work to develop a previously “failed experiment” into an operation that connected the subclavian artery to the pulmonary artery, thus giving the blue oxygen-deprived blood another chance to be oxygenated by the lungs. First, he had to simulate the heart defect in an animal so they would have a model to test and prove their theories. He also had to design and build custom surgical instruments. It took two years to hone the life-saving procedure that became known as the Blalock-Taussig shunt.

Thomas did not plan to be in the O.R. for the first shunt operation on November 29, 1944. At Blalock’s insistence, he stood on a stool, leaned over Blalock’s right shoulder and advised him through the challenging four-and-a-half-hour procedure. When the bulldog clamp was released, 15-month Eileen Saxon’s lips turned from blue to red and her cheeks blushed healthy pink. “You’ve never seen anything so dramatic,” Thomas said. “It was almost a miracle.” A few months later, Saxon turned cyanotic; a second shunt attempt was unsuccessful, but this first surgery demonstrated feasibility. Thomas continued to advise Blalock through hundreds of procedures, and by the time Blalock retired in 1964, this surgery had been performed on more than 2,000 children at Hopkins.

While Blalock and Taussig received much-deserved accolades for their accomplishments, the contribution of their key partner, Vivien Thomas, remained unspoken for decades. He worked in the shadows, directing the surgical research labs at Hopkins and training many physicians who became chiefs of surgery throughout the U.S., including renowned heart surgeon Denton Cooley. In 1971, several of these surgeons commissioned the painting of Thomas’ portrait and arranged for it to be hung near Blalock’s in the Alfred Blalock Clinical Sciences Building. Five years later, Johns Hopkins presented Thomas with an honorary doctorate. Because of legal restrictions, it was a doctorate of law and not medicine, but at least this great pioneer, instructor and skilled surgeon could finally be referred to as “doctor.” What an honor for such a humble man to finally receive accolades from his peers for his significant contributions to medicine. Dr. Vivien Thomas died of pancreatic cancer in 1985.

For an excellent portrayal of Thomas’ inspirational life story, check out the 2004 HBO film entitled Something the Lord Made. Here are some other resources:

  • “Like Something the Lord Made,” an article by Kate McCabe in the 1989 Washingtonian
  • “Partners of the Heart,” a PBS documentary
  • Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock, an autobiography by Vivien Thomas

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