November 18, 2020 • 38 mins
In 1944, Thomas developed a surgical treatment for babies with cyanotic heart conditions. Thomas was a Black man working at an institution whose only other black employees did janitorial work, and he had not attended medical school – or even college.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff You Missed in History Class, a production
of I Heart Radio. Hello, and welcome to the podcast.
I'm Tracy B. Wilson and I'm Holly Frying. Today we
have the second episode in our not exactly a two
parter about the development of a surgical treatment for blue
(00:24):
babies that as children who have cionodic heart conditions, particularly
to Trilogy of Felow. The earlier episode was on Dr
Helen Tausig, and these two episodes are really pretty much
stand alone. But Dr Tausig's name is going to come
up a lot in this one and the like anatomical
detail about what te Trilogy of Felow is we talked
(00:47):
about earlier. Um, I think you can understand the surgery
without knowing all that detail. If you're like, but I didn't.
I didn't listen to that one yet, It'll be okay.
Today though, we're going to talk about surgery. Cool technician
Vivian Thomas. Thomas was the one who really worked out
how to do this surgery, and when Dr Alfred Blaylock
(01:08):
performed it for the first time, Thomas was standing behind
him walking him through it. Blaylock was the surgeon in
chief at Johns Hopkins at this point, and Thomas's presence
and the operating room was baffling or maybe even offensive
to other observers. This was in nineteen forty four, and
Thomas was a black man working at an institution whose
(01:31):
only other black employees did janitorial work. He also had
not ever attended medical school or even college. Also, Thomas's
work that we're talking about today involved research on animals,
and we're not going to have a ton of detail
about that, but it isn't there. Vivian Theodore Thomas was
born on August in Lake Providence, Louisiana. A lot of
(01:54):
sources list his place of birth as New Iberia, and
it is not entirely clear what is behind that discrepancy.
The two cities are well over two hundred miles apart,
and Thomas's autobiography says New Providence. His autobiography also says
that he liked to joke that his parents named him
Vivian because they thought they were going to have a girl.
They had already had a daughter followed by two sons,
(02:15):
and thought another daughter was on the way. Vivian's father, William,
was a carpenter and his mother, Mary was a seamstress. Yeah,
I don't. I don't know if he was named after
anyone in particular, but that was a story he liked
to tell. Uh. I'm not sure what his his parents
thought of that story. When Vivian was to the family
moved to Nashville, Tennessee, and as he got a little older,
(02:38):
Vivian started helping his father with the carpentry business. In
Vivian graduated with honors from Pearl High School, which was
the only high school in the area that admitted black
students and which also had just an excellent reputation. He
dreamed of going to medical school, and in addition to
his carpentry work for his father, he had taken a
(02:58):
job as an orderly to try to earn enough money
for it. Vivian also spent his summers doing maintenance work
at Fisk University. Later in life, he described a formative
experience he had at this job. After he replaced some
worn out flooring, his foreman told him that his work
was unacceptable. The foreman could still see where the repair
had been made. Vivian did it over, and later his
(03:21):
foreman pointed out that he could have just done it
right the first time. Vivian really took this to heart
and the fall of n Vivian, Thomas enrolled in the
pre med program at Tennessee Agricultural and Industrial College, which
is now Tennessee State University, the historically black Land Grant University.
He hoped to go from there to Maharry Medical College
(03:45):
following the nineteen ten release of the Flexner Report, which
we talked about on the show earlier this year. This
was one of only two remaining medical schools that accepted
black students. But the Great Depression made Thomas's medical school
aspirations in possible. The bank where he had deposited his
savings closed and he lost it all. Carpentry work dried
(04:07):
up as well, and he started working a collection of
odd jobs just to try to make ends meet. In
early nineteen thirty, Thomas asked his friend Charles man Love,
who worked at Vanderbilt University, whether he knew of any
job openings there, and man Love answered that he did
know about a job assisting in a laboratory, but that
the doctor running that lab, dr Alfred Blaylock, was, in
(04:30):
his words, hell to work with. So for just a
little on Blaylock, he had been born in Georgia in
eight He attended Georgia Military Academy and served in the
army during World War One before going on to the
University of Georgia. From there, he studied medicine at Johns
Hopkins University. Blaylock was not a particularly great student, not bad,
(04:51):
but also not exceptional. Consequently, he lost the general surgery
residency that he wanted because his grades just weren't good enough,
so Blaylock started a residency in neurology instead. After a while,
he did manage to move back over to general surgery,
but he had some kind of dispute with the other
surgical residents and ultimately resigned. He wound up finishing his
(05:15):
surgical residency at Vanderbilt University in Nashville, which is the
place he described as a backwater. After he finished that residency,
Blaylock continued to work at Vanderbilt. In addition to his
work as a surgeon, he was researching the nature of shock.
At the time, the prevailing theory was that shock brought
on by trauma to the body was caused by toxins,
(05:37):
and doctors did not really know how to treat it. So,
after finding out about Vivian Thomas's background, including that he
wanted to go to medical school, Blaylock hired him. Blaylock's
research needed really careful monitoring, so he wanted somebody who
could set up and monitor experiments in the lab while
Blaylock was treating patients in the hospital. Blaylock described it
(05:58):
to Thomas as wanting someone he could train to do
anything that he could do, and maybe some things he couldn't.
Thomas started this new job on February. The pay was
twelve dollars a week. The previous summer, he had earned
twenty dollars a week as a carpenter, so at first
Thomas was a little reluctant. At the same time, he
(06:19):
imagined that this was temporary. The carpentry jobs were going
to come back with warmer weather in the spring, so
he saw this is just something to carry him over.
In the meantime, most of Blaylock's research was being conducted
on dogs, and Thomas started out weighing them, taking measurements,
anesthetizing them, preparing them for surgical procedures, monitoring them, and
(06:40):
keeping records. But it quickly became clear that his abilities
went beyond all that. He started learning to make incisions
into suture, and Dr Joseph Beard, who was one of
Blaylock's research fellows, tutored Thomas an anatomy, physiology, and chemistry.
A couple of months into Thomas's work with Blaylock, he
made some kind of error. By the time he wrote
(07:01):
his autobiography many years later to describe this, he no
longer remembered the details of exactly what he had done wrong,
but when Blaylock discovered it, he was living shouting and
swearing and what Thomas described as almost a temper tantrum
full of foul language. After Blaylock left the room, Thomas
asked one of the lab assistants how often that happened.
(07:22):
The answer was any time Blaylock had previously had a
bad night, meaning that he had drunk to excess. So
Thomas went into Blaylock's office and told him that while
he was doing his best, that he might make mistakes sometimes,
and that he could not work for Blaylock if he
was going to be spoken to that way every time
it happened. Thomas went on to say that he had
(07:44):
not been raised to use or to take that kind
of language. Although the other assistants expressed some doubts that
Blaylock's behavior would ever improve. Thomas said that he never
faced this kind of an outburst from Blaylock. Again, just
in case you're thinking, hey, wasn't this during prohibition, Yep,
the answer was yes. Blaylock had an illicit keg of
(08:06):
whiskey hidden in the lab, and eventually his and Thomas's
relationship progressed to sometimes having a drink together, but they
only socialized this way within the confines of the lab,
always out of public view. By nineteen thirty three, Thomas
had reached the point that he would prepare a dog
for surgery and open and clothes, while Blaylock only did
(08:26):
the actual surgical procedure that they were developing. And then
this progressed to Thomas doing the surgical procedures himself from
beginning to end. That started one day when Blaylock had
asked for an animal to be prepared for surgery, but
then he didn't arrive in the lab as expected. Thomas's
work went way beyond what other technicians in the lab
were typically doing. Blaylock would have an idea, Thomas would
(08:49):
work out and document how to do it before teaching
it to Blaylock and Blaylock relied on Thomas's work extensively.
He published papers that were based on techniques that Thomas
had develop, lipt and perfected, and he used data that
Thomas had gathered. When drafting papers, Blaylock would call on
Thomas to check his wording to make sure that what
he was describing was accurate, since Thomas was the one
(09:12):
who had the most thorough knowledge. In nineteen thirty three,
Blaylock delivered a groundbreaking lecture on the nature of traumatic
shock based on their work together. He connected shock to
blood and fluid loss and described it as treatable with
blood transfusions or plasma, or if neither of those was available,
with sailing. That same year, Vivian Thomas married Clara Flanders.
(09:35):
They would go on to have two daughters, Olga Fay
born in nineteen thirty four and Theodosia, born in When
the girls were still young, the family moved, and we're
going to get into that after a sponsor break. The
research that Alfred Blaylock, Vivian Thomas, and others in the
(09:58):
research lab at Vanderbilt Wrede doing in the nineteen thirties
and into nineteen forty led to life saving treatment for
wounded soldiers during World War Two, but Thomas's contributions were
really not acknowledged at the time. His pay was also
low enough that he had some moonlight as a bartender
to make ends meet. It's included at parties hosted by
(10:20):
Dr Blaylock, where Thomas sometimes had to serve drinks to
his colleagues from the lab. Over the years, the possibility
of going to medical school faded away. Even after the
end of the Great Depression. There just wasn't enough money
to save for school while also supporting a family. Even
though Thomas was doing the work of a senior research fellow,
he was being paid and classified as a janitor. When
(10:43):
Thomas realized this and asked for a raise, he was
given one, but he wasn't sure if he was moved
into a technicians position or if he was just being
paid more and was still being listed as a janitor.
In nineteen thirty seven, Blaylock was offered a job as
chief of surgery at Henry Ford hosp Biddle in Detroit,
and this would have been a huge step up for
his career, But when Blaylock asked about bringing Thomas with
(11:06):
him as his assistant, the hospital made it clear that
it did not hire black people. Blaylock turned down the job,
not because of any kind of sense of fairness, but
because he knew that Thomas was critical to his work.
In y eight, Blaylock and Thomas started researching pulmonary hypertension.
Their experiment involved rerouting the blood flow around the pulmonary
(11:28):
artery and back into the lungs. It did not work
as they had hoped, but that will come up again
later in the episode. In one, Blaylock was offered another job,
this time at Johns Hopkins in Baltimore, Maryland, again as
surgeon in chief. Once again, Blaylock asked about bringing Thomas
with him as his assistant. Johns Hopkins only black employees
(11:49):
at the time, we're working in janitorial roles, but they
ultimately agreed, but Thomas wasn't sure that he wanted to go. Uh.
It meant relocating his whole family from Nashville to Baltimore,
the city that he had never been to and where
they didn't know anybody. But it also seemed unlikely that
he could find a job related to medicine without his
connection to Blaylock, and with World War two looming, Thomas
(12:12):
thought the job might offer him some protection if he
were drafted, he might wind up in a medical unit. Ultimately,
Thomas did decide to go with Blaylock, and this move
turned out to be a lot harder than expected. Blaylock
had negotiated their salaries without a clear sense of how
much more expensive Baltimore was than Nashville. It's affected both
(12:33):
of them, obviously, but it affected Thomas, who was making
a lot less money a lot more profoundly, and it
turned out that Thomas's pay just was not enough to
support his family. The two cities were also quite different
for their black residents. In Nashville, the Thomas's had lived
in a thriving black neighborhood with black owned businesses and
(12:54):
a robust middle class, But most of Baltimore's black residents
were living in overcrowded tenements and many were living in poverty.
Thomas described many of the apartments he saw while looking
for a place to live in the only neighborhoods where
he would be allowed to live as barely fit for
human habitation. JOHNS. Hopkins refused to increase Thomas's pay from
(13:15):
what had originally been negotiated, so Blaylock convinced neurosurgeon Walter
Dandy to make a gift to the medical school earmarked
for Thomas's salary. That made Thomas's living situation more comfortable
in terms of finances, but he was still having to
face segregation and racism at work every day. Johns Hopkins
treated black patients, but they entered the facility through a
(13:37):
separate door. Some departments had segregated wards and others saw
black and white patients on different days of the week.
Blood banks and morgues were also segregated by race. Also.
I mean, as I mentioned earlier, the only other black
employees there were doing things like janitorial work, and so
after being openly stared at while walking through the building
(13:57):
wearing his white lab coat, Thomas decided just not to
wear it outside of the lab again. The lab was
the old Hunterian laboratory, and it was also in disrepair.
Thomas had to repaint, make repairs, and order new equipment
before it was really workable. Once they were settled in Blaylock,
and Thomas began working on finding ways to treat narrowed
(14:19):
A orders in babies and children, including developing techniques to
suiture blood vessels together in pediatric cardiologist Dr Helen Tausig
approached Dr Blaylock about trying to find a surgical treatment
for cyanotic heart disease or heart conditions that cause the
skin in the mucus membranes to look blue because of
(14:39):
a lack of oxygen. This is also known as blue
baby syndrome. In particular, she was interested in a treatment
for tetrology of follow and as we talked about in
more detail on the episode on Tausig, this is a
collection of four congenital malformations that causes blood to circulate
through the body without carrying enough oxygen and with out treatment,
(15:00):
about half of children born with tetrology of flow die
before their third birthday, and the vast majority don't live
to adulthood. There's a bit of debate about who came
up with which piece of the idea for a surgical
treatment for this condition. Various versions credit Blaylock, Tausig, and
Dr Edwards Park, who was chief of pediatrics at Johns Hopkins,
(15:21):
with specific details including which specific blood vessels to focus on,
but it's generally agreed that Tausig suggested that Blaylock look
for a surgical treatment for the tetrology of flow and
that Thomas was the one who worked out the process,
and I worked out the process. Blaylock and Thomas's attempts
(15:41):
at inducing pulmonary hypertension provided a starting point. So first
Thomas worked out how to surgically replicate a condition similar
to tetrology of flow and dogs, and then he worked
out how to connect the subclavian and pulmonary arteries, basically
allowing more blood to travel back him too the lungs
to pick up more oxygen. It took Thomas two years
(16:04):
of work and hundreds of surgeries to perfect this process,
starting on dogs and then moving on to human cadavers.
Because there were no suturing needles small enough to work
on the blood vessels of babies and small children, Thomas
had to manually file them down from larger needles. He
also had to improvise suturing silk, as no silk had
(16:26):
been developed that was made specifically for working on blood vessels.
In addition to all of that, there were worries about
whether children who were sick enough to need this surgery
could actually survive being anesthetized for it. Thomas felt pretty
confident in the process that he had worked out by
late nineteen and we will talk about the first time
Blaylock performed it on a human patient after a sponsor break.
(16:57):
Eileen Saxon was born August three, nineteen forty three, seven
weeks before her mother was due to give birth, and
she had tetrology of fellow by the age of fifteen months.
Her prognosis was grave. She weighed only nine pounds, and
she had spent several months living in an oxygen tent.
So because this was a brand new surgery that had
(17:18):
never been done on a living person, it was inherently
incredibly risky. So the surgical team was looking for a
patient who simply could not survive without it. Eileen fit
that description. Blaylock and Tausig wanted to avoid pressuring Eileen's
parents one way or another, but they also wanted them
to be able to make an informed decision, so Blaylock
(17:39):
and Tausig carefully explained what was involved in what the
risks were, including showing Eileen's parents before and after diagrams.
Eileen's parents ultimately agreed to the surgery, which was conducted
on November twenty nine. Dr Blaylock was the surgeon and
doctor Helen Tausig was also in the operating room. Standing
(18:01):
behind Blaylock in just to his left was Vivian Thomas,
who walked Blaylock through the surgery step by step. Thomas
had not planned to attend the surgery at all, but
Blaylock wound up sending for him. Blaylock had never actually
done this procedure himself, he had seen Thomas do it.
He had assisted Thomas on one surgery on a dog.
(18:23):
There just had not been time for Blaylock to practice
beyond that because Eileen's condition took a turn for the worst.
Eileen survived this surgery, although the first published paper about
it describes her post operative course as quote stormy. She
was able to go home about two months later, although
she died during a follow up surgery later on. In
(18:46):
By that point, Blaylock had operated on two more human patients,
on eleven year old girl on February three and a
six and a half year old boy on February ten.
They chose older patients because Eileen's blood vessels had just
been so so tiny they were less than half the
size of the dog's vessels that Thomas had developed this
(19:06):
procedure on both these procedures were successful, though, and in
the February tenth surgery, the patient's coloring dramatically shifted from
blue to pink while he was still on the operating table,
even though they had only done this surgery three times.
By May of nineteen forty five, Blaylock and Tausig were
confident enough in the results that they published a paper
(19:28):
in the Journal of the American Medical Association. Anesthesiologists, nurse anesthetists,
and people who were part of patients post operative care
were mentioned in this article, but Vivian Thomas was not.
By ninety six, medical professionals were calling this the Blaylock
Tausig operation, or sometimes just the Blaylock operation. Within a decade,
(19:50):
it was the standard treatment for tetrology of fellow, and
it's possible that the success with the surgery saved Blaylock's career.
He had a tempted several complicated surgeries, and the months
leading up to all this, several of them had not
gone very well, and his reliance on a black surgical
technician had also raised some eyebrows. Basically before this, people
(20:13):
had started to question his abilities, both as a surgeon
and as the chief of surgery. But afterwards started to
spread about the success of the Blaylock Tausig operation, new
patients flooded Johns Hopkins so many that a portion of
the children's surgical ward had to be designated the tet
room for patients with tetrology of Felow and other cyonotic conditions.
(20:35):
Vivian Thomas was present in the operating room for the
first one hundred of these surgeries that Blaylock performed, advising
him and correcting all kinds of details, like how big
the sutures were, how far apart they were, and whether
they were in the right direction. If anyone tried to
stand behind and to the left of Blaylock, he would
tell them that only Vivian was to stand in that spot.
(20:59):
Over the course of six years, Blaylock performed this surgery
one thousand times on children with several different syonotic heart conditions,
about seventy five percent of them with tetrology of flow. So,
as we noted earlier, John's Hopkins did treat black patients,
but there were some racial disparities among the children that
Blaylock treated for cyanotic heart conditions. Only a few of
(21:20):
those first thousand patients were black. In nineteen seventy seven
paper reporting the long term outcomes of these surgeries, Tausig
attributed this to a collection of factors that affected black patients.
The first was that cionosis was harder to see in
patients who had darker skin. She also noted that doctors
who were treating black patients might be less experienced, and
(21:42):
that families involved might not have the means to pay
for the operation or be aware of sources of funding
that were available that might help them pay for it.
In Thomas became lab supervisor. It had become something of
a tradition to use the lab as a veterinary clinic
on Friday afternoons, and after a while, Thomas became the
(22:02):
go to veterinary surgeon for Johns Hopkins faculty and staff.
The first dog to survive the blue baby procedure, a
dog named Anna, also became something of a laboratory pet
under Thomas's care and a public relations face for the hospital,
which fased ongoing vocal criticism from anti vivisectionists for this work.
(22:23):
In Thomas seriously considered leaving Johns Hopkins and moving back
to Nashville. Demand for carpenters had really surged during the
construction boom that followed World War Two, Thomas had the
opportunity for far more lucrative work. Just before Christmas of
that year, Blaylock presented him with an offer that would
(22:43):
more than double his salary. After Thomas had already accepted it,
Blaylock told him that was going to be the last
conversation they would ever be having about his pay. Thomas
said he would not have accepted that offer had he
known about that condition. I think it's fair, that's absolutely fair.
It kind of infuriates me. They went back and forth
(23:04):
about it, with Blaylock going back to the Johns Hopkins
Board of Trustees, and in the end, a new salary
bracket was created for people like Vivian Thomas, people who
were in highly skilled, critically necessary positions but who didn't
have degrees. Thomas was placed in this bracket, meaning that
he wasn't at a dead end in terms of his salary. Yeah,
(23:26):
before this point, I mean, in addition to you know,
moonlighting is a bartender that we talked about earlier, there
was a time when he was also trying to moonlight
as like a pharmaceutical sales trip, and with this they
were like, Okay, you cannot do this pharmaceutical sales thing anymore.
That's almost the whole separate thing. So Thomas and Blaylock
continued to work together for decades later. Thomas developed a
(23:49):
procedure called atrial septech. To me, this involves making a
small hole in the wall between the hearts left and
right atria, and that can help treat pulmonary hypertes and
some congenital heart diseases, including when a person's blood vessels
around their hearts are transposed. This procedure is something that
(24:09):
Thomas had worked on discreetly. He kept it a secret
and showed Blaylock his success only after he was sure
that it had worked. This was the procedure that Blaylock
described as looking quote like something the Lord made. That
became the title of a nineteen nine article in The
Washington i In that was many people's first exposure to
(24:29):
Vivian Thomas, as well as the title of the HBO
film that dramatizes this relationship. In nineteen fifty one, Thomas
was credited in a published paper for the first time
after a visiting fellow from Canada included him among the authors,
not realizing all the social and racial implications involved. Other
doctors included Thomas in the years that followed, although he
(24:51):
was never credited on Blaylock's publications. In nineteen fifty nine,
Blaylock turned sixty and Thomas was not invited to the
faculty party his honor. Some of the organizers sneaked him
in and he watched from behind the plants, which is
something that he later described as humiliating. Blaylock retired from
Johns Hopkins five years later, and as he was mumbling
(25:14):
over how to spend his time after his retirement, Thomas
said not to include him in those plans. For most
of their thirty four years working together, Blaylock had just
assumed that they were a package when entertaining other job
and research offers, thinking that if he left Johns Hopkins,
Thomas would obviously go to but Thomas wanted to make
his own way. Blaylock died on September fifteenth, nineteen sixty four,
(25:38):
just a few months after he retired. Towards the end
of his life, he expressed some regret over having not
ever sent Thomas to medical school. Blaylock's obituary in the
New York Times described the surgery performed on Eileen Saxon. Quote.
Hospital officials recalled that Dr. Blaylock made a long incision
and exposed the beating heart of a fifteen month old girl.
(25:59):
Then for three hours he worked at an operation no
one had ever done before. The obituary also mentioned Tausig's involvement,
but not that Thomas was standing behind Blaylock and walking
him through it. Vivian Thomas continued to have a career
at Johns Hopkins after Blaylock's retirement as lab supervisor. He
had been training surgeons and technicians for years, including training
(26:23):
twenty black surgical technicians, two of whom later went on
to medical school. The Johns Hopkins School of Medicine integrated
in nineteen sixty three, and Thomas had also become a
mentor for the university's first black medical students and residents.
In the years that followed, attitudes about race were shifting
in the United States in general and at Johns Hopkins specifically,
(26:46):
and in the late nineteen sixties, surgeons and technicians who
had trained with Vivian Thomas started to advocate for him
to be recognized for his contributions. A group of former
surgical Fellows, nicknamed the Old Hands Club, took the lead
on commissioning and pay for a portrait of Vivian Thomas
to be hung across from Blaylock's portrait in the lobby
of the Blaylock Building at the Johns Hopkins Hospital. The
(27:09):
portrait was unveiled at a meeting of the Johns Hopkins
Medical and Surgical Society in nine after a series of speeches.
Thomas spoke as well. He said that when he had
learned about the plans for this portrait, quote, my emotions
were quite mixed, and they still are. People in our
category are not accustomed to being in the limelight. Most
(27:31):
of you are. If our names get into print, it's
usually in the very fine print, down at the bottom somewhere.
But being placed in the position I find myself now
makes me feel quite humbled, but at the self same
time just a little proud. At no time, during all
the years that I have been here at Hopkins, have
I had any idea that I would ever do anything
(27:52):
that would make a mark upon this institution, or make
any contribution to the field of medicine that would merit
such recognition as I am getting here today. Press coverage
about the unveiling of this portrait is how many of
Thomas's friends and neighbors learned for the first time just
what kind of work he had been doing at Johns Hopkins.
(28:15):
He wrote in his autobiography about getting this this call
from a friend, like the morning the newspaper came out,
asking all these questions, and he was like, I'm still
in bed. I don't I don't know what you're talking about.
Further recognition of Thomas's achievements and contributions followed from there.
In nineteen seventy six, he was named Instructor of Surgery
(28:35):
at Johns Hopkins University School of Medicine, meaning that he
was for the first time formally part of the faculty.
He was awarded an honorary doctorate by the university that
same year. This followed an effort from University of Maryland
College Park to do the same, which fell through after
the Board of regents voted not to approve it, even
though Thomas had already been informed that it was in
(28:57):
the works. Yeah, that seemed very embarrassing for the University
of Maryland College Park. Also for reasons that aren't entirely
clear to me. The honorary doctor he got is a
doctorate of laws and not a doctor of medicine um.
And I was not able to track down why that was.
That there were vague references to there being some restrictions,
(29:18):
and I was like, what restrictions do you mean. Toward
the end of his time at Johns Hopkins, Thomas worked
with Dr Levi Watkins, Jr. He was the first black
medical student to graduate from Vanderbilt University and the first
black cardiac surgery resident at Johns Hopkins. Thomas helped Watkins
develop and troubleshoot the process for implanting an automatic cardiac defibrillator,
(29:42):
that is, a surgery that Watkins performed for the first
time ever in nineteen eighty. Thomas had retired just a
year before that happened, and at the request of many
of his colleagues, he had started writing an autobiography. The
autobiography was printed as Pioneering Research in Surgical Shock and
cardio Vascular Surgery, Vivian Thomas and his work with Alfred Blaylock.
(30:04):
Copies printed more recently are titled Partners of the Heart,
which is also the title of a movie from PBS
American Experience that debuted in two thousand four. The HBO
movie called Something The Lord main stars most Deaf as
Vivian Thomas, Allen Rickman is Alfred Blaylock, and Mary Stuart
Masterson is Helen Tausig, and it also came out in
two thousand four. Vivian Thomas died of pancreatic cancer on November.
(30:30):
The work that he did with Alfred Blaylock really set
the stage for the field of cardiac surgery. It was
a field that really flourished from there. Blaylock and Thomas
and the rest of the surgical team demonstrated that it
was possible to operate on a heart and that patients
who were sick enough to require cardiac surgery could survive
the anesthesia and the physical trauma that were required to
(30:53):
carry it out. When Alfred Blaylock, Helen Tausick, and Robert
Gross were granted the Albert Lasker Clinical Medical Research Award
in ninety four, they were described as launching quote a
worldwide surge of effective investigation and corrective surgery into all
phases of cardiovascular dynamics. This absolutely would not have been
(31:17):
possible without Vivian Thomas surgical procedures that Thomas developed are
still performed today, although the Blaylock Thomas Tausig shunt, as
it is increasingly known, is often a temporary first step
to help a patient survive until they can have other
procedures to address a heart malformation more directly. Today, it
typically involves a synthetic shunt rather than one of the
(31:39):
patient's own blood vessels. So one point of conjecture that
often comes up as what Thomas might have achieved if
he had been able to attend medical school, the idea
being that if he was so brilliant with a high
school education, that he might have been truly astounding if
he had been able to earn an m d. But
really that's a little complicated. Thomas's connection to Blaylock gave
(32:01):
him access to white medical institutions which he would not
have had if he had gone to medical school and
started a career of his own. And the words of
Dr Roweena Spencer, who worked with Thomas on the development
of the atrial septectomy and was the only woman ever
to serve as a surgical intern for Alfred Blaylock quote,
(32:22):
the truth of the matter is that is a black
physician in that era, he would probably have had to
spend all his time and energy making a living among
an economically deprived black population. And we'll end with a
brief and frequently repeated an illustrative story from the late
Dr j Alex Haller. Early in his career, Hallard was
working at the National Institutes of Health with Alfred Casper
(32:44):
as a technician. One day, while working in the lab,
Howard ran into trouble with bleeding during a procedure, but
solved the problem. Casper complimented Hallar on how he had
handled himself, and Hallard said, well, I trained with Dr Blaylock. Later,
during another procedure that went even further awry, Hallard found
himself totally at a loss for what to do, and
(33:04):
Casper stepped in and fixed the situation. When Haller thanked
and complimented Casper, he said, I trained with Vivian Tracy.
Do you have a little listener mail to wrap this
one up? I do. It's also related to medicine and
previous episodes that we have done on the theme of
saving lots of babies. Uh, and it is from Shauna.
(33:27):
Shawna says, Hello, Holly and Tracy. I've been listening to
the podcast for years, and I've always wanted to be
a part of your listener emails, but had never had
anything interesting to impart. And then when I felt like
I did, I never actually got around to writing that email.
I even put it on my to do list, maybe
even last year, where it's been lingering until now. This
(33:48):
year has been a year of fate, especially surrounding my
wedding last weekend that we booked in August as a
purposeful COVID wedding. It was a pop up wedding, which
was perfect for me as a bride who wanted nothing
to do with the planning part of a wedding, and
it was amazing anyway, not the purpose of this email.
It was your podcast recently where Tracy mentioned procrastination, to
(34:09):
which I reminded myself about emailing. And then at the
end of the bram Stoker episode you talked about the
episode Deja Vu, which is what I originally was going
to email you about. See fate. So now I feel
compelled to actually push aside the procrastination and get down
to business. This goes back to the episode about Dr
Cooney and the premature babies. I started listening to saw
(34:32):
Bones as a recommendation from you guys, and they did
an episode about Dr Cooney and I was like, yes, Stephew,
miss in History did this topic already. The Inventor Doctor,
the Premature Babies, Invented Incubator showed it as some kind
of world fair, brought it to America. It was like
a beach side attraction or something. I totally remember this.
And then shortly thereafter, you guys released an episode on
(34:56):
Dr Cooney and mentioned that it was on saw Bones,
and I said, are utterly confused, because in my mind
you had already done that topic. That's how I knew
about it. I tried searching the archives and found nothing.
So Ever since I've had this itching thought of how
did I know all about Dr Cooney before both podcasted
episodes on it. Maybe I'll never knew, but it's the
(35:18):
weirdest thing, and I understand episode deja vu. Um. So
Seana went on to write a little bit about the
home economics episode that we did previously, and of course
that was offered in Ontario called Managing Personal and Family Resources,
which included all kinds of basic life stuff including what
(35:41):
the symbols on your clothes mean for washing? Um, I'm
not going to read the whole rest of the email
because it is relatively long, but I just want to
say I hate those washing symbols. I know the point
was to try to standardize laundering instruction on labels, but
I don't know what any of the main And every
time I'm looking at a new piece, like a new
garment that I'm washing for the first time, if it
only has those symbols and it doesn't have words, I'm
(36:03):
like having to google laundry symbols to be able to
do my laundry. So anyway, Shanna, thank you so much
for this email. I became very curious to be like,
how did Shanna learn about the babyside shows that that
that you know seemed to already be Shawna's mind before
(36:25):
having um got into our episode. Um, there was a
couple of years before uh we or saw Oons did
the episode. Um, there was an episode of story Corps
which would have been played during Morning Edition on NPR
if you are a Morning Edition listener or just a
story Corps listener. UM, and that predated our episode and
(36:50):
the saw Bones episode in the ninety invisible episode, all
of which you know we're reasonably near one another. I
think yeah, or maybe the sab Bonnes was was first,
the sub Owns was first, and then it was like
us at nine of visible near each other. Anyway, that's
a great mystery to solve. I'm all the time, I'm like,
(37:12):
didn't I hear that before? What's the happening? We're out
of Halloween season, so I can't go past life experience,
but go um so Sean also sent lots of UH
future episode suggestions as well, So anyway, thank you SHAWNA
for this email. Thanks to everybody who's been writing to
(37:35):
us lately. UH. If you would like to write to
us about this or any other podcast, History podcast at
I heart radio dot com, we're all over social media
as a miss in History. That's where you'll find our Facebook, Twitter, Pinterest,
and Instagram, and you can subscribe to our show on
the I heart radio app and Apple podcast at anywhere
else we get your podcasts. Stuff you missed in History
(37:59):
Class is a pro ouption of I heart Radio. For
more podcasts from I heart Radio, visit the I heart
Radio app, Apple Podcasts, or wherever you listen to your
favorite shows. H
Welcome to Stuff You Missed in History Class, a production
of I Heart Radio. Hello, and welcome to the podcast.
I'm Tracy B. Wilson and I'm Holly Frying. Today we
have the second episode in our not exactly a two
parter about the development of a surgical treatment for blue
(00:24):
babies that as children who have cionodic heart conditions, particularly
to Trilogy of Felow. The earlier episode was on Dr
Helen Tausig, and these two episodes are really pretty much
stand alone. But Dr Tausig's name is going to come
up a lot in this one and the like anatomical
detail about what te Trilogy of Felow is we talked
(00:47):
about earlier. Um, I think you can understand the surgery
without knowing all that detail. If you're like, but I didn't.
I didn't listen to that one yet, It'll be okay.
Today though, we're going to talk about surgery. Cool technician
Vivian Thomas. Thomas was the one who really worked out
how to do this surgery, and when Dr Alfred Blaylock
(01:08):
performed it for the first time, Thomas was standing behind
him walking him through it. Blaylock was the surgeon in
chief at Johns Hopkins at this point, and Thomas's presence
and the operating room was baffling or maybe even offensive
to other observers. This was in nineteen forty four, and
Thomas was a black man working at an institution whose
(01:31):
only other black employees did janitorial work. He also had
not ever attended medical school or even college. Also, Thomas's
work that we're talking about today involved research on animals,
and we're not going to have a ton of detail
about that, but it isn't there. Vivian Theodore Thomas was
born on August in Lake Providence, Louisiana. A lot of
(01:54):
sources list his place of birth as New Iberia, and
it is not entirely clear what is behind that discrepancy.
The two cities are well over two hundred miles apart,
and Thomas's autobiography says New Providence. His autobiography also says
that he liked to joke that his parents named him
Vivian because they thought they were going to have a girl.
They had already had a daughter followed by two sons,
(02:15):
and thought another daughter was on the way. Vivian's father, William,
was a carpenter and his mother, Mary was a seamstress. Yeah,
I don't. I don't know if he was named after
anyone in particular, but that was a story he liked
to tell. Uh. I'm not sure what his his parents
thought of that story. When Vivian was to the family
moved to Nashville, Tennessee, and as he got a little older,
(02:38):
Vivian started helping his father with the carpentry business. In
Vivian graduated with honors from Pearl High School, which was
the only high school in the area that admitted black
students and which also had just an excellent reputation. He
dreamed of going to medical school, and in addition to
his carpentry work for his father, he had taken a
(02:58):
job as an orderly to try to earn enough money
for it. Vivian also spent his summers doing maintenance work
at Fisk University. Later in life, he described a formative
experience he had at this job. After he replaced some
worn out flooring, his foreman told him that his work
was unacceptable. The foreman could still see where the repair
had been made. Vivian did it over, and later his
(03:21):
foreman pointed out that he could have just done it
right the first time. Vivian really took this to heart
and the fall of n Vivian, Thomas enrolled in the
pre med program at Tennessee Agricultural and Industrial College, which
is now Tennessee State University, the historically black Land Grant University.
He hoped to go from there to Maharry Medical College
(03:45):
following the nineteen ten release of the Flexner Report, which
we talked about on the show earlier this year. This
was one of only two remaining medical schools that accepted
black students. But the Great Depression made Thomas's medical school
aspirations in possible. The bank where he had deposited his
savings closed and he lost it all. Carpentry work dried
(04:07):
up as well, and he started working a collection of
odd jobs just to try to make ends meet. In
early nineteen thirty, Thomas asked his friend Charles man Love,
who worked at Vanderbilt University, whether he knew of any
job openings there, and man Love answered that he did
know about a job assisting in a laboratory, but that
the doctor running that lab, dr Alfred Blaylock, was, in
(04:30):
his words, hell to work with. So for just a
little on Blaylock, he had been born in Georgia in
eight He attended Georgia Military Academy and served in the
army during World War One before going on to the
University of Georgia. From there, he studied medicine at Johns
Hopkins University. Blaylock was not a particularly great student, not bad,
(04:51):
but also not exceptional. Consequently, he lost the general surgery
residency that he wanted because his grades just weren't good enough,
so Blaylock started a residency in neurology instead. After a while,
he did manage to move back over to general surgery,
but he had some kind of dispute with the other
surgical residents and ultimately resigned. He wound up finishing his
(05:15):
surgical residency at Vanderbilt University in Nashville, which is the
place he described as a backwater. After he finished that residency,
Blaylock continued to work at Vanderbilt. In addition to his
work as a surgeon, he was researching the nature of shock.
At the time, the prevailing theory was that shock brought
on by trauma to the body was caused by toxins,
(05:37):
and doctors did not really know how to treat it. So,
after finding out about Vivian Thomas's background, including that he
wanted to go to medical school, Blaylock hired him. Blaylock's
research needed really careful monitoring, so he wanted somebody who
could set up and monitor experiments in the lab while
Blaylock was treating patients in the hospital. Blaylock described it
(05:58):
to Thomas as wanting someone he could train to do
anything that he could do, and maybe some things he couldn't.
Thomas started this new job on February. The pay was
twelve dollars a week. The previous summer, he had earned
twenty dollars a week as a carpenter, so at first
Thomas was a little reluctant. At the same time, he
(06:19):
imagined that this was temporary. The carpentry jobs were going
to come back with warmer weather in the spring, so
he saw this is just something to carry him over.
In the meantime, most of Blaylock's research was being conducted
on dogs, and Thomas started out weighing them, taking measurements,
anesthetizing them, preparing them for surgical procedures, monitoring them, and
(06:40):
keeping records. But it quickly became clear that his abilities
went beyond all that. He started learning to make incisions
into suture, and Dr Joseph Beard, who was one of
Blaylock's research fellows, tutored Thomas an anatomy, physiology, and chemistry.
A couple of months into Thomas's work with Blaylock, he
made some kind of error. By the time he wrote
(07:01):
his autobiography many years later to describe this, he no
longer remembered the details of exactly what he had done wrong,
but when Blaylock discovered it, he was living shouting and
swearing and what Thomas described as almost a temper tantrum
full of foul language. After Blaylock left the room, Thomas
asked one of the lab assistants how often that happened.
(07:22):
The answer was any time Blaylock had previously had a
bad night, meaning that he had drunk to excess. So
Thomas went into Blaylock's office and told him that while
he was doing his best, that he might make mistakes sometimes,
and that he could not work for Blaylock if he
was going to be spoken to that way every time
it happened. Thomas went on to say that he had
(07:44):
not been raised to use or to take that kind
of language. Although the other assistants expressed some doubts that
Blaylock's behavior would ever improve. Thomas said that he never
faced this kind of an outburst from Blaylock. Again, just
in case you're thinking, hey, wasn't this during prohibition, Yep,
the answer was yes. Blaylock had an illicit keg of
(08:06):
whiskey hidden in the lab, and eventually his and Thomas's
relationship progressed to sometimes having a drink together, but they
only socialized this way within the confines of the lab,
always out of public view. By nineteen thirty three, Thomas
had reached the point that he would prepare a dog
for surgery and open and clothes, while Blaylock only did
(08:26):
the actual surgical procedure that they were developing. And then
this progressed to Thomas doing the surgical procedures himself from
beginning to end. That started one day when Blaylock had
asked for an animal to be prepared for surgery, but
then he didn't arrive in the lab as expected. Thomas's
work went way beyond what other technicians in the lab
were typically doing. Blaylock would have an idea, Thomas would
(08:49):
work out and document how to do it before teaching
it to Blaylock and Blaylock relied on Thomas's work extensively.
He published papers that were based on techniques that Thomas
had develop, lipt and perfected, and he used data that
Thomas had gathered. When drafting papers, Blaylock would call on
Thomas to check his wording to make sure that what
he was describing was accurate, since Thomas was the one
(09:12):
who had the most thorough knowledge. In nineteen thirty three,
Blaylock delivered a groundbreaking lecture on the nature of traumatic
shock based on their work together. He connected shock to
blood and fluid loss and described it as treatable with
blood transfusions or plasma, or if neither of those was available,
with sailing. That same year, Vivian Thomas married Clara Flanders.
(09:35):
They would go on to have two daughters, Olga Fay
born in nineteen thirty four and Theodosia, born in When
the girls were still young, the family moved, and we're
going to get into that after a sponsor break. The
research that Alfred Blaylock, Vivian Thomas, and others in the
(09:58):
research lab at Vanderbilt Wrede doing in the nineteen thirties
and into nineteen forty led to life saving treatment for
wounded soldiers during World War Two, but Thomas's contributions were
really not acknowledged at the time. His pay was also
low enough that he had some moonlight as a bartender
to make ends meet. It's included at parties hosted by
(10:20):
Dr Blaylock, where Thomas sometimes had to serve drinks to
his colleagues from the lab. Over the years, the possibility
of going to medical school faded away. Even after the
end of the Great Depression. There just wasn't enough money
to save for school while also supporting a family. Even
though Thomas was doing the work of a senior research fellow,
he was being paid and classified as a janitor. When
(10:43):
Thomas realized this and asked for a raise, he was
given one, but he wasn't sure if he was moved
into a technicians position or if he was just being
paid more and was still being listed as a janitor.
In nineteen thirty seven, Blaylock was offered a job as
chief of surgery at Henry Ford hosp Biddle in Detroit,
and this would have been a huge step up for
his career, But when Blaylock asked about bringing Thomas with
(11:06):
him as his assistant, the hospital made it clear that
it did not hire black people. Blaylock turned down the job,
not because of any kind of sense of fairness, but
because he knew that Thomas was critical to his work.
In y eight, Blaylock and Thomas started researching pulmonary hypertension.
Their experiment involved rerouting the blood flow around the pulmonary
(11:28):
artery and back into the lungs. It did not work
as they had hoped, but that will come up again
later in the episode. In one, Blaylock was offered another job,
this time at Johns Hopkins in Baltimore, Maryland, again as
surgeon in chief. Once again, Blaylock asked about bringing Thomas
with him as his assistant. Johns Hopkins only black employees
(11:49):
at the time, we're working in janitorial roles, but they
ultimately agreed, but Thomas wasn't sure that he wanted to go. Uh.
It meant relocating his whole family from Nashville to Baltimore,
the city that he had never been to and where
they didn't know anybody. But it also seemed unlikely that
he could find a job related to medicine without his
connection to Blaylock, and with World War two looming, Thomas
(12:12):
thought the job might offer him some protection if he
were drafted, he might wind up in a medical unit. Ultimately,
Thomas did decide to go with Blaylock, and this move
turned out to be a lot harder than expected. Blaylock
had negotiated their salaries without a clear sense of how
much more expensive Baltimore was than Nashville. It's affected both
(12:33):
of them, obviously, but it affected Thomas, who was making
a lot less money a lot more profoundly, and it
turned out that Thomas's pay just was not enough to
support his family. The two cities were also quite different
for their black residents. In Nashville, the Thomas's had lived
in a thriving black neighborhood with black owned businesses and
(12:54):
a robust middle class, But most of Baltimore's black residents
were living in overcrowded tenements and many were living in poverty.
Thomas described many of the apartments he saw while looking
for a place to live in the only neighborhoods where
he would be allowed to live as barely fit for
human habitation. JOHNS. Hopkins refused to increase Thomas's pay from
(13:15):
what had originally been negotiated, so Blaylock convinced neurosurgeon Walter
Dandy to make a gift to the medical school earmarked
for Thomas's salary. That made Thomas's living situation more comfortable
in terms of finances, but he was still having to
face segregation and racism at work every day. Johns Hopkins
treated black patients, but they entered the facility through a
(13:37):
separate door. Some departments had segregated wards and others saw
black and white patients on different days of the week.
Blood banks and morgues were also segregated by race. Also.
I mean, as I mentioned earlier, the only other black
employees there were doing things like janitorial work, and so
after being openly stared at while walking through the building
(13:57):
wearing his white lab coat, Thomas decided just not to
wear it outside of the lab again. The lab was
the old Hunterian laboratory, and it was also in disrepair.
Thomas had to repaint, make repairs, and order new equipment
before it was really workable. Once they were settled in Blaylock,
and Thomas began working on finding ways to treat narrowed
(14:19):
A orders in babies and children, including developing techniques to
suiture blood vessels together in pediatric cardiologist Dr Helen Tausig
approached Dr Blaylock about trying to find a surgical treatment
for cyanotic heart disease or heart conditions that cause the
skin in the mucus membranes to look blue because of
(14:39):
a lack of oxygen. This is also known as blue
baby syndrome. In particular, she was interested in a treatment
for tetrology of follow and as we talked about in
more detail on the episode on Tausig, this is a
collection of four congenital malformations that causes blood to circulate
through the body without carrying enough oxygen and with out treatment,
(15:00):
about half of children born with tetrology of flow die
before their third birthday, and the vast majority don't live
to adulthood. There's a bit of debate about who came
up with which piece of the idea for a surgical
treatment for this condition. Various versions credit Blaylock, Tausig, and
Dr Edwards Park, who was chief of pediatrics at Johns Hopkins,
(15:21):
with specific details including which specific blood vessels to focus on,
but it's generally agreed that Tausig suggested that Blaylock look
for a surgical treatment for the tetrology of flow and
that Thomas was the one who worked out the process,
and I worked out the process. Blaylock and Thomas's attempts
(15:41):
at inducing pulmonary hypertension provided a starting point. So first
Thomas worked out how to surgically replicate a condition similar
to tetrology of flow and dogs, and then he worked
out how to connect the subclavian and pulmonary arteries, basically
allowing more blood to travel back him too the lungs
to pick up more oxygen. It took Thomas two years
(16:04):
of work and hundreds of surgeries to perfect this process,
starting on dogs and then moving on to human cadavers.
Because there were no suturing needles small enough to work
on the blood vessels of babies and small children, Thomas
had to manually file them down from larger needles. He
also had to improvise suturing silk, as no silk had
(16:26):
been developed that was made specifically for working on blood vessels.
In addition to all of that, there were worries about
whether children who were sick enough to need this surgery
could actually survive being anesthetized for it. Thomas felt pretty
confident in the process that he had worked out by
late nineteen and we will talk about the first time
Blaylock performed it on a human patient after a sponsor break.
(16:57):
Eileen Saxon was born August three, nineteen forty three, seven
weeks before her mother was due to give birth, and
she had tetrology of fellow by the age of fifteen months.
Her prognosis was grave. She weighed only nine pounds, and
she had spent several months living in an oxygen tent.
So because this was a brand new surgery that had
(17:18):
never been done on a living person, it was inherently
incredibly risky. So the surgical team was looking for a
patient who simply could not survive without it. Eileen fit
that description. Blaylock and Tausig wanted to avoid pressuring Eileen's
parents one way or another, but they also wanted them
to be able to make an informed decision, so Blaylock
(17:39):
and Tausig carefully explained what was involved in what the
risks were, including showing Eileen's parents before and after diagrams.
Eileen's parents ultimately agreed to the surgery, which was conducted
on November twenty nine. Dr Blaylock was the surgeon and
doctor Helen Tausig was also in the operating room. Standing
(18:01):
behind Blaylock in just to his left was Vivian Thomas,
who walked Blaylock through the surgery step by step. Thomas
had not planned to attend the surgery at all, but
Blaylock wound up sending for him. Blaylock had never actually
done this procedure himself, he had seen Thomas do it.
He had assisted Thomas on one surgery on a dog.
(18:23):
There just had not been time for Blaylock to practice
beyond that because Eileen's condition took a turn for the worst.
Eileen survived this surgery, although the first published paper about
it describes her post operative course as quote stormy. She
was able to go home about two months later, although
she died during a follow up surgery later on. In
(18:46):
By that point, Blaylock had operated on two more human patients,
on eleven year old girl on February three and a
six and a half year old boy on February ten.
They chose older patients because Eileen's blood vessels had just
been so so tiny they were less than half the
size of the dog's vessels that Thomas had developed this
(19:06):
procedure on both these procedures were successful, though, and in
the February tenth surgery, the patient's coloring dramatically shifted from
blue to pink while he was still on the operating table,
even though they had only done this surgery three times.
By May of nineteen forty five, Blaylock and Tausig were
confident enough in the results that they published a paper
(19:28):
in the Journal of the American Medical Association. Anesthesiologists, nurse anesthetists,
and people who were part of patients post operative care
were mentioned in this article, but Vivian Thomas was not.
By ninety six, medical professionals were calling this the Blaylock
Tausig operation, or sometimes just the Blaylock operation. Within a decade,
(19:50):
it was the standard treatment for tetrology of fellow, and
it's possible that the success with the surgery saved Blaylock's career.
He had a tempted several complicated surgeries, and the months
leading up to all this, several of them had not
gone very well, and his reliance on a black surgical
technician had also raised some eyebrows. Basically before this, people
(20:13):
had started to question his abilities, both as a surgeon
and as the chief of surgery. But afterwards started to
spread about the success of the Blaylock Tausig operation, new
patients flooded Johns Hopkins so many that a portion of
the children's surgical ward had to be designated the tet
room for patients with tetrology of Felow and other cyonotic conditions.
(20:35):
Vivian Thomas was present in the operating room for the
first one hundred of these surgeries that Blaylock performed, advising
him and correcting all kinds of details, like how big
the sutures were, how far apart they were, and whether
they were in the right direction. If anyone tried to
stand behind and to the left of Blaylock, he would
tell them that only Vivian was to stand in that spot.
(20:59):
Over the course of six years, Blaylock performed this surgery
one thousand times on children with several different syonotic heart conditions,
about seventy five percent of them with tetrology of flow. So,
as we noted earlier, John's Hopkins did treat black patients,
but there were some racial disparities among the children that
Blaylock treated for cyanotic heart conditions. Only a few of
(21:20):
those first thousand patients were black. In nineteen seventy seven
paper reporting the long term outcomes of these surgeries, Tausig
attributed this to a collection of factors that affected black patients.
The first was that cionosis was harder to see in
patients who had darker skin. She also noted that doctors
who were treating black patients might be less experienced, and
(21:42):
that families involved might not have the means to pay
for the operation or be aware of sources of funding
that were available that might help them pay for it.
In Thomas became lab supervisor. It had become something of
a tradition to use the lab as a veterinary clinic
on Friday afternoons, and after a while, Thomas became the
(22:02):
go to veterinary surgeon for Johns Hopkins faculty and staff.
The first dog to survive the blue baby procedure, a
dog named Anna, also became something of a laboratory pet
under Thomas's care and a public relations face for the hospital,
which fased ongoing vocal criticism from anti vivisectionists for this work.
(22:23):
In Thomas seriously considered leaving Johns Hopkins and moving back
to Nashville. Demand for carpenters had really surged during the
construction boom that followed World War Two, Thomas had the
opportunity for far more lucrative work. Just before Christmas of
that year, Blaylock presented him with an offer that would
(22:43):
more than double his salary. After Thomas had already accepted it,
Blaylock told him that was going to be the last
conversation they would ever be having about his pay. Thomas
said he would not have accepted that offer had he
known about that condition. I think it's fair, that's absolutely fair.
It kind of infuriates me. They went back and forth
(23:04):
about it, with Blaylock going back to the Johns Hopkins
Board of Trustees, and in the end, a new salary
bracket was created for people like Vivian Thomas, people who
were in highly skilled, critically necessary positions but who didn't
have degrees. Thomas was placed in this bracket, meaning that
he wasn't at a dead end in terms of his salary. Yeah,
(23:26):
before this point, I mean, in addition to you know,
moonlighting is a bartender that we talked about earlier, there
was a time when he was also trying to moonlight
as like a pharmaceutical sales trip, and with this they
were like, Okay, you cannot do this pharmaceutical sales thing anymore.
That's almost the whole separate thing. So Thomas and Blaylock
continued to work together for decades later. Thomas developed a
(23:49):
procedure called atrial septech. To me, this involves making a
small hole in the wall between the hearts left and
right atria, and that can help treat pulmonary hypertes and
some congenital heart diseases, including when a person's blood vessels
around their hearts are transposed. This procedure is something that
(24:09):
Thomas had worked on discreetly. He kept it a secret
and showed Blaylock his success only after he was sure
that it had worked. This was the procedure that Blaylock
described as looking quote like something the Lord made. That
became the title of a nineteen nine article in The
Washington i In that was many people's first exposure to
(24:29):
Vivian Thomas, as well as the title of the HBO
film that dramatizes this relationship. In nineteen fifty one, Thomas
was credited in a published paper for the first time
after a visiting fellow from Canada included him among the authors,
not realizing all the social and racial implications involved. Other
doctors included Thomas in the years that followed, although he
(24:51):
was never credited on Blaylock's publications. In nineteen fifty nine,
Blaylock turned sixty and Thomas was not invited to the
faculty party his honor. Some of the organizers sneaked him
in and he watched from behind the plants, which is
something that he later described as humiliating. Blaylock retired from
Johns Hopkins five years later, and as he was mumbling
(25:14):
over how to spend his time after his retirement, Thomas
said not to include him in those plans. For most
of their thirty four years working together, Blaylock had just
assumed that they were a package when entertaining other job
and research offers, thinking that if he left Johns Hopkins,
Thomas would obviously go to but Thomas wanted to make
his own way. Blaylock died on September fifteenth, nineteen sixty four,
(25:38):
just a few months after he retired. Towards the end
of his life, he expressed some regret over having not
ever sent Thomas to medical school. Blaylock's obituary in the
New York Times described the surgery performed on Eileen Saxon. Quote.
Hospital officials recalled that Dr. Blaylock made a long incision
and exposed the beating heart of a fifteen month old girl.
(25:59):
Then for three hours he worked at an operation no
one had ever done before. The obituary also mentioned Tausig's involvement,
but not that Thomas was standing behind Blaylock and walking
him through it. Vivian Thomas continued to have a career
at Johns Hopkins after Blaylock's retirement as lab supervisor. He
had been training surgeons and technicians for years, including training
(26:23):
twenty black surgical technicians, two of whom later went on
to medical school. The Johns Hopkins School of Medicine integrated
in nineteen sixty three, and Thomas had also become a
mentor for the university's first black medical students and residents.
In the years that followed, attitudes about race were shifting
in the United States in general and at Johns Hopkins specifically,
(26:46):
and in the late nineteen sixties, surgeons and technicians who
had trained with Vivian Thomas started to advocate for him
to be recognized for his contributions. A group of former
surgical Fellows, nicknamed the Old Hands Club, took the lead
on commissioning and pay for a portrait of Vivian Thomas
to be hung across from Blaylock's portrait in the lobby
of the Blaylock Building at the Johns Hopkins Hospital. The
(27:09):
portrait was unveiled at a meeting of the Johns Hopkins
Medical and Surgical Society in nine after a series of speeches.
Thomas spoke as well. He said that when he had
learned about the plans for this portrait, quote, my emotions
were quite mixed, and they still are. People in our
category are not accustomed to being in the limelight. Most
(27:31):
of you are. If our names get into print, it's
usually in the very fine print, down at the bottom somewhere.
But being placed in the position I find myself now
makes me feel quite humbled, but at the self same
time just a little proud. At no time, during all
the years that I have been here at Hopkins, have
I had any idea that I would ever do anything
(27:52):
that would make a mark upon this institution, or make
any contribution to the field of medicine that would merit
such recognition as I am getting here today. Press coverage
about the unveiling of this portrait is how many of
Thomas's friends and neighbors learned for the first time just
what kind of work he had been doing at Johns Hopkins.
(28:15):
He wrote in his autobiography about getting this this call
from a friend, like the morning the newspaper came out,
asking all these questions, and he was like, I'm still
in bed. I don't I don't know what you're talking about.
Further recognition of Thomas's achievements and contributions followed from there.
In nineteen seventy six, he was named Instructor of Surgery
(28:35):
at Johns Hopkins University School of Medicine, meaning that he
was for the first time formally part of the faculty.
He was awarded an honorary doctorate by the university that
same year. This followed an effort from University of Maryland
College Park to do the same, which fell through after
the Board of regents voted not to approve it, even
though Thomas had already been informed that it was in
(28:57):
the works. Yeah, that seemed very embarrassing for the University
of Maryland College Park. Also for reasons that aren't entirely
clear to me. The honorary doctor he got is a
doctorate of laws and not a doctor of medicine um.
And I was not able to track down why that was.
That there were vague references to there being some restrictions,
(29:18):
and I was like, what restrictions do you mean. Toward
the end of his time at Johns Hopkins, Thomas worked
with Dr Levi Watkins, Jr. He was the first black
medical student to graduate from Vanderbilt University and the first
black cardiac surgery resident at Johns Hopkins. Thomas helped Watkins
develop and troubleshoot the process for implanting an automatic cardiac defibrillator,
(29:42):
that is, a surgery that Watkins performed for the first
time ever in nineteen eighty. Thomas had retired just a
year before that happened, and at the request of many
of his colleagues, he had started writing an autobiography. The
autobiography was printed as Pioneering Research in Surgical Shock and
cardio Vascular Surgery, Vivian Thomas and his work with Alfred Blaylock.
(30:04):
Copies printed more recently are titled Partners of the Heart,
which is also the title of a movie from PBS
American Experience that debuted in two thousand four. The HBO
movie called Something The Lord main stars most Deaf as
Vivian Thomas, Allen Rickman is Alfred Blaylock, and Mary Stuart
Masterson is Helen Tausig, and it also came out in
two thousand four. Vivian Thomas died of pancreatic cancer on November.
(30:30):
The work that he did with Alfred Blaylock really set
the stage for the field of cardiac surgery. It was
a field that really flourished from there. Blaylock and Thomas
and the rest of the surgical team demonstrated that it
was possible to operate on a heart and that patients
who were sick enough to require cardiac surgery could survive
the anesthesia and the physical trauma that were required to
(30:53):
carry it out. When Alfred Blaylock, Helen Tausick, and Robert
Gross were granted the Albert Lasker Clinical Medical Research Award
in ninety four, they were described as launching quote a
worldwide surge of effective investigation and corrective surgery into all
phases of cardiovascular dynamics. This absolutely would not have been
(31:17):
possible without Vivian Thomas surgical procedures that Thomas developed are
still performed today, although the Blaylock Thomas Tausig shunt, as
it is increasingly known, is often a temporary first step
to help a patient survive until they can have other
procedures to address a heart malformation more directly. Today, it
typically involves a synthetic shunt rather than one of the
(31:39):
patient's own blood vessels. So one point of conjecture that
often comes up as what Thomas might have achieved if
he had been able to attend medical school, the idea
being that if he was so brilliant with a high
school education, that he might have been truly astounding if
he had been able to earn an m d. But
really that's a little complicated. Thomas's connection to Blaylock gave
(32:01):
him access to white medical institutions which he would not
have had if he had gone to medical school and
started a career of his own. And the words of
Dr Roweena Spencer, who worked with Thomas on the development
of the atrial septectomy and was the only woman ever
to serve as a surgical intern for Alfred Blaylock quote,
(32:22):
the truth of the matter is that is a black
physician in that era, he would probably have had to
spend all his time and energy making a living among
an economically deprived black population. And we'll end with a
brief and frequently repeated an illustrative story from the late
Dr j Alex Haller. Early in his career, Hallard was
working at the National Institutes of Health with Alfred Casper
(32:44):
as a technician. One day, while working in the lab,
Howard ran into trouble with bleeding during a procedure, but
solved the problem. Casper complimented Hallar on how he had
handled himself, and Hallard said, well, I trained with Dr Blaylock. Later,
during another procedure that went even further awry, Hallard found
himself totally at a loss for what to do, and
(33:04):
Casper stepped in and fixed the situation. When Haller thanked
and complimented Casper, he said, I trained with Vivian Tracy.
Do you have a little listener mail to wrap this
one up? I do. It's also related to medicine and
previous episodes that we have done on the theme of
saving lots of babies. Uh, and it is from Shauna.
(33:27):
Shawna says, Hello, Holly and Tracy. I've been listening to
the podcast for years, and I've always wanted to be
a part of your listener emails, but had never had
anything interesting to impart. And then when I felt like
I did, I never actually got around to writing that email.
I even put it on my to do list, maybe
even last year, where it's been lingering until now. This
(33:48):
year has been a year of fate, especially surrounding my
wedding last weekend that we booked in August as a
purposeful COVID wedding. It was a pop up wedding, which
was perfect for me as a bride who wanted nothing
to do with the planning part of a wedding, and
it was amazing anyway, not the purpose of this email.
It was your podcast recently where Tracy mentioned procrastination, to
(34:09):
which I reminded myself about emailing. And then at the
end of the bram Stoker episode you talked about the
episode Deja Vu, which is what I originally was going
to email you about. See fate. So now I feel
compelled to actually push aside the procrastination and get down
to business. This goes back to the episode about Dr
Cooney and the premature babies. I started listening to saw
(34:32):
Bones as a recommendation from you guys, and they did
an episode about Dr Cooney and I was like, yes, Stephew,
miss in History did this topic already. The Inventor Doctor,
the Premature Babies, Invented Incubator showed it as some kind
of world fair, brought it to America. It was like
a beach side attraction or something. I totally remember this.
And then shortly thereafter, you guys released an episode on
(34:56):
Dr Cooney and mentioned that it was on saw Bones,
and I said, are utterly confused, because in my mind
you had already done that topic. That's how I knew
about it. I tried searching the archives and found nothing.
So Ever since I've had this itching thought of how
did I know all about Dr Cooney before both podcasted
episodes on it. Maybe I'll never knew, but it's the
(35:18):
weirdest thing, and I understand episode deja vu. Um. So
Seana went on to write a little bit about the
home economics episode that we did previously, and of course
that was offered in Ontario called Managing Personal and Family Resources,
which included all kinds of basic life stuff including what
(35:41):
the symbols on your clothes mean for washing? Um, I'm
not going to read the whole rest of the email
because it is relatively long, but I just want to
say I hate those washing symbols. I know the point
was to try to standardize laundering instruction on labels, but
I don't know what any of the main And every
time I'm looking at a new piece, like a new
garment that I'm washing for the first time, if it
only has those symbols and it doesn't have words, I'm
(36:03):
like having to google laundry symbols to be able to
do my laundry. So anyway, Shanna, thank you so much
for this email. I became very curious to be like,
how did Shanna learn about the babyside shows that that
that you know seemed to already be Shawna's mind before
(36:25):
having um got into our episode. Um, there was a
couple of years before uh we or saw Oons did
the episode. Um, there was an episode of story Corps
which would have been played during Morning Edition on NPR
if you are a Morning Edition listener or just a
story Corps listener. UM, and that predated our episode and
(36:50):
the saw Bones episode in the ninety invisible episode, all
of which you know we're reasonably near one another. I
think yeah, or maybe the sab Bonnes was was first,
the sub Owns was first, and then it was like
us at nine of visible near each other. Anyway, that's
a great mystery to solve. I'm all the time, I'm like,
(37:12):
didn't I hear that before? What's the happening? We're out
of Halloween season, so I can't go past life experience,
but go um so Sean also sent lots of UH
future episode suggestions as well, So anyway, thank you SHAWNA
for this email. Thanks to everybody who's been writing to
(37:35):
us lately. UH. If you would like to write to
us about this or any other podcast, History podcast at
I heart radio dot com, we're all over social media
as a miss in History. That's where you'll find our Facebook, Twitter, Pinterest,
and Instagram, and you can subscribe to our show on
the I heart radio app and Apple podcast at anywhere
else we get your podcasts. Stuff you missed in History
(37:59):
Class is a pro ouption of I heart Radio. For
more podcasts from I heart Radio, visit the I heart
Radio app, Apple Podcasts, or wherever you listen to your
favorite shows. H
Stuff You Missed in History Class News
Hosts And Creators
Holly Frey
Tracy Wilson
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