African American lab technician Vivien Thomas (1910–1985) spent three decades conducting research alongside famed U.S. cardiac surgeon Alfred Blalock. Their work led to the development of a life-saving surgical procedure to fix a congenital heart defect known as “blue baby syndrome.” Over the years, Thomas's investigations triggered advancements in the emerging field of open-heart surgery, yet his name was left off hundreds of research papers published by Blalock. Only after his death did the true nature of his involvement in Blalock's lab come to light.
The grandson of a slave, Vivien Thomas was born August 29, 1910, in New Iberia, Louisiana. His father, William Maceo Thomas, worked as a carpenter while his mother, Mary Eaton Thomas, worked as a seamstress. Thomas grew up alongside two older brothers and a sister. The family moved to Nashville when Thomas was little. At age 13, Thomas began helping his father with carpentry jobs after school and on weekends.
By age 16, Thomas was employed as a carpenter in his own right. He saved his earnings, intent on attending medical school. He graduated from Pearl High School in 1929 and secured a construction job at Fisk University to pay his way through Tennessee State Agricultural and Industrial College. He never got to attend, though, because after the stock market crash of 1929, he lost his job and his life savings when the bank that held his money failed.
In 1930, Thomas applied for a job in a surgical research lab at the Vanderbilt University Medical School. He was told that the only drawback was the employer, a hard-to-please surgeon named Alfred Blalock. Thomas interviewed and got the job, even though it paid only $12 a week. Although this was a cut in pay from his $20-a-week salary in construction, he accepted the position, assuming that it would be temporary.
When Thomas joined Blalock, the cardiac surgeon was researching traumatic shock. At the time, traumatic shock caused frequent death in the operating room and at accident scenes. Blalock wanted to understand what caused shock so he could find a solution. The prevailing thinking was that shock led to the release of unidentified toxins, which wreaked havoc on the body. To conduct his experiments, he performed surgeries on lab dogs to send them into shock. Before, during, and after the procedures, Blalock took measurements on blood pressure, oxygen consumption, and blood-gas content.
On Thomas's first day, Blalock showed him how to weigh a dog and calculate the amount of anesthetic needed to put it to sleep. He also taught his new lab assistant how to administer the drugs to the dog and prepare the equipment for surgery. On his second day at the lab, Thomas was given the responsibility to anesthetize a dog—on his own—and assemble the equipment so that everything would be ready when Blalock arrived. Day after day, he prepared dogs for experimentation and Blalock performed procedures to put them into shock. Thomas was responsible for collecting and compiling the data.
Soon, a postdoctoral fellow named Joseph Beard joined the lab team. Beard coached Thomas, teaching him anatomy and physiology to fill in his knowledge gaps. In his spare time, Thomas read about Blalock's research and soon became an integral and introspective member of the research staff. Under the surgeon's direction, Thomas conducted experiments where he treated canine shock victims with different drugs, heat and cold therapies, and fluids. Armed with detailed data—some of it provided by Thomas—Blalock debunked the theory that toxins caused shock.
Blalock concluded that rapid blood loss led to shock because it caused the body's circulation system to collapse. Given this fact, the best treatment was fluid replacement in the circulatory system through the use of blood transfusions or plasma. If no blood products were available, he suggested saline as a viable alternative. In 1933, Blalock presented his groundbreaking findings on traumatic shock at a meeting of the Chicago Surgical Society. His shock-treatment strategies were implemented on wounded soldiers during World War II, saving many lives.
In 1933, Blalock began teaching Thomas to perform cardiac and thoracic surgeries on the lab dogs. He showed him how to scrub for surgery, how to make an incision, and how to suture dog organs, muscles, and skin. From this point, Thomas started the surgeries by making the initial incisions; Blalock took over mid-stream, and then Thomas performed the final suturing. One day, Thomas prepared a dog and made the opening cuts, then covered the incision to wait for Blalock. The doctor never showed, so he performed the surgery himself. Afterward, Blalock relied on Thomas to perform the surgeries and collect the data. In this way, Thomas kept the research going while the busy surgeon attended to other administrative matters at the hospital.
Although Thomas was doing the work of a senior research fellow, he did not get paid like one. In 1935, he discovered that the white lab technicians made significantly more money than he did. He soon found out that Vanderbilt classified—and paid—all black workers as janitors, no matter what position they held. Although Blalock secured a pay raise for his assistant, it did not bring Thomas's salary into alignment with those of his white counterparts. During his career, Thomas did not complain about his unequal treatment, and some biographers suggested that he feared losing his job.
By the mid-1930s, Thomas was working a lot on his own, maintaining a clear, scientific record of each surgery so that Blalock could analyze the findings. His carpenter hands had amazing dexterity, making him an ideal surgeon. He learned to execute complicated cardiac operations and forge ahead with new ones for testing purposes. In a sense, Thomas and Blalock worked as independent partners. As Jim Murphy wrote in Breakthrough! How Three People Saved “Blue Babies” and Changed Medicine Forever, the learning went both ways. According to Murphy, fellow doctor Henry Bahnson once remarked that “Dr. Blalock taught Vivien a lot, but Vivien also discovered a lot of new techniques himself and taught them to Dr. Blalock.”
In 1937, the Henry Ford Hospital in Detroit, Michigan, attempted to hire Blalock as its new chief of surgery. When he found out the hospital would not employ Thomas as his lab assistant, he turned the offer down. A few years later, the Johns Hopkins School of Medicine hired Blalock to run its surgery department, and Blalock was able to secure a position for Thomas. In June 1941, Thomas arrived in Baltimore and found the highly segregated atmosphere at Johns Hopkins stifling. There was a separate ward for African-American patients, as well as a separate blood bank and a separate morgue. Waiting rooms, restrooms, and clinics were all segregated. Thomas was the only black employee at the hospital who was not performing manual labor. He was such an anomaly that everyone stared at him when he walked the hallways in his white lab coat.
Under Blalock's direction, Thomas continued his investigations into cardiac care. In the early 1940s, no surgeons conducted open-heart surgery because it was a new area of research. Blalock was interested in finding a surgical fix for people born with narrow aortas, which put them at risk for strokes and heart attacks. Working together, Blalock and Thomas performed vascular surgeries on lab dogs as they investigated this problem. They learned how to stitch blood vessels together, a cutting-edge procedure at the time. As usual, Thomas worked a lot on his own, with Blalock checking in a few times each week and asking probing questions to guide the research.
In 1943, pediatric cardiologist Helen Taussig asked Blalock to find a cure for a congenital heart defect known as Tetralogy of Fallot—better known as blue baby syndrome. The defect led to an insufficient amount of oxygen flowing in the bloodstream, giving those affected a bluish tint. The condition killed thousands of U.S. children each year. Taussig provided Blalock with her clinical observations and research into the matter. She wanted to know if it would be possible to re-route one of the coronary arteries to enhance the oxygen uptake.
To investigate this matter, Blalock and Thomas had to devise a surgical procedure to re-create the congenital abnormality in lab dogs. In other words, they had to find a way to restrict the flow of oxygenated blood in a dog's circulatory system so they could then test a cure for the abnormality. This took many months, and along the way, Thomas became an expert in open-heart surgery. He developed new surgical techniques and adaptations for surgical tools, even creating tiny needles to suture the small dog vessels. Working with another doctor, he designed a new kind of surgical clamp with a screw closure that became known as the Blalock pulmonary artery clamp. According to Breakthrough!, Blalock inspected one of Thomas's surgeries and was so astounded by the precision with which he had sewn up an artery that he described it as resembling “something the Lord had made.”
Eventually, the researchers hit upon the idea of rerouting an artery to send the blood back to the lungs a second time. Thomas and Blalock had performed a similar surgery back at Vanderbilt when they were working on blood-pressure issues. The procedure involved attaching the subclavian artery to the pulmonary artery. Week after week, Thomas worked to perfect the surgery, with Blalock assisting only once. After Thomas tested the surgery on more than 200 dogs, Blalock suggested that it was time for a human trial.
In May 1945, Blalock published a scientific paper on the blue baby syndrome surgery in the Journal of the American Medical Association. Thomas's name was not mentioned, and photographs of the surgery team that performed the historic procedure did not include Thomas. Blalock authored more than 300 papers during his career. Once, in 1951, Thomas earned research credit when a visiting fellow listed him as a co-author on a paper. Blalock became known as the “father of cardiovascular surgery,” while Thomas did a lot of the work and pioneered many of the procedures.
Blalock died in 1964, but Thomas stayed on at Johns Hopkins and continued his cardiac research. In 1971, he received his first recognition for his contributions to heart surgery when the hospital hung a commissioned portrait of Thomas in the medical school. In 1976, he received an honorary doctorate from Johns Hopkins, and a year later he was made an official instructor in the surgery department. Thomas spent his last years teaching new surgeons and conducting research on implantable defibrillators, aided by the hospital's first black cardiac resident, Levi Watkins.
After retiring in 1979, Thomas wrote an autobiography, titled, Partners of the Heart, which was published shortly after his death from pancreatic cancer on November 26, 1985. He was survived by his wife, Clara Beatrice Flanders, whom he had married in 1933. He also had two daughters, Olga Fay and Theodosia Patricia.
In the years after Thomas's death, an investigative reporter dove into his story, hoping to bring wider attention to his overlooked achievements. In the 2003 PBS documentary Partners of the Heart, Dr. Watkins summed up Thomas's life this way: “I think he is the most untalked about, unappreciated, unknown giant in the African American community. What he helped facilitate impacted people all over the world.”
Murphy, Jim, Breakthrough! How Three People Saved “Blue Babies” and Changed Medicine Forever, Clarion Books, 2015.
Yount, Lisa, Alfred Blalock, Helen Taussig, and Vivien Thomas: Mending Children's Hearts, Chelsea House, 2012.
Investor's Business Daily, October 5, 2004; February 22, 2016.
Journal of Investigative Surgery, June 2014.
Washington Post, December 6, 1994.
Public Broadcasting Service website, http://www.pbs.org/wgbh/ (December 17, 2016), transcript of documentary film Partners of the Heart.❑