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Vivien Thomas

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Vivien Theodore Thomas

Vivien Thomas' autobiography, Partners of the Heart: Vivien Thomas and His Work With Alfred Blalock

Vivien Theodore Thomas (August 29, 1910 – November 26, 1985) was an African-American surgical technician who helped develop the procedures used to treat blue baby syndrome in the 1940s. He was an assistant to Alfred Blalock at Vanderbilt University in Nashville, Tennessee and later at the Johns Hopkins University in Baltimore, Maryland. Without any education past high school, Thomas rose above poverty and racism to become a cardiac surgery pioneer and a teacher to many of the country's most prominent surgeons. Thomas was born close to Lake Providence, Louisiana. The son of a carpenter, he attended Pearl High School (now known as Martin Luther King Magnet High School for Health Science and Engineering) in Nashville, Tennessee, in the 1920s. Even though it was part of a racially segregated system, the school provided him with a high-quality education. Later, when Thomas' savings were wiped out, he abandoned entirely his plans for college and medical school, relieved to have even a low-salary job as the Great Depression deepened.

Thomas showed an extraordinary aptitude for surgery and precise experimentation, which led Blalock to grant him more freedom in the execution of the procedures. Tutored in anatomy and physiology by Blalock and his young research fellow (Dr. Joseph Beard), Thomas rapidly mastered complex surgical techniques and research methodology. He and Blalock developed great respect for one another, forging such a close working relationship that they came to operate almost as a single mind. Outside the lab environment, however, they maintained the social distance dictated by the norms of the times. In an era when institutional racism was the norm, Thomas was classified, and paid, as a janitor, despite the fact that by the mid 1930s he was doing the work of a postdoctoral researcher in Blalock's lab.

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[edit] Unrecognized accomplishments

Thomas trained others in the Blue Baby procedure, as well as in a number of other cardiac techniques, including one he developed in 1946 for improving circulation in patients whose great vessels (the aorta and the pulmonary artery) were transposed. A complex operation called an atrial septectomy, the procedure was executed so flawlessly by Thomas that Blalock, upon examining the nearly undetectable suture line, was prompted to remark, "Vivien, this looks like something the Lord made."

The most common cause of "Blue Baby" (and hence the main surgery developed by Thomas and Blalock) was Tetralogy of Fallot which combines 4 heart defects.

To the host of young surgeons Thomas trained during the 1940s, he became a figure of legend, the model of the dexterous and efficient cutting surgeon. "Even if you'd never seen surgery before, you could do it because Vivien made it look so simple," the renowned surgeon Denton Cooley told Washingtonian magazine in 1989. "There wasn't a false move, not a wasted motion, when he operated." Surgeons like Cooley, along with Alex Haller, Frank Spencer, Rowena Spencer, and others credited Thomas with teaching them the surgical technique which placed them at the forefront of medicine in the United States. Despite the deep respect Thomas was accorded by these surgeons and by the many black lab technicians he trained at Hopkins, he was not well paid. He sometimes resorted to working as a bartender, often at Blalock's parties. This led to the peculiar circumstance of his serving drinks to people he had been teaching earlier in the day. Eventually, after negotiations in his behalf by Blalock, he became the highest paid technician at Johns Hopkins by 1946, and by far the highest paid African-American on the institution's rolls. Although Thomas never wrote or spoke publicly about his ongoing desire to return to college and obtain a medical degree, his widow, the late Clara Flanders Thomas, revealed in a 1987 interview with Washingtonian writer Katie McCabe that her husband had clung to the possibility of further education throughout the Blue Baby period and had only abandoned the idea with great reluctance. Mrs. Thomas stated that in 1947, Thomas had investigated the possibility of enrolling in college and pursuing his dream of becoming a doctor, but had been deterred by the inflexibility of Morgan State University, which refused to grant him credit for life experience and insisted that he fulfill the standard freshman requirements. Realizing that he would be 50 years old by the time he completed college and medical school, Thomas decided to give up the idea of further education.

[edit] Relations with Blalock

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

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

[edit] Institutional acknowledgment

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

In 1976, Johns Hopkins University presented Thomas with an honorary doctorate. However, because of certain restrictions, he received an Honorary Doctor of Laws, rather than a medical doctorate. Thomas was also appointed to the faculty of Johns Hopkins Medical School as Instructor of Surgery.

Following his retirement in 1979, Thomas began work on an autobiography, Partners of the Heart: Vivien Thomas and his Work with Alfred Blalock, ISBN 0-8122-1634-2. He died in November 1985, at age 75, and the book was published just days later. Having learned of Thomas on the day of his death, Washingtonian writer Katie McCabe brought his story to public attention for the first time in a 1989 article entitled "Like Something the Lord Made", which became the basis for the Emmy and Peabody Award-winning 2004 HBO film Something the Lord Made.

[edit] Legacy

Vivien Thomas' legacy as an educator and scientist, and the Vivien Thomas Young Investigator Awards, given by the Council on Cardiovascular Surgery and Anaesthesiology beginning in 1996. The Vivien Thomas Scholarship

[edit] References

• (1985) Partners of the Heart: Vivien Thomas and His Work with Alfred Blalock (originally published as Pioneering Research in Surgical Shock and Cadiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock), U. Penn. Press.
• (1989) "Like Something the Lord Made", by Katie McCabe. Washingtonian magazine, August 1989. Reprinted in Feature Writing for Newspapers and Magazines: The Pursuit of Excellence, ed. by Jay Friedlander and John Lee. May also be accessed by going to the film's web site, below.
• (2003). Partners of the Heart. American Experience.
• (2003) Stefan Timmermans, "A Black Technician and Blue Babies" in Social Studies of Science 33:2 (April 2003), 197–229.
• (2004)"Something the Lord Made", HBO movie, Portrayed by Mos Def