Vivien Thomas

Vivien Thomas, the 'technician' who helped Dr. Alfred Blalock and Dr. Helen Taussig develop the 'blue baby' operation at Johns Hopkins (Sun file photo / May 25, 1997)

'Technician' showed surgeon what to do
Adviser: Vivien Thomas helped Dr. Alfred Blalock and Dr. Helen Taussig develop the 'blue baby' operation.
Vivien T. Thomas, who was born in New Iberia, La., and raised in Nashville, Tenn., had hoped one day to become a surgeon. A bank failure during the early days of the Great Depression wiped away his medical-school savings and nearly his dream.The son of a contractor, Thomas was so impressed as a youth by his family's physician that he pledged to "be like him." He had scraped together the money for his medical education by working after school and as an orderly in a private infirmary.

In 1929, Thomas enrolled in a premedical course at the Tennessee Agricultural and Industrial College and, after losing his money in the stock market crash, went to work in 1930 for Dr. Alfred Blalock at Vanderbilt University, who eventually trained him to be his surgical assistant.

At Vanderbilt, both Blalock and Thomas conducted experiments pulmonary hypertension and traumatic shock.

Out of their research came the revelation that shock was associated with loss of fluid and a decrease in blood volume. The importance of this discovery later saved thousands and thousands of lives during World War II, when casualties were treated with massive blood and blood-plasma transfusions.

Blalock, a graduate of the Johns Hopkins Medical School, was associated with Vanderbilt for 10 years and built a distinguished career and reputation there. He returned to Hopkins as chief of surgery in 1941, bringing Thomas with him.

Doctors' fame

Three years later, Blalock and Dr. Helen Taussig earned international acclaim for their "blue baby" operation on a 14-month-old girl, while Thomas' accomplishments at the time went unoticed. However, the success of the procedure could not have been accomplished without his research and operating-room expertise.

Present throughout the history-making surgery, he was able to advise both Blalock and Taussig because he had performed the same operation, which bypasses constricted vessels leading from the heart, more than 300 times on dogs.

He had worked with them, side by side, in the development of the surgical procedure that eventually corrected the heart defect known as tetralogy of Fallot, or "blue-baby syndrome."

As the operation proceeded, Blalock would occasionally turn to Thomas and ask, "Is that all right, Vivien?" "Are the bites [sutures] close enough together?"

The surgery, which has saved thousands of cyanotic children, corrects the lack of oxygen in the blood that turns a seemingly healthy pink baby blue.

While the operation was a success and the little girl recovered, she later died of complications. However, what they had learned eventually guaranteed an 80 percent success rate in such cases.

"What he has done is help develop some of the most significant surgical procedures in medical history," said The Sun in 1971 of his accomplishments.

When Blalock performed the surgery, "it was Mr. Thomas, the surgical technician, who stood looking over his shoulder offering suggestions and advising about techniques. Unlike the surgeons and other specialists he has worked with for almost half a century, he has no medical classwork behind him and -- no degree," said the newspaper.

Several years earlier, Taussig tried to find a remedy for the constriction of the blood vessels from the heart, when she found a report by Blalock and Dr. Edwards A. Park on the narrowing of the aorta. Their solution was to divert blood past the constriction, and she thought the procedure could be adapted for "blue babies."

"Mr. Thomas began producing 'blue baby dogs,' he says, and spent 'hours and hours in Dr. Taussig's museum of heart specimens, opening them, and closing, looking and thinking," said The Sun.

Thomas later said that the success of the operation on the first patient "blew the field wide open."