Heart Surgery's Invisible Man

That Vivien Thomas, a black man with neither a college nor a medical degree, could have worked as a research assistant at Hopkins Hospital during the 1940s was in itself something of a minor miracle. In that era of strict racial segregation, the only black men who worked at the hospital were pushing brooms and mops. Not only were there no black doctors at Hopkins, there were no black professionals of any kind.

The hospital wards and waiting rooms were designated "white" and "colored" -- even the blood bank carefully separated blood donated by whites from blood donated by blacks. (Giving "colored blood" to white patients was strictly prohibited, even in emergencies, although blacks occasionally were allowed to receive infusions of "white blood" if no suitable "colored blood" was available.)


In this almost feudal racial environment, Vivien Thomas taughwhite men everything from tying their first sutures to performing intricate open heart surgeries. It was he, along with his illustrious collaborator and employer, Alfred Blalock, who perfected the technique for the famous "blue baby" operation of 1944 that set the course of modern cardiac surgery.

"Vivien Thomas was a great man," says Levi Watkins, the first black surgical resident admitted to the Johns Hopkins Hospital staff, in 1971, and today an eminent surgeon. "Vivien Thomas was a man motivated by the possibilities of discovery." But Thomas lived in an age when black men, no matter how gifted, were invisible. So, outside the small fraternity of "old hands" at Hopkins, his name is practically unknown.


Thomas arrived at Hopkins in 1941, when he accompanied the legendary Alfred Blalock from Vanderbilt University in Tennessee his research assistant. The unlikely partnership between the two men, one the aristocratic descendant of a prominent old Southern family, the other a modest, unassuming man with a wife and children to support, had been forged a decade earlier when Blalock hired Thomas to work in his lab at Vanderbilt.

In later years, Blalock would claim he spotted something right away about the bright young black man who appeared in his office one day looking for work. "I'm looking for someone whom I can teach to do everything that I can do, and maybe some things I can't do," Thomas recalled Blalock saying.

Thomas, in fact, had once dreamed of becoming a physician himself. When he met Blalock, he had already worked for seven years as a carpenter in hopes of saving enough money to attend Meharry Medical College in Nashville. But the Depression destroyed the carpentry business and bank failures wiped out Thomas' savings.

Thomas heard from a friend there was opening in the lab at Vanderbilt, where the 30-year-old Blalock was already gaining recognition for his work in shock trauma theory, which laid the groundwork for blood transfusions.

Thomas' carpentry background may seem an unlikely qualification for work in a hospital lab, but it had taught him many valuable lessons.

One day, for example, a construction foreman on the job had asked Thomas to repair a worn patch of flooring in the home of a Fisk University faculty member. A few hours later the foreman returned to inspect the work.

"Thomas, that won't do," he told the young man. "I can see where you put the new piece in." The foreman left without another word, and Thomas went back to work. Three days later he happened to see the same foreman again. The man's only comment was, "Thomas, you could have fixed that floor right the first time."

Such lessons served Thomas well in his capacity as Blalock's assistant. He quickly mastered every aspect of the lab's routine, excelling in anatomy and physiology and making himself indispensable as Blalock's right-hand man.


The two men worked well together, despite the fact that Blalock was notorious for his explosive temper, which could be set off by the slightest mistake -- or sometimes for no reason at all. Inevitably the two men clashed one day.

"Something went wrong in the lab," Thomas recalled in his autobiography, "Pioneering Research in Surgical Shock and Cardiovascular Surgery," published by University of Pennsylvania Press in 1971. "I no longer recall what, but I made a small error. Dr. Blalock sounded off like a child throwing a temper tantrum. The profanity he used would have made the proverbial sailor proud. I told him he could just pay me off, that I had not been brought up to take or use that kind of language. He apologized, saying he had lost his temper, and he asked me to go back to work.

"From that day on," wrote Thomas, "neither one of us ever hesitated to tell the other in a straightforward, man-to-man manner what he thought or how he felt. In retrospect, I think that incident set the stage for what I consider our mutual respect throughout the years."

[At Hopkins, Blalock and Thomas' work eventually led to the development of blood transfusions as a standard procedure; the technique saved the lives of thousands of U.S. soldiers during World War II. Even more significant was their invention of open heart-surgery, first performed Nov. 29, 1944 on a 15-month-old girl suffering from "blue baby" syndrome, a congenital heart deformity that prevents blood from reaching the lungs. The operation's success made Blalock a celebrity overnight.]

In the scores of medical journal articles and history books devoted to the breakthrough, Thomas' name was mentioned, if at all, only as an insignificant footnote. He was never invited to lecture on his role in developing the procedure, which is still routinely used today.

Thomas remained the virtual invisible man as far as medical history was concerned until 1971, when Hopkins finally acknowledged his contribution by commissioning Thomas' portrait, to be hung next to that of Blalock in the building that bears the white doctor's name.


Thomas probably never expected to win any special recognition for his efforts. His widow, Clara, who still resides in Baltimore, says Thomas didn't seem bitter about the way he was treated. "My husband never brought his problems home," she said recently. "He preferred to plant azaleas and roses in the garden during his leisure."

Levi Watkins believes today that Thomas' skin color was not something his Hopkins colleagues of the period could see beyond. "Of course there were problems," Dr. Watkins said recently. "He couldn't live where they lived, he couldn't join the societies they joined. This isn't to say they didn't love him. But I don't think they ever really saw his struggle."

Thomas died in 1985, and only recently has his role as a pioneer of 20th-century medicine become more widely known. "Unfortunately, Vivien wasn't really recognized until after he died," said Raymond Lee, now a physician assistant whom Thomas met when Mr. Lee was a hospital elevator operator in the 1960s. "People in medical circles know him, but hardly anyone else. It's sad when you have to die in order to be recognized."

Roz Hamlett is a Baltimore writer. This article is excerpted from a longer article in the current issue of Johns Hopkins Magazine.