Pioneers in Black History: Dr Vivien Theodore Thomas
Dr Vivien Theodore Thomas (1910-1985) was an African-American surgical technician who developed the procedures used to treat blue baby syndrome in the 1940s. He was the assistant to surgeon Alfred Blalock in Blalock’s experimental animal laboratory at Vanderbilt University later at the Johns Hopkins University in Baltimore. He served as supervisor of the surgical laboratories at Johns Hopkins for 35 years.
In 1976 Hopkins awarded him an honorary doctorate and named him an instructor of surgery for the Johns Hopkins School of Medicine. Without any education past high school, Thomas rose above poverty and racism to become a cardiac surgery pioneer and a teacher of operative techniques to many of the country’s most prominent surgeons. He was the first African-American without a doctorate to perform open heart surgery on a white patient in the United States.
Thomas was born August 29, 1910, in Louisiana. The grandson of a slave, he attended high school in Nashville in the 1920s. He had hoped to attend college and become a doctor, but the Great Depression derailed his plans. In February 1930, he secured a job as surgical research technician with Dr Alfred Blalock at Vanderbilt University. On his first day of work, Thomas assisted Blalock with a surgical experiment on a dog. Within a few weeks, Thomas was starting surgery on his own. Thomas was classified and paid as a janitor, despite the fact that by the mid-1930s, he was doing the work of a post-doctoral researcher in the lab.
Working with Blalock
Blalock and Thomas began experimental work in vascular and cardiac surgery, defying medical taboos against operating upon the heart.
In 1943, while pursuing his shock research, Blalock was approached by renowned paediatric cardiologist Helen Taussig, who was seeking a surgical solution to a heart anomaly called Tetralogy of Fallot (or blue baby syndrome).
Blalock and Thomas realised immediately that the answer lay in a procedure they had perfected for a different purpose in their Vanderbilt work. Thomas was charged with the task of first creating a blue baby-like condition in a dog, and then correcting the condition.
In nearly two years of laboratory work, involving some 200 dogs, Thomas demonstrated that the corrective procedure was not lethal, thus persuading Blalock that the operation could be safely attempted on a human patient. Even though Thomas knew he was not allowed to operate on patients at that time, he still followed Blalock’s rules and assisted him during surgery.
On November 29, 1944, the procedure was first tried on an 18-month-old infant named Eileen Saxon. During the surgery itself, at Blalock’s request, Thomas stood on a step stool at Blalock’s shoulder and coached him step by step through the procedure, Thomas performed the operation hundreds of times on a dog, whereas Blalock only once as Thomas’ assistant. The surgery was not completely successful, though it did prolong the infant’s life for several more months.
Blalock and his team operated again on an 11-year-old girl, this time with complete success, and the patient was able to leave the hospital three weeks after the surgery. Next, they operated upon a six-year-old boy, who dramatically regained his colour at the end of the surgery. The three cases formed the basis for the article that was published in the May 1945 issue of the ‘Journal of the American Medical Association’’, giving credit to Blalock and Taussig for the procedure. Thomas received no mention.
News of this ground-breaking story was circulated around the world by the Associated Press. Newsreels touted the event, greatly enhancing the status of Johns Hopkins and solidifying the reputation of Blalock. Thomas’ contribution remained unacknowledged, both by Blalock and by Hopkins. Within a year, the operation known as the Blalock-Taussig shunt had been performed on more than 200 patients at Hopkins.
To the host of young surgeons Thomas trained during the 1940s, he became a figure of legend. Surgeons like Denton Cooley, along with Alex Haller, Frank Spencer, Rowena Spencer, and others credited Thomas with teaching them the surgical technique that 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 on his behalf by Blalock, he became the highest paid technician at Johns Hopkins by 1946.
Relations with Blalock
Blalock’s approach to the issue of Thomas’s race was complicated and contradictory throughout their 34-year partnership. On the one hand, he defended his choice of Thomas to his superiors at Vanderbilt and to Hopkins colleagues, 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.