Thomas, Vivien 1910–1985

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Vivien Thomas 1910–1985

Surgical research technician

At a Glance…

Became Blalock’s Laboratory Assistant

Conducted Groundbreaking Work

Raised Eyebrows at Johns Hopkins

Guided Blalock Through Historic Operation

Honored by Colleagues

Selected writings

Sources

Vivien Thomas was highly regarded in the medical community for his scientific genius and surgical skill. With no formal medical training, Thomas helped develop intricate surgical techniques that ultimately saved thousands of lives. Thomas performed research in the animal laboratories at Vanderbilt University during the 1930s, leading to the widespread use of blood and plasma transfusions during World War II.

Later, at Johns Hopkins University, Thomas worked with Dr. Alfred Blalock as he performed hundreds of experimental procedures on laboratory dogs to develop the “blue baby” operation for treating congenital cyanotic heart disease, a malformation of the heart which results in insufficient oxygen in the blood and causes a bluish discoloration of the skin and mucous membranes. “In truth,” Dr. J. Alex Haller, professor of pediatric surgery at Johns Hopkins, was quoted as saying in News American, Vivien Thomas was “the surgical glove on Blalock’s experimental hand.”

Although he received little formal recognition during Blalock’s lifetime, Thomas served as supervisor of the surgical research laboratories at Johns Hopkins University from 1941 until 1979. During this time, he played an important role in training many of the nation’s top surgeons. 30 years before Johns Hopkins admitted its first black surgical resident, Thomas served as a black research technician without a degree and was teaching operative techniques to white staff surgeons at the university’s hospital.

Thomas was finally honored for his work in 1971, when, during the biennial meeting of the Johns Hopkins Medical and Surgical Society, his portrait was unveiled and hung next to that of Dr. Blalock in the hospital’s Blalock Building. In 1976 he was awarded an honorary doctorate from Johns Hopkins, and the following year he became an official member of the medical school faculty. Shortly before his death in 1985, Thomas completed his autobiography, Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work With Alfred Blalock, in which he recalled his extraordinary life and work.

Thomas, the son of a building contractor, was born in Nashville, Tennessee, in 1910. During his childhood he was impressed by the wisdom and kindness of his family doctor and made up his mind to pursue a career in medicine. After school, on weekends, and during the summer, he worked as an apprentice carpenter and as an orderly in a private

At a Glance…

Born Vivien T. Thomas, 1910, in Nashville, TN; died, 1985; married; children: two daughters. Education: Attended Tennessee Agricultural and Industrial State College.

Vanderbilt University Medical School, surgical research technician, 1930–41; Johns Hopkins University School of Medicine, research associate and supervisor of surgical research laboratories, 1941–79, appointed to the medical school faculty, 1977. Author of autobiography, Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work With Alfred Blalock, 1985.

Awards: Received honorary doctorate from Johns Hopkins University, 1976.

infirmary, hoping to earn enough money to pay his college tuition. He graduated from high school in 1929, and the following fall enrolled as a premedical student at Tennessee Agricultural and Industrial State College. Within a few months, however, the stock market had crashed, and with it, the banks. Nearly all of his savings was gone. His dreams of an education were shattered.

Became Blalock’s Laboratory Assistant

The Great Depression also meant the end of carpentry projects in Nashville, so Thomas was forced to look elsewhere for permanent work. After several months as a jack-of-all-trades, fixing roofs, plumbing, and worn-out steps, he heard about an opening in the research laboratory at Vanderbilt University Medical School. A surgeon named Alfred Blalock needed a laboratory assistant who, Thomas recalled in an interview with Corinne F. Hammett in News American,“would be able to do everything that he could do and some things that he couldn’t do.”

Blalock, then 30, was conducting groundbreaking research into the causes and effects of shock, the body’s reaction to trauma. Because his clinical duties required him to spend much of his time with patients in the hospital, he wanted someone knowledgeable and independent who could carry out his research work in the laboratory. Although Thomas was only 19, Blalock was impressed by his confident, business-like air, and hired him immediately. Their association was to last until Blalock’s death in 1964.

Thomas had originally intended to work in the Vanderbilt laboratory part time, and only until he had earned enough money to return to Tennessee State. After completing his studies there, he hoped to attend Meharry Medical College. But as the Depression deepened, his prospects for further education grew dimmer. “For the time being, I felt secure,” he wrote in his autobiography. “At least I had a job. It seemed to be a matter of survival.” He threw himself into his work. Before long, he was spending 16 hours a day in the laboratory, supervising experiments at night and devouring chemistry and physiology textbooks during the day.

Conducted Groundbreaking Work

Thomas’s surgical talent manifested itself almost immediately. “Within three days,” wrote Katie McCabe in Reader’s Digest,“[he] was administering anesthesia and performing arterial punctures on laboratory dogs. Within months, he was performing delicate and complex procedures with the ease of a master.” During the 1930s, Blalock’s experiments focused on hypertension, or high blood pressure, and traumatic shock. Together, he and Thomas worked to recreate in laboratory animals the kinds of stressful conditions people experienced when trapped for prolonged periods under piles of rubble. To help in the investigation, Thomas invented a heavy spring device which they used to apply varying degrees of pressure to the extremities of animals. He then recorded each reaction. The information they collected enabled Blalock to construct a new understanding of traumatic shock.

Blalock’s landmark discovery that shock was linked to a loss of fluid and a decrease in blood volume earned him the respect and admiration of the international medical community, and resulted in the widespread application of life-saving blood transfusions during World War II. As time went on, Blalock spent less and less time in the laboratory, and it was up to Thomas to develop, monitor, and calculate the results of all of their experimental procedures. The surgeon trusted him implicitly, and regarded him as a full and equal partner. “It was extremely difficult to tell if Dr. Blalock had the original idea for a particular technique or if it was Vivien Thomas,” Dr. Alan Woods, Jr., a former intern at Johns Hopkins, told Hammett. “They worked so smoothly together, we—the medical students—didn’t know….”

The fruitful and enduring partnership between Blalock and Thomas was especially remarkable considering the time and the place. “Both were steeped in the social traditions of the Old South and knew the rigidly prescribed codes of behavior for whites and blacks,” McCabe wrote. “They understood the line in 1930 between life inside the lab, where they could drink together, and life outside, where they could not. In all their years together, neither would ever cross that line. But within the insular world of the laboratory, they functioned almost as a single unit, Thomas’s deft hands turning Blalock’s ideas into elegant and detailed experiments. They were an unbeatable combination: Blalock, the scientist, asking the simple but profound questions; Thomas, the pragmatist, figuring the simplest way to get the answers.”

Raised Eyebrows at Johns Hopkins

In 1940, Blalock, then at the height of his career, was offered the position of surgeon-in-chief at Johns Hopkins Hospital. He accepted the job, but only on one condition: that Vivien Thomas be allowed to accompany him. Although the university agreed to Blalock’s terms, Thomas’s arrival in June of 1941 caused quite a stir. “On one occasion when Thomas walked across campus, he halted traffic,” McCabe wrote. “A black man in a lab coat was something unheard of at Johns Hopkins, which had segregated restrooms and a separate entrance for black patients. But inside the lab it was Thomas’s skill, rather than his skin color, that raised eyebrows.”

As director of the university’s Hunterian Surgical Research Laboratory, Thomas continued to carry out research programs for Dr. Blalock. But it was Thomas’s own inventive genius that helped bring many of the projects to fruition. Shortly after Blalock and Thomas arrived at Johns Hopkins, the hospital’s chief of pediatrics approached Blalock for help in correcting the problem of coarctation, or narrowing, of the aorta in children. In order to investigate the disorder—as well as many others—in laboratory animals, Thomas devised a positive-pressure respirator that inflated the lungs of dogs under anesthesia. At that time, no such machine was available. He and Blalock then went on to create, and attempt to correct, specific cardiovascular defects in dogs.

In 1943 Johns Hopkins cardiologist Helen Taussig met with Blalock and Thomas to solicit their advice concerning the treatment of an infant with deficient blood flow to the lungs. Young Eileen Saxon, born with multiple heart defects that caused her to become weak and cyanotic, was only one of a growing number of “blue babies” whom Taussig had been unable to help. By this time, Blalock and his assistant had performed hundreds of intricate cardiac procedures in the lab. In a series of experimental operations at Vanderbilt, they had attempted to bring more blood to the lungs of laboratory dogs by dividing a major artery and sewing it to the pulmonary artery that supplies the lungs. They believed that a refined version of this procedure might help Dr. Taussig’s “blue babies.”

Guided Blalock Through Historic Operation

Blalock and Thomas spent much of the following year developing and performing experimental procedures in the laboratory in preparation for the historic operation on Eileen Saxon. But it was Thomas who worked out the final details of the surgical technique and taught them to his famous associate. On the day of the operation, however, Thomas was nowhere to be found. Flanked by a surgical team that included some of the country’s foremost physicians and researchers, Blalock refused to begin the procedure without his laboratory assistant at his side. Eventually Thomas was located in the laboratory and summoned to the operating floor.

For the next three hours, Thomas stood quietly at Blalock’s right shoulder, watching carefully as the surgeon’s scalpel and needles moved in and out, and offering helpful suggestions. Because of Thomas’s surgical expertise, and his exhaustive knowledge of the procedure, Blalock insisted that he be present for the first 100 operations. According to McCabe, if any operating room staff member attempted to move into the space behind Blalock’s right shoulder, the surgeon would deliver the quick admonishment, “Only Vivien is to stand there.”

In addition to providing invaluable help to Dr. Blalock in the operating room, as head of the surgical research laboratory at Johns Hopkins, Thomas helped to train a generation of surgeons and lab technicians. “For the residents and research fellows who worked in the Surgical Hunterian Laboratory, Vivien’s ability to teach us the newly evolving techniques in vascular and cardiac surgery was unique,” wrote Dr. David C. Sabiston in the Journal of the American Medical Association. “He always provided willing advice and assistance, and our respect and admiration for him were no less than that of our professors.”

Thomas was also regarded as the Johns Hopkins veterinarian because of his tremendous success in treating both lab animals and pets belonging to students and staff. At one point, his reputation was such that practicing vets in the Baltimore area called on him for consultation. Yet, despite his hard work and many talents, Thomas remained largely invisible at Johns Hopkins and earned little more than a mediocre income. Not until he announced his intention to leave the university to accept a more lucrative job as a carpenter did the hospital offer to double his salary. Thomas then agreed to stay.

Honored by Colleagues

By the time Dr. Blalock died in 1964, Thomas had come to terms with the fact that he had never obtained a college degree. He continued to supervise the surgical research laboratories at Johns Hopkins until his retirement in 1979. As time went on, however, he became more embroiled in teaching and administrative responsibilities, and less involved in surgical research. He was genuinely surprised, and deeply moved, in February of 1971, when a large group of surgeons from around the country—members of the elite group of residents he and Blalock had helped to train—gathered in the auditorium at Johns Hopkins to pay tribute to his life and accomplishments.

After the ceremony, Thomas’s portrait, commissioned by his former students, was unveiled and hung in the foyer of the Blalock Building. “We could not let Vivien recede into the misty past,” Dr. Rollins Hanlon, former president of the American College of Surgeons, was quoted as saying in Reader’s Digest. “He was a person whose impact was enormous.” Five years later the university awarded him an honorary degree, and in 1977 he was appointed to the medical school faculty. “To have an honorary degree conferred upon me was far beyond any hope or expectation I could imagine,” Thomas wrote in his autobiography. “The ovation on the awarding of the degree was so great that I felt very small.”

In the early 1980s, Thomas’s nephew, Koco Eaton, was admitted to Johns Hopkins Medical School. Eaton, McClure reflected, was “trained in surgery by the men his uncle had helped to train a generation earlier. And he turned heads in the halls of Johns Hopkins—as his uncle had in 1941— not because he was black, but because he was the nephew of Vivien Thomas.”

Selected writings

Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock, University of Pennsylvania Press, 1985.