“I think he is the most untalked about, unappreciated, unknown giant in the African American community. What he helped facilitate impacted people all over the world.”

 

The hospital at Johns Hopkins University is one of the most prestigious places to practice as a medical doctor. Many major medical breakthroughs have occurred there, and, as you walk the halls on campus, you will notice numerous portraits of the prominent doctors who have trained, worked and taught at this fine institution. Two of these portraits sit side-by-side because the individuals depicted are indelibly linked.  The first portrait is of Dr. Alfred Blalock, a pioneer in cardiac surgery. Situated next to Dr. Blalock is the portrait of Mr. Vivien Thomas. However, unlike all of the other people in these portraits, Thomas was not a physician. He was a Black man with a high school education who had served as Dr. Blalock’s lab assistant for 34 years. This chapter will explain why the portrait of Vivien Thomas rightly belongs next to that of one of the leading cardiac surgeons this country has ever known. His story will also demonstrate how his overall character makes him a role model for us all.

Vivien Thomas was born on August 29, 1910, to Willar and Mary Alice Thomas. His mother was certain that she was carrying a girl, so the young couple named the baby Vivien months before the birth. The couple never changed his name. And, because Vivien’s father was a master carpenter, he naturally taught his son the trade. And from the time Vivien was 13, he worked for his father on the weekends and throughout the summers.

Vivien Thomas was mostly raised in Nashville, Tennessee during its “Jim Crow” era. This era was marked by the ugly and unjust ways that Black individuals were treated after America’s Civil War between the States. The States of the Confederacy were afraid of the power of the newly-emancipated Black population. Therefore they passed laws — called Jim Crow Laws — to subdue them.  Although this body of laws was touted as a “separate by equal” doctrine, there wasn’t much equal about it. White folk and Black folk could not eat at the same restaurants, go to the same schools, or even drink out of the same water fountains. All these things were forbidden in the South, and they did not end for 100 years. Then, the Civil Rights Acts of 1964 were passed by the United States Congress.

Despite all these barriers, Thomas set his sights on becoming a doctor. He was an honors student at Pearl High School in the graduating class of 1929. He had saved his money from the seven years he had worked for his father, and he was all set to go to Tennessee State University as a pre-med major. Unfortunately, the stock market crash of 1929 triggered the Great Depression which, in turn, would dominate the social and economic landscape of the entire United States for the next ten years. Because Thomas had kept all of his money in one of the banks in Nashville that defaulted, within a matter of days he was a broke 20-year-old kid. Thomas also found himself unable to earn a living. His carpenter skills were worthless: Because the banks had collapsed, almost no one was able to secure a loan to build houses. Therefore, Thomas’s ideas about going to college had to be put on hold, while he now had to compete against other people for jobs that simply ceased to exist after the stock market crash.

At this juncture, Thomas asked a friend if they were hiring at Vanderbilt University. The only position available at the time was a lab research assistant, working for a Dr. Alfred Blalock. Thomas gratefully accepted that job as a research assistant even though, because he was Black, he was classified and paid as a janitor. (Vanderbilt was located in Tennessee, a Southern State.) Despite his job title, within 24 hours, young Thomas was assisting Blalock with surgical experiments. Blalock was immediately impressed with Thomas’s work ethic and skills, and so he assigned more responsibilities to his young assistant. Within a few weeks, Thomas was conducting the initial parts of these surgeries by himself. Within a year, Thomas took over the lab.

Dr. Blalock’s research was focused on understanding the reasons why some people went into traumatic shock and what treatments would best save their lives. He conducted most of his experiments on dogs. The idea was to create a state of shock in these animals and then try many different procedures to save their lives. Blalock taught Thomas to document every step in the process with copious notes so that their successes could be replicated. Together, they disproved many of the traditional theories of the day while providing an alternative theory and treatment. They proved that shock was caused by the loss of blood and other fluids. They also established a new standard of care by replacing fluids in the body with water, blood, and plasma. Their discovery would save the lives of untold millions of men on the battlefields in WWII.

The relationship between Blalock and Thomas was complicated. In many ways, it captured race relations in America during the 20^th Century. It was shrouded in power imbalances based on race, education, and work hierarchy. For example, shortly after Dr. Blalock published several articles on the successful experiments, he began receiving a great deal of acclaim. Blalock obviously knew the contributions of Thomas, but he never mentioned Thomas’s name in any of those publications. This deeply hurt Thomas. Yes, he worked under the direct supervision of Blalock, and it is customary for the senior professor to receive the credit. However, Blalock fully understood that Thomas was the one conducting the day-to-day experiments.

In the privacy of the lab, the two were good friends. They were able to talk, laugh, and share ideas. Each was free to fully argue their points without society casting judgment. Outside the lab, however, it was all “Jim Crow.” Both men were constrained by societal boundaries. All the students at Vanderbilt University were white. The entire faculty was white. Black people served as janitors, cooks, and secretaries. There were no exceptions. Blalock understood the value of this fine young man working by his side, but he also knew that Black individuals could not possess a job title higher than janitor. This reality created a major strain on their working relationship. This became more pronounced in 1933 when Thomas married Clara Beatrice Flanders. As the main breadwinner, Thomas soon had to provide for his wife and two daughters, which was difficult on a “janitor’s” salary.

Meanwhile, Blalock’s name was bantered about by universities that wanted to hire the new hot-shot doctor. With each offer that came in, Blalock always made it a condition that  Thomas accompany him. In 1941, Johns Hopkins University accepted these terms. Blalock was subsequently hired as Chief of Surgery and Thomas was hired to run the research laboratory.

Thomas was ambivalent about the move to Baltimore. “I didn’t know what to expect at Hopkins,” stated Thomas. “It would mean leaving our community and the house that I had built with my own hands. But we were young and hoped that big things lay ahead.” Mrs. Thomas had other thoughts when she arrived in the big city. “I was ready to go back when I saw Baltimore,” reflected Clara. “All I wanted to do was get out as fast as I came in. It was something I had to put up with and I put up with it.” It turns out that the race relations of Baltimore were not much different from the deep South. Historian Fraser Smith observed, “There were just as many exclusions for Black people in the city of Baltimore as there were anywhere else. In some ways, they were worse and more pronounced and divided.”

Johns Hopkins University was no exception to the rule. The university was very segregated and so was its hospital. Moreover, raised in southern Georgia, Dr. Blalock was not opposed to segregation and he had white Southern attitudes about race. Therefore, Blalock had to hold two separate thoughts as true in his head at the same time: His beliefs and stereotypes about the inferiority of Black people in general and his respect for Thomas as an individual. Indeed, Blalock fully understood that he could not succeed without Thomas by his side.

So, Blalock did fight for Thomas. For example, when Thomas could not find acceptable housing in Baltimore, Blalock invited him to live with his family for several months. Blalock also gave Thomas the finest white lab coat to wear at work, which directly contrasted with the strict dress codes and norms of the university. Over the years, Blalock also fought for job titles and pay grades commensurate with Thomas’ duties. These attempts were not always successful, but he did try.

As the chief of surgery at Hopkins, Blalock was looking for a new research project that was worthy of his time. One day, Dr. Helen Taussig, chief of pediatric cardiology walked into Blalock’s office to discuss the congenital heart disease of the babies in her care. Because these babies’ hearts could not circulate blood throughout the body, they were left with a blue complexion. She called these patients, her “Blue babies.” This condition was essentially a death sentence for these babies because medical professionals had no viable treatment. Thousands of blue babies were born every year and their parents were desperate for a cure.

Blalock agreed to make this medical issue the top priority at the lab. However, at the time, treating the heart was off-limits for doctors. It was viewed as taboo to do surgery on the heart. Doctors weren’t supposed to “play God.” Blalock, however, was just the kind of person to challenge the norms of the medical establishment. Of course, as chief of surgery, he had many responsibilities in the hospital. He could supervise the research, but Thomas was left to run the daily experiments. “They came up with a very ingenious idea of connecting an artery that sent blood out into the body to an artery that brings blood into the lungs,” wrote historian Wayne Miller. “By doing that, they added significantly more oxygen to the blood.”

The first task was to find medical devices that could facilitate such an experimental procedure. They quickly discovered that these devices did not exist. Fortunately, Thomas’s background in carpentry came in handy for this task. He created the instruments himself, which would later become standard surgical equipment used in hospitals across the world. And, like other medical research hospitals, at Vanderbilt dogs were used to test their theories. So Thomas set out to reproduce the “blue baby syndrome” in these dogs and then he sought to perfect a procedure to save their lives. After months of trial and error, and over 100 successful surgeries on these dogs, Thomas developed a procedure that consistently worked.

Nearly every day, Thomas would update Blalock on the progress of the research. The relationship was a real give and take; Each person respected what the other brought to the table. One day, Dr. Blalock examined an incision that Thomas had made earlier in the day. Blalock asked, “Vivien, are you sure you did this? This looks like something the Lord made.”

The pair felt confident that they were ready to perform this operation on humans and begin saving lives. Eileen Saxon was an infant who weighed a fragile nine pounds. Dr. Taussig was sure that she would die within the next few days without intervention. Other doctors thought this little girl was too frail to survive the surgery. In fact, when the anesthesiologist saw this tiny patient, he refused to participate. Of course, Blalock fully understood the risks of this experimental surgery, but he — logically — determined that this was Eileen’s only hope for survival. The surgery was set for the next day.

What’s true in 1944 is true today. Someone without a medical degree and proper credentials was not going to operate on a human in a hospital. The surgery was left to Dr. Blalock. So, at 8 am on November 29, 1944, Dr. Blalock and his team prepared Eileen for surgery. Other doctors watched from the balcony seating that surrounded the operating room. However, Thomas was not present. “Where is Thomas,” shouted Blalock. “Go get him.”  The reason was obvious. Thomas had performed this procedure over 100 times while Blalock had only successfully performed this surgery one time from start to finish.

At Dr. Blalock’s insistence, Vivien Thomas stood on a small step stool just behind him, and guided him through the procedure. Surgery was much more primitive in those days. Vital signs like heart rate, blood pressure, and oxygen could not be measured during surgery. Blalock was flying blind, except for the guiding words of Thomas. The two men who could not share the same lunch table at the university now stood elbow to elbow, making ground-breaking medical history. No one knew if this surgery was going to save Eileen’s life. The outcome would only be revealed when the team removed the arterial bulldog clamps after surgery. Within seconds of doing so, Eileen’s cheeks and lips turned a rosy pink color. Blood flow began racing through her body. It was like a miracle. Dr. Alan Woods who was present that day reflected, “I can’t even talk about that day without emotion. Everybody was crying.”

The success of this procedure put Johns Hopkins on the map. Surgeons from all the over the world came to this hospital to learn this ground-breaking procedure, eventually named the Blalock-Thomas-Taussig Shunt.  Moreover, desperate parents came from all over the world for the slim chance that Dr. Blalock could save their children. In the first year alone, doctors at Johns Hopkins School of Medicine performed over 200 life-saving surgeries while becoming the most famous department of surgery in the world.

And so, the relationship between the two men continued. “They depended on each other and each knew the other’s important strengths and roles and they simply leaned on each other,” recalled Dr. Alex Haller, then Johns Hopkins’ famed professor of pediatric surgery.  Indeed, if any doctor stood behind Blalock’s right shoulder during surgery, Blalock would loudly announce, “Only Thomas is to stand there.” Thomas’s responsibilities grew as well. Every surgeon in training was required to study surgical techniques under Vivian Thomas. And, as director of the surgical research laboratory, he was responsible for the surgical training of individuals who were handpicked by Dr. Blalock. Over the years, these highly trained doctors became known as “The Old Hands Club.”

One such member, Rowena Spencer, became Thomas’ assistant. Spencer became the first female surgical intern to work for Blalock, and one of the first female pediatric surgeons in the country. She relayed a story that she has repeated during her successful career: “Many times during my career I was complimented on my surgical technique, and I will admit that a good many people were shocked when I told them that I learned my surgical technique from a Black man who had only a high school education.”

And, while Thomas received a substantial raise and a new job title at Johns Hopkins, no one outside of this small circle of doctors knew his name or understood his contributions. Once again, as the research papers were published, the name Vivien Thomas was never mentioned. Worse, when parties were held to celebrate their achievements, Thomas attended, but as a bartender. Blalock looked at this gig as a way for Thomas to make some extra cash, and on some level, Thomas appreciated the opportunity. However, it put Thomas in a strange scenario whereby he was training individuals during the day and then serving them their drinks at night. More than anything, this moonlighting job drew a stark line between the white doctors and the Black man without a degree.

Thomas knew that he had what it took to be a doctor, but he also knew that he would have to attend 4 years of college, then go to medical school, and then perform a 4-year internship. Embarking on this adventure as a 40-year-old man meant that he would be older than 50 when he could begin to officially practice medicine. Still, in 1947 Thomas briefly enrolled as a freshman at Morgan State University, but he was devastated to learn that the university would not count any of his life experience as course credits. “He had a family and children,” commented family friend, Gwen Manlove Clarke. “He knew that he was going to let the dream of going back to college go. And that hurt. That was very crushing.”

Meanwhile, Blalock was receiving worldwide fame. He traveled throughout Europe to show the “blue baby” surgery to doctors. He attended parties and received honorary doctorates at major institutions. This type of pomp and circumstance went on for years. In 1948, Blalock was honored with the Baltimore “Man of the Year” award. In 1955, Blalock became chairman of the medical board of Johns Hopkins Hospital and held that position for 9 years. Finally, Blalock retired from Hopkins in 1964 because of health problems. His retirement occurred two and a half months before his death.

Ironically, as Blalock lay dying, the Civil Rights Acts of 1964 were passed. This meant that Johns Hopkins University and numerous other educational institutions were to be desegregated. Nevertheless, Thomas knew that his own time had passed to become a doctor. Instead, he became a mentor to promising young Black doctors who had set their sights on Johns Hopkins’ now internationally famous School of Medicine. One of these young African-Americans was Dr. Richard Scott who proudly said, “Thomas was the first male African American that was operating in an operating room – albeit the surgical research laboratories – who I could relate to.” Later that young man would return to Johns Hopkins and become their first Black surgical intern. “He was my initial supporter, said Dr. Scott. “It was a result of his encouragement that I was able to persevere in some of my career choices.”

On February 27, 1971, life began to turn full circle for Vivien Thomas. In a unanimous voice, members of Blalock’s “Old Hands Club” had quietly commissioned Thomas’s portrait and arranged to have it hung next to Blalock’s portrait in the lobby of the Clinical Sciences Building. They then invited Thomas, his family and his friends to a function. The purpose of this function was not disclosed, but people could tell that something monumental was about to happen. When they unveiled his portrait, Thomas modestly protested by saying, “This is not appropriate.” The moderator assured Thomas that he was wrong: “Oh, it’s most appropriate.” Thomas was then invited to the podium to give an impromptu speech. During his remarks, he said, “People in my category are not accustomed to being in the limelight as most of you are.  Being placed in the position I find myself now, makes me feel quite humble. But, at the same time, just a little proud.”

Nearing 60, Thomas began to receive the public attention that he so rightly deserved. On Graduation Day, in 1976, he received an honorary doctorate from Johns Hopkins. He was called “a man of the finest traditions of Johns Hopkins.” After 37 years at Johns Hopkins School of Medicine, Thomas was officially recognized as a teacher and was appointed to the school’s faculty. In 2005, Johns Hopkins School of Medicine began the practice of splitting incoming first-year students into four colleges, each named for a faculty member who had a major impact on the history of medicine. Vivian Thomas was chosen as one of the four names to represent those colleges.

It took a while for Johns Hopkins to catch up and understand the injustices they had perpetrated on the now-Doctor Vivien Thomas. On so many levels, these highly intelligent individuals had to know that Thomas should have been celebrated right alongside Alfred Blalock. Without any formal medical training or medical school, he helped to save the lives of so many people. Dr. Levi Watkins, Thomas’ first Black medical intern, looked upon Thomas as a man of great character:

I think the implications are extraordinary. Take a man like this, without much from anything, that impacts on inventions and also impacts on the nation’s premier heart surgeons. I look at him as a global person that rose above the conditions of his time.

…I think he is the most untalked about, unappreciated, unknown giant in the African American community, said Dr. Levi Watkins. “What he helped facilitate impacted people all over the world.

It also had taken a long time for America to catch up. Twenty years ago, most Americans had never heard of Vivien Thomas and the enormous contributions that he had made to medical science over his career. However, in 2003, the Public Broadcasting System (PBS) televised Partners of the Heart, a documentary that highlighted the long-term, complicated relationship between Blalock and Thomas. One year later, HBO released the movie “Something the Lord Made” to rave reviews.

Thomas passed away at the age of 75 after suffering from a stroke. However, before he passed, he was able to witness his nephew being admitted to medical school at Johns Hopkins. And, two days after he died, his autobiography Partners of the Heart was published.

Discussion Questions:

1. In your own words, try to explain the complicated relationship between Blalock and Thomas.
   1. What factors allowed the relationship to unfold as it did?
   2. If Dr. Blalock knew how Thomas felt, why didn’t he fight harder for his advancement and respect?
   3. Why did Vivien Thomas agree to remain employed for so long under those conditions?
   4. Given how times have changed since then, how do you think a black man with all of this character and talent would be treated today?
2. Explain how Thomas must have felt when he was not given any credit in the research articles or at the university for his contributions to the Blue Baby experiments? Conversely, how did he feel at the end of his career when the pay raises, promotions and accolades came his way?
3. What inspires you about Vivien Thomas and how can his life make you a better person?