Vivien Thomas' life and legacy are rife with colors – black, white and blue. A poor Black man and grandson of an enslaved person, Thomas was classified as a janitor at Johns Hopkins University but donned a white lab coat and eventually played a crucial role in developing surgical techniques to overcome tetralogy of Fallot, a cause of blue baby syndrome.

Thomas was born in Louisiana in 1910. While he never realized his dream of going to college and medical school, losing his college savings during the Great Depression, he became a scientist and educator and the teacher of many cardiac surgeons who went on to head surgery departments across the U.S.

Thomas' natural talent and dexterity for surgery quickly became apparent when he began working in 1930 as a laboratory assistant to Alfred Blalock, MD, at Vanderbilt University. On his first day, Thomas assisted Blalock with a surgical experiment on a dog and was soon performing similar procedures on his own.

Performing the work of a postdoctoral researcher, Thomas became an essential part of Blalock's research into the causes and treatment of hemorrhagic and traumatic shock, which evolved into the study of crush syndrome.

Blalock's respect for Thomas' work and intellect led him to reject a job offer when he was not allowed to hire a Black man. Eventually, in 1941, Blalock became surgeon-in-chief at Johns Hopkins University, with Thomas as his assistant, at a time when a Black man wearing a white coat walking across a still-segregated campus was noticed.

The Blalock-Thomas-Taussig Shunt

A failed experiment to treat hypertension became the starting point for finding a treatment for cyanotic "blue" babies. When Helen Taussig, MD, a Johns Hopkins cardiologist, asked Blalock and Thomas for help in finding a treatment for babies with tetralogy of Fallot whose lack of blood oxygen led to weakness and death, they revisited the vascular surgery techniques they had used in the hypertension experiment.

Using the procedure, they joined the subclavian artery to the pulmonary artery to increase blood flow to the lungs. Thomas studied the minute heart specimens of infants at the Hopkins pathology museum for a year before he could reproduce the four-part anomaly of tetralogy of Fallot in a dog's heart.

Over two years he worked on 200 canines to demonstrate that joining the arteries was not fatal, so Blalock could duplicate the Blalock-Thomas-Taussig shunt in a human patient.

Clinical Topics: Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Prevention, Congenital Heart Disease, CHD and Pediatrics and Prevention, Hypertension

Keywords: ACC Publications, Cardiology Magazine, Pulmonary Artery, Subclavian Artery, Tetralogy of Fallot, Shock, Traumatic, African Americans, Laboratories, Crush Syndrome, Surgeons, Aorta, Hypertension, Cultural Diversity, Racism, Inventions

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