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The Hidden History of Vivien Thomas and Racial Bias in Medicine


Joseph L. Wright, MD, MPH, FAAP
November 22, 2019

At last year’s American Academy of Pediatrics Annual Leadership Forum workshop, I had the privilege of introducing Gail Christopher, DN, a renowned scholar and advocate for health and racial healing. As a prelude to her workshop, “Overcoming the Belief in a Hierarchy of Human Value:  How Pediatricians Can Help All Children Thrive, Dr. Christopher shared the story of her infant daughter, Ntianu, who succumbed in 1971 to the congenital heart defect, Tetralogy of Fallot (blue baby syndrome).

Doctors who diagnosed the condition said nothing could be done and told the young parents of color to take their baby home. Ntianu died six weeks later.

I sat on the dais that afternoon listening to Dr. Christopher relate her family’s tragic experience, stunned knowing that the procedure that could have corrected her daughter’s defect, the Blalock-Taussig shunt, had actually been developed in the 1940s. Dr. Christopher subsequently became aware of inequitable access at the small hospital in their racially segregated community to life saving procedures, such as the Blalock-Taussig shunt, and the fact that this access had clearly been denied to them.  


The further irony of Ntianu’s story is that the surgical technician principally responsible for the experimental development and procedural perfection of the Blalock-Taussig shunt was an African American man whose contributions have largely gone unrecognized. As I rose to the podium to facilitate transition of our workshop from didactic to interactive, I briefly debated whether to share my own reaction to this irony, given the personal sensitivity of what Dr. Christopher had just related. However, inspired by her courage, I chose to leverage the moment to offer to the leadership audience of pediatric colleagues, the hidden story of Vivien Thomas.

Dr. Joseph Wright recounts the “hidden history” of Vivien Thomas and the surgical procedure he developed that could have saved #AAP2019 plenary speaker Gail Christopher’s infant daughter, who died in 1971 from blue baby syndrome. #AAPvoices #RacismAndHealth

I consider Vivien Thomas (1910-1985) a late-in-career inspiration. I remember feeling viscerally incensed in 2003 when, as a senior academic pediatrician with responsibility for training the next generation of learners--and who, over a twenty-year period, had participated in the care of dozens, if not several hundred, babies with congenital heart disease--I realized I had until then been totally unaware of the true story behind development of the corrective procedure for the blue baby syndrome.

I first learned of Vivien Thomas from the PBS documentary, "Partners of the Heart," which details the partnership between Dr. Alfred Blalock, considered the father of modern cardiac surgery, and Thomas, a talented carpenter from Nashville, Tennessee. Blalock hired Thomas as a laboratory assistant in 1930 while at Vanderbilt University and, over the ensuing decade, the two conducted a series of groundbreaking experiments focused primarily on the treatment of hemorrhagic shock, developing a number of novel animal models.  As Blalock’s academic obligations began to limit his physical presence in the lab, Thomas assumed greater responsibility for refinement of the experiments. In 1941, Blalock was recruited back to his alma mater, Johns Hopkins, and Thomas accompanied him re-establishing their surgical lab in Baltimore.

At Hopkins, the collaboration of Blalock and Thomas with pediatric cardiologist, Helen Taussig, resulted in development of a groundbreaking surgical procedure to correct the Tetralogy of Fallot.  Thomas was responsible for perfecting the anastomotic modeling, teaching the technique to Blalock, even creating the surgical instruments to perform the delicate operation.

In November 1944, the first surgery on a baby to correct the Tetralogy of Fallot was successfully performed by Blalock, with Thomas guiding at his side, changing the landscape of medicine forever.  Thomas later trained a generation of surgical residents in his lab at Hopkins, including Drs. Denton Cooley and William Longmire, who went on to define cardiovascular surgery in this country as we know it today.

“Broad exposure at NCE to the particular hidden history around development of what should clearly be called the Blalock-Thomas-Taussig shunt--and a condition that is so fundamentally pediatric--reminds me of just how important it is to be fully transparent about structural inequities, their root causes, and the beliefs that perpetuate them.”


Despite the private respect Blalock may have had for his surgical technician, there was no acknowledgement of Thomas’ contributions, not even a footnote.  He was not publically recognized until 1976, when Johns Hopkins University awarded him an honorary doctorate, fully twelve years after Blalock’s death.

Fast forward to the recently completed AAP National Conference and Exhibition (NCE).  As part of a plenary adaptation of her earlier workshop, Dr. Christopher reprised her personal story. Today, she refers to her daughter as an “angel who came into my life and started me on my trajectory to work toward racial healing.”

Broad exposure at NCE to the particular hidden history around development of what should clearly be called the Blalock-Thomas-Taussig shunt--and a condition that is so fundamentally pediatric--reminds me of just how important it is to be fully transparent about structural inequities, their root causes, and the beliefs that perpetuate them.

As the AAP focuses on a heightened equity agenda, we all need to be authentically honest about recognizing discrimination challenges in our own histories, in our own communities, and in our own perspectives no matter where we personally believe we may, or may not, be on the bias spectrum.

 
* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.


About the Author


Joseph L. Wright, MD, MPH, FAAP, is an at-large member-elect of the AAP Board of Directors and immediate past Chair of the AAP’s Task Force on Addressing Bias and Discrimination.  He is also Chair of the AAP Committee on Pediatric Emergency Medicine. He is President and Chief Executive Officer (interim) of Capital Region Health within the University of Maryland Medical System and has been recognized throughout his career for his advocacy and community engagement work.