Touch not the heart, so said the age old medical dictum, repeated and believed for centuries by every doctor since Hippocrates. Of course, nowadays heart surgery is performed thousands of times each day across the globe. The story of that shift in thinking, that initial courage to even attempt surgery on the heart, begins in Nashville, Tennessee in 1930 and it involves the grandfather and great-grandfather of the Dijkhoffz family of St. Maarten.
The man’s name was Vivien Thomas, and he was born in 1910 in Louisiana and raised in Nashville. He graduated from that city’s Pearl High School in 1929 with plans of becoming a doctor. This wasn’t a far-fetched dream, Nashville in those days already had many black doctors, and his grades were good. His father was a carpenter and he picked up those skills, earning money for college across seven years of part-time work. That money disappeared in the financial crash of 1929, though, along with his dreams of becoming a doctor.
He found a job helping a medical researcher, Dr. Alfred Blalock, who was a brash and ambitious man with plans to understand the mechanisms of traumatic shock and develop effective treatments. Blalock ran a laboratory at Nashville’s Vanderbilt University in which he operated on dogs from the pound to learn successful surgical techniques. Thomas’ job was to sweep out the animal pens, but Blalock quickly realized the young man’s intelligence, dedication and outstanding eye-hand-coordination. Within one year Blalock had Thomas running his lab, keeping the notes and conferring on the research. His pay and job title, however, remained that of janitor.
Vivien Thomas was more than Blalock’s assistant, he was a colleague with skills and insights that were invaluable to the surgeon. Together they broke ground and Blalock became famous, while Thomas remained invisible. Blalock had a well-earned reputation for being abrasive, but Thomas, though soft-spoken and professional, managed to assert his own dignity and the two held each other in mutual respect.
By 1943 Blalock’s techniques were being celebrated; World War II was in full swing and the treatment of shock was being heralded as a life-saving innovation. He was given the post of Head of Surgery at the famed Johns Hopkins Hospital in Baltimore, Maryland. He asked Thomas to come with him to the new job, and Thomas felt compelled to go, although the decision wasn’t easy. He had become a husband to his high school sweetheart, Clara, and father to their children, two little girls that were deeply connected to the community in Nashville. They owned a home in a nice neighborhood with trees in the yard – Baltimore was a world away. But they did follow Blalock to Johns Hopkins and the unlikely collaboration continued.
Surprisingly, in those days, Baltimore was more segregated than Nashville, and Johns Hopkins was not open to seeing Vivien Thomas, a black man in a white lab coat, walking their halls. The Thomas family was not happy with Baltimore, their housing situation was appalling and they were so far from family and friends they loved. But the researchers were focusing on the work, and family’s needs were secondary. “I was ready to go back when I saw Baltimore,” remembered Clara Thomas during an interview seen in the documentary Partners of the Heart. “It was something I had to put up with,” she said with a chuckle, “and I put up with it.”
Dr. Helen Taussig soon entered the picture. This woman was one of the few female surgeons at that time and she specialized in pediatrics and cardiac care. She asked the pair of Blalock and Thomas to consider the dilemma of “blue babies” — infants born with a heart defect that keeps their bodies from getting enough oxygen, turning them slightly blue. The condition is also called cyanotic heart disease, a birth defect that at the time, was fatal.
At Taussig’s urging the research was undertaken. Blalock was a bold risk-taker, and imagined a chance to make history, but he found only a handful of physicians willing to consider surgery on the heart. The entire research workload he gave to Thomas who threw himself into collecting data on the infant hearts including documenting the sounds of the blood moving through the arteries and chambers of the heart. Thomas devised a method to replicate the condition of a cyanotic heart in one of their laboratory animals. Then he proceeded to try to cure it. Over time Vivien Thomas succeeded in mastering the technique of restoring proper blood flow to the dogs. He even designed and built a small surgical clamp for use in pediatric heart surgeries.
On November 29, 1944 Dr. Alfred Blalock is at the operating table of Johns Hopkins Hospital’s operating theatre. The hospital’s top surgeons are sitting in the audience to observe. A tiny baby named Eileen Saxon is anesthetized and laying on the table. Her skin is an odd shade of blue. This is the moment of the first ever heart surgery on a human being, but Blalock cannot proceed. To the shock of everyone in the room, he calls for Vivien Thomas to join the surgical team. Thomas reports to the operating theatre, is scrubbed up and joins Blalock at the operating table. A nurse gets him a box to stand on so he can look directly over Blalock’s shoulder and guide his every move. During the surgery Thomas quietly corrected Blalock’s actions if he strayed from the methods Thomas had perfected and he answered any question Blalock had with stunning confidence. History records that as the surgery concluded, Baby Eileen’s color immediately shifted from sickly blue to rosy pink.
Blalock’s risk paid off big time. His success put John Hopkins Hospital at the pinnacle of the medical profession. News of the successful “Blue Baby Operations” made headlines around the world. Families from across North America and Europe flooded to the hospital with their cyanotic children in need of the surgery. In the first year alone, he performed over 200 operations, always with Vivien Thomas standing over his right shoulder, offering advice. The procedure is now known to cardiac surgeons as the Blalock-Thomas-Taussig Anastomosis.
By the 1960s Johns Hopkins Hospital was doing ground-breaking research on open heart surgery. Vivien Thomas had earned his place as an instructor at Johns Hopkins, and Blalock, also teaching, was nearing retirement. In 1976, Thomas was given an honorary doctorate from Johns Hopkins and his portrait was placed in the hall of honor at the Welch Medical Library, where he had once been told he couldn’t even come in.
Vivien Thomas had a huge impact – he helped to change prevailing attitudes both in medicine and in the greater society – He proved to the medical community that African Americans are equally capable as the most prestigious white physicians. For many years he trained surgeons at Johns Hopkins, even during the turbulent times of the civil rights movement. His work was also a turning point in pediatric cardiology and changed heart surgery forever. After his and Blalock’s successes, surgeons were more willing to perform critical procedures on children and as a result many other life-saving treatments were developed.
Vivien Thomas’ granddaughter, Ursula Dijkhoffz, recalls him from her childhood in Baltimore. “My sister and I were born and raised in Baltimore Maryland and grew up with our mother, Theodosia, and her parents, Vivien and Clara Thomas. My grandfather was always hopeful that I would pursue a career as a doctor as I often walked the hallways of Johns Hopkins with him. He was the father figure in our lives and though he was very stern and serious, we have fond memories.”
Ursula regrets that her children never had the pleasure to meet their great grandfather, but told how she took them up to Baltimore every summer to share in the life of their great-grandmother, Clara Thomas, and to visit Johns Hopkins where his portrait hangs. “My sister and I knew very little about his genius or his struggles while growing up until later in our young adult lives. We didn't realize the impact that his work contributed to the medical field until much later. To us, he was our grandfather. The movie, Something the Lord Made, depicted more than his brilliance, but showed a humble man who endured without losing sight of his passion through the tough times of life. A lesson for all of us. My family and I are all proud and honored to be part of his legacy.”
Ursula and her daughters attended a ceremony last month at Vanderbilt Medical University where Thomas was honored along with two others that had contributed major impacts to the medical field. Ursula shared with WEEKender: “We are all very proud of this endeavor from Vanderbilt and I am honored that I was able to attend this event. My daughters whom were all born and raised on St. Maarten, celebrated this event along with me. They are the heirs to his legacy as his great-granddaughters.
- Maritza Dijkhoffz- General Manager of Sint Maarten Executive Business Services N.V., BIMACO Distributors N.V., and Divi Little Bay Superette
- Anisa Dijkhoffz - Credit Manager for Corporate and Investment banking at CIBC/FCIB
- Bianca Dijkhoffz - professional dancer in New York City
Thomas's legacy as an educator and scientist continues with the Vivien Thomas Young Investigator Awards, given by the Council on Cardiovascular Surgery and Anesthesiology. In 1993, the Congressional Black Caucus Foundation instituted the Vivien Thomas Scholarship for Medical Science and Research. In fall 2004, the Baltimore City Public School System opened a school in his name: The Vivien T. Thomas Medical Arts Academy. Here is a link to more information about that school in Baltimore: https://spark.adobe.com/page/hVMkbchXf0IK6/ . The Journal of Surgical Case Reports announced in January 2010 that its annual prizes for the best case report written by a doctor and best case report written by a medical student would be named after Thomas.
Want to know more? Youtube has a feature film that you can enjoy about this topic. Something The Lord Made, is a 2004 HBO film starring Alan Rickman, Mos Def and Gabrielle Union. Also there is a very good documentary on Thomas and Blalock, called Partners of the Heart, narrated by Morgan Freeman. There is also impressive reading to be found on the Vivien Thomas Wikipedia page.
Written by Lisa Davis-Burnett
