In 1945, a Black laboratory assistant named Vivien Thomas collaborated with two white physicians on a landmark procedure for treating cyanotic heart disease, which can cause “blue baby syndrome.”
Thomas’ contributions to the development of what’s long been known as the Blalock-Taussig (B-T) shunt—a surgical rejoining of the subclavian or innominate artery to a pulmonary artery—were overlooked by medicine for decades.
Thomas, who died in 1985, deserves some posthumous justice, according to Kathleen Blake, MD, MPH, former AMA Senior Adviser and Clyde W. Yancy, MD, MSc, the vice dean of diversity and inclusion and chief of the cardiology division at Northwestern University Feinberg School of Medicine.
Drs. Blake and Yancy co-wrote an article published in JAMA Surgery to explain why the B-T shunt’s name should be changed to the Blalock-Thomas-Taussig shunt—a version of the eponym that is already surfacing in the medical literature. The Vivien Thomas story also inspired a 2004 HBO TV movie, “Something The Lord Made.”
The procedure’s development “was an eruptive moment” in the history of medicine and Black history, said Dr. Yancy. In an AMA video interview, Dr. Yancy detailed the article and shared more about Thomas’ journey—and the importance of recognizing Black pioneers in medicine.
“Opportunities were limited”
Thomas never received any formal training in laboratory work or medicine. “He started life very poor with nothing but a dream, trying to find a way to get to med school,” said Dr. Yancy who also serves as a deputy editor of JAMA Cardiology.
Most medical schools in the early 20th century did not admit Black students or others from historically excluded racial and ethnic groups. “Opportunities were limited. Those persons like Vivien Thomas seeking medical education thus had an artificial and very difficult barrier to realize their dream.”
Thomas did reach his potential, however. “That's an important part of the story,” said Dr. Yancy, an AMA member.
Wartime conditions inspired procedure
Thomas worked in conjunction with Alfred Blalock, MD, and Helen Taussig, MD, at Johns Hopkins University to develop the shunt, which was inspired by events of World War II.
“They were keenly focused on the exigencies of the time, meaning young men were away at war and were exsanguinating on the battlefield because of injury,” explained Dr. Yancy. Dr. Blalock was looking for a lifesaving, quick procedure appropriate for field applications.
In his examination of pulmonary circuitry, Dr. Blalock had an epiphany with Dr. Taussig.
They had the notion that “maybe these surgeries that we're working on to resuscitate those that are going through hemorrhagic blood loss might be appropriate for these children that are dying at such an early age from cyanotic heart disease,” said Dr. Yancy.
Thomas had that spatial perception, the understanding of how to make this work, said Dr. Yancy. Working together, Thomas and Drs. Blalock and Taussig developed the surgical procedure to redirect blood flow so that oxygenated blood could enter the cardiovascular circulation in cyanotic children.
Long-overdue recognition
The procedure “was a substantial breakthrough and it began the process of saving lives for the classic blue baby syndrome,” Dr. Yancy said.
“That's where we go back and revisit the pain and the challenges that Vivien Thomas experienced—being accepted as more than just an orderly or an aide, but as a scientist,” said Dr. Yancy.
Thomas and his contributions went unmentioned in the original JAMA report on the procedure, co-written by Drs. Blalock and Taussig.
“When it was revisited some years later, he still wasn't mentioned,” said Dr. Yancy. It wasn’t until 1976 that Johns Hopkins awarded Thomas an honorary doctorate and named him instructor of surgery at the medical school.
“It's consequential that we are making the effort to really bring Vivien Thomas' name into the references of the Blalock-Taussig shunt,” he added.
Learn more with this JAMA article, “The Blalock-Taussig-Thomas Collaboration.”
Why this Black history matters
Introducing positive biases is one of the most effective tools to address implicit bias stereotyping. Recognizing that Vivien Thomas, a Black man, was predominantly responsible for a lifesaving procedure that helped thousands of children might change people’s perspectives, said Dr. Yancy.
“If you think about other contributions of individuals self-described as Black or African American and realizing that those contributions changed the life and living circumstances for many, then the positive bias shows up,” providing a counterweight for any subconscious biases, he said.
