March 9, 2023

Lecture gives new insight on surgery icon Thomas

Vanderbilt’s recent H. William Scott Jr. Lecture in Surgical History offered unfiltered insight on the legacy of surgical pioneer Vivien Thomas.

Robert S.D. Higgins, MD, MSHA, center, with Seth Karp, MD, left, and Sunil Geevarghese, MD.
Robert S.D. Higgins, MD, MSHA, center, with Seth Karp, MD, left, and Sunil Geevarghese, MD. (photo by Donn Jones)

The legacy of surgical pioneer Vivien Thomas, with unfiltered insight gleaned directly from his personal writings, was celebrated during the recent H. William Scott Jr. Lecture in Surgical History that was presented by Robert S.D. Higgins, MD, MSHA, president of Brigham and Women’s Hospital and executive vice president of Mass General Brigham.

The event kicked off the 50th anniversary celebration of the H. William Scott Jr. Society, a Vanderbilt University Medical Center organization established in 1972 to honor Scott, who served as chair of the Department of Surgery from 1952 until 1982.

Thomas, an African American man living in Nashville, worked as a Vanderbilt laboratory assistant with Alfred Blalock, MD. Blalock and Thomas began experimental work in hemorrhagic shock and pulmonary hypertension, and Thomas created and mastered complex surgical techniques. When Blalock was offered the position of chief of surgery at Johns Hopkins in 1941, he insisted that Thomas join him.

There, Thomas was charged with creating a ‘blue baby’-like condition (cyanosis) in a dog, then correcting the condition by means of a subclavian artery to pulmonary artery anastomosis. In 1944, Thomas guided Blalock through the first such procedure in a human.

Thomas’ time at Vanderbilt and his contributions to cardiac surgery have been noted in many historical accounts and retold in both the PBS documentary “Partners of the Heart” and in an HBO movie, “Something the Lord Made.”

But Higgins felt there was much more of the “complicated history” of Thomas that needed to be told. Higgins received a grant from the Andrew Mellon Foundation, and he and a small team of researchers pored through more than 1,000 pages of Thomas’ writings — including laboratory notebooks, personal correspondence and draft revisions of Thomas’ autobiography — to compile a more detailed picture of Thomas, his work and his relationship with Blalock. Higgins noted that Thomas was the “first person of color to have his personal files collected and preserved” in the Alan Mason Chesney Medical Archives at Johns Hopkins.

“He really was famous in helping to create a field that didn’t exist,” Higgins said. “And he partnered with Blalock and [cardiologist Dr. Helen] Taussig to do so when he was in a structured, racially exclusive space. There was discrimination and Jim Crow laws, and they maintained the order of things in Baltimore at the time. Thomas was prevented from having full rights as a surgeon or as a scientist, which created barriers to his full acceptance. In spite of those barriers, they worked together to create a new horizon for the cardiac surgery world.”

Higgins is no stranger to making history himself. An internationally renowned heart-lung transplant surgeon, Higgins followed in the footsteps of his father, Robert Higgins Sr., MD, who was one of first African American physicians in Charleston, South Carolina. His parents met in Nashville in the 1950s when his mother attended Fisk University and his father attended Meharry Medical College, then one of the few medical schools in the country to admit African Americans.

In 2015, Higgins became the first African American to lead any department at Johns Hopkins as he was named chair of the Department of Surgery at Johns Hopkins University School of Medicine.

Viewing the world through this lens understandably energized Higgins as he unearthed clues about how discrimination, racism and the socio-political climate of the time affected Thomas and his work.

Higgins learned one of Thomas’ sponsors and an individual he trained in the lab, Johns Hopkins surgeon Mark Ravitch, MD, encouraged Thomas to be candid when he penned his autobiography, “Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and his Work with Alfred Blalock: an Autobiography.” In a letter to Thomas, Ravitch wrote, “This is your story, it is history and I think you have got to be free to write it as you wish.”

As Thomas reflected on revisions to his autobiography, he wrote, “I only want enough emphasis on the race issue to show what a ‘fly in the buttermilk’ situation (smiles) I was in.” And in 1985, Thomas wrote, “I didn’t know if Hopkins had a policy about hiring Negroes in certain positions and capabilities, but if I delivered, they couldn’t use me as an excuse to not hire Negroes.”

In the end, Higgins said Thomas’ autobiography remained “a censored version of events, palatable to contemporaries and the institution.”

Higgins noted several efforts in recent years to better acknowledge Thomas’ achievements and contributions to cardiac surgery. He pointed out that in operating rooms around the world there are “surgeons performing lifesaving surgical procedures who received their training from Vivien Thomas.”

In 1976, Hopkins awarded Thomas an honorary doctor of laws degree, and an appeal is gaining ground to add his name to the groundbreaking procedure he helped pioneer so it would be known as the Blalock-Thomas-Taussig shunt. In 2021, a street on the Vanderbilt University campus formerly known as Dixie Place was renamed Vivien Thomas Way.

Also in 2021, Michael Bloomberg contributed $150 million to establish the Vivien Thomas Scholars Initiative at Johns Hopkins to address underrepresentation of individuals of diverse backgrounds in science, technology, engineering, and mathematics (STEM). The initiative provides permanent funding for PhD students to attend Johns Hopkins STEM programs.

“We honor Vivien for all of his contributions,” Higgins said. “Even though in life he might not have received the recognition he deserved, he certainly is receiving it now.”