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Vol. LVII, No. 19
September 23, 2005
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Stellar Night at the Movies
Something a Partnership Made: Medical History

If Vivien Thomas visited NIH today, he would walk through the main entrance of the Clinical Research Center. Our most eminent surgeons and scientists might greet him. From the podium in Masur Auditorium, he would present his latest research findings to a mix of students, postdoctoral fellows, scientists and clinicians of varied races and nationalities. Afterward, he might mingle with the audience for further discussions or talk with other NIH researchers over lunch. Yet during the life and times of Vivien Thomas, none of that would have happened.

 
On hand at the recent OSE-sponsored film were (from l) Dr. J. Alex Haller (guest speaker at Science in the Cinema); Clayton LeBouef (who played Vivien Thomas’s brother in the film); Jessica Floria (who played a pediatric patient at Hopkins); John Leslie Wolfe (who played Dr. Walter Dandy, leading surgeon at Hopkins); and Kate McCabe, who wrote the article on which the film was based.  
The incredible accomplishments of Thomas and his colleagues are depicted in the HBO docudrama Something the Lord Made. The film was recently screened for the Office of Science Education's "Science in the Cinema" program to a crowd at the American Film Institute's Silver Theater in Silver Spring. The event went beyond its usual scope because of the film's poignant content and special guests in attendance.

The film tells a true story in which medical science, history and sociology converge. It follows the 34-year association of two men who overcame social stigma and developed a revolutionary technique that would save countless lives.

In 1930, Vivien Thomas was a 19-year-old African American carpenter who dreamed of going to medical school. Dr. Alfred Blalock was a white surgeon and a rising star among his peers. In the lab, Blalock asked the scientific questions. Thomas figured out the best ways to find the answers. With only a high school education, Thomas assumed the role of a senior research fellow and developed into a talented surgical technician. He devised unique surgical instruments and worked out complex techniques in animal models. The film's title comes from Blalock's remarks about the nearly flawless healing of a surgical incision Thomas made in a canine heart.

The pair's achievements are even more remarkable because of the setting in which they took place. It was an era marked by the Great Depression, World War II, racial tension and segregation. The young lawyer Thurgood Marshall had just begun to champion the cause of civil rights and the desegregation of schools. So in 1941, when Blalock and Thomas came to Johns Hopkins University from Nashville, people stared at Thomas in his white lab coat. At that time and place, black employees were janitors and had separate building entrances and rest rooms. This unusual duo was about to open a lot of previously locked doors in medicine and society.

Helen Taussig, a pediatric cardiologist at Hopkins, approached Blalock for help with her "blue babies." These patients have a congenital syndrome — tetralogy of Fallot — that limits blood flow to the lungs. The resulting lack of oxygen makes their skin appear blue. Blalock accepted the challenge and began to work with Thomas on developing a corrective procedure.

In 1944, Blalock performed surgery on a young girl while Thomas stood behind him, coaching him through the procedure he had perfected. By rearranging blood vessels, the team turned the blue baby pink again. That first successful operation launched the modern field of cardiac surgery and simultaneously rattled the social status quo.

Following the film, the Science in the Cinema audience was treated to an insider's perspective. The guest speaker and expert in the film's medical subject was Dr. J. Alex Haller, emeritus professor of pediatric surgery, pediatrics and emergency medicine at Johns Hopkins Hospital. Haller had trained with Blalock during his residency and had first-hand knowledge of the events portrayed in the film. He spent over 100 hours as a consultant to HBO producers during the making of the movie. Also present were three actors from the film and Katie McCabe, who wrote the award-winning article on which the film was based ("Like Something the Lord Made," Washingtonian magazine, 1989).

Haller added his own stories to those presented in the film. He emphasized a point he felt was not made clear. He said that Thomas's "role as the teacher of medical students, residents and junior faculty members was a critically important part of the training of cardiac surgeons at John Hopkins. He trained many technicians and helped other doctors in their research, including those at NIH."

Haller spent a year working in an NIH research lab with Alfred Casper. Both men had trained at Johns Hopkins and were working on a study involving heart-valve abnormalities. During a canine surgery, Haller skillfully halted a serious bleeding episode. "That was beautifully done," Casper said. Haller replied that he had "trained with Alfred Blalock." On a subsequent occasion, Casper managed a more severe bleeding problem. "That was fabulously done," remarked Haller. Casper replied, "with a twinkle in his eye, 'I trained with Vivien Thomas.'"

The audience learned more through a question-and-answer exchange with Haller. In response to a question about the use of animals in research, Haller recalled an incident from the 1950s when Taussig received a standing ovation from a crowd of animal rights activists in Baltimore. Holding her poodle in her arms, she said, "He's alive because of what we have learned about human congenital heart abnormalities." Thomas and Haller had performed life-saving surgery on the dog.

Haller confirmed the Blalock-Thomas partnership. "The relationship was different outside the hospital as was typical of our society then. Vivien was treated just like a colleague. On the other hand, they [Thomas and Blalock] had different bathrooms."

McCabe praised the film's accuracy and subtlety in portraying the diverse social worlds of the principal characters. "That's one of the beauties of film. You can create a context of the social environment...without a single line of dialogue," she said. She also gave high praise to the script writer, Peter Silverman, who was able to capture the nuances of the Blalock-Thomas relationship.

If Thomas visited NIH today, he'd be stepping into a new world — one he helped pioneer.

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