Vivien Thomas's path to fame

Thanks to a December Baltimore Banner article by Leslie Gray Streeter about the popularity on TikTok and YouTube of Vivien Thomas, the self-taught pioneering African American surgeon, Baltimoreans are discovering and re-discovering the 2004 HBO movie about his life, Something the Lord Made.

A friend who saw the movie for the first time asked if I had known of it, since my book, A Heart Afire, a biography of the pediatrician Helen Brooke Taussig, details some of Thomas’s work at Johns Hopkins hospital with the surgeon Alfred Blalock to develop lifesaving heart surgery for her patients.  

 Yes! The movie was based in part on Thomas’s 1985 memoire, a source I consulted to learn about the surgery and Helen’s role in it. It’s an eclectic take on history: blow-by-blow details of laboratory experiments and techniques, chatty sketches of famous surgeons, and straightforward tales of indignities suffered by a self-made Black man.

It was a book Thomas never expected to write. A publisher was hard to find. And with the original title of Pioneering Research in Surgical Shock and Cardiovascular Surgery, the audience was limited.  

How did Vivien Thomas win his place in history and popular culture?

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A top surgeon at Hopkins realized the importance and extent of Vivien Thomas’s work while researching Blalock’s life and pushed Thomas to write his autobiography. Mark M. Ravitch, an outsized personality who helped develop pediatric surgery, kept after Thomas for nearly two decades after learning, to his surprise, that Blalock delegated his experimental work on the nature of traumatic shock to Thomas and a surgical resident. At the time, it was customary for surgeons to perform their own experiments. Neither Thomas’s name nor his contribution was noted on papers Blalock wrote about his pioneering discovery, which made surgery safer.

Ravitch was also chagrinned to learn that he himself mistakenly credited another surgeon, C. Rollins Hanlon, with an innovative surgery Thomas developed. This was first surgical treatment to help children born with their major arteries reversed (transposition of the great arteries). Hanlon and Blalock are listed as authors on the 1948 paper describing it. Thomas had embarked on his solution for this condition secretly, testing it again and again in dogs before unveiling it to Blalock. (Usually, Blalock directed and the two improved on the idea.) When he showed Blalock the opening he created between the upper heart and a pulmonary vein — a new path that allowed oxygenated blood to flow into the body — Blalock reacted with disbelief. It looks “like something the Lord made,” Blalock said.  (Hanlon also played a key role in this surgery; his refinements dramatically reduced mortality.)

While Thomas worked a second job tending bar to pay his bills and wondered whether his life story was worth telling, Ravitch and other surgeons in Blalock’s famed training program – many of whom learned to operate in Thomas’s dog lab -- commissioned a portrait of him to hang in the medical school. It was unveiled in 1971. In 1976, Hopkins awarded him an honorary degree and made him an official member of the faculty.

After he retired in 1979, Thomas began writing his account longhand using his extensive lab records. Ravitch pushed Thomas to provide more detail about the people he named and his own impressions. Thomas added this without judgment. (In one memorable scene, Thomas prepared to quit after Blalock angrily dressed him down, leading Blalock to promise never again to speak to Thomas in raised voice.)

To help with what an ailing Thomas called his “production problem,” Ravitch assembled and ordered Thomas’s chapters and handwritten scenes, and wrote the index. A few days before his book was published by the University of Pennsylvania Press in December 1985, Thomas died. Ravitch went into high gear, pitching the memoire with ferocity, as is evident from Ravitch’s papers archived at the National Library of Medicine. He mailed the book or letters about it to everyone on his Rolodex (he was a past president of the American Surgical Association.) It was his colleague Judson G. Randolph, a George Washington University surgeon, chief of Washington’s Children’s Hospital, and Ravitch’s co-author on a pediatric surgery textbook, who told writer Katie McCabe about Thomas.

McCabe tried for four years to sell a story about Thomas before Washingtonian published it in 1989. By then, Ravitch was dead. Her article won the 1990 National Magazine Award and admiration from a local dentist, Irving Sorkin, whose daughter Arleen was a Hollywood actress and passed it around, including to folks at HBO. Nearly 15 years later, Robert W. Cort produced the Emmy award winning 2004 HBO film Something the Lord Made. He told me he learned of Thomas when a writer friend sent him McCabe’s piece. Almost 20 years later, his film is still being seen by millions.

Helen realized after reading Thomas’s book that he helped develop cardiac surgery far more than she had appreciated, she told his widow, Clara Thomas. In a Feb. 21, 1986, condolence letter, she also said she admired Thomas for standing up for what is right and just, and “all the more” for quietly bringing it out in his book.

A doctor asked me recently what it was like for a white woman to work with a Black man in the 1940s and 50s. The 1944 first pathbreaking surgery Blalock designed and Thomas tested to save children with abnormal hearts (“blue babies” with Tetralogy of Fallot) was Helen’s idea. Helen visited Thomas in his laboratory likely only once, to explain at length her patients’ problems, and thereafter communicated with him through Blalock. They worked in different spheres, she in a patient clinic and he in the laboratory. After surgery on the heart exploded, I imagine them exchanging nods in hospital hallways or stopping to chat amicably. They had much in common. Both were underpaid and underappreciated. Both fought injustices. Helen welcomed the opportunity to work with people different from herself; half of the physicians she selected every year for her fellowship training program in children’s hearts came from foreign countries, some with underdeveloped health care systems. Her 1952 fellows included Georgia native Effie Ellis, a biologist and infant health specialist. Ellis was the first full-time African American doctor to work at Hopkins.

The true meaning of Christmas

This time of year, as children’s doctor Helen Brooke Taussig prepared to join her family in Boston, her Baltimore living room windows and walls would be decorated with strings of glittery Christmas cards and photos from her patients.

They were her real family, Helen’s niece, Polly, told me.

Like most women doctors in her era, Helen chose not to marry. She wrote that while she didn’t have the satisfaction of raising children of her own, she was blessed with a multitude of nieces and nephews. She saw them mainly in summer, though, at the family’s home on Cape Cod. Helen had to leave her beloved family to study at the Johns Hopkins school of medicine, one of few science-oriented schools to accept women, and stayed in Baltimore for the one job offer that allowed her to treat patients.

Except for 1930, the year she came down with chicken pox and admitted herself to the infectious diseases ward in the children’s hospital, Helen always returned to her family in Boston for Christmas.

“I had a lovely Christmas with my two sisters,” she wrote a friend after one visit. “My sister Mary had real candles on her tree! Oh – I’d forgotten how lovely they were and what a different feel they give one – the true meaning of Christmas swept back over me – and of course, for both of us – the Christmas of our childhood.”

Light illuminates the darkest corner, so I suspect she meant hope, the theme of A Heart Afire, my newly released biography of Helen.  The renewed hope that accompanies a birth. Without hope, there can be no change. Helen called it imagination, which when accompanied by a strategy and hard work leads to advances in science and art and I will add, politics. This was a paraphrase of one of her heroes, Ralph Waldo Emerson. The German theologian Dietrich Bonhoeffer, one of my heroes, called it optimism even in the face of overwhelming darkness, a feeling of not wanting the other guy to win that inspires you to act no matter the odds. He was executed in a Nazi prison for his part in an attempted assassination of Adolf Hitler. He explains in Letters and Papers from Prison, but this time of year, I dip into his Christmas Sermons.

Helen took a job that no male classmate wanted, studying children destined to die from heart damage. Even women colleagues worried she was wasting her time. She never gave up. Like Emerson, she renewed her spirit by walking the woods near her house and observing nature. As she wrote in the 1960s to a grieving mother, it was by studying and re-studying the problems of dying children that “we learned to help so many.”

Helen’s grandniece Mary sent me this old photo of a family dinner, possibly Thanksgiving or Christmas. Helen is far right, looking elegant as usual.

What it takes to succeed

Today is the birthday of Charlotte Ferencz (1921-2016), one of many stellar 20th Century female doctors and scientists who names are known mostly within their professions. She helps narrate my biography of the children’s doctor Helen Brooke Taussig, (A Heart Afire, MIT Press, 2023). The story begins in Charlotte’s living room.

She was at first a source who pointed me to other sources and helped interpret documents. But I soon recognized that as a witness to the rise of women in medicine and key events of Helen’s life, Charlotte was perfectly placed to frame Helen’s story. She agreed to play “a bit part” in the book after much cajoling. But in the history of women in medicine, her role is larger than life. One task she took on was to ensure that that history is accurate.

One of nine women in a class of 94 at McGill University School of Medicine, Charlotte arrived in Baltimore in 1949 on a fellowship to study in Helen’s world-famous children’s heart clinic at the Johns Hopkins School of Medicine. Unable to obtain a suitable job in Canada, she returned to Baltimore in the mid-1950s to run Helen’s rhematic fever clinic. Her disappointments were many, but her accomplishments greater than most women in her generation. She became a full professor at the University of Maryland School of Medicine in two fields, epidemiology & preventive medicine in 1978 and, in 1985, pediatrics. She directed the first large-scale investigation into the causes of children’s heart defects.

Until the day in 2011 that I knocked on Charlotte’s door at Charlestown, a suburban Maryland retirement community, I had never met a female physician of grandmotherly age. They existed, but not in large numbers. Until this generation, to live in an era when women doctors were common, you would have to return to colonial times, when women took care of their families out of necessity.

Like Helen, who moved to Baltimore to study medicine because Harvard didn’t admit women, Charlotte had to leave her family to fulfill her ambition. She also faced sorrow in childhood, her life forever changed by war. Today I remember her gentle, scholarly, and fun-loving nature. But above all, she possessed in enormous measure a quality that allowed her and so many other women in her era to succeed: courage.

PS:  Charlotte refused to sit for a professional photographer, hence the blurred image here, taken by a neighbor passing by Charlotte’s door.  

Lessons in Geology

Two women in science are about to become even more famous.

The fictional chemist Elizabeth Zott (Lessons in Chemistry), whose career is derailed by sexism, comes to Apple TV on Oct. 13. Her real-life counterpart, the planetary scientist Lindy Elkins-Tanton, leads an $800 million NASA mission to the asteroid Psyche that launches next Thursday, Oct. 5.

Their stories were published within weeks of each other. Since June 2022 when I spotted Elkins-Tanton’s memoire, Portrait of the Scientist as a Young Girl, in a Vero Beach, Fl., bookstore, I have been hyping her story to friends. The widely popular Lessons in Chemistry, No. 5 on the NYT bestseller list, is a rollicking tale, an indictment of sexism in higher education and an ode to science and love. The elegantly written Portrait of the Scientist as a Young Girl is that and much more, and I hope it will have a longer tail. 

You cannot make this up. Like Zott, who winds up a TV cooking host when her advisor and rapist kicks her out of grad school, Elkins-Tanton detours from a science career, nagged by self-doubt despite earning a BS/MS in geology at MIT in four years. Teaching in a sleepy southern Maryland town, she confronts PTSD linked to childhood sexual attacks in woods near her home. Like Zott, she finds a love partner her equal. At 31 she returns to MIT for a Ph.D. Leads four field exhibitions to Alaska despite bad knees. Assembles an international team of scientists to collect hundreds of pounds of rocks in remote Siberian towns. Escapes a drunk Russian coal miner by stepping into a spa for a massage.  

Chemists and physicists on her team calculate the temperature and pressure of sinking rock to confirm the process that leads to volcanic eruption, proving her idea about how molten rock formed and flooded Siberia. From particles on rocks, they link the eruption of gases like carbon monoxide to a mass extinction event 250 million years ago, a warning for our planet. 

From rocks on earth, she moves to rocks in space. Gets her dream job at Arizona State University’s School of Earth and Space Exploration. Wins the NASA mission in 2015, just when she learns she has cancer, early stage.

Lindy Elkins-Tanton

Why forge ahead? Elkins-Tanton’s description of her pursuit of the unknown makes me want to join her team. It’s about the calm from working at the outer limits of knowledge, of going for the impossible. If Psyche is a piece of exploded planet, it might reveal what’s inside our own rocky planet. Or not. It might be rich enough in metal to supply Earth for ages. Or not. The liftoff might be grounded, as happened a year ago August, when NASA’s Jet Propulsion Lab encountered a software problem. It will take three years for the spacecraft to get close enough to Psyche to collect data. No matter what happens, she writes, “if you are sure of your values and your vision, then every unit of work, every day of effort, is a real piece of progress and of value in itself.”

This sounds familiar! The children’s doctor whose story I tell in A Heart Afire, Helen Brooke Taussig’s Battle Against Defective Hearts, Unsafe Drugs, and Injustice in Medicine (MIT Press, Dec. 2023) mapped the inner workings of defective hearts knowing there was no treatment for dying children. “If the problem in which you are interested in is right, it is an objective and goal in itself,” Helen told an audience of women scientists in 1954. Eventually, following scientific methods, somebody would find the answer. As she did, with her idea for life-saving heart surgery.

In style, the graceful Elkins-Tanton is more like Helen than Zott. She takes small steps to topple what she calls the outdated “hero” model: the autocrat directing doctoral students and taking all the credit. She forces the ouster of a serial abuser and convinces her professional society to make abusive behavior a disqualifier for membership. Her team of bantering physicists, chemists, astronomers, and engineers is a model of the collaboration needed to tackle questions bigger than any one discipline. With her son and husband, she developed and is deploying a student-driven learning system to inspire the next generation of scientists.

Her motto:  Change begins with questions.

Helen would agree. And the question we should be asking is not whether women can be scientists, as she told women professionals long ago, but what problems scientists should try to solve.

 Change begins with questions.

Portraits of bold women

John Singer Sargent, the European-born American portrait artist, was a rising star in the Paris art world when he displayed an edgy, slightly decadent painting now known as Madame X at the Paris Salon in 1884. Parisians were horrified (if titillated) by the depiction of a society maven effortlessly flaunting her beauty; everyone recognized the subject, the married Amelie Gautreau, rumored to be an adulteress. As cultural historian Paul Fisher explains in The Grand Affair: John Singer Sargent in His World, (Farrar, Straus, and Giroux, 2022), the painting forced Parisians to confront the “decadence in their midst” —truths they quietly tolerated but preferred not to acknowledge. Unnerved by the outrage, Sargent exiled himself to London.  

Portraits and the relationship between artist and subject have long been an obsession, so I listened eagerly to Fisher talk recently about how Sargent pursued bold women to model for him as he built his reputation in Belle Epoque Paris. They were divas, dancers, iconoclasts, women who defied social norms and cultural constraints. Sargent admired his subjects’ daring and gives them noble attributes in his paintings, which is why Fisher said he likes Sargent so much.

Sargent’s women, painted in 1880-1890s Paris, hung from banners and flashed across flat screens during Fisher’s talk last month at the Hay-Adams Hotel in Washington, DC. The artist signals their fearlessness, their defiance, their power with the removal of a white glove, a darkness about the face, or in the original version of the famous Madame X, the strap of her evening gown falling from her shoulder. “Sargent’s women are not objects,” Fisher said, “Sargent saw women as people, which is why (his paintings) “are so gorgeous.”  

Fisher dug into Sargent's life to find out the backstory of Sargent’s women. Who was the man behind these innovative portraits? Why was he was drawn to painting transgressions, sometimes highlighting secrets that his subjects may not have wanted revealed? In his stunning account of the “buttoned-up,” never-married artist, Fisher explores what was it like for a man of Sargent’s talents and sensibilities to move between high society and bohemian cultures in Europe at the turn of the 20th century. He details Sargent’s deep relationship with his sisters and other women as well as his male friendships to try to understand his subject’s sexuality in his time and because they influence his painting and choice of subject, which include male nudes and homoerotic scenes discovered after Sargent’s death. Fisher says Sargent painted bold women to work out what he could not do in his own life, “They are courageous enough to do the things he could not do…” he said.

Sargent hid Madame X in his studio for 20 years, when he restored her dress strap and sold it to the Metropolitan Museum of Art in New York City. He considered it one of his best portraits. Today the elegant and confident Madame X feels modern, like another long-hidden portrait I have seen, this one of Helen Brooke Taussig, a children’s doctor and the subject of my upcoming biography, (A Heart Afire, Helen Brooke Taussig’s Battle Against Defective Hearts, Unsafe Drugs, and Injustice in Medicine, MIT Press, Dec. 2023). It is stored in the archives of the Johns Hopkins University School of Medicine.

In May 1964, eighty years after Madame X’s disastrous debut, Helen’s portrait was unveiled to similar horror. Her blouse hangs slightly off her shoulder, oddly reminiscent of Madame X’s fallen strap. But it is her intense gaze that moved admirers to tears. Within days, the portrait was whisked away by doctors who hired the artist, Jamie Wyeth, not to be seen again for nearly 50 years, during which they battled repeatedly over whether it should ever be displayed and what it represented.

Why such an outcry over an image that today seems so realistic, even noble? I delved into Helen’s life to find out. Who was the woman whose honor they guarded? How had she endeared herself to so many? What were the social and cultural obstacles women doctors encountered in her era? At the time of the portrait?


One thing I learned was how tenaciously Helen pursued treatments for her patients. She never gave up. She was also gracious. Unlike the tearful Madame Gautreau, she did not fear her reputation would be ruined by a portrait, though she did suggest Wyeth give it a clandestine title: “Portrait of a Physician.”

A la Sargent’s Madame X in 1884, did Wyeth’s “Portrait of a Physician” in 1964 reveal a secret about Helen too unseemly to acknowledge in public? Too ahead of its time?

What should powerful women look like?

And who decides?

 

Blooms of hope

Helen clearing her land with her dog, Spot, 1949.

May, with its life-affirming new blooms, was a significant month for Helen Brooke Taussig, one of the 20th century’s most important doctors and the subject of my new biography, A Heart Afire (MIT Press, Dec. 12, 2023). She was born in May (May 24, 1898). She staged garden parties in May. She died in May (May 20, 1986). Who was she? A saint or a holy terror, depending on where you stood during her lifelong crusade for patients.

 But back to May. When she wasn’t saving lives and founding the study of children’s hearts, Helen cultivated beauty. It took years and help from doctors she trained to turn her vast expanse of dirt and rocks in Baltimore into a colorful landscape. May was its showiest and when she regularly invited these doctors back to her garden to dine and share their discoveries. After she retired and moved away, Helen returned to Baltimore herself each May to see her gardens.

I don’t know if she grew lily-of-the-valley, the delicate small white flower associated with May, but one of Helen’s friends told me she did grow towering white lilies, which she dug up and presented to a colleague mourning the death of her husband.