Barbara Moreland, a cheery grandmother who runs her husband Gary’s plumbing business in rural West Virginia, still has the patient wrist band she wore in 1965 when surgeons at Johns Hopkins Hospital fixed her flawed heart. She was 8 years old, and she remembers crying over the sensitive incision, and maybe, too, the trauma. She stayed in Baltimore a month, including about three weeks in a basement apartment near the hospital where she returned for frequent exams. She remembers her mother made her eat green beans.
Recently as she assembled Christmas gifts for her grandchildren and set up little challenges they must conquer before they can choose a present to open, she expressed gratitude that it all worked out. “I just thank God I’ve lived a normal life,” she said.
A newspaper photo Barbara has shows her being examined by Helen Taussig in 1959.
Barbara is a former patient of Helen Brooke Taussig, who in the 1940s in a humble clinic helped invent life-saving surgery for children born with abnormal hearts. I had hoped to find more stories about former patients once my biography of Helen was published (A Heart Afire, MIT Press, 2023). With Barbara’s permission, her surgeon and nurse practitioner introduced us.
Now 67, Barbara was among the first generation of children to undergo a total repair of Tetralogy of Fallot, a heart condition present at birth in which the normal route for blood to the lungs is partially blocked. Children struggle to breathe because they can’t get enough oxygen. A full repair of heart abnormalities like hers first became possible in 1955 with the invention of a heart-lung pump, a machine outside the body that takes over for the heart, pumping blood to the body and lungs. It allowed surgeons to cut, sew, and move around blood vessels on the stilled heart, all to restore normal blood flow.
She returned to Hopkins in 2021 to have her pulmonary valve replaced. Her surgeon, Hannah Fraint, inserted a tiny tube – catheter -- through an incision in the veins in her groin and guided it toward the valve, which controls blood flow to the lungs. This time her hospital stay was only 24 hours.
Barbara got the special care she needed beginning in infancy not only because Helen spent over than a decade learning how hearts like hers worked and how to fix them; Helen also started a satellite children’s heart clinic in Martinsburg, W. Va., in 1954, a few years before Barbara was born, to make new treatments accessible.
A dish commemorating the 25th anniversary of the Martinsburg clinic, from Charlotte Ferencz, MD., Helen’s deputy, who worked at the clinic and helped me tell Helen’s story..
The clinic was a partnership with the Berkeley County health department made possible after Helen and other doctors lobbied for funds from the US Children’s Bureau. Helen or her deputies drove from Baltimore to Martinsburg regularly to diagnose and monitor children born with heart problems. Barbara’s memory of Helen is vague, but she does recall Anthony “Tony” Perlman, Helen’s trainee, friend, and a Baltimore physician in private practice who oversaw the clinic in later years and recommended her for surgery.
The clinic was a source of great pride for Helen, who returned to Martinsburg in 1979 at the age of 81 to celebrate its 25th anniversary. She first tried to remedy inequities in health care in the 1930s when children with rheumatic fever arrived at her free clinic at Hopkins too late to save. They could not afford private doctors. In the 1940s, when her idea to save children with heart defects took off, many of the first children to benefit came from families who could afford to pay for the new surgery; some even arrived by airplane. But impoverished parents were just as determined to save their babies. In a journey that captivated the nation, Louella Champ hitchhiked 375 miles to Baltimore from southwest West Virginia in January 1946 with her breathless 2-year-old on her back. People she met along the way bought her food and on her last leg to Baltimore, a bus ticket.
Barbara and Gary Moreland
As the nation debated how to pay for hospital care, no child who needed a heart operation at Hopkins was turned away, thanks to a charity established by Robert Garrett, son of Baltimore B & O Railroad magnate John Garrett. But there were other costs. Helen maintained what she called a “mercy fund” to help families pay for lodging, food, and travel; she raised the money from grateful patients and by pleading her case to wealthy Baltimore women at luncheons and dinners.
Barbara’s surgery was probably covered by the Garrett fund. Her family certainly had no health insurance, she told me. Her parents did not even own a car. A “Mr. Lefevre” from Barbara’s church volunteered to drive her and her mother back and forth to Baltimore for her surgery. Barbara remembers the long drive.
Her life was normal afterward, she said. She didn’t ice skate like her sisters – her mother feared she would fall and hurt herself. She didn’t complain. (It was her mother who first noticed when she fell ill from childhood diseases like chick pox). When she turned 10, her father died from pneumonia. Barbara’s job after her mother remarried was to help manage the household -- their blended family included nine children — while her stepfather ran the farm and orchard. After high school she worked as a key punch operator until the business closed, leaving her unemployed for a time. Later she placed orders from salesmen working for a wholesaler. Ultimately her husband opened the plumbing business for which she handles the paperwork. Through his plumbers’ union, she got health insurance for the first time.
She returned to Hopkins when she was married in 1981 to be sure she could have children. Her two sons and three grandchildren live close by. They are the center of her life in Bunker Hill, W. VA, she says. Among her challenges was debilitating rheumatoid arthritis when her sons were young, she said, but they opened doors and carried her packages. She no longer crochets, but she reads avidly and relishes weekly meals and games with extended family. “There’s no need in feeling sorry for yourself. Just get on about your business, do the best you can do,” she said. “That’s always been how I felt about life.”
Thanks to advances in medicine, there are more adults living with heart defects today than children born with them. Those whose hearts have been repaired still need special care. Every six months Barbara drives to Hagerstown to see her nurse practitioner, Kathleen Byrne, who monitors her heart and lung function.
It’s easier now that she is on Medicare, the federal program for the elderly. Helen advocated for that, too; she was among a minority of doctors, many of them pediatricians, who campaigned for government-sponsored health care for the poor and elderly. (Back in 1965, the American Medical Association opposed the idea.) President Lyndon B. Johnson showed his appreciation by inviting Helen to the ceremony with former President Harry S. Truman in Independence, Mo., where he signed the landmark bill creating Medicare and Medicaid. When she couldn’t make it, he sent one of the pens he used to sign the bill; last I visited Helen’s archived papers, it was still in the original envelop, an artifact of history.
The battle she fought for access to health care is ongoing, though, and the question she asked in 1954 still valid: what good are advances in medicine if most people cannot afford health care? To borrow from Barbara’s code for living, let’s get on about our business of making health care accessible to all.