Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock : An Autobiography

By Vivien T. Thomas | Go to book overview
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I had done or had assisted during numerous minor acute surgical procedures -- cutdowns of femoral or neck vessels and the bisections of animals at autopsy during the shock studies -- but the first project that I considered to involve "real surgery" was our work on the effect of adrenalectomy on cardiac output.4 This took place during the period that Dr. Beard, although officially on the clinical service, was spending time in the laboratory. The operations were carried out with aseptic techniques and were my first experience in doing, or rather, assisting in aseptic surgical procedures -- putting on a cap and mask, scrubbing up, putting on a sterile gown and gloves, and adhering to operating room techniques.

Most of these operations were performed by Dr. Blalock, usually in the afternoon while we had an acute shock experiment in progress in the chemistry laboratory. I would leave the acute experiments to scrub up and assist him. The adrenal glands, although small in size, are somewhat difficult to remove due to their anatomical location and blood supply. They lie above the kidneys on each side, just beneath the diaphragm, and are most easily approached through a posterior subcostal (flank) incision. The operations were staged, that is, the adrenal was removed on one side and the animal allowed to recover. Several weeks later, the other adrenal gland was removed and the studies began. The Van Slyke was used for oxygen determinations. Some of the late-night (9:00 or 10:00 p.m.) observations and oxygen determinations were done by Dr. Blalock. He worked as long and as hard as everyone else; it was never a matter of "You do it, I'm gone." It was "follow the leader."

Since these experiments did not occupy a full day's work, there were overlapping projects in progress at all times. One would have priority, but if some unusually interesting observation was made in one of the secondary projects, that project would likely be given priority and would be studied until some conclusions could be reached or the idea abandoned. Sometimes a short, uncomplicated project such as that on the effect of complete occlusion of the thoracic aorta 5 would be completed as a secondary project. This overlapping of projects is an example of how Dr. Blalock "never put all his eggs in one basket." If one research project completely failed, he always had another in progress.

Dr. Gunnar Nystrom, Professor of Surgery at Upsala, Sweden, was Abraham Flexner Lecturer in Surgery at Vanderbilt in 1935. He worked

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