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

8

One morning in 1943, Dr. Blalock called to ask what I was doing and if I would be free by late morning. He said a Dr. Taussig had a problem she wanted to discuss and that they should meet in the laboratory so that I could be in on the discussion. He arrived about ten minutes before the appointed time; we talked about the progress of current projects, but the upcoming discussion was not mentioned. When Dr. Taussig arrived Dr. Blalock introduced us. I had not met her, since she was headquartered in the Hospital and I, in the laboratory. I was to learn later that Dr. Helen B. Taussig was the Director of the Cardiac Clinic in the Harriet Lane Home for Invalid Children at the Hospital. She was a pediatric cardiologist, a skillful diagnostician and an outstanding authority on congenital heart disease.

Dr. Blalock restated what he had said on the telephone and turned to her. She was tall and slender with a pleasant personality and spoke with a distinct New England accent. I don't know how much discussion they had held previously, but she went into great detail about the problems of patients with cyanotic heart disease. There were other types, but she said she was particularly interested in the tetralogy of Fallot (Blue Baby). She described to us the anatomical abnormalities of the heart -- the interventricular septal defect, the stenosis (constriction) of the pulmonary artery, how the aorta overrode the septum and the hypertrophy of the right ventricle. She explained the mechanism of how in the presence of the stenosis of the pulmonary artery a varying amount of venous blood was shunted through the defect in the septum out through the aorta into the general circulation and how the amount of the shunting was compounded by the aorta's overriding (straddling) the septal defect. Thus she explained that, under these conditions, there was not sufficient blood getting through to the lungs to be oxygenated.

She also told us of the physical findings, describing the clubbing of the fingers and toes, the blue appearance of the mucous membranes and nail beds, the lack of tolerance to exercise, and the tendency of afflicted children to squat to rest. She told us that they almost invariably had polycythemia (an increased number of red blood cells). She said she had followed these patients in the clinic and seen their condition gradually deteriorate until they finally succumbed, there being no known medical help for them. She expressed her belief that, by surgical means, it should be possible to do something to get more blood to the lungs, as a plumber

-80-

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