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

Inquiries about the apparatus for positive-pressure anesthesia were still being made in 1948 by visitors to the laboratory. Letters were being sent, some to Dr. Blalock, by doctors who had seen the apparatus, which I had devised, being used in other laboratories. In discussing the demand for the unit with Dr. Johns, the Halsted Fellow in the laboratory, Dr. Hanlon suggested that it might be wise to publish a detailed description so that other institutions with adequate shop facilities could assemble their own. On publication of the description,²⁹ there was an immediate increase in the number of inquiries instead of the expected decrease. Physicians wanted to know if we could supply the apparatus to them. To accommodate those who had previously requested the unit, I had made good contacts to have the valve machined and motors and other components procured. Allowing myself about one-third the price, I quoted $125 for the first few units I had sent out. When, in 1950, I quoted $145 to Herbert Sloan, M.D., then Professor of Thoracic and Cardiovascular Surgery at the University of Michigan at Ann Arbor, he thought the price was exorbitant until he obtained prices on the components. Earlier, a representative of a company that manufactures medical equipment had asked how much it cost to assemble the unit. When told, he named the price we should have been charging and I was amazed. He explained that the rule was to multiply cost by four or five or even a larger figure if the market would bear it. I assumed from the reaction of Dr. Sloan and others that many of the research laboratories were in the same strained financial condition ours had been and I did not follow the rule. Richard Clay, M.D., who is Clinical Professor of Surgery at the University of Miami, was quoted a price. He wrote back, saying I was a "profiteering burglar," but he bought the anesthesia apparatus. The last unit sent out in 1959 was priced at $210, approximately half the cost of the efficient Harvard respirator, which by then was being widely used. I had supplied over 125 apparatuses for positive-pressure anesthesia to United States laboratories. Three had been sent to Canada and one that required a special motor, to England; a visiting doctor from Brazil took one home with him.

My correspondence was not limited to procurement of the anesthesia apparatus. I became a consultant and general advisor on technical procedure and research projects. Many of the communications covered anything and everything concerning a research laboratory. Doctors who

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