The Open Heart Club by Gabriel Brownstein

Author:Gabriel Brownstein
Language: eng
Format: epub
Publisher: PublicAffairs
Published: 2019-10-21T16:00:00+00:00

On the train from Baltimore to Boston, Helen Taussig rehearsed her notes on tetralogy patients as she would present them to Gross. Because of the ventricular septal defect, the venous and arterial blood mixed in the large chambers of the tet patient’s heart. Because of the pulmonary stenosis, not enough blood got to the lungs. But with the ductus arteriosus open, some of additional blood went back into the lungs instead of going out into the body. This increased the volume of blood going into the lungs, thus the volume of oxygen going out to the body, and hence improved the health of the child.

So Helen Taussig practiced reciting her theory: one could relieve the symptoms of tetralogy of Fallot by creating an artificial patent ductus. Make a hole, make a shunt between the arteries, and direct more of the blood to the lungs and more oxygen to the body. She got off the train. She went to Longwood Avenue. She found Gross’s office. When she explained her idea to him, he laughed at her.

“I think,” Taussig remembered later, “he thought it was one of the craziest things he’d heard in a long time.”

“Madame,” he said, “I close ductuses. I don’t create them.”

Taussig, a half foot taller than him but begging, asked if he could, if it would be possible. She said meekly, “It would be a great help to a cyanotic child.”

Gross turned her down.

To be fair to Gross, all his dogs with artificial PDAs had died. Building a shunt between the great arteries is a tricky business—too narrow and not enough blood gets to the lungs; too wide and the lungs are flooded. No one had ever done it before. So Taussig went back to Baltimore.

She decided to try her idea on the newest surgeon hired by the hospital, Dr. Alfred Blalock. He had recently come from Vanderbilt and had a reputation for experimentation. Blalock had made tremendous strides in the treatment of battlefield shock. He was a rising young star in American surgery.

She met him in his lab at Hopkins. He was small, pale, handsome, and intense, with round glasses and dark hair swept back from his forehead, a southern gentleman, directly descended on his mother’s side from the president of the Confederacy, Jefferson Davis. On the stool beside Dr. Blalock sat another man, Vivien Thomas. Taller and younger than Blalock, with a longer face and milder manners, he wore a white lab coat, and—this must have been confusing at first for Helen Taussig—he was a black man.

Baltimore was a Jim Crow town. Johns Hopkins had separate entrances and bathrooms marked “colored.” Thomas wasn’t supposed to drink from the same fountains as Taussig or Blalock. All the other black people working in the hospital held menial positions. None of them wore lab coats. Thomas could have been arrested for eating lunch with Blalock or Taussig. But he sat there, expectant, Dr. Blalock’s special assistant, brought with him from Vanderbilt to work in the lab. Taussig made her presentation about tet kids and PDAs.

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