Alfred Blalock, M.D.

Surgeon
1899 - 1964


Portrait of Alfred Blalock by Yousuf Karsh, ©Karsh

Alfred Blalock earned his M.D. from Johns Hopkins in 1922. Three years later he left Baltimore, considering himself something of a failure at age 26, for he had not achieved a residency in surgery. He headed to Nashville to become the first resident in surgery in the new Vanderbilt University Hospital. While at Vanderbilt he did pioneering work on the nature and treatment of hemorrhagic and traumatic shock. He demonstrated that surgical shock resulted primarily from the loss of blood, and he encouraged the use of plasma or whole-blood transfusions as treatment following the onset of shock. This early work on shock is credited with saving the lives of many casualties during World War II.

Blalock and his team who were working on shock at Vanderbilt, labored to create different physical conditions in dogs. In 1938, he conducted one experiment in which the left subclavian artery was joined (anastomosed) to the left pulmonary artery in an effort to produce pulmonary hypertension. The experiment failed and was put aside. Years later Blalock was to return to the idea.

In 1941 Alfred Blalock returned to Hopkins to assume dual appointments as surgeon-in-chief of the hospital, and professor and director of the department of surgery of the medical school, positions he was to hold until his retirement in 1964.


Alfred Blalock lecturing at The Johns Hopkins University School of Medicine,
from the Olive Berger papers of The Alan Mason Chesney Medical Archives

Blalock arrived well prepared for the surgical work that was to challenge him. He brought with him one of his most valued colleagues, his surgical research technician Vivien Thomas. Together they formed a close partnership that was to last more than 30 years. Thomas was known for his eager intelligence and his superb surgical skill.

Over the next few years, the shunt technique was developed further at Hopkins. It was used as a means of bypassing an obstruction (coarctation) of the aorta.

It was while Blalock was discussing his work on coarctation that Helen Taussig presented to him the problem of the blue-baby in relation to some sort of arterial shunt that would furnish more blood to the lungs.

Later Blalock wrote, "Vivien Thomas, my superb technician, and I performed many experiments with this end in view." Vivien Thomas said, "Our first attack on the problem was to try to form in an animal a 'blue-baby syndrome' in order that we could work out a procedure for correction."

The 'syndrome' is the tetralogy of Fallot, which consists of a hole in the wall between the heart's two major chambers (ventricles), an elarged right ventricle, a defective pulmonary valve that prevents full flow of blood to the lung, and cyanosis. Cyanosis is indicated outwardly by blueness and caused by the lung's inability to oxygenate sufficient blood for the system.

The first operation on a patient occurred on November 29, 1944. First assistant in that operation was William P. Longmire, Resident Surgeon. In 1965 he recalled,

I must say my enthusiasm for the idea completely disintegrated when I saw the frail cyanotic infant in the oxygen tent on the east ward of Harriet Lane 4. At that time Blalock spoke briefly with the parents (and indicated again the serious nature of the operation). It seemed to me from the way he greeted them that they had discussed the operation prior to the child's admission to the hospital....At the time of the first operation we lacked all of the modern vascular intstruments and really had little but the Professor's determination to carry us through the procedure. The child had extensive collateral vessels full of thick dark blood which I of course, had never seen before. The pulmonary artery was identified with some difficulty and was isolated back into the mediastinum. It was amazing to see the Professor gently but blindly insert a right angle clamp into the mediastinum and after dissecting over his index finger, pull out the innominate artery...Vivien Thomas stood in back of Blalock and offered a number of helpful suggestions in regard to the actual technique of the procedure.


An illustration by Leon Schlossberg of the procedure.
By permission of Surgery, Gynecology & Obstetrics, now known
as the Journal of The American College of Surgeons.

The operation was successful, and word spread quickly, bringing a steady flow of patients and visitors to the hospital.

Blalock's contributions to surgery were recognized nationally and internationally. He was elected to membership in the National Academy of Sciences and the American Philosophical Society.


A detail of a presentation letter given to Blalock following the
Moynihan Lecture, which he gave in 1954, in Leeds, England.

Among the prestigious honors which Alfred Blalock received were the Chevalier de la Legion d'Honneur, the Passano Award, the Matas Award, and the Albert Lasker Medical Research Award.

Continue with Exhibit

Introduction
The Operation
Surgeon - Alfred Blalock
Pediatric Cardiologist - Helen B. Taussig
Surgical Technician - Vivien T. Thomas

Frequently Asked Questions
Sources for this Exhibit

 

The Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions