Guest Post: “Phthisiophobia”: The Tuberculosis Clinic in New York City and Popular Anxieties about Public Health Dangers

Today we are pleased to feature five guest posts from students in Tom Ewing’s Virginia Tech Introduction to Data in Social Context class! The first is from Allyson Manhart, Andrew Pregnall, and Harshitha Narayanan.


TB_Infirmary_OpenToPatientsAt the beginning of the twentieth century the Treasury Department of the United States classified pulmonary tuberculosis as a “dangerously contagious disease” which meant that any immigrant found to have tuberculosis coming to the United States would be denied entrance. The ban led to a swift reaction from the physicians of the New York Academy of Medicine, many of whom argued that the ban created unnecessary fear of those with tuberculosis.

On January 2, 1902 the monthly meeting of the New York Academy of Medicine resulted in the Academy physicians proposing a resolution which rejected the Treasury Department’s new classification of pulmonary tuberculosis.  The physicians felt their plans to establish a clinic for consumptives on Blackwell’s Island was threatened by the Treasury Department’s classification and the unnecessary fear they felt it created. Less than a month later on January 31, 1902, the Tuberculosis Clinic of the Metropolitan Hospital of New York opened its door to patients who needed public healthcare, both the curable and incurable (New York Times 1902).

The Tuberculosis Clinic of the Metropolitan Hospital of New York quickly became the central destination for consumptive patients in New York City as all consumptives in other charity hospitals were removed to the Metropolitan Hospital’s clinic. In the chart above, created by the director of the Metropolitan Hospital’s clinic, we can see the number of patients who were admitted or discharged, the number of patients who died, and the patients remaining in the clinic after a six year period.

While the mortality rate of almost one-in-three patients is high compared to other hospitals, it is important to remember that the Metropolitan Hospital’s clinic took in all patients from the New York City region — regardless of whether they could be cured or not.  This raises a broader question: Who were the hospital’s patients?

TB_Infirmary_Occupations

The clinic took in 13,610 patients from 1902 to 1908. The graphic above shows the ethnic breakdown of the patients in the clinic versus the breakdown of the entire New York City population. People who were natives of the United States made up about 23% of the New York population and 42.8% of the patient population. The hospital reported that many of these patients were “born of foreign parents.” The second largest demographic group was the Irish, coming at 21.9% of the patient population. The surprising statistic was Germany’s representation. About 23% of the New York City population was German, but they only made up 8.2% of the clinic’s population. They are followed by Russia at 7.5%, Italy at 6%, Austria at 2.7%, and England at 2.5%. Ultimately, by looking at these statistics, it is easy to see that most of the consumption patients in New York City were first or second generation immigrants.

TB_Infirmary_Occupations

In addition to collecting information on the nationalities of their patients, the Tuberculosis Clinic of the Metropolitan Hospital of New York also collected data on their religions (65% were Roman Catholic and 25% were Protestant), sexes (about 80% male), age (65% were between the ages of 21 and 50), and occupations as seen in the graph above. The biggest takeaway from all of this data is that the patient population of the Tuberculosis Clinic of the Metropolitan Hospital of New York was comprised of poor first or second generation immigrants who likely worked long hours in poor paying, physically demanding service jobs,  with less than ideal conditions, and then returned home to the tenement housing — characterized by poor sanitary conditions, overcrowding, malnutrition, etc — that was so prominent throughout urban centers of the United States at the time. These considerations explain to a large degree why these immigrants were so susceptible to tuberculosis.

Interestingly, the Tuberculosis Clinic of the Metropolitan Hospital of New York was very aware of the background of their patients and the effects they were having on the City of New York hospital system. In the words of the Clinic’s director:

The municipal hospital facilities of New York City have never yet been adequate to house in comfort all the sick poor seeking municipal aid. The main reason of this is the great influx of foreigners each year who never get any further into the United States than New York City. A glance at the nationality of the patients in Tuberculosis Infirmary will show this. [Emphasis added] (New York Times 1902)

Now that we understand who the Clinic’s patients were, one final question must be addressed: What social effects did tuberculosis have on these vulnerable first and second generation immigrant populations?

The simple answer is stigma. In an address to the New York Academy of Medicine on January 2nd 1902, Dr. Sigard Adolphus Knopf, an expert on pulmonary tuberculosis, said:

To my deep regret I learned recently that new difficulties have arisen concerning the site of our future New York State Sanitarium. Phthisiophobia, an exaggerated fear of the vicinity of consumptives, is the cause. What the people must learn is that consumption is not contagious, where the sputum is destroyed. It is hard to estimate how much hardship and suffering is incurred through the fear of consumption. It leads to real inhumanity. Useful citizens may be removed from their chances at success. [Emphasis added] (New York Times 1902)

He went on to say that the classification of pulmonary tuberculosis as a dangerously contagious disease, “plac[es] a stigma wholly undeserved upon every American citizen who is suffering with consumption,” and proposed a resolution, adopted by the Academy at their next meeting, which declared the exclusion of immigrants based on their consumptive status to be “unwise, inhumane, and contrary to the spirit of American justice.” (New York Times 1902)

Ultimately, the Tuberculosis Clinic of the Metropolitan Hospital of New York took in thousands of patients in the six year period, regardless of their curability. While we did not learn when the Tuberculosis Clinic closed from our research, there is still a hospital on those Blackwell Island grounds today (whether it was renamed or is part of a new organization, we are not sure). After analyzing the ethnic and occupational backgrounds of the patients, there is substantial evidence that the majority of the patients were poor first or second generation immigrants who likely worked jobs rife with occupational hazards and lived in unsanitary tenement housing. These occupational and domestic risk factors meant that these immigrants contracted tuberculosis at a substantially higher rate, and subsequently composed the majority of tuberculosis patients in New York City. Unfortunately, as Dr. Knopf explains, tuberculosis was a great source of fear in the early 20th century, and this fear was ultimately projected onto the immigrant populations most in need of public help.

Works Cited

Mills, Walter Sands. 1908. The Tuberculosis Infirmary of the Metropolitan Hospital, Department of Public Charities, New York City. New York: M. B. Brown Company. https//catalog.hathitrust.org/Record/002086417.

New York Times. 1902. “FEAR OF TUBERCULOSIS CALLED EXAGGERATED; Dr. Knopf Says It Leads to Real Inhumanity. Exclusion of Consumptive Immigrants Denounced at Academy of Medicine — Separate Hospital Advocated.,” January 3, 1902. http://query.nytimes.com/mem/archive-free/pdf?res=940CE0D81430E733A25750C0A9679C946397D6CF.

From Fugitive Leaves: “I Love the Flu”

~Guest post courtesy of Emily T.H. Redman, an Assistant Professor of History at the University of Massachusetts, Amherst where she teaches history of science.

I love the flu.

Don’t get me wrong. I don’t love the fever and chills, the runny nose, the sore throat, or the all-encompassing ache that seems to span from deep in the bones all the way to one’s hair follicles. I don’t love the complications—the respiratory infections, the myocarditis. In particular, I really don’t love the potential for death. What I love the flu for is divorced from these horrors, and lies in the pedagogical value afforded by teaching students about the history of influenza epidemics. Influenza epidemics are fascinating on a micro level, an evolving and mutating virus hitting the body with a slightly different impact every year. But flu season hits us on another level; as we collectively respond to epidemics it shapes our cultures, ideas, and traditions.

It was for additional information about the flu, among other examples from medical history, that I came to the collections of the College of Physicians of Philadelphia in January 2014. I was planning a new seminar on the history of medicine, and sought primary source materials for both lectures and for supplemental independent student research projects. I also used my visit to look for materials useful to my other courses, which span various topics in the history of science, technology, and medicine from my home department as an assistant professor of history at the University of Massachusetts, Amherst.

Nearly every fall semester, I (shamelessly) use my position at the front of the classroom to proselytize getting a flu shot. As a historian of science, I use examples from history to make the argument that it is imperative that most healthy individuals should protect themselves from the flu, for their own health as well as the health of the collective public. With the opportunity afforded by a new seminar in the history of medicine, I came to the archives to strengthen these arguments.

One of the aspects of the 1918-1919 influenza outbreak that makes for such compelling classroom fodder is the fact that this particular strain disproportionately impacted healthy young adults. This flu was fast acting, with a shockingly high rate of mortality. It was a flu that would have ravaged, say, a community of college-aged students living in close proximity in dorms and small apartments. This morbid drama offers the perfect opportunity for teaching about epidemiology and the cultural impact of disease on populations.

The materials I collected during my time researching at the College of Physicians of Philadelphia provided me with a rich assortment of primary source materials to explicate the devastation wrought by the flu. These primary sources

London Ministry of Health. Reports on Public Health and Medical Subjects No. 4: Report on the Pandemic of Influenza 1918-1919. (London, 1920): 17.

London Ministry of Health. Reports on Public Health and Medical Subjects No. 4: Report on the Pandemic of Influenza 1918-1919. (London, 1920): 17.

are crucial, as I have found a major obstacle to teaching about the influenza outbreak (and indeed, convincing students of the need for a yearly flu shot) is debunking the myth that the common flu is at worst a mere annoyance. Many students come to the classroom assuming the flu is nothing more than a more severe cold. One student—not alone in her query—asked why people no longer die from the flu. There are many misconceptions about the disease, and a historical approach can help us address them.

 

Using materials collected during my research, I developed a lesson beginning with the origins of the influenza outbreak. This history offers a complex view of epidemiology, as the flu spread with rapidity not just by sneezes and coughs, but also by the opportunity afforded by the waning years of WWI, when soldiers congregated in close quarters and civilians joined in large celebrations to mark the end of combat. These gatherings provided the perfect storm of disease propagation.

Unfortunately, this perfect storm was met with a flu unlike most others. This was a flu with an extremely high mortality rate. The chart below dramatically depicts the devastation wrought, with the high peak at the right side of the graph signifying the sharp uptick of deaths related to the flu as compared to earlier years’ epidemics.

A similar chart underscores the relative devastation among communities, particular in cities, by the flu. The figure below charts the total deaths in Philadelphia. Though the reproduction is of poor quality, the chart shows a spike in deaths in the mid fall of 1918. Two lines draw this spike: the outermost indicates the total deaths from all causes in the city, while the inner, nesting spike indicates the total number of deaths from influenza alone. This chart is chilling. The dramatic increase of deaths in Fall 1918 is clearly due almost exclusively to the outbreak of the flu.

Such images certainly lay the groundwork for teaching about the impact of the epidemic, yet numbers and line graphs only go so far in driving home historical reality. To make the winter of 1918-1919 come alive for students, I employ a seemingly benign table of figures to create a hands-on activity that packs a punch.

United States Department of Commerce. Special Tables of Mortality from Influenza and Pneumonia in Indiana, Kansas, and Philadelphia, PA September 1 to December 31, 1918.

United States Department of Commerce. Special Tables of Mortality from Influenza and Pneumonia in Indiana, Kansas, and Philadelphia, PA September 1 to December 31, 1918.

The table below lists the number of cases of influenza (and related pneumonia) among U.S. troops in camps and barracks. I use this example to mimic, somewhat, the close proximity with which our students live (though presumably they do so in a bit more luxury than that afforded by military barracks). In class, I annotate the image, replacing the numbers with figures reflecting the size of the class. I then ask students to take index cards corresponding to the first week, then the second, and so on. Over the course of our simulated autumnal flu season, we see how many students survive into January. This never fails to hit home.

Undoubtedly morbid, this exercise is nevertheless highly effective if implemented with care. Students gripping slips of paper can look around the classroom and begin to internalize what it might have been like, in those days before flu shots, to experience such a dramatic loss of life in their community, to live in fear of succumbing to this pervasive death themselves.

This exercise brings the historical reality of the epidemic from mere charts and tables, and underscores its human aspect.

This is why I love history. Collecting source material from the past—even the seemingly dull charts and graphs full of raw data—helps us understand the social, cultural, and political impact of events of the past. As students more fully comprehend the historical import of this moment in time, I allow them to explore a rich variety of sources related to the flu. One of the most valuable resources I obtained from my visit to the archives came in the form of a thick portfolio of clippings from local Philadelphia newspapers, magazines, posters, and other ephemera produced during and after the peak of the epidemic in 1918 and 1919. The bound collection is full of examples ranging from gruesome images of mass graves within city limits, to published reminders to citizens of hygiene recommendations like handwashing, drinking water, and, improbably, rinsing fruit.

These documents enrich students understanding of the history of medicine in ways my lecturing along cannot convey. They

London Ministry of Health. Reports on Public Health and Medical Subjects No. 4: Report on the Pandemic of Influenza 1918-1919. (London, 1920): 293.

London Ministry of Health. Reports on Public Health and Medical Subjects No. 4: Report on the Pandemic of Influenza 1918-1919. (London, 1920): 293.

allow students to read and experience it as if among the historical actors they are studying. The documents provide important opportunity for critical thinking and historical analysis, placing each within a multifaceted context. The documents, the materials I collected while conducting research at the College of the Physicians of Philadelphia, are crucial tools in my attempts to teach the history of medicine.

Of course, the collections I examined contain far more than only materials on the flu epidemic of nearly a hundred years ago. I feverishly photographed text and images from myriad sources in the collection, helping develop lectures on Progressive Era mental health policies and how these were related to themes of nationalism, tied to the emergence of psychology as a scientific profession. I transcribed documents related to the Northampton Lunatic Hospital, which was once situated just miles from the classroom where I teach. I collected countless ephemera – advertisements, promotional materials, product labels, and essays by medical professionals – on various (and often appallingly humorous in their dated sexism) aspects of women’s health.

My time in the reading room was not just professionally productive, but highly enjoyable, punctuated by laughter over old texts that did not quite stand the test of time, by jaw dropping moments, and by sober reflections on the impact of disease. I left the archives armed with hundreds of photographs and dozens of pages of notes, as well as new friendships forged with staff at the Historical Medical Library and Mütter Museum. I have since directed students to the collections, with one spending time in the archives and others using digital collections for various research projects.

Scrapbook of newspaper clippings (September 14, 1918 to March 1, 1919) concerning the influenza epidemic in Philadelphia, 1918-1919. Philadelphia, PA, 1919.

Scrapbook of newspaper clippings (September 14, 1918 to March 1, 1919) concerning the influenza epidemic in Philadelphia, 1918-1919. Philadelphia, PA, 1919.

Perhaps you should take it with a grain of salt, as I’m a self-proclaimed fan of the flu, but I cannot recommend more highly the collections or the experience of working at the archives of the College of Physicians of Philadelphia.

Live Symposia TODAY on Universities and Slavery: Bound by History

In March 2016, Harvard President Drew Gilpin Faust, in an opinion piece in the Harvard Crimson, urged the university to more fully acknowledge and understand its links to slavery, stating, “The past never dies or disappears. It continues to shape us in ways we should not try to erase or ignore.”

On March 3, 2017, the Radcliffe Institute for Advanced Study at Harvard University will host a daylong conference to explore the relationship between slavery and universities, across the country and around the world.

The faculty conference organizers are Harvard professors

  • Sven Beckert, Laird Bell Professor of History
  • Evelyn Brooks Higginbotham, Victor S. Thomas Professor of History and of African and African American Studies
  • Daniel Carpenter, director of the social sciences program at the Radcliffe Institute and Allie S. Freed Professor of Government

The conference builds on the Harvard and Slavery initiative, founded in 2007, in which students and faculty—led by Beckert—began a detailed examination of Harvard’s range of connections to slavery.

This event will be webcast live, in its entirety, and videos will be available online after the conference.

How to watch the live webcast

Please use the hashtag #unislavery.

SCHEDULE

9 a.m.

WELCOME

Lizabeth Cohen, Dean of the Radcliffe Institute and Howard Mumford Jones Professor of American Studies, Harvard University

9:15 a.m.

OPENING REMARKS

Drew Gilpin Faust, President of Harvard University and Lincoln Professor of History

9:30 a.m.

KEYNOTE

Ta-Nehisi Coates, Journalist, national correspondent for The Atlantic, author of Between the World and Me and The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood

Conversation between Ta-Nehisi Coates and Drew Gilpin Faust

10:30 a.m.

BREAK

10:45 a.m.

SLAVERY AND UNIVERSITIES NATIONALLY

Moderator: Evelyn Brooks Higginbotham, Victor S. Thomas Professor of History and of African and African American Studies, Harvard University

Adam Rothman, Professor of History, Georgetown University

James T. Campbell, Edgar E. Robinson Professor in United States History, Stanford University

Craig Steven Wilder, Barton L. Weller Professor of History, Massachusetts Institute of Technology

12:15 p.m.

LUNCH BREAK

1:15 p.m.

POETRY READING

Introduced by: Vincent Brown RI ’06, Charles Warren Professor of American History and Professor of African and African American Studies, Harvard University

Natasha Trethewey RI ’01, former United States Poet Laureate, Robert W. Woodruff Professor of English and Creative Writing, Emory University

1:30 p.m.

SLAVERY AND HARVARD

Moderator: Annette Gordon-Reed RI ’16, Charles Warren Professor of American Legal History, Harvard Law School, and Professor of History, Harvard University

Sven Beckert, Laird Bell Professor of History, Harvard University

Julian Bonder, Principal, Wodiczko + Bonder and Julian Bonder + Associates; Professor of Architecture, Roger Williams University

Daniel R. Coquillette, J. Donald Monan, S.J. University Professor, Boston College Law School

Alexandra Rahman ’12, Student contributor to the Harvard and Slavery Research Project

3 p.m.

BREAK

3:15 p.m.

SLAVERY AND UNIVERSITIES GLOBALLY

Moderator: Alejandro de la Fuente, Robert Woods Bliss Professor of Latin American History and Economics; Professor of African and African American Studies and of History; Director, Afro-Latin American Research Institute, Harvard University

Hilary Beckles, Vice-Chancellor of the University of the West Indies

Max Price, Vice-Chancellor of the University of Cape Town

Christiane Taubira, former Minister of Justice (France)

4:45 p.m.

CONCLUDING REMARKS

Daniel Carpenter, Director of the Social Sciences Program at the Radcliffe Institute; Allie S. Freed Professor of Government, Harvard University

5 p.m.

RECEPTION

Medical and Public Health Ethics in the Shadow of the Holocaust: The Nazi Doctors, Jewish Resistance, Resilience and Survival

~This post courtesy of Lisa Mix, Head, Medical Center Archives Weill Cornell Medicine Samuel J. Wood Library & C.V. Starr Biomedical Information Center

The Heberden Society and the WCM Division of Medical Ethics jointly present: Michael A. Grodin, MD on Medical and Public Health Ethics in the Shadow of the Holocaust: The Nazi Doctors, Jewish Resistance, Resilience and Survival.

The lecture will take place on Monday, March 13, 2017, 5:00 pm at the Selma Ruben Conference Center, Weill Cornell Medical College Weill Greenberg Center, 1305 York Avenue Room A-B (2nd floor).

Michael Alan Grodin, MD, is Professor of Health Law, Ethics and Human Rights at the Boston University School of Public Health, and in the Center for Health Law, Ethics & Human Rights, and is Professor of Psychiatry and Family Medicine at the Boston University School of Medicine. He completed his B.S. degree at the Massachusetts Institute of Technology, his M.D. degree at the Albert Einstein College of Medicine, his postdoctoral and fellowship training at UCLA and Harvard, and he has been on the faculty of Boston University for the past 35 years. Dr. Grodin is the Medical Ethicist at Boston Medical Center and for thirteen years served as Chairman of the Institutional Review Board of the Department of Health and Hospitals of the City of Boston. He is a fellow of the Hastings Center, served on the board of directors of Public Responsibility in Medicine and Research, the American Society of Law, Medicine and Ethics, and the Advisory Board of the Center for the Philosophy and History of Science. He is a member of the Ethics Review Board of Physicians for Human Rights and co-director of Global Lawyers and Physicians: Working Together for Human Rights, a transnational NGO. He was founding director of the Boston Center for Refugee Health and Human Rights: Caring for Survivors of Torture, which received the 2002 Outstanding Achievement Award from the Political Asylum/Immigration Representation Project. Professor Grodin received a special citation from the United States Holocaust Memorial Museum in recognition of his “profound contributions – through original and creative research – to the cause of Holocaust education and remembrance.” He was a Member of the Global Implementation Project of the Istanbul Protocol Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, and an Advisor to UNESCO. Dr. Grodin was the 2000 Julius Silberger Scholar and recipient of the 2014 Kravetz Award as an elected member of the Boston Psychoanalytic Society and Institute and the American Psychoanalytic Association.

Dr. Grodin has published more than 200 scholarly papers, and edited or co-edited 7 books: The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation, Children as Research Subjects: Science, Ethics and Law (both in the Bioethics Series of Oxford University Press); Meta-Medical Ethics: The Philosophical Foundations of Bioethics (Boston Studies in the Philosophy of Science Series, Kluwer Academic Press); Health and Human Rights: A Reader (selected as 2nd of the top 10 humanitarian books of 1999); Perspectives on Health and Human Rights; and Health and Human Rights in a Changing World. His most recent book is Jewish Medical Resistance in the Holocaust. He is working on a new book, Spiritual Resistance and Rabbinic Response During the Holocaust.

The Heberden Society, which seeks to promote an interest in the history of medicine, was founded at the medical center in 1975. With funding from the Office of the Dean, the society sponsors a series of lectures during each academic year.

National Endowment for the Humanities Awards New York Academy of Medicine Library with Digital Projects for the Public Discovery Grant

Interactive digital “Biography of a Book” project brings to life the creation, use and collection of key historic texts in the Academy Library’s rare book collections

The National Endowment for the Humanities has awarded The New York Academy of Medicine Library $30,000 through its Humanities Digital Projects for the Public Discovery Grant program to support the development of its interactive digital “Biography of a Book” project. This innovative project aims to tell the individual and collective stories of books, ranging from the survival of one of only two extant medieval copies of an ancient Roman cookbook, to a twentieth century re-imagining of a classic work of Renaissance anatomy.

“We are extremely pleased to have the support of the National Endowment for the Humanities for our growing digital program,” said Academy President Jo Ivey Boufford, MD. “Exploring the intersections of medicine, humanities and the arts is a core priority for the Academy. This prestigious planning grant will allow us to bring some of our world-class Library’s treasures to broad public audiences.”

The Academy Library, which holds one of the most extensive rare book collections in the United States, has selected and digitized 12 rare books and manuscripts from its collection for the project, including the two earliest manuscripts: Apicius de re culinaria, a collection of recipes attributed to the second century Roman gourmand by the same name; and Guy de Chauliac’s Chirurgia Magna, or “great surgery,” a fourteenth-century illuminated manuscript and authoritative text on surgery through the seventeenth century. The goal of the project is to produce an innovative, interactive exhibit that will make these books more accessible to a broad audience through the use of timelines, side by side technologies, and digital interactives that illuminate how they were created, who used them, and who collected them.

The main goal of the “Biography of a Book” discovery phase, to be conducted between January and December 2017, is to develop a robust design document that will help to inform the prototype and implementation phases of the project.

The grant supports the convening an advisory committee comprising experts in the areas of history of medicine, history of the book, digital humanities, user research and technology. The committee will provide feedback both on content and on user experience.

“The distinguished group of scholars in the humanities and information science who have volunteered their time to help take the project forward indicates the importance of the work the Academy Library is doing to bring interdisciplinary communities together,” said Robin Naughton, PhD, Head of Digital at the Academy Library.

 

Advisory Committee Members

Denise Agosto, Professor, College of Computing & Informatics, Drexel University

Carin Berkowitz, Director, Beckman Center for the History of Chemistry, Chemical Heritage Foundation

Janet Golden, Professor of History, Department of History, Rutgers University-Camden

Anthony Grafton, Professor, Department of History, Princeton University

Heidi Knoblauch, Independent scholar (formerly Bard College)

Craig MacDonald, Assistant Professor, School of Information, Pratt Institute

Mike Sappol, EURIAS Senior Fellow, Swedish Collegium for Advanced Study, Uppsala

Pamela H. Smith, Seth Low Professor of History, Columbia University

Nick Wilding, Associate Professor, Department of History, Georgia State University

About The New York Academy of Medicine

The New York Academy of Medicine advances solutions that promote the health and well-being of people in cities worldwide.

Established in 1847, The New York Academy of Medicine continues to address the health challenges facing New York City and the world’s rapidly growing urban populations. We accomplish this through our Institute for Urban Health, home of interdisciplinary research, evaluation, policy, and program initiatives; our world class historical medical library and its public programming in history, the humanities and the arts; and our Fellows program, a network of more than 2,000 experts elected by their peers from across the professions affecting health. Our current priorities are healthy aging, disease prevention, and eliminating health disparities.

Celebrating Vivien Thomas

~This post courtesy of Phoebe Evans Letocha, Collections Management Archivist, Alan Mason Chesney Medical Archives Johns Hopkins Medical Institutions.

Vivien T. Thomas, oil portrait by Bob Gee, 1969

Vivien T. Thomas, oil portrait by Bob Gee, 1969

To commemorate February as both Black History Month and American Heart Month, the Medical Heritage Library salutes the contributions of Vivien Thomas, an African American surgical technician at Johns Hopkins.

Born in Lake Providence, Louisiana on August 29, 1910, Vivien Thomas grew up attending segregated public schools in Nashville Tennessee. In 1930 after being forced to drop out of pre-medical studies in college when his life savings were wiped out by a bank crash, Thomas took a position as a laboratory assistant to surgeon Alfred Blalock at Vanderbilt University. Thomas’ abilities as a surgical assistant and research associate were of the highest quality, and when Blalock moved to Johns Hopkins in 1941 he asked Thomas to accompany him to Baltimore.

At Johns Hopkins, Thomas collaborated with Alfred Blalock and Helen Taussig to devise the operative technique to correct a congenital heart defect, Tetralogy of Fallot, or “Blue Baby Syndrome” that robs the blood of oxygen. First performed in 1944, the anastomosis operation named the Blalock-Taussig Shunt, brought fame to Blalock and Taussig. However due to racial prejudice at the time and the academic custom of not giving credit to non-degreed lab assistants, Thomas’s contributions went unrecognized. He was a hidden figure, critical to the success of the operation. He worked out the surgical technique in the dog lab, using a clamp of his own design, and coached Blalock in the operating room through the first human operation.

Third year medical student Reginald Davis holding a child with Levi Watkins, and Vivien Thomas in front of Johns Hopkins Hospital Administration Building, 1979

Third year medical student Reginald Davis holding a child with Levi Watkins, and Vivien Thomas in front of Johns Hopkins Hospital Administration Building, 1979

As supervisor of the surgical laboratories for over 35 years, Thomas went on to train a generation of surgeons at Johns Hopkins in the delicate techniques necessary for heart and lung operations. Notable among them was Hopkins first black cardiac resident Levi Watkins, Jr, who was a pioneer in the use of the automatic implantable defibrillator, performing the first human operation in 1980, after having first tested the device on dogs with Thomas in his lab. Thomas had earlier worked with William Kouwenhoven, James Jude, and Guy Knickerbocker in contributing to the development of the closed chest electrical defibrillator.

Thomas’ achievements were finally recognized formally by Johns Hopkins with a portrait presented in 1971, and with a 1976 faculty appointment and honorary degree from the University. He retired in 1979 to write his autobiography, Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock (Philadelphia: University of Pennsylvania Press, 1985), later republished as Partners of the Heart: Vivien Thomas and his work with Alfred Blalock (1998). Sadly, Thomas died November 26, 1985, just as the book was published. In 2005, the Johns Hopkins University School of Medicine named one of its 4 new colleges after Vivien Thomas.

Thomas’ story was dramatized in the 2004 HBO film Something the Lord Made, and the 2003 PBS documentary Partners of the Heart.

MHL partner, the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions houses the Vivien Thomas Collection, and in 2015 published a finding aid to the processed collection. The collection includes the manuscript and its various drafts for the memoir, along with correspondence principally with Mark Ravitch, one of the surgeons Thomas had trained at Hopkins and who assisted Thomas in editing the book and securing a publisher.