Breakthrough!: How Three People Saved “Blue Babies” and Changed Medicine Forever by Jim Murphy (review)

Less than a century ago, congenital heart defects carried a sentence of doom, and cutting into a human heart to repair damage was, in most scientific circles, unthinkable. A trio of medical personnel at Johns Hopkins Hospital, driven by the desperation of young sufferers and their own commitment to the possible, risked their reputations in the first surgery to “replumb” a child’s heart to deliver oxygen to her failing system. Dr. Alfred Blalock was regarded as a quiet Southern gentleman, a gifted researcher delving into treatment for shock, but not the most nimble surgeon. His African-American assistant, Vivien Thomas, was meticulous in the lab and undaunted by such obstacles as lack of equipment (surmounted by his inventions) and surgical precedent. Dr. Helen Taussig, a pediatric cardiologist and a leader among women doctors in mid-twentieth century America, convinced Blalock that heart repair was feasible and that his knowledge of the circulatory system would make him a fine candidate to invent the procedure. Murphy provides cogent explanations of how congenital heart defects occur and the challenges of performing surgery on diminutive arteries in a tiny thoracic space. His primary focus, though, is on the team itself and the challenges they faced confronting a skeptical and mainly white male medical profession. Thomas met with blatant noncooperation and enjoyed little credit for his work; Blalock faced censure for defending his black assistant; Taussig (who continued to practice as she became deaf) constantly fought turf wars over the care for her patients. Focus on the debut operation and its aftermath allows readers to examine both the medical and interpersonal dramas in a relatively slim volume, and the gallery of black and white photos contextualize the historical era. Annotated chapter notes, a bibliography, and an index are also included.