The cast-iron radiator in Johns Hopkins Hospital operating room 706 rattled and hissed but didn’t give off much heat on the morning of November 29, 1944. Outside, a miserable, cold rain was falling, allowing only a feeble bit of gray light to seep through the room’s large windows.
The somber atmosphere was matched by the mood of the surgeon, Dr. Alfred Blalock, and the seven other people who made up his surgical team. And for good reason. The patient they were about to operate on, Eileen Saxon, was eighteen months old and weighed only 8.8 pounds. Eileen had a severe congenital heart defect that made it difficult for her to breathe and turned the skin on parts of her body an unhealthy looking dark color. Dr. William Longmire, assisting Blalock that morning, was absolutely horrified by what he saw. “I took one look at the little patient and thought, ‘My God, this man isn’t going to operate on her!’ I thought that after [the initial] incision…this child would surely die.”
Others had worried that simply administering the anesthetic might kill Eileen. Dr. Austin Lamont, the chief of anesthesia at Johns Hopkins, felt the girl’s health was so fragile that he refused to assist Blalock.
No doctor who examined the girl would have disagreed with Lamont’s assessment. Eileen was gravely ill and about to die. But Blalock and the head of the Children’s Cardiac Clinic, Dr. Helen Taussig, had argued that it was precisely because she was so close to death that the surgery was necessary. Eileen’s condition was rapidly deteriorating, they explained. She might live for a few hours, possibly even a day, but probably not much longer. The operation, if successful, was the only way to prolong her life.
The procedure was allowed to go forward, but the words “if successful” haunted Blalock. Responsibility for the operation and for Eileen’s life rested squarely on his shoulders. Self-doubt had been nagging at him since he’d first scheduled the surgery a few days before. At one point, he grew so upset over some research experiments that hadn’t gone well that he blurted out to his colleague Longmire, “Bill, I am discouraged. Nothing I do seems to work these days.” His lack of confidence had been following him everywhere and at all times. The night before the procedure Blalock had a difficult time sleeping; the next morning he was so distracted and nervous that he decided he couldn’t drive safely and asked his wife to drive him to the hospital.
It wasn’t only that the operation was very complex and risky. The surgery he was about to perform on Eileen’s struggling heart had never been done on a human before, let alone one so tiny or frail. This was why the balcony-type observation stand along the west side of room 706 was packed with curious Johns Hopkins staff and why a movie camera had been set up pointing at the operating table. If the operation worked — if the patient survived — history would be made.
Moreover, Blalock had never performed this procedure, not even on an experimental animal. In fact, the only person to have done it successfully, start to finish, wasn’t an official member of the surgical team. According to hospital rules, he wasn’t even supposed to be in the room. But he was there now, at Blalock’s request, standing just behind the surgeon on a wooden step stool. His name was Vivien Thomas, and most people at the hospital thought he was a janitor.