Breakthrough.jpgTitle: Breakthrough!: How Three People Saved “Blue Babies” and Changed Medicine Forever
Author: Jim Murphy
ISBN: 9780547821832
Pages: 130 pages
Publisher/Date: Clarion Books, an imprint of Houghton Mifflin Harcourt Publishing Company, c2015.

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. (xiii)

On Wednesday, November 29, 1944, history was made. The first ever operation on a child to increase blood flow to the heart was scheduled to take place. Not only was it a moment in medical history, but it was also a moment in women’s rights and African-American rights. For over a year Dr. Alfred Blalock, chief surgeon and researcher at Johns Hopkins Hospital, and his African-American research assistant Vivien Thomas had been studying the research of hearing-impaired pediatric physician Dr. Helen Taussig. At Taussig’s request, they had been searching for a means to solve this reoccurring problem of abnormal development of the heart, which had cost her the lives of over two hundred patients. When they finally develop what they think is a solution, they find themselves in a race against time with undeveloped technology and unpracticed procedures to save the life of a young child.

An interesting introduction to a rarely considered medical event, this narrative nonfiction provides background contextual information, primary source photographs, and simplified descriptions of scientific concepts. Mentioned in the short description above, this book could be used to spread knowledge about medical, women’s, or African-American history. Vivien Thomas is unable to attend medical school due to the economic collapse of the 1930s, and ends up being essentially educated on-the-job after he is hired by Blalock, ten years his senior. With his boss and upon first arriving at Johns Hopkins, Thomas is forced to confront racist tendencies that had been culturally ingrained for decades. Dr. Helen Taussig also had to confront others’ prejudices against her, including not being allowed to take more than one or two classes at a time and not being allowed to study in the same room as her classmates for fear she would “contaminate” the other students. Her gradual hearing loss also proved unique problems that she solved in order to continue the professional career track she had fought so hard to achieve. Other social issues at the time that are still prevalent today, including animal testing, sterilization methods, and insider industry information, are touched upon to provide context.

It’s the personal vignettes behind the discovery that create the compelling narrative. The inclusion of period photographs featuring the people and places involved all bring the incredible story to life. The medical concepts are broken down into the barest, most simplistic terms. While that makes it easy to understand for readers, additional visuals to aid in comprehending the surgery and the anatomy involved would have been appreciated. The sequence of development of the heart on page 28 and the drawing of the chest cavity inside a child on page 49 was extremely helpful in envisioning it, although the captain makes it sound like the drawing was done by Thomas. Even enlarging the newspaper clipping found on page 77 would have sufficed, to make it easier to read the information contained and see the drawing provided, although it is a remarkably clear and readable scan.

For a fuller picture of the historic event, it’s implications, and aftermath, readers should read the detailed source notes, which contain information that regrettably did not make it into the primary text. It’s my impression that most people neglect to read the included back matter in informational texts. For instance, while the text vaguely mentions that Thomas was later recognized, including a formal portrait, an honorary doctorate, and made head of the laboratory, the significance of his becoming an “instructor of surgery at the school, an extraordinarily rare appointment for someone who was neither a surgeon nor a doctor” is only mentioned in the source notes. Overall, the book does a solid job recognizing the accomplishments of scientists that no one has heard of or probably even considered investigating.

nonfiction mondayThis review is posted in honor of Nonfiction Monday. Take a look at what everyone else is reading in nonfiction this week.

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