Breakthrough!: How Three People Saved "Blue Babies" and Changed Medicine Forever – An Award-Winning Young Adult History of Vivien Thomas and a Historic Surgical Triumph

by Jim Murphy

"Murphy’s dramatic nonfiction narrative recounting of one of the first open heart surgeries ever performed is not to be missed." —School Library Journal (starred review)

In 1944, a groundbreaking operation repaired the congenital heart defect known as blue baby syndrome. The operation’s success brought the surgeon Alfred Blalock international fame and paved the way for open-heart surgery. But the technique had been painstakingly developed by Vivien Thomas, Blalock’s African American lab assistant, who stood behind Blalock in the operating room to give him step-by-step instructions.

The stories of this medical and social breakthrough and the lives of Thomas, Blalock, and their colleague Dr. Helen Taussig are intertwined in this compelling nonfiction narrative.

Winner, Notable Books for a Global Society * Horn Book Fanfare List * A Booklist Best Young Adult Book

Genres: Nonfiction, Science, History, Medicine, Middle Grade, Medical, Historical

122 pages, Kindle Edition

First published December 8, 2015

About the author

An American author of more than 35 nonfiction and fiction books for children, young adults, and general audiences, including more than 30 about American history. He won the Margaret Edwards Award from the American Library Association in 2010 for his contribution in writing for teens. Jim lives in Maplewood, New Jersey, in a hundred-year-old house with his wife Alison Blank, a children’s TV producer and children’s book author and editor, his two talented musician sons, a regal mutt, an African water frog that will live forever, and a house vast collection of books..

Reviews

[Richie Partington · Rating 5 out of 5]

Richie’s Picks: BREAKTHROUGH! HOW THREE PEOPLE SAVED “BLUE BABIES” AND CHANGED MEDICINE FOREVER by Jim Murphy, Clarion, December 2015, 144p., ISBN: 978-0-547-82183-2

“Please help me mend my broken heart
And let me live again.”
--Barry, Robin, and Maurice Gibb (1971)

“It wasn’t only that the operation was very complex and risky. The surgery he [Dr. Blalock] 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 John 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.”

Why did most people figure Vivien Thomas to be a janitor? Because this was taking place in the South in 1944 and he was the black guy in the room. BREAKTHROUGH! is, in large measure, the story of Vivien Thomas. Thomas, had he been white, would have gotten credit a whole lot sooner for his trailblazing role in saving babies and little kids born with defective hearts. Had he been white, and given his talent, he’d undoubtedly have had the opportunity to become a surgeon like his boss, Dr. Alfred Blalock.

Dr. Blalock got all the credit for the successful heart operation. He was white. When Vivien Thomas followed Dr. Blalock to John Hopkins University in 1941, after eleven years as Blalock’s research assistant at Vanderbilt, you can guess which of the two couldn’t find a decent place to live. BREAKTHROUGH! is, in part, a story of discrimination in America shortly before the dawn of the modern Civil Rights Movement.

The book’s third principal character is Dr. Helen Taussig, head of the Children’s Cardiac Clinic at John Hopkins for more than three decades. She had jars and jars filled with little hearts from the young patients she’d not been able to save. She was the one who asked Dr. Blalock to figure out how to repair defective hearts. Blalock asked Vivien Thomas to solve the problem.

In chronicling what was wrong with the gravely ill child being operated on, author Jim Murphy provides understandable explanations of how a heart develops, how it’s supposed to work, and what needed to be repaired so that Eileen might live and prosper. There is a strong science component to BREAKTHROUGH!.

By the time the historic operation took place in November 1944, Vivien Thomas had repeatedly and successfully performed this heart surgery on dogs. Animal experimentation is the way that new medical procedures are perfected: Doctors experiment on animals before performing new medical procedures on people. Drug companies, cosmetic companies, and food additive companies all engage in animal testing before marketing new products.

Should animals undergo experimental surgical procedures so that doctors can figure out whether a procedure will work on people? Should animals have perfume splashed in their eyes for the sake of cosmetic companies? Author Jim Murphy presents this issue, too. The ethics of animal testing might be the what many young readers--particularly young pet owners--reflect upon after finishing this book.

Jim Murphy’s BREAKTHROUGH! is a tasty mix of biography, history, science, and ethics. There’s a lot to like and to think about in this quick nonfiction read for middle schoolers.

Richie Partington, MLIS
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[Bridget · Rating 5 out of 5]

fascinating how this surgery came to be, I am very thankful for these 3 people in history!

[Malory · Rating 4 out of 5]

This was a good book detailing the process of saving babies with heart conditions. We take advantage of modern medicine and don't often stop to think there had to be a first for everything. And operating on the heart seemed impossible and unthinkable. And yet three people worked together to achieve the impossible. I read this with my 6th grader for science and it was definitely eye opening to see how much medical science has changed over the years. I would recommend this book for upper elementary/middle school students.

[Carol · Rating 5 out of 5]

I enjoyed reading about these people and how they made a difference in the world.

[Amy · Rating 4 out of 5]

ARC from Edelweiss Above the Treeline

Recommended for: grades 6+

Content advisory: some descriptions may make readers queasy

Booktalk:

How many of you have ever had or know somebody who has had surgery?

What do you know about how surgeries?

I ask you because all of these things you’re mentioning - the importance of sterile equipment, intense post-surgery follow-up … once upon a time, not too long ago…. in the 1940s, in fact, these features of surgery didn’t exist yet, not even in the nation’s most prestigious hospital.

This book is about the team who worked together to develop a surgery that healed “blue babies.” “Blue babies” had a bluish skin tint because their hearts weren’t properly circulating blood around their bodies and so they weren’t getting enough oxygen.

Sounds like a simple problem, but to invent a surgery to fix it required a lot of practice, patience, and collaboration.

This was one of my favorite books of the year because I not only learned a lot about medicine and surgery, but I also learned about the personal lives and conflicts of those who worked on this innovation -- one of whom was a Vivien Thomas, a black man without a medical degree and another of whom was Helen Taussig, a woman with a reading disability, working at a time where minorities and women weren’t exactly welcome in a field like medicine and faced discrimination along the way.

Review:

I found this book chock-full with information on an appealing topic and yet well-paced for a tween reader. While there were many fascinating diversions into the complicated ethics of animal testing, the stigma around operating on the heart, and the intense political hierarchies of the medical community, these sidenotes didn’t distract me from the central story.

Murphy quotes extensively from other sources: while I appreciate his transparency and thorough research, I am not sure my students will feel the same way, as they are still used to determining the difference between what the author wrote and what the author researched, and some of the nuance from these sources may be completely lost on my students -- for example, they might not be able to infer the casual misogyny and racism in some of the sources.

In addition, I found his description of how the heart worked and the science behind why the surgery was successful a little hasty -- perhaps overburdening the reader with the science would have bogged down what is a great story about individuals who overcome many personal and professional hurdles to accomplish something that transforms lives.

[Rebecca · Rating 4 out of 5]

This tells the stories of the three main medical people in the 1940s who figured out how to ameliorate the problem of "blue babies," babies and children with congenital heart problems that meant they weren't getting enough oxygenated blood. Vivien Thomas (not sure if I'm spelling that right) was an African American man who had wanted to be a doctor, but the Depression made that impossible. He became a medical research assistant to Dr. Blalock, a white man famous for his work with shock. Dr. Helen Taussig worked with babies and desperately wanted to find a way to fix the heart issues that were taking so many lives. She approached Blalock, who set Thomas on to research the problem, and Thomas came up with a stopgap that actually worked when Blalock performed the first surgery on a baby. It changed medical history, but Thomas didn't get his due until much later in his life--but he did get it, and all the respect he deserved.

This was really well-written, though I'll admit I skipped some of the medical details because of the squeamish factor. I liked how the author explained Thomas' situation as an African American in Boston at the time, and how he let readers draw their own conclusions about those involved. Blalock comes across as a realistically imperfect man, with attitudes born of the times, but he did involved Thomas at every step and respect his abilities. Murphy also touches on the issues of vivisection, though not in great detail; readers might be interested to pursue the topic on their own. Overall, this is a balanced, well-structured story that would be of interest mostly to kids who might like to pursue medicine.

[Alexa Hamilton · Rating 4 out of 5]

Jim Murphy is always phenomenal. I read a digital ARC of this book and I can't wait to get my hands on the final copy with all of the photos--though I had quite a few included. This was less of a mystery than some of his other books and more of an incredible story that is almost miraculous. He does not shy away from discussing racism and sexism, which was rampant. The notes were well done and great for kids who might be interested in some of the real nuances of the story.

[Elizabeth · Rating 4 out of 5]

Jim Murphy is known for writing well-researched and highly readable non-fiction for young adults and Breakthrough upholds his reputation. Medical history can be quite dry, but Murphy brings out the humanity in this particular piece of history, making it easy to see why he has been honored by the Newbery, Sibert, and National Book Award committees over his career.

The story begins with Vivien Thomas, an intelligent and hard-working Aftrican-American teen, who has worked through out his school days to save up money for college. Acceptance to Tennessee State College was his first step in pursuing his dream of becoming a doctor, but just as he was ready to leave for school, the 1929 economic collapse caused the bank holding his life savings to fail—and also meant that there were no jobs in construction for him to work in order to build up his savings again. A friend gave him a lead on a research assistant job at Vanderbilt University, which is where he met Dr. Alfred Blalock.

Dr. Blalock, while leading a relatively privileged life was not without his own struggles, some brought on by his own actions and others by illness. However, his response to the struggles was to want to be great in his position. He recognized in Thomas an intelligent man who could fulfill the relatively high demands of the research job.

These two became a very effective research team studying the treatment of medical shock, which still killed many people at the time. As WWII began to heat up, the team moved from Vandebilt to Johns Hopkins to continue their research on shock.

It is at Johns Hopkins that story shifts into that of the blue babies, with introduction of Dr. Helen Taussig. Taussig had fought dyslexia to make it to medical school, in addition to prejudices against female doctors. At the time many medical schools would not accept women—or would allow them to study medicine, but not receive a degree. She was in charge of the pediatric heart clinic at Johns Hopkins.

Breakthrough sets all of this in historical context, showing the many ways the story of surgery on tiny Eileen Saxon is not only a breakthrough moment in medical history- it reflects modern American history as well. It also provides stellar examples of hard work, grit, and the power of failure. (A key piece of the blue baby puzzle had been unknowingly solved years before though the failure of another experiment.) It is also an interesting look at the way science is applied in the “real world”.

The main story itself comes it at 99 pages, although there 20 additional pages of notes and citations. The book is filled with pictures of the key players, illustrations of their work, and even copies of their post-surgical notes and newspaper articles. The set-up and length makes this a great non-fiction choice for middle schoolers or as a “quick pick” for older students.

Reading about the ways this diverse team came together to change the course of medical history and the key role each person played was not only informative, but also interesting. Murphy doesn’t leave the reader hanging, providing information on what happened with the members of the team in later years, making for a satisfying read.

[Jennifer Ritchie · Rating 5 out of 5]

This is a great book about three interesting people and their creative collaboration which led to a life-saving surgery that saved many babies and young children. The details about medical research were interesting, but what really makes this book worth reading is the way it presents the stories of the people involved. Dr. Alfred Blalock, the skilled surgeon and meticulous researcher, who knew that his days were numbered and burned with the desire to make a difference before he died. Dr. Helen Taussig, who overcame many childhood obstacles to become one of the few female doctors of the time; she was gentle with her patients but fierce as she battled to save them. And best of all, Vivien Thomas, the African American research assistant whose creativity in the lab led directly to the breakthrough. He was so respected by Blalock that he was asked to be present to advise Blalock at the first attempt of the procedure on a human patient. He lived a life of quiet dignity, integrity, and excellence, never complaining when he didn’t initially get credit for his contribution to the breakthrough. He taught the procedure to scores of surgeons, helping to save many lives, and he did eventually receive the credit and appreciation he deserved.

The book deals with issues like racial discrimination and experimental research on animals; it does so concisely and in an even-handed way. Kids who love dogs might be really sad about one part where a researcher has to break a dog’s leg with a hammer in order to study the effects of shock (this was at the beginning of WWII when they were trying to save soldiers who were dying of shock after being wounded).

The only complaint I have (and it’s a small one) is that some of the most fascinating tidbits of information are buried in the source notes at the end of the book, where kids aren’t likely to read them. For instance, one of the notes mentions that Olympic champion snowboarder Shaun White was a “blue baby” who was surgically treated with this same procedure, which today is considered pretty routine. I’m sure that would interest most of the young readers of this book!

Overall, a well-written and inspiring true story for young readers. Ages 9 and up.

[Angie · Rating 4 out of 5]

Babies born with heart defects that affected the flow of oxygen were called blue babies because their extremities would be blue instead of a healthy pink. Cardiac surgery was not something doctors even considered as the heart was a sacred organ and to cut into it seemed wrong. That all changed in the 1940s at Johns Hopkins Medical Center.

Dr. Helen Taussig was the head of the pediatrics unit and was tired of seeing her patients die. She enlisted the help of Dr. Alfred Blalock and his assistant Vivien Thomas to come up with a way to fix the hearts of these tiny patients. Dr. Blalock was a famous surgeon and researcher who revolutionized the way shock was treated. Thomas was a young African American who was unable to attend medical school but was one of the best researchers and surgeons. Dr. Blalock directed Thomas to find a way to redirect oxygen to the heart and he did. In fact, Dr. Blalock had only performed the surgery on a dog once when he was called in to perform it on a human.

Eileen Saxon was 18 months old and not going to make it unless they intervened. Dr. Blalock, Dr. Taussig and Thomas enlisted a team and performed the first surgery to correct the blue baby problem. It revolutionized cardiac medicine.

What was most interesting about this story was that Vivien Thomas was the actual person who came up with the solution, the surgery procedures and the instruments. He perfected the surgery on dogs before teaching it to Dr. Blalock, but it wasn't until years later that he got the recognition he deserved for his contributions.

[Valerie McEnroe · Rating 4 out of 5]

In a normal heart, the ventricles are fully separated, preventing oxygenated and deoxygenated blood from mixing. "Blue babies" don't have enough oxygen in their blood due to a hole in the heart that allows the deoxygenated blood to mix with the oxygenated blood. In the 1940s a pediatric cardiologist at Johns Hopkins University, Dr. Helen Taussig, approached Dr. Alfred Blalock, a medical researcher, to find a surgical procedure to correct the blue baby defect. Dr. Blalock put his black assistant, Vivien Thomas, in charge. Thomas had no medical degree, but he was highly intelligent and independent. He practiced his technique on laboratory animals.

Blalock was not ready to test out Thomas' new procedure when Taussig brought him a blue baby that was failing fast. He agreed to do the surgery with Thomas present to guide him. Under primitive surgical conditions, by today's standards, Blalock saved the infant's life. Both he an Taussig received much acclaim, while Thomas stood in the shadows. Thomas continued to work for Johns Hopkins and 30 years later received an honorary Doctorate for his accomplishments.

Jim Murphy successfully pulls together two issues to create one very interesting story. One issue is the development of a surgical cure for "blue baby" syndrome and the other is racial discrimination. Murphy's decision to include both issues allowed for a story with more depth and detail. As usual, Murphy uses his classic narrative style to fully engage the reader. Another nonfiction book in the win column.

[Abby Bauernfeind · Rating 4 out of 5]

The approach to telling the true story of the blue baby syndrome surgery sheds light on an issue that was most likely not rare for the time period. The book initiates questioning of what other medical procedures were contributed to by someone of lower social status based on his/her race or gender. The perspective of the book allows it to expand children’s knowledge of the inequality that existed historically across America. The book provides knowledge of a new venue for discrimination, one that is not frequently discussed. Many historical accounts of Jim Crow laws and discrimination surround issues in public spaces like bathrooms, buses and schools. This book allows for expansion of the severity of discrimination in the United States and the liberties that were not afforded in public as well as private, professional settings. A weakness of the book is its appeal, or lack of appeal, to children. The historical approach and the need to share a multitude of facts, makes it challenging to engage the reader. There is a distinct lack of important literary elements that seek to engage the reader on another level. The book could serve to be livened up, but the process of doing so may result in a loss of important information that is crucial for understanding the entire story.

[Taylor · Rating 4 out of 5]

⭐The Good

*This book is well researched
*The selected photographs are a
*There is a balanced perspective regarding the discrimination permeating the culture of the time. Rather than going on an angry rant about racism and sexism, the author gives historical context, answers tough questions with facts, and focuses on the hard work of Thomas and Dr. Taussig. It's brutally honest, but optimistic. Rather than getting distracted by anger, you're more focused on the achievements of the people who are the subject of this book.

📝 What Lacked

* Some of the writing was really anticlimactic. I would feel dropped in to the story, but then it would be over in a flash. Some of the facts were just casually thrown in about the future. I wanted to feel like I was present during that first surgery.
*The book was just too short. Some of the details were just like, really detailed bullet points. I was left with more questions than I had answers. If this is a book meant for a Jr. High or High School library for the reference section, it's fine. But if the author wants a broader audience, then we need more of a narrative. I want to SEE the conversations between Blalock and Taussig when she first approaches him. Something. I feel teased.

[Abby Pratt · Rating 5 out of 5]

The approach to telling the true story of the blue baby syndrome surgery sheds light on an issue that was most likely not rare for the time period. The book initiates questioning of what other medical procedures were contributed to by someone of lower social status based on his/her race or gender. The perspective of the book allows it to expand children’s knowledge of the inequality that existed historically across America. The book provides knowledge of a new venue for discrimination, one that is not frequently discussed. Many historical accounts of Jim Crow laws and discrimination surround issues in public spaces like bathrooms, buses and schools. This book allows for expansion of the severity of discrimination in the United States and the liberties that were not afforded in public as well as private, professional settings.

[Vivian · Rating 4 out of 5]

This is more than a surgery story, more than a hospital conditions story, more than a research story, and more than a human rights story. It is a story of overcoming workplace politics, racial prejudices, feminist obstacles, medical science status quo, and more. It is also the story of three remarkable individuals, namely Dr. Alfred Blalock, Dr. Helen Taussig, and lab technician Vivien Thomas.

This short work of 100 pages, replete with photographs, is a page-turner story of one medical breakthrough. Having read it, I have a greater appreciation for medical practices that are taken for granted today, the ways in which obstacles were overcome, innovations made and the ripple effect of these contributions.

[Julie G Miles · Rating 5 out of 5]

I might be a bit biased, but this was a fabulous book! My oldest son (12) was born with a CHD, and without the bravery and wisdom of these 3 medical pioneers, he would not be here! He has a different defect (HLHS) than the TOF mentioned in this book, yet his first surgery used the BT (Blalock-Taussig) shunt named after 2 of these 3 people, which is what drew me to this book. Vivien Thomas is my new hero. So thankful for his dedication and perseverance for pursuing his dreams of working in the medical field, despite the racist challenges he faced with being an African American in the 1940s. He is definitely "something the Lord made"!

[Jay :) · Rating 3 out of 5]

for my nonfiction book, I read "Breakthrough! How Three People Saved Blue Babies And Changed Medicine Forever". Personally, this book was about a 3/5, because the way the book was written wasn't too expressive. I DEFINITELY think this is an important story for people to know about, but if you're not a huge non-fiction fan, wouldn't recommend this book to you! This was written more in a story telling way, rather than a factual way, but the actual information on the blue babies didn't show up until chapters 4-5. If you like learning about a little history, and about famous doctors along with reading about medical procedures, this book is definitely for you!

Thank you for reading!

[Tamsyn · Rating 3 out of 5]

This was a very interesting book about the teamwork between 3 people (one a woman, and another a black man) in 1944 to solve the medical issue of "blue babies". I think my favorite part was when the black man, Vivien Thomas, who'd been planning to attend medical school when he lost all his tuition money to the Crash in 1929 but went on to be an exacting medical practitioner, developing a lot of the techniques that proved successful in these operations, was gifted with a portrait of himself that was hung alongside all the famous surgeons at Johns Hopkins Hospital.

[Luna Hourani · Rating 4 out of 5]

Breakthrough by Jim Murphy is a really good book. This book is about how some babies develop a heart condition that can take their life away in just a few days. A few doctors try to come up with a cure for this condition. It isn't very easy though. They have to test on a lot of animals just to figure out how to help people. I like this book because it can teach the reader something while making the situation very interesting.The only problem I find is that this book doesn't really focus on the problem that much. It mainly just talks about the doctor's life.

[Laura · Rating 3 out of 5]

Fascinating story of collaboration between a white woman, white man, and black man in the 1940s--when black men weren't physicians and women physicians weren't respected much. I enjoyed the story and the science, although I think there could have been more diagrams about the actual operation (I was confused about what was happening). The best part, however, was reading about the interesting history behind who got credit for the operation and who didn't and how it changed as time went on.

[Kmleeh · Rating 4 out of 5]

Jim Murphy has always been one of my favorite juvenile nonfiction authors. He manages to truly create a full story out of the history presented, never fearing to touch on tough topics and even criticizing those he covers. By doing so he gives readers the complete truth of an event in ways they can easily understand. I highly recommend his books to anyone interested in or uninterested in history, medicine or the other varied topics he writes about.

[Carrie G · Rating 4 out of 5]

I came across this book on the shelves of give-aways that had been withdrawn from my public library. I had never heard of it before, but I am well-acquainted with Jim Murphy's work. Can I just say... what a FASCINTING book. I have *no idea* which student I could give this to, what teen would want to read this, but I'm SO GLAD that someone took the time to tell the story of Vivien Thomas and his dedication to medical research! This book is a quick read and well-worth every minute!

[Amyc · Rating 4 out of 5]

Interesting non-fiction about Dr. Alfred Blalock, Vivien Thomas, and Dr. Helen Taussig and their quest to treat blue baby syndrome.

If you want to see a great movie about this story, watch 'Something the Lord Made' starring Alan Rickman as Blalock, Mos Def as Thomas, and Mary Stuart Masterson as Taussig. https://www.imdb.com/title/tt0386792/...

Here is a trailer from YouTube: https://www.youtube.com/watch?v=UmiRo...

[Terri Dreismeier · Rating 3 out of 5]

Because I am trying to expand my nonfiction reads, I decided to read this book. Not only did I learn about the research behind the blue baby syndrome and the life saving operation developed, the laboratory research assistant who was instrumental in the procedure was African American and faced discrimination in one of the most prestigious hospitals in our country-Johns Hopkins.

[Kristen · Rating 3 out of 5]

This is an interesting narrative nonfiction piece that fills a gap; it presents a nicely melded story with aspects of both social history and medical science. Kids who enjoyed Terrible Typhoid Mary but would appreciate something shorter would be the perfect audience for this.

[Brenda Selner · Rating 4 out of 5]

Very good detail about the efforts to treat babies with Tetralogy of Fallot. Provides info on Vivien Thomas, who is credited with development of the surgical procedure. There are a few instances, however, where a sentence or phrase is repeated in a later chapter.

[Thereasa · Rating 5 out of 5]

I found this a very interesting story about the development of surgery to correct heart problems in "blue babies". My youngest sister, born in 1948, was a blue baby and lived only a few months. I never knew that four years before that doctors were already doing the corrective surgeey.

[Megan Harty · Rating 4 out of 5]

suuuuper quick read but interesting! loved how much it focused on the under-crediting of Vivien Thomas. obvi would’ve loved more intricate medical details and more follow up but what was there was well done

[Nikki Edgar · Rating 4 out of 5]

Jim Murphy is a great author of history! I love all of his books that I have read!

[Susan · Rating 5 out of 5]

Looking for summer reading titles and this one was really good. The science and social history was fascinating.