Thomas was born in New Iberia, Louisiana. Thegrandson of a
slave, he attended Pearl High School (named for a Union sympathizer Joshua
Fenton Pearl and now known as Pearl Cohn Comprehensive High School) in Nashville
in the 1920s. Thomas had hoped to attend college and become a doctor, but the
Great Depression derailed his plans. He worked at Fisk University in the summer
of 1929 doing carpentry but was laid off in the fall. In the wake of the stock
market crash in October, Thomas put his educational plans on hold, and, through
a friend, in February 1930 secured a job as surgical research technician with
Dr. Alfred Blalock at Vanderbilt University. On his first day of work, Thomas
assisted Blalock with a surgical experiment on a dog. At the end of Thomas’
first day, Blalock told Thomas they would do another experiment the next
morning. Blalock told Thomas to “come in and put the animal to sleep and get
it set up”. Within a few weeks, Thomas was starting surgery on his own. [1]
Thomas was classified and paid as a janitor, despite the fact that by the mid 1930s,
he was doing the work of a postdoctoral researcher in the lab. Before meeting Blalock,
Thomas married Clara and had two daughters. When Nashville’s banks failed nine months
after starting his job with Blalock and Thomas’ savings were wiped out, he abandoned
his plans for college and medical school, relieved to have even a low paying job
as the Great Depression deepened. Thomas and Blalock did groundbreaking Research
into the causes of hemorrhagic and traumatic shock. This work later evolved into
research on Crush syndrome and saved the lives of thousands of soldiers on the
battlefields of World War II. In hundreds of flawlessly executed experiments, the
two disproved traditional theories which held that shock was caused by toxins
in the blood. Blalock, a highly original scientific thinker and something of an
iconoclast, had theorized that shock resulted from fluid loss outside the vascular
bed and that the condition could be effectively treated by fluid replacement. Assisted
by Thomas, he was able to provide incontrovertible proof of this theory, and in
so doing, he gained wide recognition in the medical community by the mid 1930s.
At this same time, Blalock and Thomas began experimental work in vascular and
cardiac surgery, defying medical taboos against operating upon the heart. It
was this work that laid the foundation for the revolutionary lifesaving surgery
they were to perform at Johns Hopkins a decade later. By 1940, the work Blalock
had done with Thomas placed him at the forefront of American surgery, and when
he was offered the position of Chief of Surgery at his alma mater Johns Hopkins
in 1941, he requested that Thomas accompany him. Thomas arrived in Baltimore
with his family in June of that year, confronting a severe housing shortage and
a level of racism worse than they had endured in Nashville. Hopkins, like the
rest of Baltimore, was rigidly segregated, and the only black employees at the
institution were janitors. When Thomas walked the halls in his white lab coat,
heads turned. In 1943, while pursuing his shock research, Blalock was
approached by renowned pediatric cardiologist Dr. Helen Taussig, who was seeking
a surgical solution to a complex and fatal four-part heart anomaly called Tetralogy
of Fallot (also known as blue baby syndrome, although other cardiac anomalies
produce blueness, or cyanosis). In infants born with this defect, blood is
shunted past the lungs, thus creating oxygen deprivation and a blue pallor. Having
treated many such patients in her work in Hopkins’ Harriet Lane Home, Taussig
was desperate to find a surgical cure. According to the accounts in Thomas’
1985 autobiography and in a 1967 interview with medical historian Peter Olch,
Taussig suggested only that it might be possible to “reconnect the
pipes” in some way to increase the level of blood flow to the lungs but
did not suggest how this could be accomplished. Blalock and Thomas realized immediately
that the answer lay in a procedure they had perfected for a different purpose
in their Vanderbilt work, involving the anastomosis, or joining, of the
subclavian to the pulmonary artery, which had the effect  of increasing blood flow to the lungs. Thomas
was charged with the task of first creating a blue baby-like condition in a
dog, and then correcting the condition by means of the pulmonary-to subclavian anastomosis.
Among the dogs on whom Thomas operated was one named Anna, who became the first
long-term survivor of the operation and the only animal to have her portrait hung
on the walls of Johns Hopkins. In nearly two years of laboratory work,
involving some 200 dogs, Thomas was ultimately able to replicate only two of
the four cardiac anomalies involved in Tetralogy of Fallot. He did demonstrate that
the corrective procedure was not lethal, thus persuading Blalock that the operation
could be safely attempted on a human patient. Even though Thomas knew he was
not allowed to operate on patients at that time, he still followed Blalock’s
rules and assisted him during surgery. On November 29, 1944, the procedure was
first tried on an eighteen-month-old infant named Eileen Saxon. The blue baby
syndrome had made her lips and fingers turn blue, with the rest of her skin having
a very faint blue tinge. She could only take a few steps before beginning
to  breathe heavily. Because no
instruments for cardiac surgery then existed, Thomas adapted the needles and
clamps for the procedure from those in use in the animal lab. During the
surgery itself, at Blalock’s request, Thomas stood on a step stool at Blalock’s
shoulder and coached him step by step through the procedure, Thomas having
performed the operation hundreds of times on a dog, Blalock only once, as
Thomas’ assistant. The surgery was not completely successful, though it did
prolong the infant’s life for several more months. Blalock and his team
operated again on an 11-yearold girl, this time with complete success, and the
patient was able to leave the hospital three weeks after the surgery. Next,
they operated upon a six-year-old boy, who dramatically regained his color at the
end of the surgery. The three cases formed the basis for the article that was published
in the May 1945 issue of the Journal of the American Medical Association,
giving credit to Blalock and Taussig for the procedure.  Thomas received no mention. News of this groundbreaking
story circulated around the world via the Associated Press. Newsreels touted
the event, greatly enhancing the status of Johns Hopkins and solidifying the reputation
of Blalock, who had been regarded as a maverick up until that point by some in
the Hopkins old guard. Thomas’ contribution remained unacknowledged, both by Blalock
and by Hopkins. Within a year, the operation known as the Blalock-Taussig shunt
had been performed  on more than 200
patients at Hopkins, with parents bringing their suffering children from thousands
of miles away. Thomas’ surgical techniques included one he developed in 1946 for
improving circulation in patients whose great vessels (the aorta and the pulmonary
artery) were transposed. A complex operation called an atrial septectomy, the
procedure was executed so flawlessly by Thomas that Blalock, upon examining the
nearly undetectable  suture line, was prompted
to remark, “Vivien, this looks like something the Lord made.” To the
host of young surgeons Thomas trained during the 1940s, he became a figure of legend,
the model of a dexterous and efficient cutting surgeon. “Even if you’d
never seen surgery before, you could do it because Vivien made it look so
simple,” the renowned surgeon Denton Cooley told Washingtonian magazine in
1989. “There wasn’t a false move, not a wasted motion, when he
operated.” Surgeons like Cooley, along with Alex Haller, Frank Spencer,
Rowena Spencer, and others credited Thomas with teaching them the surgical
technique that placed them at the forefront of medicine in the United States.
Despite the deep respect Thomas was accorded by these surgeons and by the many black
lab technicians he trained at Hopkins, he was not well paid. He sometimes resorted
to working as a bartender, often at Blalock’s parties. In 1968, the surgeons Thomas
trained, who had then become chiefs of surgical departments throughout America,
commissioned the painting of his portrait (by Bob Gee, oil on canvas, 1969, The
Johns Hopkins Alan Mason Chesney Medical Archives) and arranged to have it hung
next to Blalock’s in the lobby of the Alfred Blalock Clinical Sciences Building.
In 1976, Johns Hopkins University presented Thomas with an honorary doctorate. However,
because of certain restrictions, he received an Honorary Doctor of Laws, rather
than a medical doctorate, but it did allow the staff and students of Johns
Hopkins Hospital and Johns Hopkins Medical School to call him doctor. Thomas was
also appointed to the faculty of Johns Hopkins Medical School as Instructor.