Unsung Heroes: Helen Taussig

Rob Mulligan — Fri, 13 May 2011 08:00:14 +0000

You know you’re pretty awesome when you’re credited with founding a field of medicine. Not just a particular technique or methodology, which is impressive enough in itself, but a whole field of practice. It’s the sort of achievement that you drop into conversation and then everyone else feels a little bit bad, because they will never do anything quite as cool. One person who can claim such an achievement is Dr Helen Taussig, pioneer of paediatric cardiology.

Helen Taussig, taken during her time as a professor at Johns Hopkins University.

Prior to 1944, children born with a condition known as Tetralogy of Fallot – or more commonly “blue baby syndrome” – could expect poor physical development, difficulty feeding, and an early death (untreated cases saw only 30% survive to the age of 10). Tetralogy of Fallot was the most common (400 cases out of every million live births) of complex heart defects and considered at the time to be surgically irreparable.

Taussig (b. 1898) had other ideas. Having studied at a series of prestigious schools, including Harvard, Taussig graduated from Johns Hopkins University Medical School in 1927, moving to Johns Hopkins Hospital to spend several years specialising in cardiology and paediatrics. In 1930 she was appointed head of the Children’s Heart Clinic, making her one of the highest ranking women in American medicine at the time. She noted that infants with another particular heart deformity (patent ductus arteriosus, which allows blood to flow between the aorta and the pulmonary artery) who suffered from Tetralogy of Fallot tended to have better survivability than those with Tetralogy of Fallot alone.

Based on this, Taussig came to a conclusion that had evaded everyone else up until then: by creating an artificial hole, or shunt, between the two arteries it might be possible to overcome most of the problems caused by Tetralogy of Fallot. She took her ideas to Robert Gross, a surgeon at Boston who had pioneered patent ductus arteriosus ligation (the tying off of the hole between the arteries to stop the flow between them). Gross dismissed the idea, acting on the accepted wisdom of the time that stated the condition to be impossible to fix surgically. Without the help of an experienced cardiac surgeon, there would be no way to actually test Taussig’s ideas.

In addition to the resistance from established surgeons, Taussig faced another obstacle to developing her idea: Around the time of graduating from Johns Hopkins she had become profoundly deaf, something which seemed, at the time, like it might put an end to her career. How could one practise cardiology without being able to hear heart rhythms through a stethoscope? Taussig was not one to be stopped by such trifling matters though, and developed an exceptional proficiency for feeling the rhythms by hand instead of listening to them, later crediting some of her discoveries to this talent.

You must learn to listen with your fingers.

– Dr Helen Taussig

This might be the point where a less awesome individual might give up, might let their idea drop and become just another footnote in medical history. Instead, Taussig approached Alfred Blalock, a recent appointment at Johns Hopkins Hospital. Together with his surgical technician, Vivien Thomas, they began to develop the idea, and by 1944 were ready to perform their first operation on a person.

The first operation was a qualified success – the initial surgery went well, but the patient didn’t survive a follow up surgery the following year. The following two attempts were wholly successful, and by 1952 over 1,000 patients had undergone the Blalock-Taussig Shunt procedure, as it became known, with around 85% survival rates. Taussig and Blalock lectured on their technique in Paris and London, where surgeons experienced similar success rates.

But pioneering a new field of medicine and improving the life expectancy and quality of life for countless infants wasn’t enough for Taussig – she had more awesome achievements still to go. In 1957 the sedative drug Thalidomide was distributed to thousands of clinicians in the US for testing, proposed as a safe drug for a variety of conditions. We now know, of course, that the drug was far from safe for this, having massively teratogenic properties. Taussig was one of the doctors, along with the FDA inspector Frances Oldham Kelsey, who provided evidence for the dangers of the drug. This lead to its being refused approval for sale in the US, and eventually removed from other markets once its dangers had been exposed.

So that’s twice that Taussig was a key figure in improving the quality of life of infants, thus arguably making the world a better place through her actions. In addition to this she campaigned for the legalisation of abortion and became one of the first women to be appointed to a full professorship at Johns Hopkins University in 1959, and the first to serve as president of the American Heart Association. One of the four colleges of the Johns Hopkins medical school still bears her name.

Her 1947 textbook, Congenital Malformations of the Heart, is worth reading whether or not one has a medical background, as it stands as an example of a very well written work by one of the field’s most incisive minds.

[Taussig] was truly a remarkably notable woman in health care.

– Harold Ellis, Journal of Perioperative Practice

Unsung Heroes: spotlighting fascinating people we never learned about at school. Rob Mulligan also blogs at Stuttering Demagogue. Stay tuned for future Heroes, or send your own in to [email protected]!

frances oldham kelsey – Bad Reputation

Unsung Heroes: Helen Taussig