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Helen Brooke Taussig

Helen Brooke Taussig

Physician Helen Brooke Taussig discovered a surgical procedure for treating "blue babies." She proved that "blue babies" died of insufficient circulation rather than cardiac arrest, as had been previously thought.

Physician and cardiologist Helen Brooke Taussig spent her career as the head of the Children's Heart Clinic at Johns Hopkins University. In the course of her work with young children, she discovered that cyanotic infants—known as "blue-babies"—died of insufficient circulation to the lungs, not of cardiac arrest, as had been thought. She and colleague Dr. Alfred Blalock developed a surgical procedure, the Blalock-Taussig shunt, to correct the problem. First used in 1944, the Blalock-Taussig shunt has saved the lives of thousands of children. In 1961, after investigating reports of numerous birth defects in Germany, Taussig determined that the cause was use of the drug Thalidomide, and it was her intervention that prevented Thalidomide from being sold in the United States. She was the recipient of numerous honorary degrees and awards, including the Medal of Freedom in 1964 and the 1977 National Medal of Science.

Taussig was born on May 24, 1898, in Cambridge, Massachusetts, the youngest of four children of well-known Harvard economist Frank William Taussig. Her mother, Edith Guild Taussig, who had attended Radcliffe College and was interested in the natural sciences, died of tuberculosis when Helen was eleven years old. Like her mother, Taussig attended Radcliffe, where she played championship tennis. However, wishing to be further removed from the shadow of her well-known father, she transferred to the University of California at Berkeley, where she earned her B.A. in 1921.

Having decided on a career in medicine, Taussig's educational choices were limited by sex discrimination. Although she began her studies at Harvard University, the medical school did not admit women to its regular curriculum, and would not begin to do so until 1945. Taussig enrolled in Harvard's School of Public Health, where, like other women, she was permitted to take courses but not allowed to work toward obtaining a degree. She also was permitted to study histology as a special student in the medical school. After her studies at Harvard, Taussig took anatomy at nearby Boston University. There, her anatomy professor, Alexander Begg, suggested that she apply herself to the study of the heart, which she did. Also following Begg's advice, Taussig submitted her application to attend the medical school at Johns Hopkins University, where she was accepted.

During her four years of study at Johns Hopkins Medical School, Taussig worked at the Hopkins Heart Station. After receiving her M.D. in 1927, she spent another year there as a fellow, followed by an additional year and a half there as a pediatric intern. During this time, Taussig served as an attending physician at the recently established Pediatric Cardiac Clinic. The new chair of pediatrics, Edwards A. Park, recognized Taussig's abilities and became her mentor. Upon the completion of her pediatric internship in 1930, she was appointed physician-in-charge of the Pediatric Cardiac Clinic in the Harriet Lane Home, the children's division at Johns Hopkins. Taussig would spend her entire career at Johns Hopkins until her retirement in 1963. In 1946 she was appointed associate professor of pediatrics, and was promoted to full professor in 1959, the first woman in the history of the Medical School to hold that title.

Taussig began her studies of congenital heart disease at the Pediatric Cardiac Clinic in 1930. Over the years she examined and treated hundreds of children whose hearts were damaged by rheumatic fever, as well as those with congenital heart disease. She developed new observational methods that led to a new understanding of pediatric heart problems. First Taussig became accomplished in the use of the fluoroscope, a new instrument which passed x-ray beams through the body and projected an image of the heart, lungs, and major arteries onto a florescent screen. Second, she used the electrocardiograph which makes a graphic record of the heart's movements. Third, she became expert at diagnosis through physical examination—made more complex in her case due to the fact that Taussig was somewhat deaf as a result of childhood whooping cough and unable to use a stethoscope, thereby necessitating her reliance on visual examination.

Taussig gradually realized that the blueness of cyanotic children was the result of insufficient oxygen in the blood. In the normal heart, bluish blood from the periphery of the body enters the right atrium (upper receiving chamber) of the heart and then goes to the right ventricle (the lower pumping chamber) to be pumped through a major artery to the lungs. In the lungs, the blood receives a new supply of oxygen that changes its color to bright red. Then it returns to the heart, entering the left atrium and descending to the left ventricle which pumps it to the rest of the body. The two sides of the heart are kept separate by a wall called the septum. Taussig discovered that the insufficient oxygen level of the blood of "blue-babies" was usually the result of either a leaking septum or an overly narrow artery leading from the left ventricle to the lungs. Although at that time surgeons were unable enter the heart to repair the septum surgically, Taussig believed that it might be possible either to repair the artery, or to attach a new vessel that would perform the same function.

She persuaded Dr. Alfred Blalock, the chairman of the Hopkins Department of Surgery, to work on the problem. Blalock was a vascular surgeon who had done experimental research on an artificial artery with the assistance of long-time associate Vivian Thomas. Accepting Taussig's challenge, Blalock set Thomas to work on the technical problems. During the next year and a half, Thomas developed the technical procedures, using about two hundred dogs as experimental animals. In 1944, although earlier than Thomas had planned, the technique was tried on a human infant, a desperately ill patient of Taussig's named Eileen Saxon. With Taussig as an observer and Thomas standing by to give advice concerning the correct suturing of the artery, Blalock performed the surgery successfully. A branch of the aorta that normally went to the infant's arm was connected to the lungs. In the years that followed, the procedure, known as the Blalock-Taussig shunt, saved the lives of thousands of cyanotic children.

The fame of the Pediatric Cardiac Clinic grew rapidly. As they became flooded with patients, Blalock and Taussig developed team methods for dealing with the different phases of treatment. Their management methods became the model for many cardiac centers, as well as other kinds of medical care. Taussig's growing reputation also brought her numerous students. She trained a whole generation of pediatric cardiologists and wrote the standard textbook of the field, Congenital Malformations of the Heart, first published in 1947. In addition to her work in congenital heart disease, she carried out research on rheumatic fever, the leading cause of heart problems in children. Taussig is considered the founder of the specialty of pediatric cardiology. Neither her scientific and clinical acumen, nor her enormously demanding schedule, ever prevented Taussig from being a warm, compassionate physician to her many patients and their families. She followed her patients for years, even after her own retirement. She never found it necessary to distance herself from the critically-ill children that she treated, or from their parents. Her warmth and ability to see and treat people as individuals has been recalled by many who knew her.

In the 1950s Taussig served on numerous national and international committees. In 1962, a German graduate of her training program told her of the striking increase in his country of phocomelia, a rare congenital defect in which infants were born with severely deformed limbs. The defect was thought, but not yet proven, to be associated with a popular sedative called Contergan that was sold throughout Germany and other European countries and often taken by women to counteract nausea during early pregnancy. Taussig decided to investigate for herself and spent six weeks in Germany visiting clinics, examining babies with the abnormalities, and interviewing their doctors and mothers. She noted the absence of such birth defect in the infants of American soldiers living at U.S. military installations in Germany where the drug was banned. But there was one exception: a baby whose mother had gone off the post to obtain Contergan was born severely deformed. Taussig's testimony was instrumental in the U.S. Food and Drug Administration's rejection of the application from the William S. Merrell Company to market the drug they renamed Thalidomide in the United States.

Although Taussig formally retired in 1963, she remained deeply involved as a scientist, a clinician, and an activist in causes that affected the health of children. She fought for the right of scientists to use animals in experimental studies and advocated that women in the United States be able to choose to terminate their pregnancies through abortion. She was the author of a hundred major scientific publications, forty-one of which were written after her retirement. She occupied a home in Baltimore, often visited by guests and friends, and owned the cottage in Cape Cod where she had spent many happy childhood summers. Taussig enjoyed fishing, swimming, and gardening, as well as caring for her many pets. In the late 1970s she moved to a retirement community near Philadelphia. She became interested in the embryological causes of congenital heart defects and had begun a study of the hearts of birds when, on May 21, 1986, while driving some of her fellow retirees to vote in a primary election, she was killed in an automobile accident at the age of 87.

Further Reading

Baldwin, Joyce, To Heal the Heart of A Child: Helen Taussig, M.D. (juvenile), Walker, 1992.

Nuland, Sherwin B., Doctors: The Biography of Medicine, Knopf, 1988, pp. 422-456.

Harvey, W. Proctor, "A Conversation with Helen Taussig, " in Medical Times, Volume 106, November, 1978, pp. 28-44. □

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