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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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Helen Brooke Taussig

Helen Brooke Taussig

1898-1986

American Physician

Helen Brooke Taussig is recognized as the founder of pediatric cardiology. Along with Alfred Blalock (1899-1964), she devised a procedure for the treatment of newborns afflicted with "blue baby" syndrome.

Born May 24, 1898, in Cambridge, Massachusetts, Taussig was the youngest of four children of famed Harvard economist Frank Taussig. Her mother had attended Radcliffe College but died of tuberculosis when Taussig was 11. Taussig began her studies at Radcliffe in 1917, where she was a member of the tennis team, but finished her B.A. at the University of California, Berkeley, in 1919.

Though medicine was her primary interest, she enrolled at the Harvard School of Public Health. At the time, Harvard permitted women to take classes, but did not allow female students to earn a degree in medicine until 1945. Thus, she studied medicine at Boston College, where her professor, Alexander Begg, suggested she study the heart. Begg also helped Taussig gain acceptance to Johns Hopkins Medical School in Baltimore, Maryland.

Taussig especially enjoyed work at the heart station, and after receiving the M.D. in 1927, she completed additional studies in cardiology and pediatrics. In 1930 she became head of the Pediatric Cardiac Clinic called the Harriet Lane Home, a position she held until her retirement in 1963. She was appointed associate professor of pediatrics at the Johns Hopkins Medical School in 1946 and became the first female full professor in 1959.

Taussig began a study of babies who had congenital heart defects and hearts damaged by rheumatic fever, a condition caused by complications of a streptococcal infection. She became proficient in the use of a new instrument called the fluoroscope, which passes x-ray beams through the body and displays the image on a screen. This device showed the exact location of the malformation. She also used another newly developed device, the electrocardiograph (EKG), which records heart beat patterns on a graph.

In the early 1940s Taussig began to study a birth deformity known as the tetralogy of Fallot or "blue baby" syndrome. The skin of babies suffering from this condition appears blue because a defect in the heart prevents their blood from getting enough oxygen.

Taussig developed an idea for a procedure to repair the artery or attach a new artery. She sold the idea to Alfred Blalock, a Johns Hopkins surgeon who had experimented with artificial arteries. Along with Vivien Thomas (1910-1985), the two developed the procedures after using about 200 experimental dogs. The first human trial came sooner than expected when, in 1944, one of Taussig's patients was born with a serious deformity. Blalock reconnected a branch of the child's aorta, which normally went to the arm, to her lungs. The successful procedure became known as the Blalock-Taussig procedure and since that time has saved the lives of thousands of children.

News of the success spread worldwide, and Taussig was flooded with patients as well as students who wanted to study the procedure. She developed a team approach to cardiology care, which has been adopted in clinics today. Her 1947 textbook, Congenital Malformations of the Heart, was a classic text that described heart defects and the techniques and tools to treat them.

Taussig served on several national and international committees. In 1963, one of her students from Germany reported an increase in the prevalence of a birth defect call phocomelia, in which the arms and legs develop a flipper-like appearance. The student thought the drug Contergan, used to counter morning sickness among pregnant women, may be the cause. Taussig spent six weeks in Germany, during which she investigated the problem. Noting the absence of the defect in the United States military camps, where the drug was banned, she was able to make the connection between the drug and defect. She was also able to halt usage of the drug, renamed thalidomide, in the United States.

When Taussig retired in 1963, she turned her attention to causes involving the treatment of laboratory animals and a woman's right to terminate pregnancy. During her career, she wrote over 100 papers, 40 of which were published after her retirement. She became very interested in the embryological development of heart defects and had launched into a major study shortly before her death at age 87. She was killed in an automobile collision while driving home after voting in a political primary.

Taussig was recognized for her many achievements with 20 honorary degrees and numerous awards, including the 1984 Medal of Freedom.

EVELYN B. KELLY

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