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Some babies are born with lips and fingertips tinged blue, gasping after every feed. In the 1940s many of them died young. Helen Taussig, a heart specialist who could barely hear, worked out a pattern in which of them survived longer, and turned it into an operation. This post covers who she was, the blood-flow problem behind blue babies, how the Blalock-Taussig shunt works, a step-by-step way to trace it, and what you can learn from her.
Who was Helen Taussig?
The US National Library of Medicine's Changing the Face of Medicine biography records that Taussig (1898 to 1986) was born in Cambridge, Massachusetts. She had dyslexia, studied at Radcliffe and Berkeley, and graduated in medicine from Johns Hopkins in 1927. In 1930 she became head of the Children's Heart Clinic at the Harriet Lane Home, part of Johns Hopkins Hospital, and worked there until she retired in 1963.
By then she had lost her hearing and relied on lip-reading and hearing aids. The NLM biography notes that some of her insight has been credited to her ability to tell normal and damaged heart rhythms apart by touch rather than sound. She also used fluoroscopy, an X-ray technique, to see the heart's shape.
Why are some babies born blue?
Normally the right ventricle pumps deoxygenated blood to the lungs through the pulmonary artery. The NCERT Class 11 Biology chapter on Body Fluids and Circulation explains this double circulation, where oxygenated and deoxygenated blood stay separate.
In tetralogy of Fallot, the defect most often behind the blue babies Taussig saw, the pulmonary artery is narrow and there is a hole between the ventricles. As a 2016 profile in Facts, Views and Vision in ObGyn explains, too little blood reaches the lungs to pick up oxygen. Poorly oxygenated blood goes round the body, and the skin looks blue.
What pattern did Taussig spot?
Before birth, a short vessel called the ductus arteriosus links the pulmonary artery and the aorta. It normally closes soon after birth. The 2016 profile describes Taussig's key observation: blue babies whose ductus stayed open did noticeably better, looked less blue and lived longer than those whose ductus closed.
A 2017 review in the Annals of Cardiac Anaesthesia puts it the same way: in babies with a blocked route to the lungs, cyanosis increased after the ductus closed. Her reasoning followed: if an open ductus helps, build a new one.
How was the operation developed?
The NLM biography says Taussig suggested the idea in 1941 to surgeon Alfred Blalock and surgical technician Vivien Thomas. Thomas worked out the procedure in dogs, joining the subclavian artery, which normally feeds the arm, to the side of the pulmonary artery.
In November 1944 the first patient, 15-month-old Eileen Saxon, was operated on at Johns Hopkins. The 2016 profile records that she weighed only 5 kg. The NLM biography notes they repeated it successfully on two more patients, and they published their results in JAMA in 1945. The Blalock-Taussig shunt was soon used around the world, and modified versions are still used today.
Worked example: trace the blood
Use this to check your understanding of the circulation chapter.
Without surgery. Body → right atrium → right ventricle → narrow pulmonary artery. Only a little blood reaches the lungs; much passes through the hole between the ventricles into the aorta without visiting the lungs.
Result. The aorta carries mixed, poorly oxygenated blood. The baby looks blue.
After the shunt. Aorta → subclavian artery → shunt → pulmonary artery → lungs → left atrium. Extra blood now passes through the lungs on each loop.
Result. More oxygenated blood returns to the left side, mixes into what the aorta sends out, and the baby becomes less blue.
The shunt does not repair the defect. It buys time, which is why the later development of open heart surgery, told in our post on John Gibbon and the heart-lung machine, mattered so much.
What else did she do?
In January 1962 Taussig learned from a former student about European babies born with severely shortened limbs. The 2016 profile describes how she travelled to Europe, concluded that the sedative thalidomide was the cause, and campaigned in the United States, where the NLM biography notes she testified to the Food and Drug Administration. The drug was not approved there.
She received the Lasker Award in 1954 and the Medal of Freedom in 1964, and in 1965 became the first woman president of the American Heart Association. For the full circulation chapter, see our post on body fluids and circulation.
If tracing blood through the heart still feels hard to hold in your head, the Fermi Simulation Lab has interactive simulations for ideas that are easier to see than read.
What can a student learn from Taussig's way of working?
Look for the cases that do better. She asked why some blue babies lived longer, and the answer pointed to a fix.
Work round a limit. Losing her hearing pushed her to use touch and X-ray images, not just a stethoscope.
Share credit across skills. The operation needed her reasoning, Blalock's surgery and Thomas's lab work.
Next step: draw the heart with its four chambers, mark the ductus arteriosus and the shunt, and trace one drop of blood through both versions.
