The Takao Memorial Lecture

University of Utah, USA
Edward B. Clark

In the early 20th century, Holts’textbook, the Diseases of Infancy and Childhood, advised for congenital anomalies of the heart, “No treatment is of the slightest avail in diminishing the amount of deformity or promoting the closure of any of the abnormal openings. All cases are to be treated symptomatically.” In 1944, this prospect was to change and in the process change the face of modern medicine.
At Johns Hopkins, a team of physicians and surgeons sought to improve on that expectation. Guided by Dr. Taussig’s clinical acumen, Dr. Blalock and Mr. Thomas designed a procedure, tested the concept, and successfully constructed a Blalock-Taussig shunt for a girl with tetralogy of Fallot. Suddenly, the “blue baby operation” gave hope to parents of children born with heart defects. Young physicians grasped the enormity of change and were inspired by their new role models: Blalock for cardiac surgery, Taussig for pediatric cardiology.
The women and men from Taussig’s program scattered across the globe. Among them, Mary Allen Engle went to Cornell, Ruth Whittemore to Yale, Eugenia Doyle to NYU-Bellevue, Catherine Neill to London and Dan McNamara to Baylor. Each established their own programs, and trained the second generation of young physicians. Thus prepared, Atsuyoshi Takao returned from Houston to found The Heart Institute of Japan at Tokyo Women’s Medical College.
In her final years, Taussig turned to the unanswered question of what factors, genetic and/or environmental, caused congenital heart defects. She called for a renaissance in cardiac embryology and morphology. And that renaissance came not from Baltimore but from Tokyo. Atsuyoshi Takao created the forum that brought together young clinicians and scientists who studied the fundamental formation and malformations of the heart and catalyzed the new era of cardiovascular biology.
Many of these pioneers have left us. Thus, it is fitting to pause and honor them for their experience, judgment, vision and passion; and refocus on the challenges ahead.