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Johns Hopkins’ Pioneering Cardiac Surgeon Reflects on Lifetime of Service

It’s been three decades since Dr. Levi Watkins Jr. made medical history when he stopped the heart of a California woman just long enough to perform the first human implantation of the automatic defibrillator. Watkins, who is African-American, finds it “ironic,” even today, that “women and African-Americans are 30 to 40 percent less likely to get a defibrillator even when they meet the criteria and have the insurance.”

When the idea came to him three decades ago, Watkins told Johns Hopkins Hospital officials that the institution “needed a King program” to mark the birthday of the Rev. Dr. Martin Luther King Jr. each January. Watkins, who orchestrates the popular event and hand picks each star-studded guest speaker, says it’s probably one of the few times at the hospital when janitors, medical students, cafeteria cooks, executives and nurses can “sit down together in one auditorium in the name of humanity.”

Watkins also made himself a pitchman and a champion who was determined to tackle the shortage of minority students and faculty at Hopkins. In 1983, Watkins was appointed to the medical school admissions board, and the recruitment, retention, and graduation rates for minorities climbed to an all-time high for the institution. As many as 14 Black students out of a total of 121 students earned their medical degrees that year.

Over the years, Watkins’ message has remained as constant as a heartbeat: “When you come to Johns Hopkins, you will see your own self” in the faces of the hospital’s Black and minority neighbors, “and you’ll see the world” among the global patients and researchers it attracts.

The presence of his African-American recruits, especially in the hospital’s emergency room, “made them passive role models” for the throng of Black parents and children who passed through, counting on ER care when they couldn’t afford primary care.

Bringing Black patients together with Black doctors was Watkins’ aim. At the same time, Watkins says, incoming students continue to need role models of their own.

“The best way to recruit minority students is by example” and the intervention of mentors, says Watkins. Since 1983, he has also been busy trying to boost the number of African-American and minority medical faculty nationally through his work on the Robert Wood Johnson Foundation’s Harold Amos Medical Faculty Development Program. Its stated mission is racial diversity.
“Students don’t look at recruitment and diversity offices when they are choosing schools, but they want to see if there are faculty and students in the place that look like them,” says Watkins.

For the students who accepted his invitation to come to Hopkins, Watkins lets them know that it comes with “a lifelong mentor” — himself. Two among the long list of doctors Watkins has picked, molded and boasts about are surgeon Selwyn Vickers, M.D., who, earlier this month, became the first African-American dean of the University of Alabama at Birmingham School of Medicine and only one of three in the nation to lead a majority medical school. That roster also includes immunologist James E.K. Hildreth, renowned for the important discoveries he’s made related to HIV and AIDS. Hildreth is now dean of the University of California, Davis’ College of Biological Sciences. Watkins’ list goes on.

Moving on

But after spending four decades as a heart healer, gladiator, scholar and change agent at Hopkins, Watkins says he plans to retire in December as associate dean for postdoctoral programs and faculty development.

“I can’t stay here forever,” quips Watkins, who, years ago, found a home and “a forum for intellectual thought, for speeches and actions” that he says Hopkins came to embrace. “Being at Hopkins changed my whole life.”

Watkins’ 43 years have not gone unnoticed by those who brought him to the institution. “Levi has remained as powerful a presence and as important an influence on Johns Hopkins as he was when he arrived here in 1970 as a general surgery intern,” wrote Dr. Paul B. Rothman, dean of the medical faculty and hospital CEO, in an open letter to Hopkins staff.

With news of his leaving, however, many at Hopkins who have been swept up over the years and touched by Watkins’ powerful Southern breeze, or who just watched him in motion from the sidelines, wonder about the pace of diversity and change when he is no longer at the wheel.

When he is asked about that future at Hopkins, the place he’s become synonymous with, Watkins contends he is hopeful that his mark on lives, a medical school, a hospital and a community will be indelible.

“I think the program [King Day] will go on. Student recruitment and retention will go on because we have faculty,” he says. “The defibrillator will go on because we have cardiologists who can now implant it in the catheterization lab.”

Watkins’ longtime Hopkins colleague and friend, Dr. Earl D. Kidwell, ophthalmologist, says he will wait and see.

“If there is not someone of color in the boardroom or where decisions are being made about minority recruitment and problems of minority health and more, change can come very slowly,” says Kidwell, who in 1974 became the hospital’s first African-American resident in ophthalmology. When Watkins joined the admissions board, Kidwell was its only other Black member.

Destined for Hopkins

Others have come after him, but for decades, Watkins has been that “someone” on the scene at Hopkins. In the summer of 1970, though, a storied medical career was just budding for Watkins.

It began when the new graduate of Vanderbilt University Medical School arrived in the North, bound for Baltimore, Md., to his final destination, Johns Hopkins Hospital. He was leaving behind Nashville, Tenn., where, in the late 1960s, being called “a nigger” by his patients was the price of practicing medicine while Black. And for decades in his native city of Montgomery, Ala., it had been the price of living while Black.

As Watkins eased into Baltimore and made his way through its east side, the Northern Promised Land he envisioned faded fast. Watkins says he may have been a “bright-eyed intern” when he arrived, but he could clearly see that the city surrounding him smacked of the segregated South he thought he left behind.

Baltimore, Watkins concluded, “was a Northern Montgomery.” Chunks of life, culture and health in the urban city where he landed were in decay and, in many ways, still marred by the color line. Watkins arrived just two years after the Baltimore riots. There were grim days and nights of civil unrest, looting and destruction, ignited largely by King’s assassination on April 4, 1968, in Memphis.

“It was a city that was culturally segregated,” Watkins recalls. “Blacks lived in certain sections, ate in a certain section and shopped in their own sections.” Now, nearly 50 years later, countless houses and buildings along swaths of inner city blocks are boarded up, and others remain casualties of the uprising, adds Watkins, who now proudly calls Baltimore home.

Not quite as expected

The famed Johns Hopkins Hospital sits on a hill in the middle of a quadrant of Baltimore’s east side and casts a billion dollar shadow over its closest neighbors — largely African-American and low income. By the time Watkins arrived, desegregation at Hopkins had begun, but racial diversity at almost every level was just a notion, even at this premier medical training ground. Gone were the ‘Colored Only’ blood banks, wards, clinics and emergency rooms, but, to a dismayed Watkins, little else had changed from the 1940s Hopkins, when the only people pushing brooms and toting mops were Black men and women.

At Hopkins, Watkins was a lone Black face among a canvas of interns in white coats. “There wasn’t much here in terms of racial equality, and what made it worse was that the neighborhood didn’t trust Hopkins,” says Watkins of those early days.

In the Hopkins halls, Vivien Thomas, the grandson of a slave, was also a rarity. Watkins first met Thomas in a lab at Vanderbilt, and when the two crossed paths again at Hopkins, Watkins welcomed having a smart teacher and trusted guide “who knew what it was like to be the only one.”

Thomas, who landed a position as a surgical technician, helped Watkins guide his hands in the lab and perfect his technique when he began testing the defibrillator on dog models. Watkins says one of the most important lessons he learned early from Thomas “was to watch the mouth,” especially when he wanted to rail during times when racial etiquette and inclusion went lacking. Watkins says he heeded Thomas’ advice at least until he completed his surgical training. “Vivien wanted to see me, a young Black doctor, succeed,” says Watkins in a recent interview.

Watkins soared. The first Black surgical intern became the hospital’s first Black chief resident in cardiac surgery. Still, some patients only saw Black, not brains, when they were with him in the exam room or in their hospital beds. Watkins admits that those moments could hurt and annoy him, but they couldn’t break his resolve to gain his Hopkins credentials and to one day open the door so that other African-American students and faculty could enter.

A child of the Civil Rights Movement and a beneficiary, Watkins succeeded at integrating Vanderbilt’s medical school in 1966. In those days, he says, “the ugliness of segregation” and prejudice was pervasive. Before the movement, though, “it was our normal,” remembers Watkins, who grew up on the campus of the historically Black Alabama State University, where his father, Levi Watkins Sr., served as president and a faculty member.

Once Watkins graduated with honors from Tennessee State University, an HBCU, the “inspiration” he drew from being at King’s side propelled him to integrate Vanderbilt. But it didn’t take long for him to conclude that integration didn’t always mean he would be welcomed. Vivid is Watkins’ memory of the day White medical school classmates “dumped feces” on his face from their fourth-floor dorm window as he walked out of his first-floor room; or the times he tramped across the railroad tracks to get back to the Tennessee State University campus where he found solace and a welcome place to eat.

When he received his medical degree in 1970, Watkins was still the only one. Four decades later, Watkins says he is now lauded by his alma mater — the annual Levi Watkins Jr. Premedical Conference at Vanderbilt works to recruit underrepresented minorities to its medical school and the institution’s annual lecture on diversity in medical education is also named for him. And he’s received the highest honor bestowed on a Vanderbilt University graduate.

When Watkins recounts the racial past, woven snuggly into the fabric of his life, he can deliver with the fervor of a preacher or the folksiness of a friend sharing a special gift. He’s committed to telling his story over and over even after he retires.

“I try to make sure that they don’t forget the past,” he says of the future doctors and scientists, the underachievers and the young Black physicians he wants to be on the receiving end of those messages. It’s been a part of his activist approach to medicine and to life, Watkins says. As he tells it, his brand of activism has been in keeping with the example of those who raised him and with the mission of some who birthed the Civil Rights Movement, such as his parents, the Rev. Ralph Abernathy — the family’s minister — and King, whose Dexter Avenue Baptist Church Watkins joined in high school. At King’s request, Watkins drove the church station wagon on Sunday mornings so that members could boycott the city’s segregated bus system in the 1950s.

Coming full circle

For Watkins, “life has come full circle.” At 69, he is tall, trim and natty. It’s another busy day on the campus, and Watkins is wearing pinstripes and a bold bright tie, no white physician’s coat. His slender hands set down the scalpel in 2006. He remembers using the few minutes he would get to scrub in preparation for surgery to pray for God to guide his hands and to help him mend the broken hearts of his patients.

Watkins rarely mentions publically one of his most important patients and his “greatest accomplishment.”

The day he performed a “triple bypass mitral valve repair” at Hopkins on his 82-year-old father, he prayed like never before. “He asked me to do it. It’s what Daddy and Momma wanted,” Watkins says of that urgent and uncommon request. Looking back, Watkins said the surgery gave his father the gift of time — two more Christmases, two more Father’s Days.

That was decades ago.

On a recent crisp September morning, a medical pioneer sits in his cramped office. He is again, telling his story. When he stiches it all together, Watkins has forged a career that offered many avenues to make a difference. Referencing a line from the familiar “Serenity Prayer,” one of his favorite works, Watkins declares, “Yes, I changed the things that I could.”

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