Was Alfred Blalock's Portrait Altered?

To the Editor:

I read with great interest the article by Dr. Cooley on “The Early Development of Surgical Treatment for Aortic Aneurysms” in the Texas Heart Institute Journal, ¹ and as always with Dr. Cooley's historical notes, I enjoyed it very much. This article is supplemented by photographs of pioneers in cardiovascular surgery, including Dr. Cooley himself.

Figure 3 is a picture of Dr. Alfred Blalock. Dr. Blalock was apparently a cigarette smoker, something that was very common at the time. In fact, there are photographs of Dr. Blalock with a lighted cigarette in his hand. In figure 3, the position of Dr. Blalock's left hand indicates that he must have been holding a cigarette between his index and middle finger when the picture was taken, but, for some unknown reason, the photograph has been retouched or otherwise altered to erase the cigarette.

I think that in a historical note we should present people as they were—not as we would like them to be. Despite my great dislike for cigarette smoking, I believe (and I am certain that Dr. Cooley would agree) that the cigarette-smoking habit of Dr. Blalock in the 1940s does not in any way detract from his image or from the impact that he had on the entire field of cardiac surgery.