"Women are liberated from the time they
leave the womb."
Dr. Virginia Apgar never held her
breath when it came time to start something new. She began taking flying
lessons when she was in her 50s. She often joked that her goal was to one day
fly under the George Washington Bridge that spanned the Hudson River in New
York City. She was no under achiever.
During her long career, she flew higher than most physicians.
Her
interest in medicine began because, as a child, her brother was chronically ill,
and she took a loving interest in his condition. She could have done most
anything in life. In school she was irrepressible, playing seven sports, acting
in stage plays, working on the school newspaper, and playing violin in the
orchestra. She did do poorly in one subject—home economics. Friends said she
never learned how to cook.
There
were few female doctors when she started medical school in 1929 at New York's Columbia
College of Physicians. By the time she graduated (fourth in her class), she had
amassed debts totaling $4,000, an astounding amount at the time. She wanted to
become a surgeon. Opportunities were few in that specialty, and with pressing
economic needs, she turned to anesthesia, a field more open to women.
“Stag Dinner—MAD!”
But
that was a struggle, too. At the time, nurses often performed anesthesia, and
surgeons looked down on doctors who were anesthesiologists. Professional
dinners were held at men's clubs which forbid entry to women. In her diary, Dr.
Apgar once wrote, "Good meeting. Stag dinner—MAD!"
Anesthesiology continued to be a
neglected area of medicine for years, but Dr. Apgar worked tirelessly, becoming
her alma mater's first female professor in 1949. Her research focused on
anesthesia during childbirth. Though medical care had improved greatly since
the early 1900s, infant mortality rates remained high—especially during the
first 24 hours of life. In those days, many newborns were not routinely given
immediate medical attention.
Apgar realized that a key to saving
the lives of more babies was examining them closely and immediately after birth
to see if they were breathing well and getting enough oxygen. At the time,
various doctors used competing systems to determine whether or not a newborn
was in distress.
“You’d Do
It Like This.”
Legend has it that one day in 1949 a
medical student commented to her about the need to better evaluate newborns.
Taking a piece of paper, Dr. Apgar said, "That's easy. You'd do it like
this" and wrote down the vital signs that should be observed.
Word spread, but it wasn't until
1952 that her name actually became a word. That's when a Denver physician wrote
her to let her know one of his residents had invented a clever way to remember
her five scoring criteria: APGAR—Appearance (color); Pulse (heart rate);
Grimace (reflex irritability); Activity (muscle tone); and Respiration
She was most amused to be honored by
this eponym. (That's the technical term for an acronym named after a person.)
In short order, doctors around the nation adopted the APGAR Score. Today all
newborns are evaluated and rated using these criteria one minute and five
minutes after birth. "Every baby born in a modern hospital anywhere in the
world is looked at through the eyes of Dr. Virginia Apgar," says the National
Library of Medicine's website.
Dr. Apgar lived to bring the breath
of life to millions. She made a point of this in her work as a clinical
instructor. Because resuscitation is an essential aspect of anesthesiology, she
demanded that her students be ready to resuscitate anyone at any time anywhere.
That's why she always carried with her a laryngoscope (for viewing the throat),
an endotracheal tube, and a pocket knife for performing emergency tracheotomies
(to open the windpipe). She told her students to be similarly prepared.
MORAL: Stay awake on the job.
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