Dr. Virginia Apgar
This Month in Medical History – No need to study for Dr. Apgar’s test
June 10, 2016
Virginia Apgar was born on June 7, 1909, in Westfield, New Jersey. She was the youngest child of three in a middle-class family. Although her father was a businessman, he encouraged his children to play music, and Apgar picked up the violin at an early age. Her father also had substantial curiosity about the world and maintained a basement science lab where he conducted a variety of experiments that ranged from work with electricity and radio waves to amateur astronomy and building his own telescope. This early exposure to science and the positive reinforcement of pursuing answers and following scientific methods may have influenced Apgar’s career path in later life.
After graduating from Mount Holyoke College with a bachelor’s at the age of 20, she went on to the College of Physicians and Surgeons at Columbia University in New York City the following year. While she had worked a variety of jobs to put herself through college at Columbia, that became untenable when the Great Depression struck. Apgar managed to borrow money to stay in school and she graduated fourth in her class in 1933 with a medical degree, but substantial debt. She considered working as a surgeon, but it was readily apparent that the Great Depression had upended the profession, leaving many surgeons struggling to find work.
For a female surgeon at that time, work would be even rarer. With that consideration, she made the decision to pursue a career in anesthesiology. Contrary to today’s turf wars, anesthesia was usually administered by nurses in the early 1900s, but doctors were gradually moving into the field. Two years after graduating from medical school, Apgar commenced a two-year anesthesiology program. Her career decision paid off when she was hired by Columbia University to head their anesthesia division.
Although the job was obtained, the support and respect of her fellow doctors was longer in coming. Apgar battled to be treated as an equal and eventually amassed enough power, and grew her department enough, that she was able to increase funding for it and pay for department staff by threatening to quit if the school did not meet her funding requests. Although her star was on the rise, she still faced sexism. When Columbia created a separate department for training and research around anesthesia, a male doctor was offered the position. However, Apgar was named a full professor, making her the first female full professor at Columbia.
It was in her role as professor that Apgar pursued research that would make her a household name. She combined her substantial knowledge about anesthesia with research into childbirth. Her studies led her to realize newborns were being overlooked, and that serious health issues which might be managed if caught soon enough after birth, would sometimes lead to death. Knowing that birth resulted in at least two patients needing care, and realizing the doctor was often outnumbered by patients during the event, Apgar created a simple, five-part test to allow the harried physician the opportunity to quickly assess, or score, the baby’s condition.
The score took into account heart rate, respiration, muscle tone, color and reflexes. After some reluctance from the male-dominated medical field, Apgar’s test became the standard by which physicians check the health of the baby after birth. Apgar’s research also helped her make a connection between a type of anesthesia and health issues for newborns. The research she published about her findings led U.S. doctors to stop using cyclopropane on women going into labor.
More than two decades after Apgar rose to her post at Columbia, she took a sabbatical leave to join Johns Hopkins University to get a master of public health degree. It was at Columbia that she had also joined the March of Dimes. She was named head of the division on congenital birth defects, and a decade later named to head the March of Dimes research program. From Johns Hopkins, she moved on to Cornell University. There, she became the first U.S. medical professor with a focus on specializing in research on birth defects.
Apgar died on Aug. 7, 1974, in New York City. She was 65. Although she is gone, her legacy remains, and many a new parent hears her name when they’re anxiously getting information on how their new baby is faring. Apgar’s test is the first test many children encounter in life, although it’s decidedly non-academic for them, even if it was created by a highly accomplished health care professional.