Woman Crush Wednesday: Dr. Virginia Apgar
Virginia Apgar is a legendary figure in the medical community, a trailblazer in anesthesiology and an inspiration for all women in science and medicine. The love for learning and science that Apgar contained is said to have stemmed from her father and his many scientific hobbies, as well as her two brothers who had severe medical conditions during her childhood. Her passion for medicine continued to grow throughout her highschool years and after her graduation in 1925 she set off to Mt. Holyoke College. As a college student her professors and peers remarked that she was a hard worker with an energy unmatched by any other person. She played on seven sports teams, reported for her college newspaper, acted in theater productions and played the violin in the school orchestra all while supporting herself with many side jobs and thriving in her academic work. All of her hard work paid off in 1929 when she graduated with a degree in Zoology.
After her undergraduate studies were complete, Virginia decided to further her academic career at Columbia University’s College of Physicians and Surgeons. She was one of only nine women in her class of ninety, and she graduated fourth in her class in 1933 when she earned her MD. After her graduation she set out to obtain a surgical internship, which she landed at her Alma Mater, Columbia-Presbyterian Medical Center, where she continued to perform exceptionally well. During this time, her mentor encouraged her to explore the world of anesthesia, for a few reasons, the first being that he was worried about the economic position she may face as a female surgeon during the Great Depression. The second reason was that he saw the potential in Virginia to advance medicine, and anesthesiology was a field that was in need of innovation.
So in 1937, at the end of her residency, she joined the nurse anesthetist program at Columbia-Presbyterian Hospital to learn more. She then packed up and spent the next year between residency programs at the University of Wisconsin and New York’s Bellevue Hospital.
In 1938 Dr. Apgar returned to Columbia University as the Director of the Division of Anesthesia. This made her the first woman to head a division at the facility. Through her role she was responsible for recruiting and training all of her residents, teaching the medical students about anesthesia and coordinating all the anesthetic work and research for the hospital. At first she had trouble recruiting physicians to work for her because surgeons did not see anesthesiologists as equals, and therefore the pay was lower. This resulted in her being the only full time member of her department until the mid 1940s. Even though it was not an easy journey, Dr. Apgar’s was able to switch the entire department staff from nurses to physicians, as well as established an anesthesiology education program. In 1946 Anesthesiology started to gain notoriety as it now required residency training and the tone shifted in how physicians felt the field.
In 1949 the Division of Anesthesiology that Dr. Apgar had been operating, got promoted to its own department and it was thought that she would be the first department chair. This did not end up being the case, as the position was given to one of her male colleagues. She was instead given the opportunity to be a full professor at Columbia University College of Physicians and Surgeons, where she became the first woman to gain full professorship at the university.
During her time as a professor, she dedicated her research time to obstetrical anesthesia. Through the 1950s, Dr. Apgar studied the effects that maternal anesthesia, during labor, had on the baby. During this time she developed her most famous contributions to medicine, the Apgar Score. This was a, five point, standardized method of evaluating a newborn’s transition to life outside the womb. The criteria included the baby’s heart rate, respiratory effort, muscle tone, reflex response and color. Each category is scored from 0-2 and then all scores are added together to get a holistic score for the baby. This method was published in 1953 and is now used around the world.
She went on to study the effects of labor, delivery and maternal anesthetics on the baby’s score. After attending over 17,000 births she started to see a correlation between some of the babies’ scores and their birth defects. A few of her colleagues, Dr. Holaday and Dr. James, helped to make these connections by providing new methods of measuring blood gases, blood levels of anesthesia and specialized cardiology knowledge. Together they proved that a low blood oxygen level and high blood acidity led to a lower Apgar score, and that cyclopropane anesthesia given to the mother resulted in a lower score as well. Their collaboration ultimately proved that the Apgar Score can predict neonatal survival and neurological development.
After these major breakthroughs, Dr. Apgar opted to take a sabbatical, during which time she pursued her Masters in Public Health at Johns Hopkins University. She ultimately decided not to go back to academia after this, but rather use her time to research the prevention of birth defects.
She quickly became the Director of the Division of Congenital Defects at the National Foundation for Infantile Paralysis, now known as the March of Dimes. She once again proved her worth, as she was noted as an excellent ambassador for the organization and it was said that their annual revenue more than doubled during her tenure. During this time she served as the Director of Basic Medical Research from 1967-68 and Vice-President for Medical Affairs from 1971-74.
Ultimately Dr. Apgar did go back to academia in a multitude of ways from being a lecturer and clinical professor of pediatrics at Cornell University School of Medicine, as well as lecturing about medical genetics at the Johns Hopkins School of Public Health. She published an amazing collection of scientific articles, short essays for newspapers and magazines, as well as her book, Is My Baby All Right?, written with Joan Beck, during her career. On top of all of that she was given many different honors including two honorary doctorates and awards from the American Medical Women’s Association, the American Society of Anesthesiologists, Columbia University College of Physicians and Surgeons, and Ladies Home Journal where she was named 1973s Woman of the Year in Science.
Dr. Apgar remained active in the medical community until shortly before her death, when she was slowed down by liver disease. She passed away in 1974 at her beloved Columbia-Presbyterian Medical Center, where she worked most of her life. Her memory lives on through her friends, collegauses and former students as an incredible woman full of warmth, life, passion, humor and incredible intelligence. After her passing her life and contributions were commemorated on a U.S. postage stamp and she was inducted into the U.S. Women’s hall of Fame.
Dr. Apgar continues to be an inspiration for all young women in science and medicine today, and her contributions live on in our current hospital practices.
If you would like to learn more about Virginia Apgar our information was sourced from Changing the Face of Medicine and the U.S. National Library of Medicine.