VIRGINIA APGAR Biography - Famous Medicine & health care related men and women


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Virginia Apgar, M.D., the first woman to become a full professor at Columbia           
University College of Physicians and Surgeons, designed the first standardized         
method for evaluating the newborn's transition to life outside the womb?the             
Apgar Score.                                                                           
By the time she graduated from high school,Virginia Apgar was determined to be a       
doctor. She may have been inspired by her father's scientific hobbies, or by her       
eldest brother's early death from tuberculosis, and another brother's chronic           
childhood illness. With the help of several scholarships, she attended Mt.             
Holyoke College, performing in the college orchestra as a gifted violinist and         
cellist and graduating with a major in zoology in 1929.                                 
Apgar entered the College of Physicians and Surgeons at Columbia University just       
before the Wall Street crash of October 1929, the beginning of the Great               
Depression. Despite financial problems, she graduated fourth in her class in           
1933. Determined to become a surgeon, she won a surgical internship at Columbia         
and performed brilliantly. Nevertheless, the chair of surgery, Dr. Alan Whipple,       
discouraged her from continuing because other women he had trained in surgery           
failed to establish successful careers in the specialty. Whipple also believed         
that innovations and improvements were needed in anesthesia (at that time               
handled mostly by nurses) if surgery was to advance, and he saw in Apgar "the           
energy, intelligence, and ability needed to make significant contributions in           
this area." Because anesthesiology was not generally recognized as a specialty         
until the mid-1940s, Apgar struggled to find a training program when she               
completed her surgical residency in 1937. She spent six months training with Dr.       
Ralph Waters' department of anesthesia, the first in the United States, at the         
University of Wisconsin-Madison. She then spent six months with Dr. Ernest             
Rovenstine at Bellevue Hospital in New York.                                           
In 1938, Dr. Apgar returned to Columbia University as the director of the               
division of anesthesia and as an attending anesthetist. Despite her title, she         
had trouble recruiting physicians to work for her. Surgeons did not accept             
anesthesiologists as equals, and the pay for the less well-respected specialty         
was low. Apgar was the only staff member until the mid-1940s. By 1946,                 
anesthesia began to become an acknowledged medical specialty with required             
residency training, and in 1949, when anesthesia research became an academic           
department, Dr. Apgar was appointed the first woman full professor at the               
Columbia University College of Physicians and Surgeons.                                 
She began studying obstetrical anesthesia?the effects of anesthesia given to a         
mother during labor on her newborn baby?where she made her greatest contribution       
to the field, the Apgar Score. This was the first standardized method for               
evaluating the newborn's transition to life outside the womb. "Five points?heart       
rate, respiratory effort, muscle tone, reflex response, and color?are observed         
and given 0, 1, or 2 points. The points are then totaled to arrive at the baby's       
score." The score was presented in 1952 at a scientific meeting, and first             
published in 1953. Despite initial resistance, the score was eventually accepted       
and is now used throughout the world. Apgar first planned the score to be taken         
one minute after birth, as a guide to the need for resuscitation. Others began         
to take measurements at longer intervals, to evaluate how the baby had responded       
to any necessary resuscitation. Eventually, the one- and five-minute Apgar Score       
became standard.                                                                       
Apgar went on to relate the score more closely to the effects of labor, delivery,       
and maternal anesthetics on the baby's condition. Colleagues Dr. Duncan Holaday         
and Dr. Stanley James helped her make these connections, providing new methods         
of measuring blood gases and blood levels of anesthesia, and contributing               
specialized knowledge in cardiology. Together, they were able to demonstrate           
that babies with low levels of blood oxygen and highly acidic blood had low             
Apgar Scores and that giving cyclopropane anesthesia to the mother was likely to       
result in an infant's low Apgar Score. Finally, the Collaborative Project, a           
twelve-institution study involving 17,221 babies, established that the Apgar           
Score, especially the five-minute score, can predict neonatal survival and             
neurological development.                                                               
In 1959, while on sabbatical leave, Apgar earned a master's degree in public           
health from the Johns Hopkins University. Deciding not to return to academic           
medicine, she devoted herself to the prevention of birth defects through public         
education and fundraising for research. She became the director of the division         
of congenital defects at the National Foundation for Infantile Paralysis (now           
the March of Dimes) and received many honors and awards for her work.