Nevertheless, She Persisted: Virginia Apgar

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Asked why she always carried a basic respiratory resuscitation kit everywhere she went –it included a penknife for impromptu tracheotomies — Apgar replied, “Nobody, but nobody, is going to stop breathing on me.”

Virginia Apgar 1909-1974

Women’s History Month is coming to a close, and this entry is going to be a little bit different, starting with an apology for not having kept up with my original goal of a post a day featuring a different American woman.

However, I did make at least a basic sketch for every day of the month, and so I’m just going to extend my own celebration of Women’s History Month beyond the end of March.

Next, I note that in the interest of posting this entry today –March 30th is National Doctors’ Day in the United States –I am posting a draft of today’s comic in lieu of a polished, final product, and will also make the entry itself more cursory. Modern cartoonists often post their work in stages, to demonstrate their process, and I’m tempted to say that’s what I’m doing here. 

But I admit I’ve touched up parts of this initial sketch — mainly redoing my handwriting on the components of the Apgar scale so that it’s legible. You know, on the off-chance some doctor or medical professional somewhere has to deliver a baby outside a hospital, and has forgotten the points of the Apgar Scale, and for some unlikely reason this blog entry is the only reference to it s/he can find on her/his smartphone.

The overall scribbliness, though, remains. Call it “process.”

Now on to Virginia Apgar.

In 1952, Virginia Apgar, an obstetrical anesthesiologist at the Columbia University College of Physicians and Surgeons, developed the first standardized method for evaluating the health of newborn babies. It consisted of five qualities, each measured on a scale of 0 to 2, observed just after birth, and then again five minutes later: color, heart rate, reflexes, muscle tone, and respiration.

The highest possible Apgar score is 10 (though few babies actually score that high due to fluctuations in the initial appearance of their skin) A low score is a warning sign that an infant may be in need of special medical care or extra medical attention.

This was the first time a consistent method had been applied to babies’ state of health upon entering the world, and as a result, countless numbers of infants survived who may not have survived otherwise –merely because no one had kept track of initial signals of trouble.

Eventually, to honor Apgar’s achievement–and to provide a handy mnemonic for medical students– the names of the steps on the Apgar scale were adapted so that their initial letters spelled out Apgar’s name:

Appearance (color)

Pulse (heart rate)

–(Reflex irritability) Grimace

Activity (muscle tone & flexion)

Respiration

(Many, however, didn’t realize the “backronym”‘s significance; Apgar was once visiting a Boston hospital, where a secretary exclaimed, “Oh, I didn’t know Apgar was a person; I thought it was just a thing!”)

Apgar was the only woman in her anesthesiology program at the University of Wisconsin-Madison, and only the fiftieth doctor in the United States to be certified in anesthesiology.

She was the first woman to head the anesthesiology division of the Columbia University College of Physicians and Surgeons, and the first woman to be made a full professor at the medical school.

At age 45, she earned a Master’s in Public Health degree, eventually becoming the Executive Director of the March of Dimes, and later, its director of research.

In her spare time — I know, when did she have any? — she was a talented violinist, and made her own violin, mezzo violin, viola and cello. Apgar was also an avid gardener — she’s got an orchid named after her — and a stamp collector; she was honored with her own United States Postal Service stamp in 1994. At the ceremony commemorating Apgar’s stamp, a quartet of pediatricians played Apgar’s own handmade string instruments. (They were eventually donated to Columbia, where you can now rent them.  The instruments, not the pediatricians.)

Virginia Apgar was a woman you’d want to keep breathing for. You wouldn’t dare not to.

Sources:

Bause, George S., M.D. “The 20-cent Virginia Apgar Stamp.” Anesthesiology. V. 113, No. 4, October 2010, p. 944.

DeBenedette, Valerie. “Retrobituaries: Virginia Apgar, the Woman Whose Name Saves Newborns.” Mental Floss, October 12, 2016.
Mount Holyoke College. “Virginia Apgar.”
Smithsonian National Postal Museum. “Arago –People, Postage and the Post: The 20-cent Apgar.”

U.S. National Library of Medicine, Exhibition Program. “Changing the Face of Medicine: Dr. Virginia Apgar.”

U.S. National Library of Medicine. “The Virginia Apgar Papers.”

 

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