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June 7, 2009 2:43 AM   Subscribe

Dr. Virginia Apgar was born 100 years ago today. Although she is best known for her scoring system for assessing the health of newborn infants, she was a remarkable person in many other ways.

She entered medicine at the height of the great depression, a time when it was unusual for women to become physicians. She began training for surgery at Columbia University under Allen Whipple (yes, that Dr. Whipple), but transferred to the University of Wisconsin to train in anesthesiology under Ralph Waters (who deserves an FPP of his own). Her work in pediatric anesthesiology led to an interest in the health of newborns and then to an interest in the causes and prevention of birth defects. During the last part of her career she held a number of executive positions with the March of Dimes, where she helped establish the field of perinatology. For an intimate look at what it was like to be such a pioneer, collections of her papers can be viewed online at both the Wood Library-Museum and the National Library of Medcine. Happy Birthday, Dr. Apgar!
posted by TedW (19 comments total) 4 users marked this as a favorite
 
I always thought it was pretty convenient that her scale just happened to spell out her name.
posted by brevator at 6:41 AM on June 7, 2009


Fantastic....thanks for this.
posted by availablelight at 6:44 AM on June 7, 2009


I love the language trivia around the Apgar test. The following is from Wikipedia, edited liberally:

"Ten years after Apgar's publication, the acronym APGAR was coined in 1963 by the pediatrician Dr. Joseph Butterfield: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.

The same acronym is used in
German (Atmung, Puls, Grundtonus, Aussehen, Reflexe),
Spanish (Apariencia, Pulso, Gesticulación, Actividad, Respiración) and
French (Apparence, Pouls, Grimace, Activité, Respiration)
although the letters have different meanings.
Another backformation is American Pediatric Gross Assessment Record.

The test, however, is named for Dr. Apgar, making Apgar an eponymous backronym.
"
posted by ardgedee at 7:19 AM on June 7, 2009 [3 favorites]


I read somewhere that her personal motto was "Do what is necessary, do it now." I love this phrase kind of a lot.
posted by aint broke at 7:28 AM on June 7, 2009


IIRC, the Apgar test was the first attempt to introduce an objective metric to clinical medicine. As such, it made obstetric anesthesiology measurable and accountable, more so than almost any other field of applied medicine. I am only related to an anesthesiologist, but my understanding is that they are still one of the few specialties to apply statistics to everything they do, in an effort to hone their protocols and skills in order to improve patient survivability. The end result of this process has been a massive increase in the survivability of newborns, as doctors could finally measure what parts of the protocol were successful and by how much.
posted by costas at 8:21 AM on June 7, 2009


I read somewhere that her personal motto was "Do what is necessary, do it now." (aint broke)

I read that in Atul Gawande's New Yorker article, "The Score: How childbirth went industrial."
posted by ocherdraco at 8:46 AM on June 7, 2009


When a very smart and much loved professor' at my college had a baby, someone in the department put a sign on his office door:
New Baby is here. Apgar score: 750 Verbal, 720 Math
posted by pointystick at 8:54 AM on June 7, 2009 [3 favorites]


Interesting to read that anesthesiology, which is now among the highest paid specialties in medicine, was once considered sub-par. Something for the nurses, etc. Thank you for this post. I collected stamps as a child and had four babies with nice, healthy Apgar scores and I never knew about Virginia or that APGAR was an acronym.
posted by emhutchinson at 9:06 AM on June 7, 2009


I read somewhere that her personal motto was "Do what is necessary, do it now."

Another favorite phrase of hers (featured on the Columbia University link) was "Nobody, but nobody, is going to stop breathing on me." A good motto for an anesthesiologist.

...they are still one of the few specialties to apply statistics to everything they do, in an effort to hone their protocols and skills in order to improve patient survivability.

Two of the organizations that exist for that purpose are the Anesthesia Patient Safety Foundation and the Closed Claims Project of the ASA, both of which have been instrumental in making modern anesthesia very safe.

...anesthesiology, which is now among the highest paid specialties in medicine...
I wish! Actually, in both pay and malpractice premiums we rank in the middle, somewhere between primary care specialties such as pediatrics and family medicine and surgical specialties such as neurosurgery or ophthalmology. We used to pay relatively high malpractice rates, but the initiatives mentioned above were successful in bringing those rates down considerably in the 1980s.
posted by TedW at 10:01 AM on June 7, 2009


I read that in Atul Gawande's New Yorker article, "The Score: How childbirth went industrial."

From the article:

Sometimes sharp downward pressure with a fist just above the mother’s pubic bone can dislodge the shoulder;


Ahhh! Ahhh! Someone please tell me they don't do this any more? Oh that made me cringe.
posted by fermezporte at 11:15 AM on June 7, 2009


We sure do, in fact I had to do it this weekend. When the baby's stuck half way, you gotta get it out. In the typical protocol for shoulder dystocia, this maneuver comes just after bringing the legs up to the chest, and just before cutting an episiotomy. You don't even want to know what comes further down the list.
posted by Slarty Bartfast at 12:05 PM on June 7, 2009


You don't even want to know what comes further down the list.

Like locked twins? (warning-NSFW, the squeamish, people who love babies, or just about anyone) I post this horrible link as a reminder that before the 20th century childbirth was an occasion of wonder and dread simultaneously. Although it is easy to complain about how modern medical management of childbirth takes away from the experience, the ugly reality is that modern humans are not set up very well for childbirth, and the reduction of peripartum deaths among both mother and baby has been one of the great achievements of modern medicine.
posted by TedW at 1:24 PM on June 7, 2009 [5 favorites]


I wish I could favourite TedW a bajillion times.
posted by rodgerd at 3:38 PM on June 7, 2009


Congratulations, TedW, I never thought I'd see another medical photo that would shock me again. That's a low Apgar score, right there.
posted by Slarty Bartfast at 7:02 PM on June 7, 2009


PS: NSFW doesn't even begin to cover it.
posted by Slarty Bartfast at 7:02 PM on June 7, 2009



PS: NSFW doesn't even begin to cover it.

I'm not being a dick, I just wanted to underscore the warning that there is something awful behind that link.
posted by Slarty Bartfast at 7:10 PM on June 7, 2009


Oh my goodness. "Something awful" does not even begin to describe it. There is a dead baby behind that link.
posted by ocherdraco at 8:58 PM on June 7, 2009


Fuck Apgar. I only got an 8 and it kept me out of an Ivy. Shit, my cord wasn't even cut yet and they got me on the No Child Left Behind track!
posted by Pollomacho at 7:01 AM on June 8, 2009


Allen Whipple is not to be confused with his contemporary & fellow physician, Nobel prize winner George Whipple, apparently no relation. (Until this morning, I thought the Rochester Whipple was the one who did the procedure.)
posted by knile at 6:11 AM on June 12, 2009


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