Virginia Apgar’s Legacy Continues, 50 Years After Her Death

Few Columbia medical school graduates or faculty members have left as indelible an imprint on medicine and medical history as Virginia Apgar. She graduated from what is now the Vagelos College of Physicians and Surgeons in 1933 and spent 21 years on the VP&S faculty. During that time she made her major contribution to health care: the Apgar Score.

This year—50 years after her death—we revisit some of the many ways Apgar made her mark on the world. She is primarily remembered for publishing the Apgar Score in the 1950s to assess newborn health, a public health advance still used around the world and credited with saving millions of lives. The score came out of a discussion at breakfast in the hospital cafeteria after a student asked her about the need to evaluate the newborn. She grabbed the nearest piece of paper—a “Please bus your own trays” sign—and jotted down her idea for a five-point score. The score was presented at a meeting in 1952 and published in 1953.

The Apgar Score measures a newborn’s color, heart rate, reflexes, muscle tone, and respiration. Whether the Apgar Score was the best method for assessing newborn health was debated over the years, but a study published in the New England Journal of Medicine in 2001 found that the Apgar test was a better predictor of distress than a newer method of testing the acidity of blood from the umbilical cord. More recent studies have addressed what Apgar herself called the "most unsatisfactory" of the score's five components: its assessment of skin color.

Apgar is remembered for far more than the score named for her.

• Virginia Apgar was born June 7, 1909, in New Jersey. Her father’s amateur radio work exposed an espionage ring during World War I.
• She was a 1933 graduate of VP&S, where she graduated fourth in her class. After completing a residency in surgery at Columbia, she was advised against pursuing a career as a surgeon because women had not been successful in the field. She turned to anesthesiology and trained at the University of Wisconsin and Bellevue Hospital. 
• She returned to Columbia in 1938 as director of the new division of anesthesia. She is said to have assisted in the delivery of nearly 2,000 babies during her career.

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  Apgar and Allen Whipple started the medical school’s anesthesia division, a division Apgar ran for more than a decade. When the division was made a department in 1949, Apgar was not named chair, reportedly because of her lack of research. In 1949, she became the first woman named a full professor at VP&S.
• After leaving Columbia in 1959, Apgar directed the March of Dimes research program to prevent and treat birth defects. She earned a master of public health degree from Johns Hopkins University and was well-known through her public appearances to advocate for universal vaccination to prevent mother-to-child transmission of rubella and other issues in infant health.
• She wrote numerous articles for medical journals and in 1973 published a book, co-authored with Joan Beck, titled “Is My Baby All Right?”

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  In 1973, Ladies Home Journal named her Woman of the Year in Science, and she appeared on a CBS television special May 14, 1973, that honored her and seven other women. This accolade honored her work to prevent birth defects as an executive of the March of Dimes.
• She played the violin and made stringed instruments. One famous story reported in the New York Times recounts the time Apgar and another musician removed a shelf from a phone booth in the Harkness Pavilion to make the back of a viola. Because Apgar had been unsuccessful in getting the wood through proper channels, the two women devised a plot to steal it. When they found that the piece of wood they brought to replace the shelf was too long, they used a women’s lounge to shorten the replacement piece with a saw. Apgar, standing guard, told a nurse who heard the sounds coming from the lounge, “It’s the only time repairmen can work in there.”
• Apgar died in August 1974. A Columbia obituary noted that “Anybody who met her had a ‘Ginny’ story to tell, whether it had to do with her interest in music, playing the violin and cello, or building her own string instruments. Or whether it had to do with her love of fishing. There were stories about her stamp collecting and her love of baseball and golf. There were stories about her driving her automobile as if it was an airplane.” (At her memorial service, a colleague said she started flying lessons a few years before her death and wanted to fly under the George Washington Bridge.) 

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  In 1994, Apgar, a stamp collector, was honored with a postage stamp in the Great Americans series.
• In 1995, Apgar was inducted into the National Women’s Hall of Fame in Seneca Falls, New York.
• Apgar’s native New Jersey inducted her into the New Jersey Hall of Fame in 2019.
• VP&S named a teaching academy—the Virginia Apgar Academy of Medical Educators—for her. 
• In 2018, on what would have been her 109th birthday, Apgar was honored by Google with an animated doodle.