Virginia Apgar was a woman who transformed a chaotic field of medicine into a precise science that saves lives. Today, her name is carried by one of the most important medical tests in the world, used at the birth of every child.
An Exceptional Talent
Born in 1909 in Westfield, New Jersey, Virginia Apgar stood out for her extraordinary abilities from an early age. She excelled in academics and sports, performed in the school theater, played the violin, and wrote for the school newspaper. This versatility foreshadowed a remarkable career, although no one at the time could have predicted how difficult her path would be.
In 1929, the young zoology graduate from Mount Holyoke College entered the gates of the Columbia University College of Physicians & Surgeons. Out of ninety students, only nine were women. Apgar had to take out a loan to pay for her studies, but four years later, she graduated ranked fourth in her class.
Surgery seemed like the natural choice for such a talented doctor. However, Dr. Allen Whipple, head of the surgery department, persuaded her to change her plans. He argued that anesthesiology needed pioneers, while surgery was the domain of men who would not accept a woman among their ranks. This advice determined her entire professional life.
Building a Specialty from Scratch
Anesthesiology in the 1930s barely existed as a separate medical field. There were only thirteen courses in the entire United States, ranging from two weeks to three years in length. The tasks of an anesthesiologist were usually carried out by trained nurses, and only a handful of doctors took the field seriously.
Apgar began with a one-year course for nurse anesthetists. It was not until 1936 that Dr. Ralph Waters of the University of Wisconsin-Madison invited her as the first student to his anesthesiology course. After half-year residencies in Madison and at New York’s Bellevue Hospital, in 1937 Virginia Apgar became the first woman in the United States to be certified as an anesthesiologist.
Returning to Columbia Presbyterian Hospital brought Apgar an appointment as director of the Institute of Anesthesiology. The specialty’s low prestige and poor pay meant that no one wanted to work there. Apgar took matters into her own hands, co-wrote a manual with nurse Anne Penland, and for eleven years built the institute from the ground up almost single-handedly. In 1949, she became the first woman to hold a full-time professorship in the history of Columbia University.
The 1950s revealed a dramatic problem in obstetrics. Doctors and nurses assessed newborns entirely by intuition, with no shared standards. Some looked at breathing, others at heart rate, and still others at skin color. In this chaos, many children lost their lives in the first minutes after birth, as no one could quickly identify which newborns needed immediate help.
Virginia Apgar witnessed this tragedy from the delivery room. One morning in the hospital cafeteria, she grabbed a napkin and listed five parameters to assess in seconds: heart rate, breathing, muscle tone, reflex response, and skin color. Each element was scored from zero to two points, up to a maximum of ten. Thus, the Apgar Score was born.
The genius of this system lay in its simplicity. No specialized equipment was needed, just knowledge and attentiveness from the staff. Assessment at one and five minutes after birth immediately indicated whether resuscitation was needed. After the scale was introduced at Columbia-Presbyterian Hospital, newborn mortality rates dropped sharply.
The Legacy of Five Words
Virginia Apgar first presented her system in 1952, published it a year later, and by 1954, European hospitals began using it. Within a decade, the method became the global standard. Medical institutions on every continent adopted a test that was created on a simple napkin during a hospital breakfast.
More than seventy years later, the Apgar Score remains a fundamental element in assessing every newborn’s health status. In the age of ultramodern equipment, advanced monitors, and sensors, just a few observations and five simple assessments still suffice. This remarkable longevity speaks to the brilliance of a solution that got to the heart of the problem.
Marcus Renfell
Marcus Renfell is a historian driven by curiosity and passion. He refuses to accept the “safe,” polished versions of the past. Instead, he brings forgotten, overlooked, and distorted stories back to life. His work blends scholarly precision with the art of storytelling, turning historical narratives into vivid, page-turning experiences.
His mission is simple: to prove that history can be gripping, alive, and deeply personal.
His debut book: Women of Science. Stories You Were Never Told
In his first publication, Marcus Renfell shines a light on the remarkable women who shaped the world of science — both the pioneers whose names we know and the brilliant minds history forgot. It’s an inspiring journey through untold stories, groundbreaking achievements, and the resilience of women who changed our understanding of the world.
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