Virginia Apgar was born on June 7, 1909, in Westfield, New Jersey, the youngest of three children in a household she later described as one that “never sat down.” Her father, Charles Emory Apgar, was an insurance executive, amateur astronomer, inventor, and radio enthusiast. Her mother, Helen May Clarke, came from a ministerial family. Music filled the home. Virginia began violin lessons at six and never stopped playing. Family illness also left a mark: one brother died of tuberculosis before she was born; another suffered chronic childhood sickness. By high school she had already decided on medicine.
She graduated from Westfield High School in 1925 and entered Mount Holyoke College, majoring in zoology with work in physiology and chemistry. She supported herself with part-time jobs, played in the orchestra, competed on multiple sports teams, wrote for the newspaper, and acted in campus productions. Her energy was already legendary. A yearbook caption asked, “Frankly, how does she do it?” She received her A.B. in 1929.
That fall she entered Columbia University’s College of Physicians and Surgeons as one of only nine women in a class of ninety. The stock-market crash hit weeks later. She graduated fourth in her class in 1933 and won a surgical internship at Presbyterian Hospital. The chairman of surgery, Allen O. Whipple, admired her skill but steered her toward anesthesiology. Surgery, he believed, offered limited prospects for women during the Depression; the newer field of anesthesia needed people with her drive. She trained with nurse anesthetists at Presbyterian, then with Ralph Waters at the University of Wisconsin and Emery Rovenstine at Bellevue. In 1937 she became one of the first women board-certified in anesthesiology.
In 1938 she returned to Columbia-Presbyterian as director of the newly formed Division of Anesthesiology—the first woman to head a specialty division there. For years she was essentially the entire staff. She built a residency program, taught relentlessly, and carried a pocket knife and rubber tubing wherever she went. “Nobody, but nobody, is going to stop breathing on me,” she said. When the division became a full department in 1949, the chairmanship went to a male colleague. Apgar was instead named full professor of anesthesiology, the first woman to hold that rank at the College of Physicians and Surgeons.
By then her attention had turned to the delivery room. She noticed that newborns received far less systematic attention than their mothers. Infants who looked lifeless were often set aside with little attempt at resuscitation. In 1952 she proposed a simple five-sign score to be assigned one minute after birth: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each sign received 0, 1, or 2 points. A total of 7–10 was generally reassuring; lower scores signaled the need for immediate help. She presented the method at a scientific meeting that year and published it in 1953. The later mnemonic—Appearance, Pulse, Grimace, Activity, Respiration—was coined by others, not by Apgar herself. She was delighted when she learned of it.
Working with L. Stanley James, Duncan Holaday, and others, she correlated scores with maternal anesthesia, labor practices, and newborn blood gases and pH. Studies of tens of thousands of births showed that the one-minute and especially the five-minute scores predicted survival and later neurological status. The test was cheap, required no special equipment, and could be performed by nurses or interns. It focused attention on the first minutes of life and helped create the intellectual and practical foundation for neonatology and neonatal intensive-care units. Apgar herself attended more than 17,000 deliveries.
In 1959 she left Columbia to earn a Master of Public Health degree at Johns Hopkins. The National Foundation (soon better known as the March of Dimes) recruited her to head its new Division of Congenital Malformations. Polio had been largely conquered; the organization needed a new mission. Apgar helped redirect it toward birth defects and perinatal health. After the devastating 1964–65 rubella epidemic she campaigned for immunization, testified before Congress, and traveled constantly to educate physicians and the public. She later became director of basic research and then vice president for medical affairs. In 1972 she co-authored the popular book Is My Baby All Right? with journalist Joan Beck. She published more than sixty scientific papers and remained a clinical professor of pediatrics at Cornell.
Apgar never married. When asked why, she replied that she had not found a man who could cook. She remained a gifted amateur musician, traveling with her violin and joining chamber groups wherever she went. In the 1950s she learned instrument-making and, with a friend, built two violins, a viola, and a cello—one piece of wood famously taken from a hospital telephone-booth shelf. She gardened, collected stamps, fished, played golf, and in her fifties took flying lessons, joking that she wanted to fly under the George Washington Bridge. Colleagues remembered her rapid speech, boundless curiosity, and refusal to become rigid with age. She kept learning until the end.
Progressive liver disease slowed her in her final years. She died on August 7, 1974, at Columbia-Presbyterian Medical Center, the institution where she had trained and spent most of her career. She was 65. Honors followed: a U.S. postage stamp, induction into the National Women’s Hall of Fame and the New Jersey Hall of Fame, and an academy of medical educators named for her at Columbia. The Apgar score is still performed on virtually every baby born in a hospital worldwide. It is one of the simplest and most durable tools in medicine, a reminder that systematic observation in the first minute of life can change everything that follows. Virginia Apgar’s real achievement was not only the numbers she assigned but the insistence that every newborn deserved to be seen, counted, and, if necessary, saved.