Virginia Apgar (1909–1974): Neurological Evaluation of the Newborn Infant

ence. At a time when few women even attended college [1] , she was determined to be a doctor [2] . In September 1929, she entered the College of Physicians and Surgeons at Columbia University. In dire fi nancial diffi culties at the time of the stock market crash, Apgar had to borrow money from family friends. She graduated in 1933, fourth in her class, a member of Alpha Omega Alpha Society, and nearly $4,000 in debt [2] . She won a prized surgical internship at Columbia [3] , where she performed brilliantly. But Alan Whipple, chairman of surgery, discouraged her because so many women surgeons had failed to succeed fi nancially in a male-dominated specialty that was competitive and overcrowded [3] . Whipple, recognising her ability, persuaded her to train in anaesthesiology, then often performed by nurses. Neurologists often are asked to advise about epilepsy, infant and childhood cerebral handicap, their aetiology, treatment and prognosis. A crucial factor in assessment has been the Apgar score to assess the neonatal condition that may be relevant to later neurological damage. Dr. Apgar developed the 10-point scoring system ( table 1 ) in 1952 to focus attention on neonates in the fi rst critically precarious minutes of life. A low score immediately signalled the need for emergency attention.