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The Virginia Apgar Papers

[L. Stanley James' eulogy for Virginia Apgar] pdf (247,448 Bytes) transcript of pdf
[L. Stanley James' eulogy for Virginia Apgar]
Dr. L. Stanley James was one of Apgar's close friends and colleagues. He presented these reminiscences of Apgar at a memorial service held at Riverside Church in New York on September 15, 1974.
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7 (247,448 Bytes)
Date Supplied:
15 September 1974
James, L. Stanley
Original Repository: Mount Holyoke College. Archives and Special Collections. L. Stanley James Papers [MS 0782]
Box 2, Folder 7: Writings about Apgar 1974
Courtesy of Mount Holyoke College.
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Second Career: The National Foundation-March of Dimes, 1959-1974
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I am very proud and honored to be able to pay a tribute to Virginia, and to share with you some of my own memories, as well as some from her closest friends.
Virginia Apgar is one of the most remarkable people I have ever known. With her, life was exciting; her youthful enthusiasm and energy were boundless. She was warm and compassionate, and at the same time had a great sense of humor, sometimes earthy. Integrity was her hallmark: she was utterly sincere and honest and could not tolerate any form of deception. Her approach was forthright, direct, realistic and practical. She was loyal and generous, always dependable, and ready to help those in crisis. And despite her many talents and achievements, she had great humility. All these qualities, and many more, together with her magnetism and charm, contributed to her greatness as a physician, teacher and friend.
Virginia was a student until the day she died. Learning was the focal point of her life. Her curiosity was insatiable, and new knowledge held a continuing fascination for her. She was always ready to accept new information, and to modify or change her ideas accordingly. She never became rigid. This rare quality enabled her to progress through life, without becoming walled in by tradition or custom. It kept her young and vital. She started flying lessons a few years ago - and even wanted to fly under the George Washington Bridge.
As a physician, Virginia inspired complete trust. One of her inflexible rules was to visit, and carefully examine the patient she was to anesthetize, the day prior to surgery. This, she never failed to do - radiating confidence, gentleness and concern, as well as good humor; and she always had a little joke. Her realistic and practical approach created an air of optimism, and relieved anxiety; the worst problems became less serious. She even made them seem routine. The patients never forgot her. She was available for anesthesia 24 hours a day.
Although scrupulously honest, she was not above a little deceit if it was for the patient's welfare. At a time when certain surgeons insisted that ether was the only anesthetic, she would quietly and comfortably put the patient to sleep with some other agent; but ether was close at hand and frequently would be dropped on the drapes near the surgeon, who would murmur his approval. At the same time she would explain to any students or visitors at hand, in her reverberating stage whisper, exactly what she was doing and why.
As a teacher her effervescent personality engulfed you. She was one person the medical students nerver [sic] forgot. She was quite uninhibited, and could talk about any part of the body without embarrassment. It was impossible to shock her; but at the same time she would throw in a little shock factor, or a funny situation to emphasize a point. Most of the students learned about the caudal canal by feeling her coccyx, which had an unusual angle. Not infrequently, a resident would come into the office or laboratory looking for Dr. Apgar's pelvis, part of an old and much used skeleton upon which she demonstrated regional anesthesia. To a rather startled Australian gentleman, she jokingly offered to demonstrate the technique of paracervical block on herself, when the skeleton could not be found.
One of the few things she could not do was talk slowly. Translators found her impossible. Some people believed she had another hole for breathing. After a talk to several hundred physicians at an international meeting, it was later apparent that many had not understood a word; but they were enraptured and loved it. Somehow they got the message. It was not what she said, but how she said it.
She taught to do what is right and to do it now. This could even be her motto. In any emergency, whether in the hospital, on the sidewalk, the highway, or in church, she was the first one to help -- with her airway, laryngoscope and even a pocket knife, which were always in her purse. She was fearless and refused to be bound by convention or legal tradition. Before the "Good Samaritan Law", and when students were literally being taught to protect their own welfare before treating a patient, she was outspokenly teaching the opposite. Virginia never considered herself or tried to save her own skin. She personified idealism, and firmly believed that once idealism was lost, everything else would die on the vine.
In order to learn, it was essential to seek the truth and to be able to admit error. The first lecture I ever heard her give was on anesthetic deaths in infants, at a time when any wrongdoing was usually denied. Virginia examined every possible cause, and admitted every mistake.
During her training period as a surgical resident, one of her patients developed post-operative complications and died. Virginia worried and worried that she might have clamped a small, but essential artery. No autopsy permit could be obtained. So she secretly went to the morgue and opened the operative incision to find the cause. That small artery had been clamped. She immediately told the surgeon. She never tried to cover a mistake. She had to know the truth no matter what the cost.
Her honesty and humility together, enabled her to point out mistakes to students or residents, without offending them. She was completely disarming, and would sit down with a warm smile saying, "Tell Momma all about it."
She had an extraordinary ability to get the best out of people without antagonizing them.
As an investigator, Virginia was completely dedicated to seeking out new information that would improve the quality of life. Failure to do this, was to her, almost immoral. When Virginia was there, there was a sense of excitement; and in some way, she made what you were doing seem important.
Old and new ideas were constantly re-examined with objectivity. One of her favorite anesthetic agents for delivery was cyclopropane, which she firmly believed to be completely safe and harmless for the infant. When her research fellows found that infants born under cyclopropane were slightly, but significantly more depressed, compared to other infants, she was horrified. After looking at the data, she accepted the verdict without question, and immediately announced at luncheon -- "There goes my favorite gas".
She had an extraordinary ability, to ferret out the essentials, and cut into the core of a problem. She was the first person to catheterize the umbilical artery in a newborn infant, and undoubtedly the whole area of newborn intensive care would not be where it is today, were it not for Virginia.
She encouraged constantly, and if she believed in your ability, you just had to do it.
Virginia had countless friends all over the world, and to everyone who loved her, she was their special friend. To most of us she was more than a friend - she was an inspiration. She had something for everybody. People found her irresistible. She could establish an instant rapport, and her victim was immediately captivated. She was completely without prejudice, be it race, sex, color, age, or position. Her thoughtfulness and attention to little details were unforgettable. One of her talents was an uncanny memory for names and faces. She hated to forget anyone. Once, as a test, I presented one of her medical school classmates to her unexpectedly, and with no introduction. In 40 years he had become grey, somewhat increased in size, and had acquired glasses. Virginia could not guess his name. This was the only time I remember her being furious with me, and I was informed, "Never do that to me again, young man!" And I never did.
She did everything with gusto. Everything about her was accelerated -- speech, walking and thought, and she gave all she had, even when very ill and dying. There was no such thing as half measure. She was very competitive and loved to win, but only if up against someone who was a real challenge -- scrabble - cribbage - tennis. She was taught to play tennis like a man and played well. Asking a young friend how good her game was, she was told, "Quite good for a girl". "What do you mean? - If you're good, you're good." How she loved a challenge. And she was a gracious loser.
She loved simple things such as fishing and gardening, even weeding - in fact she loved to get covered with mud. She particularly loved fires, and would chop wood all day in order to sit by the fire at night.
She also loved music and was never happier than when playing chamber music with friends. How many people she introduced into this special world!
There were very few things that she disliked, but these included administration and red tape. She also abhorred intensely any form of scheming or subterfuge. These were beyond her.
She also hated to cook. Most food got well done frequently burned. Some people thought she liked burned food - and others were certain she loved burned pots.
She had unswerving loyalty and rallied to those with insurmountable problems, with strength and understanding. In contrast, I never remember her ever complaining, about any problem she might have had. She hated sympathy, and could not bear being incapacitated. She forbade her closest friends from visiting her in the hospital, when she was really ill.
She was completely devoid of vanity and conceit. Her modesty and humility were just natural qualities, that pervaded every aspect of her being and her life.
Unbeknown to many of her medical friends, she was deeply religious. Her religion was idealistic, rather than spiritual. It was a religion of action - of doing good on earth. Her favorite hymn appropriately was - "Take My Life and Let It Be, Consecrated Lord to Thee". With all her outgoing characteristics, she had an elusive quality. It was a belief in something bigger than self, and was part of her natural missionary spirit.
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