Add it Like Apgar

How do we make data relevant to what seems like a non-binary, non-enumerable story? We learn from the famous doctor who saved countless newborn babies by thinking of them as numbers. Even something as valuable as a baby’s life can be reduced to a number from 0 to 10.

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The Apgar Score at a glance

via Wikipedia:


Do what's right and do it now

From Atul Gawande in The New Yorker:

But the situation wasn’t so encouraging for newborns: one in thirty still died at birth—odds that were scarcely better than those of the century before—and it wasn’t clear how that could be changed. Then a doctor named Virginia Apgar, who was working in New York, had an idea. It was a ridiculously simple idea, but it transformed obstetrics and the nature of childbirth. Apgar was an unlikely revolutionary for obstetrics. For starters, she had never delivered a baby—not as a doctor and not even as a mother.

At the end of her surgical residency, her chairman told her that, however good she was, a female surgeon had little chance of attracting patients. He persuaded her to join Columbia’s faculty as an anesthesiologist, then a position of far lesser status. She threw herself into the job, and became the second woman in the country to be board-certified in anesthesiology. She established anesthesia as its own division at Columbia and, eventually, as its own department, on an equal footing with surgery. She administered anesthesia to more than twenty thousand patients during her career. She even carried a scalpel and a length of tubing in her purse, in case a passerby needed an emergency airway—and, apparently, employed them successfully more than a dozen times. “Do what is right and do it now,” she used to say.

More background on The Apgar score

The Apgar score, as it became known universally, allowed nurses to rate the condition of babies at birth on a scale from zero to ten. An infant got two points if it was pink all over, two for crying, two for taking good, vigorous breaths, two for moving all four limbs, and two if its heart rate was over a hundred. Ten points meant a child born in perfect condition. Four points or less meant a blue, limp baby.

The score was published in 1953, and it transformed child delivery. It turned an intangible and impressionistic clinical concept—the condition of a newly born baby—into a number that people could collect and compare. Using it required observation and documentation of the true condition of every baby. Moreover, even if only because doctors are competitive, it drove them to want to produce better scores—and therefore better outcomes—for the newborns they delivered.

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