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March of Dimes/Library of Congress via Wikimedia // Public Domain
March of Dimes/Library of Congress via Wikimedia // Public Domain

Virginia Apgar, the Woman Whose Name Saves Newborns

March of Dimes/Library of Congress via Wikimedia // Public Domain
March of Dimes/Library of Congress via Wikimedia // Public Domain

How important is Dr. Virginia Apgar to the modern practice of obstetrics? Here is the way the National Library of Medicine’s website puts it: “[E]very baby born in a modern hospital anywhere in the world is looked at first through the eyes of Dr. Virginia Apgar.”

Apgar created a quick and reliable way to determine the health of a newborn baby, an examination that is usually referred to today as a baby’s Apgar test. Before her test, invented in 1952, there was no objective way to determine the health of a newborn, and babies were given little medical attention immediately after birth. Problems often escaped notice until they became critical.

To determine an Apgar score, a nurse, midwife, or physician examines the baby for five criteria—skin color, heart rate, reflexes, muscle tone, and breathing—at both one minute and five minutes after birth (and sometimes in further follow-up tests). Each criterion is given zero, one, or two points. A score over seven is considered normal. A score below three is seriously low. Babies often have lower scores at one minute after birth, but by five minutes have perked up and score in the normal range.

Because a common mnemonic for the criteria uses the letters APGAR (appearance, pulse, grimace, activity, and respiration) to create a “backronym,” or retrofitted acronym, many people do not realize Apgar is an eponym—named after a person. Apgar herself was often amused when people were surprised to find she was a real individual.

But in person, Virginia Apgar was hard to forget. She was a pioneer in several fields of medicine, helping to establish anesthesiology as a medical specialty, working to study and improve obstetrical anesthesia, and advancing the study of birth defects. She helped organize and administer the first Division of Anesthesia at Columbia University College of Physicians & Surgeons, her alma mater, and became the first woman to be a full professor there.

As a teacher of medicine, Apgar was known for her uninhibited sense of humor and could talk about anything without embarrassment. Because her own tailbone was at an odd angle, she would have medical students feel for it to help them learn how to administer spinal anesthetics. She always traveled with a resuscitation kit that included a penknife and an endotracheal tube (a plastic tube inserted into the windpipe to ventilate the lungs). "Nobody, but nobody, is going to stop breathing on me!" she reportedly declared.

In the late 1950s, after Apgar had already made a name for herself with her work in anesthesiology and the creation of the Apgar score, she turned her attention to the study and prevention of birth defects. She was asked to join what was then the National Foundation for Infantile Paralysis-March of Dimes (now simply the March of Dimes), which started researching and advocating for those with birth defects after it met its original goal of creating a vaccine against polio. As a director and later vice president at the March of Dimes, Apgar championed research that showed how factors such as infectious diseases, radiation exposure, substance abuse, and chemical exposure could cause birth defects. In her years with the organization, she also traveled the country speaking and calling attention to the issue of birth defects.

Outside of medicine, Apgar was a gardener, fly fisherman, and took flying lessons. Throughout her life, she was an excellent amateur violinist who often played in chamber ensembles. She even learned to make stringed instruments, including violins, a viola, and a cello.

In fact, her work as an amateur luthier even led her to a short career as a thief. In 1957, a musician friend noticed that a maple shelf in a phone booth at Columbia-Presbyterian Medical Center would make an excellent back for a viola. The friend and Apgar set out to take the shelf at night and replace it with another piece of wood, which they managed to stain to just the right color. But the piece they brought was slightly too long, and needed to be shortened. While her friend went into a nearby ladies’ room to do the sawing, Apgar guarded the door. The piece became the back of Apgar’s viola, and was one of four instruments she handcrafted that were played by pediatricians at a 1994 ceremony to honor a commemorative U.S. stamp with Apgar’s image. (The instruments were later donated to Columbia, where they can still be rented.)

Virginia Apgar died of liver disease at the age of 65 in 1974, but her name lives on around the world—even though many don’t know it—in the life-saving score she designed for infants.

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Photo illustration by Lucy Quintanilla, Mental Floss. Trains, iStock. Portrait, Project Gutenberg // Public Domain
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Retrobituaries
Leon Ray Livingston, America's Most Famous Hobo
Photo illustration by Lucy Quintanilla, Mental Floss. Trains, iStock. Portrait, Project Gutenberg // Public Domain
Photo illustration by Lucy Quintanilla, Mental Floss. Trains, iStock. Portrait, Project Gutenberg // Public Domain

With no more troops or supplies to move after the end of the Civil War, the country's railroads became home to another army—that of the hobos. The ever-increasing web of rails nationwide would go from 45,000 miles before 1871 to nearly 200,000 by 1900, making it easier for the poorest of working-class folk, many of whom were veterans, to hitch a ride on a train and travel from state to state looking for employment. These hobos were soon a familiar sight coast to coast.

The journeys of these destitute travelers quickly caught on in the popular culture of the late 19th and early 20th centuries, creating a romanticized view of this unique lifestyle. It was a time when writers like W. H. Davies and Jack London parlayed their hoboing experiences into literary notoriety, while Charlie Chaplin's "Little Tramp" would become one of the most recognizable movie characters of the 20th century. Among these wandering folk figures was a man with a sense of showmanship and a keen eye for branding: Leon Ray Livingston—a writer, lecturer, and transient who would go on to dub himself "King of the Hobos."

What we know about Livingston's early life comes solely from the books he wrote, which often read like tall tales designed to help build his mystique. According to Livingston, he was born in August 1872 into a family from San Francisco that he described as "well-to-do," but at age 11, misbehavior at school led him down a different path in life. On the day after his 11th birthday, his teacher sent him home with a note detailing his bad behavior, which was to be signed by Livingston's father. The boy didn't show his father the note that night, and when he spotted his teacher heading toward his house the next morning, Livingston snuck out of the house and kept moving. He wouldn't fully stop for decades.

Livingston says he left his house that day armed with a .22-caliber rifle and a pocket full of money—some stolen from his mother, some a birthday gift from his uncle. From there, his life became an odyssey of riding the rails, hopping on steamers, and taking on odd jobs as he traversed a country in the midst of an industrial revolution. Years later, Livingston would famously brag that he traveled 500,000 miles while only spending $7.61 on fares.

In his decades on the road, he took to writing about his experiences, eventually self-publishing around a dozen books about his adventures; the most comprehensive was Life and Adventures of A-No. 1: America's Most Celebrated Tramp. Published in 1910—nearly 30 years after he left home—this book includes tales of his early life as a hobo, including one globe-trotting adventure in his first year that found him working aboard a British trade ship that set off from New Orleans for Belize, where he jumped ship and began working for a mahogany camp.

Book cover for The Trail of the Tramp
The book cover to Livingston's The Trail of the Tramp
Project Gutenberg // Public Domain

Livingston's Central American exploits include anecdotes about the working conditions in the British mahogany camps, his repeated (but failed) attempts to desert his employers and head home on their dime, feasting on "roasted baboon," and his near-fatal run-in with something he called Black Swamp Fever (which could be a reference to malaria). The writing is colorful and no doubt romanticized, making it hard to separate facts from the legend Livingston aimed to enhance.

It was after his return trip to America that Livingston was christened with the nickname that would help him become something bigger than a lowly transient: A-No. 1. In his book, Livingston said the moniker was given to him by an older companion named Frenchy, who said:

"Every tramp gives his kid a nickname, a name that will distinguish him from all other members of the craft. You have been a good lad while you have been with me, in fact been always 'A-No. 1' in everything you had to do, and, Kid, take my advice, if you have to be anything in life, even if a tramp, try to be 'A-No. 1' all the time and in everything you undertake."

He also told Livingston to carve this new nickname into each mile post he passed on his journey, letting the world know who'd traveled here before them. This piece of advice gave the legend of Livingston more longevity than he could ever imagine: In the 21st century, people are still finding "A-No. 1" scribbled under bridges.

In addition to signing their nickname, the wandering tramps would also draw up symbols to alert others of possible danger or hospitality ahead. In his 1911 book Hobo-Camp-Fire-Tales, Livingston provides drawings of 32 of these symbols and what they all mean—including signs for "This town has saloons," "The police in this place are 'Strictly Hostile,'" and "Hostile police judge in this town. Look out!" It's not completely clear if Livingston played a role in creating this hobo code, but he is credited with preserving these symbols and bringing them to the attention of a curious American public.

As Livingston became more of a cultural figure, he seemingly took an interest in leading people away from the tramp life. His books would often begin with a warning, telling readers, "Wandering, once it becomes a habit, is almost incurable, so NEVER RUN AWAY, but STAY AT HOME, as a roving lad usually ends in becoming a confirmed tramp." He then finished, saying this "pitiful existence" would likely end with any would-be tramp in a "pauper's grave." These warnings could be a well-meaning public service announcement, although scholars say they can also be read as Livingston's attempt to enhance the danger of the lifestyle to create even more intrigue about his exploits (and sell more books).

Always a showman, Livingston understood publicity as well as any celebrity at the time; in his travels he would often seek out local reporters, becoming the subject of numerous newspaper articles and magazine interviews around the country. Taking pride in his exploits, he carried a scrapbook of his journeys around with him, which included personalized letters and autographs from notable figures such as Thomas Edison, George Dewey, Theodore Roosevelt, and William Howard Taft.

His influence among the community was far-reaching, even capturing the imagination of a young Jack London, author of White Fang and The Call of the Wild, during his formative years. London had reached out to Livingston about his lifestyle in the late 19th century, and the two adventured together, as chronicled in Livingston's book From Coast to Coast with Jack London, which was published in 1917, a year after London's death.

Despite the freight-hopping and steamer trips and odd jobs, Livingston wasn't hurting for money; for him, hoboing was a spiritual necessity, not a financial one. When he would seek some stability during his travels, he could often be found staying at Mrs. Cunningham's Boarding House in Cambridge Springs, Pennsylvania, where he would write many of his books. In The Ways of the Hobo, he claimed the house became "a veritable Mecca to chronic hoboes," including old friends like "Hobo Mike" and "Denver Johnny," who sought out his counsel and companionship.

In 1914, Livingston married a woman named Mary Trohoske (sometimes spelled Trohoski), and he settled down—as best a tramp could—in a house in Erie, Pennsylvania. His later years were spent working various jobs—including at electric and steel companies around Erie, though one source places him in real estate. While he stayed relatively put in his later years, Livingston did travel the lecture circuit to speak out against the lifestyle that defined him. With the country in the throes of the Great Depression, the warnings Livingston wrote about the hobo lifestyle in each of his books had transformed into full-on speeches against tramping. (Sadly, his lectures don't seem to have survived.)

Rumors persist about Livingston's final days. Some claim that he continued his traveling ways toward the end, dying in a train wreck in Houston, Texas, in 1944, but this is likely confusion with a 1912 wreck that killed one of his impersonators. According to most accounts, Livingston passed away due to heart failure in his home on April 5, 1944 around age 71, with his wife by his side. But for a man who lived to mythologize his own story, a little ambiguity about his end is only fitting.

Livingston's fame has waned significantly since the first quarter of the 20th century. He's only re-emerged in the mainstream a few times, most notably when Lee Marvin played A-No. 1 in the 1973 movie Emperor of the North, based on Livingston's travels with Jack London and on London's own book The Road. Though little-remembered now, Livingston was part of a fleeting moment in American history—a time when the country was getting the first real glimpse of itself as an interconnected nation, and when someone who lived by wandering could be the stuff of folklore.

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Carl Van Vechten, Wikimedia // Public Domain
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Retrobituaries
Zora Neale Hurston, Genius of the Harlem Renaissance
Carl Van Vechten, Wikimedia // Public Domain
Carl Van Vechten, Wikimedia // Public Domain

Twentieth century African-American author Zora Neale Hurston is best known for her novel Their Eyes Were Watching God. But her perseverance and love of her culture made for a much richer life than many people know.

Near the turn of the century, Hurston was born the spirited daughter of former slaves. Her parents had gone on to become a schoolteacher and a Baptist preacher. Her father's sermons were likely what sparked the girl's fascination with storytelling, which she'd later use not only in her works, but also in the construction of her public persona.

Over the course of her life, Hurston offered contradictory dates of birth. And in her 1942 autobiography Dust Tracks on a Road, she inaccurately claimed Eatonville, Florida, as her birthplace, when in truth she was born in Notasulga, Alabama, probably on January 7, 1891. But Eatonville was her home from about age 3 to 13, and a major influence on her work. One of the first places in the United States to be incorporated as an all-black town, it was also home to a vibrant and proud African-American community that protected the young Hurston from the cruel racial prejudices found elsewhere in the United States. Years later, Hurston would cherish this place and the self-confidence it instilled in her works. She once described it as "A city of five lakes, three croquet courts, three hundred brown skins, three hundred good swimmers, plenty guavas, two schools and no jailhouse."

Despite a seemingly ideal hometown, Hurston knew hardship. At 13, she lost her mother, and was booted out of boarding school when her father and new step-mom failed to foot the tuition bill. Down but not out, Hurston found work as a maid, serving an actress in a traveling theatrical company that gave her a taste of the world beyond Florida. In Baltimore, she lopped a decade off her age (a subtraction she maintained the rest of her days) to qualify for free public schooling that would allow her to complete her long-delayed high school education. From there, she worked her way through college, studied anthropology and folklore, and had her earliest works published in her school's paper. By 1920, the 29-year-old earned an associate degree from Howard University in Washington D.C. Five years later, she made the fateful move to New York City, where she eventually graduated with a Bachelor of Arts in anthropology from Barnard College after studying with the pioneering anthropologist Franz Boas. There, she also became a seminal and controversial icon of the Harlem Renaissance.

It's said that Hurston—with her brazen wit, affable humor, and charm—waltzed into the Harlem scene, easily befriending actress Ethel Waters, and poets Langston Hughes and Countee Cullen. Professor and fellow folklorist Sterling Brown once remarked of her appeal, "When Zora was there, she was the party."

Electrified by the thriving literary movement that strove to define the contemporary African-American experience, Hurston penned the personal essay "How It Feels To Be Colored Me," where she boldly declared

"I am not tragically colored. There is no great sorrow dammed up in my soul, nor lurking behind my eyes. I do not mind at all. I do not belong to the sobbing school of Negrohood who hold that nature somehow has given them a lowdown dirty deal and whose feelings are all hurt about it. Even in the helter-skelter skirmish that is my life, I have seen that the world is to the strong regardless of a little pigmentation more or less. No, I do not weep at the world—I am too busy sharpening my oyster knife."

She and Hughes teamed up in 1930 to create a play for African-American actors that wouldn't use racial stereotypes. Regrettably, creative differences led to a falling out between the two that sunk The Mule Bone: A Comedy of Negro Life In Three Acts before the Eatonville-set fable managed to be produced. But Hurston rebounded with her musical The Great Day, which premiered on Broadway January 10, 1932. Next, came her first novel, Jonah’s Gourd Vine, in 1934. The following year saw the release of a meticulously curated collection of African American oral folklore. Mules and Men became the greatest success she'd see in her lifetime, and yet it earned Hurston only $943.75.  

Her next book, 1937’s Their Eyes Were Watching God, was written during her anthropological expedition to Haiti to study voodoo. Reflecting its divorced author's life, it followed a forty-something African American woman's journey through three marriages and self-acceptance. While the mainstream press praised Hurston's anthropological eye and her writing "with her head as with her heart," she faced a backlash from some of her Harlem Renaissance peers.

Zora Neale Hurston drumming, 1937. Wikimedia/Library of Congress // Public Domain

As the movement evolved, Harlem Renaissance writers had been debating how African-Americans should present their people and culture in their art. Should they devotedly fight against the negative stereotypes long established by Caucasian writers? Should their work be penned as progressive propaganda intended to expose the racism of modern America as a means to provoke change? Or should African-Americans create without the constraints of a political or creative ideology? Hurston sided with the last group, and saw her novel criticized for its embrace of the vernacular of the black South, its exploration of female sexuality, and its absence of an overt political agenda. Literary critic Ralph Ellison called Their Eyes Were Watching God a "blight of calculated burlesque," while essayist Richard Wright jeered, "Miss Hurston seems to have no desire whatsoever to move in the direction of serious fiction." But fiction wasn't all she wrote. 

In 1938, Hurston published the anthropological study Tell My Horse; her aforementioned autobiography, Dust Tracks on a Road, came six years later. But following the release of her final novel Seraph on the Suwanee, Hurston's career fell into decline. Through the 1950s, she occasionally managed to secure some work as a journalist, scraping by with stints as a substitute teacher and sometimes maid. Despite a prolific output that included four novels, two folklore collections, an autobiography, and a wealth of short stories, essays, articles and plays, Hurston died penniless and alone in a welfare home on January 28, 1960; her body—dressed in a pink dressing gown and fuzzy slippers—was buried in an unmarked grave in Fort Pierce.

It was an especially cruel fate because she'd once appealed to activist W.E.B. Du Bois to create "a cemetery for the illustrious Negro dead" to assure that they'd never be discarded. Her rejected proposal read in part: "Let no Negro celebrity, no matter what financial condition they might be in at death, lie in inconspicuous forgetfulness. We must assume the responsibility of their graves being known and honored." 

This confident and rebellious creator's contribution to the Harlem Renaissance seemed certain to have doomed her to the realm of the forgotten. But in 1975, Alice Walker, who would go on to write the heralded novel The Color Purple, penned a legacy-shifting essay for Ms. magazine called "In Search of Zora Neale Hurston." The essay encouraged a new generation of readers to rediscover Hurston’s work. Their Eyes Were Watching God found a new life, and began popping up on school reading curriculums and earning reprintings in other languages, as did her other books. Mule Bone was finally published and staged in 1991. Historians scoured archives and uncovered a never-published manuscript of folklore Hurston had collected. Titled Every Tongue Got To Confess, it was published posthumously in 2001.

Not only were Hurston's works at long last given their due—so was she. In honor of the author who'd inspired her and countless others, Walker traveled to Florida to put a proper tombstone on Hurston's grave. It reads: "Zora Neale Hurston, A Genius of the South. Novelist, folklorist, anthropologist."

This story originally ran in 2016.

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