My volleyball coach yelled ‘puka’ when nobody covered the open spot. I built a career on it.

In 1949, a doctor named Virginia Apgar was having breakfast in a hospital cafeteria when a medical student asked her a question nobody had previously thought to answer: how do you know, in the first moments after a baby is born, whether it is going to be okay? Virginia grabbed a napkin and wrote down five things: Heart rate.

Breathing.

Muscle tone.

Reflexes.

Color.

Doctors had known all of these markers for decades.

The knowledge was not new.

What was new was someone finally organizing it into something a nurse could use in sixty seconds in the chaos of a delivery room.

That became the Apgar Score.

It is used in delivery rooms around the world today.

Somewhere right now, a nurse is scoring a newborn out of ten because Virginia saw over breakfast something nobody else had bothered to address.

The gap was not a secret.

It was just sitting there, waiting for someone to act.

I learned a word for that gap from my volleyball coach, who grew up in Hawaii.