Remembering When a House Call Cost $5

By Eugene Scheel

Sunday, March 1, 2009

The recent debate over building a hospital in Broadlands made me think back to previous incarnations of Inova Loudoun Hospital. I decided to have a talk with Earl Edward Virts Jr., one of 10 physicians who staffed Loudoun Hospital in the late 1950s and early '60s.

Hospitals were unknown in the rural Virginia Piedmont until the early 20th century. Loudoun County's first was the 18-bed Leesburg Hospital, which opened in 1912 on West Market Street and is now an office building. Fauquier County did not have a hospital until 1925.

Leesburg Hospital closed in 1918, and construction of the 25-bed Loudoun Hospital was completed that year near the west end of Cornwall Street, a site that was then the outskirts of Leesburg. The building's facade, embellished with a columned portico, a Georgian entranceway, louvered blinds and a gable roof with dormers, resembled a country mansion. The intended effect was to reassure patients, as hospitals then were often thought of as places to die.

The refurbished and enlarged Loudoun Hospital that opened in 1951 kept this appearance, enhanced by more dormers and a front wing that increased the number of beds to 51. The black-owned Middleburg firm of William N. Hall & Son built the additions, but Middleburg's longtime black physician, Maurice Edmead, was not permitted to practice at the hospital. He left Loudoun the following year.

The building was renovated and expanded several more times, and sections of it are part of Inova Loudoun Hospital's Cornwall campus.

Virts began working at Loudoun Hospital in 1958. He was 29 and had just completed his residency at Winchester Hospital. Born in Bluemont, he had graduated from Bluemont Elementary and Lincoln High School.

"I might have thought about becoming a physician, but I didn't want to go to school that long," he told me recently.

But after graduating from George Washington University's school of pharmacy, he changed his mind and entered the Medical College of Virginia (now Virginia Commonwealth University). "Too long to go to school, and I ended up going longer," he said.

As Virts was completing an internship in Winchester, physician Robert "Bobby" Orr needed a partner. He and Virts began a joint practice in July 1958. Orr was the son of physician William Clayton Orr, one of the founders of Leesburg Hospital in 1912.

Virts practiced medicine six days a week, usually from 7 a.m. to 4 p.m. Visiting his eight to 10 hospital patients took up the early hours of his day. About six hours were allotted to office visits, half of them walk-ins. "If I saw 20 patients a day, I had a big day," he said.

Two nights a week, he saw about 15 patients from 6 to 11 p.m. "My wife brought meals to the office, but if I was busy I'd never eat them," Virts said.

He took off Sundays and Wednesday afternoons, but, as Virts said, "When you were at home, you were on call." He told me his house calls often numbered five a day. During a flu outbreak, he treated patients from 4 a.m. to midnight.

On-call duty at Loudoun Hospital added to his demanding regimen. Virts was in a rotation that required him and another doctor to be on call twice a year for a month at a time, day and night. The shifts included covering the emergency room.

"I weighed 165 pounds when I started my practice," said Virts, who is 6 foot 3, "and I was down to 130 pounds when I quit. If I turned sideways you couldn't see me. I was burnt out in eight years." He left private practice in 1966.

Virts charged standard Virginia Piedmont rates for the 1950s: $3 for an office visit and $5 for a house call. The majority of Loudoun workers farmed, and the average farm wage was $1 an hour. "I collected about 80 percent of the money. The rest of them really couldn't pay; they just didn't have it. I don't think any doctor turned anybody down," Virts said.

Some common serious ailments, Virts said, were flu, pneumonia and heart trouble. Although an antibiotic cured none of those, "they'd want a shot of penicillin," Virts said. "A lot of people thought it was the cure." Penicillin, the World War II wonder drug, killed many bacterial infections, as did tetracycline, another antibiotic then in use.

Respiratory ailments were rife among Loudoun's 24,000 residents. "We treated a lot of allergies with antihistamines," Virts said. He prescribed a cough syrup of turpin hydrate to cut phlegm loose and codeine to depress the cough reflex. "'We used more aspirin than anything else," he said.

The tobacco habit was so prevalent that in the semiprivate and private rooms of Loudoun Hospital, patients could smoke. More than half of the attending doctors smoked, Virts said.

Intestinal and stomach maladies also were common. Many households drew water from springs or shallow wells and had outhouses or primitive septic systems. Cures included drinking clear liquids such as tea and ginger ale and taking Kaopectate. "I didn't discourage home remedies," Virts said, prompting me to mention an old standby: mustard plaster for chest colds.

Then his wife, Elaine, said her mother would take rock candy and whiskey to cure a sore throat. "She kept a cough all winter," Elaine Virts quipped.

In his 7 1/2 years as a general practitioner, Virts delivered about 450 babies at Loudoun Hospital. Difficult deliveries were handled by John Wynkoop, "a specialist in that area," Virts recalled. Virts charged $50 for each delivery; they often took many hours. The fee included a six-week checkup.

Virts has vivid memories of one patient. Reluctantly, he told why. Virts was at his office on a Saturday afternoon when a woman came in with her very ill 8-year-old daughter. They took her to the hospital. While Virts was testing the child with blood work, a spinal tap and chest X-rays, she broke out in a hemorrhagic rash, a sign of an overwhelming bacterial infection. He and the child's regular physician, whom Virts had called in from Arlington County, treated the girl with intravenous drugs, cortisone and penicillin. Her condition did not improve.

When he called Georgetown University Hospital to ask whether they would admit the child, he was told that such infections had no cure. After five hours of treatment, the girl died. "You never forget something like that," Virts said.

Eighteen months after he began his practice, Virts's fellow doctors elected him vice chief of staff of Loudoun Hospital physicians. A year later, they elected him chief of staff.

He held various positions after he left private practice, including Loudoun health director, vice president of Acacia Mutual Life Insurance, medical director for the northern region of Virginia and operations director of the Virginia health department. He retired in 1995.

Eugene Scheel is a historian and mapmaker who lives in Waterford.

Tagged: health, health care, history, hospital, Inova Loudoun Hospital

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