Remembering When a House Call Cost $5

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.