EARLY ON CHRISTMAS MORNING in the year 1882, in Alexandria, a doctor named George T. Klipstein was called in haste to a railroad accident. He found the victim, a black man, laid on the dirt floor of a stable near the track, one leg hopelessly crushed above the ankle. The lower leg had to be amputated, but that raised a question. Operating in the dirt of the stable was impossible. The man's home was miles away. If he remained in the unheated stable over night, he would die of exposure and the loss of blood. Dr. Klipstein then thought of the Alexandria Infirmary -- the forerunner of the present Alexandria Hospital -- which a group of local women had established 10 years earlier.

But the infirmary in those days was simply a home for the elderly and infirm, and it was fully occupied. All of its residents were white.

Dr. Klipstein made his patient as comfortable as possible and set off to call, one by one, on each of the infirmary's board of managers. One by one, they gave him their permission to admit his patient and to operate on him there -- but with an important proviso. One of the residents would have to give up, voluntarily, his room. With that, Dr. Klipstein returned to the infirmary, a house on Duke Street, and talked with the household there. An elderly man named Neal offered that Christmas afternoon to move in with his sister, who also lived at the infirmary, and let the injured man have his room.

"It took from 8:30 in the morning to 3 o'clock in the afternoon to perfect these arrangements," according to a handwritten account of the event that you will find displayed in the lobby of the present Alexandria Hospital, "and the patient was carried on a window shutter to Mr. Neal's room in the infirmary." There Dr. Klipstein and two other physicians -- one assisting in the surgery, the other administering the anesthetic -- proceeded to operate. The patient recovered well.

That was the first surgery to be performed at the infirmary, which has become Alexandria Hospital. This year some 10,000 surgical procedures will have been carried out there. It is neither the biggest nor the smallest of the hospitals that serve this area, but, like most, it is essential to the community around it.

Large beneficial institutions do not spring out of the ground automatically, merely because they are needed. Each has its own intricate history, but nearly all of them begin with a few people of strong will and a driving sense of moral duty. In this case they were the original Board of Lady Visitors who founded the infirmary, followed by the doctor who saw the larger purpose that it needed to address. Where a few people of imagination and energy made a beginning, others quickly responded and joined them. The steady progress of the hospital, after it first began to provide medical and surgical care 105 years ago today, may have had something to do with the special character of the day on which the enterprise first began