Loudoun Hospital: A Century of Service

century Loudoun Hospital ­— Century Of Of Service Service Loudoun Hospital — AA Century

1

Inova Loudoun Hospital

...a century of service

by Margaret Morton

Loudoun Hospital ­— A Century Of Service

Thank you for years of Teamwork Leadership and Dedication

Loudoun County Fire-Rescue To volunteer as a prehospital provider visit

www.answerthecall.info Free training provided

Loudoun Hospital ­— A Century Of Service

Loudoun Hospital ­— A Century Of Service

Celebrating Our History, Looking to Our Future

By H. Patrick Walters, CEO Inova Loudoun Hospital

On June 5, 1912, Leesburg Hospital opened its doors on West Market Street in a rented house. Two hundred patients were cared for that first year. Since then our community has grown and so has Loudoun’s not-for-profit hospital. In 2012 we expect to care for more than 100,000 inpatients, emergency and outpatients.

Since 1912 our nurses, staff, volunteers, physicians, local governments, area employers, community organizations and Loudoun citizens have all worked together, neighbor helping neighbor, to make Inova Loudoun the hospital we are today.

One dedicated group deserves special recognition for sustaining the spirit of caring that has always been clearly reflected in the fabric of our services—The Ladies Board of Inova Loudoun Hospital. Their collective vision, determination and enthusiastic support have sustained our mission to provide health care for our growing community.

Our founders envisioned that each patient would be cared for with kindness and sensitivity to their individual needs. Our founders envisioned a hospital offering clinically excellent acute and advanced services. Our organization today reflects their vision. Our nursing staff is recognized as a “Magnet Hospital” for nursing excellence. Our critical care and telemetry services received the “Beacon Award” for critical care excellence. Our Nursing and Rehabilitation Center received “five-star” recognition from CMS and our cancer services are nationally accredited with commendation. Our emergency services, cardiac services and women’s services all have received national recognitions for quality. Advanced services have been added and the expertise of our physician community has expanded to ensure that our community has access to excellent, “state-of-the-art” clinical services.

Embarking upon our next century of service, our vision is to optimize the health and well-being of each individual we

About this centennial series: In a salute to Inova Loudoun Hospital’s 100th anniversary, Leesburg Today presents the story of the facility compiled by Margaret Morton through hospital documents, histories and newsletters, Ladies Board records, media reports and, above all, the reminiscences of those it touched—doctors, family members, nurses, pharmacists, Ladies Board members, hospital trustees and medical directors, administrators and top management, support staff, counselors and patients.

Some have long memories

are privileged to serve. Our health care services will continue to grow with our community. We will expand and enhance our services to ensure the people we serve have access to exceptional clinical services close to home. Our commitment to our community is that we will maintain the focus on our fundamental values of clinical excellence and personalized care.

On behalf of all the employees and staff at Inova Loudoun Hospital, we thank Leesburg Today for the outstanding coverage of our 100th anniversary.

The series has been remarkable in many ways, enjoyable to read, educational and inspiring. We commend Leesburg Today editor Norm Styer and his staff H. Patrick Walters for committing the space each week to share these stories with the residents of our community. Special thanks to writer Margaret Morton for bringing her careful eye for detail, commitment of time to interview the many people associated with the hospital and for her writing and storytelling skills. She has documented a history of our organization and its links to the Loudoun community that we will maintain and pass on to future generations of nurses, clinicians, supporting staff and volunteers.

We are grateful to our community for continued support and rededicate ourselves to Loudoun’s care for the next 100 years. dating back to childhood; others have served the hospital for more than 30 years, while some reminiscences are more recent.

But, wherever they have touched the story of Loudoun’s hospital, their pride in the institution, though bad times and good, remains.

The articles were written by Margaret Morton.

Leesburg Today also thanks the community businesses and organizations who supported this project.

Read more of the continuing series at: www.leesburgtoday. com/news/loudoun/hospital_centennial/.

Loudoun Hospital ­— A Century Of Service

Thank You FOR PROVIDING A CENTURY OF SERVICE

FROM YOUR FRIENDS AT ABBEY DESIGN CENTER

www.AbbeyDesignCenterVA.com STERLING

LEESBURG

21465 PRICE CASCADES PLAZA STERLING,VA 20164

161 FORT EVANS RD. LEESBURG,VA 20175

(703) 450-8181

(703) 779-8181

Loudoun Hospital ­— A Century Of Service

Loudoun Hospital Reaches 100-Year Mark

“We can’t do it without you.” That plea uttered a century enterprise was supported by Dr. Charles S. White, a Washington, ago by Loudoun County doctors to their wives was not just a DC, physician who served the community for more than 40 years statement of conviction—it also was the basis of a remarkable as a visiting surgeon.

When the founders started their venture they could have had partnership between medical professionals and the community that led to the formation of Leesburg Hospital June 5, 1912. It is no inkling of the future, of how their simple six-room hospital would morph over the century into a state-of-the-art medical instia partnership that has endured ever since.

From its simple beginnings in six leased rooms on West tution that now has its sights set firmly on becoming a regional Market Street to the current Lansdowne and Cornwall Street tertiary care medical facility. complexes, Loudoun’s hospital has ridden a roller coaster journey, Nor could they have had an idea of the explosive growth full of ups, downs and major changes. Today, the organization Loudoun would see in the second half of the century, nor of stands poised to enter its what that would mean second century of service to the hospital and the to the community offering almost dizzying changes an unprecedented array of in treatment brought about through today’s services. technological revolution.

As Inova Loudoun “The hospital” has Hospital celebrates its censeen a series of name tennial, that partnership changes and expansions, with the community is and experienced some still going strong—notably tumultuous years with through the backbone of controversy over the deciunwavering support the hospital’s Ladies Board has sion to move from Leesprovided through thick and burg to Lansdowne and a severe financial crisis thin. that in the words of one

The hospital opened trustee “had us hanging its doors in Capt. Garrett’s by a hair.” former home, a hand But, it survived, and some brick house on through the merger with West Market Street. Its Inova Health System it first patient, appropriately enters its second century enough in light of LouThe 1912 hospital and two on solid footing. As an doun’s equestrian history, of its founders: Dr John affiliate of the five-facility was a jockey with the colorA.Gibson (left) and Dr. Wilnonprofit Inova regional ful name of Pee Wee Rose liam C. Orr. health care system, it still who had been thrown from functions as a nonprofit his horse. community hospital with

The fledgling enterprise was backed by $100 in the bank, $2,000 more in pledges a local Board of Directors and its own particular characteristics.

That first hospital evolved into a diverse medical enterprise and the determination and vision of its founders—Dr. William C. Orr and Dr. John A. Gibson, also Dr. Truman Parker, along with that today boasts two medical campuses, an increasing number pharmacist Horace Littlejohn and P. Howell Lightfoot, who were of sub-specialists, top-notch nursing, cancer, diabetes and cardiac care, sophisticated maternity care through The Birthing Inn, a in turn backed by the ladies of the community.

The women entered the spirit of the venture with gusto. greatly expanded treatment range through technological advances, It took them only three weeks to organize and found the Ladies extensive pediatric services including a pediatric emergency room, Board of Managers, with the intent to oversee housekeeping at the educational, therapeutic and counseling services and a wide hospital and rally volunteer and financial assistance from the com- range of community health programs through its Mobile Health munity. From its formation June 25, 1912, to today, its members department. have not ceased in those endeavors.

In addition to its Lansdowne and Leesburg campuses, Inova

It was Lightfoot’s experience out west in hospital manage- Loudoun provides ancillary services in Dulles South and Purcellment and his tales of small hospitals being built around the coun- ville, with medical offices slated to open shortly in Lovettsville. tryside that hit a receptive note with the doctors, who long had felt A HealthPlex, including a 24-hour full emergency department, diagnostic imaging center and physician offices, is in the works Leesburg needed a hospital.

While the pharmacist and the doctors worked out the details, for the Ashburn community, and the Leesburg campus is about to the experienced Lightfoot went on the road throughout 1911 to undergo a $32 million renovation. persuade somewhat skeptical county residents of the need. The

Loudoun Hospital ­— A Century Of Service

Celebrating 100 Years of Working Together In June of 1912, the Ladies Board of Managers formed to support a new hospital in downtown Leesburg.

Raising vegetables to feed the first patients at Leesburg Hospital was but one of our early endeavors.

Since then, with your help, The Ladies Board of Inova Loudoun Hospital has raised millions of dollars to support our community hospital.

As Inova Loudoun Hospital celebrates its 100th year, we extend grateful

thanks

to our community. You have always responded when we asked.

With Appreciation,

The Ladies Board of inova Loudoun hospiTaL 44045 Riverside Parkway Leesburg, Virginia 20176

Loudoun Hospital ­— A Century Of Service

Horace C. Littlejohn, A Founding Father

When we look back at the grainy photographs of those early 20th century instigators of Loudoun’s first hospital, it is easy to forget these were men in the prime of their lives, determined, vigorous leaders with a civic-minded goal.

Their partnership combined vision and practicality.

Dr. William Clayton Orr started out in Loudoun in Hillsboro, with his “horse and buggy and $40,” before moving to Leesburg. Orr would go on to serve as the hospital’s president until his death in 1926. His colleague, Dr. John A. Gibson, liked to call himself “the country doctor,” making house calls in the worst of conditions. Both men were baseball fans and loved to hunt.

But it is Horace Littlejohn who provides the most telling snapshot of early 20th century leadership in Leesburg. Littlejohn was 29, but already a businessman, when he and the doctors brainstormed over their vision of establishing a local hospital. The conversations took place in the backroom of his King Street pharmacy where many decisions about Leesburg’s future were made.

His granddaughter, Charlotte “Boonie” Henry, lives with her husband Bill west of Leesburg off Rt. 7. She was 13 years old when her grandfather died in 1965 after serving as a pharmacist in Leesburg for 61 years. She has fond memories of him as well as evocative photographs, including “Hobby” Littlejohn and his friends and colleagues, smoking and playing the card game “SetBack” in his back room—not something they likely would have been allowed to do at home, Henry said.

Doc Littlejohn’s commitment to the institution he helped found was profound. He served as the hospital’s treasurer for 37 years, without compensation, and on the Board of Directors for well over 40 years. He also taught classes to students in the hospital’s nursing school. To the end, he worked tirelessly to improve the standards of his profession and employees at the hospital.

In describing Littlejohn, his granddaughter also drew a picture of an older, simpler Leesburg—a town that now has houses where the pharmacist once kept his cows on 13 acres bordering Ayr Street. He also owned farms outside Leesburg. By the time Littlejohn and the doctors were drawing up their hospital plans, he was an established businessman and civic leader—a vestryman at St. James Episcopal Church, a member of the Masonic Lodge, a charter member of Leesburg Rotary and a member, as well as oneyear president, of the Virginia Pharmaceutical Association. “A man with his hand in many pies,” his granddaughter said.

He operated one of three pharmacies in town—Bodmer’s, Edward’s and Littlejohn’s. At age 17, Littlejohn went to work as a clerk at Mott and Purcell’s pharmacy in Leesburg—later to become Purcell and Littlejohn, and later still Littlejohn’s only. His North King Street drugstore was located across from the courthouse where the Downtown Saloon is today. As was the practice, Littlejohn learned his trade by apprenticing from a registered pharmacist. He also sold items such as ice cream and chicken salad sandwiches.

According to Henry’s mother, Ethel Adams, in a note she wrote in 1992, her father was “happiest in the drug store,” a place where he was known to spend long hours, content to mix up drugs for anyone in need late into the night.

When Henry was growing up, “we all lived in the same house,” she recalled of that intergenerational family life. Their house was two blocks from the hospital, on West Market Street. At 3 p.m.,

Littlejohn would go to work, and stay there until 3 or 4 o’clock in the morning. “The store was closed, but he was in the back doing paperwork and making up medicines,” his granddaughter said.

“We’d take food at around 7:30 p.m. and he’d eat at 11 o’clock.”

Littlejohn also sold tickets for the Greyhound bus company. “He’d go back, or make us run back, to a small booth in the rear, and bring back a ticket to give to the customer,” she said.

The cigar- and smoke-filled back

Horace C. Littlejohn

room, often with the leading men of the town sitting around, playing cards or watching, with newspapers piled high on the radiators “was a mess,” Henry said, but representative of an earlier, less healthconscious age. “They were always smoking cigars.”

As a child, Henry remembered observing the Leesburg movers and shakers chatting in each other’s offices. No one went on vacation, she said. And they were all thin. “They worked a lot,” she said. “Everyone knew everyone, knew their personalities and their values.” She recalled one Leesburg stalwart, lawyer Wilbur Hall, always had “wads of cash in his pockets—he wore big, old suit coats that didn’t fit,” filled with money that people paid him back for loans he had made.

In the early 1960s, Littlejohn closed the drugstore. It was a time when small, independent pharmacies were giving way to the emergence of chain stores and growing drug addictions were changing the formerly medicinal quality of drug prescriptions.

Horace Littlejohn was 81 years old when he died. Although the store is no more, Henry still has a living link with it. She has a number of artifacts, including a straw dispenser, mortar and pestle, and some of the store cabinets, all reminders of those days when civic service was considered a duty, part of being “a good citizen.”

In a 1970 tribute to Littlejohn, Loudoun Times-Mirror reporter George Ward imagined the former baseball player returning to earth for a happy reunion with those he had known in life and celebrating with a strong base hit:

“With this column we honor the memory of Dr. Littlejohn on the fifth anniversary of his death, an old-time baseball star, druggist, civic leader, churchman and useful citizen, beloved by everyone.”

Loudoun Hospital ­— A Century Of Service

The Women Of Loudoun: Integral To The Hospital

The first president was Edith Morton Eustis, who, with her

One cannot tell the history of Loudoun Hospital’s first cen- husband William Corcoran Eustis, owned Oatlands Plantation. tury of service without talking about the Ladies Board.

The Ladies Board also celebrated its centennial in June and A major force in the county, she was joined by another powerful this look back at the key people and events in the hospital’s history woman, Miss Alice Davis, the daughter of a local clergyman-as her vice president. will feature different facets of the Ladies Board’s parallel story.

From the earliest talks about establishing a hospital for the It was recorded that the arrival of the first patient, a local rural community early in the 20th century, the county business jockey named Pee Wee Rose who had been thrown from his leaders contemplating the venture said they wouldn’t start the horse, caused no greater excitement than did the sight of Miss pursuit without the support of the women of the county. It didn’t Davis hurrying from her home with an armful of linen from her take those women but three weeks to form their own board—at own cupboard, all topped by a large tin basin. It was that intrepid first called the Ladies Board of Managers, but it quickly evolved female who helped galvanize local women to support the hospital. into “The Ladies Board”—and they’ve been working to support The original 40-member board now has about 75 active members, the needs of the hospital, its doctors, nurses and patients ever and some 20 honorary directors.

A natural, although not professionally trained, nurse, Alice since.

Davis would continue to care for the sick, many of them charity

Successive waves of women, those seen as leaders in their society and community, willingly took up the challenge of acting cases, throughout her lifetime. It was Mrs. Eustis who established as a support system for the growing institution, dedicating both the Lena Morton Memorial Nurse Service for Loudoun, creating financial and moral support. They formed a close-knit group with the first visiting nurse service in Virginia.

Nursing was a strong component of the hospital from the one objective: to do whatever they could to support the hospital beginning.

It had a nursing school, later disbanded, and a home as it grew.

Over the years they have provided significant funds sup- for the nurses, for which the Ladies Board helped raise funds. porting hospital projects and equipment purchases, “between Support for the hospital initially came through a series of “Dona$3 and $4 million overall,” it is estimated, according to current tion Days,” community bazaars, community suppers, fairs and Ladies Board President Joan Elliott. Included in that sum is a $1 million pledge toward The Birthing Inn and a second $1 million pledge, recently announced to support redevelopment of the Cornwall campus. The Ladies Board gave an additional $50,000 for lobby renovations to The Birthing Inn and $10,000 for the new concierge program that ensures someone is there to see to attendees’ needs at all times.

Their first duties were to take care of the “housekeeping” side of the fledgling hospital after it began The Ladies Board of Managers’ first president, Mrs. William Corcoran Eustis (left), with an taking patients on unidentified woman at an early rummage sale in the 1940s.

Courtesy of Oatlands West Market Street.

They procured sheets, blankets and other supplies for the wards and glassware, china and silver for the other activities. The resourceful ladies also joined forces with the dining room. From those duties, they branched out to more direct Leesburg Garden Club, whose members began a vegetable garden financial forms of giving­—increasing their support as the hospital to supply patients and staff members with fresh produce in the summer and potatoes and canned goods in winter—Ladies Board expanded.

The Ladies Board had two remarkable women at its head members helping with the extensive canning operation.

during those first years.

Continued On Next Page

10

Loudoun Hospital ­— A Century Of Service

But, in 1938, the Ladies Board established its first major permanent fundraiser—the Hospital Rummage Sale—that itself would become a community institution. The first sale was held in the Rotary Room of the Leesburg Inn located to the north of the court house along North King Street.

Former Ladies Board President Esther Cowart, now aged 97 and serving as member emeritus, recalls being assigned to the Hat Department when she turned up to report for duty in the fall of 1938. That first sale grossed $150. Interestingly enough, although the money values are far different today, the 2011 rummage sale grossed $154,000.

“It just grew, and grew and grew,” Cowart recalled, bringing “more people and more rummage.”

Over the past 40 years, the Ladies Board created three more entities through which to raise funds for the hospital­—the Gift Shop at the “new” Leesburg hospital built off Cornwall Street in 1974.

That sales outlet was closed when the hospital moved to Lansdowne in 1997. In 1983, the Ladies Board inaugurated its Lights of Love memorial program to fund a nursing scholarship—a program that is running strongly today at both the Cornwall and Lansdowne campuses. In 1990, the board opened the Twice is Nice thrift shop, originally located in downtown Leesburg, but moved to the Tollhouse Shopping Center on East Market Street in 2000.

The partnership with the hospital is remarkable. It has not always been easy. There have been times, such as when the hospital board took the controversial decision to move away from Leesburg and build a new hospital farther east at Lansdowne, or later, when the board voted to merge with the Inova Health

System, the members of the Ladies Board had to dig deep to adhere to a position of support, even though many of them were either opposed to the actions or had private reservations.

In a remarkable show of “standing by their man,” not only did they help persuade reluctant members of the community as to the necessity of the move—to be nearer the center of population growth and to attract specialists—but they redoubled their efforts to help the hospital over the difficult public relations hump.

The “glue” in the remarkable structure that is the Ladies Board is perhaps the camaraderie that goes along with the objective. President of the organization in the early 1960s, Esther Cowart recalled, “We were ‘togetherness.’ Everybody was involved, and most everybody became friends.”

“It was the highlight of my life for a long time,” she said.

Joan Elliott is the latest in a long line of Ladies Board presidents. In July she will step down. Looking back on her two-year term, Elliott said she is “overwhelmed by these ladies, their tremendous commitment to the community and how well we work with the community. I’ve never felt that anywhere else.”

The board radiates “such a sense of place” and continuity, she said. What’s so gratifying is “to see the smiles on people’s faces, such as a woman coming up to me and saying ‘thank you, my daughter received a nursing scholarship and you don’t know how much that means to us all.’”

After the June 5 centennial celebration, Elliott said, “We’ll look to the future, to another 100 years of service and continue what we’ve always done before: honor and respect the work of those who came before us.”

Loudoun Hospital ­— A Century Of Service

11

1912-1949: Growing To Meet The Needs

In every era of innovation there is a feeling of excitement the storm clouds that had drenched Europe with blood during the and satisfaction that the bright, gleaming new world made by its First World War had dissipated and Leesburg celebrated with flagdecked automobile parades, watched by more than 7,000 people. creators will last, if not forever, for a good while.

The heady achievement of beginning the exodus from treat- At the same time, according to hospital historians, the first “tar” ing the sick and injured at home to hospital care started a move- road was laid in the county.

Eight years later, a spacious Nurses’ Home was built, located ment that would only grow in intensity. When Leesburg Hospital opened in 1912, its founders also established a training school for to the west of the hospital, where nurses could relax between shifts. nurses, setting the stage for a pattern of professionalism and excel- The building was constructed for $12,000 and contained a large living room, used also for meetings by physicians, the Board of lence that has increased exponentially over the past century.

But, the new project would soon fall victim to the pressures Directors and the Ladies Board, whose members provided attracof expanding need and its own success. The history of the next 62 tive furnishings and kept the building maintained and remodeled years is one of demand repeatedly outstripping available service. through the years.

Carrying surgical patients up a winding exterior stair to the operating room at the original hospital on West Market Street soon palled. Although 200 patients were treated during that first year, many were turned away for lack of space as only 18 people could be accommodated at a time in “Capt.

Garrett’s house.”

In a dizzyingly short time, the hospital set out on a course of expansion through five construction projects in Leesburg.

Within two years of its founding, the hospital had changed its name to Loudoun Hospital, reflecting its wider community appeal, and appointed a committee to plan construction of a new facility—outside of busy and noisy downtown Leesburg. Both committee members and the Ladies Board held a series of fundraising activities to support the new venture.

1918 hospital and nurses’ home to left.

Courtesy of Thomas Balch Library

In 1916, the hospital bought a 13-acre tract on the then-western edge of Leesburg from the In 1930, the hospital changed its name again—to Loudoun Harrison family for the princely sum of $3,600. Photographs of County Hospital, Inc. At the same time, the original stockholdthe building and its subsequent wings show a complex set in open ing arrangement was abolished and a new charter established to land, a sharp contrast with the surrounding residential neighbor- deflect criticism from those erroneously charging the stockholders with earning interest on their stock from patient revenues. The hoods today.

The movers and shakers must have thought they had achieved new charter named three county officials as active members of the nirvana when they opened the new 25-bed hospital off Cornwall corporation: the judge of the Circuit Court, the chairman of the Street. It included six private rooms, four wards containing five Board of Supervisors and the chairman of the School Board.

Those were the days of recession, following the 1929 stock beds each, an operating room, a chemical laboratory and an X-ray machine. No longer were patients carried upstairs; now they were market crash. In 1931, more than 800 U.S. banks closed in a two-month period. But the hospital hung on, although the cost of lifted to the second floor by a rope elevator, as were supplies.

As with the opening of the first hospital six years earlier, the indigent care was becoming a burden. By 1930, the hospital also facility was outfitted by the women in the community. Ladies from boasted a delivery room, a newborn nursery, five children’s beds the Leesburg Methodist Church held a sewing group, meeting and a new X-ray room. The Ladies Board was contributing evermonthly to mend hospital linens. Ladies Board members scoured more significant funds to the hospital, having begun its rummage sales venues and hotel supply companies for silver plate cutlery sale in 1938, just before World War II broke out.

But, believe it or not, need would again exceed the availand china. The ladies of the Leesburg Garden Club provided fresh food, and later flowers, for patients and staff through a one-acre ability to provide service. Once again, by the end of the world garden plot on the north side of the building that would continue conflagration hospital administrators and physicians would be until the early 1950s. planning an addition to the Loudoun County Hospital.

As the handsome, white porticoed building opened in 1918,

12

Loudoun Hospital ­— A Century Of Service

End of WWII-1961: Growing Again

By the end of World War II, overcrowding and outdated equipment at Loudoun County Hospital had become a serious problem, forcing the Board of Directors to begin planning the first expansion to the 1918 building on Cornwall Street.

Newborns were sleeping on pillows in bureau drawers, while corridors were crowded with patients lying on beds.

A new wing was planned to expand the hospital from 25 beds to 51, including more private rooms, sun porches for convalescing patients and major facilities such as a new delivery room, nursery and laboratory. The wing was planned to be a memorial to Loudoun men

Arthur Godfrey gave the hospital a much-needed ambulance. He was the keynote speaker during the dedication of the Arthur Godfrey and East wings in 1960.

Courtesy Thomas Balch Library and women who had participated in the war.

Raising the funds proved to be a struggle. The campaign chairman was Col. Robert H. Fletcher, a major supporter of the hospital. But he too optimistically thought he could raise the required $275,000 within a few weeks. Although there were many generous donations—ranging from $30,500 from the Old Dominion Fund chaired by Paul Mellon to the few cents wrapped in paper given by an unknown child in Purcellville—by January 1947 the total only amounted to $160,000.

Against its grain, the hospital applied for federal funding. Late in 1948, $105,866 was granted, along with $61,221 from the state.

But a further shock was on the horizon. The lowest construction bid received totaled almost $400,000, excluding $86,000 for equipment, fees and furnishings.

Philanthropist Mellon came to the rescue with another $50,000, while an anonymous donor provided the balance of the $115,000 needed until the funds could be raised.

The new wing was inaugurated in May 1951, with visitors marveling at the modern new hospital. For the first time, the increasing staff of 18 general practitioners, 10 visiting consultants and the ever-growing numbers of nurses, aides and technicians had many of the facilities for which they had long wished.

Again, that euphoria was short-lived. Five years later, expansion was once more on the books.

And, behind the scenes, financial woes were becoming increas-

ingly severe, mostly because the hospital, following its mission to care for all sick people, was serving many patients without insurance and who could not pay their bills. Although the Ladies Board had been supplementing hospital funds for years, and other civic groups had donated funds for care of those unable to pay, it was not enough to solve the hospital’s financial crisis. In 1959, for the first time in its history, the hospital directors were forced to ask the Board of Supervisors for an annual appropriation. Funds were approved, but not budgeted. Help instead came in trickles through the State Department of Welfare.

In 1956, cots were again lining the corridors, cribs were borrowed and there was an urgent need of “more of everything,” as occupancy was running at 96 percent, in contrast with the state average of 75 percent. Two more wings were planned. A second major donor came on board to boost the effort: popular entertainer and radio showman Arthur Godfrey who lived at Beacon Hill west of Leesburg. He donated a very welcome Cadillac ambulance to the hospital and became chairman of the Building Committee.

Getting the ball rolling with a $50,000 donation, conditional on receipt of federal funding, Godfrey was aided by the Ladies Board, which purchased the land needed for the expansion. By 1958, however, occupancy was double what it had been a decade earlier and donations raised were still far short of the needed $447,000. In a further blow, the federal Hill-Burton funds were cut. But, the funds did come in and in April 1959, groundbreaking took place for what would become the Arthur Godfrey and East wings.

The following year, 1960, the two wings opened to general acclaim, expanding the hospital to 80 beds. In 1961, a new children’s ward was completed.

The expanded building, its promoters proudly noted, was fireproof and air conditioned, with rubber tile flooring, piped in oxygen, hot and cold running water, bedside lights, a nurse-to-patient call system and a high speed elevator in the East Wing, “twice the speed of the old one.”

At the opening of the two wings, President of Medical Staff J.T. Jackson commented, “no one need ever fear to undergo surgery in the Loudoun County Hospital because of any lack in variety or quality of its surgical plant or equipment.”

An ebullient personality, Godfrey was the chief cheerleader for the hospital as well as for the American spirit. Citing a deplorable tendency among “too many Americans” to believe the nation was no longer number one, Godfrey railed against those who were “suckers enough to think in terms of second place.”

During the June 1960 dedication ceremonies at Loudoun County High School, Godfrey said he had seen those same attitudes during the recent fund drive. But, his purpose that afternoon in helping dedicate the new facility he said was to show “non-believers there are things in which one can really take pride.”

Although the hospital complex would come to be termed irreverently by some as “The Band-Aid Station,” the improved facilities stilled the clamor for a while. But the constant need for more services, continuing financial pressures and the increasing call for more specialists so patients with serious cases would not have to be moved to Fairfax or Washington, DC, or west to Winchester only ensured further expansion would be in the air. In fact, plans were well underway barely a decade later.

Loudoun Hospital ­— A Century Of Service

13

1960s: Expansion Pressures Return

Every time we see a television ad promoting a product—laundry detergent, for example—it’s always new and improved, washing our clothes ever whiter.

So it must have seemed to those who followed the 100-year evolution of the hospital as different eras claimed a new and vastly improved facility. But after an interval of success, changing or increasing need and shifting health care parameters would soon render each latest edition of the new, modern hospital obsolete and inadequate.

And it was not long before the 1960 complex on Cornwell Street in Leesburg would suffer the same fate.

For a while all was well.

A new children’s ward opened in 1961, the hospital celebrated its 50th anniversary and in 1963 purchased an additional two acres to enlarge the facility.

The institution saw yet another name change, to Loudoun Memorial Hospital, in 1963, to honor the county’s service men and women who gave their lives during World War II.

The financial situation appeared to be improving. The coming of Medicare in 1966 was key and the hospital was declared eligible to receive Medicare payments that year. A large, $8 million trust donation from Round Hill residents Mr. and Mrs. Walter S. Fox in 1967 provided the hospital with an annual income of $275,000, appearing to create a worry-free financial future.

But to some new physicians, the hospital—considered the height of medical modernity to Loudouners—was sorely lacking.

In 1965, former Air Force obstetrician Dr. James Towe arrived in Loudoun County on a rural scholarship from the Medical College of Virginia. He and his wife Eleanore looked around, drove through Purcellville, liking its stone library and stone Methodist church, where their daughters would later marry.

Towe opened his practice on West Main Street, just west of the White Palace, where Ed Nichols, owner of Nichols Hardware, gave him a year’s rent-free tenancy. The day after he opened, “the phone was ringing from all over the county” and he quickly built up a thriving practice. It would be hard to count the babies he has brought into the world in Loudoun.

But there weren’t enough doctors in the county, only a few specialists who came to the hospital intermittently, and no regular orthopedist.

Even improved, the hospital was something of a challenge, Towe recalled. The emergency room was reached by a ramp into the basement, where “there were two rooms, and another one used by an urologist who came on Fridays.” There was no regular ER staff; the nurse on duty would summon one of the doctors, who worked on a rotating basis. Babies were delivered on the top floor.

“There was no helicopter,” Towe said of those days that seem almost incomprehensible today, ruefully recalling rushed rides in cars to the hospital. Coming from military medicine, as he had, the lack of proper X-ray equipment or a lab, was regrettable. “In the Air Force we had a brand new lab; it was a shock when I got here,” he said of his early days in the rural community. A radiologist came twice a week, and blood cultures had to be sent to a lab in Washington, DC.

On the other hand, the camaraderie among the physicians was strong. “We were friendly with each other,” Towe recalled. The

bond between physician and patient was also close. Towe’s wife recalled one instance when her husband drove a woman in labor to the hospital, delivered her baby and later brought her to their home.

But the decade also saw a number of changes in the broader world that would affect the county and the hospital significantly, portents of the developments that would turn Loudoun on its head, changing the course of the rural, agricultural community to today’s sophisticated, suburban county.

The first, and ultimately the greatest factor, by which technology replaced agriculture as Loudoun’s dominant industry, was President Eisenhower’s decision to “plop down an international airport in a cowfield,” in the words of the late B. Powell Harrison, who would serve as one of the county’s key business and community leaders over the next three decades. The opening of Dulles Airport in 1962 provided the stimulus for the pattern of growth that continues to the present day. Two years later, Leesburg had its own airport, greatly aided by radio personality Arthur Godfrey, who lived at Beacon Hill west of town.

By 1967, it was apparent another expansion was necessary and the hospital board of trustees had already settled on a 30-year building plan, geared for major improvements every decade. The Fox gift appeared to provide the wherewithal to meet the everexpanding needs of a growing county. Plans for enlarging and modernizing the hospital were re-examined by the board in March 1968, which decided the Cornwall site was adequate for future construction. But, the early building plans, required to obtain federal Hill-Burton funding, were found to be obsolete and redesigned architectural plans had to be submitted in 1968.

There were a few problems: a new access was imperative from Rt. 7; the Fox bequest, while considerable, went only so far in that the trustees could not touch the principal, only the annual income; and Hill-Burton funds were uncertain. In the final result, less than one-third of the eventual $6.6 million construction cost came from the Fox bequest, government grants were not available and the remainder would come from bank loans and public funding.

In May 1970, it was announced the hospital would build a completely new facility on the northwest side of its 15-acre tract.

Del. Lucas D. Phillips donated a 60-foot right-of-way through his property for access, and the Town of Leesburg and Loudoun County were asked to share the cost of $45,000 for the new road, today’s Memorial Drive off West Market Street.

But there were voices raised against the plan to build the new hospital in Leesburg. Dr. Sam Morrison, a member of the hospital’s medical staff, forcefully criticized the decision, calling it “a medical tragedy,” contrary to what progressive communities were doing elsewhere and called for it to be reversed. Morrison cited the medical staff’s unanimous recommendation that the new facility be built on a larger site and be closer to the center of Loudoun’s ever-growing population-i.e. east of Leesburg. A modern hospital with the latest facilities and equipment would attract specialists and allow first-class health care in the area, Morrison said. Then-Broad Run District Supervisor Charles Waddell warned the hospital board that pressure from populous eastern Loudoun would lead to calls for a second hospital, noting access concerns among residents in his district about a Leesburg hospital.

14

Loudoun Hospital ­— A Century Of Service

Uneasy Time of Transition: 1970s & 1980s

Looking back, the 1974 hospital appears to have been more a transitional building than a bright new facility that would set the scene for years to come.

Instead, it seems to represent an uneasy transition between the 1960s small rural hospital that quickly could not keep pace with demand and the eventual state-of-the-art facility that would be constructed at Lansdowne. It also serves as a psychological and emotional tipping point between western and eastern Loudoun, cementing the growing divide in the community as growth intensified in the former dairy farming eastern portion of the county and cows began to give way to rooftops.

That divide deepened as the 1960 hospital that had seemed to be vastly superior to what had been before—increasing bed capacity to 80 and adding new wings, better reception, administrative, physician and kitchen space, outpatient facilities, a larger laboratory, new obstetrical suites, improved air-conditioning and heating plants—was soon engulfed by the forces of demand.

In the years before the triumphant dedication of the new $6.6 million hospital in Leesburg in 1974, only a few perspicacious heads predicted the sweeping changes that lay ahead, in technology, computerization, the impacts of Medicare and, above all, the changing patterns of treatment.

The decision to remain in Leesburg, at first only criticized by a few, soon was the focus of constant demands by those who

Congratulations on your 100th Anniversary Inova Loudoun Hospital We

look forward to partnering with you in the future as you bring services to the Town of Lovettsville.

argued for a hospital closer to the fast growing subdivisions of eastern Loudoun. That clamor set up a backlash from mostly Leesburg and western Loudoun residents who felt they had supported the hospital through thick and thin, with their money, their time and their expertise.

Mac Brownell, the hospital’s first director of volunteers, summed up that feeling during a speech she gave in 1977 thanking her audience for giving her the opportunity to “say a few words about our hospital.”

“When I say our hospital—it is just that. It belongs to the community. It is not supported by federal, state or county funds.

We have it through the foresight and generosity of members of this community, who either during their lifetime or in their will realized the importance and the need for a hospital in our midst,” she said.

The growing feeling throughout the 1970s and 1980s that a new hospital was needed—and in a different location-sent shock waves through the community and also divided Loudoun’s physicians.

A new wave of doctors who’d arrived in the county during the 1970s and early 1980s quickly found the hospital wanting, despite improvements that included fetal monitors, a cardiac rehab program, planning for mental health beds and an alcohol treatment program, new laboratory equipment, educational programs for nurses and technicians, community health programs and a new long term care unit of 85 beds in the renovated old building.

Clinical pathologist Dr. William Silberman came to Loudoun to practice in 1971. The plan for the 1974 expansion was already on the drawing board. “They pulled the plan from [the federal] Hill-Burton designs so they wouldn’t have to pay the architects, and it was already out of date as they used a 10-yearold plan,” Silberman said.

“It was not adequate to carry us into the 21st century; the rooms were too small and the corridors too narrow; and the ductwork was inadequate.” Despite those many flaws, Silberman nevertheless is among those who claim the hospital perhaps could have been built up, rather than moved. “We could have gone up another two stories,” he said, as the building had a “huge foundation.”

Part of the problem, according to Silberman, was that the new hospital was designed as an inpatient facility. But the trend was moving away from beds to service on an outpatient basis.

“Everything shifted, the emphasis was as much as possible on outpatient care,” Silberman said.

“Sam Morrison was the most outspoken doc against the [1974 hospital]. He recognized Leesburg was not the right location. It was behind on design and didn’t predict the inpatient/ outpatient shift,” Silberman said.

But general practitioner Dr. Stephen Napolitano, who arrived in 1974, found the hospital was “very comfortable, and an excellent facility for 1974, with a good ICU and good ICU nurses.”

The area was still very rural, and the medical fraternity included few sub-specialists. Initially, Napolitano did not favor a move east, preferring to rebuild at Cornwall. “But I eventually came to see that was a decision the [medical] board needed to support.”

Loudoun Hospital ­— A Century Of Service

Now retired, Dr. Donald Sabella, longtime head of the Emergency Department who came to Loudoun in 1980, also supported the move, noting the space improvement in the 1974 emergency room over the 1960 facility was too small. “It was never quite acceptable. We’d all accepted expansion was necessary; we saw what was happening to the east.”

Internist John “Jack” Cook, who came to Loudoun in 1980, also saw the 1974 hospital as out of date. Noting the evolution of medicine was very rapid after Medicare was enacted in 1966, Cook said the hospital had been designed for the technology that existed in the early 1970s—that quickly was taken over by developments.

“The radiology site was not up to par, there was no room for CT scans—so there were none. The ICU was not up to date.

Since it was a primary care hospital, it was poorly equipped,” he recalled. Despite the improvements of the 1980s, it was clear to the medical staff from the “explosive” growth, and equal growth in outpatient care, “we had to grow in place or move,” Cook said.

As the decade progressed, even as planning for an eventual new hospital was debated, along with the uncertainty as to where it would be located, new features were added at the hospital— rooming-in opportunities for newborns and mothers; opening of the cardiac rehab center; recognitions for nursing and health care quality; and groundbreaking for a 100-bed long term care center that was dedicated in 1981.

“Outreach” became the buzzword for the hospital’s major

15

role in the 1980s, intensifying the effort to make programs, resources and services more accessible to the public and to encourage individuals to consider their health a personal responsibility. A new wing was built to accommodate the fast-growing outpatient services, along with a 12-bed mental health unit and a helicopter landing site developed.

The late 1980s and early 1990s saw rapid changes. The first concrete push to move east came with the opening in 1987 of the Sterling Medical Office Park and the relocation of MEDEX Immediate Care Center at the complex. In 1988, Sterling/Dulles Imaging Center opened at the office park and the hospital was renamed, again, from Loudoun Memorial Hospital to Loudoun Hospital Center. A major innovation came with the opening of the Birthing Inn in 1989.

In 1990, the CountrySide Ambulatory Surgery Center was dedicated; Sterling/Dulles Imaging and MRI Center relocated to the CountrySide facility. Another eastern Loudoun facility opened in 1991, the Loudoun Cancer Care Center in Sterling.

Hospital authorities and physicians got serious in the early 1990s about rebuilding, focusing on the need for an improved hospital at the same time dealing with the thorny problem of location.

In 1992, as the hospital celebrated its 80th anniversary it was on the cusp of great change, swept along by the huge changes in technology, patient treatment patterns and medical reimbursements.

36-C Catoctin Circle, SE Leesburg, VA 20175 703-777-5333 www.leesburgpharamcy.com

16

Loudoun Hospital ­— A Century Of Service

Volunteers: From Individual Acts To Formal Program

Shakespeare was on target when he wrote Portia’s famous lines in The Merchant of Venice.

The quality of mercy is not strained. It droppeth as the gentle rain from heaven, upon the place beneath. It is twice blessed. It blesseth him that gives and him that takes.

Portia’s words could easily describe the many individuals who have provided both gentle and robust care to countless sick patients over the years—from words of comfort, holding a hand, soothing a frightened child to creating homemade gifts and delivering flowers or books. And, many will agree with Portia that the giving of care is as much a benefit to the giver as it is to the recipient, a source of satisfaction and pride to have helped someone in need.

From those women in 1912 who rushed to find bed linens and other supplies for the fledgling Leesburg Hospital on West Market Street to today’s well-organized volunteer services, the aim has always been the same—to provide ancillary service in support of the medical care.

Volunteer efforts in the early years focused on providing supplies—sheets, cutlery, china, etc. It was volunteers also who planted a garden to provide fresh produce for patients. Most of those efforts by church and civic groups, schools, garden and community clubs as well as individuals were channeled through the Ladies Board of the then-Loudoun Memorial Hospital.

In 1964, the Ladies Board revamped the informal arrangements into a regular adult volunteer program. “Pink Ladies,” and a little later, “Candy Stripers” became familiar and anticipated sights around the hospital, as they delivered mail, newspapers, books and flowers and managed the information desk. Head Nurse Helen Abramoska provided orientation for the volunteers, who were assigned to every department of the hospital, except the Administrator’s Office.

The Candy Striper program was established by the Ladies Board and the Junior Woman’s Club of Loudoun to provide a twoyear program for juniors and seniors considering a nursing career.

The name was coined by an elderly patient in the Evanston Hospital, IL, where the first Teenage Voluntary Program was instituted in 1942, when he asked “where is my pretty little candy striper tonight” in reference to their red and white striped uniforms.

A big change came in 1974 after the opening of the new hospital at Cornwall Street and the conversion of the old building to a long-term care unit. The Ladies Board officially became an auxiliary arm of the hospital and all volunteer services were taken over by hospital administration, which established the first Department of Volunteer Services, under the direction of Zora M. “Mac” Brownell. The new director had the responsibility for recruiting and coordinating all volunteer activities.

The directorship was a paid position, but Brownell never took any reimbursement for her service. She already had been volunteering at the old hospital and the progression was a natural one, although she was startled by the offer, which “came out of the blue.” A dynamo of human energy, Brownell took to her new job with characteristic vigor and creativity. “Volunteerism is our American heritage,” she said.

The job was also a deeply needed solace after the death of the Brownells’ daughter Susan in a car accident in 1972. She was one of the first candy stripers and while Brownell found working with the students “couldn’t replace what she might have done,” it

was comforting to be working in the arena where her daughter had served. “That made me feel good, helped me handle my grief.”

The shift to hospital oversight of volunteers had caused some strains and Brownell always made sure her reports to the hospital Board of Trustees also were submitted to the Ladies Board, “out of respect and to keep them in the loop.” A lot had been taken away from them, especially considering the Ladies Board had started the volunteer program, she said.

She found the job rewarding. “I was full of enthusiasm; I liked people,” she said, recalling all the programs she helped set up. Among them was establishing a weekly chapel service with different ministers; bulletins were printed, taped music provided and patients who wanted to attend the15-minute service were brought by volunteers.

It was an intense six years, during which Brownell created new volunteer programs, including “The Stork Zora M. “Mac” Brownell Club” to ensure new parents were treated to an elegant dinner served by volunteers. In addition to the chapel service, there was a pre-surgery tour for adults and children, and numerous programs for patients in the Long Term Care Unit. Volunteers took around a morning and mid-afternoon refreshment cart, served as personal shoppers and representatives for patients, helped with transportation, messages and even helped stranded accident victims.

Volunteers staffed the gift shop and held a bazaar each December to raise money for equipment. From June 1976 to June 1977, the 150 volunteers provided 23,109 service hours to the hospital. That year, Brownell was named the Loudoun Chamber of Commerce’s “Woman of the Year.”

Brownell’s volunteers were her pride and joy. She and her husband Jim Brownell hosted annual awards picnics and other events at their Whitehall home in Bluemont. There were also dinner and dance parties, annual Valentine’s celebrations, coffees and fashion shows.

By 1980, however, “I was burned out,” Brownell said. “I had worked very, very hard, and loved every minute of it. It was so fulfilling and I loved the candy stripers.” She resigned, to the sorrow of her volunteers, but it was not long before she found another outlet, moving next to run the Red Cross blood program.

“If I was going to do something, it had to be helping people in some way.”

Loudoun Hospital ­— A Century Of Service

17

1980s-1990s: Move Debate Also Divided Hospital Staff

“The Hospital of Today & Tomorrow,” so proudly envisioned by benefactor Arthur Godfrey when opening a modern hospital in 1960 and its successor in ’74, was far from the tomorrow being eyed by hospital administration, board directors and physicians in the face of constant growth pressures and fast-changing evolution in the medical field as the hospital turned into the 1990s. As the hospital’s board of trustees and top administrators, and the community at-large, debated the merits of building a new hospital outside of downtown Leesburg, the rank and file staff also was split on the issue.

Janell Hoffman can remember starting work at the 1974 hospital, first as a unit secretary, later as a nurse. By the time she became an intensive care unit nurse in 1990 the facility was in the final years of active hospital use as pressure mounted to build a replacement hospital closer to the growing communities in eastern Loudoun.

Still serving today as an ICU nurse on an “as needed” basis, Hoffman also served on the hospital’s 100th anniversary committee and is part of the Cornwall renovation and expansion team. There is some irony in her presence in the latter group in that she had no problem in supporting the then-controversial move to Lansdowne in the 1990s.

“I was for it; the rooms were smaller than 10 [feet] by 10, and the equipment was sometimes bigger than the rooms,” Hoffman recalled. She remembered one instance where she and a doctor were treating a patient who was in danger of crashing. The X-ray equipment they were using was so large that it blocked movement around the bed and the two were forced to toss needed medical implements to each other.

“It was very limited, not state of the art at all,” Hoffman said, recalling patients had to be transferred to Fairfax Hospital for catheterization lab work. “We had none,” she remembered.

She was young and forthright. She wrote a story that was published in a local newspaper, “saying what I thought.” However, she had a female patient, affectionately known as “The General” to whom she was devoted, who was on the other side of the issue.

When she heard about Hoffman’s views, and presumably read the account, she was furious.

“She told me ‘get out of my room. Don’t touch or speak to me; get another nurse!’”

Other irritations were present. “In the old building, when I’d have to take patients to Radiology, I’d bag them, go down by the elevator to the ER, have to pass its waiting room where there were lots of the public, then go past the cafeteria.” There was no privacy for the patient, Hoffman said—a stark contrast to today’s insistence on the patient’s privacy.

“So I was in favor. There were some divisions, but the majority of nurses understood why.” Hoffman acknowledged that for many people the decision to move from Leesburg was difficult. “We couldn’t build up because of the asbestos, and parking and access were big problems. To make it a full-scale hospital wasn’t possible on that footprint. It was hard for people to understand,” she concedes, looking back.

But the old hospital has its defenders. Longtime Hamilton

Rescue Squad member Randy Breton had worked in the ER from 1977-1980 as an orderly, where he first got to know Dr. Donald Sabella, who joined the ER staff in 1980 and became its director in 1984. The two men would go on to work closely together in the emergency medicine field until 2000, when Sabella retired.

“I loved the ‘74 building; it had the best patient layout and was very straightforward for ambulance crews,” Breton said, favorably contrasting that simple geography with Lansdowne’s more “difficult and rambling” layout. He acknowledges the ICU and OR were out of date and too small, but still avows, “for that time it was a huge accomplishment.”

As the Cornwall facility creaked its way to obscurity in the face of the growing momentum to move east and to build a new state-ofthe-art hospital, there was one last construction flourish in Leesburg.

The 85-bed Long Term Care Unit opened in the renovated 1960 building in 1974 had welcomed Mrs. George C. Marshall as its first patient. In 1981, a new long term care facility opened behind the hospital’s water tower. The building housed 100 beds, 80 for general use and 20 for skilled nursing care. In August 2002, the name changed to Loudoun Nursing and Rehabilitation Center. Last year, the building celebrated its 30th anniversary.

Congratulations on your first

100 years and wishes for a successful next 100!

Your friends at Loudoun Habitat for Humanity and the Loudoun Habitat ReStore

703.737.6772

540.579.4508

www.loudounhabitat.org

18

Loudoun Hospital ­— A Century Of Service

ER Services Advance From Bone Setting To Specialization

From its very first days, when the Leesburg Hospital treated its first patient, a jockey thrown from his horse, in 1912, setting bones and treating various ailments has been a century-long commitment to caring. The emergency room has been a core function of the mission.

In the early days, the rural doctors, at least by later standards, had only rudimentary premises and rudimentary equipment with which to practice emergency medicine. Not for nothing did an old-time retired nurse quip recently: “setting bones and delivering babies, that’s what they did.”

Even when the hospital moved from West Market to a new building on Cornwall Street in 1918, the emergency room was still not front and central. It was reached by a ramp down to the basement, where two rooms were given over to the ER.

It was an easy come, easy go manner of working. Now retired, Dr. James Towe recalls coming to Loudoun in 1965. “There were only about 10 doctors, all general practitioners, and we were working all over Loudoun.”

There was no ER staff; the doctors rotated coverage duties.

And there was no helicopter service, Towe recalled. Everyone just helped out, he said, remembering being on duty one day, trying to stitch up a man who’d been in a terrible car wreck, when Dr. Joe Rogers looked in. “Need some help?” Together they worked on the man, who’d been almost scalped. Rogers was a key figure in emergency room treatment during the period from the 1960s through the 1970s, together with Dr. Robert Orr, son of founder Dr. William Clayton Orr.

Dr. Keith Belote, who grew up in Leesburg, and returned to practice medicine in town in 1978, has long memories of the ER. His family moved to Leesburg in 1958. He was a pretty healthy kid and he never darkened the doors of the ER until he was in college and was sent there by Dr. George Hocker after having an allergic reaction to soft shelled crab. “I went in by the back door and that was the ER. There was a nurse there, no doctor on duty—back then they rotated responsibilities—otherwise the nurse triaged and took orders. I was given a shot, watched, then sent out.” That was a far different order from today. He had no plug in to IV fluids, no heart monitor or machine recording vital signs every 15 minutes, no adrenaline and steroids. “It was altogether different.”

And, as late as 1969, when this writer’s husband was rushed to the ER after being badly injured in a car crash on Waterford Road, it was in circumstances far different from those of today. As the gurney was brought swiftly down to the small examining room to the right, Billy Jones, a prince of orderlies, ran along the corridor lined with patients, all smoking like chimneys, yelling “put out your cigarettes.

This man has been doused in gasoline.”

But those simpler methods would begin to change when Dr. Donald Sabella took over the ER in 1980. Recently called “a force to be reckoned with” by one colleague, Sabella came to Loudoun from Arlington.

“I was always interested in emergency medicine. At the time I graduated in 1972 there were very few training opportunities in emergency medicine, so I got as much training as I could before coming to Loudoun.” That training included working with para-

medics, an experience and partnership that would have a lasting influence on the development of emergency services in the county.

Sabella joined a group of four emergency doctors and became the director of the department in 1984. As advanced as the 1974 hospital was for a time, it needed changes, improvements in equipment and space, Sabella said, wryly noting the ER “was never acceptable.”

Sabella ruled the ER from 1984 to 2000, when he retired after contracting Parkinson’s disease. When he took over he looked to the future, seeking to improve the credentials of the ER doctors and increase the number of specialties on the ER staff. “It wasn’t as

Donald Sabella, MD (center) moved the ED to a new level, increasing the number of specialists in the department.

Courtesy of Inova Loudoun Hospital focused as before, it was more generalized.”

One key change he insisted on was board certification. Most of the Loudoun ER docs had already obtained those credentials by the 1995 mandatory deadline imposed by the American Board of Emergency Medicine, which came into existence in 1980. In 1995, there were still only five ER doctors, in stark contrast with today’s 30, split between the hospital’s three emergency departments, led by Sabella’s successor Dr. Edward Puccio.

Sabella and his staff also faced increased demand from Loudoun’s rapidly growing population. When he started there were 10,000 to 12,000 ER visits per year. When he retired in 2000, that number had risen to 60,000 visits per year. In 2011, there were almost 67,000.

Pathologist Dr. William Silberman worked closely with Sabella.

He recalled their close relationship, in which both did everything they could to coordinate the work and use “every problem as an opportunity to study and upgrade our service.”

“He (Sabella) was a very fine gentleman. Were he still practicing; I’d still be there,” the now retired Silberman said. But if Sabella is known as the man who took the ER to a different level, perhaps it is his work in developing and leading the county’s emergengy services that is recognized as his stellar achievement.

LOUDOUN MEDICAL GROUP Loudoun Hospital ­— A Century Of Service

19

Congratulates Inova Loudoun Hospital on Their 100TH Anniversary!

Advanced ENT Specialists 703.858.5885 Nauman Akhtar, MD, Orthopaedics 703.777.3262 Ashburn Pediatrics 703.729.7652 Ashburn Sterling Internal Medicine & Pediatrics 703.729.9220 Breast Care Consultants of Northern Virginia 703.858.3200 Center for Spinal Surgery & Spinal Disorders 703.777.1553 Coleman Primary Care 703.430.7090 Corporate Health Center 703.444.5656 Family Allergy & Asthma Associates 703.444.7234 G. Neil Foster, MD, Obstetrics/Gynecology 703.858.3070 Matthew Gavin, MD, Orthopaedics 703.777.3262 Infectious Disease: Tropical Medicine & Travelers Health 703.858.9966 Integrative Family Medicine Center 703.669.6118 Michael Kavanagh, MD, Orthopaedics 703.777.3262 Leesburg/Sterling Family Practice 703.724.7530 Loudoun Community Midwives 703.726.1300 Loudoun Dermatology Associates 703.723.7171 Loudoun Gynecology Associates 703.858.2811 Loudoun Internal Medicine Associates 703.858.3220 LMG Immediate & Primary Care Center 703.450.1125 Loudoun OBGYN 703.858.1500

Loudoun Pediatric Associates 703.723.7337 Loudoun Radiation Oncology 703.858.8850 Loudoun Spine & Rehabilitation 703.443.8110 Loudoun Surgical 703.858.3131 Loudoun Valley Family Practice 540.338.6101 Mancini & Korkowski, Internal Medicine 703.858.1395 Medical Doctor Value in Prevention 703.777.1146 Mountcastle Plastic Surgery & Vein Institute 703.858.3208 MountainView Medical Associates 540.751.0255 Neurology Consultant Services 703.858.5454 Northern Virginia ENT Associates 703.729.8080 Optimum Physical Therapy & Sports Medicine 703.443.2223 Orthopaedic & Spine Surgery Institute 703.723.6774 Pediatric Healthcare 703.779.0699 Potomac Family Practice 703.444.3302 Skin Cancer Center of Northern Virginia 703.723.5700 Sterling Family Practice 703.421.7000 Surgical Specialists of Northern Virginia 703.858.3200 The Urology Group 703.724.1195 Virginia Medical Arts Clinic 703.404.6900

703.737.6010 www.lmgdoctors.com

20

Loudoun Hospital ­— A Century Of Service

The Ladies Board: A Strong Right Arm

From the hospital’s earliest days in a rented house on West Market Street in Leesburg, the ladies of Loudoun stood at the back of their menfolk as they started out on the brave new venture to bring improved medical care to the county.

The story of the Ladies Board’s financial support—at first providing housekeeping supplies to purchasing small items of equipment and now helping to provide major apparatus and program assistance—is remarkable, and one that is not known widely in the community.

The women lost little time in forming their own organization, the Ladies Board of Managers, a mere two weeks after the establishment of the Leesburg Hospital June 12, 1912. With money scarce, their early assistance was practical as well as financial, providing bed linens and other essential supplies of a housekeeping nature while acting, as the organization’s name suggests, as supervisors of the fledgling hospital.

“The Ladies Board? Isn’t that a bunch of women who help the hospital out from time to time,” one young woman asked not long ago. Hardly. The women might more accurately be likened to the children’s story, The Little Engine That Could. Through the years, the organization—entirely volunteer—has contributed millions of dollars to Loudoun’s hospital. Co-founder Dr. John Gibson is reported to have said the hospital project would not

have been possible without the aid of the women of the county, and that sentiment is echoed today by numerous hospital physicians and administrators.

The early movers and shakers, including Mrs. William Corcoran Eustis and Alice Davis, spread their net widely—inviting 40 members to serve as representatives of all the churches in Leesburg and the surrounding towns and villages. Mrs. Eustis was elected president and the redoubtable Davis as her vice president.

The ladies immediately showed what they were made of by holding a community wide Donation Day, in which they invited the women of the community to bring with them a donation, “no matter how small or how large.” Those donations could be of money, furniture, pictures, sheets, towels, a pound of tea, groceries, eggs, vegetables, china and cutlery—anything which might contribute to the “well-being and comfort of the patients.”

And, almost 100 years later, that last phrase is still a mantra for the Ladies Board. While in the early days the group oversaw the housekeeping, supplied china, glassware and silver for the hospital dining room and maintained equipment and supplies for kitchen, rooms and wards, the volunteers slowly consolidated in a different role, one in which they provided a steady stream of financial support and acted as ambassadors of good will in the community for the growing hospital.

BRING YOUR DONATIONS FOR THE RUMMAGE SALE

Books HOUSEHOLD

ANTIQUES

O

TOOLS GADGETS

Sports Equipment

VINTAGE

FURNITURE

a

COLLECTIBLES

CLOTHING

Monday July 9TH 8am - 4pm

Morven Park - Tutt Lane 41793 Tutt Lane Leesburg, VA 20176

224 Cornwall Street, Leesburg 44045 Riverside Parkway, Lansdowne

Please box or bag all items

oard.org \ w w w. L a d i e s B 7 0 3 .7 7 1 . 2 9 8 5 \

Early Bird Hou

Friday, 8am-9am $5 tickret

Proceeds benefit Polly Cle mens

Nursery Fund

Loudoun Hospital ­— A Century Of Service

Donation Days turned into the annual Ladies Board Rummage Sale, first inaugurated in 1938, along with various bazaars, teas, suppers, fairs, flower and fashion shows and other fundraising activities. A novel form of raising funds indirectly was through the Leesburg Garden Club’s creation of a vegetable garden to supply patients and staff with fresh vegetables and canned goods, saving thousands of dollars each year. The Ladies Board helped the garden club members in the annual canning task until it was taken over by the hospital staff.

The major fundraising activities expanded. In addition to the rummage sale, the Ladies Board opened the Twice is Nice thrift shop, the hospital gift shop and the Lights of Love memorial program that has provided more than $82,000 for nursing scholarships. Typical of the determination to support “the wellbeing and comfort of the patients” was the establishment of the Memorial Bed Fund, in 1941, to help pay hospital bills for those who couldn’t afford treatment. Between 1957 and 1978, that fund contributed more than $90,000 toward direct patient care.

The plethora of items contributed over the years makes for fascinating reading: bassinettes for babies, a rocking chair for nursing mothers, washing machines, X-ray machines, linens and land, a cafeteria, a flexible sigmoidoscopy system, furnishings for the Nurses Homes built in 1926, instruments for laparoscopic surgery, a CT scanner … the list goes on. The small items have swelled over the years to major endowments for buildings and

21

equipment, including $1 million toward the Birthing Inn in 2000 and other improvements, and another $1 million pledged this year for the current expansion and renovation of the Cornwall campus. Recently, the Ladies Board funded a new lobby at the Birthing Inn.

But hand in hand with the satisfaction of hitting or exceeding the target for the annual rummage sale, is the sense of camaraderie among the women, many of whom say they have made lifelong friendships through their committed service together to the hospital.

Although one former Ladies Board member dryly recalled her opinions as a young woman entering that august group: “the blood in their veins was always blue, and their noses rather elevated,” the dedication of the members has never been in doubt.

While once perhaps it was the cachet of the social distinction of being invited to be a member that appealed, the group today is more diverse and the core aim and commitment has never wavered. Most of all, the Ladies Board’s reach has touched all parts of the community, particularly through the rummage sale as hundreds of volunteers gladly participate in the annual selling and buying spree.

Canny marketers, the Ladies Board members understand that selling donated items in clean, good condition at very affordable prices reaps great financial rewards. It has stood the hospital in great stead over the years.

Celebrating 35 Years Helping Members Untie Finanical Knots Personal Loans Online Account Access Credit & Debit Cards Savings Accounts

Home Equity Loans College Student Loans CDs & IRAs Money Market Account

Checking Accounts Bill Pay New Car Loans Used Car Loans

Loudoun Credit Union Join Today

703.777.4744 Sycolin Main Branch 801 Sycolin Road, Suite 101 Monday-Friday 8:00AM-5:30PM

www.loudouncu.com federally insured by NCUA

Market Street Branch Market Station, Leesburg Thursday & Friday 8:30AM-4:00PM

22

Loudoun Hospital ­— A Century Of Service

The Pre-Specialist Era In Loudoun

Today’s pattern of medical treatment is so different from that of years gone by that it’s hard to imagine what it was like in a simpler day when there were no home-based specialists, when Loudoun was a rural, agricultural community, when people were more accustomed to taking care of simple maladies at home and when payment might easily be offered in kind—not cash or by insurance reimbursement.

The huge changes wrought in the national medical system by the launch of Medicare and Medicaid in the 1960s and the growth of the health insurance industry over the following decades have changed the face of medicine as well as the emergence of highly sophisticated technological diagnostic equipment and the increasing search for more specialized medical knowledge.

Today, when we go to the doctor we take it for granted that we may receive a referral for more specialized diagnosis and treatment from a specialist in the area. Similarly, we expect the bill for our treatment to be submitted to our insurance company.

Not so, back in the day—not in 1912 when three good friends, Dr. William C. Orr, Dr. John A. Gibson and pharmacist Horace C. Littlejohn, started out on the great venture to have Dr. Rogers leading the hunt. a hospital in Leesburg and when Dr. Orr would come with horse and buckboard from his home in Hillsboro to minister to people, not even when he’d graduated to owning one of the first cars in the county. It was Dr. Gibson who proudly called himself “the country doctor,” a man known for tirelessly going out on calls. On one occasion, during a terrible snowfall, he hired a horse and sleigh to get through. By evening, only he and the horse made it back, the sleigh stuck in a snowdrift.

It was not so in somewhat later days when doctors including Keith Oliver, William Frazier, Sam Morrison, J.T. Jackson, Joe Rogers, Jim Towe, Earl Virts, Alton Echols, Harold Jackson and George Hocker spread themselves thin, driving miles around the countryside on house visits and when “birthing babies and setting bones” was common in the hospital.

Specialized surgical treatment was provided at the hospital from its first year by a visiting specialist from Washington, DC, Dr. Charles S. White who would go on to have a more than 40-year connection with Loudoun’s hospital. But all those who needed further diagnosis and treatment had to be referred out of Loudoun—to Winchester or the Washington, DC, area, or, in the past 50 years, increasingly to Fairfax.

Treated with great respect and deference, Loudoun’s “country docs” treated a variety of ailments, receiving payment in as varied an assortment of ways as the illnesses and breakages they treated.

In a time when farm products were plentiful and home canning was “king,” those were likely the only payments a doctor would receive. “He got a pig once, sometimes it was a chicken, or eggs, and a whole of canned goods,” Dr. Orr’s granddaughter Page Glascock of Upperville recalled in a recent interview. “That’s all we have,” the patient’s wife said.

Another granddaughter, Louise Noyes, recalled a mother who said, “We have no money.” Instead, that family named their children in honor of Dr. Orr.

“There are a lot of William Claytons running around,” she remarked dryly.

Dr. Harold Jackson would take fruit and vegetables in payment, sometimes sharing them with the nurses.

Longtime Leesburg businessman and jeweler Stanley Caulkins knew former Loudoun Hospital Chief of Staff J.T. Jackson well and recalled a time when “J.T.” had visited a farm out in the country to treat a farmer. When he left, he took with him a “gift in kind” that was to prove somewhat embarrassing. Unbeknownst to Jackson, the grateful farmer put some pork ribs in the boot of his car, loosely wrapped in newspaper. After a week, the gift began to stink, to put it mildly. Not knowing where it had come from, or why, the doctor threw it out. Unfortunately, the word got back to the donor.

While some specialists began to come into the Loudoun scene, well into the 1960s and even the ‘70s, the term general practitioner meant just that. In that less regimented day, people were accustomed to multi-tasking as a matter of course, and so it went with the country docs who must have set a record for long-distance driving in an era when home visits were still commonplace.

They had their idiosyncracies as well. Drs. Orr and Gibson were great baseball fans. They also both loved to hunt and often kept a gun under the buggy seat when making house calls in the country.

Dr. Oliver, who rotated on-call duties with Dr. Frazier in Purcellville, was also a great hunter. One nurse who knew him well recalled him delivering babies while sporting feathers from some downed bird tucked in his hatband.

The timing of visits to his Purcellville practice bore no relation to the hour for which one had been summoned. This writer and her friend Marie Anderson recalled the days when they would pack a sandwich lunch along with crayons and coloring paper when taking children for a check-up. A favorite Oliver trick in reassuring a nervous youngster who disliked having an instrument stuck down his ear was to make bird whistles and calls as a distraction.

And in an era when it was no problem in showing favorite pursuits, they often had other talents they displayed prominently.

Rogers, who would become one of the faces of emergency medicine in Loudoun, in his spare time was a horse breeder, trainer, huntsman and horseman of distinction. Forever associated with the Loudoun Hunt Point to Point races at Oatlands, “Dr. Joe” had a remarkable racing career, starting with a first race at age 12 in Berryville. Another of Loudoun’s remarkable country doctors, Rogers was known for refusing to send a bill to those he knew could not pay.

Loudoun Hospital ­— A Century Of Service

Pressures Increase To Build New Hospital—In The East

It is a truism that whatever one regards as “the latest, most modern invention,� by its very nature is almost out of date by the time it has opened. And that was true for the 1974 hospital that was built to the west of the 1918 Loudoun Hospital and its subsequent expansions.

It was not long before doctors with an eye to the future were pushing for a more modern and more sophisticated hospital that would allow them to provide more services. Even more significantly, they were pushing for a move east of Leesburg. The early country doctors had been boosted by a wave of new physicians who began arriving in Loudoun from the 1970s through the 1980s and it was many of them who were eager to move to the next level. Nursing staff was split on the issue, some perfectly comfortable with the 1974 hospital, while others were anxious to move.

There had been forceful voices in support of the move, dating back even before the 1974 hospital when Dr. Sam Morrison argued strongly for a move east to be where the population growth was.

Later, then eastern Loudoun Supervisor Charles S. Waddell also argued for the hospital to be located in eastern Loudoun, for the same reasons.

Tensions rose during the 1990s, forcing an east-west split where residents in Leesburg and western Loudoun, whose families

23

had been strongly pro-hospital throughout its life in Leesburg and who had financially supported it, considered the move a betrayal of their long commitment to the institution. Some western Loudoun physicians felt the same, although today even some against the move at the time now agree it was the right decision.

Mass community meetings featured angry residents protesting the change, which sometimes pitted neighbor against neighbor. It also made life difficult for members of the Ladies Board, many of whom privately had trouble with, or actively opposed, a move, but who nevertheless stuck to their avowed position of supporting the hospital.

For internist John “Jack� Cook, relocating east was essential if the hospital wanted to become a tertiary center down the road. “My recommendation in 1988 was to put the hospital at the corner of the Toll Road and Belmont Ridge Road,� exactly the spot Reston Hospital was eying. His vision was to have the new hospital in the center of Loudoun’s growth and, at the same time, bring Cornwall to outpatient center status, to serve western Loudoun: “Exactly what we’re doing now,� he said of the planned $30 million renovation to Cornwall.

But the hospital lacked the funds to do that and, despite the

Continued On Page 25

Middleburg Bank congratulates Inova Loudoun Hospital on its 100 year anniversary.

Still looking good after all these years.

Š 2012 Middleburg Bank. Member FDIC.

0%.B B \HDU DQQLYHUVDU\B5HY LQGG

MiddleburgBank.com $0

24

Loudoun Hospital ­— A Century Of Service

Landsdowne Move Shadowed By Financial Peril

For those who thought the hard-fought and long-planned move east from Leesburg to Lansdowne would be a panacea for all ills, the reality was to prove different, especially on the financial side.

Every hospital has to have a mix of compassion and caring along with sound business acumen, a sort of mix between Mother Teresa and Lee Iacocca. The two don’t always blend well with each other, but both are vital for the success of the institution.

Loudoun has always been a very community minded place, with its corporate, professional and financial leaders providing strong support for its institutions because they wanted those things for their county and were determined to have them succeed. Over the years before the final move to Lansdowne, a listing of the hospital Board of Directors reads like a “Who’s Who of anybody who was anything” in Loudoun.

From the beginning, Loudoun’s hospital had faced financial difficulties because its outgoings exceeded its incomings and records and minutes through the years are rife with calls for cutting costs and dire predictions of financial doom. One big problem was the amount of uncompensated care provided to indigent patients—a financial outlay as prevalent back in the day as now.

Although generous donors and the Ladies Board often stepped in with funds to help ease the situation, by the time the hospital

Congratulations Inova Loudoun!

Thank You for 100 Years of Service.

BUSINESS

PERSONAL

EMPLOYEE BENEFITS

7IRT 3TREET 37 3UITE s ,EESBURG 6!

4 s &

WWW.LOUDOUNINSURANCEGROUP.COM

moved to Lansdowne its financial position was shaky.

The first two years in the sparkling new facility, which offered so much more than the old 1974 hospital in terms of space, equipment and service capability, also represented a period when, in the words of one board member, “We hung by a thread.”

But the hospital survived those dark first years after the move, a period in which the hospital board, administration and staff worked side by side to overcome the difficulties, with a fierce determination to never let patient care suffer.

As former Loudoun Hospital Center counsel Woodrow “Woody” Turner recalled, by 1997 “we had a lot of problems.”

Despite financial aid from the Ladies Board, “without whom the hospital wouldn’t exist; they bailed us out on more than 50 occasions,” and community support from those who donated their wealth, time and effort, the hospital was losing ground financially.

The cost of indigent care was one big problem, while increasing benefits for employees, new equipment, managed care, which was driving reimbursements down, the leap forward in medical science, physician employment costs and the cost of the new building all contributed to what Turner called “a financially perfect storm.” It was a dire time for community hospitals in general, Turner said, noting many went out of business.

He has nothing but admiration for the all-volunteer board, citing the directors’ “tremendous service” in time and effort, efforts that “generally are only met with criticism. People only see the negative.”

Global financier and insurance expert Mark Lowers, an associate of Turner’s, was invited to join the Board of Directors while discussions were ongoing in the mid 1990s about the hospital’s move from Cornwall Street to Lansdowne. It was a decision that at the time was “very contentious and emotional, but today I think has been proven to be a right vision,” he said, noting “You couldn’t do at Leesburg what you could do at Lansdowne,”

At the time, Joe Ramos, CEO of the Rubbermaid Group in Winchester, was chairman of the hospital Board of Directors.

After Administrator Dunlop Ecker resigned, “We ran the hospital.

At that point it was Joe, me and Woody—we took the reins, and began to dig into the issues,” Lowers said.

What followed was a “horrendous year,” one in which “we were trying to get out arms around it,” Lowers said. Bankruptcy was never an option, he said, even though “cash on hand could be measured by the hour. It was an awful time.” But Lowers and Ramos realized that if they could get the right people there, including filling the CEO and CFO positions, they could right the ship.

It took the services of a turnaround company, getting the constructive advice of an independent group of advisors “with no agenda,” hiring the right CEOs—Rod Huebbers and Randall Kelley—and enduring an uneasy time of bad relations with the county as well as steep financial losses before the ship began to turn around. But turn around it did. When Huebbers was selected as the new CEO of the hospital, “it was a relief to hand over the reins,” Lowers said. He would continue his service to the hospital, serving as chairman of the board for almost 11 years.

Loudoun Hospital ­— A Century Of Service

New Hospital Continued From Page 23

elegant and shining new medical facility that eventually would be opened in 1997 on donated land at Lansdowne, the institution would undergo a severe financial crisis that would take all the resources of hospital board directors, administrators and medical staff to overcome.

Back in the 1980s and early 1990s when the hospital board, administration and medical staff were debating the pros and cons of a move, consideration was given to rebuilding on the site or building up. But, although there was room to go up, the building was full of asbestos with all its inherent dangers—that were not fully realized until later. Another problem with rebuilding was the impossibility of having construction side by side with continuing operations at the facility.

Acreage was also a problem at the approximately 22-acre hospital property. “There wasn’t enough land at Cornwall,” Cook recalled, noting Winchester Hospital had gone through the same analysis in the late 1980s and early 1990s. “You needed 50 acres to be a tertiary center. We got 30 at Lansdowne and then another 20 immediately,” he said.

Winchester went through the same process, eventually adding another 20 and finishing with 70 acres and in a much better position than Inova Fairfax Hospital which ideally should have “found another 100 acres instead of constantly having to pack in more buildings,” according to Cook. Another possibility for the new location was a 30-acre parcel owned by Helmi Carr where REHAU is located today. But it got turned down by the board.

The decision to move east was taken in early 1993. In April 1994, the Board of Directors unanimously agreed to begin the design development of the Lansdowne Campus, a decision that

25

would result in the opening of the new facility three years later.

Looking back, Cook said most of the opposition was not from “those [physicians] operating in areas like gastroenterology, oncology or cardiology,” those functions that are the driving engine of a hospital, he said. “We needed a modern hospital; growth was going on and we could not build here. We couldn’t operate while building, plus it was very expensive.”

Even then, growth occurred where it still does today, bringing young, active and employed people to the area. Despite his determination that a move was essential, Cook acknowledges that in the old days the really strong support for a hospital was from Leesburg and the west, so the dismay over the move was unsurprising. He recalled a lovely story told to his wife Agnes DiZerega Cook by a cousin that nicely depicted the west-east divide of the day. In the days of social niceties, it was essential for young women to pay a call on Mrs. Fairfax, the doyenne of Loudoun society. When a young newcomer, the late Vinton Pickens, who would go on to be the first head of the Loudoun County Planning Commission, duly called on Mrs. Fairfax, Pickens reportedly found favor.

“I like that lady, she has spunk,” Mrs. Fairfax pronounced. “It’s OK she lives east of Goose Creek; besides, she lives near Belmont and is building a chateau.” The “chateau” to which she referred was Janelia Farms, now home to Howard Hughes Medical Institute.

Although Cook was unable to get his way in the 1990s in turning Cornwall into an outpatient center, that vision will become reality. Back in the 1990s, “we wanted to have it happen contemporaneously with the move; everyone knew it had to happen at some point.”

But, in the meantime, he built what some local residents irreverently call “Cook’s Hill,” a large physicians office block attached to the 1974 building, which he opened in June 2008. What goes around, comes around.

To: Inova Lo u dou n Ho s p it al Th a n k yo u for you r co m mi t m e n t to servi n g o u r com m u ni t y for t h e p a s t 1 0 0 ye a r s. Co ngr a t u l a tio n s a n d be s t wis h e s.

Mayor, Co u n cil, St aff & Citize n s of th e

Tow n of Middleb u rg

26

Loudoun Hospital ­— A Century Of Service

Survival: Everyone Lends A Hand

In those dire financial days for the Loudoun Hospital Center just after its 1997 move to Lansdowne, the situation required the help of everyone involved in the medical community—administration, staff, Ladies Board and physicians alike—to get through.

Dan Smith first got involved in the hospital’s affairs through his role as a financial advisor and estate planner for Dr. William Frazer and his wife, Anne Frazer. The late physician was one of the early doctors in Loudoun, who along with many others, such as Dr. Joe Rogers, a pioneer of Loudoun’s emergency room treatment, would often take only payment in kind. In Frazer’s case, that included “delivering babies for cabbages.”

As were others, particularly in western Loudoun, Frazer was “emotionally torn” by the idea of moving the hospital east from Leesburg, but he was a strong supporter of the hospital and wanted to help. As part of his estate planning, he decided to make a charitable gift of his farm near Hamilton to the hospital while retaining life tenancy, Smith said. That gift was made to the hospital at the time of “the great west-east divide.” Seeing the hospital was in dire straits, Frazier eventually gave up the life estate provision so the hospital could have the full benefits of unencumbered land to do what it needed to help the institution, Smith recalled.

“[The hospital was] on the edge of bankruptcy, and had no

For All That You Do For Loudoun Cares and /RXGRXQ·V 1RQSURÀW &RPPXQLW\

Thank You

Inova /RXGRXQ +RVSLWDO

www.Loudouncares.org

703.669.4636 (INFO)

deep pockets.” The gift of 200 rural acres, eventually purchased by developer Sal Cangiano and developed in single-family housing between Hamilton and Lincoln, eased the hospital’s plight somewhat, but hardly improved its already badly dented public relations image in the minds of western Loudoun residents.

“They caught tremendous flak,” Smith recalled.

The financial crisis came to a head in the years immediately following the move, and it took the efforts of many to weather the storm. The 55 physicians at the Lansdowne campus agreed to reduce the hospital’s rent for the medical building adjacent to the main building, and held it in abeyance for a year to help with cash flow. Staff members also felt the pinch as hospital administrators cut costs everywhere they could.

Charlene Martin remembers those days vividly. An affable, friendly woman, now working in Community Affairs and in the Chaplaincy Department, Martin had been an employee of the hospital for about a decade before the move. She’d seen several sides of the hospital—working in Central Services as a supervisor and later as a buyer, procuring operating room instruments and supplies. She also was responsible for buying for the lab.

“Lab and OR [buying] was my main function,” she said.

She also was the buyer for the Mobile Health bus in 1999. She worked in Materials Management and left the department as its buyer on being offered a job in Human Resources.

Martin was present for the groundbreaking for the new hospital and so has had a ringside seat for its evolution over the past 15 years. She recalled the beginnings of the turn-around under then-Loudoun Healthcare administration head Rod Huebbers, who was hired as hospital CEO in 2000.

“He was fun,” and would always say the hospital’s greatest asset was its employees, she recalled.

Fully understanding the transition had been “a rough time,” Huebbers decided to celebrate the staff. And he chose to have a Halloween party, Martin said, urging everyone to “dress up and have fun.” And he didn’t leave himself out of the nonsense, asking her to help him appear as Verne, an old country hick on TV commercials. “He paraded through the whole hospital, leading the parade and passing out candies,” Martin said, describing his action as an eye opener for staff. “We’d never been allowed to have fun before. The staff was hesitant at first, particularly when Huebbers wanted to decorate the hospital with Christmas lights.

“You can’t, we’re not allowed to put lights up,” he was told.

“Yes, you can. We’re going to celebrate,” Huebbers replied— an action that acted as a huge tonic for the somewhat dispirited staff members.

“During the rough times we were afraid to do anything,” Martin said, noting under predecessor Dunlop Ecker’s administration, which managed the move and was then hit with the financial troubles, there was “no fun at all.”

Lance Greene, director of Supply Chain Management for Inova Loudoun Hospital, remembered the bad times, as well as the welcome changes under Huebbers, and later under his successor Randy Kelley.

Huebbers could not have come to a new job at a more challenging time. His predecessor had resigned in 1999 after having announced what the Washington Business Journal called

Loudoun Hospital ­— A Century Of Service

“monstrous losses” in the neighborhood of $20 million and his announcement to employees that the hospital soon would be forced to slash costs or find a buyer.

The cost of the new $58 million hospital was only one cause of the disastrous financial situation, along with the costcutting practices of managed care and other factors. It was Huebbers’ recognition that an institution’s staff is its most valuable asset and, moreover, that at Loudoun Hospital that asset was not functioning properly, that was invaluable, the two said.

Several of the psychological boosts dreamed up for staff, Martin said, continued for years, citing Oktoberfest in the back parking lot with a dunking tank and a Twinkie eating contest, along with bonuses for staff and gift cards at Christmas.

Both Greene and Martin said Huebbers didn’t draw a line between staff and administration. “He wanted to tear down that wall,” Martin said. Greene remembered tales of Huebbers walking the halls in blue jeans. “He walked around the ER to see how people greeted him. They smiled at him—with respect,” he said.

And Kelley pursued that same philosophy and more. “Like Rod, once he met you, he never lost that knowledge. He’d walk the halls and greet you,” Greene said of Kelley, who departed for another job in late 2011.

Greene had been a buyer for the hospital since 1993 after having joined as a volunteer in 1991, “straight out of high school.” From there he worked his way up the supplies chain to eventually lead the department. The worst years were from 1997

27

to 1999, he said, “three years top.” Martin laughed as she recalled those belt-tightening days when supplies were scarce, even to the point that “Lance would take the coffee pots out and fill them because there wasn’t enough coffee on hand.”

But with the arrival of Huebbers, staff members saw things begin to come around. “It was amazing. He put [survival] in the hands of people who worked here. We were tasked with finding ways of how to save the hospital,” Greene said.

For those two employees at least, the partnership with Inova Health System, which took over the hospital in a merger with Loudoun Healthcare Inc., has been vital, Greene recalling, “the day we closed [the deal], Rod was his happiest,” while Martin said “We were very proud of that. It was a very defining moment.”

The growth that has come since 2002 is representative of where the hospital is today—part of a system but also retaining a strong community focus, according to Greene.

And that community focus is within the hospital itself, Greene said, pointing to its people. “Any time there is a crisis, the people who work here, they’ll stay until midnight or later.”

Martin recalled in the early 2000s when the roof collapsed at the Heritage Hall nursing home in Leesburg, within two-and-ahalf hours Huebbers had coordinated the removal of patients to rooms at the hospital’s nearby Cornwall campus. “Between two and three o’clock in the morning, we ran out of water and there was a contamination problem. So we went around the 7-Elevens getting bottled water.”

Congratulations!

T

he Mayor, Town Council and Staff would like to congratulate Loudoun Hospital on reaching the Century mark. The Town of Purcellville recently celebrated its Centennial.

Thank you to all the doctors, nurses, support staff and hospi-

tal leaders—past and present for providing the best possible helathcare for the citizens of Loudoun County.

28

Loudoun Hospital ­— A Century Of Service

Cornwall: Downtown Medical Complex Finds New Life

The phoenix is a colorful and mythical bird that, at the end of a long life, builds itself a nest of twigs that then ignites, converting both nest and bird to ashes. From the debris, a new, young phoenix was said to arise, reborn to live again.

One might liken the Loudoun Hospital’s Cornwall facility in downtown Leesburg to the mythical bird. It was a close-run thing, but the 1974 hospital did almost die in its nest of twigs, facing the threat of extinction, and it did in fact survive to live another day.

And not only survive, but faces a renewed future with a glorious $32 million facelift in a modern-day parallel to a reborn phoenix.

The credit for the recovery goes to many who devoted hours to finding ways to revive Cornwall, but most cite Rod Huebbers who became CEO of Loudoun Hospital in 2000 and his successor, Randall Kelley, who left Inova Loudoun Hospital late last year to take a new hospital CEO position in North Carolina.

Construction began on the renovation last year, with a slated completion date of May 2013. Meanwhile, existing services of emergency medicine, imaging, behavioral health and the nursing and rehab center will continue as normal.

In the dark period following the 1997 move to Lansdowne, Cornwall became a poor sister, left to languish in the shade of her more glamorous sibling, now the darling of all. As the hospital faced a worsening financial crisis in the succeeding years, the calls for Cornwall’s removal from the family increased. Medical services ceased and for all intents and purposes the hospital had closed down. The building however provided space and shelter for a number of nonprofits, including the Loudoun Library Foundation, Loudoun Cares—which still operates its helpline referral service there—the Loudoun Free Clinic and the Loudoun Community Health Center.

And that assistance is appreciated to this day. Loudoun Cares Executive Director Andy Johnston recalled the fledgling community services referral organization moved to the hospital in 2004.

“First, the hospital, then Inova donated the space free all those years,” he said. “They helped launch Loudoun Cares. We had the big vision, but all we had then was a telephone helpline,” he said of those early days when Loudoun Cares was just getting started and couldn’t afford any rent. It was Huebbers and Loudoun Hospital Foundation head David Goldberg who made that happen, Johnston said. “They saw the value of it.”

In the years following the move, Leesburg and western Loudoun residents in particular strongly protested the loss of services and called for Cornwall’s resurrection. Then-Supervisor Jim Burton, Leesburg Mayor Kristen Umstattd and Lovettsville Mayor Elaine Walker were members of the Western Loudoun Medical Center Task Force, charged with coming up with ways to put the hospital back to productive use.

“We were trying to find ways to bring back the ER and open up more medical services at Cornwall after it shut down,” Umstattd recalled. “I, along with Jim and Elaine, was strongly opposed to closing it down,” she said, noting she got involved after becoming mayor in July 2002. Previously Mayor B.J. Webb had been on the committee.

High on the minds of the group was the need for at least emer-

gency services to return to Cornwall, according to Burton. He and his wife Lina had been members of a group opposed to the move to Lansdowne, Loudoun Citizens Health Watch, and saw the “hurt to a lot of people.” But, the arrival of Huebbers as Loudoun Hospital CEO in 2002 began to turn things around. “He tried to bridge the gulf that had been formed,” Burton said.

The new task force met at Cornwall. “We talked about what we could do with or without a Certificate of Public Need. As it worked out, we could do a lot regarding the ER.” At the time, with the loss of an emergency room in Leesburg, there was a bypass crisis, when full hospital beds forced rescue squads having to find other places to take patients.

“That was key to getting the ER back,” Burton recalled. “I give the hospital management credit; they recognized the demand was there.” He and his wife drove around the county with a map, estimating the distance and times to both Cornwall and Lansdowne from every village and community in the area west of Goose Creek.

“The demand was always there, it never went away.”

Walker, a longtime supporter of the hospital, also had opposed both the move and Cornwall’s shutting down. While she supported the hospital once constructed in its new, Lansdowne, location, “I always had high hopes to get the ER back at Cornwall to accommodate western Loudoun residents and rescue squads.”

Inova Health System’s Public Relations Officer Tony Raker, formerly director of public relations at Loudoun Hospital, recalled Huebbers telling him of his realization that Cornwall must be retained and revived, as the “Crown Jewel” of the hospital. At the time, later in 2000, Huebbers was still flying home to New England at weekends to be with his family. It was on one of those flights that he came to the realization that Cornwall must be kept, and not sold.

“That’s when he called [Chairman of the Board] Mark Lowers.”

Key to the turnaround was the re-establishment of the emergency room. Not only did it bring back service to a large number of people in Leesburg and west, but, “we never had to do bypass again, which in turn took a tremendous pressure off other hospitals in the region,” Raker said. If Huebbers had the vision and overall plan by which to go forward, by the time he handed over to Kelley in 2007 it was the latter who fleshed out that plan and saw it through to construction, according to Raker.

What goes around comes around. Just over a century after the first hospital opened its doors on West Market Street in Leesburg, the expansion will be completed, probably in May 2013, according to Interim Inova Loudoun Hospital CEO H. Patrick Walters.

The “old” hospital then will have a state-of-the-art emergency department and imaging center, both expansions of existing services, a lab and a new behavioral health unit as well as the existing Inova Loudoun Nursing and Rehabilitation Center, now 30 years old.

Mayor Walker personifies those Loudoun residents who have a particular fondness for the former Cornwall Street hospital. Her children were born there and it was for so many years for her and others, “the hospital.”

“I am so very proud of the renovation that is taking place and look forward to the new Emergency Room. Maybe one day it will again be a full hospital. The need is there,” the mayor said.

Loudoun Hospital ­— A Century Of Service

29

Accounting: Moving Into The Digital Era

One of the discoveries one makes in looking over 100 years of history is the sharp contrast between then and now.

Sharon Kelley has worked for the hospital for 33 years and she’s seen tremendous changes in her field of patient accounts since she first came to work in 1978. With the growth of technology and the coming of the digital age the changes are staggering.

The department had a staff of four when she started and is now at 14. There was one person who did payroll, a statistic today that makes one blink.

Born and raised in Lincoln, Kelley has spent most of her life in Loudoun, with only a brief interlude in Clarke County. Then in her early 20s, Kelley was talking with a friend who worked at the hospital, who suggested “why not come to Loudoun.” The next day she interviewed for a job in Patient Accounts. “I was hired on the spot and started the next day,” she recalled—another instance of employment practices even in large institutions that were much simpler then than today.

“We did everything by hand; every process was manual,” she said, ruefully recalling she had “the worst calluses on my fingers from the constant writing.” Employees in each hospital department punched in and out and their hours were manually calculated. It was a cumbersome billing process, in which the hospital acted as a clearinghouse for reimbursements from insurance companies. Blue Cross was the first to do some electronic work, but “we still had to input it.” Slowly, others began to climb aboard the electronic movement, which gathered steam during the 1980s.

By the end of that decade the system was fully automated, billing improvements provided more efficiency and increased the hospital’s cash flow, and the increasing presence of insurance reimbursement dominated the accounting field, Kelley said.

Insurance coverage then in some instances was also greater than it is today, “sometimes 100 percent,” she said, noting that Medicare really established itself and one in which the bite to employers was less.

And all along, one of the biggest problem areas was unpaid bills and charity care. Financial aid was available for those who couldn’t pay, based on poverty guidelines, which used a sliding scale. But bad debt didn’t qualify and there was a constant attempt to get people to pay their bills where they could.

As the years progressed, “we saw more charity [patients].

We’d have to write off more,” Kelley said. Contrary to some views of accounting staff being hard-hearted Hannahs, Kelley said when people didn’t qualify under the federal poverty guidelines for assistance, staff members would endeavor to work with them to examine various options.

“If they don’t qualify, we look to see if there is some other measure,” she said. If not, Kelley noted that accounting staff would work with patients to develop some system of payment.

Some were very open and cooperative, some were not. Some patients get very upset they can’t pay, while others are not pleasant about it. “I’ve had my share, but I don’t take it personally,” Kelley said dryly.

Her solution when people get upset or hostile about their bills is simple. “They often don’t know why they’re angry or what they’re dealing with, so I take a step back and lower the rhetoric.

It usually works,” she said. Then, of course, there are those who

“you just can’t please and some who just refuse to pay.”

“We’d try to set up a payment plan on a sliding scale,” she said. “Some of them get to know you, and we establish a rapport.

They only want to work with one person, and they’ll ask about my family,” Kelley says. But it’s hard for people when they don’t qualify for aid in some way and they can’t pay, she acknowledged.

Some of the patients with whom she deals are “extremely open, and it’s hard not to get consumed by it.” If the patients can’t pay, they can’t get medication and they’re elderly, “it’s a big problem,” she says.

Now after a decade or more as manager of Patient Accounts, it’s a far cry from the days when she arrived in the department.

“When I came, we were logging checks manually. We wrote each charge into a big book and at the end of the fiscal year we’d total it manually and used a calculator to make sure the page balanced.

“When we got the first computers, we thought it was the greatest thing.” Kelley remembers the first time she used a Lotus spreadsheet. “It was absolutely wonderful,” she recalled. While there’s still paperwork, “it’s much less,” she says.

No matter how different her job is from when she started in 1978, Kelley still wants to continue as long as she can. “I love what I do. I’ll retire one day—from Patient Accounts,” she says firmly. “That’s the goal.”

Loudoun County is looking for people just like you!

Loudoun County is looking for people just like you!

Loudoun County, Virginia, is one of the fastest growing counties in the United States. The County is constantly seeking to fill vacancies and to provide numerous opportunities to enhance your career with more than 30 different County departments and agencies. The County offers competitive salaries and benefits including health, dental, vision, disability and retirement benefits.

The County is an Equal Opportunity Employer and recognizes the value of a diverse workforce. We strive to foster a diverse and equitable work environment where employees can develop their careers. We encourage women, minorities, veterans and persons with disabilities to apply for positions with Loudoun County Government.

Please go to www.loudoun.gov and click on “Jobs” to complete an on-line application. If you do not have internet access or would like to apply in person, you may visit our available kiosks at the Human Resources division located at 1 Harrison Street S.E. in Leesburg, Virginia. All of our employment opportunities are available on-line and can be accessed at your local library or our Workforce Resource Center located at the Shenandoah Building at 102 Heritage Way N.E. in Leesburg. EOE

30

Loudoun Hospital ­— A Century Of Service

The Coming Of Specialists

The transformation in medical treatment at the Loudoun Hospital took off with the influx of specialists, starting in the 1980s.

With their appearance on the scene, at first slowly, then in a growing and steady stream, the hospital evolved from a small county hospital “birthing babies and setting bones” to a medical facility that could treat more and more complex problems.

The period between the construction of the 1974 hospital and the move to the new state-of-the-art building at Lansdowne in 1997 in hindsight can be seen as a transition period, one in which a growing number of new doctors and specialists would come to the hospital to join the cadre of older physicians, most of whom were general or family practitioners.

“In the late 1970s and early 1980s, we got the first real specialists, Bob Herron and Beth Simms,” internist and former Chief of Medical Staff Jack Cook, who arrived also in the 1980s, recalled.

Longtime Loudoun doctor Steve Napolitano, who has served as chief of staff, came to the county in 1974. “Loudoun was still really rural, and other than surgeons and a couple of eurologists and orthopedists, there was very little in the way of sub specialties; primary docs were still doing it all,” he recalled. The change occurred slowly, he said, also pointing to the impact of Herron—whom he called a “wonderful cardiologist”—and Simms. But that’s a story for another day.

Today, Inova Loudoun Hospital is home to more than 250 spePrmrs_70109_- Ad #2666 - THIS AD CAN NOT BE EDITED-

Call Today to begin an education of a lifetime

cialists and sub specialists. But, of all the many changes wrought by specialization and technological changes, perhaps the clearest indication of the evolving road to specialization is seen in the Emergency Room.

From its early days under the guidance of Doctors Robert Orr and Joe Rogers, when doctors rotated to provide coverage, the emergency room has evolved to three emergency departments—two at Lansdowne, one for children, the other for adults, and one for all ages at the Cornwall campus in Leesburg.

It was Dr. Donald Sabella, who as head of the ER in 1984 started the trend toward more specialization. From 1984 to 2000, when he retired, Sabella steadily increased credentialing requirements for ER doctors and increased the number of specialties on the ER staff. He insisted on board certification for ER physicians. By 1995, there were still only five ER doctors—in contrast with today’s total 30 emergency physicians, split between the three emergency departments, now led by Sabella’s successor Dr. Edward Puccio.

Puccio’s “empire” is a far cry from the days of the old basement ER in the 1917 building at Cornwall. He was hired in 1995 and took over the ER in 2000. His job was to transition the ER medical force to those who were trained specifically in emergency medicine—to deal with heart attacks, accidents, miscarriages, etc.

Before 1995, a physician could be trained in another specialty and grandfathered in to emergency medicine. After 1995, however, there 6.25 x 4.5

An investment in your child’s future.

Proprietary Balanced Learning curriculum ®

Integrated character development program Before and After School programs for school-age children

Primrose School at Moorefield Station

703-726-9306

Primrose School of Ashburn

703-724-9050

Educational Child Care for Infants through Private Kindergarten and After School

Each Primrose School is a privately owned and operated franchise. Primrose Schools, Balanced Learning, and The Leader in Educational Child Care are trademarks of Primrose School Franchising Company. ©2012 Primrose School Franchising Company. All rights reserved.

70109_Prmrs_Rdns_Ad_ID_2666.indd 1

6/29/12 12:00 PM

Loudoun Hospital ­— A Century Of Service

was no more grandfathering. “You couldn’t be board-certified unless you were trained in emergency medicine.”

After moving to Lansdowne in 1997, Puccio said, “the first thing we did was to recognize the need for emergency services in Loudoun. We re-opened Cornwall, did re-route to make turn around times quicker and provide easier access.” The then-two departments had the same treatment and the same physicians, and Cornwall “could handle all the normal ER stuff.”

The second thing was to develop the children’s side of emergency medicine. With Cornwall re-opened, “we were now seeing a lot of children and young people,” Puccio recalled.

Lansdowne was new and modern and not particularly child friendly; the kids were mixed in with adults. “It was not a place that a child could be comfortable in, so we decided to open a kids’ ER,” he said.

The doctors quickly realized they needed an inpatient component to be in tandem, to provide a comfortable place for sick kids in the hospital. So, a pediatric hospitalist program was set up, in which a hospitalist was on duty at all times and a pediatrician always in the hospital. “We’re unusual. We have a child life specialist, whose job is simply to comfort kids through painful or scary procedures. They talk to them, comfort them, show them the machinery, such as the X-ray, help them be comfortable with IVs and suturing, let them have games and toys—to make the experience better for them.”

Former children who recall dreaded times at the old ER would be amazed at the bright, cheerful emergency room that today greets young patients.

Next, after re-opening the Cornwall ER and eliminating the necessity to re-route or divert ambulances, came a huge step: the decision to establish a cath lab at Lansdowne. “Every minute someone is having a heart attack, muscle is dying—an hour plus of time that heart muscle is dying,” Puccio said.

“We needed to do that here,” Puccio said. When they realized the volume of heart attacks was sufficient to warrant the equipment, the doctors took a high-level heart cath training program. “From the moment to enter and opening the vessel—the national standard

31

is 90 minutes, ours was 70.” A generous donation from Karen and Fred Schaufeld, Barbara Schaufeld and Michael Schaufeld enabled the purchase of the required equipment for the facility that is now known as the Schaufeld Family Heart Center. “That donation has saved many lives; many people are alive because of them,” Puccio said in reference to the donors.

Several years ago, the department became stroke certified.

Clot buster medicine supplanted the former treatment, which was little more than “watch and give aspirin.” If the medicine can be given within three hours of the onset of a stroke, there will be better results. It all has to happen with lightening speed. “We have to work with the emergency technicians to get [patients] here quickly, to tell us the time of the onset, so we can call radiology and say a stroke patient is coming in, get the cat scanner ready—then work with the neurologist, then with ICU, the telemetry unit and ready speech pathology—every aspect of the hospital,” Puccio said.

“It’s a huge effort, but, once again, every minute counts or brain tissue dies.” All current ED physicians are trained in emergency medicine and are board certified. “We’ve maintained all those original goals made in 1995,” Puccio says with pride.

The ED director is grateful that Inova Loudoun has made emergency medicine such a priority. “They recognize we touch about 70,000 patients per annum. It could be as minor as a bee sting, or major, like a car accident, stroke or heart attack or asthma.”

The next goal is to have more specialty care for pediatric patients, Puccio said, including for pulmonary, cystic fibrosis, orthopedics or endocrinology, for which currently the hospital has to rely on Fairfax. He’s like to develop a step-down unit and a pediatric intensive care unit. Those are long-term goals.

In general, Puccio and his staff would like to become traumacertified, to do in the short-term more neurosurgery. “I think we’re right on the edge of incorporating some of those services here,” he said.

“We have a goal to exceed the expectations of the community with regard to emergency care. To go beyond.”

Cardiology Comes Of Age

Probably one could find no better measure of the progress of the long road from the 18-bed Leesburg Hospital founded 100 years ago on West Market Street to today’s Inova Loudoun Hospital than the changes in cardiology. Just over the past 30 years innovations have been remarkable.

And it all began with Bob Herron, a physician widely recognized as the first true specialist to arrive permanently on the Loudoun scene. From difficult beginnings in Loudoun his practice and the physicians he gathered to join him have evolved to a degree of sophisticated treatment for ailing hearts that might not have been imaginable in the late 1970s.

The very idea of today’s Heart & Vascular Institute at Inova Loudoun Hospital might have seemed a far-fetched mirage to physicians 30 years ago. Dean Pollock, who is medical director of the Cardiac Cath Lab and director of Cardiac Rehab, knows it is no mirage as he and his colleague Cary Marder have experienced first hand the enormous changes wrought in cardiac treatments over those years.

When Herron, who received his medical training at St. Louis,

came to Loudoun in 1979, it was a different world. He was the first specialized cardiologist, the first board certified internal medicine physician to come to Loudoun. Internist Jack Cook, whom Herron cited also as a “medical pioneer in Loudoun,” arrived a couple of years later. With George Poehlman, Cook and Herron, cardiology began to come into the mainstream.

Herron began his practice in Northern Virginia and life was difficult for him at first, Pollock said. He came out to the hospital in Leesburg, and for the first several months he got little or no response; no one asked him to consult.

“He was threatening to general practitioners,” Pollock said.

One day, Herron got chatting with another doctor, who finally said, “This is not a good idea. You’re too educated to come to Loudoun.” But Herron persisted and eventually got accepted in the Loudoun medical community.

As Herron got busier, internist and cardiologist Marder joined the practice, the two having met earlier in St. Louis. “He was an ice breaker,” Marder said of his friend and colleague.

Continued On Next Page

32

Loudoun Hospital ­— A Century Of Service

Cardiology Continued From Page 31

The earlier difficulties smoothed away and by 1986 the practice was well established in Vienna and Loudoun, and growing ever busier and in need of extra physicians. In 1986, Pollock left the Cleveland Clinic and came to Northern Virginia in response to Herron’s advertisement.

“I loved the area and was impressed with the guys,” he said, describing Herron as having “a magnetic personality.” He joined the practice, which just kept growing, attracting more physicians and subspecialists. Today, the Cardiovascular Group PC has more than 37 physicians and is the largest single specialty cardiovascular group in Northern Virginia. The practice was recently renamed Virginia Heart.

“It all started with Bob Herron’s vision,” Pollock said. The reality of heart treatment at the hospital in Herron’s early days was far from that vision. “If you had a heart attack, you prescribed bed rest and hoped for the best,” Pollock said, citing a mortality rate of 30 percent to 40 percent. If the patient survived, it would be with a “very damaged heart.”

Marder recalled when he was in the Navy seeing a young man who was having a heart attack. “There was nothing to do except give him morphine,” he said, vividly recalling being in the ICU and watching him die over eight hours. Likewise, in the early 1960s, when his father-in-law had chest pains and was told to go home and rest, he did and died in bed.

Slowly things changed with more advances in treatment—clotard Aw or d oct ard Awar D Aw or op A T hoice Doct V ern t C ate rth ien on No 1 Pat passi 12 20 201 t Com s Mo 11 20

busting drugs to restore proper blood flow in the heart, beta blockers, ACE inhibitors, angioplasty to unblock clogged arteries and stents to keep them open, statins to combat high cholesterol, pacemakers and catheterization labs. Another long practice is also changing—the ability to treat more heart conditions in Loudoun, rather than having to send patients to Inova Fairfax Hospital.

The establishment of the heart catheterization lab at Loudoun in 2005 was a milestone. Funded by the Schaufeld family, the technology has proved a godsend.

“We used to keep patients in the hospital for one or two days then transfer to Fairfax,” Pollock said. The heart cath lab is important because it shows pictures of the blocked arteries. “We can see how severe the blockage is and decide on the best treatment,” Pollock said.

Previously, balloon technology would be used to open up the artery, but not always enough or they would close again. In the mid1990s, the first stents appeared—“a huge advance,” Pollock said, noting they provided a permanent structure to keep arteries open during a coronary intervention. Once stents were in, “we could fix almost every problem,” Pollock said.

At the time all that was being done only at Fairfax Hospital. In 1995, Pollock was head of critical care. It was “Ed Puccio who said ‘we need all that at Loudoun.’” With the Schaufeld family donation, Loudoun got a cath lab, at first for diagnostics only. Then in 2009 Pollock started coronary intervention, with no surgical backup. To get a patient coming in with a heart attack “from door to balloon inflation” takes about 90 minutes. Before the physicians had the ability to do the procedure at Loudoun—having to call the helicopter to get to Fairfax—that time frame was almost impossible and the patient would lose too much heart muscle. That ability to intervene over the past four years has made all the difference for Loudoun patients, Marder said.

There are now two cath labs, one for coronary use and an interventional radiology lab. Eventually, Marder said, there will be three or four cath labs. Inova has always been supportive of cath labs, Marder said. “I’m very proud of this hospital.”

Looking back on his internship days 40 years ago, Marder said “anything we’re doing now they basically would have laughed at.

Now’s its normal; blood thinners are standard of care, but in the early ‘70s they didn’t do it, no one believed in it.”

Marder recalled when he was an intern in the ICU, there was a doctor who put his patients on blood thinners. “We laughed at him, thinking, ‘dodgy old fool’—he was 45—God knows how many lives he saved,” Marder said.

For the future, Marder foresees more stents, statins, exercise values, probably open heart surgery at some point and maybe bypass surgery.

New, big clot-buster medications are coming on the market and the next step up will be drugs to increase good cholesterol.

“I’ve enjoyed my ride,” Marder said, regretting only one thing—the death of his good friend Herron from lung cancer two years ago.

Putting things in historical perspective from the days when one had to watch someone die before you because you didn’t have the wherewithal to save him, Marder said, “Today, you don’t die of a heart attack. In the ‘70s you did.” In the ‘70s, 50 percent to 60 percent of heart attack patients didn’t make it to the hospital. Now the mortality rate is 20 percent and dropping. “We were like Albert Schweitzer in the jungle,” he joked. “There were no cell phones, and we knew every pay phone on Rt. 7 between Fairfax and Loudoun.”

Loudoun Hospital ­— A Century Of Service

33

Robots Revolutionize Joint Surgery

The merger of Loudoun Healthcare Inc. with Inova Health System has resulted in many changes, not the least of which is the arrival of more specialists and new technology that has altered our perceptions of what can be done, pushing the frontiers of what once seemed the outer limit.

And perhaps nowhere is that new technology so noticeable and revolutionary as in the orthopedic field. For years, comic books drew a portrait of a future in which robots ruled the world.

Today, we are seeing that become an amazing reality.

Loudoun Spine surgeon Dr. Ali Moshirfar came to Loudoun in 2006 from Rockville, MD, joining the Loudoun Medical Group shortly after the merger with Inova, and becoming a colleague to Ian Wattenmaker, Michael Kavanaugh, Matthew Gavin and, more recently, Nauman Akhtar.

Moshirfar has been chairman of the orthopedics department at ILH for more than a year, ever since he succeeded longtime Loudoun orthopedic surgeon James T. Gable, who retired last year and is now an emeritus member of the committee. There are 36 doctors in the practice, 15 of them podiatrists and 21 orthopedic physicians.

“For orthopedics, it’s a very exciting time,” Moshirfar said.

One of the first things he did after Akhtar was hired was to work with him and CFO Glenn Zirbser to “get the MAKO robot.”

“The technology is amazing,” Moshirfar said of the costly— $1.4 million—equipment—“too much.” So far, the hospital has not sprung for the hip replacement software. The technology may also one day be available for spine surgery, although that’s more high risk. “We’d need more volume for difficult cases, and we don’t have that as yet.”

The practice involves all kinds of orthopedic surgery: spine, hip and knee replacements, sports fractures, as well as a lot of hand and foot surgery. Moshirfar is an associate professor at Johns Hopkins University in Baltimore, MD, where he trained and is a part-time professor.

While Moshirfar has done robotic surgery for almost nine years, the MAKO technology is someDr. Akhtar and Mako thing else. “The new technology involves minimally invasive surgery, but there’s so much more we can do,” he said of the improvements for shoulder, hand, foot and ankle, and sports injuries. And more and more surgery is being done through cameras and outpatient surgery.

The incisions involve only a small slit on the skin. “It’s very exciting,” Moshirfar said of the technique. One of the challenges is to achieve fusion when using the newer implants. “Before, you’d have to take bone from other areas; that was very painful.” Now you can use artificial bone. “You don’t have to take huge chunks out of someone’s body any more.”

Akhtar was specifically hired two years ago for his expertise as a joint specialist. Born and raised in Michigan, he came to Wash-

Continued On Next Page

Compassionate Care For Those With Cancer

If the dread word “cancer” conjures up a big capital C in our minds, those caring for cancer patients at Inova Loudoun Hospital are ready to dole out a large helping of another and equally large C—compassion. The disease brings a high emotional reaction and staff members at the Mary Elizabeth Miller Radiation Oncology Center at ILH do everything they can to address that side of the affliction.

Whether it is the medical or organizational skills of Oncology Radiation Medical Director Dr. Kin-Sing Au and department director Punam Dutt or the caring qualities of breast cancer advocate Barb McDonnell, lead mammographer Stephanie Carr and social worker Karen Archer, patients receive equal doses of expert treatment and loving attention to meet their needs.

Trained at John’s Hopkins, Au has been at the hospital for about 20 years. Chemotherapy uses a drug, usually a complex chemical—which is typically taken by mouth or injected into the patient’s vein—to treat cancer. As it circulates it absorbs into the body. “It’s somewhat harmful to the cancer cells and can harm other structures indiscriminately,” Au said. Because the chemo circulates through the blood it is hard to avoid side effects.

Radiation, on the other hand, is a high energy X-ray. “You can direct where it goes,” using different angles and beam inten-

sity, Au said. Both machines and computers have become much more sophisticated over the past decade—allowing the radiation to be precisely targeted. And that, in turn, lessens the side effects.

Because the radiation is not circulating around the body, it can be customized for each patient and critical structures, such as the heart, liver or kidney, can be avoided while therapists can image to identify exactly where the tumor is.

Radiation can come from multiple beams, or from a rotating machine, and the intensity and shape changes as it rotates.

The computer calculates the amount needed. The first step in treatment is to produce a 3-D rendition of the patient’s anatomy by identifying where and how large the tumor is through imaging studies and where the normal structures are so organ tissues can be avoided. The second, and most critical stage, is planning; how to determine with the computer the best way to give the radiation.

All the variables are entered into the computer to help decide how best to “optimize the delivery,” Au said. The skill lies in visualizing the structures and working with the computer to get to the tumor with as little damage to surrounding tissue as possible. The final stage is the actual delivery. The patient has to be in the exact same position he was in when the imaging took place.

Continued On Page 35

34

Loudoun Hospital ­— A Century Of Service

Surgery Continued From Page 33 ington, DC, with the National Institute of Health, then went to Boston and on to Detroit, MI, for his residency and subsequently to New England Baptist Hospital, renowned for its orthopedic specialties.

“I was recruited here to take the lead on total joint replacement. When I was training in Boston I specialized in hip, knee and shoulder revisions—re-dos of hip and knee replacements that are worn out or loosened, or with infections,” Akhtar said.

Akhtar directs the hospital’s total joint program. “We’re one of the few to have the MAKO robots,” he said. There are only 100 in the country and the Inova Loudoun MAKO robot is only the second in the Washington, DC, area, the first being at Inova Fair Oaks Hospital.

The MAKO robot is perfect for partial knee replacements.

It’s a robotic arm with a small cutting tip at the end, which cuts, aided manually by the surgeon. “Eventually, we’ll be able to do hips,” Akhtar said. There’s a large population—people between the ages of 40 and 65—who increasingly have arthritis in part of their knees as sports-related injuries are on the rise, a difficult proposition to treat. Previously, Akhtar said, the option was to “get them going with injections, pills and exercise. Now one can do a partial, rather than a total, replacement, which would wear out.” The new technology surpasses the results of the past partial replacements in which the implant was difficult to put in and

Congratulations on 100 years of innovative care and creating jobs

www.leesburgva.gov

would fail within 10 years.

“With the new technology, it will last 15 years or more.

It will buy time.” Over the last two years, Akhtar has done computer navigated hip and knee replacements. And that’s the fascinating part of the robot. “It communicates with my trackers in the [patient’s] body with infra red technology” and helps with pre- and intra-operative planning. “We’re pushing the envelope of using technology in patients, with better results,” Akhtar said.

The computer navigation technology has been around for some time, and the new robotic equipment adds the extra factor of removing bone. “That’s where the precision comes in. You do a pre-op CAT scan of the knee and it melds with the anatomy of the knee.” Begun a decade ago, the technology is still relatively new.

“All it’s doing is letting you put it exactly where you want to put the implant.” The CAT scan of the knee and all the bony detail is mapped out by hand, and the data transferred into the computer. Recently, Akhtar went through the computer program with the company representative, on the day the surgery was scheduled, telling him “these are the implant sizes and this is where I want them.”

When he opens the knee, sometimes he finds more arthritis than he’s expected—sometimes he can change how he will operate or maybe recommend a total knee replacement. In the operating room, Akhtar decides how to go forward, then matches up the computer images with the live tracking to know where the implants will sit. “The computer says ‘doc, this is how loose or tight the knee will be.’” He can fine tune that by one-tenth of a millimeter on the computer, to lock it in—then brings the robotic arm in.

The beauty of that is “I can’t go outside the lines,” Akhtar said.” The final cut places are already preplanned and locked in on the computer. Given that precision, the technology has become so good the incision is sometimes only 10-12 centimeters, resulting in “better outcomes.”

Amazingly, half Akhtar’s patients leave the next day, in contrast to a total knee, which takes two to three days and requires much more therapy. “When you do a partial, you control the [robotic] arm, so you are cutting in fact. I am doing the surgery, but instead of a free-hand sawblade, I’m using a small tip bone cutter attached to the robotic arm, but doing it manually.”

The big advantage lies in the preplanning to gain precision and the arm helps guide the surgeon. It makes the surgery faster, the bone removal is always perfect, leaving a free hand if there is a need of adjustment. “We try first with trial components—and it’s always perfect every time. It’s changed the way we do these surgeries.” Best of all, Akhtar said, he can better meet the need of younger patients with arthritic knee problems, sometimes debilitating, or patients needing re-dos. “It’s an amazing alternative to what they’ve been living with.”

Akhtar sees more and more technology coming into his work, as well as a need for better pain controls. “My technique is to pre-medicate so I can stop the pain starting, inject while the patient is asleep before the surgery. It’s a pain cocktail of three medications, which I squirt all around inside.”

Moshirfar, who now and then does very complex surgeries at John’s Hopkins, looks to the future. “I’d be so happy to be able to do them at Loudoun. It’s a great department, and all the surgeons are well trained, very conservative and very ethical.”

Loudoun Hospital ­— A Century Of Service

Cancer Continued From Page 33 Possible side effects depend on the strength of the dose—“the more we give, the worse the side effects,” Au said. Skin, muscle and bone are resilient, but sensitive treatment areas like the stomach may produce nausea and vomiting, or the bladder can get irritated.

Better technology has produced increased cure rates and also reduced side effects. The big change over the past decade has been in computer ability, Au said. “We’re constantly evolving; it’s incremental improvements as the computer provides more ability to control delivery.”

Dutt serves as administrative director. She came to Lansdowne shortly after the hospital moved from Leesburg. She began her career as a radiation therapist, then became a certified dosimetrist, calculating the amount of radiation therapy needed. She became director of the unit in 2000. She has retained her dosimetrist skills and if she is short, “I can jump in and do it.”

The linear accelerator is a powerful machine.

“It doesn’t know what’s good or bad [tissue]. We plan to target the tumor volume and try to spare the normal organs and tissues around it,” she said, noting “our goal is to provide care for patient at the utmost quality and safety.”

“Because it’s a high energy beam, no one can be there in the linear accelerator room with the patient. But we monitor them on screens outside and talk to them through an intercom. The patient doesn’t feel anything, nothing touches, but they must remain still,” Dutt said, adding the beam is on anywhere from seconds to a minute. “You’re in and out of the department in a half hour.” Treatment lasts from two to eight weeks. The oncology center is accredited by the Commission on Cancer and the American College of Radiology.

“We try to help with patients’ fear through educating them, showing how treatments work, how long they take, what will it involve, side effects, etc. We address their issues as they go along,” Dutt said, adding everyone on the staff of about 15 is very compassionate. “They really care about each and every individual.”

That care extends to large friendly dogs that greet patients as they come for treatment. It also comes in the form of McDonnell, an ebullient woman with a warm, engulfing personality, who is a breast care navigator and patient care advocate. She deals with the reactions of patients and their families. “A diagnosis of breast cancer gets a very emotional response,” she noted. Most women, however, amaze her. “They’re devastated at first, then once they’ve had that they’re really ready to fight.”

A former registered nurse in the OR, McDonnell has had breast cancer herself, so becoming a breast care navigator was very important. “When you’re diagnosed with breast cancer, you want to help others faced with mortality.”

“When husbands come in I ask them ‘are you OK?’ Sometimes they tear up, others say, ‘I’m fine.’ I take it to them—‘she needs you.’”

She tells husbands “I understand how you feel; you love her and now she’s got this disease.” Most are really amazing, and bear it well. “I tell them, ‘You have to man up. I need you to be there.’”

35

Sometimes families can’t manage that emotional support, she said, and sometimes the patient shuts it out. “That shocks me, I can’t imagine going through it without family. But, it’s all about them, and I have to respect that.”

Carr has been giving women mammograms for 15 years.

She’s always worked in radiology from the day she started as a parttimer at 22 years old. She didn’t really want to continue: “At 22, you’re still clueless, but I grew to love it and the interaction with

patients.” She has a calm and serene demeanor. Her job is not to advise a patient or comment on a result, and when a patient asks after she’s taken the X-ray, “how does it look?” she avoids a direct answer.

Any woman will tell you the procedure is unpleasant. It can be painful and it leaves the patient feeling undignified. But, technological improvements over the past decade have been night and day, Carr said. “In 1996 I was doing screen film. Taking the picture, taking the cassette out and putting it in the processor took so long.” In 2000, the unit got a daylight processor. It did the processing, and spit the result out. “No dark room, did it in 90 seconds,” she said. Then in 2008, “we went digital; patients are in and out in 15 minutes instead of 30 minutes.”

And people who usually are scared to death, when they get the digital mammography, say, “Oh, it wasn’t as horrible as I thought it would be.”

For patient Kristi Drummond, who had multiple myeloma, Dr. Au and the team at the center have been wonderful. She found out she had a tumor when she broke her arm badly. She did her radiation treatment in September and October last year. “It wasn’t a great thing to have to go through, but everyone was so kind.”

And they’re comforting, but also funny and made her laugh. “Just what you need.” Archer’s support classes have been invaluable, she said. And she’s still attending them. “The classes I took got me back into a passion for nutrition. I want to help people do what they do best,” so she’s going to school to get an online degree in nutrition.

“A big part of fighting the disease is helping others to fight and help provide wellness.”

36

Loudoun Hospital ­— A Century Of Service

On The Front Lines Of Care

Every one of the more than 500 nurses on staff at Inova Loudoun Hospital has a story to tell. Although they share similarities in their daily work—their schedules, the petty inconveniences, the sometimes trying or great relationships with a colleague or doctor, the funny moments or the times of immense satisfaction when they’ve helped a sick patient—each one’s story is different.

But, while there have been many changes over those years, including the huge impact of technology and increased quality of training, at its core each nurse’s task is fundamentally the same—to be part of the healing process for a sick person in the hospital.

Below, we touch on the stories of just a few representatives of that caring army.

Janell Hoffman is unusual in that she is both an ICU nurse, on an as needed basis, and a member of the ILH Foundation Board. She began her career as a nurse in Loudoun in 1990.

After having worked her way up, she tried management for three years, but was miserable. “I got back to patient care. I did it in a heartbeat.”

Like many of her colleagues, Hoffman said the nurse’s role places her in the middle of a three-way relationship between doctor, nurse and patient. If the physician is the diagnostician and the one who orders the treatment, nurses are the implementers and evaluators.

“[The physician] says what’s wrong and gives treatment.

Our job is to evaluate why she’s teary eyed, or what’s lacking,” Hoffman said.

And part of that evaluation can involve direct action on a nurse’s part to rectify a patient’s emotional distress.

Hoffman once pulled off such an action, which she calls “her proudest moment,” although, at the time, she thought she was going to get fired. A horsewoman, Hoffman was sympathetic to the emotional yearnings of a man who was terminally sick and who knew he would not be going home. He owned a horse, of which he was very fond, and whose pictures lined the walls of his room. He told her, “I want to go home and I want to see my horse again.” So she took action to ensure at least part of that wish.

“I snuck a horse into the ICU, here in the old ICU on the ground floor by the heliport [at Lansdowne],” she said. The whole ICU team was in on the secret. Hoffman “stole a key from the maintenance department” to open the window.

“The horse put his whole head and neck in the window; we moved the man’s bed over so he could pat his horse,” she said.

“After seeing his horse, he lit up. He would tell the story of how the horse came to his room,” Hoffman recalled.

Five days later, the man died peacefully.

Senior Director of Nursing Marissa Putman grew up steeped in the medical world, her father a radiologist and her mother a child psychiatrist. She began her career, first as a candy striper, then as a nurse’s aide in the telemetry unit at Cornwall before becoming an RN in 1989. She left the area but returned in 1995, becoming first a nurse in radiology and then ICU staff nursing supervisor. Like Hoffman, she “dabbled in manage-

ment,” and was one of the first to go through Inova’s Nursing Administration degree program.

Unlike Hoffman, however, administration proved more of a natural fit for Putman. She managed the ICU for three or four years, but when her former boss, Lisa Dugan, was promoted to director of critical care, Putman assumed her duties as senior director of nursing and patient care director.

As chief nurse, “I carry the patient’s voice to administration,” she said, calling that a “vital role.” She loves her function as overseer of the hospital’s nurses, whom she calls “beautiful care givers.”

Patients don’t stay as long in hospital as they used to, about three days, and they go home while still sick and recovering.

“Our job is to help prepare them to continue at home; its much more of a teaching and multi-disciplinary role,” she said.

“Patients don’t want to be here, but they trust you to give them what they need.” And she’s proud that while so much has changed in the medical and nursing field, “We haven’t lost that small-town feel. Time contracts when you only have three days,” she says.

KC LeBlanc sees a different kind of patient population.

She’s the team leader for Inova Loudoun Mobile Health Services.

She’s in charge of about 14 nurses and tasked with providing flu shots, blood pressure screenings and other services all across Loudoun—and now, through the Mobile Hope Program, assistance to children without enough food or adequate accommodations.

After becoming an RN, she got a job at the Cornwall hospital in downtown Leesburg and worked nights for many years.

She liked that. “There were no distractions; you could do your job,” she said.

About six years ago, LeBlanc transferred to the mobile health unit, which she has led for the past three years along with co-leader Lisa Evans. “Our nurses have to do everything,” she said.

That includes, seven days a week, going to the homeless shelter at nights to give flu shots, pick up homeless people near the airport and clinics at the hospital for employees.

Some of her most fragile and poignant “patients” come to her through Mobile Hope, a program supervised by LeBlanc’s boss Director of Community Affairs and Director of Mobile Health Services Donna Fortier.

The mobile health unit serves about 650 “precariously housed kids, sleeping in cars, on couches, or in homes where there are five families to a room,” LeBlanc said. “We go around the area looking for them,” providing food, warm coats, clothing and blankets, in conjunction with the school system, local churches and the county.

In a reminder of how much even a simple item can mean to someone in need, LeBlanc recalled one little girl who came with her siblings. “We gave each girl her own toothpaste and toothbrush.

“My own toothbrush?” the girl enquired, ecstatic.

Last year, the department had 18,800 “community touches” overall.

Loudoun Hospital ­— A Century Of Service

37

Nurses: The Other Half Of The Healing Process

If doctors form the central core of any medical institution, nurses and the assistance they provide to both physicians and their patients are essential elements.

The one can’t do without the other. As one nurse put it, “The doctor has to make the diagnosis and provide the treatment. The nurse’s role is to care for the patient and often help the patient understand that diagnosis and treatment as he or she moves through the process.”

And that relationship, while changing, has always been strong at Loudoun’s hospital, from the earliest days when there were only a few nurses at the first location on West Market Street to today’s nursing staff of more than 500. The founders took nursing very seriously, opening a training school for nurses that same year.

The nursing role has deep historical roots. While today’s nurses have more independence of thought, expression and dress than in years past, there is still a definite line beyond which a prudent nurse does not go in the physician-nurse relationship.

In the early days of Loudoun Hospital, the doctor was almost always male, a figure of authority, almost God-like, whose word was law to both patient and nurse. The lessening of that authoritarian relationship over the years has not diminished its efficacy; rather it has increased the care both give through a better understanding of and respect for the responsibilities and abilities of each, according to some nurses.

While today’s nursing force does include men, some 5 percent nationwide, it is still overwhelmingly female and it is the nurse who spends the most time with her patient. She gets to hear all about their families, and sometimes gets to know them. She gets to learn her patient’s funny little characteristics, and, mostly, be tolerant of them. Most important, she gets to know their fears, and helps calm them, help them through the worst of them. She often is an effective advocate for her patients, with administration or the physician, because of the extra knowledge she gains through being close to them.

Today’s nurse has to be intelligent, well educated and thoroughly steeped in the intricacies and requirements of first-class nursing care. She is a far cry from the pre-Florence Nightingale days when a nurse was frequently a slatternly drunk, with little knowledge or care for a patient. She has to acquire rigorous credentials if she is to gain admission into the hospital of her choice.

Would-be-nurses today apply to top nursing institutions in as competitive an atmosphere as for any other degree.

Since Loudoun started as a small community hospital, with many in Loudoun not convinced it was necessary, it comes somewhat as a surprise to find that Loudoun Hospital had a nursing school from the beginning. A comfortable Nurses’ Home with dorms where nurses could sleep or take breaks was built at the Cornwall Street hospital in 1926. Although the school did not survive and the Nurses’ Home was pulled down as part of the 1974 hospital construction, support for nursing education has remained strong. The Ladies Board, which financed all the furnishings at the Nurses’ Home, has provided more than $82,000 in nursing scholarships through its Lights of Love memorial program.

And that focus on nursing quality and training has seen the hospital reach the coveted Magnet certification for nursing excellence twice consecutively, in 2006 and 2011.

One longtime Loudoun Hospital nurse, Joanna Boxwell, who

retired in 2004 as a nurse in outpatient surgery, looked back on her 43-year nursing career, recalling those more authoritarian days.

“You stood when a doctor came in. That was the relationship,” she said. “Certainly, their word was law. If they said do something, you did it,” she said, even if she didn’t agree with the action. She agrees today’s nurses have more freedom to disagree.

And that’s not a bad thing in some circumstances, she says.

On the other hand, the country doctors with whom she worked when she arrived as a registered nurse in 1961 after training at Winchester Memorial, “gave wonderful, excellent care,” according to the knowledge they had then. She was referring to doctors like William Frazer, Keith Oliver, John Wynkoop, Joe Rogers, Jim Towe, and J.T. Jackson. Despite the huge advances in medical knowledge through technology, better diagnosis and treatment options today, those earlier physicians often had a more intimate relationship with their patients.

“Those were the good times,” she said. “Doctor Oliver made house calls. He’d eat dinner with you and would sit and talk on the porch. We’ve lost something.”

Boxwell started her career at Loudoun as a candy striper in 1957/58, then went to Winchester for training before returning to Loudoun in 1961. It was not until the 1974 hospital was built that Boxwell said she started to see a little change in that previous boss/ subordinate relationship and attitude. And that change became more marked when the hospital moved from Leesburg to Lansdowne.

Women’s Healthcare Associates

Find a Healthy Lifestyle Women’s Healthcare Associates is a practice of providers consisting of a Board Certified Obstetrician/Gynecologist and Women’s Health Nurse Practitioners. We are dedicated to working together as a team to better serve you.

Women’s Healthcare Associates Services Include: • Normal and High-Risk Obstetrics • Contraception Counseling • Female Cancer Screening • Treatment of Endometriosis, Fibroids, Ovarian Cysts & other Pelvic Problems • Natural and Medical Management of Menopause • Health and Wellness Counseling • Essure

• Natural Childbirth • Infertility Evaluation and Treatment • Treatment of Premenstrual Symptoms • Adolescent Gynecology • Advancement Laparoscopy and Laser Techniques • In-Office Procedures for Heavy Bleeding (Ablation) • Out-Patient Laparoscopic Hysterectomy

Chauncey C. Stokes, MD FACOG Chairman of OB/GYN Department

Jessica Braun, MSN, NP Cynthia Stone, MSN, NP

703-858-3230 www.whcal.com

44055 Riverside Parkway • Suite 220 • Lansdowne, VA 20176

38

Loudoun Hospital ­— A Century Of Service

A Century Comes Full Circle: The Orrs

It all began with a dream and late night planning in a smokefilled back room at a Leesburg pharmacy. One hundred years ago, in June 1912, four men created a vision to open a hospital in Leesburg that would bring medical treatment out of the heretofore almost exclusively private realm of the home and provide care in the county.

Two country doctors, a pharmacist and a medical superintendent—those four individuals set off a train of events, of triumphs and disasters, that would culminate in today’s medical scene in Loudoun. Drs. John A. Gibson and William Clayton Orr, Horace C. Littlejohn and P. Howell Lightfoot had the backing of 11 likeminded citizens and, most importantly, the support of their wives and other women of the community. Shrewdly, and truthfully, the men told their wives, “We can’t do it without you,” an appeal that found its mark.

Two weeks after the hospital opened in Capt. Garrett’s handsome brick house on West Market Street in Leesburg, the women established their own association—the Ladies Board of Managers—and formed a support organization whose history is inseparable from that of the hospital.

The Ladies Board, as it became known, provided an essential quiet moral support and financial assistance that was crucial at key times in the hospital’s history.

From six small rooms in rented space in Leesburg, Loudoun’s hospital would evolve into a sprawling medical empire that spans the county. From simple bone setting—the first two patients reportedly were jockeys, who had broken their legs after being thrown from their horses—to sophisticated surgery by robot, the hospital has evolved to provide an array of services to the community that would have been unimaginable a century ago.

What sets the story apart is the determination and verve of the founders, the stalwart backing of their womenfolk and the everpresent support of the community. Through thick and thin, and there have been some very thin patches in the story, “the hospital” has always had the community at its back. No longer an independent rural community hospital, but a flourishing member of a fivefacility health care system, there is still that strong community base and connection as Inova Loudoun Hospital stands on the brink of becoming the next tertiary hospital in the region.

What also characterizes the story is that the hospital’s growth, particularly in the last half century, has been matched by growth of the community. The hospital’s story has marched in lock step with that of Loudoun as growth west of Washington, DC, expanded steadily after World War II and then exploded in the last quarter of the 20th Century.

What those four men achieved was not easy. Drumming up support for the venture in a somewhat skeptical community, getting the needed financial backing, the physical management and supply component took a lot of footslogging and hard work.

After incorporating in January 1912, the four set about raising funds and leasing space. They established a 15-member Board of Directors. Orr served as president, Gibson as vice president and Littlejohn as treasurer. Dr. Truman Parker was secretary. They had $100 in the bank and pledges for $2,000 when they leased the space and furnished the six rooms, including a bath, a hopper and an outmoded gasoline sterilizer. Lightfoot was appointed superintendent and manager of the hospital, while Catherine Oxley was named

superintendent of nursing, with one “pupil” nurse to aid her.

The flashback to those early weeks after the opening June 5, 1912, is imprinted on the eye. The contrast between now and then could hardly be greater; from today’s being wheeled into surgery flanked by nurses and medical personnel to the scene of those first two surgeries in Leesburg, when the (mercifully anesthetized) patients were carried manually up winding stairs to the operating room off the side porch to be operated on by visiting surgeon Dr. Charles S. White, from Washington, DC, who would continue his service to the Loudoun community for more than 40 years.

The contrasts continue: from the modern hospital’s extensive supply department from which bed linens and towels appear like clockwork to the reported sight of the clergyman’s daughter “Miss Alice Davis,” hurrying down the street bearing an armful of linen she had assembled from her own linen cupboard and a large tin basin when jockey Pee Wee Rose was brought to the hospital.

Just as doctors today are fond of their sports, some with golf high on the list, so Gibson, Orr and Littlejohn had their favorites— hunting in the case of Gibson and Orr, and all three were ardent baseball fans and players. Orr at one point managed a local baseball club and Littlejohn was renowned for his passion for the game.

We see the men through the prism of history. But their descendants see them from the eye of family recollection. Two of Orr’s granddaughters, Page Glascock and Louise Noyes, live locally. Their mother was his daughter and Orr retired when she was 12. The three men, Orr, Gibson and Littlejohn were great friends and Orr asked Littlejohn to be his daughter’s godfather. Her parents had moved to Leesburg, where they built a house on West Market Street, now Sunrise Assisted Living, and where their mother was born.

The Orrs lived in Hillsboro and their mother would often go with Orr when he went out in his buckboard to visit patients. As was customary in that era, Orr was often paid in kind. “Once he got a pig,” along with chickens, eggs and a “lot of home canned goods,” according to Glascock. In a variation on that theme, Noyes said, once a mother told him “we have no money,” but she named her children in his honor. “There are a lot of William Claytons around,” she said.

Their grandmother, Mary Page, was quite a character. “She loved to gamble, she played poker and she smoked,” Noyes recalled.

The Orrs had seven children—two girls, then a boy, another three girls and a last boy, Robert Orr, who would become an eminent Leesburg doctor himself. Of her grandmother, Noyes said, “All her sons-in-law adored her. They’d come to court the girls and end up playing poker with her.”

Orr loved people and to practice, according to Noyes.

Although he died relatively young, in his late 40s in 1926, “he was fulfilled.” Mary Page Orr died in 1951, after having moved to Texas to live with her oldest daughter. Dr. Robert Orr, ‘Uncle Bobby,’ was born the year before his father died and his nieces remembered him with affection.

“Bobby was wonderful to me. He was our doctor and would do home visits. He’d call me ‘precious,’ and say ‘fresh air is all she needs’ when I had the croup,” Noyes remembered. His office was on Dry Mill Road, next to today’s Catoctin Veterinary Clinic.

And the circle is complete, as a great-great granddaughter of Orr is a pediatric nurse at Inova Loudoun Hospital. He would have found that fitting.

Loudoun Hospital ­— A Century Of Service

Sosun Faqiri, MD, FAAP A Board Certified Pediatrician

Announces the opening of

161 Fort Evans Road NE, Suite 330, Leesburg, VA 20176 Phone (703) 777-5224 www.capspediatrics.com Open Mon, Tues, 8:00 am – 5:00 pm, Wed, 8:00 am – 8:30 pm Thurs, Fri 8:00 am – 5:30 pm, Sat 9:00 am - 12:00 pm, Sun, 9:00 am – 11:00 am

"DDFQUJOH /FX 1BUJFOUT t .PTU *OTVSBODF 1MBOT "DDFQUFE $BMM OPX GPS "QQPJOUNFOUT

Opening August 2012

39

40

Loudoun Hospital ­— A Century Of Service

Dr. Timothy Mountcastle, M.D. Plastic Surgery & Vein Institute

www.MountcastlePlasticSurgery.com

Get ready to make this the best summer ever. With Mountcastle Plastic Surgery & Vein Institute discover a life free of vein disorders, no matter if it is cosmetic or health-related. We offer customizable and comprehensive vein treatments that are minimally invasive.

Varicose Veinever.

Treatment Sclerotherapy Get ready to make this the best summer With Mountcastle Varicose Vein Treatment Plastic Surgery & Vein Institute discover a life free of vein disorders, Spider Vein Therapy Lasers no matter if it is cosmetic or health-related.

We Therapy offer customizable BEFORE Spider Vein

Varicose Vein Treatment Call Sclerotherapy and make an appointment today! 703.858.3208 Lasers Offices for your convenience:

ASHBURN

LEESBURG

44095 Pipeline Plaza Suite 430 Ashburn, VA 20147

AFTERCornwall St., 224-D Suite 304 Leesburg, VA 20176

1860 Town Ce

Call and make an appointment today! 703.858.3208 Offices for your convenience:

ASHBURN

LEESBURG

RESTON

44095 Pipeline Plaza Suite 430 Ashburn, VA 20147

224-D Cornwall St., Suite 304 Leesburg, VA 20176

1860 Town Center Dr. Suite 340 Reston, VA 20190