History of Healthcare in Lynchburg & Southside Volumes I & II by OurHealth Media LLC

THE

HISTORY OF HEALTHCARE

IN LYNCHBURG PRESENTED BY THE PUBLISHER OF OUR HEALTH MAGAZINE

the history of healthcare

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THE HISTORY OF HEALTHCARE IN LYNCHBURG

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McClintic Media, Inc. Stephen McClintic, Jr. | steve@ourhealthvirginia.com Rick Piester | rick@ourhealthvirginia.com Angela Holmes Jennifer Hungate Karrie Pridemore Lauren Coetzee Laura Scott Adapt Partners

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COMMENTS/FEEDBACK/QUESTIONS McClintic Media, Inc., publisher of Our Health magazine, welcomes your feedback. Please send your comments and/or questions to: “Letters,” McClintic Media, Inc. 305 Colorado Street • Salem, VA 24153, 540.387.6482 or you may send via email to steve@ourhealthvirginia.com. Information in this magazine is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2012 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. Our Health is published bi-monthly by McClintic Media, Inc.. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com. Advertising rates upon request.

the history of healthcare

VOLUME I & VOLUME II

TABLE OF CONTENTS VOLUME I

VOLUME II

10.

Introduction

43.

Introduction II

13.

Healthcare Development

44.

Healthcare Development II

19.

Ambulance Service

54.

Ambulance Service II

22.

Epidemics

57.

Epidemics II

27.

Funeral Homes

62.

Heros II

31.

Heros

67.

Nurses II

34.

Locations

70.

Technology II

37.

Nurses

40.

Technology

ABOUT THE AUTHOR Rick Piesterâ&#x20AC;&#x2122;s career has included successful experience as a musician, a newspaper reporter and magazine editor, a healthcare communications executive, a symphony orchestra executive and a freelance writer. He has worked in healthcare communications for more than 30 years, including service as executive communications officer for a large New England health system, and providing communications counsel for the Massachusetts Medical Society, publishers of the New England Journal of Medicine. He is now semi-retired, living and writing in Lynchburg, VA, while he and his wife Patricia make their way through their bucket list. the history of healthcare

Courtesy of Library of Congress

PANORAMIC VIEW OF LYNCHBURG, VIRGINIA, 1909.

VOLUME I

INTRODUCTION

t seems that healthcare and those who practice it have always held a special place in Lynchburg.

some of the people and some of the forces that have shaped the healthcare that we rely upon today.

To this day, physicians are held in especially high esteem. Nurses and other health care professionals are of high quality and are almost universally admired. Centra Health, the mid-sized system that provides much of the care in Lynchburg and surrounding areas, is widely hailed as one of the best in the country.

As unlikely as it seems today, progress has not always been a given. It’s a fairly recent notion. Until late in the 17th century, humankind had suffered more than a thousand years of stagnation, bogged in the intellectual mire that followed the collapse of the Roman Empire.

For more than five years, it has been our privilege to chronicle some of that work. With our two editions serving readers in Central Virginia and in the Roanoke Valley, we at Our Health Virginia have worked hard at fulfilling our mission of becoming a premier resource for healthcare and healthy living information. We hope we have done a worthy job of capturing and explaining the here and now.

Thomas Hobbs, writing in his 1660 treatise on political and social philosophy Leviathan, famously described the contemporary human condition as “solitary, poor, nasty, brutish, and short.” Life expectancy at the time was typically little more than 30, with few people reaching 40 years and fewer still 50. Those who did make it into what was then regarded as old age were wracked by the infirmities and diseases of the very old.

Our work is made easier by the level of healthcare we can rely upon in our community. There are lots of good stories to tell, and in the telling, we aim to improve the health and the lifestyle of the people we reach.

Little by little, however, the concept began to gain ground that people could make their lives better, steadily advance scientific insight, and improve technological effectiveness. Perhaps most profound of all, the idea emerged that we could come to understand the functions of the human body and thereby enhance our health and extend our lives.

But the high quality we enjoy now did not come quickly, and it did not come easily. We believe that to truly appreciate how far we have come, we have to go back to the beginnings. We have to measure exactly how far we have progressed as a community and some of the paths taken to get us here. That’s the purpose of this project - we want you to understand

the history of healthcare

More than 200 years later, in Central Virginia and in much of the country at the end of the 19th century, not a great deal of progress had been made. Society had learned more, many cities were being industrialized, wars had been fought and won or lost, and slavery had been abolished; yet in terms of biological understanding of human life and how its quality might be

enhanced by science, we were still pretty much in the Dark Ages. Even at the turn of the 20th century, average American life expectancy was only about 47 years, and nearly every family lost one or more young children to disease. Only following World War II have such terrible diseases as cholera, polio, diphtheria, and smallpox largely vanished from the American experience. Since then, enflamed by a growing core of knowledge and a dream for better life, bioscience and medicine have bestowed once unimaginable marvels on our age. Our aim with this project is to trace the development of some of these marvels — how they came to Central Virginia, some of the people responsible for bringing them here, and how they affected life in our community. This is Volume One. It covers the period roughly between the settling of the community up to about 1935. Future volumes

— we plan four in all — will explore healthcare in our region, divided by eras right up to the present. We’ll learn how such unlikely events as the 1859 hanging of militant abolitionist John Brown served to boost medical training in Virginia. How the Civil War and Lynchburg’s role as a major hospital center, although it did little to advance medical knowledge, did create some valuable lessons in hospital management and patient care. How a young boy who witnessed a drowning grew up to have a major impact on healthcare, here and nationwide. And much, much more.

So let’s begin.

RED CROSS NURSES MADE LYNCHBURG FAMOUS DURING WWI AS “LUNCHBURG” BY FEEDING TROOP TRAINS STOPPING IN LYNCHBURG.

Courtesy of Lynchburg History and Jones Memorial Hospital the history of healthcare

the history of healthcare

HEALTH DEVELOPMENT

n the mid 1850s — at about the same time that it was officially chartered as a city — Lynchburg, Virginia was one of the wealthiest cities in America.

century, Lynchburg would be a major transportation center with coal, iron, and steel joining tobacco to be carried on railcars passing through town.

Shortly after its early settlement, Lynchburg was a tobacco town. Growing it, selling it, buying it, and processing it were the principal occupations of the town, and those who engaged in the trade reaped fortunes. It was so important that Lynchburg, along with the whaling city of New Bedford, MA, were the two richest cities per capita in the nation.

There is very little written history of healthcare during this period. In those days, a person with an illness or injury was most often treated at home and cared for by family or neighbors. If the ailment became acute, then the doctor was sent for, under emergency circumstances. It is difficult to think of a doctor at the time without also thinking of him traveling at any hour to the home of a patient.

The city’s prominence in tobacco can be traced to the very same factors that brought much of its success, and some of its tragedies, through all of its history — transportation. Long before the white man appeared, the Monacan tribe of Native Americans had plied the James River with their canoes. In 1757, the ambitious, 17-year-old John Lynch began a ferry service across the river for the benefit of settlers traveling west and traders headed south to what was then the Bedford County trading town of New London. Later, the river route would be augmented by the James River and Kanawha Canal, to be closely followed by the addition of three railroads. By 1818, tobacco entrepreneurs had established seven tobacco warehouses. Tobacco processing plants turned the dark leaf into plugs for chewing or to be cut or scraped for pipes. Processing tobacco for cigarettes would come in the latter part of the 19th century. The number of tobacco plants would eventually reach 57. Further fortunes would be made in the marketing and transport of tobacco. By the 1830s, Lynchburg would handle about 100,000 pounds of the leaf each year, making it the largest such center in the United States. Courtesy of Co-op Extension, Virginia Tech

And by the middle of the

It is also unclear how many physicians were in practice in the Lynchburg area. There may have been about a dozen. That there were even that many may well have been the result of an event that had the improbable outcome of a new emphasis on physician training in Virginia and in the South – the hanging of militant abolitionist John Brown. In the late 1850s, most southern physicians had been trained in northern medical schools. There were medical schools in the south; in Virginia, the primary schools were at the University of Virginia and at the Medical College of Virginia. But the northern schools dominated, despite arguments from a growing chorus of southern physicians, including those in Virginia, that the practice of medicine was different in the south. The science was basically the same, they argued, but the distinctiveness of southern climate, population characteristics, and health concerns forced southern physicians to readjust much of what they had learned when they returned home to practice. The winds of change blew from the political arena. In 1859, Virginia students in northern medical schools were shocked and angered by John Brown’s bold raid on the federal arsenal at Harper’s Ferry. Although he was white, Brown planned to start an armed slave rebellion in the south. Southerners were further enraged by northern marches in protest of Brown’s hanging on December 2, 1859. Encouraged and financially supported by southern medical educators, the students ‘seceded’ from their medical schools –

CENTRAL VIRGINIA TOBACCO FARMER.

the history of healthcare

Courtesy of Library of Congress RANDOLPH-MACON WOMAN’S COLLEGE, 1894

300 alone at the University of Pennsylvania and at the Thomas Jefferson School of Medicine — and moved to southern medical schools in Richmond, Charleston, and elsewhere. As a result of what was called the “Philadelphia stampede,” Virginia finally had viable medical schools.

What had been high hopes for a brief, glorious, and victorious war were replaced by horror and anguish. The city was almost clear of the first wave of soldiers heading to battle when city residents heard of the Confederate victory at First Manassas. Then trains began arriving with war casualties.

But the distinction soon became meaningless. The training of those

As a tobacco town, Lynchburg was almost providentially ready to

who had transferred to medical school in Virginia and elsewhere in the south was soon to be tested, and altered, by the coming of the Civil War.

fulfill its major role in the war. Handling tobacco required plenty of space. The warehouses were huge buildings for the time, with a lot of vacant areas for wagons to unload and space to let tobacco be baked by the sun. The tobacco factories were also spacious and low buildings, again surrounded by vacant space to accommodate wagons. There were a fair number of hotels downtown with numerous rooms. And Lynchburg College (no connection to the present day college) had been operating for a few years in a very large building close to downtown Lynchburg. These were all qualities that would be needed for the care of the ill and injured throughout the war.

In Lynchburg, there were mixed and conflicted feelings about the issues that threatened to turn into war. There were slave owners in the city who had freed their slaves, and others were engaged in rewriting their wills, planning to free their slaves. Many people hoped that cooler heads would prevail and that the prospect of actual armed conflict would somehow pass. But John Brown’s raid enraged Lynchburg, and the city went on full alarm and raised a strong local militia. Yet the city voted to remain with the Union in January 1861. But in April of 1861, after Northern-held Fort Sumter in South Carolina fell to Confederate troops, Lynchburg found itself at war when Virginia seceded from the Union. The city’s central location in Virginia, its excellent transportation features, and its location protected by the nearby mountains offered outstanding logistical and strategic values. The city quickly became a distribution hub for all manner of supplies for the gathering storm. The same qualities made it an ideal assembly area for troops being assigned to the front. Two major encampments in the city accommodated up to 10,000 soldiers, but the troops were accommodated badly. Young men, most of them from rural areas, found themselves away from home for the first time without adequate shelter, food or clothing. Women of the city organized themselves into relief societies to meet their needs, but their efforts were not enough to overcome the incidence of diarrhea and dysentery. Soldiers sickened and died without ever seeing combat. More than 6,000 would perish from disease within the first 18 months of the war.

the history of healthcare

Modern wars have often become something of an incubator for new methods of treating wounds and illnesses and new therapies for recovery of injured warriors. Not true for the Civil War. In strictly medical terms, the Civil War was fought before its time. Caregivers had not developed an understanding of antisepsis — how to prevent infection by arresting the growth and multiplication of germs and bacteria. There were no sophisticated surgical techniques and no antibiotics. Medicine did not understand how diseases were caused or spread. What medical supplies might have been available — drugs, instruments, and recently developed chloroform and ether — were in short supply, as were physicians to work on the battlefields or in field hospitals. The Confederate medical corps was under qualified, understaffed, and undersupplied. At the war’s outbreak, the entire Confederacy had but 24 medical officers. Much of the conflict took place on Virginia soil, and some sources estimate that as many as 60 percent of Confederate wounded were treated in Virginia.

As one surgeon wrote after the Battle of First Manassas (also called the Battle of Bull Run) in July 1861, the cities of Richmond and Lynchburg had each become “one vast hospital.” The early days of the city’s service as a hospital center were disastrous. Far too many casualties and far too few caregivers combined to produce terrible human suffering as the wounded poured into the city from seemingly everywhere and overtaxed almost every aspect of the city’s ability to cope. But the people responded. The women of Lynchburg organized themselves into the Ladies Relief Society, at first providing food, clothing and bandages, and eventually opening the most widely respected Civil War hospital in the city. The Ladies Relief Hospital, housed in what had been the Union Hotel, was the most humane of Lynchburg’s more than 30 hospitals. The worst casualties were sent to Ladies Relief and the Ladies often greeted their patients with kind words and a cup of buttermilk before their treatment began. Despite the noble attempts at gentility, however, medical treatment of injuries during the war was usually desperate and brutal. Dr. Peter W. Houck, in his masterful work on the hospitals of wartime Lynchburg (A Prototype of a Confederate Hospital Center in Lynchburg, Virginia, Warwick House, 1986), wrote that “an awesome number of amputations were performed, many unnecessarily done as a way to prevent gangrene. So poorly understood was infection control that amputations could have been avoided by merely cleaning off the layers of blood, dirt and grime from a penetrating wound.” Although the war did not have much impact on the contemporary day-to-day practice of medicine, it did have far-reaching influence on some key social issues that would later affect healthcare. While so many men were off soldiering beginning in 1861, more of the domestic medical care at home was being taken up by the women. On southern plantations, black men and women also helped take care of patients, and slaves were often hired out to work as attendants and nurses at military hospitals. So it seems that despite the generations of social turmoil and the post-war devastation suffered by both sides, the war did bring a measure of freedom on two fronts: women began to break free from their relegation to purely domestic chores, and slaves were ultimately freed, legally at least, from the chains of bondage.

By the time the war ended in April 1865, Lynchburg, like many Southern cities, was drained. Banks were insolvent, the Confederate currency and locally printed money was worthless, every industry was all but destroyed, real estate was worth almost nothing, government was in disarray. The cruel war had ended with 1,500 of the city’s men (out of a total population about 6,000) having gone to battle with tragically few returning – 203 died in battle or as a result of disease, 202 were wounded, and 286 were captured. The suffering continued in the city’s hospitals, with 24 more deaths before they finally closed two months after the surrender at Appomattox. But within a few years, Lynchburg had regained some of its lost economic power. Manufacturers retooled their damaged and outdated factories. Tobacco would begin a slow resurgence that would once again lead it to reign as an economic engine by the close of the century. Families dealt with their losses as best they could. Things began to get better. It was not normalcy. Too much had been damaged, too many lives had been lost, and too many families had been shattered for normalcy. But it was better. Lynchburg’s economy turned more diverse after the war. Tobacco enjoyed a resurgence, but it would not rise to the level of prominence that it occupied before the war. Added to manufacturing activities in the city were shoes, furniture, leather goods, and more. The new industries would soon replace tobacco as the queen of Lynchburg production as the city, along with the rest of the country, enjoyed an industrial revolution that would lead to the boom years of the 1890s. The city’s industries were not the only organizations enjoying good times. The local lodge of Masons had been in operation since 1793, when its charter was issued by John Marshall, the Masons’ Grand Master at the time. Marshall would later become the Chief Justice of the U.S. Supreme Court in 1801. The local organization took the name Marshall Lodge in his honor. The Lodge was doing well financially. Members were informed in 1885 that Lodge income was more than enough to cover its expenses as well as the Masons’ charitable work, and the discussion was started on the most beneficial use of the excess funding.

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The notion of a hospital was advanced, but the idea had as many detractors as it had those in favor. Although Lynchburg had been a major Civil War hospital center just 20 years earlier, no one had made a particularly appealing case for a hospital after the war ended and the military hospitals closed. In part, this may have been a reflection of the contemporary perception of what a hospital was. Hospitals were thought to be places of last resort where the aged and alone, the poor, the mentally deranged went to die. “Decent” families cared for their own ill and aged at home. Sometimes the neighbors helped. When the illness took a turn for the worse, you summoned the doctor and you prepared for death at home. But, championed by local physicians, the idea of a hospital prevailed and the Masons determined that they would establish “an institution in the form of an infirmary.” So earnestly did the organization avoid using the dreaded word “hospital” that the enterprise was to bear the name “Marshall Lodge Home and Retreat” when it opened on April 5, 1886. The first location of the Home and Retreat was in a rented residence at Washington and Church Streets (the “gold coast” of Lynchburg at the time) that was able to accommodate 20 patients at a time. The Home and Retreat was not especially successful, and it treated only 60 people in its first year of existence. Although the hospital seemed a risky venture, the Masons in 1888 bought property at the corner of Grace and 15th Street, also a private residence, enlarged it, and made it a permanent home. Activity was still disappointing, however, and a number of Masons lost faith and interest in continuing operations at a loss. As a last-ditch effort, they turned to newspaper publisher Carter Glass, asking him to conduct an old-fashioned public relations campaign that would change attitudes and convince people that going to the hospital to recover from illness was an acceptable notion. That is what Carter Glass and the newspaper did, and it worked. In 1907, the building was enlarged a second time. In 1919, the hospital was converted to an independent, non-profit corporation named the Marshall Lodge Memorial Hospital. By 1921, demand for the hospital had increased to the point where a new wing was added and then another in 1931. Although the hospital was modern according to the standards of the time, it was still basic by today’s standards. It established the legitimacy of the hospital as a center for healing. Perhaps spurred by the wartime necessity of commandeering tobacco warehouses, factories, hotels, homes, and any suitable building for the collective treatment of ill and injured soldiers, healthcare began to shift to the hospital. And the site of health practice began to shift from the home to the doctor’s office. Local physicians were also feeling the need to be more collaborative, to share experience, and to share knowledge. To this end, 17 of the 20-odd local physicians met on February 14, 1893 for the purposes of forming a medical society. The organization became known as the Lynchburg Academy of Medicine. With the eventual acceptance of the Marshall Lodge Home and Retreat, the white, middle-class citizens of Lynchburg were becoming well served by healthcare organizations. But for the 8,000 black residents of the city and the city’s poor whites, life was not so promising. A charity home, or alms house, situated on Hollins Mill Road above Blackwater Creek provided some services for the disadvantaged, but, in the words of beloved physician Dr. Elisha Barksdale, it was a rat hole for paupers and Negroes. The city-operated Lynchburg Hospital opened near the old almshouse in 1912, primarily to meet the medical needs of those who were unable to pay for medical care. The new hospital was under the medical guidance of Dr. Barksdale, and it was overseen administratively by Dr. Mosby G. Perrow, a chemist who was appointed director of the city health department two years earlier. In his 1925 annual report, Dr. Perrow summed up the mission of Lynchburg Hospital: “Preference is given to charity cases, except for colored, there being no other hospital in the city for colored patients.” The hospital also attracted its share of paying patients, and it was enlarged and refitted several times. It would serve until 1956, when the new Lynchburg General Hospital would open on what had been

the history of healthcare

farmland (the Tate Springs Farm) in the center of the city.

the “broad avenues” foreseen by Sen. Daniels were in the offing.

The economic boom of the 1890s fueled a great many improvements that today are accepted as part of the face of Lynchburg. During a speech highlighting the city’s centennial in 1886, favorite son Senator Chester Daniel called on his constituents to “spread wide your city limits, stretch out broad avenues to the plateaus and valleys around you...establish here a female college of the highest grade...wake up Lynchurg!

A dark chapter in the healthcare history of Virginia is centered just over the James River, in Amherst County on a bluff overlooking Lynchburg. In May 1911, the first patients were admitted to a newly built state facility for the treatment of people with epilepsy. The Virginia State Epileptic Colony, as it was named, was designed to serve 100 people with epilepsy, who had been residents in the three state mental hospitals that existed at the time. Instead, it became a dumping ground for the state’s undesirables — troubled kids from broken homes, the state’s poorest people, just about anyone that state officials considered socially inadequate. They were lumped together under the vague term “feebleminded.”

And Lynchburg did exactly that. Companies sprang up to develop and expand every corner of the city. One of them, the Rivermont Company, set about the work of developing the land immediately west of downtown, some of which was actually within the city limits but most of which at the time belonged to neighboring Campbell County. One signal event was the opening of the 1,200-foot bridge that linked the west end of Main Street to the newly named Rivermont area. Two years later, the college that Senator Daniels had talked about, Randolph-Macon Woman’s College, opened its doors and quickly became an anchor of the new neighborhood. But by then the bubble had burst and Lynchburg struggled through three years of depression along with the rest of the country. A number of the industries and companies that had been established during the boom, including the Rivermont Land Company, went bust. Yet for all that, the bridge did provide quick and safe transportation over the deep cut of the Blackstone Creek, the new woman’s college was becoming successful, and

By 1919, there were 508 residents of “the Colony,” 351 categorized as epileptics and 157 labeled as “feebleminded.” By 1926, the population was 845 people and the name of the facility was changed to the more descriptive State Colony for Epileptics and Feebleminded. At the time, the idea of sterilization as a means to control the population of “unfit” individuals was supported in scientific circles as well as by the general population. The principal was referred to as eugenics, the belief that the overall quality of the human species can be improved by various means, including discouraging reproduction by people who are presumed to have undesirable genetic traits — such as being “feebleminded.”

VIRGINIA EPILEPTIC COLONY

Courtesy of Lynchburg History the history of healthcare

Courtesy of Lynchburg History

Courtesy of Lynchburg History and the private collections of Bill Williams

ABOVE WOMEN AND CHILDREN IN LYNCHBURG, VA, 1898. LEFT RANDOLPH MACON WOMEN’S COLLEGE STUDENTS, 1900’S.

In 1927, the state began a program of involuntary sterilizations, combined with routine appendectomies, performed in a Lynchburg hospital. The program continued until 1972, with about 4,000 people having been sterilized. Neither the patients nor most of Virginia knew about the practice until the American Civil Liberties Union filed a class action suit on behalf of the patients who had been sterilized, and the story hit the nation’s media. A much more affirmative note was struck on July 12, 1924, when the city celebrated the opening of the Virginia Baptist Hospital. Lynchburg had prevailed over Charlottesville and Bedford in convincing the state Baptist General Association that the new hospital was best located on a 26-acre site along Rivermont Avenue. Designed by widely admired local architect Stanhope Johnson, it was described at the time as “one of the most modern, up-todate hospitals in the South, free from noise, dust and smoke.” Equipment and facilities were unsurpassed, according to witnesses of the day. The hospital was classed as A-1 by the American College of Surgeons, and the “Xray, Pathology, Laboratory and Dietary departments were in charge of skilled experts.” In his opening address, hospital board chairman O.B. Barker noted that it was his hope that the new hospital be looked at as “a Lynchburg institution...undenominational in its service and patronage, and every patient, regardless of sect or religious belief, will be given every kindness and consideration.”

the history of healthcare

There was yet another hospital to open in Lynchburg. The will of Mrs. Max Guggenheimer provided for a specialized hospital for children at the time of her death. The family home, not far from the Marshall Lodge Memorial Hospital, was designated as the site of the new facility. Enlarged and adapted for its new mission, the Guggenheimer Memorial Hospital opened in 1931. It was later enlarged to serve as a maternity hospital and today serves as a long-term care facility for the elderly. Although Lynchburg had no hospitals to serve the community until late in the 19th Century, by the time that the clouds of World War II were gathering, the city had four operating hospitals. Modern marvels such as the CT scan and the replacement of human organs were generations away from being imagined, but there was a solid foundation for the start of a more modern age for Lynchburg and its environs, and it provided fertile ground for what was to follow.

AMBULANCE SERVICE

Courtesy of Lynchburg Museum

MCGEHEE FURNITURE FIRE, MAIN STREET, 1934.

he Lynchburg winter of 1933-34 was bitter and deadly. Around 5 o’clock the morning of March 24, 1934, breakfast was being prepared for the residents of the Lynchburg Transient Bureau, a two-story shelter for homeless men that had been established in an old warehouse at the corner of Church and 12th Streets. A grease fire in the kitchen spread quickly through the old building. Trapped on the second floor, the Bureau’s nearly 100 residents panicked, many of them leaping to the ice-covered sidewalks below. All told, 22 men lost their lives in the fire, and another 70 or more were injured. There was no on-scene emergency medical service and no system of transportation to take the injured and dying to the hospital. Every available hearse, truck, and car was pressed into service. The very next evening, eleven young men gathered in the attic of the Diuguid Mortuary, which at the time was not unlike a barber

shop, where men of the town gathered to discuss their lives, their philosophies, and the events of the day. No doubt they also had in mind another fire that struck Lynchburg during the same winter, when the building housing the McGehee Furniture Company burned on the evening of February 10th. Though there was no loss of life in that fire, temperatures were so bitterly cold that ice covered everything, including the firemen battling the blaze. Firemen fell victim to cold-related injuries, and others were overcome with smoke. Six were sent to the hospital and — again — there was no on-site treatment available for the injured. The 11 men meeting at Diuguid Mortuary discussed these tragedies at some length and determined that they would form an organization of volunteers to assist fellow citizens and countrymen in emergencies and life threatening situations. That meeting was the basis for the Lynchburg Life Saving and First Aid Crew.

the history of healthcare

For inspiration and guidance, they had only to look a short distance to the west, where the Roanoke Life Saving and First Aid Crew had been organized six years earlier. It too had had its genesis in a disaster. “On a May afternoon in 1909,” according to an article in the Readers Digest issue of February 1945, “a boy on the bank of the Roanoke River watched helplessly while two men struggled in the water trying to reach their overturned canoe. “Bystanders shouted hoarse advice and tossed branches into the stream. The men kept crying for help -- then suddenly, they were gone.” The boy, Julian Wise, was haunted by the memory of his experience. He went on to take all available first aid and water rescue training offered at the time through the Boy Scouts and the American Red Cross. He became an Eagle Scout and stayed active in the scouting program into adulthood. “I resolved that I was going to become a lifesaver,” he later said. “Never again would I watch a man die when he could be saved.” And he acted on his intentions. As an adult nineteen years later, with nine of his workmates from the Norfolk and Western Railway, he formed the Roanoke Life Saving and First Aid Crew, chartered on May 25, 1928.

learning the skills they would need, they were also seeking funds for equipment and operating expenses. Among other activities, the life saving crew sponsored boxing matches to bring in money. Donations came in heavily from the citizens of Lynchburg, to the point that a stable financial base had been established within the first year of the crew’s organization. The crew’s first vehicle arrived in July of 1934. It was a 1918 Cadillac ambulance that had been donated to the Roanoke crew by the Oakey Funeral Service of Roanoke. Roanoke crew members had converted to a rescue vehicle, and they donated it to Lynchburg when a new vehicle was secured in the Star City. The vehicle came equipped with the proper gear to handle most emergency situations. It was put into service in September 1934, housed at the Rivermont fire station. Additional equipment found its way to the crew. A local physician loaned a rowboat to the crew for use in water rescue. The wooden boat, mounted on a trailer, needed to be partially filled with water at all times so the wood would remain swollen, preventing leaks. When the boat was required for a rescue call, the water would have to be dumped before it and its trailer could be attached to a tow vehicle. And the loan arrangement included a proviso that the physician could use the boat whenever he wished.

It was the first rescue squad in America. And it served as the model for all others that would follow, including the Lynchburg effort. The first months of the fledgling life saving crew were divided between training and fundraising. While members were

Courtesy of Lynchburg History

Courtesy of REMS, Inc.

LYNCHBURG LIFE SAVING AND FIRST AID CREW, FIRST VEHICLE, 1922 CADILLAC.

JULIAN WISE

the history of healthcare

EPIDEMICS

Courtesy of Peter Houck, MD and Medical and Surgical Records of the War of Rebellion CIVIL WAR AMBULANCE

isease was a frequent visitor to Central Virginia in the late 19th century. Understanding the cause and treatment of communicable diseases was in its infancy, sanitation was poor, and good health practices were largely unheard of. People had begun migrating from the countryside into cities such as Lynchburg, and in the cities, neither housing nor sanitation could keep pace with the growing population. Open privies drew flies that spread illness; standing, stagnant water was a handy breeding ground for mosquitos. Drinking water was often contaminated by typhoid, and milk was often contaminated by the tuberculosis bacillus. The result of it all was that disease of all types — malaria, smallpox, typhoid, diphtheria, tuberculosis and more — appeared often and stayed long. An 1832 outbreak of scarlet fever killed many people, particularly children. Very soon after, word reached Lynchburg that cholera had killed people in Richmond and Norfolk. The city

the history of healthcare

responded by organizing Lynchburg’s first board of health, which took quick action to clean up the town and ban the sale of fruit that bore the disease. Lynchburg was spared a cholera outbreak. The hospitality of Lynchburg’s people was heralded in the summer of 1855 when an outbreak of yellow fever was triggered after a ship was allowed into port in Portsmouth with the disease aboard. As the disease spread rapidly in Norfolk and Portsmouth, residents of those port cities headed for the cleaner air of the Virginia mountains. The disease itself did not reach Lynchburg, but as W. Asbury Christian writes in Lynchburg and its People, “Lynchburg opened wide its doors and invited all who wanted to come here. Every train was crowded with refugees.” The epidemic burned through the Tidewater area, claiming 1,575 lives. Lynchburg citizens then went on to raise money for the families of the deceased, raising about $5,000, which would have had the purchasing power of about $116,350 in 2011.

With the coming of the Civil War, however, the threat of disease increased immeasurably. In the early days of the war, Lynchburg’s strategic location on three major railroads made it a key staging point for Confederate soldiers from across the South. By early May 1861, barely two weeks after the surrender of Ft. Sumter, the city — with a population of about 6,800 people — was preparing itself for the arrival of as many as 10,000 troops who would be en route to points of battle in the Confederacy. Soldiers from Virginia were encamped in a wooded area just to the south of what is now downtown Lynchburg. It was called Camp Davis. Soldiers from other states were encamped in fairgrounds near what is now Miller Park. Sheds were quickly built to house the men, who slept in bunk beds, six to a stall. The city was teeming with young men who were without adequate clothing, proper food, or sanitary conditions. It was a recipe for medical disaster, and Lynchburg found itself in nearly constant battle with disease as it also faced the Civil War. Dysentery and diarrhea killed young soldiers in Lynchburg, and the diseases would go on to kill more than 6,000 troops in the first 18 months of the war. Measles attacked one in seven Confederate soldiers in the first months of the war. But it was smallpox that was most feared. The virulent killer disease of Europe and America in earlier centuries seemed to be in its own death throes until early in the war. Although a vaccine had been in effective use for more than 60 years before the war, it was inexplicably not administered to troops in the North or the South. The first case of smallpox in Lynchburg was reported in the early fall of 1861. Although the first smallpox death did not occur until the next fall, this began the first wave of outbreaks of the disease that would go on to devastate Lynchburg over the next two years. All patients fighting smallpox were moved to a specially designated smallpox hospital near the City Cemetery, and they were put under the care of Dr. John Jay Terrell while the smallpox vaccine was brought in to Lynchburg from wherever it could be found. Between Dr. Terrell’s care of the smallpox victims and vaccination, a true epidemic was averted. Still, the only mortuary in town at the time, Diuguid’s Funeral Service, reported 99 burials of soldiers who were killed by smallpox and who could afford burial. An additional 375 victims who could not afford burial were interred in a common pit dug in City Cemetery. During the period of the war, Lynchburg was the site of a major advancement in veterinary medicine: the identification of the causes and control of the equine respiratory disease called “glanders.” Horses and mules were essential to the war, and as a depot for many types of supplies to the Confederate army, Lynchburg was supplying

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Images courtesy of Historical Collections and Services, Claude Moore Health Sciences Library, University of Virginia

the history of healthcare

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the disease.

It was, however, an outbreak of influenza in 1918 that set the standard for epidemics in the United States. The country had entered World War I in April, 1917, a war that had already killed about 9 million people

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The disease began to ravage the United States just as it appeared that the country would soon be able to enjoy some relief from the uncertainty and loss of the “war to end all wars.”

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World War I did not cause the flu, experts believe, but troops living in quarters and massive movements of fighting men hastened the spread of the disease and made it more lethal. A major factor looked at in today’s pandemics — the spread of disease across large geographic areas, or worldwide — is the ease with which people move from place to place. At the outbreak of the worldwide flu epidemic, contemporary transportation methods made it much easier for soldiers, sailors and civilian travelers to spread disease.

Dr. Terrell and Dr. John R. Page, two of the physicians attending to the wounded and sick in Lynchburg’s many hospitals, were pressed into service to learn what they could about the disease. Their research included performing autopsies on animals that had fallen victim to glanders, as well as transmitting the disease intentionally to a healthy animal to study the progress of

Their work was considered a landmark study of early pathological experimentation. They concluded that glanders disease was caused by a virus spread at watering troughs and in unhealthy crowded stable conditions. There was no cure. Prevention of the disease was the only solution to controlling the epidemic. This was achieved by housing horses and mules in uncrowded, well-ventilated stables, introducing good sanitation and a healthy diet, and destroying the infected animals.

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thousands of the animals to the Army of Northern Virginia. But over a 15-month period beginning in 1863, only 1,000 of the nearly 7,000 horses and mules quartered in Lynchburg ever made it into the field. The rest fell victim to glanders, a highly infectious and rapidly fatal disease. It can also infect humans.

the history of healthcare

According to many accounts, the first appearance of the flu in this country was when an Army cook at a training camp in Kansas reported to the infirmary on March 11, 1918, complaining of a fever, headache, and other typical flu symptoms. He was sent to bed. By noon on the same day, more than 100 soldiers reported the same symptoms. Within a couple of days, more than 500 soldiers were ill, with some close to death. Almost immediately, other military bases made similar reports. Naval vessels docked

off the East Coast began to report illnesses, and even the isolated prison on Alcatraz Island in San Francisco Bay — it was a military prison at the time — reported cases. Within weeks, it was in France, and then it jumped to China and Japan, followed by Africa and South America. On September 11th, several sailors in Norfolk reported ill with influenza. At that time, Virginia officials saw no cause for concern and it was not until nearly two weeks later that officials filed their first report with the Public Health Service. According to that report, influenza had now spread across the state. Petersburg, Newport News, Norfolk, Portsmouth, Pittsylvania and a variety of other places were all now reporting cases of severe influenza. The first mention of the epidemic in a Lynchburg newspaper was on October 3, 1918, when The News, in a page one article, noted that the flu was “spreading daily in Lynchburg.” Although the newspaper could make no estimate of the numbers of Lynchburg residents who had been stricken by the disease, the article did note that the Lynchburg undertaker Diuguid Funeral Service had been asked to provide help to a Petersburg funeral home that had become overwhelmed with the demand created by the deaths of soldiers stationed at nearby Camp Lee. The next day, the Lynchburg newspaper included the death notices of the first four people to die as a result of the epidemic — a freshman at Randolph Macon Woman’s College, a 10-yearold girl, and two adults. On October 4th, Virginia officials formally stated that influenza was “epidemic in many parts of the State.” Four days later, the disease was so pervasive that authorities closed the Virginia State Fair. And on October 15th, officials estimated “that there were at least 200,000 cases in the State.” Because state officials were often overwhelmed and unable to track the epidemic effectively, the actual number of cases was probably much higher. The death toll would climb daily. As the month drew to a close, 200 people in Lynchburg and surrounding areas would be dead as a result of the flu. Apart from the illnesses and deaths, the epidemic was deeply disruptive. Quarantines were imposed, schools were shut down, and businesses operated on greatly reduced schedules. Organizational meetings and social events were canceled on a wholesale basis. In his report of the activities of the Health Department for the month of January 1919, director Dr. Mosby G. Perrow, a chemist, noted, “The influenza epidemic was the dominating feature of January health conditions. Nine hundred and nineteen cases were reported during the month, with 54 deaths from influenza,

15 from bronchopneumonia, and 3 from lobar pneumonia, totaling 72.” “The epidemic has now almost subsided. The effects of influenza, however, will in all probability be felt for the next year, and influenza itself, like a great fire, will take considerable time to smoulder (sic) entirely out.” The death toll hit those in the prime of life the heaviest - 34 of the 72 that died during that January were between the ages of 25 and 45. By the summer of 1919, influenza had begun to disappear from the state. State officials still worried, however, that the disease would return. In the fall of 1919, the Virginia State Board of Health released the following statement. It was published throughout the state. “State-Wide Campaign for the Prevention of Influenza: Richmond, Va., October 9-- With a field force numbering ten or twelve, the State Board of Health and the State Tuberculosis Association are driving hard to launch in the hundred counties of Virginia a campaign for the prevention of the influenza epidemic which swept Virginia last year, claiming a death toll of 15,678. A year ago last September there were 19,500 cases of influenza reported by physicians, besides a great number that were probably not seen by physicians or otherwise recorded. During the twelve months ending September 1, 1919, there were 139,000 cases reported, with a total of 15,678 deaths. Of the death toll, about 4,700 were of persons between the ages of twenty to thirty, in the very prime of young manhood and womanhood. To prevent the recurrence of the tragic story of last year, a determined effort is being made to organize the forces of the state in a great campaign for prevention.” Not until March 31, 1920 would Lynchburg health director Perrow be able to report, “The influenza epidemic has disappeared entirely.” Going further into the 1920s, epidemics lessened dramatically. Typhoid became rare because of an efficient health department, a cleaner city with better garbage disposal, general enlightenment about health conservation, better paved and cleaner streets, and adequate handling of sewage. Typhoid practically disappeared. And vaccination against smallpox all but eliminated the sight of pitted faces of those who had suffered the disease.

the history of healthcare

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the history of healthcare

FUNERAL HOMES

Courtesy of Lynchburg History and Jones Memorial Library ADVERTISEMENT, 1887.

n 1817, one of Lynchburg’s more successful businesses was a cabinetmaking concern run by one of the town’s leading citizens. Appomattox County native Sampson Diuguid had moved to town to launch a furniture business with Connecticut-born craftsman Alanson Winston. The two master craftsmen quickly built a flourishing business, making all manner of wooden furniture and accessories on order from the residents of what was then the very wealthy town of Lynchburg. Although history is vague on what became of Alanson Winston, Diuguid was a meticulous record-keeper when it came to his business dealings. His ledgers have come to be the source of much information on many aspects of Lynchburg’s history. One such ledger entry, for June 2, 1820, relates that on that day, “Mr. Diuguid was approached at his shop on Main Street by Dr. Robert to build a burial box for his son.” It was not unusual for skilled tradesmen of the time to be called upon to craft coffins for burial, but this is the first recorded instance of Sampson Diuguid’s transition from furniture maker by

trade to undertaker by chance. His ledgers go on to list a total of 18 funerals that year. In those early days, when a death occurred in the home, Diuguid would transport his supplies to the home where he prepared the body for burial, fully dressed and placed in bed. At the same time, Diuguid would take measurements so the coffin could be built to size for the deceased. Before the end of the Civil War, we most often buried our dead on the day after death, or two days after death at the most. Methods of preserving the body of the deceased were practiced in medical schools as a way of making bodies available for students. There are scattered accounts of embalming reported as long ago as the mummification of members of ancient Egyptian royalty and during the Middle Ages for wealthy knights who fell during the Crusades. But the average American family would have been horrified at the idea of embalming. To do so would have been considered an unnatural intervention in the process of decomposition and an invasion of the integrity of a loved one’s body.

the history of healthcare

The Civil War changed all that. With the war and its bounty of death came more widespread acceptance of embalming. Families wanted one last look at their loved one, no matter that the family may have been in the North and the loved one had fallen on a Southern battlefield far away. Embalmers during the war experimented with a wide combination of arsenic, creosote, mercury, turpentine and various forms of alcohol. Formaldehyde would not be discovered until 1866. Representatives for embalming fluid companies would travel the country presenting one or two day how-to classes in the use of their product. For attending these classes and purchasing a quantity of fluid, an undertaker received a certificate as an embalmer. It wasn’t until the 1930s that state licensing would become almost universal. One of the most famous embalmers of the Civil War was Dr. George A. Diuguid, the youngest son of Sampson Diuguid. When Sampson Diuguid died in 1856, operation of what was then Diuguid Funeral Service fell to his two sons, David P. Diuguid and George, but David died in 1864. Diuguid Funeral Service has become the second oldest of its type in the country and the oldest in the South.

Courtesy of Lynchburg History

TOP THE DIUGUID FAMILY FUNERAL DIRECTORS FROM A 1903 BOOK

In the early days of the company, however, furniture-making was by far the busiest aspect of the Diuguid activities. Funerals accounted for only 9.6% of the Diuguid business from 1821 through 1837. But then the war came. As the only undertaker in a city that was chock full of hospitals caring for the injured and dying on both sides, the Diuguids were responsible for the burials and embalming of both military and civilian dead. From their workshop in Lynchburg they tended to over 3,000 Confederate and Union soldiers. Following his father’s practice, George Diuguid was also a superb record-keeper, detailing every burial or removal during the War. Each body was documented, listing name, place of death, date of burial, military unit, place of burial along with coffin and body measurements.

PUBLISHED BY J.P. BELL ABOVE ORIGINAL PIECE BY DIUGUID FURNITURE, 1800’S

The deceased was usually placed on display in the parlor of the family home, while friends and family came to pay respects. That is the origin of the term “funeral parlor” that is widely used today. Bodies would sometimes rest on cooling boards for longer periods of time, but no one tampered with the interior of the corpse, and funerals were held in the home, in a church, or at the graveside.

the history of healthcare

These records would prove to be invaluable after the War when the Federal Government wished to removed the remains of 200 of the Union soldiers and place them in the national cemetery near Petersburg in 1866.

THERE IS A

These records also enabled the Lynchburg Confederate Memorial Association, a women’s group, to mark each soldier’s grave with its own headstone in the early twentieth century in what is now the City Cemetery. Acceptance of the notion of embalming was given a further boost by the epic journey of the body of assassinated president Abraham Lincoln to his final resting place in Springfield, Illinois. After his death on April 15, Lincoln lay in state in Washington, D.C., for about 6 days before beginning the journey “home.”

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A train carrying the slain president’s body traveled for 13 days through 180 cities and seven states on its 1,700-mile trip to Illinois. (Also on the train was a coffin containing the body of Lincoln’s son Willie, who had died of typhoid fever in 1862. Willie’s body had been disinterred from a plot in Washington after his father’s death, so that he could be buried alongside the president.) Scheduled stops for the special funeral train were published in newspapers. At each stop, Lincoln’s coffin was taken off the train, placed on an elaborately decorated horse-drawn hearse and led by solemn processions to a public building for viewing. Newspapers reported that people had to wait more than five hours to pass by the president’s coffin in some cities. Hundreds of thousands of people viewed the body, and everyone read newspaper accounts of how the body was preserved.

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The Diuguid business was originally located at 616 Main Street in Lynchburg, the present-day site of a parking lot. In 1872, the original building was replaced at the same site by a fourstory red brick building which was the home of Diuguid Funeral Service until 1933, when a second location was added at 1016 Rivermont Avenue. Both locations, separated by just a few miles, operated until the Main Street building was closed in 1936. More than 190 years after its founding, the Diuguid Funeral Service is no longer family-owned but it operates still, now from a more modern chapel building located on Wiggington Road in Lynchburg.

the history of healthcare

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AAAHC

HEROS

ealthcare is populated by heroes. For some, it is an occupation, a livelihood, and a calling. They work exhausting long hours, balancing the myriad details of life and death. For others, it is an obligation — a young mother sitting up beside the bed of a young child or a middle-aged man looking after the health affairs of his elderly parent. No matter the setting, it is the vision and the vitality of an extraordinary type of person that is key to providing care for the health of others. HERE ARE SOME OF THEM O. B. BARKER. Although the Baptist General Association of Virginia chose to locate its new hospital in Lynchburg in 1919, the institution was not warmly welcomed by the city’s medical establishment in its early years, and the state’s Baptist parishioners were not as generous as hoped in their donations to help fund the new hospital. The hospital was championed by Oscar Bayne Barker, of the Lynchburg-based hardware supplier Barker-Jennings. As president of the board of the new hospital, Barker was a pivotal figure in the construction and operation of the new hospital. He financed $25,000 for the construction of the nursing school on the campus, which was named the Barker Building. He worked to launch a Mother’s Day Fund among the many Baptist churches in the state, with each participating church earmarking a once-a-year collection for the new hospital. And he guided and inspired the hospital as board president and as a board member to his death in 1937. In his will, he left a $10,000 endowment to the institution.

DR. ELISHA BARKSDALE. A respected Lynchburg physician, Dr. Barksdale’s determination not to pull punches in 1907 laid the groundwork for what would much later become Lynchburg General Hospital. He denounced an almshouse on Lynchburg’s

Hollins Mill Road as a rat hole for “paupers and Negroes,” and he triggered activity to create what would become the city hospital serving an indigent population.

C.B. FLEET. Trained as a pharmacist, Charles Browne Fleet operated a Main Street drug store after the Civil War. He constantly dabbled in chemistry, and two of his products enjoyed success. One of them was a laxative product and the other was a lip balm that looked like a wickless candle wrapped in foil. Sold locally, the product did not catch on, and Fleet sold the rights to the product to his friend John T. Morton for $5. Morton altered the shape and packaging of the product, and sales soared, fueling the growth of the Morton Manufacturing Company. Later, Lynchburg commercial artist Frank Wright, Jr. was hired to design a new logo for the product, called ChapStick. Worldwide sales of the product are strong to this day, and it has become a generic name for any lip balm. After Fleet’s death in 1916, the company was operated by his son Paul Fleet. His development of personal care products has made the company, renamed Fleet Laboratories and still headquartered in Lynchburg, one of the top non-prescription drug companies in the country.

LUCY WILHELMINA OTEY. Born to a distinguished family in Lynchburg, by August 1861, Lucy Otey had lost three of her seven sons in the earliest days of the war and had lost her husband shortly after. But she was a determined, feisty woman

the history of healthcare

who had already been active along with many Lynchburg women who were providing food, clothing, and medical supplies to the Confederate troops assigned to the Lynchburg camps or who were patients in the city’s military hospitals. Rebuked and angered by chief surgeon Dr. William Owen (he famously said that the city’s military hospitals were not a place for “women or flies”), she exerted her considerable influence with President Jefferson Davis and secured government permission to establish and supervise a Ladies Relief Hospital Association. The organization quickly established the Ladies Relief Hospital, housed in what had been the Union Hotel, the present day site of the offices, galleries, and Warehouse Theater of the Lynchburg Academy of Fine Arts. It

DR. MOSBY PERROW. This Campbell County native earned his doctorate in chemistry at the University of Chicago and taught in Lynchburg public schools until his appointment as the city’s milk inspector in 1907. In 1910 he became the chief of the city’s reorganized health department, and he served in that capacity until his death in 1943. It was Dr. Perrow’s levelheaded candor and fervor for sharing health information that shepherded the city through the Spanish influenza epidemic of 1918. He and the city’s mayor Royston Jester, Jr. used the city’s newspapers to dispense a sense of calm and a constant stream of information about how to avoid and manage the disease. Perrow guided the city through the establishment of most of its hospitals, and he served as the director of the city-owned Lynchburg Hospital. In summing up his career after Perrow’s death, the Lynchburg News wrote in an editorial: “Starting when public health work was almost in its infancy, and met with prejudice by laymen and... by elements of the medical profession itself, he met the challenge

became the most desired Lynchburg hospital of the war.

with persistence, with patience, and with courage.”

DR. WILLIAM OTWAY OWEN. Although evidently not a friend of Lynchburg’s women (see Lucy Otey above), Dr. Owen was a skilled and experienced surgeon who was chosen by the Confederate War department to head up all of the hospitals established in Lynchburg during the Civil War. A Lynchburg native, Dr. Owen was a leader of physicians during a time when as many as 1,800 wounded soldiers at a time poured into Lynchburg’s many hospitals. During the horror of the Battle of the Wilderness, Owen left the relative safety of Lynchburg to tend to the horribly injured soldiers on the battlefield.

DR. JOHN JAY TERRELL. A third generation physician, Dr. Terrell was a member of Lynchburg’s dwindling Quaker community who completed his medical studies at the Jefferson Medical College in Philadelphia. He established a practice in Bedford County. Although a Quaker and a pacifist, he was determined to enlist in the Confederate Army, but Dr. William Owen (see above) persuaded him to instead remain in Lynchburg to tend to the ill and injured in Lynchburg’s rapidly growing military hospitals. When smallpox burned through the military camps in 1862, Dr. Terrell willingly agreed to establish a special hospital for smallpox victims. The “pest house” as it was called, became the crucible for Dr. Terrell’s management of the disease. Modern-day medical experts agree that the treatment methods he established prevented even more widespread occurrence of smallpox deaths. In a barn neighboring the Pest House, Dr. Terrell also undertook research that resulted in the prevention and management of Glanders, a disease that had decimated the supply of horses and mules so important to military operations.

NARCISSA OWEN. Married to the brother of Dr. William Otway Owen, Narcissa Owen was the daughter of a Cherokee Indian war chief and an Irish woman. She became a leader of Lynchburg women along with Lucy Otey, providing food and hospital supplies and making uniforms for the shabbily clothed soldiers who passed through Lynchburg.

the history of healthcare

ALL IMAGES, COURTESY OF LYNCHBURG HISTORY AND JONES MEMORIAL LIBRARY

the history of healthcare

LOCATIONS

ynchburg is dotted with sites that were once devoted to healthcare activities. Most of these are long gone, but here are some:

what had been the Union Hotel, present day site of the offices, galleries, and Warehouse Theater of the Lynchburg Academy of Fine Arts on Main Street between 5th and 7th.

CAMP DAVIS. This camp served as a Civil War mustering site for solders from Virginia being assigned to Virginia units. It was in an area bordered by Pierce and Kemper Streets, from 12th to 16th Streets.

LYNCHBURG HOSPITAL. It was built near the site of a home for indigent city residents at Federal Street and Hollins Mill Road. It consisted of the main hospital building, the nurse’s home, an office building, a picnic pavilion, a storage building, and a boiler building. It was opened in 1912 and operated by the city of Lynchburg to serve as a municipal hospital. This building is listed in the National Register of Historic Places.

COLLEGE HOSPITAL. This was the largest of Lynchburg’s Civil War hospitals. A large structure near downtown Lynchburg on a campus formed by 10th, 11th, Floyd and Wise Streets, it had been in operation as a college less than six years before its conversion to a military hospital in 1861. In this hospital were treated more than 20,000 Confederate casualties during the four years of the war. It’s use as a hospital so depleted the building that it was demolished not long after the war’s end. THE FAIRGROUNDS. In an area west of present day downtown Lynchburg, this property encompassed what is now Miller Park, as well as the site of E.C. Glass High School. It was an encampment area for Southern solders from states other than Virginia, as well as the location of a prison for captured Federal soldiers.

MARSHALL LODGE HOME AND RETREAT. Studiously avoiding the word “hospital” because hospitals were thought of as places where one went to die, the Marshall of Lodge of Masons in Lynchburg established a facility for the care of the ill in 1886. Sited first in a former private residence at Washington and Church Streets, it soon relocated to the site of another private residence at Grace and 15th Streets. Enlarged a number of times over the years, it later became Marshall Lodge Memorial Hospital, and finally, a long-term care facility. LYNCHBURG GENERAL HOSPITAL ON FEDERAL STREET, 1936

GUGGENHEIMER HOSPITAL. The home of the philanthropic Guggenheimer family, it was enlarged in 1931 to become a maternity and children’s hospital. Enlarged again in 1944, the building on Grace Street now serves as a nursing home.

LADIES RELIEF HOSPITAL. The Civil War Hospital opened by Lucy Otey and the women of Lynchburg. The hospital occupied

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Courtesy of Lynchburg History

Dr. Peter W. Houck, in his landmark work A Prototype of a Confederate Hospital Center in Lynchburg, Virginia, lists the following as the most prominent in addition to the sites above:

BOOKER’S Variously identified as at Commerce & 7th or at Court between 5th and 6th

Courtesy of Lynchburg History MARSHALL LODGE HOME & RETREAT HOSPITAL

BURTON’S 4th and Harrison CANDLER’S 5th and Polk CHRISTIAN’S 14th & Commerce, also Main between 12th and 13th CHAMBER’S Main between 12th and 13th CLAYTOR’S Salem and 12th CRUMPTON’S 12th between Clay and Madison

Courtesy of Lynchburg History GUGGENHEIMER MEMORIAL CHILDREN’S HOSPITAL

DUDLEY HALL Church between 10th and 11th FERGUSON’S Main and 13th FORD’S 12th and Court

THE PEST HOUSE. Located next to the Courtesy of Southern Memorial City Cemetery, the Pest House was Association/Old City Cemetery Lynchburg’s answer to a frightening epidemic of smallpox in 1862. Under the direction of Dr. John Jay Terrell, Confederate soldiers suffering from the disease were sequestered here while Dr. Terrell worked feverishly to both ease the symptoms of the disease and prevent its spread. Dr. Terrell’s efforts lowered the death rate drastically. ST. ANDREW’S HOME. A private, three-bed hospital established in 1895 by Dr. Samuel Lile and Dr. A.W. Terrell, this was originally located at Church and 11th Streets and later at 917 Court Street. The hospital was closed in 1917, but opened for a short time in 1918 as Lynchburg battled an epidemic of Spanish influenza. WARWICK HOTEL. Another building that was among the first of many military hospitals in Lynchburg, it was located at 1003 Main Street. CIVIL WAR HOSPITALS. Over the course of the Civil War, there were more than 30 sites put into use at one time or another as hospitals to care for the sick and wounded from both sides of the conflict.

KNIGHT’S AND MILLERS’S 12th and Madison and Harrison LANGHORNE’S 11th and Clay, 8th and Clay MASSIE’S 13th and Monroe ODD FELLOW’S HALL 12th between Church and Main PLANTER’S 515 Main PRATT The former Union Station off 12th and Kemper SANDER’S 4th between Main and Church TALIAFERRO’S Court and 5th SAUNDER’S 4th near Church WAYSIDE First location Franklin and 9th, then on Jefferson between 6th and 7th

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NURSES

ursing is often called the oldest of arts and the youngest of professions.

Early nursing is intricately tied to the Church. Modeled after the teachings of Christ with regard to caring for the sick, feeding the hungry, and burying the dead, it is also an almost organic part of motherhood. A traditionally female undertaking in the vast majority of its years, nursing in the early 20th century was made up almost exclusively of women, and most nurses at the time were unmarried. In the mid-1800s, despite the work of the celebrated English nurse Florence Nightingale during the Crimean War, nursing was not viewed as a desirable or respectable occupation for women. During the Civil War, some nursing-like duties were performed only by married or widowed women, but most were nuns — specifically nuns trained as nurses by the Sisters of Charity. Originating in France, the Sisters of Charity maintained the only nurse training efforts at the time. Members of the order were trained and assigned to nursing missions wherever they were needed. Assigned to Lynchburg in late 1862, they were the only nurses willing to care for the soldiers battling smallpox in Dr. John Jay Terrell’s “pest house.” (And the only clergyman who ministered to the patients was the Sisters’ chaplain, Father Lewis-Hippolyte Gache.) Then, as now, the primary efforts of nursing were

concentrated on patient care, patient comfort, and preventing the spread of infection and disease. During their 12-hour days, six days a week, nurses took care of patients as well as tending to housekeeping duties in their respective hospitals. As Virginia’s hospitals became busier and more relied upon by their communities in the late 19th century, the need for skilled assistants and improved patient care in hospitals spurred the recognition of nursing as a legitimate profession. In Richmond, St. Luke’s Hospital opened a training school in 1886 to educate future nurses in the new medicine. Students at St. Luke’s studied blistering, leeching, and cupping along with anatomy, physiology, and other modern scientific subjects. Hampton Training School for Nurses began operation at Dixie Hospital in Hampton in 1891 as the first and only facility for black nurses. In Lynchburg, some early form of nursing education was provided at two Civil War hospital locations — College Hospital and Ferguson’s Hospital — by the Sisters of Charity. In 1900, Marshall Lodge Hospital launched a nurse training program that would continue until 1930. In 1912, the opening of Lynchburg Hospital also heralded a long-lived program in nurse training. The day-to-day responsibility of running the hospital and the nursing school was in the hands of a graduate nurse, who carried the title “Superintendent.” In many communities, the turnover of the hospital superintendent was an almost annual event, but superintendents in Lynchburg were more long-term. During the new hospital’s first five years, superintendent Anne Belle Johnson,

FATHER LOUIS-HIPPOLYTE GACHE the history of healthcare

MARY FRANCES COWLING | Courtesy of Centra Virginia Baptist Hospital 38

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RN, did much to both establish the hospital and its nursing school, which produced its first graduate nurse in 1914. In 1916, a graduate of the Lynchburg Hospital nurse training program, Mayme Lee Cloer, RN, returned to her alma mater to become the hospital’s first assistant superintendent. She also fulfilled the duties of anesthetist, having completed a postgraduate course in anesthesia at a Richmond hospital. The next year, a nurse who would serve the community for the next 37 years became superintendent of Lynchburg Hospital. Mary Frances Cowling, R.N., had been trained during a shortlived program at St. Andrews Hospital in Lynchburg. She would lead the hospital until 1923, when she was appointed the first superintendent of the Virginia Baptist Hospital, then under construction at its Rivermont site, and head of the new hospital’s nursing school. Before the hospital’s opening on July 1, 1924, she worked with board president O.B. Barker to hire staff, plan, organize the hospital’s operations, and purchase equipment for the new hospital. That September, she welcomed students of the first nursing school, as she would for the next 30 years.

Courtesy of Peter Houck, MD.

In 1924, the day of a nursing student began with a devotional service at 6:45 AM. All classes were taught by nurses and physicians from the hospital staff, a practice that lasted until 1965, when courses began at Lynchburg College. Admission requirements for a slot in the nursing school were simple and straightforward. Miss Cowling would interview each applicant. Depending on whether she felt each candidate possessed the right stuff, the person either would or would not be accepted. Candidates who were accepted were sent home with a sewing pattern and enough fabric to make a uniform. Courtesy of Lynchburg History and Jones Memorial Hospital

Mary Frances Cowling also lived at Virginia Baptist Hospital until her retirement in 1954. She returned to the hospital for the last time in 1971, to be cared for by the nurses she trained. She died shortly before her 80th birthday in September 1971.

TOP SKETCH OF ‘OLD’ LYNCHBURG COLLEGE ABOVE RED CROSS NURSES MADE LYNCHBURG FAMOUS DURING WWI AS “LUNCHBURG” BY FEEDING TROOP TRAINS STOPPING IN LYNCHBURG.

Her constant admonition to nursing students throughout her service as a nurse educator was, “Patients always come first,” the watchword for graduates of the Virginia Baptist Hospital School of Nursing to this day.

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TECHNOLOGY

he concept of “technology” in the late 19th century, if the word was used at all, would have been vastly different from today.

In the late 1800s, many physicians were still relying on patients to describe symptoms that they had been experiencing and not on a hands-on examination of the patient’s body. Modern understanding of the role in healthcare played by chemistry, laboratory techniques and equipment, bacteriology, and virology was very much in its infancy. In this time, bleeding was still in use as a therapy, and what drugs had been developed — opium and opium derivatives, digitalis, quinine, mercury, and salicylate preparations (which we now know as aspirin) — were used mostly to treat symptoms. Therapeutic use of drugs to address the causes of disease would not come into widespread use until the development of sulfa drugs and penicillin in the middle of the 20th century. It’s not that scientific research that would benefit medicine was not being carried out, it was. But scientific discoveries and their application to medicine were sometimes very slow to be adopted by the medical community. One example:

Courtesy of Lynchburg History and private collections of Alvin Womack

In May of 1863, Confederate surgeon Dr. Hunter Holmes McGuire was struggling mightily to save the life of a very important patient — General Thomas Jonathan “Stonewall” Jackson. Jackson was accidentally shot by his own troops during the Battle of Chancellorsville. Wounded in the right hand by one bullet and in the left arm by two rounds, Jackson was taken to a field hospital, where his left arm was amputated by Dr. McGuire. The operation seemed successful at first, but the utter absence of antiseptic procedure resulted in Jackson suffering infection. He died days later, depriving the south of the leader who military historians agree to be one of the most gifted tactical commanders in U.S. history.

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At about the same time in Scotland, Joseph Lister was testing whether the application of carbolic acid to surgeons’ hands and instruments and to surgical wounds would eliminate the infection that all too frequently took the lives of patients after surgery. He proved to be correct and published his results in 1867. He visited the United States on a lecture tour in 1876, his lectures heard by several Virginia surgeons who went on to practice the antiseptic techniques he had pioneered.

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But not everyone was convinced. The same Dr. Hunter McGuire who had been treating “Stonewall” Jackson famously said during an 1884 meeting of the Medical Society of Virginia, “Listerism is generally unnecessary, the pure country air of Virginia being in itself quite aseptic.” But other physicians in Virginia were impressed by the work being done by Lister and his colleagues. Among them was Dr. John Jay Terrell, one of the physicians who labored in Lynchburg’s Civil War hospitals treating war casualties from both sides of the conflict. At a time when doctors did not wash their hands or clean their instruments between patients, Dr. Terrell did. Put in charge of a special hospital for soldiers in Lynchburg who had become infected with smallpox, he found the facility — it was called the “Pest House” — to be a horribly stinking place that was little more than a warehouse for dying smallpox patients. Dr. Terrell implemented some basic sanitary procedures. He improved nutrition for the patients. He repainted the facility and arranged for fresh bed linens and fresh clothing. He discovered that a layer of white sand absorbed the fetid smell that came from the oozing sores of the smallpox patients. All of it together served to reduce the death rate, which had been as high as half of all patients, to about five percent until the epidemic played itself out. Lister’s work was among a number of key scientific discoveries of the late 19th century. Other new findings included the realization that all living things are composed of cells (cell theory) and that germs cause diseases (germ theory.) But even into the early part of the 20th century, masks, gloves, and hair coverings were not worn during surgery. Many patients died from postoperative infections. Understanding of antiseptic procedures during the early 1900s and development of antibiotics in the 1940s would produce seismic shifts in medical and health practices that would pay benefits in years to come. Along with new awakenings in the process of disease and the nature of good public health measures came the development of tools and techniques for diagnosing

changes in the human body. Among these were the stethoscope (to detect abnormal sounds in the heart, lungs, and abdomen) and percussion techniques (tapping the chest and abdomen to look for changes in the size and location of organs and to detect the presence of abnormal fluids in the body.) Soon to follow was equipment such as the thermometer to check body temperature, the sphygmomanometer to measure and record changes in blood pressure, and more. Medicine also adopted the regular performance of autopsies to examine the deceased and formulate lessons that would help the living. In the late 1890s, William Roentgen, a professor of physics in Bavaria, was discovering the ability of radiology to penetrate solid objects of low density — such as the human body. Almost by accident — something that seems common to many great discoveries — he was able to see his own flickering ghostly skeleton on a viewing screen that he had developed. It was then that he decided he would carry out his experience in secrecy, lest his work be discovered to the ruin of his professional reputation if he was in error.

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He was not in error, and his work led to the invention of the x-ray, which allows physicians to look inside the body without surgery. World War I spurred the usage and refinement of the x-ray as well as the electrocardiograph, which monitors heart function. Both have become indispensable in modern healthcare. As the 1920s dawned, x-rays could be found in the private offices of some physicians in Lynchburg, but no hospital in the city had x-ray equipment until a private citizen donated funds to Lynchburg Hospital for purchase of the equipment. Science was not the only factor shaping the tools and techniques of healthcare at the turn of the century, however. Items as common place today as the telephone and the auto were having a dramatic affect on the way health care was delivered in the late 1800s and early 1900s. Where they were available, telephones helped physicians and other caregivers communicate with patients and patient families. The automobile made it much easier for physicians to visit, examine, and treat their patients, particularly in largely rural areas such as Lynchburg and its environs. Up to this time, physicians would ride horseback or in a horse and buggy to visit patients in their homes. The automobile made it possible for the physician to meet with more people and to get there faster. Families who were early owners of automobiles could reach their doctorâ&#x20AC;&#x2122;s offices more readily. And more physicians could live in town where they would meet with their colleagues and gain new medical knowledge.

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VOLUME II

INTRODUCTION II

his is the second volume of our history of healthcare in Central Virginia. It covers the years from approximately 1930 to the late 1950s, a time of great tumult, uncertainty, and challenge to the people and organizations dedicated to taking care of our health and a period that saw great maturing in the healthcare industry. These years saw the transition of healthcare from a time of severely limited capabilities on the part of healers and caregivers and appropriately low expectations on the part of the population, to the foundations of the extremely capable, extremely expensive healthcare structure we have today. During this era, healthcare organizations were tested repeatedly. The terrible grip of the Great Depression saw the advent of health services that were desired more and more by people who were less and less able to pay for them. This was followed by four years of a nation at war, bringing almost crippling shortages of labor and materials. Together, those forces shaped the way healthcare would be practiced for the rest of the 20th century and beyond, not the least of which was the birth of the notion of pre-paid health insurance. This was also an era that marked the emergence of healthcare organizations as major contributors to the life of the community. Employment, training, and local spending by a growing number of hospitals became an important part of the region’s economy, a trend that would grow exponentially in the future. Healthcare organizations would also become important ingredients in the quality of life in a community, a far cry from the way- stations on the path to the grave, as they were viewed not many years earlier. We at Our Health Magazine hope that our efforts here interest you, just as we hope that you have found our regular issues to provide an accurate chronicle of healthcare as it is today in our region. We would very much like to have your thoughts on what kind of job we are doing and how we might improve it.

Here is Volume 2.

Courtesy of Centra Virginia Baptist Hospital

Courtesy of Centra Virginia Baptist Hospital MURAL COMMISSIONED BY MISS ELSIE GILLIAM AND DONATED TO VIRGINIA BAPTIST HOSPITAL IN 1929. “TO SERVE AS AN INSPIRATION AND GUIDING LIGHT FOR THE MANY WHO PASS THROUGH THE HOSPITAL’S DOORS.”

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HEALTH DEVELOPMENT II

uring the Great Depression, Lynchburg was a town that prided itself on taking care of its own. Although the early 1930s saw some small businesses close and moderate unemployment, larger businesses cut back, and the area did not feel the full impact of the times as it was felt in many other parts of the country.

In Lynchburg, the Transient Bureau shelter was established in December 1933 in a former department store at 12th and Church Streets. The shelter (commonly called “camps” at the time) was in a two-story building capable of housing up to 200. The spot is now occupied by the city’s Tourist Information Center.

No banks failed, and, according to historian Philip Lightfoot Scruggs in his The History of Lynchburg Virginia 1786-1946, “families on relief were fed and clothed and sheltered in a transient bureau for those of the thousands of indigent wanderers who came this way.”

In the pre-dawn hours of Saturday, March 24, 1934, cook William Rasch was in the basement kitchen preparing breakfast for the 190 men, from all over the US, sleeping on side-by-side cots two floors above. Rasch was preparing to make gravy, using some grease in a five-gallon kettle that boiled over, hit the hot stove, and flashed into fire.

In 1930, Lynchburg’s population was about 41,000 people, with another 79,000 in the surrounding counties. The community was graced with four hospitals — Lynchburg Hospital (1912), Marshall Lodge Memorial Hospital (1919), Virginia Baptist (1924), and Guggenheimer Hospital, which opened during the Depression in 1931.

The fire quickly involved the wooden ceiling of the kitchen and ran up an abandoned elevator shaft, toward the sleeping transients. It was a fast-moving fire in a tinder-dry building. Firemen reported that moments after fire crews responded to the first alarm at 5:03 AM, the rear floors of the building were already collapsing.

“There was compassion,” Scruggs wrote, “human understanding, patience, courage, improvisation and, in hindsight, a quieter, happier society for those not ill and destitute.”

Screams of “Fire!” touched off panic among the awakening transients two floors above the kitchen. A wooden board wall had been built around two large sleeping compartments (one for whites, one for Negroes) to prevent building occupants from falling through the floor-to-ceiling plate glass windows and to screen the transients from public view. Already suffering burns and smoke inhalation, the men began tearing the wall down, jumping through the windows in bitter cold and onto the ground two stories below. There was no outside fire escape. City ordinances required fire escapes only for buildings three stories and above. Escaping transients, some already badly burned, broke bones when they landed. Two of the fatalities were from the falls.

Until the fire. The same confluence of railroads and highways that had fostered the commercial success of Lynchburg also served to bring thousands of drifters to the city as the Depression deepened. People took to the roads, especially the railroads, in search of work. With local welfare agencies already strained from taking care of needy locals, drifters found themselves sent to the city jail, not as criminals, but to seek shelter and food. Some measure of relief came from the Federal government, which established the Federal Transit Bureau to deal with the large numbers of people who traveled the country in search of employment. Transients were promised a bed and hot meals at shelters across the country.

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Police at the scene began summoning every vehicle available to transport the dead and injured. Ambulances (operated at that time mainly by the Diuguid and Fauber funeral homes), hearses, private vehicles, mail trucks, and even trucks from the nearby

Lynchburg Steam Bakery were commandeered to transport injured men to area hospitals, sometimes as many as eight to a vehicle. Initially, 59 were taken to Lynchburg Hospital, 13 to Virginia Baptist Hospital, and one to Marshall Lodge Memorial, although it had lost electrical power as a result of the fire. Lynchburg Director of Public Welfare, Dr. Mosby Perrow, took personal command at Lynchburg Hospital, which was then operated by the city. At first, the hospital had trouble finding enough beds for the injured. Perrow ordered 48 mattresses “from downtown,” according to news accounts, and the hospital staff broke out old cots from storage. A quick-thinking hospital telephone operator summoned extra nurses and doctors to the hospital.

Courtesy of Lynchburg History

The entire supply of the city health department’s anti-tetanus serum was used on the injured men. Contacting the families of the dead and injured proved to be difficult because many of the men had given fictitious names when registering at the Transient Bureau. A total of 17 men died in the fire, and another five died afterwards, bringing the total fatalities to 22. More than 80 were injured, and some of the men, already suffering from burns, smoke inhalation, and multiple fractures, developed pneumonia while in the hospitals. It was the city’s single largest disaster. As unquestionably tragic as it was, some social good did come out of the fire. In Virginia and much of the nation, investigations were launched to determine the level of protection against fire in other shelters for transients. Lynchburg citizens were inspired to establish a rescue squad for the on-site treatment and safe transport of people who were ill or injured. And the hospitals proved their worth in providing healing and comfort to victims of mass disasters. The hospitals of Lynchburg had already begun compiling their distinguished records of service, gaining the trust of the people they served. During the previous decade, doctors and hospitals had learned enough about disease that people began to feel that they could be reliably treated. People were beginning to feel personal, emotional relationships between themselves and the healthcare establishment. Activity at the city’s hospitals continued at a busy pace throughout the Depression, and construction projects provided badly needed work and income for Lynchburg residents in the building trades. In 1931, a new patient care wing was added to the southern end of Marshall Lodge Memorial Hospital, the first construction at that site since 1921. Also in 1931, the number of patients at the city-owned Lynchburg Hospital became so great that it became necessary to add a total of 130 beds in a new addition. The addition housed health features that surpassed all that Lynchburgers had known to date. Along with added patient capacity, the hospital was able to add new and improved facilities for radiology and surgery, rooms for first-aid

Courtesy of Lynchburg History

TOP GROUNDBREAKING CEREMONIES AT LYNCHBURG GENERAL HOSPITAL ON LANGHORNE ROAD, 1956. ABOVE LYNCHBURG GENERAL HOSPITAL ON FEDERAL STREET

and outpatient services, and improved noise-resistant flooring. An open air sun porch was added to the building, designed to accommodate convalescing patients and providing a scenic view of the Blue Ridge Mountains. At the same time, the hospital’s nurses’ residence was moved into a new and larger location at the rear of the hospital building. A few miles away at Virginia Baptist Hospital, business had increased to the point where the governing board felt the need for a person to assist Mary Frances Cowling, RN, who had served as the hospital’s superintendent since 1924 and who would continue to serve in that position until 1954. The assistant’s duties, under the new title General Manager, would be to handle unexpected problems as they arose, do the purchasing for the hospital, handle collections for the hospital, and cultivate physicians. The portfolio for the new position also included increasing charitable contributions to the hospital and keeping the needs of the hospital in front of all the Sunday Schools in Baptist churches throughout the state, which, since 1926, had devoted one collection per year — on Mother’s Day — to Virginia Baptist Hospital. After a search, the board brought Dr. John E. White of Burkeville into the position in 1933, at a salary of $1,800 per year and car

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expenses when they were incurred for the benefit of the hospital. Dr. White left two years later and was replaced by T.F. Reece, who evidently received the first vacation granted by the hospital — two weeks each year. Longtime hospital champion and leader as board president, Oscar B. Barker stepped out of the position in 1935 due to his health, although he retained a seat on the hospital’s board. He died in September 1937, leaving a $10,000 endowment (the equivalent of about $160,000 in today’s dollars) to the hospital. Although the use of penicillin and vaccines for many of the diseases that plagued the country was still in the future, many of the country’s traditional enemies of health, typhoid and diphtheria among them, had been controlled by public health measures. Medicine was by then firmly grounded in science, and work was under way to develop vaccines for tuberculosis, tetanus and, eventually, polio. The threat of Lynchburg’s biggest killers across all ages during the 1920s and into the 1930s — diarrhea and enteritis — had been dramatically reduced, chiefly by the work of the city’s health department under Dr. Mosby Perrow. Sewage systems had been improved, and the regulation and inspection of food, water, and milk sources had made these illnesses no longer a serious threat. The 1930s drew to an optimistic close. But forces were at work that would change the nature of healthcare forever. Out of the misery and fear of the Depression came a fundamental shift in how we pay for healthcare. Shortly before the economy crashed, Dallas educator Justin Ford Kimbell and Baylor University Hospital tried an experiment — they offered teachers in Dallas free hospital stays in exchange for small monthly advance payments. About 1,500 of the city’s teachers took advantage of the offer, paying fifty cents each month, which entitled them to receive up to 21 days in the hospital should they need it. At about the same time, in the lumber and mining camps of the Pacific Northwest, employers were becoming alarmed at the cost of treating the illnesses and injuries among the workers in those hazardous industries. The employers made arrangements with local physicians, who received a monthly payment from the employers and treated the employees for the one single fee. The approach caught on. Similar plans followed, and by 1937, more than a million people were covered. Hospital officials realized that offering pre-paid plans could help their hospitals by furnishing a steady, reliable cash flow. The American Hospital Association, the industry trade group, began to offer prepaid hospitalization plans throughout its member hospitals. The plans evolved into what we now know as Blue Cross and Blue Shield, which operated as a non-profit corporation in every state. Since the plans were owned by hospitals, they were not recognized as insurance companies, which in turned exempted them from state taxes on premiums they collected.

In Lynchburg, a similar approach to an employer-sponsored health plan came to an undetermined conclusion. On March 1, 1937, members of the Lynchburg Academy of Medicine — the society for Lynchburg’s white physicians — heard from representatives of the Craddock-Terry Cooperative Association requesting reduced fees for its members. The Craddock-Terry Shoe Company was once one of the area’s largest employers. The matter was referred to the Academy’s committee on legislation and public health. On October 4 of the same year, that committee asked for a special committee to be formed to work with local hospitals “to evolve a working plan for group hospitalization.” The Academy’s minutes reflect nothing further. What the Academy’s minutes do reflect, however, was a growing sense of the nation’s possible involvement in war then raging in Europe. The country was on the verge of a wartime defense posture. An entire meeting of Academy membership in July 1940 was devoted to the war situation. Committees were formed to formulate plans on how to deal with various emergencies. The Academy adopted a resolution that members in good standing would retain their Academy membership and would be relieved of paying dues to the organization during their period of military service.

Courtesy of Lynchburg History and News & Advance

ABOVE NURSE IN LOCAL COTTON GOODS PLANT, CONSOLIDATED TEXTILE

The day after the Japanese attack on the U.S. Naval base in Pearl Harbor on December 7, 1941, the United States entered World War II. The attack was a profound shock, and entry into the war triggered an almost immediate shift in the political and economic profile of America and in the American psyche. America was not ready to go to war, and the focus of nearly every aspect of American life was suddenly shifted to accommodate the all-out war effort. Lynchburg industry saw a large-scale switchover to wartime production and a wartime mindset. Plants were retooled to turn out shoes, socks, and parachutes for the military, metal castings for Liberty ships, and secret materials for the country’s fledging efforts at making an atomic bomb. Area farmers redirected their efforts to feeding the troops. “Victory Gardens” appeared in almost every backyard, and

even in city parks, to provide vegetables, herbs, and fruit for Lynchburg tables. They also gave the gardener a sense of empowerment in the face of the hugely overpowering concept of world war. Doctors, nurses, dietitians, and other healthcare workers began to disappear from American hospitals as they headed for military service. Clerks, maintenance men, housekeeping personnel and other healthcare support workers became scarce as they too went to war or into more highly paid war production jobs. The loss of nurses was most particularly felt as registered nurses joined the war effort, and there were few students to enter training programs. Lynchburg’s working nurses and entire classes of graduate nurses began volunteering for wartime duty. To try to compensate, accelerated nursing education programs, such as the U.S. Cadet Nurse Training Corps and the Red Cross-sponsored Volunteer Nurse Aide Course, worked to turn out qualified nurses and aides in record time. High school girls provided valuable help as ward assistants at Lynchburg General Hospital, where officials determined that “if additional hands and feet could be secured to perform the odd jobs and errands necessary at a hospital, problems raised by one of the worst nursing shortages in history could be solved.” (For more detail, please see the chapter on Nursing in this volume.) More than 3,000 area citizens became part of the Lynchburg Civilian Defense Corps, ready to serve as air raid wardens, firemen, auxiliary police officers, medical workers, and more. Their frequent drills took on increased urgency and seriousness when the deputy chief of Virginia Emergency Medical Services announced that patients would be sent inland to such locations as Lynchburg if the state’s coastal cities — teeming with wartime activities — were to be attacked or if other large-scale catastrophes were to occur. Intensity ramped up further when Central Virginia learned that German submarines had been attacking and sinking American ships off the Virginia Capes. Lynchburg General Hospital and Guggenheimer Hospital developed plans to supply up to 150 beds in the event of air attack and

the history of healthcare

bombing casualties in nearby cities.In all, some 6,232 people from the Lynchburg area were in uniform during the war, either at home or fighting across the bloodied landscapes of Europe, Africa, and the Pacific. A total of 169 lost their lives. Among those who were killed were three Lynchburg physicians — Maj. John E. Adams, First. Lt., William A. Davis, and Capt. Robert P. Ware. Many medical personnel from Central Virginia were assigned to the U.S. Army’s 45th General Hospital based at Camp (now Fort) Lee, VA, which was deployed to Africa and later Italy. When the hospital was being organized in Virginia, it was affiliated with the Medical College of Virginia for recruitment and training purposes. A young physician and senior resident at MCV, George B. Craddock, MD of Lynchburg was activated as part of the hospital unit and served overseas until his discharge after the war, bringing back with him to Lynchburg Army buddy Frank N. Buck, MD. They both became icons of medical history and medical practice in later years. The Academy of Medicine President John T. Hundley, MD announced his entry into military service in May of 1942. By that November, 15 physician members of the Academy were among the military. Among the many local nurses recognized for their war service is Virginia Baptist School of Nursing graduate Nellie Feagans, RN, who also served with the 45th General Hospital, earning three Bronze Stars for her courage in combat and earning a fourth Bronze Star during the Korean War. The 1937 Virginia Baptist graduate stayed with the Army, retiring as a lieutenant colonel in 1964. In addition to personnel shortages, healthcare in Lynchburg braved all kinds of wartime shortages, some of them unexpected. A shortage of wooden flooring slowed the 1945 reconstruction of a building at Lynchburg General Hospital, which was complete except for its floors. “We’ve looked everywhere,” reported Inspection Engineer J. Eldon Rucker, “but we can’t find enough for the job. Flooring is one of the scarcest items we have to contend with.” A 1943 appropriation by Congress set aside more than $18 million for the care of the wives and infants of lowerlevel enlisted servicemen — including prenatal care, delivery and post-delivery health services, and hospital care for mothers and infants of men in uniform. Lynchburg General Hospital participated in the service, although they could not at that time give statistics for how many had taken advantage of it.

were born in American hospitals. In 1942, the number of hospitalborn babies soared to 1,670,599. That kind of increase was felt all over the country. In Lynchburg, for example, Guggenheimer Hospital responded to this increase and, by June of 1944, had undergone extensive renovation and opened as a complete new maternity hospital, the first hospital in the state to be devoted exclusively to maternity and infant care. Medicine in general gained a great deal as a result of the war. Combat surgeons developed new approaches and techniques that saved countless lives on and off of the battlefields. Orthopaedic surgeons learned how to save injured arms and legs that in most previous wars had simply been amputated. Surgeons worked on perfecting debridement, the art of removing dead or dying skin from burns and other injuries as a way of healing and preventing infection. Infectious disease specialists gained better understanding of how to treat and prevent diseases such as malaria. Miracle drugs such as penicillin were in wide combat use as a way to prevent infection, and by the end of the war, the drugs were going into mass production for civilian use. Not all wartime injuries are physical, however. Military psychiatrists and psychologists schooled themselves on the effects that combat has on the individual. They recognized that a break from fighting and rest in a safe place with good food can restore troops in battle. Those who carried the mental scars of battle could be treated in military hospitals. All of these lessons and more were full of implications for the practice of medicine and healing after the war. Peace finally came, and with the war’s end came pent-up demand for all of the things that America had done without during the past four years. Surviving the crucible of the Great Depression and the war years, America was poised for great development and economic vitality. Servicemen and servicewomen returning from the war went back to life with a vengeance. They resumed their educations, resumed their careers, built houses, had babies, and became active consumers. The air was filled with promise. VIRGINIA BAPTIST HOSPITAL.

The preference for military wives to have babies in hospitals — rather than at home, which had been the family choice for earlier generations — was mirrored in the general population. In 1931, 708,889 babies Courtesy of Centra Virginia Baptist Hospital 48

the history of healthcare

Courtesy of Centra Virginia Baptist Hospital DIETETICS LAB AT VIRGINIA BAPTIST HOSPITAL, 1950.

Much discussion in communities across the country centered on how well communities served public need, with the underlying wish that American servicemen return home to a better community than the one they left. The city-owned Lynchburg General Hospital (the word “General” had been added in the 1930s) needed renovation to meet increased demand fueled by population growth, as did Marshall Lodge Memorial Hospital and Virginia Baptist Hospital. Within these discussions, conversations arose about the possibility of a hospital for the city’s “Negro” population. Earlier efforts to establish a hospital for African-Americans had failed, although there had been some preliminary activity aimed at integrating the practice of medicine in Lynchburg. In May 1940, the Academy of Medicine extended an invitation to Negro physicians to attend the scientific session of the Academy and to use the Academy’s recently established medical library. In 1944, a group of black doctors petitioned city council to allow African-American physicians and nurses to practice at Lynchburg General Hospital, still under city ownership, but real integration did not come until some 20 years later, ushered in by the Federal government. Little if any progress was made in the racial integration of healthcare at that time, but it became clear that new health facilities would be needed to accommodate what was expected to

be significant growth in the population of Lynchburg, coupled with medicine’s growing capability to understand, diagnose, and treat illness and injury. Lynchburg City Manager R.W.B. Hart and other interested citizens began looking into how best to plan for the future. In their search, they discovered other city-owned hospitals that had been transferred into the control of independent authorities. In late November 1945, the study became a proposal, with Hart noting that, “change in the character of patients from predominantly charity to predominantly self-paying indicate future trends and future needs best met by taking the hospital (Lynchburg General) out of city control and integrating it as an autonomous unit under the authority of a competent board as a nonprofit association.” Hart said that operating the hospital under an independent authority would “provide greatly improved hospital facilities much faster and with far greater community interest and support than could possibly be obtained under the present plan of operation.” What followed were several months of discussion and debate over the proposal. In fact, a questionnaire for City Council candidates, circulated in April 1946, posed a question seeking candidate’s views toward establishment of the Lynchburg Hospital Authority, its financing, and financing of a new, modern medical center to meet the needs of the region.

the history of healthcare

On June 25, 1946, the council established the independent authority, to be overseen by a nine-member board representing the public and headed by prominent Lynchburg area businessman David Hugh Dillard, president of Dominion Box Co. The Authority was given complete authority over the facilities, financing, and operation of Lynchburg General Hospital, although costs for indigent patients treated in the hospital would continue to be borne by the city. Two studies conducted by the new authority showed that the region would soon need 85 additional hospital beds, along with more modern accommodations for the new medical techniques that were rapidly changing healthcare. The studies further established that an “expert and hardworking” staff at Lynchburg General was making the best of an outmoded, inadequate and cramped structure. They concluded that the existing hospital on Hollins Mill Road could not be successfully enlarged, and construction of an entirely new building was recommended. The recommendations touched off a wave of hospital planning and design that stretched out over the next seven years. To be located on a 250-acre tract of land on Tate Springs Road that the city had acquired for the purpose in 1946, the $4 million hospital would be built with a combination of local funding, donations by area residents, and federal funds. Federal funding would be provided under a new government program to aid in the construction of healthcare facilities in the United States. In all areas of the country, population growth and demand for health services was increasing, which in turn led to furious planning for expansion of existing hospitals and early work on establishing hospitals where none had been before. Through their trade associations, hospitals in America agreed that the time was right to press for federal assistance in the planning and construction of new hospital facilities. Two U.S. Senators, Lister Hill of Alabama and Harold Burton of Ohio, introduced legislation in 1945 that would inject Federal funding into hospital construction. The Hill-Burton Act, signed into law in 1946, influenced the growth of hospitals for most of the next 50 years. The law gave hospitals, nursing homes, and other health facilities grants and loans for construction and modernization. In return, they agreed to provide a “reasonable volume of services to persons unable to pay and to make their services available to all persons residing in the facility’s area, without discrimination on the basis of race, color, national origin, creed or any other ground unrelated to the individual’s need for the service or the availability of needed service in the facility.” At Virginia Baptist Hospital, the almost-constant process of adding new wings continued, although early on, its board adopted a resolution that the hospital would not accept Hill-Burton Funds or funds from any other public source. The resolution noted, “Believing in the absolute separation of church and state...we will not solicit or accept money from any municipality or State or the federal government wither as a loan or a direct gift...” The hospital opened the Cowling Building (named for the long-time superintendent Mary Frances Cowling) in 1949, while also planning a major construction program to be mounted in future years. But it was the planning and construction of the new Lynchburg General Hospital that occupied the attention of most of Lynchburg. Rather than presenting the new facility in terms of a “hospital,” planners instead labeled it a “medical center,” meaning a facility staffed and equipped to deal with a much broader range of illnesses and injuries than a typical community hospital. The term took on added meaning in that it was located in the approximate geographic center of the city as well, instead of on the northern fringes of Lynchburg, where most medical care was taking place at the time.

the history of healthcare

To orchestrate the planning and construction of the modern medical center, the Hospital Authority brought in Robert S. Hudgens, who at that time was serving as director of the Medical College of Virginia Hospitals in Richmond. Taking on the role of administrator of the authority, Hudgens set the tone for planning and construction of the new hospital, which he said he saw as “the opportunity for a modern medical center second to none in the nation.” And that is precisely the goal that guided hospital planners for the next few years. Plans for construction were slowed slightly because of the postwar scarcity of some building materials and because planners were intent on coordinating with future plans for the University of Virginia Medical School and hospital and the Medical College of Virginia.

a modern hospital”); lighting (“Another factor to be considered... was the proper type of light bulbs for each of the public rooms”); the x-ray division (“ ...has come into its own at the new medical center...”); and even the system of keys for the new hospital (the new master key “will be guarded like gold”). A series of tours for about 6,000 area residents to preview the hospital produced rave reviews. Pre-dedication tours for members of the hospital’s medical staff scored big points for the physicians, as well as for area residents who read of their reactions in the newspapers. Lynchburg Academy of Medicine’s J.W. Houck, MD marveled that he was “plainly somewhat stunned. It has every facility for the practice of medicine and is completely modern in

Time was needed for local fundraising activities as well that eventually raised about $1.25 million to be put toward construction costs. By November of 1952, the Hospital Authority was ready to contract for working drawings of the new hospital, and by July of 1954, with construction plans in hand, contracts were signed with Virginia Engineering Corp. of Newport News for construction of the building at a cost of $3,532,000. At the ceremony marking the start of construction on Oct. 5, 1954, Nurse Sadie Kesler, president of the hospital’s student nurse association, pulled a switch to pour the first load of concrete for the building’s foundation. Speaking at the ceremony, Lynchburg mayor John Suttenfield noted that he doubted that “any fundraising campaign in Lynchburg had been as successful as the campaign to raise local funds for the hospital.” Presiding over the festivities was Hospital Authority R.G. Atherholt, for whom one of the major streets in the hospital complex is named. As the opening date for the new hospital approached, the Hospital Authority started conducting preview tours of the new building for various groups from the community, and the newspapers carried frequent articles about the features of the new facility. By reading the newspaper, area residents got a glimpse of the new emergency department (“second to none”); furniture and décor (“color therapy is of utmost importance in

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every way.” S.H. Rosenthal, MD put it more bluntly: “If we doctors can’t do the work there, the fault is with the doctors.” By the time the hospital opened, 26 physicians had announced plans to open a medical building of their own near the hospital. But it was the special tours for the hospital’s student nurses that seemed to produce the largest chorus of ooh’s and aah’s. Walking through the new building in small groups that could linger wherever they wanted, the nurses seemed to be delighted at every turn. “Great day!” one nurse declared. “This is like living in a dream world.”

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The new building was not a dream world, however; it was a bricks-and-mortar house of healing. Detailed plans were laid for moving patients into the new facility. Shortly before move-in day on November 17, 1956, the hospital eliminated all patient activity, other than emergencies, to pare down the number of patients that would need to be moved. On a rainy, chilly Saturday morning, there were 61 patients to be moved from the “old” hospital site on Hollins Mill Road to the new building several miles away. Trucking firms in Lynchburg donated their vehicles and their drivers’ time. Members of the Lynchburg Jaycees — 170 in all — moved patients in their beds from the old building to the vans, and from the vans into the new building. Administrator Hudgens described the scene: “I looked down quiet little Hollins Street and saw it lined with huge vans. Their drivers, who had been hauling cargo the day before, were almost over-careful in handling their big trucks.” The move was completed in a few hours, and the new Lynchburg General was a hospital in function as well as in name. With the move at Lynchburg General Hospital and every other healthcare facility in the region, the pieces were nearly in place for the explosive growth of medicine and healthcare that would begin in the 1960s.

the history of healthcare

AMBULANCE SERVICE II

The donated ambulance became inoperable in early 1935, and the vehicle was taken out of service. The crew, which was becoming well-trained and increasingly well-equipped with rescue gear, was effectively out of business without a vehicle.

Courtesy of Lynchburg History LIFE SAVING CREW EQUIPMENT DISPLAY AT RIVERSIDE PARK.

he fledgling Lynchburg Life Saving and First Aid Crew had made remarkable progress since its founding in 1934, when two major fires — one of them with multiple fatalities — underscored the need for such a source of help in the city. Shortly after organizing in March 1934, the new crew received its first vehicle as a gift when the trailblazing Roanoke Life Saving and First Aid Crew, organized only six years earlier, gave their 1918 Cadillac ambulance to the Lynchburg group. It had been donated to the Roanoke crew by Oakey Funeral Service of Roanoke, and the Roanoke crew members had converted it into a rescue vehicle. The Roanoke crew donated it to Lynchburg when a new vehicle was secured in the Star City. The vehicle came equipped with the proper gear to handle most emergency situations. It arrived in Lynchburg in July and went into service in September 1934, housed at the Rivermont fire station. Later, a local physician offered the use of his personal rowboat and trailer for water rescue. The boat was wooden and needed to be kept filled with six inches of water to prevent the wood from shrinking, splitting, and causing leaks. Each time the boat was used, the water needed to be dumped from the boat before it was attached to the rear of the ambulance to continue its rescue mission.

the history of healthcare

Perhaps providentially, the crew had started fundraising activities not long after organizing. Crew members sought donations from individuals — the very first donation being a $25 gift from the secretary-treasurer of funeral home W.D. Diuguid Inc. — and also raised money from the sponsorship of two boxing matches and a benefit ball. Because of these fundraising efforts, the crew was in reasonable financial shape to buy a new vehicle, a 1933 Dodge half-ton panel body vehicle bought from Lynchburg’s John P. Hughes Motor Company. It was dubbed Emergency Car 99. It came equipped with a radio. In the early days, the help of Lynchburg radio station WLVA — which later became present-day television station WSET — was enlisted to announce emergency calls to volunteer members, who listened to the station for that purpose. The Lynchburg Police Department then established a short wave radio system, and a radio receiver and transmitter were installed to enable communications with the vehicle. In March of 1936, a chain of storms swept across much of the eastern US, with widespread flooding caused by the combination of heavy rains. The rains in turn melted the accumulated snowfall of an especially snowy winter. The rain and snowmelt produced flooding throughout the region, including the Potomac, Rappahannock, York, and James Rivers in Virginia. The floods in the region claimed as many as 200 lives and many millions of dollars of damage. One of those lives was a member of the Lynchburg crew. On March 18, when the James River in Lynchburg crested at 24 feet above its normal level, the crew received a rescue call to go to the aid of victims in the river. In the rescue attempt, the Lynchburg crew lost its first volunteer killed in the line of duty. Kenith Patterson was one of the 13 founding members of the

Lynchburg Life Saving Crew. Although a volunteer, he was on an official leave of absence to be at the bedside of his father, who was near death. Alerted by telephone of the serious flood conditions and the need for workers, Patterson canceled his leave and reported for rescue service. Patterson worked with fellow crew members all night, returning to his father’s bedside in the morning only to be called back into service almost immediately. He then saved a man and his daughter and grandson, taking them safely ashore and then taking a boat alone to retrieve records from a company lower on the James River. En route, the boat struck the guy wire of a submerged telephone pole. Exhausted and weighed down by water-filled hip boots and a heavy overcoat, he clung to the telephone pole for a while but then slipped into the churning flood waters, drowning at age 28. A double funeral was held — for Kenith and for his father. For Lynchburg, the tragedy underscored both the need for a well-developed, well-equipped rescue service and the fact that those who engage in rescuing others can very easily put their own lives at stake. Kenith Patterson was the first of three Lynchburg emergency volunteers who would sacrifice their lives in the line of duty, according to the National EMS Memorial Service. The second was Edwin Dudley “Buck” Hook Jr., who began his volunteer service with the crew in 1945 and served for 27 years until his death in August 1972. He was a member of a crew that responded to a highway accident on August 18, 1972. After freeing trapped passengers from their car and providing first aid, Hook started to have chest pain. His fellow crew members began CPR and transported him to the hospital, where efforts to save him failed and he died at age 54.

upstream, the Timberlake Dam failed, sending a wall of water that washed him downstream and flipped a boat being used during the rescue. Rescuers were able to find Martin and pull him from the water about 15 minutes later, but they were unable to revive him. The Lynchburg crew received its license as a corporation — as the Lynchburg Life Saving and First Aid Crew, Inc. — in October 1943. Five years later, the crew moved from its home in the city hall annex at 11th and Church Streets to its own building, a renovated storefront at 1216 Rivermont Avenue, which served as its headquarters for the next 22 years. Walk by that address today, and you can readily tell that the building was once a fire/rescue station, although it’s now privately owned. The building is still adorned with the “LFD” (Lynchburg Fire Department) monogram. As the years passed, the work of the crew touched many families in the region and the community rapidly gained confidence in the quality of services the crew was furnishing. With the coming of World War II, a large number of lifesaving crew members went off to fight, but those left behind continued to provide unbroken service. The crew not only answered a growing volume of calls from the community, but they also answered calls for help from the U.S. Government. Enemy attack on the United States was considered a distinct possibility, and crew members were among the more than 3,000 community members preparing themselves to come to the aid of their neighbors if the call came. By the early 1960s, the Life Saving Crew’s reputation as a dedicated, professional, and successful rescue organization was well established. The crew was even asked to assist with rescue efforts in disasters hundreds of miles away from Lynchburg, from a bridge collapse in Ohio to a plane crash that took 95 lives at Dulles International Airport in northern Virginia.

The third death is probably well-remembered today. In a rescue attempt caused again by flooding, this time on June 22, 1995, Carter Dewitt Martin was among Brookville-Timberlake fire department rescue volunteers responding to a call involving three cars trapped in deep water with passengers inside. The 41-year-old Carter, on that call serving as a volunteer but also a paid City of Lynchburg fireman, Photo Credit attempted to wade to the cars. At the same time a mile

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POLIO PATIENTS, 1945 | Courtesy of Lynchburg History and S.O. Fisher Collection

the history of healthcare

EPIDEMICS II

s America moved through mid-century, it gradually became free of the eruptions of illness that had so frequently frightened and ravaged communities. Widespread outbreaks of disease were not eradicated, however. Tuberculosis continued to be a menace, to the extent that the nearby Catawba Sanitarium in north Roanoke County had on its campus a cottage especially for nurses who had contracted the disease while treating TB patients. Funded by a nursing association, nurses who could not afford to pay for treatment could go there for treatment at little or no expense. In addition, the influenza made an annual visit, often closing schools until the danger had passed.

working to obtain the yellow fever virus to wage biological warfare. So worried was the War Department that in early 1941, it ordered the vaccination of troops stationed in the tropics. After the Japanese attack on Pearl Harbor on December 7, 1941 and America’s entry into the war, vaccination of the entire Army was made compulsory beginning in 1942. American troops in the Pacific, England, the United States, and elsewhere soon fell ill by the tens of thousands (some estimates are that as many as 50,000 troops were sickened). Scores of servicemen died, attacked by a disease that was first called “jaundice,” later identified as hepatitis B.

The most virulent killer diseases, however — cholera, diphtheria, and smallpox — were being banished from the American health landscape. But it was a burst of sickness taking place far from the Virginia mountains during early World War II that brought the war to Lynchburg’s backyard in a troublesome way. SOME BACKGROUND: According to a 2001 investigation by Richmond Times-Dispatch writer Peter Hardin, in 1939, a man carrying a diplomatic letter of introduction walked into a laboratory in New York City, where scientists were working on a vaccine for yellow fever, the life-threatening illness spread by the bite of infected mosquitos. The scientists used a live but weakened — and still highly infectious — strain of the yellow fever virus.

Courtesy of Lynchburg History and S.O. Fisher Collection

The man introduced himself as Ryoichi Naito, a faculty member of the Army Medical College in Tokyo. He asked for two strains of the yellow fever virus. He was refused. Several days later, a well-dressed stranger with a “trace of a foreign accent” approached one of the laboratory’s technicians on a New York street and offered up to $3,000 for the virus. He too was refused and, after making threatening remarks and gestures, walked away. When reported to authorities, these back-to-back incidents raised US suspicions that the Japanese, preparing for war, were

Courtesy of Lynchburg History TOP POLIO PATIENT ABOVE VIRGINIA STATE EPILEPTIC COLONY

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Military officials correlated the servicemen who fell ill with those who were vaccinated and found a strong relationship between the two groups. They were virtually the same. Use of the vaccine was discontinued in April 1942, and a substitute vaccine was put into use. At about the same time, in June 1942, an outbreak of “jaundice” in the US Virgin Islands drew the attention of the National Institutes of Health, which dispatched three physicians to investigate. They found that the Virgin Islanders had received the same batch of the yellow fever vaccine as the Army inductees. Even with the original vaccine now shelved, the government needed to know how to prevent future contamination of vaccines or important fluids, such as blood and plasma. Returning to Washington, DC, the three NIH physicians prepared a memo proposing that a study of the yellow fever vaccine be conducted at the “Virginia State Colony” near Lynchburg. “The Colony,” across the James River from Lynchburg in Madison Heights, VA, was by then one of the largest facilities in the country for the care of disabled patients. Established in 1910 as an asylum for Virginians with epilepsy, people with mental retardation were added to its patient rolls in 1916. Its official name at that time was the State Colony for the Epileptic and Feebleminded. Now it’s known as the Central Virginia Training Center, a vastly different facility from those days. Since the 1970s, government-funded research on humans has been done within the strict confines of legal regulations that include securing the permission of human research subjects. But in the 1940s, particularly under the pressure and secrecy of war, no such limitations existed, and even parental permission was considered unnecessary. And by then, there was a fairly common practice of conducting experiments on young human subjects hidden from public view behind institutional walls — jails, mental institutions, orphanages, and the like. The “volunteer” subjects were not likely to

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complain, they were easily available to researchers, and any potential objections could easily be balanced by the imperatives presented by terrible diseases and wartime demands. As one pediatrician later remembered, “everyone was a draftee” in the national war on disease.

of polio seen in some Virginia communities, newspapers in the Lynchburg area seemed

And “The Colony” was well suited as a site for research on humans that would be below the public radar. At the same time, young residents of the facility were being sterilized involuntarily under a movement referred to as eugenics, the belief that the overall quality of the human species could be improved by various means, including discouraging reproduction by people who are presumed to have undesirable genetic traits — such as being “feebleminded.” Between 1927 and 1972, some 4,000 people were sterilized under the program.

Work by Jonas Salk, MD, resulted in a preventive vaccine in 1953. Salk was hailed as a miracle maker, who further endeared himself to the American public by refusing to patent the vaccine because he said he had no desire to profit personally from the discovery. The basis for confirming the effectiveness of the vaccine involved the now-famous HeLa cells, the “immortal cells” taken from Roanoke native, and later Halifax County resident, Henrietta Lacks without her knowledge. The HeLa cells were

full of notifications of opportunities for residents to get the Salk polio vaccine.

At “The Colony,” after some initial screenings, a total of 273 patients ranging in age from 13 to 57 had been given the vaccine by March 1944, according to the Times-Dispatch investigation. A total of 37 people developed “jaundice,” most suffering a mild form. There were no deaths. With the passage of time, the newspaper report continues, “medical researchers determined that seven batches of the yellow fever vaccine given to troops at the start of World War II were contaminated with the hepatitis B virus. Human serum for the vaccine had been taken from medical school volunteers. Several of them had a history of the disease, unknown to the vaccine’s maker.” The United States was not alone in conducting secret and sometimes gruesome medical experiments on human subjects. Nazi death camp experiments were exposed and condemned in the Nuremberg trials, and the Japanese also killed thousands of prisoners with germs ranging from anthrax to yellow fever. And more is now known about the Japanese doctor who requested the yellow fever viruses in New York City in 1939. Ryoichi Naito was a protégé of Shiro Ishii, prime champion of Japan’s research in biological and chemical warfare. The Colony incident carries echoes into the modern-day, post 9/11 debate over personal freedoms in the face of threats to national security. The polio epidemic, which brought summertime terror to many regions of the country — including many areas of Virginia — during the 1940s, 1950s, and into the 1960s left Lynchburg largely untouched. In fact, Lynchburg nurses who wanted to come to the aid of large numbers of polio patients traveled to communities outside of the central Virginia area, where their help was more urgently needed. Instead of almost daily reports of the growing epidemic

the history of healthcare

highly susceptible to the polio virus, Salk learned, and he and his researchers used these cells as a test medium for the vaccine. If the vaccine was successful in killing the polio virus in the HeLa cells, it would be successful on a mass scale with humans. Mass vaccinations began in the United States in 1955, and in 1961, Albert Sabine refined an oral vaccine, the vaccine contained in the pink-tinged sugar cubes many remember from the mass vaccinations of the 1960s. Throughout the mid-1950s and into the 60s, frequent clinics for the administration of the vaccines were scheduled throughout central Virginia under the sponsorship of organizations such as the Lynchburg Academy of Medicine, the Jaycees (Junior Chambers of Commerce), Rotary clubs of various communities, and area health departments.

POLIO POSTER

Those efforts of distribution of the vaccine were credited with preventing hundreds of further cases of the disease. In fact, the vaccine was so successful that it may have led to an abundance of complacency on the part of many parents in the region. In a December 1955 editorial, the Bedford Bulletin noted that in the previous year Bedford County had been “almost free of the disease,” causing the Bedford Health Department to note “an attitude of apathy among many Virginia parents” toward the need for inoculation. Two years later, the Bedford Democrat opined that it was “hard to understand” that only a third of the total numbers of expected inoculations had been given. Though it was a national nightmare at the time, polio and the damage it left behind have become faded history to many. But the effects of the waves of polio epidemics are still very much felt today. The March of Dimes campaign, with its roots in the struggle against polio, gave rise to grassroots fundraising that has revolutionized healthcare philanthropy. The modern field of rehabilitation therapy gained much of its early knowledge from experience with polio. And the survivors of polio still constitute one of the largest groups of advocates for the disabled. Polio has been eradicated in the Western Hemisphere, but that does not mean that the disease is completely dead and gone. Outbreaks still occur in a handful of countries, Afghanistan, India, Nigeria and Pakistan chief among them. And even in America, there are still an estimated 750,000 polio survivors who live with the physical and mental reminders of how their lives were shaped by the “summer terror.”

the history of healthcare

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HEROS II

(AND ONE VILLAIN)

y its very nature, the world of healthcare is populated by some very extraordinary people. They care deeply about their patients, their problems, and their pain. They have a highly refined sense of collaboration because healthcare is most often a team sport. They understand their role in collaboration, and they are accountable for it. They adjust to change, because no two days in healthcare are exactly alike. They are compassionate, determined, intelligent, and honest. To rise above the “ordinary” in the world of healthcare takes an extremely rare sort of person. These are some of the people who made a major difference in shaping the healthcare of Central Virginia between the 1930s and the 1960s.

if he had the necessary strength, will or knowledge.” She was one of the first nurses to point out that nursing does not consist of merely following physicians’ orders. She was awarded a dozen honorary doctorate degrees from colleges across the nation. Henderson died at the age of 98 in 1996 at the Connecticut Hospice, and she was interred in her family’s plot in the churchyard of St. Stephen’s Church, just outside Lynchburg in Forest, VA. But her name lives on. In 2009, Centra Health created the Virginia Henderson Center for Nursing Research and Innovation, located at Lynchburg General Hospital. The mission of the center is “to inspire and support evidence-based practice and innovative research to promote excellence in professional nursing and patient care.”

VIRGINIA HENDERSON, RN: Although she never actually practiced nursing in the Hill City, this Lynchburg-born theorist, researcher, and educator is widely known as the “First Lady of Nursing,” who influenced the practice of nursing around the world. The American Nursing Association considers Virginia Henderson the foremost nurse of the 20th Century.Henderson was born in Lynchburg in 1897 Courtesy of Centra Health and graduated from the Army School of Nursing in Washington, DC in 1921, later studying at Columbia University. In 1953, she joined Yale School of Nursing, a particularly fitting association, since the first dean, Annie Warburton Goodrich, had served as her mentor in her early professional years. The Yale years were a time of great productivity. During a stellar career, Henderson formulated theories of nursing education and human response to nursing, creating definitions of the profession that are observed to this day. “The unique function of the nurse,” she wrote in 1966, “is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided

ROBERT WALTER JOHNSON, MD: Robert Walter Johnson was a standout athlete for much of his life, earning the nickname “Whirlwind” for his broken-field running on his college football team, where he played without shoulder pads or a helmet because they slowed him down. He played semi-pro baseball and coached football and baseball to pay for his medical school education, moving to Lynchburg to set up his medical practice in 1933. By all accounts, he was an exemplary physician, displaying a particular interest in caring for the city’s Negro residents, pressing for the admittance of Negro doctors to the Courtesy of Centra Health medical staffs of area hospitals, and striving for excellence in all that he did. He became an avid tennis player and believed that tennis would be one of the routes to equality for Negros in America. He believed also that young Negro tennis players had to begin training early in their lives if they were going to compete

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struck and killed by a car when crossing Rivermont Avenue in Lynchburg on a December night in 1985.

Courtesy of Lynchburg History DR. ROBERT WALTER JOHNSON WITH HIS TENNIS STUDENTS.

against successful white players and that tennis was a metaphor for life, and as such, required discipline, self-confidence, and social grace.To prepare young players for life, he began supporting young aspiring players, hosting them at his home for summer training camps. Among his trainees were tennis players Althea Gibson and Arthur Ashe, the first African American to win at Wimbledon, as well as champions Juan Farrow and John Lucas. Johnson’s home was also open to notable African Americans traveling through Lynchburg during the period when African Americans were excluded from white hotels. Duke Ellington, Jackie Robinson, Lionel Hampton, and Roy Campanella were said to be among the visitors hosted at 1422 Pierce Street. His home and tennis court are now listed on the National Register of Historic Places.

GEORGE CRADDOCK, MD: George Craddock, MD was a general practitioner by vocation and Lynchburg Saint by reputation. In his book “A City Unto Itself,” Lynchburg writer Darrell Laurant recounts a story told by Dr. Craddock’s colleague Jeffrey Wilson, MD. Dr. Craddock had diagnosed a young Lynchburg girl with polio in the late 1940s. The young patient was to be transferred to the Medical College of Virginia in Richmond for treatment, Laurant writes, “and Craddock presented an envelope for the family to take with them. They assumed the envelope contained medical records, but when they arrived at MCV and opened the envelope, they found six onehundred dollar bills. Dr. Craddock had taken the money out of his office safe, fearing that upon arriving so late at night, the patient and her family would find themselves without necessary funds.” “George Craddock was the most progressive thinking physician that I knew,” Dr. Wilson wrote in a memoir of Dr. Craddock. “If he saw something he felt was good overall for medicine and patients in Lynchburg, he was in favor of it regardless of personal concerns.” Dr. Craddock, who made house calls all the way into his 80s, was

DESMOND T. DOSS: Growing up in Lynchburg as a Seventh Day Adventist, Desmond Doss was inspired each day by a framed poster of the Ten Commandments and the Lord’s Prayer that his father had bought at an auction. He was especially drawn to the Sixth Commandment — “Thou shalt not kill.” World War II came, and Doss was drafted into the Army in April 1942. Given conscientious objector status because he refused to bear arms in accordance with his religious beliefs, he became a medic. He said that this was the only way he could adhere to the Sixth Commandment as well as the Fourth Commandment, to honor the Sabbath, which in his faith was Saturday. Doss felt he could serve as an unarmed medic seven days a week since, as he put it, “Christ healed on the Sabbath.” In the service, he suffered frequent harassment from both his fellow soldiers and his superiors because of his refusal to handle arms or work on Saturdays. He was assigned to the 307th Infantry, 77th Infantry Division in 1944 and saw combat on Guam and at Leyte in the Philippines,

receiving the Bronze Star. Then his unit was dispatched to take part in the battle for Okinawa, one of the fiercest and bloodiest campaigns of the latter part of the war in the Pacific, in the spring of 1945. Doss’ unit was engaged in a battle for a 400-foot-high ridge on Okinawa. Many of his fellow soldiers were pinned down atop the ridge by a Japanese counterattack. Some managed to escape from the ridge, but some were wounded and were stranded atop the ridge. It was April 29, 1944. A Saturday. The only way to save the wounded was for Doss to crawl to them across the rocks of the ridge and, one by one, lower them to safety. He did this in the face of enemy fire, lowering each man on a rope-supported litter he had devised, using double bowline knots he had learned to tie as a Boy Scout in Lynchburg. There were 75 wounded. He did this 75 times before leaving the ridge himself. After engaging in additional rescue efforts under fire over the next two weeks, Doss was wounded by a grenade that riddled him

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with shrapnel. He cared for his injuries alone for five hours, rather than have another medic emerge from cover to help him. When he was finally being carried off on a litter, he spotted a soldier who seemed worse off. He leaped off the litter, directing his aid men to help the other soldier. Soon after that, Japanese fire hit him, and he suffered a compound arm fracture. He bound a rifle stock to his shattered arm as a splint, evidently the closest he ever came to handling a weapon, and crawled 300 yards to an aid station. For his acts of bravery, President Harry S. Truman presented Doss the Congressional Medal of Honor on October 12, 1945. Doss spent more than five years in hospitals being treated for his wounds and lost a lung to tuberculosis. Because of his infirmities, he was unable to seek steady work. He devoted himself to his religion and worked with young people in church-sponsored programs, returning to Lynchburg occasionally to visit relatives. He lived for many years in Rising Fawn, GA before moving to Alabama, where he died at age 87 in 2006.

MARY FRANCES COWLING, RN: In 1917, Mary Frances Cowling, a nurse who would serve the community for the next 37 years, became superintendent of Lynchburg Hospital. Her appointment underlines one of the restrictions of nursing at the time. You had to be a single, childless woman. The superintendent at the time took a two-week vacation. Courtesy of Centra Virginia To fill in for her, the hospital brought Baptist Hospital in Miss Cowling as a replacement. During her vacation, the sitting superintendent was married, and Miss Cowling was then appointed to the post. Mary Frances Cowling, R.N. had been trained during a shortlived program at St. Andrews Hospital in Lynchburg. She would lead Lynchburg Hospital until 1923, when she was appointed the first superintendent of the Virginia Baptist Hospital, then under construction at its Rivermont site, and head of the new hospital’s nursing school. She served in this dual capacity until the hospital board recognized the need for a general manager to assist the superintendent and hired Dr. John E. White into that position in 1932. Before the hospital’s opening on July 1, 1924, she worked with board president O.B. Barker to hire staff, plan and organize the hospital’s operations, and purchase equipment for the new hospital. That September, she welcomed students of the first nursing school, as she would for the next 30 years. Cowling lived in the superintendent’s suite at the hospital until she retired in July 1954, when she moved into a retirement home on nearby Rowland Drive. She died at Virginia Baptist Hospital in 1971.The School of

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Nursing Building at Virginia Baptist is called the “Cowling Building” in recognition of her many contributions to healthcare in the city.

AND ONE VILLAIN — THE REV. AMOS CARNEGIE Along with the bona fide heroes profiled here, one particularly spectacular villain deserves mention. Not so much for what he accomplished, but for what he told others he would do. In early December 1935, the Rev. Amos H. Carnegie showed up in Lynchburg with a beautiful dream: to build a hospital specifically for the Negro (as African Americans were called at the time) population of Lynchburg and ultimately staffed by Negro doctors and nurses. Rev. Carnegie, who identified himself as a representative of the National Negro Hospital Association, said that he had just completed a 42,000-mile, 15-month tour throughout the United States, making a first-hand study of the status of Negro patients, physicians and nurses. His study, he said, convinced him that a Negro hospital should be established in every USA city with a population of at least 10,000 Negro citizens. The movement, he said, had already been backed by medical associations and by the governors of 36 states in the US. And Lynchburg was one such city. In fact, the hospital would be named to honor Henry A. Christian, MD, a Lynchburg native who went on to become physician-in-chief of the Highly regarded Peter Brent Brigham Hospital in Boston. The hospital would be built in part with local donations solicited from the entire community, with any shortfall made up by at least $100,000 raised from a similar campaign that had just been launched in Boston. Fundraising in Lynchburg began, and Rev. Carnegie made several trips to the Hill City to pick up several thousand dollars that had been raised. But the beautiful dream was just that — a dream, mostly in the minds of those who were persuaded to donate money. Rev. Carnegie turned out to be a charlatan. The scheme started to unravel when The National Medical Association, the dominant professional organization of Negro physicians, in a February 1936 editorial in the association’s Journal, declared that it was opposed to the scheme. Information on Rev. Carnegie after that point is rather sketchy, other than a brief item in a 1953 issue of Jet Magazine that Dr. Carnegie had been fined $50 and sentenced to a one-year suspended jail sentence for soliciting funds for construction of a hospital in Birmingham, AL without a building permit.

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NURSES II

merican nursing came into its own during the World War II years. For years, nurses had been caught in a perceptual tugof-war between being a loving but simple provider of tender care on the one hand, and being a trained and competent professional medical specialist on the other. In the early days of the 1930s, working nurses stood when a physician entered the room. They did not offer an opinion on the condition or treatment of a patient. They lived a largely cloistered life, making their homes at the hospital and not allowed to marry. In Lynchburg, nursing students were confined in both their working and personal lives, fulfilling expectations that they be innocent, virginal, and obedient handmaidens in the hospital and in the community. All students were unmarried young women, who lived together in dormitories with strict visitation rules and curfews, all under the watchful eye of housemothers. Nursing student clothing was mandated, even when venturing outside the hospital.

launched a long-lived nurse education program in 1925. By today’s standards, the early days of nurse training in Lynchburg were modest. Nursing schools often depended on physicians to give lectures to student nurses. With frantic schedules, the physicians were often late to their own lectures, came unprepared, or did not appear at all. But over the years, the people directing nursing schools realized that many types of improvements were needed. Hospitals started adding full- or part-time instructors and started making arrangements for proper facilities, both for nursing education and for student nurse living facilities. BELOW VIRGINIA BAPTIST HOSPITAL NURSING CLASS OF 1935 BOTTOM VIRGINIA BAPTIST HOSPITAL NURSING CLASS OF 1939

It was not until 1965, in fact, that a married nursing student was allowed at Virginia Baptist Hospital. Yet at the same time, nurses in Lynchburg held highly responsible, highly visible positions in the city’s hospitals. For example, Mary Frances Cowling, RN, educated during a short-lived nurse’s program at St. Andrew’s Hospital in Lynchburg, was superintendent (the CEO at the time) of Virginia Baptist Hospital from 1923 until her retirement in 1954. All that time, she remained unmarried and lived in the superintendent’s quarters at the hospital. For about six years before moving to Virginia Baptist, she had served as superintendent of Lynchburg Hospital.

Courtesy of Centra Virginia Baptist Hospital

It was customary for major hospitals to train their own nurses as a way to keep a fresh supply in the face of chronic nursing shortages. Marshall Lodge conducted nursing education from its opening in 1900 until training ceased in 1930. Lynchburg Hospital began a nurse training program in 1912 (Centra Health celebrated the 100th anniversary of nurse training in 2012), and Virginia Baptist

Courtesy of Lynchburg History the history of healthcare

Construction of facilities for nursing education occupied considerable time and planning in Lynchburg. In October 1939, a contract for $34,870 was issued for a new home for student nurses at Lynchburg Hospital, with the specification that construction be finished the following April. In 1944, the same hospital — now renamed Lynchburg General Hospital — opened the 4th floor of the Federal Street building to accommodate the increasing number of nursing students.

Courtesy of Centra Virginia Baptist Hospital NURSING STUDENT DORM ROOM IN THE BARKER BUILDING AT VIRGINIA BAPTIST HOSPITAL SCHOOL OF NURSING

At Virginia Baptist Hospital in 1949, an addition to the School of Nursing Building was named the Cowling Building in tribute to the service of hospital superintendent Cowling, then observing her 25th year of service. With the construction of Lynchburg General Hospital’s new home on Tate Springs Road, nursing students moved into the new building, and a new nurses’ residence building was erected there in 1960.

Courtesy of Lynchburg History LYNCHBURG HOSPITAL CADET NURSING CORPS.

With the Unites States’ entry into World War II, wartime demand for nurses changed much about the way nurses were perceived and the way they perceived themselves. Many nurses joined the military, both out of a sense of patriotism and because they sensed that doing so might be a route for elevation of their careers. In the military, enlisted men handled routine care of the sick and wounded. Nurses were considered specialists, and they were supervised by physicians. Military nurses were officers, and they supervised enlisted men. Lynchburg nurses responded to the war effort whole-heartedly. The entire Lynchburg General nursing class of 1942 volunteered for the Nurses Reserve, which meant that upon graduation and passing state requirements, the class as a whole signaled its wishes to serve in the nursing corps of the armed forces. In 1943, 13 senior nursing students applied for foreign duty, with their activation delayed until their schooling was complete in April of that year.

Courtesy of Centra Virginia Baptist Hospital VIRGINIA BAPTIST HOSPITAL NURSING CLASS OF 1952

Courtesy of Centra Virginia Baptist Hospital NELLIE FEAGANS ’37, ANNA BELLE MARTIN ’39, GLADYS OVERSTREET ’32, MARY WOLFE ’41; ALL VIRGINIA BAPTIST GRADUATES WERE POSTED TO THE 45TH GENERAL HOSPITAL AT CAMP LEE, VA AND SERVED WITH DR. GEORGE CRADDOCK AND DR. FRANK BUCK the history of healthcare 68

The flow of nurses into the military created shortages in civilian hospitals, and the value of nurses ramped up even higher. The scarcity of nurses in stateside hospitals inspired the Red Cross to create an accelerated program to train nurses’ aides, and the federal government created the Cadet Nursing Corps. The purpose of the corps was to make sure that the United States had enough nurses to care for citizens on both the home and war fronts. The results of the Cadet Nurse Corps included a dramatic rise in the number of nursing students, a greater public recognition of nurses, and changes in the manner in which nurses were educated and trained. Creation of the Corps made nursing an attractive career field once again. Women who were accepted received a government subsidy covering the costs of their education, along with a small stipend — $15, $30, or $35 per month, depending upon the length of time they spent training as a cadet.

Lynchburg General agreed to participate in the program in the early days of the war. But at Virginia Baptist, drawn-out internal debate over whether to participate centered on what some felt was the necessity to maintain the absolute independence of church and state. Virginia Baptist continued to train as many nurses as possible, but only near the end of the war in 1945 did the hospital decide that it should not affiliate with the Corps. When the war ended, the military nurses came home schooled in what was then cuttingedge medical techniques and technology. They had learned to find their way in the complexity of military bureaucracies, and they had exercised independent, lifesaving judgment during crisis after crisis. They had lived life as officers, with a taste of equal pay for equal work. They were not the same nurses, or the same women, who left home to serve their country. As the 1950s dawned, nurses began training in specialties, preparing themselves to act more independently and take on more responsibility and authority in the care of patients. And in the 1960s, nurses were on the leading edge of racial integration, even before Lynchburg hospitals fully integrated in 1966. There were few black hospitals in Virginia, none in Lynchburg. Lynchburg General’s Federal Street building for example, had been renovated in 1939, with separate sections for whites and for Negroes. Nurses of both races, however, were indiscriminately assigned to patients without regard to race. Nurses also played a prominent role in the seven years of planning that went into Lynchburg General’s new “medical center” facility where it sits today on Tate Springs Road. The first pour of concrete for the building’s foundation on December 12, 1955, was triggered by Sadie Kessler, president of the hospital’s Student Nurse Foundation. And the cornerstone for the building, when it was troweled in on October 27, 1955, was laid by Elsie Sweeney, night supervisor at the hospital who was a graduate of the 1916 graduating class of the Lynchburg Hospital nursing school and, having started work with the hospital in 1926, the hospital’s longest-term employee.

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TECHNOLOGY II

Courtesy of Lynchburg History

THE NEW LYNCHBURG GENERAL HOSPITAL, 1956

any of the medical and technological advances of midcentury came from battlefield and military hospital lessons learned during World War II and the Korean War. Physicians and nurses returned from the war with new knowledge that would not have been available anywhere else. Combat provided testing grounds for medical evacuation procedures, the use of blood substitutes, advanced surgical techniques, new miracle drugs, preventive medicine practice, and the treatment of psychiatric disorders. Peacetime applications of new methods and new technologies would continue to enhance American healthcare for generations to come.

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In Lynchburg, one of the new “miracle drugs” made an appearance rather early, in May of 1944, when Lynchburg General Hospital was designated a “depot” for the civilian use of the antibiotic penicillin, one of the drugs that changed medicine. The story of penicillin clearly illustrates what a society can do when the need is great enough. The first patient, suffering from a bacterial infection of the blood, was treated with penicillin in a study being conducted on the drug in March of 1942. Half of the total supply that had been produced at that time went to that one patient. The patient recovered nicely, and in June of the same year, enough of the drug was available to treat ten patients.

Clinical trials on penicillin (to test and demonstrate the safety and effectiveness of the new drug) were completed in 1943, and by July of that year, the War Production Board drew up plans for the mass distribution of penicillin to Allied troops fighting in Europe. By the spring of 1944, at just about the same time that Lynchburg General got its supply, 2.3 million doses of the drug were being stockpiled for the still-secret D-Day invasion of Europe. As production increased, the cost of the drug went from almost priceless in 1940, to $20 per dose in mid-1943, to 55 cents per dose by 1946. The drug was a precious material, reserved almost exclusively for military use during most of the war. As production of the drug increased, it became available for civilian use, initially through hospitals only, of which there were a total of 1,000 in the nation. The hospitals applied to receive supplies of the drug,

in Lynchburg, trumpeted the Lynchburg News on April 12. “Before doubtful onlookers...(chefs)...baked and served a previously frozen 18-ounce lobster tail within six minutes, a chicken dinner in three minutes, and a two-pound box of collards was cooked in less than three minutes.” The “new and radical form of cooking” was a microwave oven, being put into service at Lynchburg General Hospital. Lynchburg hospitals added new services, new equipment, and new technologies as soon as they could be accommodated. Plans for a one-year medical technologist course (to prepare laboratory workers) at Lynchburg General were completed in 1954. Hospital

and applications were reviewed by a panel made up of the War Production Board, the US Public Health Service, the American Medical Association, and other organizations. Lynchburg General was one of 14 regional “depot” hospitals selected to serve Virginia. As the production of penicillin increased, Marshall Lodge Memorial Hospital and Virginia Baptist Hospital became part of the second wave of “depot” hospitals designated to receive shipments of penicillin. The drug became largely available to the civilian public only after the war, in 1946. The word “technology” did not kick off the same mental images back then that we associate with it today. Although the term would not be coined for a number of years, Virginia Baptist Hospital would rightly have been considered a considered a “high-tech” facility when its telephone switchboard was installed in 1937 and when air conditioning came to the hospital’s operating rooms in 1938. Even as late as 1959, people were impressed by the technology of things that are considered commonplace today. “A new and radical form of cooking” had been demonstrated the day before

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pathologist S. Miles Gorton, MD, noted that “what was once a simple field is now a broad one, requiring a great deal of study.” The program was a collaboration between the hospital and Lynchburg College. Healthcare technology in Lynchburg gained a huge push with the design and construction of the new Lynchburg General Hospital, opening in 1956 at its new campus on Tate Springs Road. Design of the new facility from the ground up allowed improvements that, as one nurse said on her first tour of the new building, “were like living in a dream world.” Innovations in the new hospital included electric

hospital beds, a modern intercom system, piped-in oxygen (versus oxygen tanks, which were moved from room to room), centrally located recovery rooms, new radiology facilities, and more. The presence of a brand-new hospital building — along with the technological momentum that the new building fostered — soon swept in more innovations: radioisotope equipment used initially to measure thyroid function after a patient swallowed radioactive iodine but very soon became a game-changer in the fight against cancer; a poison control center, aided by the local Kiwanis Club, to provide timely information on toxic ingredients in poisons and commercial products and guidance on treatment if those products were ingested; the use of hypothermia (lowering the body temperature) to aid cardiovascular surgery; establishment of the city’s first intensive care unit in 1962, with monitoring of patients via closed-circuit television and use of electric temperature, pulse and blood pressure monitors; and, in 1963, a new computerized medical records department that replaced the series of files, cabinets, boxes, and drawers containing the life medical histories of anyone who had ever received treatment at Lynchburg General. Hospitals in Lynchburg were keeping pace with the times, but research all over the world was bearing fruit in innovations and developments that would be found in Lynchburg in just a few years. In Holland in 1945, a dying patient was treated successfully with an “artificial kidney,” a rudimentary kidney dialysis machine made of laundry tubs, cellophane tubing and wooden drums, capable of removing the patient’s blood, cleansing it of impurities, and restoring it back into the patient’s body. Work along several fronts in the United States and abroad would eventually lead to the development of the hip replacement materials and surgical techniques now used on more than 200,000 Americans each year.

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Courtesy of Lynchburg History and the private collections of Gloria Franklin.

GLORIA FRANKLIN AT VIRGINIA BAPTIST HOSPITAL

Paul Zoll, MD, developed an external cardiac pacemaker at Bostonâ&#x20AC;&#x2122;s Beth Israel Hospital in 1952. Early models had to be plugged into a wall socket, but further refinements produced an implantable pacemaker of the type available today. Pioneering work in kidney transplantation at Peter Bent Brigham Hospital in Boston in 1954 lead to solutions to the problem of organ rejection and earned a Nobel Prize (1960) for pioneer Joseph Murray, MD. The 1950s saw the dawn of computer use in healthcare. The work of keypunch operators in hospital billing and accounting departments in the early 1950s slowly morphed into computerized records-keeping, and by the 1960s, healthcare organizations were looking seriously at ways in which the new machines could be put to use in the industry. According to PC Magazine, a gigabyte of computer memory cost about $10 million in the mid-1950s. Today, the same gigabyte of memory can be had for about a dollar.

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Educating Tomorrow’s Physicians

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and is an advocate for rural health, and for affordable and accessible healthcare for the medically underserved. 2265 Kraft Drive • Blacksburg, VA 24060 • 540-231-4000 • www.vcom.edu ©2012 Edward Via College of Osteopathic Medicine. All rights reserved. VCOM is certified by the State Council of Higher Education to operate in Virginia.

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