xt7qft8dh26c https://exploreuk.uky.edu/dips/xt7qft8dh26c/data/mets.xml The Frontier Nursing Service, Inc. 1936 bulletins  English The Frontier Nursing Service, Inc. Contact the Special Collections Research Center for information regarding rights and use of this collection. Frontier Nursing Service Quarterly Bulletins The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XI, No. 3, Winter 1936 text The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. XI, No. 3, Winter 1936 1936 2014 true xt7qft8dh26c section xt7qft8dh26c 1
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PORTRAIT OF A SECRETARY AT
HER DESK
(See page 5)  
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THE QUARTERLY BULLETIN OF (
THE F RON I IER NURSING SERVICE, Inc.  
Published quarterly by the Frbntier Nursing Service, Lexington, Ky.
SUBSCRIPTION PRICE $1.00 PER YEAR
VOLUIVIE XI WINTER, 1936 NUMBER 3
{(E1lt€7‘6(Z as second class matter Jiwze 30, 1926, at the Post Office at `
Lexington, Ky., under the Act 0f March 3, 1879."
Ccpyright 1936 Frontier Nursing Service. Inc. '

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  ST. BRIDE OF THE KINDLY FLAME
February is the month of St. Bride of the Kindly Flame,
St. Bride the gentle mother of all young and tender things.
; Through the mists of centuries we see her gracious figure, her
l lamb in her arms, a lamp in her hand. When the bitter winds
  are still blowing, the kindly flame of her flower, the dandelion,
i shines out and tells us that spring is near. Gentle St. Bride is
spring’s harbinger, the patron saint of the first flowers and
young children. She watches over mothers and their new-born
babes and on the hill-sides she brings the shepherds to the new-
born lambs. She is loved in all Celtic lands, from the western
highlands and islands of Scotland to Kildare, where, for cen-
turies, her lamp was kept always burning.
St. Bride’s father was Dubtach, twelfth in descent from
Fedlimidh Rechtmar, King of Ireland in the second century.
Her mother was a beautiful slave. When St. Bride took the
veil seven virgins followed her example, and each of them
chose a Beatitude representing the grace she specially desired.
St. Bride chose "Blessed are the merciful for they shall obtain
I. mercy." The various lives of her recount many tales of her
’ gentle pity for all young creatures, and for weak and suffering
  folk. She was noted for her love of animals and birds, and she
f , particularly delighted in calling the wild duck and geese to her
 jpg and caressing them.
 i
, —From the London Spectator.

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2 THE QUARTERLY BULLETIN
Urgent Need .1
As times get better and people are in funds again, someone ‘;_
will offer to give us a new building. We want to call the atten- · -»
tion of this unknown donor to our greatest need, and it is an
expensive one. We terribly need a nurses’ home for the Frontier
Nursing Service Hospital at Hyden. Five hospital nurses, a
hospital superintendent, and three district nurses who serve
that area, are all residing in the hospital itself where every bed I
is now needed for patients. There are other things we need in
the hospital, which will be given us and installed there when ,
we can get the nurses out—such things as a properly equipped
laboratory, an x-ray room, bigger and better linen closets, a
proper supply room, a milk room for the babies, etc., etc.
These changes can easily be arranged in the hospital itself,
when we get housing space for the nursing stai in another
building. As matters now stand, nurses are living even in the
annex where we have the communicable disease patients. This
isn’t suitable or right. Sooner or later someone is going to make
us a gift of a nurses’ home and we hope it will be sooner, namely
in 1936. l
Incidentally, we need additional land adjoining the hospital,
and a new barn. Our horses are worthy of the best in horse
housing, but the stalls are full and some of them have to sleep
every night in the run-way. This is a frightfully important
message. Please read it over, and if you cannot give the nurses’
home or the land or the barn yourself, perhaps you know of
someone who can and will.  
————-———  s
"This morning I had the special pleasure of welcoming to  l
my office Miss Miller and Miss Clark. They are apparently re-  
markable young women. It is delightful to think of them as
bearers of the message of the Frontier Nursing Service." ‘
———William J. Hutchins,
President, Berea College.

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I Faoivrmn Nunsnvc smavicm 3 I -
WINTER IN THE MOUNTAINS
' " ". . . Those boughs which shake against the cold,
Bare ruin’d choirs, where late the sweet birds sang."
Winter set in early this year with a bleak November. In
, December the blizzards began, and the Christmas holidays will
be long remembered as two uninterrupted weeks of driving
snow, icy creeks and rivers. We had to give up the Christmas
, dances altogether and thousands of children couldn’t get to our
i Christmas tree parties. Friendly men and older boys have car-
ried toys and candies in big paper "pokes" around to the more
remote cabins. Those children who did get to the parties were
exceptionally jolly, singing their carols, smiling and laughing
over the jokes and the Santa Claus, warming their little red
_ ·hands before the big fires, filling up with hot cocoa and other
refreshments. But we will remember the Christmas of this year
less for its festivities than for its terrible travel and the awful
illnesses we have taken care of against fearful odds.
I The Belle Barrett Hughitt Center, at Brutus, and the Jessie
Preston Draper Center, at Beech Fork, have been particularly
busy. Each had five or six babies due just at Christmas time
and both have had dangerously ill maternity cases. One
case at Beech Fork was complicated by a bad heart—"mitral
, insufficiency, hypertrophy and dilatation, broken compensation
with fibrillation, partial heart block." Through a driving bliz-
» zard the patient hands of friendly neighbors, superintended per-
Q sonally by Dr. Kooser, carried her by stretcher into the nursing
 jj station. We sent up an extra nurse under escort--16 miles
  through the ice and snow from Hyden—to special the case, as
` Stevie and Inty were both frightfully busy with five more babies
i coming. This patient is getting along as well as can be expected.
i Over at Brutus, 45 horseback miles from Beech Fork, a
young mother came down with double lobar pneumonia. Dr.
A Kooser rode over, and with Scotty, the nurse, and again the
friendly hands of neighbors, carried the patient and her three-
days-old baby, by stretcher, through the driving snow, to the

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nursing center. Scotty and Doubleday were also expecting five i
other babies, and so a special nurse rode the 12 miles across the A
mountains from the Red Bird station to take care of the pneu-
monia. Night had fallen before she got in, but a man with a W
lantern had gone to meet her on the trail and escort her the —
last few miles. A few days later, four miles below the nursing
center at Brutus, another young mother, with her first baby,
went into convulsions, with no warning symptoms, when she
went into labor. She had 21 convulsions, and during that time
was stretchered the four miles in, to the nursing center, in the
very heart of the blizzard, along the icy Bullskin Creek. ‘
Through all of this horror there was one blessing. Every- 4
one of our loosely-strung, variegated telephone systems, includ-  
ing the forest ranger ’phone on Red Bird, the line put in by our Q
local Committees for us from Brutus to Bowlingtown, and the  
private line along the Middle Fork—everyone of them held up. tl
Hours of time were saved by this means and our grateful  
thanks go out to the women at the exchanges at Hyden, and  
in their homes in the heart of the forests, who stayed up night Q
after night to keep the lines open, so that Dr. Kooser could get  
into communication with the nursing centers. {
Dr. Kooser, going back and forth between these two nurs- L
ing centers, travelled nearly 150 miles on horseback, over trails i
so icy that often he and the horse had to slide down them, and  
always through the driving snow, often impeded by the size l
of the snowdrifts. When he went to the woman with convulsions  
the Midwifery Supervisor, ‘the old Bucket," as we call her, l
rode with him. They spent the day in the saddle, facing the R
storm, the night and a second day and night working over the T-
patient, and the next day again in the saddle. The woman with J}
convulsions is living and getting better, but her baby is dead. 3
In the next room, at the Brutus nursing station, the woman with  ~T
pneumonia has died, leaving a little baby behind her. We are '
heartbroken. It was a fight against appalling odds and we have —
lost it, and her. .
>l¢ >l¢ ¢l= =i<
A word as to our horses. We have always loved them, but .
after this December we should like to see them created Knights -

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Fnomrinia Nunsiivo smnviciz 5
_ and Dames, every one. Horses are afraid of ice, and even when
  one puts fresh ice nails in their shoes after each trip they
'  slide and slip a lot and travel in constant fear. Nevertheless,
_, you wouldn’t know it if you saw "Lassie," ridden by Jean
_ Hollins, the New York courier, and "Traveller," ridden by Dr.
Kooser, starting off for Beech Fork laden with supplies for
V glucose infusions, digitalis, brandy, and a hundred extra things.
Again and again, the ice at the fords had to be broken with
a pick axe before they could get across the river. "Dixie" and
"Cameron" carried their riders, on their way down to the
Possum Bend Center, straight across the solid ice of the river,
too thick to break, in constant danger of crashing through, but
{ gallantly. It was "Dixie" and "Lassie" who took the terrible
S trip over four mountains with Dr. Kooser and Miss Buck to
  Brutus, the worst day of the worst storm. It was "The Old Gray
  Mare" who carried the nurse from Red Bird to Brutus, a good
i part of the trail after dark; "Pinafore," a five-year-old mare,
  new to the country, who carried the nurse the 16 miles from
  Hyden to Beech Fork. .
  "Gipsy King" it was who carried the Order Secretary,
i Minnie Grove, to and from the hospital when its water supply
, froze. All the men who could round up pick axes, headed by
L Perle Lewis, broke the icy ground and laid bare the frozen pipes,
  Minnie climbing on all fours up and down the steep mountain-
  side with them. Meanwhile, the hospital had no water except
9 what could be brought from a considerable distance, and had a
E row of pneumonias, along with other patients, to take care of.
T All of the nurses went out and gathered buckets and baskets of
MJ; snow. But, as MacAlpine, the Superintendent, whimsically re-
2] marked, "When it was melted down they had just half a pint
 . of water." When everything had been righted at last, and
j "Gipsy King" was bringing Minnie home, escorted by Perle
, on his mule, the ice at the Wendover ford, which had been
` bearing up the horses, crashed through and they fell into the
river with such swiftness that "Gipsy King" may be forgiven
i for his plunges. Minnie was just thinking, "He’s scared out

 I 6 A Tina QUARTERLY_BULLETIN  
of a year’s growth," when Perle remarked, in his dry, quiet  
fashion, "That horse will never grow no more." ’
>l< =I= >l= =l= ‘
We beg of you, those friends of ours who live in cities, `
where a blizzard is met by steamheated houses, modern hos- .
pitals, quick ambulance service, plenty of doctors in closed
cars—we beg of you to keep alive in your imagination, and hold
always in your kind hearts, the thought of what our mothers .
p undergo when they face suffering and danger, and even death,
with their only help coming to them after hours of delay in 4
battling storms; when they themselves, in their anguish and  l
terror, have to be carried for miles over icy trails, with only  5
blankets between them and the winter wind and driving snow.  _,
Little John heard people complaining that his dog barked  
too much. He was discovered with an apron on and exclaimed,  j
"I’m going to op’rate on this dawg and take his bark out."  
"I enclose $100.00 for your work as a small thank offering f
for my little daughter, Eleanor, who arrived just three weeks
ago and is round and fat and lovely." M ‘
 !
TIME FOR WEANING IN THE MOUNTAINS il  
When the sign ofthe Zodiac is out of the bowels and is  
going toward the knees and feet—Virgo, the Virgin, to Sagit—  I
tarius, and Capricornus. {
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   raomrmn Nunsme simvxcm 7
  HOW DOES THE FRONTIER NURSING SERVICE
{ HANDLE OBSTETRICAL COMPLICATIONS?
By Doizornr Buck, R. N., M. A.
i Midwifery Supervisor and Second Assistant Director
According to Dr. Louis I. Dublin’s analysis of our last
. thousand maternity cases, roughly one-third of them showed
abnormalities during pregnancy, one-fourth puerperal compli-
4 cations of labor, and one-twelfth puerperal complications during
 l the lying-in period; notwithstanding this not a single mother
5 died. Many people have asked us to tell how we handle such
 _. cases to bring about such gratifying results. .
i Our first aim is, of course, prevention. No midwife wishes
  to face a serious obstetrical condition; certainly no midwife
  wishes to do so whose medical help must come to her on horse-
 , back over mountains, through rivers and around fallen tree-
  trunks, landslides and all the various road obstructions that
‘_  can occur during a mountain storm. For this reason we require
  all patients expecting to have our nurse-midwives for delivery
to register for prenatal care. We encourage them to register
  early. Our routine for normal cases is to examine each one
g every two weeks until the seventh month of pregnancy, every
 l week thereafter until delivery. This may be done when the
 A patient visits one of our weekly clinics at the nursing centers,
, or when the nurse-midwife visits the patient in her own home.
p These examinations always include urinalysis, the taking of
` blood pressure and an abdominal examination. We also take
the external measurements of each patient. By these means we
‘ hope to discover at the first opportunity such things as small
» measurements, disproportion between pelvis and baby, an un-
  desirable position of the baby, and any signs which point to-
i wards toxemia. At the time when we make these examinations
 _t we also try to help each patient to build up her general
I resistance. The two factors which we have especially to combat
 I in doing this are the inadequate and faulty diet of a people
, living on a land where only the scantiest subsistence farming
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can be done, and hookworm, which is ever prevalent where the  
sanitation is so poor. Our chief weapons against these are cod-
liver oil and "worming" under the instructions of our Medical `
Director, either in their own homes or at the Frontier Nursing p
Service Hospital at Hyden. I
Mrs. White and Mrs. Black are extreme instances which ‘
show what our preventive work may accomplish. As it is never
possible to know just what one has prevented when the preven- _ T
tion has succeeded completely, I have chosen two women who
already had trouble before our treatment was started, and
whose condition would, if it had not been checked, probably have
become worse. Mrs. White lives in the neighborhood of the l
Magaret Durbin Harper Nursing Center. Mrs. White, when
carrying her baby, seemed anaemic and run down but refused all
treatment. Her delivery was short and it was not until she began
to "stir around" that she began to have fainting attacks. She
still refused treatment, until one day her husband found her
in a heap on the floor. After that the nurse managed to get .
her into our hospital. There, our Medical Director, Dr. John
H. Kooser, found that she had a bad case of hookworm with
severe heart complications. Carefully graduated hookworm
treatments were given her. Her condition picked up and to our
delight her heart improved. She has since gone through another I
confinement satisfactorily, because of the treatment instituted  
after her first confinement.
Mrs. Black, from the Jessie Preston Draper nursing center
district, forty-five miles off the railroad, registered too late to
obtain a medical examination. She puzzled us from the start. _
She was lethargic in the extreme. Questions she answered in
non-committal monosyllables. Her eyes were dull and expres- ”`
sionless; never did she evince enthusiasm or even interest. Her  
labor was slow and wearisome. She became unduly fatigued. At I
times it seemed as though she would die merely because she `
didn’t have the energy to live. There was no question of medical  R
advice as there was a storm raging. The river was swollen  y
far past crossing and the telephone wires were down. When 1
finally the baby was born both patient and midwife were ex-  .
hausted. Convalescence was slow and incomplete. As soon as  i
possible a medical examination was arranged and Mrs. Black . 
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  Fnonrmn Nunsmc smnviciz 9
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I was found to have both hookworm and pellagra. She was first
,- carefully "wormed" in our hospital and then given appropriate
treatment to be carried out in her own home. As she was out-
,_ of-district it was several weeks before the nurse saw her
` again. Then, one day when Dr. Kooser was holding a clinic at
· that particular nursing center a woman came in all smiles and
. apparently overjoyed to be there. It took quite a few minutes
  to recognize Mrs. Black. She seemed a different woman. Life
I was again something more than a burden and she had responded
I with enthusiasm. Of course cases like these two must be
I "wormed" again and again at proper intervals, and the pellagra
I treatment extended over a long period of time to obtain the
maximum result. We, therefore, keep a special eye on such
5 patients for years.
What do our nurses do when they find any definite abnor-
mality which may hinder a safe delivery? First, they do what
V they can to rectify things themselves. In doing this they follow
our Medical Routine which has been authorized by our Medical
I Advisory Committee in Lexington, Kentucky. These routines
I are meant to cover all emergencies which may arise so that
I the nurse-midwife will always feel that she is working under
S medical direction. All faulty positions are converted, if possible,
_; into the simplest one for delivery, the anterior vertex. I have
  sometimes been asked "why we turn breeches in multiparae."
  The answer is, as in so many of our practices, because of the
' distances we cover. Two nurses serve a district with a radius
of five miles (which is 78 square miles), and some of our
deliveries are even farther than that from the nearest nursing
 _ center. As travelling is exclusively by foot or horse-back over
  rough country, and as the time involved includes that of the
J husband coming for the nurse, as well as the nurse reaching
the patient, it may be several hours beween the time the patient
_ sends for the nurse and the time the nurse arrives. Among our
_ last thousand cases 115 were delivered before the nurse-midwife
 2 arrived. The baby must, therefore, be changed to the position in
il which he can most safely be born, if the delivery should be
v_ i unattended.
  If the nurse-midwife is unable to rectify the condition she
I finds, or is uncertain of what it is she has to cope with she
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asks for help. In cases where another pair of hands may be ng
useful or a second opinion is desired, the midwifery supervisor i
visits with her. If together they cannot decide about the case
or put it right, the patient is seen by the Medical Director, as
are also those cases (like definitely small measurements) for  
whom the midwife can do nothing. As we have only one k
physician for our 700 square miles of territory we try to get
the patient to come to the nearest nursing center when Dr. y
Kooser is holding a clinic there or, if it seems expedient, to `
our hospital at Hyden where he makes his headquarters. How-
ever, if she cannot visit the doctor he does visit her in her own T
home. From then on the case is handled as it would be elsewhere. =
If the doctor considers a home delivery safe, the patient 1
returns and is treated according to his directions. If a hospital j
delivery seems indicated she comes into the Frontier Nursing
Service Hospital at Hyden, usually on muleback, and remains
there until she has recovered from her delivery. If the case is N
to be a surgical one, arrangements are made with our surgeon, l
Dr. R. L. Collins, from the nearest mining town, 24 miles away. _  
Since the completion, four years ago, of our one and only high- ;»
way this is much simplified as it now takes only one hour for  
him to reach our hospital. When our Medical Director feels the T,
need of. a consultation this is often accomplished by correspond-
ence with Dr. Scott Breckinridge, the obstetrician on our Medi- *4
cal Advisory Committee at Lexington, 165 miles away. This "
obstetrician also volunteers each year for a gynecological clinic  
held at our Hyden Hospital, where much is done in the way of  
corrective and preventive surgery.  
When abnormalities needing a course of treatment are g
discovered the nurse-midwife visits more frequently than in  
normal cases, to find out if the patient understands and is fol- cl`
lowing instructions, and how she is reacting to the treatment. lc
Often this calls for daily visits. The first treatment given is  l
always that laid down by the Medical Routine. When she gets Q 
back to her center, the nurse reports the case to the midwifery .;
supervisor for any further advice, and so that the supervisor  
may know, as far as possible, how many and from what direc-  {
tions difficulties may be expected. Luckily, though few of our  l
district families have telephones, Dr. Kooser and each of our ,

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l nursing centers are so equipped. If the telephone is working,
  · these messages are usually telephoned. If not, which is often
` the case, they are sent by mail or, if the case seems urgent, by
  messenger. If the case does not respond to the simple treatment
$3- laid down by the Routine, the physician is consulted. Often he
E manages these cases by frequent telephone messages, receiving
reports and giving advice. If necessary, he visits the case. if
, it becomes evident that the patient is not responding to home
{ treatment she too, is urged to go to our hospital where she is
put under intensive treatment. The method of getting there is _
l varied. If the patient’s condition allows it she may come on
"_ muleback. A few in a very limited area may be able to reach
1 the highway and come from there by car; many are "stretch-
j ered" in——carried by relays of kind neighbor-folk on stretchers
A made from poles cut from the hillsides and a heavy blanket
taken off their own beds. During a time when the rivers are
Cl swollen the patient may be brought part way by boat which is
i poled down or up the river. Recently one patient, who had been A
_   bleeding quite freely, was taken three miles by stretcher to the
y river and five miles down the river on a boat. From there the
·i short distance to the railroad station was covered by car. The A
1, foot of the mountain on which the hospital is situated was
iinally reached after an hour on the train and another hour in
T1 an automobile, and the patient was again put on a stretcher and
  carried up the hill. The nurse, of course, accompanies such pa-
  tients, taking with her an emergency kit.
  Complications of the puerperium, or lying-in period, are
E managed in the same manner as those of the prenatal period.
{ Complications which arise during labor, because of their extreme
  · urgency, probably give cause to a large percentage of our
M anxiety. We try by constant watchfulness and by careful ex- .
aminations to detect any abnormalities at the first possible
 ` moment. This is to give Dr. Kooser as much time as possible
  to get to our help. If there is anything about the case which
·3 makes the nurse-midwife uneasy she may ask the midwifery
l supervisor to accompany her on the delivery. This is often done
  in worrying cases who have refused hospitalization, yet are not
T considered critical enough to warrant the summoning of the
A doctor at the beginning of labor as is always done in the most
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 12 THE QUARTERLY BULLETIN  
serious cases. When an emergency actually does arise during
delivery, the nurse communicates directly with the Medical , ·
Director in order to save all possible time. If he wishes to be
accompanied by the midwifery supervisor, or thinks that she ,`
can assist the nurse sufficiently herself, he gets into touch with
her. Always his saddlebags stand packed waiting for a call.  
Malpresentations of the baby perhaps illustrate best the  
difference between maternity complications in the mountains  
and maternity complications in the city. To see how these are I
managed we may take a brief view of Mrs. Brown’s case. Mrs.  
Brown’s cabin lies in the neighborhood of the Clara Ford Nursing  
Center on Red Bird River. The nurse-midwife recognized a I
"shoulder presentation" of the baby soon after arriving, but I
unfortunately labor had already made considerable progress.
The husband was sent out immediately on the nurse-midwife’s
horse, with a note to be telephoned to Dr. Kooser. There was I
then nothing for the nurse-midwife to do, after she had tried I
to secure rest for the patient by encouragement and sedatives I
and had prepared for the delivery, but wait for the message.  
In about two hours the husband was back saying the doctor I
and midwifery supervisor were on their way. The kitchen fire I
was renewed and a fresh pot of water put on to boil. The I
minutes seemed hours as the nurse-midwife waited for the II
doctor, the patient’s pains becoming harder and her own re- i‘
sponsibility greater. Would the doctor come before she must I
act? Would she know the exact minute when it would be no I
longer safe to wait? At last, hoof-beats! Under these circum-  
stances can there be anything more welcome than the beat of I
horse’s hoofs, the horse which brings the doctor? I think that  
we all feel that once he has come, nothing can go far wrong.  
As soon as Dr. Kooser appeared the scene changed. With one IK
glance at the patient the doctor began to make ready; and both I
the midwifery supervisor and the nurse-midwife began to pre-  
pare for him. Instruments were dropped in the boiling water, the I
patient made ready across the bed, the doctor capped, gowned, I
scrubbed, the sterile instruments added to the shaky table set I
up conveniently to the doctor’s hand. Then there was a moment ·
when all stood ready-—the supervisor by the patient’s head  
with a mask and a can of ether, two neighbors to support the  
I
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 l
  Faomriza Nuasmc smnvicm 13
patient’s legs, the nurse-midwife with a flashlight ready to
j · assist the doctor. The open fire was extinguished, the chimney-
less lamp put out, the flashlight snapped on; a minute more
W and the patient was sleeping. Then the baby was pushed up,
turned and brought out and the delivery completed; all by the
  light of one small flashlight. Different perhaps from the city
  but statistics seein to show as safe.
  The most dreaded complication is probably a post-partum
_s hemorrhage. This does its damage so rapidly that it is seldom
l a doctor can get there in time. Among our last thousand cases
  168 hemorrhages occurred after the baby was born. Our usual
I routine of prevention calls for a clean sterile glove and a filled
It hypodermic to be at hand during every delivery. The waste of
‘ hundreds of rather expensive ampoules is considered better than
a moment’s delay where delay is dangerous. Consider the case
gl of Mrs. Gray, in her eighty-year-old, windowless, one-room
l log cabin. Mrs. Gray felt rather honored by the rare event of
Q being attended by two nurse-midwives. One midwife holds the
l lusty new baby; the other has just completed the delivery.
l Suddenly there is a gush of blood. It seems almost no time
Q before the mother’s face becomes a terrifying white, her skin
} cold and clammy. While the contents of one hypodermic is
’i pressed home, the other nurse is filling a second. It is evident
i‘ that the bleeding will not be controlled in time by these drugs.
l ¥Vithout a moment’s hesitation one midwife pulls on the rubber
Q glove which has been waiting and so crushes the bleeding points
? between her hands that no further blood can escape. The
l physician is sent for in post-haste. The one midwife dares not
  for a moment relax her hold on the uterus, so it is left to the
  other, with the help of a neighbor woman, to warm blankets
C" and wrap up the exhausted mother, surrounding her with irons
* heated in the open fire and fruit jars full of hot water, to band-
  age the arms and legs to keep the remaining blood near more
{ vital organs, and to give rectal salines to replace some of the
I lost fluid. At last (after four hours!) the welcome hoofs are
Q heard outside and Dr. Kooser arrives to take charge of another
· critical situation. In cases like this he always brings supplies
  and a set-up for giving iiuid intravenously, and before he leaves
tl Mrs. Gray is much better. It is still not considered wise to move
l
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' 14 THE QUARTERLY BULLETIN ·
her even to the nearest nursing center (in this case Possum Bend T
—the Cleveland center), as is frequently done with patients kt
needing intensive care who cannot be stretchered as far as our `
hospital. One of the nurse-midwives therefore stays the night ,.
with her, as a matter of course, while Dr. Kooser stops over  
night at the Possum Bend Center close by, ready to come at a  
moment’s notice. With treatment and intensive nursing it I
was not many days before Mrs. Gray was sitting up in bed, %
holding her baby, and telling the neighbors of how she had had  
two "doctor women" and a "doctor man" when she had been l
"like to die." `
— · THE OLD MIDWIFE Q
On the fringes of our territory, where there is no one to W
replace her, the old midwife, naturally and rightly, continues  l
· to ply her trade. We say "rightly" because she begins usually Q,
as a friendly neighbor and carries on because she is the only  it
person to whom the woman in childbirth may turn. Several  
times a year we get emergency calls from outside our territory . C
when the old midwife has gotten into trouble. Her patients are . .; 
her own, but we always go to her assistance. Sometimes it is , 
not too late to save the mother. More than once it has been i
too late. _·· 
Our two most recent experiences with the old midwife came  
in November. A frantic call was relayed to our hospital at  I
Hyden, where Dr. Kooser is stationed. He and Vanda Summers  
went by car along the graded road, to an agreed-upon point,
where a couple of men with mules met them. T