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Wendover Bug House

 US ISSN 00162115  
Social Service Today `  
From "Giver" to "Br0ker" §
- by Ruth Arm Dome 1  
From Courier to Courier Coordinator __ '
- by David Lee 7  
How Does Your Garden Grow? R
- by Mary Weaver 13 ` p
Outstanding "Employee of the Month"  
Program - by Mary Weaver 16 Q
Graduating High School Girls Honored By Y
The Kate Ireland Women’s
HealthCare Center
- by Debra Browning 17
School Notes - by Ruth Beeman 18
Beyond the Mountains - by Ron Hallman 20
A Special Invitation 21 1
Form of Bequest 22 `
In Memoriam: 23
Memorial Gifts 24
Staff Opportunities 25
Urgent Needs Inside Back Cover l
An Update on Julie’s Van - Inside Back Cover a
COVER: v’ ` ·
This lovely sketch of the Wendover Big House last appeared on the cover of the  
Spring 1941 Quarterly Bulletin. The artist, Miss Caroline Williams, recently `
departed this life. We wished to offer new readers an opportunity to enjoy her   ”
drawing which is so familiar to FNS friends of long standing.  
US ISSN 0016-2116 L I
Published at the end of each quarter by the Frontier Nursing Service, Inc.   I
Wendover, Kentucky 41775 l
Subscription Price $5.00 a Year
Editor’s Office, Wendover, Kentucky 41775 I  
Secondclass postage paid at Wendover, Ky. 41775 and at additional mailing offices I 1
POSTMASTER: Send address changes to Frontier Nursing Service, Wendover, Ky. 41775 [
Copyright 1986, Frontier Nursing Service, Inc. - lj
I 1

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i Ruth Ann Dome was born and raised on a farm near Sidney, Indiana.
She earned her BA in Social Work at Goshen College, Goshen, Indiana.
. Ruth Ann joined the FNS staff in 1971 and continued with the
organization until 1979 when she left to enhance her career as a social
worker with Leslie Juvenile Court. She returned to FNS in 1982 and,
today, provides FNS patients and their families with much—needed social
W _ services.
al, ` The other day I was prowling the halls of Mary Breckinridge
Hospital, as is my wont, when I encountered an old acquaintance.
Our association dates back several years to the time when she was
i living up one of the hollers served by the old Flat Creek District,
} and I was the new Frontier Nursing Service social worker. We sat
$ in the hall and talked a few minutes, catching up. I found out
I where she’s living now and what she’s doing; how the children
~ and grandchildren are making it; how many great-grandchildren
she’s accumulated, etc. She found out where I live now and what
, kind of work I’m into - the same. She knows I’m still around if she

needs my services and I know she’sgetting along pretty well these iQ
days. It’s a demonstration of my longevity as a social worker here  
and a style of "doing business". il
My tenure at Frontier Nursing Service spans °the time from  
jeeps and Wendover and Hospital Hill to computers and Mary  
Breckinridge Hospital and "that doctor across the bridge" (Hyden *
Medical Center). In my early days, Brownie and Peggy Elmore  
and Anna Mae January were still with us. The service aspect was  
district centered and all the midwives lived at Mardi Cottage. No I
"brought-on" personnel lived off campus. ’
In the Wendover days, Social Service occupied an office in the I
Garden House, overlooking the river. I lived in the Cabin and E
tended a grate fire for heat. In those days, FNS Social Service was `
closely identified with Miss Betty Lester. Many families could  
recall seeking aide from Miss Lester and would report to me just {
exactly what Miss Lester did and how she did it. Much of Social 5
Service at that time involved direct aide in the form of garden l
seeds, used clothing, school fees and medical transportation. ,,
Although transportation systems had progressed beyond mule 2
and riverboat, getting to appointments, especially outside the
area, could be difficult. Taking patients to Lexington and Cin-
cinnati was commonplace. Out of necessity, emergency transpor- ,
tation also sometimes fell to Social Service. I recall a trip over Pine  
Mountain, taking a patient with acute breathing problems to the # T
hospital in Harlan. The only medical personnel along for the trip l
was a student nurse who was coaching the patient to "Breathe,  
Harold, breathe!" Fortunately our trip was successful. __}“'
As service providers we were more mobile back then. A jeep j
was provided to Social Service and daily rounds to the old hospital  
were made as well as regular visits to districts. Much of my work    
was done via home visits. ) 
The last jeep assigned to Social Service was an early 70’s I ’
model. By then a jeep wasn’t really a jeep any more. They just  
didn’t seem as rugged or low-geared as their forerunners. But it  
was a pretty red thing. I was given the opportunity to name the w
vehicle, but Kate Ireland didn’t think "Jezebel" would be appropri-  
ate. I presented my dilemma to a young client whom I transported I`
often. She suggested "Rudolph" and it stuck. A caricature of the  
"deer" adorned the dashboard. His last year was spent mostly in  

ip the repair shop, having been wrecked twice - once by another
  Social Worker and once by a doctor (and they wondered why I
  hated to loan out my jeep).
zi For my part, I took a certain amount of pride in my jeep driving
gg record. Skip Spell always maintained that if you drove one long
 ‘ enough you would have a wreck. The worst incident I was
g involved in occurred during the construction of the Daniel Boone
_Q Parkway. The roadway would change from day to day and often
" ·. ` was a cloud of dust or a sea of muck. On this particular occasion it
A was the latter, and I was trying to steer out of a slide as I’d been
A admonished to do. But the jeep just kept pulling to the left until it
» was "sort of" over the hill. A wrecker came and got it back on the
{ road. It seems a rock had lodged between the axle and the wheel
thus preventing any steering to the right. Total damage - a step
half torn off. I went on about my business.
I Although the provision of Social Services has been an intent of
  the Frontier Nursing Service from its initial incorporation, it
seemed to me, early in my time, that perhaps Social Services
z’ needed some updating. It seemed that the same few clients would
depend on and benefit from direct services, one year to the next. At
. the same time, more public agencies were providing for the mate-
rial needs ofthe less fortunate. Of course, records had always been
.= kept and there were plenty of files. (I’ve kept a cross reference file
  from the early 50’s). But, I felt, maybe our records needed to be
li expanded. It was a point in time when Home Health services were
» being separated out for billing and requests for records of patient
j; encounters were routine. Suffice it to say that the need for detailed
·'i· records has gone full speed ahead since that time.
Q And so Social Services began to develop and change. At times,
  . though not now, this has meant a two-person department with a
$, full-time secretary to keep us and our paperwork straight. But
3 _ most of the change has related to how our services are delivered
E ; and also to government and insurance provisions and constraints.
*§ Most direct aide is now provided by government agencies,
,   churches and the family and neighborhood. Generosity remains a
ff, trait of folks hereabouts. As I was once told, "If one of us eats, we
  all eat." The role of Social Service in all of this becomes one of
  working with the local and area agencies, maintaining a knowl-
_  edge of services available and passing that knowledge on to other

providers and clients. I serve on local and area boards and plan- l
ning councils, and work to promote the development of services. ,
From early on, I have tried to teach people to advocate for them-  
selves; to learn how to deal with agencies and bureaucracies. `
Social service today plays more of a "broker" role than a "giver" '
Much of what Social Service has done over the past dozen  
years or so has dealt with contemporary issues and broad-based ` _
medical social work. At about the time Mary Breckinridge Hospi-
tal opened, we became involved with the issue of child neglect and E
abuse. We have tried to maintain a high awareness in this prob-
lem area and to cooperate with the local agencies that are empo-  
wered to deal with this issue. This concern naturally expands A
into the area of family violence. Area services have been developed  
to provide assistance to victims.  
Care of the chronically ill and elderly is also a contemporary ?*
issue which confronts us these days. I am fond of saying that with  
the increasing longevity of persons- even with debilitating ill-  
nesses- we have encountered a situation where the caretaker  
spouse and children are no longer young. The caretaker network  
may spider off into extended family members. I was rather taken  
aback a couple of years ago when I visited a home on an ordinary  
day and found five generations present. So we are left with issues  
of how to provide care for folks through collecting and assessing  
information, biding time, listening, confronting, supporting and
assisting folks to make needed changes.  
These situations present themselves on a regular basis. A per-   .
son becomes seriously ill, possibly debilitated, and will be needing ‘
ongoing care. The family gathers and reality begins to set in.  
They begin to seek answers. "How are we going to take care of   Y
daddy?" "Most of us are working or live out of state." "We don’t  
want him in a nursing home." "Maybe he’ll get better." Through  
all of this I’m reviewing the patient’s chart, talking with the  il
nursing staff and generally making myself aware of the care  
required and assessing the ongoing needs.  
Families need listening to, information, support and sometimes  
a little pushing in order to make decisions. The process is com-  ‘
pacted by today’s shorter hospital stay. Referrals may be needed  
to financial aid agencies, home health, medical equipment and ,

l supply stores, long term care facilities and so forth. Families need
. to set priorities, change schedules, and emotionally contend with
  a member’s decline. Sometimes it takes more than one spell of
` acute illness to get a plan set. Sometimes the person recuperates
' and returns to independence or needs only minimal continuing
‘, ` asistance.
{ I could probably write a book about needs. But most needs
` _ trace back to the need for an improved economy and cash flow.
Adequate income to live out the American Dream relieves stress
g and stress-related illness. It takes money and adequately supported
- institutions and agencies to provide needed care and services.
i Several years ago I heard one of my co-social workers remark
{ of me, "I don’t know what she does but it works." I came out of a
  rural background and a good undergraduate program. I came to
L, FNS with few preconceived notions of what I was getting into or
i* how I should proceed. (Face it, FNS is different anyway). I found a
  service organization that was "muddling through" and a popula-
  tion that was capable, schooled on hard-knocks and family
  oriented. It seemed that people were tired of bureaucratic social
  services that required the filling out of endless forms. And while
  the forms are necessary, they never seemed as necessary as listen-
  ing. So the forms waited, and still do, while I listen. With a few
  open ended questions and given the opportunity to talk, people
  will let you know what their concerns are and you will also dis-
cover what you need to know.
in Being family oriented is generally coming back into vogue. I
  . don’t think it ever went out of style around here. Blood is blood.
The family has remained the first line of defense and support. I
E have learned all sorts of family connections - halves and steps and
`w. P in-laws. I know families from all over the area. I maintain contact
  with folks even when no immediate needs are presenting and
  continue to build on past associations. It all works into an inten-
 i? tionally relaxed style of doing business that seems to work.
  Things are changing again, both in the area and within the
 J Frontier Nursing Service. The area is opening up - better roads
  and better vehicles to drive on them. We have a quality TV station
Jl  which represents and promotes the area. Leaders are working to
  diversify the economy. Specialty medical services are available
, closer to home. At the same time, people routinely travel out ofthe

area to vacation, shop, pursue an education or take in social l
Social Service is now based in the Mary Breckinridge Hospital.
Since early 1982, in the neighborhood of 1350 individuals have ,
come in contact with social service. The days of the jeep are gone ·
so my mobility about the area is a sometime thing and contact  
with the district clinics and home health is difficult. I do try to  
maintain visibility and keep my eyes and ears open. Keeping up l
the communications with providers within and without FNS ‘ ··
remains a priority.
As for the old Wendover days - every spring a group of us "Old »
Timers" get together. Some have remained at Wendover, some,
like myself, have been transplanted to the hospital or elsewhere in  
the FNS system and some have gone on to other things. But we all ’
get together and enjoy Wendover food, throw our financial sup- l
port to the maintenance of The Big House and reminisce. Betty T
Lester is our most honored Old Timer.
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FNS maintenance men joe Hacker (left) and Kenny Bowling at work renovating the old ,
log barn at Wendover. The small apartment will be home to David Lee and Stacey  _
Wilson.  `

David Lee is now the Coordinator of Wendover and Couriers and Volun-
teers. He was born and raised in Portland, Oregon and attended college
. in Boston where he received his degree in Biology and Comparative
I Religion. After graduating, David spent a summer teaching cell biology
‘ and photography at a boarding school in Connecticut. For the past six
.A . months, he has worked as a counselor at Pine Street Inn, Boston’s largest
` homeless shelter. David will eventually study medicine and probably go
i` into family practice.
` Stacey Wilson works as an RN on the Labor and Delivery unit at the
" Mary Breckinridge Hospital. She was born and raised in Eden Prairie,
Minnesota and attended St. Olaf College in Northfield, Minnesota where
she earned her BSN. After graduating, Stacey moved to Boston where
` she worked on Beth Israel Hospital’s surgery and gynecology ward. She
has aspirations of becoming a nurse midwife and/or family nurse
2 practitioner.
I David and Stacey will be married in June and return to live in the old
, log barn at Wendover.
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S l David Lee discusses the day's work load with courier Laura Schleussner.
l Three years ago, I served FNS as a courier, and now I’ve come back as
i the Coordinator of Wendover, Couriers, and Volunteers. I’d like this
l article to serve as my introduction to those who don’t know me. I would
 . also like to describe my experience as a courier and the plans I have for
, the Courier and Volunteer Program as its new coordinator.
I was a courier between my sophomore and junior years in college.
( Like many couriers today, I was in a period of transition in my life, a time
I  of defining myself and my relationship to the world around me. My

I was a courier between my sophomore and junior years in college.
Like many couriers today, I was in a period of transition in my life, a time
of defining myself and my relationship to the world around me. My
summer with FNS has played a crucial role in determining my future. By
the end of my two month stay, I had decided to study medicine and had
also become engaged to one of the other couriers! (Stacey Wilson).
Becoming involved in a relationship was honestly the last thing on ° i
my mind when I came to FNS. I was actually considering the priesthood i
as well as medicine before I met Stacey. I guess the world works in .
strange and wondrous ways. Some of my life’s best memories are of ll"
falling in love at Wendover. Wendover is so "Edenic" with its cardinals
singing and tiger lillies blooming. Nestled in the mountains, we felt far
away from the bustle of our urban lives and the pressures of school. We '
were free from other distractions, and after our day’s work as couriers, we
had time to build a firm foundation for our relationship. I remember long
talks atop Pine Mountain and in the living room of the log cabin Big
House. It didn’t take long to get swept away by the mystical tides of
romance. Three weeks after we met, we became engaged. We will marry in .
Minneapolis this June on the exact three year anniversary of the day we
Many things fell into place for me that summer. My life went from
being a period of exploration and confusion to one of focus and structure.
Not only did I find a lifelong companion; I also became more committed to
pursuing a career in medicine.
Before coming to FNS, I had developed some cynical views about
medicine. Many of the doctors I had known were either researchers at ,
major medical centers or private practitioners in well-to-do suburbs. At
that stage in my life, the former seemed preoccupied with advancing their F
academic careers, and the latter with earning economic security. Observ-
ing the care providers at FNS changed some of my negative conceptions  
about medicine and showed me how potentially fulfilling health care can é`
I found a staff that really cared about the patients. Dr. Lijoi made k gy
house calls. The family nurse practitioners were sensitive to their Ts"
patients’ concerns and took time to explain their diagnoses. The outpost I
clinics were involved with many aspects of the community, not just with `
medical care. All of this encouraged me to study medicine. I plan to attend — _
Dartmouth Medical School in the fall of 1989. g
Since I was curious about health care, activities involving patients ]
interested me. During my two months as a courier, I had the opportunity  I
to observe and assist in the hospital and outpost clinics. By observing the
family nurse practitioners, I learned about giving a physical exam and  .
making infants less afraid of stethoscopes. I also was able to observe a  

caesarean section and serve as a support person for a woman in labor.
These experiences captivated me; I only wish there had been more of
them. During my two month stay I only spent about eight days helping in
a medically oriented capacity.
About a third of my time was spent doing what seemed to me to be
fruitless activity. One day, somebody directed me to the hillside behind
°° the Garden House and said, "Would you please trim the kudzu? Be careful
i of rattlesnakes and copperheads." Kudzu is an insidious vine that can
. grow up to twelve inches a day. After several days work and one copper-
tl" head, I realized that I was fighting a jungle with a pair of scissors, and
began to accept the kudzu as part of Nature’s beauty. Other unexpected
yet necessary chores included gardening, xeroxing, filing, and counting
The other two-thirds of my courier duties seemed to help the commun-
· ity more directly. I went on "rounds" delivering mail and supplies to the
outpost clinics. I also transported patients and doctors, picked up guests
at the bus station, and washed dishes after FNS dinners at Wendover.
These simple tasks made me feel as though I were helping the FNS to help
the community.
Teaching week-long classes about preventive health practices was my
most fulfilling courier duty. Stacey and I had school children dissect beef
hearts while explaining how eating cholesterol clogged the arteries in
p their own hearts. We also had them run with 20 pounds of coal on their
I backs to show how being overweight made their bodies work harder.
, The best part of being at FNS, or second best to falling in love with
L Stacey, was meeting people from the community. I spent most of my
weekends eating watermelon on the front porch of Walker Fugate’s, a
1 Yerkes Clinic patient. "Walk" told me many tales about escaping from
his nursing home, digging coal in the deep mines, and getting shot by his
  brother over a game of cards. He also gave lots of advice and encourage-
-`°· ment about marriage.
  "Hurry yup and git hitched before Stacey and you tire of one
k   another. If two people love one another, then married life’s the
fj" best life there is."
  I compared sitting in a rocker with Walker for a whole day to cramming
h into the Boston subway at commuter hour and not talking to anyone. The
 Y pace of mountain life is much calmer, and the people are so genuine. The
{ warmth ofthe people is one of the biggest reasons that Stacey and I have
I moved from Boston back to Leslie County.
I was all ready to begin medical school when the former Courier
* Coordinator, Elizabeth Wilcox, wrote asking if Stacey and I were inter-
. ested in taking her position. The more we thought, the more we realized
  how unwise it would be to begin medical school and marriage at the same

time. Before us lay the rare opportunity to return to Wendover and the
organization that has been so influential in shaping our lives. So we set
medical school aside and left behind the knots of Boston traffic to make
the ride down Wendover road, and here we are.
This first month has been much more frenized than the idyllic Wen-
dover I remember. Part of my job is managing Wendover. There’ve been
lunches for 20. (Hats off to Cassie the cook who does all the real work.)
There’ve been many overnight guests. (Hats off to Hazel and Marylin
who keep things tidy.) There’ve been sinks and showers to unclog. (Hats
off to Kenny the maintenance man.) And there’s been the shopping, ~·
gardening, budget meetings, bill paying, and letter writing, not to men-
tion the little tasks that no job description could cover, like chasing a bat
out ofthe Garden House. It’s been hectic here, but I’ve enjoyed the variety
of responsibilities. Everyday, I learn something new, from IBM word
processing to reassuring a courier who feels he’s an outsider. l
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A courier helping out at the Mary Breckinridge Hospital Primary Care Clinic.   L
As an administrator, I’ve also learned much about the organization of  I
FNS and seen the larger structure in which health care is given. My view H
of FNS is much less romantic now than the view I held as a courier. I’m I
not sure if FNS has changed substantially during the past three years, or l
whether my new position no longer shelters me from the financial and  l
political issues which have faced FNS for some time. _
As a. courier, my image of FNS was that of the nurse on horseback, A
altruistically riding into the back hills. After observing at the hospital l

and outpost clinics, I felt the primary goal of FNS was to provide health
care to areas that would otherwise have had none. Although FNS has a
relatively modern hospital and its nurses and doctors have changed from
horses to Toyotas, the spirit of service to the community has remained the
_ As the Coordinator of Couriers and Wendover, I still believe that
FNS’s primary goal is to render medical care to an area of need, yet I’ve
become aware of an almost equally important goal: to survive finan-
, cially.
As a young doctor to be, my thoughts have always been focused on
surviving medical school and providing health care rather than on the
business aspects of medicine. Now that I’m beginning to see how
I government regulation and the rising cost of medical technology can
restrict the health care one can give, I sometimes wish I could have been a
Z doctor on horseback in Mary Breckinridge’s day, or at least held on to the
z naive view of medicine I had as a courier.
Many couriers today are young idealists interested in medicine or the
I health allied professions. I see many similarities between them and the
person I was three years ago. I don’t want to shatter their idealism, and
yet I do wish to share with them what I have learned about the changes in
_ health care that have occurred at FNS and nationwide. Perhaps then, we
can more realistically devote our energies towards the problems that will
, face us as the future generation of health care providers.
I believe most couriers have good experiences here, but the experience
_ isn’t always what they might have expected, and some aren’t quite satis-
‘ fied. What are some common expectations of couriers? Well, when I first
· thought of volunteering for FNS, I had envisioned more direct interaction
with the patients and the community and hoped to be of service by
g administering health care, delivering medical supplies, and transporting
E1 patients.
li When I arrived, expectation and reality were not the same. I found a
*5It small, yet modern, hospital with a well trained staff. Consequently, I
 _? wasn’t needed or competent enough to do very much medically. Most of
. the ways I helped did not involve direct interaction with the patients.
 i Hence, even though xeroxing and counting coins helped FNS, and there-
_  fore indirectly helped the community, I didn’t find the actual work very
 . emotionally or intellectually rewarding. Traditionally, couriers cleaned
 l the horses’ stalls and rode with the nurses. Although this may not have
T been very rewarding either, at least it was fun. Perhaps couriers in the
1 recent past have been a little disappointed because they feel that some of
2 their activities are neither rewarding nor fun. Cleaning kudzu amongst
 , snakes is a good example.

Although the majority of couriers feel that the current program is  
worthwhile, a major goal of mine is to improve the experience for the {
couriers. I hope to achieve three objectives:
1. Provide couriers with opportunities to perform more fulfilling service.
2. Give couriers pre-professional counseling and greater exposure to
health care providers. p
3. Provide exposure to this region’s rich, unique and changing culture. B
Couriers have always had catch-all positions, and couriers will con-
tinue to do whatever the organization needs, but I’d like to de-emphasize  
counting coins and other business related, clerical work. Couriers have l'
also transported patients and delivered medical supplies and X-rays,
even at all hours ofthe night, and will probably continue to serve FNS in
these patient related ways. Couriers really do want to help, but often lack
medical training. Therefore I’d like to see couriers provide more direct
service to the community in a variety of ways, like tutoring people to read,
delivering meals to the elderly, building houses for the homeless, teach- 5
ing preventive health classes, participating in litter cleanups, running a
distress line for abused women, and assistant-teaching childbirth classes l
with Stacey. However, I’d also like to see couriers providing direct service
in health related areas, perhaps as home health nurses’ aids, labor sup- l
port persons, or emergency medical technicians, if qualified.
Many of the couriers are interested in exploring medicine, nursing,
and midwifery as possible careers. Couriers in the recent past have
usually observed family nurse practitioners, doctors, and midwives, but
not for a very large percentage of their time here. I’d like couriers to be
able to observe in the emergency room, operating room and clinics more
frequently and with greater direction and guidance. I’d also like to invite
people from within FNS to have dinner with the couriers and describe
their professions and how they chose them. Many care providers here, .
especially the family nurse practitioners and midwives, have a unique ,
philosophy of health care which many couriers might find unfamiliar "
and interesting.  
I hop