xt7nk9313z27 https://exploreuk.uky.edu/dips/xt7nk9313z27/data/mets.xml The Frontier Nursing Service, Inc. 1961 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 Frontier Nursing Service Quarterly Bulletin, Vol. 36, No. 3, Winter 1961 text Frontier Nursing Service Quarterly Bulletin, Vol. 36, No. 3, Winter 1961 1961 2014 true xt7nk9313z27 section xt7nk9313z27 Jfmutuzr amxrznng §zrhmz ®ua1¢tzrIp Eullztm `Uulumz 36 winter, 1961 xumim 3 ` 1 <¤*{Y' 1 X 1 °» Q ~ 113-·1.¢ 1 4»· e' 4,11 A _ 1 :»%¢!• §,:!=1=·&1q:;}.;•%8`#*·: e 1 :§gb.§»£;2>‘¤ 4·< 2 i: ~ 1 _` ' jV·»}j` 4·:£_1 ,‘»" _ wgy ‘$§1¢$,;,,;•i$L1* gg 4;; 1 •<' ’ ¥§§’1$¥?*=1*é¤s“·f*‘! 1 2% $3:} 1;a?q*»\;$»$az;*%,aZ'J# ‘4l{i 1 @5; W ~·» Y gig;. L 1; 4 ,: i? ~¤’f*Z`·¤¤; 41:I 1 nf $31% ’»*•;§§.·*;& E•`I%£i$s W? Wi? Qfugx §$?$e'é·‘·,:ii? e.~·€¤*.! { g K» ` . ’I *4 I Front cover picturc.· I I St. Christ;0pher’s Chapel, Hyden Hospital "Old Chi·istmas" January 6, 1961 _ The cover picture of the east end of St. Christopl1er’s Chapel was taken lg _" by Virginia Branham. Even the children in the Kentucky mountains know ° about Old Christmas, the date when Christmas fell due under the Justinian calendar. \Vithin the last generation some of the old people observed it in preference to the new brought-on Christmas of the Gregorian calendar. It is only on the night of Old Christmas that the animals talk together in the barns and that the Christ Child comes back to visit His world. ; I i I I I I, I rl I I l FRONTIER NURSING SERVICE QUARTERLY BULLETIN ‘ Published Quarterly by thc Frontier Nursing Service, Inc., Lexington, Ky. I Subscription Price $1.00 an Year i 1·}ditor‘s Oilicez Wcndovcr, Kentucky ‘l VOLUME 36 WINTER, 1961 NUMBER 3 "Entered as second class matter June 30, 1926, at the Post Ofllce at Lexington, Kyq j under Act of March 3, 1879." , I Copyright, 1061, Frontier Nursing Service, Inc. g, L I I I a l M · CONTENTS l ARTICLE AUTHOR PAGE 7 A Night Journey to Weeping Willow Creek Anna May January 26 — An Unforgetable Experience (Illus.) Vanda Summers 30 ` · Baby’s Own Story Elaine Douglas 13 "/— Beyond the Mountains 41 U Canine Emergency Joan Antcliff 20 Death of St. Christopher (Verse) Lawrence Housman 6 i Field Notes 45 Happy Birthday The Associate Editors 15 Hospital Heating Horrors Agnes Lewis 9 Jeeps Is Jeeps Kate Ireland 38 Legend of S. Christopher 3 { L Master Mason and Master Builder Photographs Inside back cover Old Courier News 21 I Old Staff News 31 Q St. Christopher’s Chapel M. B. 7 3 The Legend of the Dogwood (Il1us.) 2 The Night Before Christmas Betty Palethorp 12 BRIEF mars A Mother’s Devotion W. B. R. Beasley 14 an Chapel Kneelers 8 Y } It Happened at Wendover English—Speakiug Union 47 m It Happened on Bullskin Creek 40 Marcus and Stuart Bockman A Photograph 37 ` The Crump Family A Photograph 29 J The Emergency Case _ 25 ` The Professor and His Hat Cooperative Farm Credit 20 I A Understatement of the Week 43 l VVhite Elephant 44 l` é i , if / / : K / / V ~\ \- \ \ \\\ Ki 4 ~`;· {7 , { or 1 ’ . \ I / ‘ ` ~ \e ‘%%i?¤ / 3 t *\ ` {KQ /iii-}»\ \ . \--, }}i?’¢?% —> ~\ \ l q ,_ "Thou must then wake and make many prayers." And Christo- 9 pher said to him: "I wot not what it is; I may do no such thing." And then the hermit said to him: "Knowest thou such a 1 `I l QUARTERLY BULLETIN 5 river, in which many be perished and lost ‘?" To whom Christo- pher said: "I know it we1l." Then said the hermit, "Because thou art noble and high of stature and strong in thy members, , thou shalt be resident by that river, and thou shalt bear over all them that shall pass there, which shall be a thing right con- -5 venable to our Lord Jesu Christ whom thou desirest to serve, Ai and I hope he shall show himself to thee." Then said Christo- pher: "Certes, this service may I well do, and I promise to him ij for to do it." Then went Christopher to this river, and made there his ig habitacle for him, and bare a great pole in his hand instead of if a staff, by which he sustained him in the water, and bare over all manner of people without ceasing. And there he abode, V thus doing, many days. And in a time, as he slept in his lodge, he heard the voice of a child which called him and said: "Chris- . topher, come out and bear me over." Then he awoke and went out, but he found no man. And Y when he was again in his house, he heard the same voice and ` he ran out and found nobody. The third time he was called and came thither, and found a child beside the rivage of the river, which prayed him goodly ; to bear him over the water. And then Christopher lift up the ~ child on his shoulders, and took his staff, and entered into the ¥ river for to pass. And the water of the river arose and swelled more and more; and the child was heavy as lead, and alway as Y he went farther the water increased and grew more, and the J. child more and more waxed heavy, insomuch that Christopher E had great anguish and was afeard to be drowned. And when .l he was escaped with great pain, and passed the water, and set ` the child aground, he said to the child: "Child, thou hast put l me in great peril: thou weighest almost as I had all the world i upon me, I might bear no greater burden." And the child i answered: ¤ "Christopher, marvel thee nothing, for thou hast not only $ borne all the world upon thee, but thou hast borne him that P, created and made all the world, upon thy shoulders. . I am J esu Christ the king, to whom thou servest in this work. And be- cause that thou know that I say to be the truth, set thy staff i in the earth by thy house, and thou shalt see to-morn that it 1 5 6 FRONTIER NURSING smnvxcm shall bear flowers and fruit," and anon he vanished from his eyes. And then Christopher set his staff in the earth, and when he arose on the morn, he found his staff like a palmier bearing flowers, leaves and dates. THE DEATH OF ST. CHRISTOPHER i' By LAWRENCE HOUSMAN , Christopher, who bore our Lord I On his shoulder through the ford, ` After years (his great reward) I One glad day lay down to die. From his body, limb by limb, ` Labour he put off from him, y Till he heard a passer—by Stand before the ford and cry. When he heard the summons sound, Christopher rose up from ground; ‘ Forth he went on duty bound, A Murmuring: "Lest I work amiss, , Christ must give me strength for this: ‘ This my latest labour is !" { When he reached the ford at length, Spake the Voice of all his bliss, Saying, "Christ shall give thee strength !" Humble, bowed, and very faint, i { At His Feet fell down the Saint, 5 At His Feet fell down to pray, j "Lord, I have not strength to-day, _ Thou must go some other way! I These old limbs can lift no more 2 That dread weight which once they bore." Q In his face the Holy Child ? Looked and smiled; , And His Voice grew full and wide, i 5 QUARTERLY BULLETIN 7 Many waters multiplied, Saying: "Christopher, let be I Since thou once didst carry Me, I am come to carry thee." il Very gently from his knees J Lifted him the Prince of Peace; ‘_ Wonderful and Counsellor, , In His Hands the Saint He bore; V He, the everlasting Lord, I Carried him across the ford. I Underneath, a level road All the trodden waters flowed; V Not a wave was dispossessed . That the Heavenly Bearer pressed, With the Saint upon His Breast. "When," said He, "My weight did hurt, V. Thou My beast of burden Wert. . Now for thee, My child and lamb, ” I the Beast of burden am." I —Printed with the kind permission of the publishers : of Lawrence Housman’s poems, Jonathan Cape, V Ltd., London, England 4. _~ ST. CHRISTOPHER’S CHAPEL r 2` For years we have read aloud the Legend of St. Christopher j and Housman’s poem on Christmas Eve at Wendover and at the . Hospital at Hyden on Christmas Day. More than any other , legendary character he has seemed peculiarly ours because of », the dangerous ford in the river over which he carried travelers. I Innumerable times in our recollection has a mountaineer, a courier, a nurse reminded us of him. Only those who have to l cross angry, rushing rivers on foot or on horseback can appre- , ciate fully how deeply this legend has imprinted itself on our , hearts. s Fnoiwmn mmsmc. smnvxcm Some twenty—two years ago the glorious St. Christopher’s window was given us by my kinsman, the late Dr. Preston Pope Satterwhite of New York, who had it in his entrance hall. When “ I went to New York and lunched or dined with Preston, I used J to stand in front of the window and tell him if we had a patron saint it could not be other than St. Christopher. He decided to ’ give us the window and had it taken down by experts and A shipped to us. It might have lain stored forever except for W. B. Rogers Beasley, M.D. He undertook last spring the erection of V; the Chapel of our dreams. He has told the story of how it was V done in earlier issues of this Quarterly Bulletin, and of the I enthusiastic support he had from all of our mountain friends and craftsmen, from members of our staff, and from other . friends beyond the mountains. · The legend of the dogwood on page 2 of this Bulletin will * tell you why we chose the dogwood for the cross. The tree was I cut out of the forest in the Wendover boundary so that it was our very own tree. Now Hyden Hospital has not only one of the most beautiful Y. chapels in North America but the place it needed for quiet medi- j tation and prayer as well as for services of praise and prayer. V It is for the use not only of the staff but of the clinic patients Q and the families of the sick and of the women who have had their babies born at Hyden Hospital. It is for the use, too, of ° anyone in the neighborhood who enters it and any stranger who ` iinds himself at our gates. A place of healing needs a place ~ for prayer. ‘ V M. B. t \ CHAPEL KNEELERS St. Christopher’s Chapel at Hyden Hospital will need three dozen kneelers. The first one has already been given by a little > girl. The price for each kneeler, including postage, is $4.50. We . will welcome individual gifts for individual kneelers. V HOSPITAL HEATING HORRORS , by Y AGNES LEWIS, Executive Secretary _ In Mrs. Breckinridge’s room there is a plaque, given her j years ago during the depression by our beloved "Mac" who was I] then superintendent of the Hospital. It reads: yi "Just about the time you think you can make both ~ ends meet, some one moves the ends." How many times over the years have those ends been moved! This time, it was the Hospital boiler that moved them. In the wee small hours of the morning, on Saturday, Decem- . ber 3, leaks sprung in all six sections of the boiler, flooding the . basement. The nightwatchman was dispatched over Thousand- ; sticks Mountain to "fetch" Alonzo Howard, our Hospital fore- , man. He came and worked through the night, putting out the · fire in the boiler, cutting off the water and electric controls, E draining the pit, getting fires going in the big hotel coal range ; in the kitchen (kept as a stand-by unit when the power fails) ° and in the two iireplaces——one in Dr. Beasley’s office and the ‘ other in the children’s ward. Liz Palethorp, superintendent, and ` the nurses on duty got out extra blankets for the beds. — The patients couldn’t have accepted the situation more 4 cheerfully. There was not a complaint from patients, staff, or » workmen all during the crisis, which lasted a week. All of the - patients in the general wing of the Hospital that could be safely moved were sent home. The remaining ones, regardless of sex , and age, were taken care of in the children’s ward with the big Y open fire to keep them warm. A) Normally, we keep our midwifery patients in the hospital eight days. In this emergency Dr. Beasley let all those whose condition was perfectly satisfactory go home after the sixth day. This eased the bed situation considerably and we were able to move all the mothers with their babies who were on the closed-in Q porch, in to the inner wards. By closing off the porches, we could keep more heat in the wards. As soon as word got around A Hyden that the Hospital was without heat, friends offered more electric heaters than our circuits could carry. Mr. Emmitt Elam, chairman of our Hyden Committee and a Trustee, was the iirst 10 FRONTIER NURSING smzvicn to get up the hill to ask what he could do for us. Everyone was most kind and helpful. At 1:30 a.m., Sunday, December 4, a mother arrived with i her baby who had measles with broncho-pneumonia, and a tem- I perature of 105.4°. The baby was placed in a small crib in front 1 of the fireplace in Dr. Beasley’s ofiice. The nightwatchman kept the iire blazing while the mother nursed her child and rocked ~ the hours away until Monday. A In the beginning, "The Matron" stoically refused to wear a , sweater over her white uniform——that was against all rules and ’ regulations in her British school of nursing. However, by the middle of the week, with the temperature dropping, she pulled Q on a cardigan, much to the delight of her associates! V As soon as the telephone exchange opened Saturday morn- . ing, we at Wendover got the news. Our problem was to get a new boiler installed as quickly as possible. We called our heating contractor, Mr. E. W. Hacker in Hazard, who said that he would ¥ settle down to the telephone and locate a boiler. Late that after- noon he had found one at the factory in Michigan City, Indiana- i a long haul from Hyden. How to get it here was the problem. i To ship it by railway or motor freight would mean a delay of i ten days to two weeks. We decided that we would have to send a truck; but what truck? Ours was too small, and Joe Roberts, who does our hauling from Hazard, didn’t have a license to haul that distance. We called various friends who suggested various men who might be able to do it; but, not every truck large enough had an interstate license and the insurance coverage for , such a trip. Finally, we called Mr. Johnny Lewis with whom we Vi trade. He had just gotten home and had not had his supper but , I he said that if we could give him half an hour he would find pk someone. In less than half an hour he lined up two young men, i` with a truck, the interstate license and, they thought, insurance “ which would cover the cargo in transit. They would check with A their agent and they would be at the Hospital at one o’clock Sunday afternoon when Mr. Hacker met us there to get our approval on his specifications for the boiler and all the bits and i pieces that had to come with it. The young men would then set ` out for Michigan City with full instructions and be on the factory doorstep when the office opened on Monday morning. It seemed . so simple! i QUARTERLY BULLETIN 11 In the meantime, Alonzo, who had been on the job since early morning, and Hobert, our Wendover foreman, were in a ‘ huddle on when and how to get the old- boiler cleared away and i the boiler pit repaired and ready for the new installation. They _ decided that Monday would be too late to start—they would .l work Sunday, which they did. Sunday afternoon, December 4, Mr. Hacker came over as J scheduled, the specifications were checked, the order signed and , full instructions given the driver for picking up the order. By ‘ two-thirty, all that was necessary to get the truck on its way was the insurance; and the driver’s agent was checking that. We relaxed and came home. Six o’clock, and the telephone rang! I q The insurance did11’t cover the cargo and the driver’s agent could _ not write the policy until his insurance office opened up Monday morning. He kindly suggested that it might be easier and i quicker for us to get proper coverage for the cargo through the r agency which carries our fleet schedule. We called our agent and he was good enough to take care of it at once. By seven o’clock, i the truck was on its way; and by three o’clock Tuesday morning, i December 6, it was back in Hyden—what a relief ! i The temperature in the hospital seemed to rise, as soon as the new boiler was actually on the grounds; but the thermometer . showed that it was getting colder—another cold wave was due i to "hit" us the end of the week! Mr. Hacker’s men and Alonzo worked all day and until midnight, trying to complete in four ? days an installation which, they said, takes two weeks. They , hoped to have the steam on by late Thursday night; but there ll was a delay. Steel caps, very important, were needed and they ll were not to be had in any town nearby. Fortunately, the machin- pk ist in Hyden, Aubrey Dixon, who is an expert in such work, was able to make them and weld them onto the pipes. Hobert I helped mount the equipment on our truck and they worked all A through the night. By this time they were getting awfully tired. Strong coffee helped! At one o’clock Saturday morning, Decem- . ber 10, a week almost to the hour, since the breakdown, the last Y bolt was put in, the controls adjusted, the fire built—and again heat was on in Hyden Hospital. · Our gratitude goes out in fullest measure to all those who helped us weather this big crisis. 12 FRoN·r1ER Nonsmo smwicn . THE NIGHT BEFORE CHRISTMAS ‘ b I BETTY PALET1—1IoRP, R.N., s.c.M. _ Shortly before 11:30 p.m. on Christmas Eve, a little band of worshippers wended its way to St. Christopher’s Chapel for i a Carol Service. To those of us who had been fortunate to wit- ness the birth and growth of the Chapel this was an especially 5 happy occasion, for, to our Christmas joy was added the glad 4, participation in the first service to be held in St. Christopher’s. ·_ It seemed particularly iitting that the beginning of this new life I of prayer and praise should coincide with the celebration of the I birth of our Lord and Saviour. The Chapel is beautiful, but the interior was even more — lovely at Christmas due to the attractive figurines so kindly donated to St. Christopher’s Chapel by an ex-staff member, Mrs. ` May Houtenville. They were placed underneath the stone altar and illuminated from behind. ’ About thirty-five people were present; a thrilling sight in church so late at night. We were very pleased to have a number of our Hyden friends, including Mr. Veley and Mr. Newell, our Presbyterian and Baptist ministers, in our midst to worship with us before the manger. The service was short, simple, and very reverent. After the - opening carol, "Once in Royal David’s City," Brownie said a prayer for the Chapel followed by a bidding prayer. Then came Q six carols, one of which, "O, Holy Night," was sung as a solo by — Elaine Douglas, and interspersed were three readings of the Christmas Story given by Betty Lester, Molly Lee, and Anna J May January. Then were recited the Lord’s Prayer and the · General Thanksgiving, and on the stroke of midnight the Chapel bell was joyfully pealed by Jinny Branham aided by Molly Lee. With glad hearts we sang the thrilling Christmas Morning Hymn, _ "Christians, Awake, Salute the Happy Morn"; listened again to the Christmas Collect and heard Mr. Veley ask the Blessing. ‘ Finally we sang that most lovely carol "Silent Night" and de- ° parted to our homes and beds. It was a happy Christmas for all. , Our prayer is that the Chapel will be the source of many , blessings both for those who use it for private meditation and , for those who attend the daily evening service. i . QUARTERLY BULLETIN is ` BABY’S OWN STORY ‘ As Reported by . ELAINE DOUGLAS, R.N. ` Student of The Frontier Graduate School of Midwifery » This is the story of my life. Actually it’s been a very happy life, although there have been a few unpleasant things gl that have happened. The first I can remember, was several , moons ago when I began to realize my pleasant surroundings. It was so dark and quiet and I just swam around all day long hear- ` ing the continual beat of some ticking motor. g I was warm and content and as time passed it seemed like I was growing bigger and bigger. I learned a new game one day; - I’d poke out my arm or leg and hit this wall. I’d hear a funny little noise as if someone were surprised or laughing. Then some- ' times something would poke back at me. Then I usually liked to poke somewhere else and see if it could find me. I called this ’ game "Poke and Hunt." Then one day something very strange happened. Every once in a while my little room would get smaller and push me up into a ball. At first I thought it was some sort of a game. Then these squeezes got closer together and longer. They began to push me down toward a little door. I began to get an awful ‘ headache from these hard squeezes and started getting a small lump on the right side of my head. Q The door kept getting bigger and bigger until all of a sudden, . there came some hard big squeezes and began pushing me right , out of my warm little room. Things happened so fast after that and I had such a headache, I can hardly remember what hap- ‘ pened. All of a sudden my head was pushed out through a big door ; and something went over my eyes and nose and something was . pushed into my mouth. It tasted terrible but it got a whole lot of stringy stuff out of my mouth. Then once again the big ` squeezes came and my shoulders and arms came out, then my I "tail" and legs. V It was so cold out of my room and then, of all things, some- . one turned me right upside down and hung me by my feet and , started patting them. At that terrible treatment, I decided to . protest at all these actions and so I yelled! Instead of putting 14 FRONTIER NURSING smnvicm me down, I heard a noise, like laughing. Then after more protest- i ing on my part, at last I was put down. » Then I heard someone make a remark about "cutting my _ cord," whatever that is, but that’s what they did and it didn’t hurt. Finally something warm was wrapped around me and I was handed to someone else. I could hardly get my breath and 1 then I heard a strange hissing noise—"oxygen," someone said. I Whatever it was, when it was over my face I could breathe easier. Then I felt something very warm at my back and I fell asleep. When I woke up I had strange wrappings on, so nice and warm, I almost thought I was back in my own room. Then I was placed in someone’s arm and something warm was put into my mouth. I began to suck and then I felt really happy. Someone said, "My own little baby—h0w I love you and thank God you’re I here." I don’t know who it was but she was so good to me, I j decided to call her "Mother"—that name just iits her. · So I’ve decided this life is pretty good after all. My little room was nice, but I think this other place with my own "Mother" ` is just perfect. I’m here to stay. I’m a newborn baby. l A MOTHER’S DEVOTION f We had forgotten the severity of the snows and ice of last year until the mother reappeared at Hyden Hospital at 1 :30 this - morning with her sick child. Q This mother’s first seven children had been delivered by 4 the nurse-midwives and she wanted the nurses to deliver her 1. eighth although she now lived out of our territory. When her time came last February 1960, though there was snow and ice on Pine Mountain and her transport was unable to cross the I top because it was so slick, and the drifts so deep, she pulled off — her shoes and walked barefooted across the top of the mountain . to the road on the other side. And so her baby was born with the nurses in the Hospital. It was a healthy child, but, in the last two weeks, measles have riddled her home. Five of her » children had had them, and now, her baby had the measles with broncho-pneumonia with a temperature of 105.4. So again she I crossed the mountain, this time in December, to bring her sick E child to Hyden Hospital. · W. B. Rogers Beasley, M.D. . ` HAPPY BIRTHDAY by ` THE ASSOCIATE EDITORS "Time, you old gypsy man, Will you not stay, l Put up yOl1I' O8.I'8.V3.1“1 A Just for one day?" —Ra1ph Hodgson S, These were our last waking thoughts on February 16, the p eve of Mrs. Breckinridge’s birthday. We had just had three I lovely springlike days, and if the weather were kind to us, the nurses from the outpost centers and the hospital would be able T to get to Wendover for the birthday dinner. ` Wendover had been buzzing for some time, making prepara- tions for the big day. Mrs. Breckinridge had invited her cousin, - Miss Katherine Carson of Knoxville, to come on the Wednesday before her birthday and stay on a week, helping go through some family papers. We, as a surprise, invited other members of her immediate family to come but bad weather at home kept Q several of them away. Miss Hope McCown, our devoted friend I and trustee from Ashland, drove Mrs. Preston Johnston from Lexington on Thursday afternoon——a real surprise for Mrs. Breckinridge. Her niece, Mrs. John Marshall Prewitt and her i husband from Mt. Sterling could not make it for the day, but _ promised to come on the Saturday. This worked out beautifully as we could prolong the celebration over the week-end. After C. all an 80th birthday comes only once in a life time. ' Mrs. Breckinridge had remarked that "tradition is a terribly important thing," so she must have a hand in some of the plans . for her birthday. Major Clifton Rodes Breckinridge, her father, celebrated his 80th birthday at Wendover on November 22, 1926, with a round cake with 80 red candles. She wanted just that, I plus her favorite menu for the dinner——spoon bread and turkey hash, turnip greens, and spring onions. Madeline Gamble offered . to bake the cake, using our very own eggs and butter. Where -. to {ind a round pan large enough for a cake that would hold 80 J candles? Alabam came to the rescue and found a dish pan that Q was just the right size. 16 FRONTIER NURSING smiavicm Friday dawned fair and warm and the birthday was heralded by Caryl Len Gabbert, the Wendover nurse-midwife. She stood on the mountainside above the Big House with her cornet and played a hymn of praise followed by "Happy Birthday to You." Mrs. Breckinridge, in her room, could hear the lovely clear notes ringing across the valley. "No birthday presents" had been the _ Hrm command from the lady herself. As all our readers know, + the editor never refuses an article for the Bulletin and many members of the staff brought in their contributions. The animals g at Wendover, horses, cows, dogs, cats, geese and chickens had sent their birthday wishes in the early morning, in the form of silly cards. By 11:30 a.m. the staff had assembled at Wendover—three noble souls had remained on guard at the Hospital—and Dr. Beasley proposed the birthday toast which we want to print for you, our readers: "Mrs. Breckinridge, here we are, your very own family, your county family, your Frontier Nursing Service family, greeting you on your 80th birthday, which has really come at long last. We are mighty proud indeed to celebrate with you today as I am sure many are celebrating for you in other parts of the world. "And I take the pleasure of proposing to you a ‘ triple toast. "First, a toast to you as our teacher. By your bril- V liant introduction of the nurse-midwife into the Ken- { tucky moun