xt7rn872wp2c https://exploreuk.uky.edu/dips/xt7rn872wp2c/data/mets.xml The Frontier Nursing Service, Inc. 1934 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. X, No. 2, Autumn 1934 text The Quarterly Bulletin of The Frontier Nursing Service, Inc., Vol. X, No. 2, Autumn 1934 1934 2014 true xt7rn872wp2c section xt7rn872wp2c T l B ll ' f
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VOL. X AUTUMN, 1934 NO. 2
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Illustration by M. Oetjen, R.N.
At six o’clock on Christmas Eve the mountain darkness
that descends so quickly in the Kentucky hills had completely
surrounded the two small white buildings composing Possum
Bend Center. The air was chilly and the nearby hillsides were ·
being leisurely powdered by a gentle snowfall. Suddenly there
gleamed in the darkness a light from a lantern, while the figure
' of a man astride a small, lean mule appeared at the wire fence
enclosing the center grounds, and a man’s voice shouted—
"Hello, Hello, Hello—Nurses."
E Before the last hello had found its echo, the door to the
little white cottage was opened and one of the nurse-midwives,
  clad in riding clothes, appeared on the porch, holding aloft a
2 kerosene lamp. She recognized the man as Sam Napier, and
 M ‘ asked him to come inside and get warm. He refused, explaining
Q that "Sally his wife was punishing turrible, and wanted the
i nurses."
l Fifteen minutes later the two nurses mounted on their
Q faithful equine friends, rode out of the white barn after the
This was first written for the Public Health Nurse and is reprinted (condensed)
. from their issue of December, 1930.

anxious young father. Both were acutely aware of the distance T
to be traveled before Sam’s house could be reached. The Napier
cabin was perched on the top of Devil’s-Jump-Branch on the
famous "Hell-fer-Sartin" creek——a rough creek bed to travel » 
either afoot or on horseback. j
Patiently the two horses, Penny and Darky, followed the  
mule through the chilly waters of the creek. The snow con- j
tinued, changing from gentle, fine powdery flakes to stinging i
icy granules that clung tenaciously to the sleek coats of the S
horses as well as to the heavy outer garments of the nurses. `
Gloves or mittens are luxuries for a poor .mountaineer. l ·
On this cold, snowy Christmas Eve, Sam’s hands were bare. ·
He frequently changed the lantern from one hand to the other  V
in order to thrust his numbed fingers into the pocket of his
shabby black overcoat. He often remarked "Hit’s a powerful
bad night, and a heap of trouble for ye to come this fur, but
Sally she allowed hit were time fur you all to come. She always I
knowed with the boys, so I reckon she needs ye." i
The nurses took turns in assuring him that this night i
journey was just part of the day’s rounds. They quoted the  ‘
motto of the Frontier Nursing Service adopted since its earliest
pioneer days: "No matter what the weather, if a father comes V
for the nurse she will return with him." .
On a sunny day the six mile horseback journey would have l
taken an hour and a half. The blackness of the night, together .
with the heavy snowfall kept the horses going at a slow walk. .
Three hours passed before the first cabin on Devil’s-Jump-
Branch was reached. The last half mile was up the particularly
steep, rocky incline long ago christened by the early settlers
"Devil’s-Jump." When this point was reached, the nurses dis- »
mounted in order to lead their weary horses up the slippery  
path ending at the door of Sam’s tiny weather-beaten log cabin.  il
The kindly neighbor women who had come to sit with
Sally during her confinement had heard the horses coming and ‘
had opened the door to call out a warm welcome to the tired _
travelers. Sam took immediate charge of the horses and
assured the nurses that the barn was warm and dry.
One of the women seized the saddle bags and carried them

Faowrma NURSING smavrcm 5
T into the cabin. Friendly hands peeled 0H the nurses’ wet wraps
and spread them out to dry before the brightly blazing log fire
which, together with the light from one "coal oil lamp" illumi-
·`  nated the combined bed and living room. The whiteness of the
j pine board floor, as well as the orderly arrangement of the
T' hand-made rustic furniture would have made a lasting im-
` ` pression on even a casual visitor. * * *
T The sooty black iron tea kettle used in every mountain
T home was waiting on the hearth Hlled with boiled water. Several
small tin lard pails had been assembled on the table for the use
T _ of the nurses. One of the beds had been made with clean sheets. ·
. Blankets were unknown in this humble mountain home. There
 ‘ was, however, a plentiful supply of clean, hand-pieced quilts
of various weights, patch work patterns and brilliant colors,
turkey red predominating. The nurses opened the midwifery
saddle bags and laid out the necessary equipment for the
A Sally had since her marriage at sixteen always been known
i as the "sewinest and workinest woman on the creek." * * *
· Silently and patiently this young twenty-six year old mountain
T mother labored. The women folk encouraged her by relating
, the story of the first Christmas Baby. When she became restless
_ they admonished her to "do what these women tell ye, because
— they know what’s best for ye."
. Shortly after midnight the first Christmas baby on "Hell-
. Fer-Sartin" made her appearance crying lustily. How her
parents rejoiced at the birth of a daughter because the other
four were sons. The nurses were given the privilege of choosing
the name for this tiny black-haired daughter; They consulted
» together and suggested Noel Mary as a name for Sally’s "least
Q one." The name pleased the parents. After Sally had given her
 il daughter a keen look and learned her weight was eight pounds,
she reckoned she was "a right pert young un."
` Meanwhile Sam had raised the door in the ceiling leading
_ to the loft above where the four boys were snuggled together in
one bed and informed them that they had a little sister. The
nurses were urged to "take a night" and share the other bed.
However, the snow had ceased and the moon had come up flood-
1 .

 6 THE QUARTERLY Bunnmrrn  
ing the snow clad slopes with magic light, so the hospitable l
invitation was refused. Sally was assured that a nurse would l
return to care for her that afternoon. One of the elderly  
neighbors had offered to remain for a week to look after the
little household, so instructions regarding the care of the mother ‘
_ and baby were given her. `
After everyone had partaken of a steaming cup of black I
coffee and Christmas greetings had been exchanged, two weary
but elated nurses mounted their horses and rode away. It was
then two o’clock in the morning and brilliant moonlight was
glistening on the snowy hillsides. In the peaceful beauty of the -
snow-powdered hills and with the memory of the happy family A
in the tiny, isolated mountain cabin, the fatigue and cold were
I forgotten. The nurses lifted their faces to the star sprinkled
sky and their silent thoughts were—"Noel Mary Napier—a `
Christmas baby on Devil’s-Jump-Branch, Hell—Fer-Sartin
yi Creek—He came, that first Christmas Babe, that you too might i
; have life and have it more abundantly."
Sayings of the Children
John, age seven, taken to the Children’s Hospital in Cin- A
cinnati and first seeing the lights of the Great City: "Who could
have lit all them lamps!"
Little Latham, passing by the Possum Bend Nursing Center  ‘.
with a friend on the day after he had had a T. A. T. shot, Q
pointed to a fallen tree: "See that log, the nurse took a needle ,
as big as that log and druve it into my bones."  
V Said Rennie, going down to the Blue Grass on a train out .
of the mountains, and struck with the widening valleys: l
"Awful big bottoms folkes has got down here." I

l  _
Beech Fork Center (Jessie Preston Draper Memorial)
` Saturday, July 28. »
’ I am here to help Stevie with a party she is giving for the
school age children in her district.
This morning we arose at about seven and, after breakfast,
started in on the scheduled party. The children had begun to
arrive at six, but read books and played games in the big clinic
room until we put in our appearance.
It has been a very rainy day, but, in spite of that, fifty-seven
children came to our party. The first thing on the program was
to weigh and measure all of them, and examine their teeth and
tonsils. This little chore took up nearly all the morning, so,
when we finished, it was time to start getting the refreshments
ready. The lunch we served consisted of cocoa, jam tarts, and
crackers, and seemed to be very successful.
After lunch, we persuaded all of them to sing some of their
songs for us, and they sang very well. One little boy named Ed,
 . who was the leader, was splendid, and, in no time, he had over-
come the shyness of the younger children and had them all
joining in. One of the songs they sang was called "Old Sailor
Man." It has innnumerable stanzas, which tell of the sailor’s
attempts to be accepted by the rocks, the sea, the angels, etc.,
all of which refuse to have anything to do with him. Finally,
in desperation, he applies to Satan, who receives him immedi-
ately. After this final verse had been sung, one little girl went
J right on singing. Ed waited until she stopped and then ex-
I ` plained to her, without a trace of impatience, "Don’t you know
 · ` that’s all there is to that song? Ole Sailor Man gets took in by
  the devil, and there just caiwft be nothin’ after that."
- After the singing, the rain having stopped for a little
. while, all the children went outside and did various odd jobs
for Stevie. One group cleared out an accumulation of trash and
· burned it; another weeded around the house; another weeded
i what is to become a lovely, natural rock garden; and a group of

 j I
 ‘ . 1
’ E
older boys weeded the flower garden. They all worked like 7
grown men, and, in just a little over half an hour, with so many Q
hands, the place looked entirely different. The remarkable thing
was that none of them seemed to feel that they were really `
working; they chattered and shouted to each other and had a  
. wonderful time. l
By this time, it had started to rain again, so we went back
to the clinic, where we played games until three or three-thirty.
Then they left, each one with a bag of hard candy (a real i
treat and the making of a party), as he said good-by. I had  
to leave, too, so I packed my saddle-bags, taking in them
W besides my change of clothes, three and a half dozen eggs g
` for the Wendover breakfasts. I felt some qualms about  
l carrying eggs on horseback, but Stevie assured me they were _
~ well packed and would be safe, so I took her word for it and
. hoped for the best. _ F
*4 I made excellent time going back to Wendover, covering
ll the eleven miles in about two hours and a half (and breaking  
l' just three eggs). I arrived in time to help bring the two mares l
I and their colts in from pasture, and then cleaned up for dinner.
After dinner, I played a little bridge, but went to bed fairly
early. ‘
Tomorrow is Sunday, so not much activity is scheduled for
the "Courier Service," except for the regular watering of
horses; but something unusual is bound to happen. I wonder
what it will be, this time. z
i Cincinnati Courier. I
A Berea and the Frontier Nursing Service are both delight- J
{ fully remembered in an article called "America Revisited" by I
g Frederick Watson in The Crippled Child, the periodical of the `
§ International Society for Crippled Children. .

Q __ igaowrnsn rsunsme smavicm _ 9
{ Anyone who has visited Wendover the past summer will
{ understand only too well the full meaning of Periodic Ophthal-
V mia, the outbreak of which in our stables has been one of the
greatest tragedies that has ever happened in the Service.
Carmenetta was the first victim. She was a little mare
l that, because of her gentle, quiet disposition and surefootedness,
i carried the most precious loads during the time we had her-
I Mrs. Breckinridge on her first trip down Hurricane after her
J back was broken, Marion after her long illness, and some of
Q our dearest friends unaccustomed to riding. Except when used
Q for special purposes, she was ridden by Inty. Inty first noticed
I Carmenetta’s eye was discharging and thought it only a gnat
' or a seed that had infected it. She gave her careful and tender .
i care and when results were not obtained, called various men
  for consultation. The only diagnosis we were able to obtain
from local authorities was "moonblindness." In the nine years
of the Service no one had ever heard of a contagious eye disease,
so the main thought was to remove whatever particle was caus-
ing the irritation. After several days without relief, Carmen-
etta was sent up to Wendover to be put in the horse hospital barn
and cared for by the couriers. After a week’s rest she seemed
much better and able to go on duty again.
Soon we began hearing of horses and mules in the district
i affected the same way, and in rapid succession Nellie Gray,
{ Little Bill, Glen, Jason and Roxy all developed bad eyes. We
l asked Dr. Charles Hagyard of Lexngton to come up, which
ft he did as a courtesy without cost to us, and he diagnosed
_  the condition as Periodic Ophthalinia, a very contagious dis-
 ` ease about which little is known except that it is recurrent
V’ and results in inevitable blindness. As there was no permanent
. cure for the disease and complete isolation was impossible for
  so many, we were forced to destroy all six of the infected horses.
I To Margaret, our \Vendover nurse, the going of Little Bill
‘ was a real bereavement. He had taken her carefully and faith-
fully for five years on the darkest nights, through swollen fords,

" l
. s
: g`
l .
l and over frozen mountain trails. No horse in the Service was 1
  more loved by his mistress than was Little Bill. To the couriers l
{ and to the rest of us, the loss of Glen was felt very deeply. He
; was a favorite with everyone. In fact each horse had one or L
  more lovers. ¤
c Rather than risk someone else’s doing it, and perhaps ls
  making a dreadful task more dreadful by bungling it, Kermit
* finally agreed to perform this last service for the horses to
il whom he had given years of devoted care. Many times he had Z
i said that he couldn’t shoot Little Bill and Glen, but neither .
  could he let it be done at the hands of one who did not love y
  them. The rest of us tried to go about our work as usual, but T
  the atmosphere at Wendover was noticeably gloomy. It was if 
  almost as though we were parting with members of our family. I
  There wasn’t much time for grieving, for all the barns  l
L; throughout the Service had to be disinfected and freshly white.  L
? washed inside, other parts creosoted, fresh cinders and saw-  s
: dust put in the stalls which the infected horses had occupied,  1
  and all the saddles and bridles disinfected with lysol. The
  drastic disinfecting did not cease until Kermit, the couriers-
  everyone who had been in contact with the sick horses—had .
L been made "surgically clean." U
The horses we have left are doing double duty, and it often  I
~ happens that we must borrow or rent local mules and horses in  %
order to carry on the necessary work. When this is done the .
borrowed or rented animal is housed outside our enclosures. We .
are enforcing an absolute quarantine in all of our barns against ·
, horses and mules not of the Service, until the epidemic is over.
~ Nor are our horses allowed in outside barns. As rapidly as
` ` possible we must fill in the ranks, although new horses cannot
replace in our hearts those we have lost.
V AGNEs LEWIS. i  l —
The "Pisen Branch" neighborhood in Bowlington district T
has been paying its midwifery fees in fodder this year, on a l
A hundred percent basis.  U
- I

l . Fnowrrmn NURSING smnvicn 11
I am driven to ponder "first causes" in this job of ours. I
think it is only by that process—discovering fundamental causes
j and understanding their implications—that we can hope to do an
_ intelligent piece of work.
y In a very simplified form our question, a two-sided question
, it is, seems to me to be this: (1) To what extent is the human
Zi  factor involved in this composite that we call the problem of the
I super-rural mountaineer? Or to put it another way, what has
 { happened to the human entity, the human spirit, through the
years and years of struggling with the narrow, harsh, unyielding
  environment which has been the lot of our mountain folk for
 § generations, an environment ruthless in its consequences for
 l human life? (2) The other side of the question is, what new or
revamped economic possibilities are there, within the mountain
area or out, which might be developed to relieve this terrific
j economic pressure that has human life literally against the
L wall? * * *
 E To look briefly at the economic aspect of the question first,
U we shall have to face at the outset certain hard, stubborn facts.
` Of course, we are not assuming that the economic factor is the
 “ whole of the external situation. That it does underlie practically
all phases of this problem is, however, a conclusion that we can-
not escape. Some of the basic economic facts that we need to
1 face are these: (1) In these remotely rural areas practically the
only source of livelihood is farming on a subsistence basis, which
_ does not really support the major part of the population, it only
* it  ` keeps them alive. (2) Subsistence farming itself, however good
j or bad of its kind, is not, unless supplemented by some source of
( cash income, an adequate way of living. One simply can’t raise
 1 on any farm, much less a mountain farm, everything that is
i needed to live decently and to contribute one’s share in maintain-
 i Reprinted from the Alpha Omicron Pi Magazine "To Dragma" of March, 1934-
, (condensed).

? , I
l si
ing a reasonable minimum of social institutions according to the ,
* lights of this Twentieth Century. (3) Industry as now managed i=
does not need mountain labor, so, for the near future at least, ll
there is little hope from that quarter, either of reducing the popu- _&
T lation-group dependent on mountain agriculture or of supple- A,
{ menting with cash the income from this basic source. (4) On g`
the quantitative side, large "spots" throughout the Southern Ap-
  palachian area are in the toils of this inadequate agricultural
  economy and the people involved run up into the hundreds of  
  thousands. (5) The "way out" of this situation is long and devi-
A; ous. It isn’t really the "way out," it’s "ways out," and will .
Q, require the effort of individuals, private organizations, public  (
Q agencies, in concert, and patient, intelligent devotion to the  
Q, mk. _,
I A discussion of these possibilities for reconstructing the L
Q economy of the region is not my first interest here, but I do want 5
if to suggest some of the possibilities that are already evident, such  
  as: Forests, scientifically handled as a regular crop, for that A
H, large portion of the land that is admirably suited to that and 1
  nothing else, plus fish and game to make these forest preserves `
A still more productive as attractions for tourists; local wood-
` working industries; intensive farming of the more adaptable ~
land, with crops better suited to the peculiar mountain situation; ¤
. marketing developments and better marketing facilities——these A
will indicate some of the variety of economic possibilities still to
be realized. ,
There is still another aspect of the economic situation that .
` we should not pass over. I think the present prospect of there —
. being undertaken a thoroughgoing attack on this tenacious,
omnipresent economic problem is brighter than it has ever been. .·
Recent years have brought a more adequate appraisal of the facts 1
in the "mountain problem," a more honest facing of the implica- ·`¢ ` ·
I tions to be derived therefrom. There seems reason for believing  *
also that the economic debacle has given us as a nation a height- .
4 ened sense of social responsibility. And finally, Government is j
itself displaying a special interest in the social and economic .  -
handicaps of the subsistence farmer, caught as he is in the circle A
of poor land, distant markets, lack of capital, lack of social insti- ,
,E I

* 1¤Rom·1ER Nuasmc; ssavrcs 13
A tutions, and all of the hampering influences that grow out of
EQ social and intellectual isolation. * * *
li It is the need for understanding that makes me think and
  talk in terms of "first causes." Understanding isn’t really big
, enough in its meaning to include all that I intend. It is more like
l` thinking and feeling oneself into the situation of another person
until one finds oneself compelled to try, on the one hand, to im-
I prove that situation, and, on the other hand, finds it possible to be
l endlessly patient and faithful with the person who is caught in
that situation. I suppose this is really my own interpretation of
I that command that one should love his neighbor as himself—that
 i is, penetrating the "neighbor’s" situation with such acumen and
3 sympathy that his problem becomes as vital and urgent as one’s
_i own.
. Before we begin thumbing through experiences which are
`! actively conditioning the mountain people here and now, we must
  remind ourselves that many of these and similar experiences
E have gone into the very warp and woof of the whole group’s
· psychological past. Their force has been accumulating through
 — generations of living under a "do-without" economy, an economic
system that has necessitated doing without almost everything of
, a material nature except enough to keep body and soul together.
R This "do without" economy has gone much deeper than material
· things, though its psychological significance is deep and perva-
sive even as it relates to material things. In the world of ideas,
the mountaineer has had to be content with traditions (dating
I back to the Eighteenth Century, many of them), the guess of his
_ fellows, his own speculations and unverified observations. The
. scientific approach to a problem, with its dauntless search for
facts and bold facing of their implications, has never reached the
y. isolated mountaineer. Do you see the deadly effect of having to
‘ confine one’s thinking to_the narrow circle of Eighteenth Century
.—, * . tradition, one’s own very limited experience and the speculation
2 of untutored minds? Can you see also how years, generations of
Q helplessly watching the ravages of typhoid, dysentery, tubercu-
~ losis, diphtheria, seeing over and over again women dying in
 . childbirth without means to prevent it, seeing the crippled and
‘ deaf and blind doomed to useless lives——can you see the stoic
J fatalism that that sort of thing engenders, crippling and stultify-

, ing when it becomes, as it inevitably does, a part of the group’s
spiritual inheritance?
With this as a very inadequate suggestion of the mountain-
eer’s psychological past, perhaps we can create something of a  
._ panorama of the circumstances and experiences which tend to k
·l mold and control the mountaineer of today. To start with the  
— breadwinner, let’s say that he is a renter, but he lives on "com- ·
f pany land" (more than half the land in Leslie County is owned
  by companies), paying either a small cashirent or a "rent" con-
  sisting of certain services to the company in the way of upkeep
  and protection of the property from fire, unlawful cutting of tim-
j, ber, etc. Easy terms apparently, but on the other hand the com-
F pany forbids his clearing any new ground, so that his farming
Ji must be confined to a small plot of bottom land which is the
Y family garden and perhaps ten acres of hill land, with a slope of
from twenty to forty degrees, land that has been farmed for
  years, leached by rains, exhausted by repeated planting to corn. `
  Last fall hog cholera was rampant. Almost nobody had the money
ll to pay for vaccination, and the hogs are dead. Perhaps the man
  will be able to "work out" a little grease and meat along from a
  merchant or a more fortunate neighbor, otherwise they will do
i" without. At any rate, the hope for an adequate supply of meat
A and lard for the winter is gone, the brood sow is dead and unborn
A is the litter of pigs that were to have made next winter’s meat
~ supply.
This is only the beginning of the breadwinner’s trials. Last
fall hunter’s torches set the woods afire and burned a long stretch
of his rail fence. To replace it he and his eldest son have worked
_ for Weeks, in wet and cold, with thin shoes and thinner clothing,
cutting dead or dying chestnuts (the only trees the company will
’ permit him to cut), snaking the logs out of the woods with the 1
T old nag, splitting them into rails and laboriously rebuilding the
fence. Thus it is with almost everything he undertakes. Lacking `»  
z tools and equipment, almost any desired end must be achieved by
the crudest, most laborious, most time-consuming method. The
· mule needs a new feed box, for example. He may either hevv it
l out of a log, spending many hours doing it; or he may seek the
l company’s permission to cut a tree, drag the log some five or ten
miles to a sawmill, leave part of the lumber in payment for the

 Fnowrimn NURSING smizvicm 15
sawing, drag or sled the remainder back home, and then wait
that uncertain moment when he will have the