xt7xd21rh407 https://exploreuk.uky.edu/dips/xt7xd21rh407/data/mets.xml The Frontier Nursing Service, Inc. 1987 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. 63, No. 1, Summer 1987 text Frontier Nursing Service Quarterly Bulletin, Vol. 63, No. 1, Summer 1987 1987 2014 true xt7xd21rh407 section xt7xd21rh407 •4\J¤S:~
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US ISSN 0016-2116  
Seventeen Years as a District Nurse `
Many Memories To Cherish — by Sharon Koser I {
The FNS Courier/Volunteer Program 9  ,`
Tradition. . .Service. . .Adventure i
Part Two: The Present Day · by Heidi Sulis and Elizabeth Wilcox 5
Notes From the School — by Ruth Beeman 18  
Courier News - Edited by Elizabeth Wilcox 18 Al
Beyond the Mountains —- by Ron Hallman 19
In Memoriam 20
Memorial Gifts 21
FNS President David M. Hatfield Delivers "State of FNS" 23
Address at Annual Meeting
Urgent Needs 49
The "New" Forgotten Frontier Inside Back Cover
In Brief Inside Back Cover
SIXTY-SECOND ANNUAL REPORT OF THE FRONTIER NURSING SERVICE,
INC. for the Fiscal Year May 1, 1986 to April 30, 1987 31-49
COVER:
Family Nurse Practitioner Sharon Koser on rounds in her FNS jeep . . .somewhere
near Greasy Creek. (1970)
»>
FRONTIER NURSING SERVICE QUARTERLY BULLETIN W
US ISSN 0016-2116
Published at the end of each quarter by the Frontier Nursing Service, Inc.  
Wendover, Kentucky 41775 Li
Subscription Price $5.00 a Year iv
Editor’s Office, Wendover, Kentucky 41775 ~
VOLUME 63 NUMBER 1 SUMMER 1987
Second·class postage paid at Wendover, Ky. 41775 and at additional mailing offices
POSTMASTER: Send address changes to Frontier Nursing Service, Wendover, Ky. 41775
Copyright 1986, Frontier Nursing Service, Inc.

 J
 i
•= =•= =•= *
Q I came to the Frontier Nursing Service in October 1969, having
’ been born and raised in Seattle, Washington — a city kid with a
~ life long desire to live on a farm. These seventeen years I’ve lived
in the Kentucky mountains have helped satisfy that desire.
'~ The first eight years here I lived at Wendover. Six of those
  years I lived on the Upper Shelf in a single room with a coal grate
i , fireplace. The last two years I lived in the remodeled horse barn.
‘ F; Part of my barn room was formerly Ted’s stall, the last mule we
J had at Wendover. My room was the only one with an outside
— entrance, and opened on to the area that used to be the tack room.
Each of those dwelling places was a historical place. Every
building and piece of hillside at Wendover spoke of history . . .
Y what came to be living history to me.
in 

  
2 FRONTIER NURSING SERVICE ?
On a clear night at Wendover the sky was so black you could  
see all the stars — where in the city, the city lights blocked them »?
out. I used to say to my family in Seattle, that it looked like God Q
had spilled a box of salt in the sky and that each star was a grain _1
of salt — there were that many stars — and that the mountains at  
night looked like a black velvet fence surrounding us for protection. :
I’ve often said I was "raised up in the FNS at Wendover". `l
Many stories, tales and legends were shared, especially at meal-
time around the Dog Trot table in the Big House. Through these
stories I developed an increased understanding and respect for all 'I
that had gone on at Wendover over the years — how the Big House ‘·
was built; how the stone chimney in the Garden House was built
five stories high; who the previous Wendover nurses were and
many stories of their adventures on horse back to deliver babies,
(these babies were now parents of children I was caring for); _
names of and stories about people who used to work at Wendover  
— to the point I came to feel that I too had known them. Some had  
passed on but I came to know their children and grandchildren as  
part of the families that lived in the Wendover district, my district.  
. i;
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"Visiting on the front porch was a useful part of my job. That's where I found out what the  °‘
current problems were."  i

 QUARTERLY BULLETIN 3
Q Others were now elderly folks who I came to know doing house
Q calls.
E One of the first times I made a home visit to see Sarah and
2 Rueben, an elderly couple, Sarah asked me to stay for dinner when
=, I finished Rueben’s care. It was 10:30 a.m. daylight savings time.
Q . When I mentioned it was early, and hadn’t been long since
breakfast, Sarah told me they "didn’t believe in that fast-time",
they just left their clock on "slow time". Therefore it was 11:30
,` . a.m., their regular dinner time. I declined, saying I had more
Q house calls to make and needed to be on my way. The next week on
  my visit to Sarah and Rueben, again I was asked to stay for
  dinner. I was flattered, but thought I needed to go on to the next
  patient. The third visit, I did Rueben’s weekly care as usual. But
  when I finished Sarah announced triumphantly, with a broad
Fg grin, "Now you’ll stay for dinner. The table’s set and dinner’s
A ready". Sure enough, there was an extra plate set and the food was
p being put on the table. I stayed for dinner. It was a feast! A Sunday
  —type dinner if there ever was one! There were about eleven
! different food items on the table. This became a weekly ritual and
— we all enjoyed it. It may have been Sarah’s way of "taking care of
me", since I was taking care of Rueben. It was also wonderful,
_, gracious mountain hospitality.
  Many months later, Rueben died in his eighth decade. I went to
  the house to visit Sarah. She told me that on the day ofthe funeral,
  she wanted to ride in the jeep with me, behind the hearse, taking
  Rueben’s body to the church. I was surprised and flattered, but
  thought there were more comfortable vehicles or possibly relatives
,; with whom she could ride. But Sarah was persistent and wanted
  to ride with me. When we arrived at the church house she marched
  me up to the front row to sit with her. Many neighbors, relatives
-7 and friends were there and a number of them in the choir. The
  choir sang without instrumental accompaniment but created
  beautiful harmony with their voices, accompanied only by the
_ " gentle, rhythmic patting of their feet on the wooden floor. I looked
  over at Sarah sitting next to me, and there she was, wearing her
~  patent leather shoes, patting her feet in time to the music.
 , After the funeral service Sarah and I went back to her house to
  prepare food for the relatives who would stop by after the
E graveside service.

 4 FRONTIER NURSING SERVICE  
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"Many of my favorites were the elderly folks I came to know doing house calls." E
Interestingly enough some of my most special memories  
revolve around death situations. I have learned a lot about death E,
in my work here and learned that death is really part of life.  
One nightl was called to the home of one ofmy patients where  
neighbors and relatives were "sitting up with the family" during E
the last hours of the woman’s life. Nora had had cancer for some  
time, plus crippling rheumatoid arthritis and had been bedfast for  
months. She had been cared for at home for the majority of her E,
illness and preferred to die at home, as do many of the elderly  
folks. The family called me this night as they felt the time was T
very near and wanted me to be with them when the time of death T;
came. In the early morning hours the situation worsened and Q
Nora’s brother asked me "Should I go wake the children?" (his "
three preschool children and Nora’s pride and joy). I replied
hesitantly, "Do whatever you need to do", but inside I was  
thinking, "No, spare them", reflecting my own insecurities. Nora l_
died before he got back with the children, but when they arrived, ~
four year old Amy walked into the bedroom, looked at Nora lying y
peacefully in bed, looked at me and matter-of-factly said "Nora’s  y
dead, isn’t she Sharon?" "Yes" I said, and with that the child  ,
turned and quietly left the room. Total acceptance by the child. i 
Totally amazing to me. _l
4

 i QUARTERLY BULLETIN 5
  A favorite recollection of mine is a story an elderly patient told
I me. She had worked at Wendover in her younger days, in the
g laundry. She was one of my favorite people, an interesting
I character with a wonderful smile. We had many talks, but one day
she told me how she had delivered her own baby at home. This
J took place about 50 years ago and the story goes something like
li this . . . "The midwives had told me the last time not to have
anymore children, that I might hemorrhage and die. So I was
g afraid to tell them I was pregnant. When the time was close I had
Y° my sister Cory come and stay with me. Cory never could do
if nothing without crying. Early one morning the ‘miseries’ came.
` When they started to get hard, I woke Cory and told her to get up.
I There she stood at the foot of the bed crying. I told her to boil some
 g water and boil the scissors and a piece of thread, and to scorch two
 , pieces of cloth and scorch a hole in one. When those miseries
 i would hit I would grab ‘holt’ of the head ofthe bed and bear down.
 V I ‘studied’ ifI could get to the foot of the bed and ‘hunker down’, the
I baby would probably come easy. So I started to ease toward the
g side ofthe bed and one of those miseries hit me and I slid right off
  the bed and onto the floor, sheets and all. I looked down and there
` l . It .l > '   X`i:?'{»
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"The opportunity of getting to know people on a more personal basis is what has given
  me satisfaction all these years."

 I
i 6 FRONTIER NURSING SERVICE
, was the baby. He was healthy!" i
  The improvising fascinated this naive nurse . . . good sterile .
g technique. The thread was to tie the baby’s cord in two places, the  
{ scissors to cut the cord, the cloth with the scorched hole fit over the
; baby’s cord, the other cloth fit around the cord and the remaining t
I thread was to secure that cloth in place. _
, The preceding experience took place in the Wendover district.
  Then the Wendover district was closed in 1976 and that was the
end of a special era in more ways than one. That same year Home i _
Health became a separate agency within the FNS and the pattern _ 
of home visits changed in all the districts. I was moved to the if 
Beech Fork Clinic. I still lived at Wendover but commuted daily by I
jeep to Beech Fork, seventeen miles up the Middle Fork River. ·
Beginning at this time more patients were seen in the district  
clinics than on traditional home visits. The focus began changing Q
i and the majority of patients came to the clinics for care rather t.
than the nurses taking care to the home. P
1 After eighteen months at Beech Fork the FNS took on the  I
i Wooton Clinic and I transferred there where I remained for the Q_ 
i next eight years. This clinic was set up on a full time, eight hour J
i clinic day, with home visits only in case of emergency. , 
It takes longer to get to know a family/extended-family well,  V
when you only see them on clinic visits and not in the home. But it lz 
isn’t impossible. The district clinic secretaries are a great asset in "
f helping a nurse to get acquainted with the families in the district ». 
L community. Usually he/ she is from the community which the * 
clinic serves, may have grown up in that community and knows  ?
everyone and who’s related to whom. Eventually the pieces of the I
p "family puzzle" fit in place in the nurse’s mind.  W
My greatest joy at Wooton Clinic was the children. There were  i
a lot of children. Preschoolers are my favorite age group. I love the  
I babies too, but preschoolers are so much fun. You can just watch V 
I their little minds at work and that fascinates me. I took great i
  pride, and still do, in teaching children not to be afraid ofthe nurse  il
  — of having their ears examined, of opening their mouth for an “ 
; exam of the throat or a throat swab, and then watching them _
Z become brave and then proud of themselves - confident.
I This accomplishment also made my job easier, that is,  ¢
examining the child.

 QUARTERLY BULLETIN 7
i I e I   I F
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`  "My greatest joy was the chiIdren."
 Z One little boy said, "I don’t want to open my mouth!" I asked
  what was the problem. He said, with tears in his eyes, "I’1lpuke".
He was afraid that he would vomit and the resultant embarasse-
~ ment was his whole hang-up. We got past that and he learned,
 .1 with great pride, that he could accomplish this task successfully.
That made my day! Watching children grow and accomplish
I developmental tasks, helping them overcome a fear, still makes
~ my day. Giving and receiving a hug also makes my day! IfI can’t
 · see at least one child a day, I can hardly survive.
 l At Wooton Clinic, also, I had the pleasure and priviledge of
·A caring for a family where I saw the mother through each of her
  three pregnancies. I feel especially close to those children, having
 _ cared for them since before birth. Watching them grow, develop
and change gives me much satisfaction, and in a way fills the
 . place of the personal experiences of home visiting.
. Another priviledge I’ve experienced is caring for and getting to
‘  know five generations of one family. This family experience
 I overlapped from the Wendover district to the Wooton district. I
» first encountered this extended family doing home visits and
Polly (generation #1) became one of my regular elderly patients.
She was basically bedfast when I met her and remained so until
 V she died. Later, her daughter (generation #2) became a patient of
t

 8 FRONTIER NURSING SERVICE `
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"l took a great pride and still do in teaching children not to be afraid of the nurse/’ I
mine with blood pressure problems. (Last week I went to her 78th  I
birthday dinner). The third generation were not patients of mine,  
however I’ve shared many Christmas, Thanksgiving and birthday  
dinners with them. They are and remain good friends. A fourth I
generation of this family was an employee at the Wooton Clinic 2
while I worked there. I also cared for her during her two t
pregnancies and those two children make the fifth generation of
this family that I’ve been acquainted with over the last seventeen  f
years.  ’
The opportunity of getting to know people on a more personal I
basis, and not "j ust as a patient", is what has given me satisfaction  I
all these years. Sitting on the front porch with people was a useful  
part of my job. That’s where I found out what the current problems .
were, that’s where I heard the progress report from the last visit to  
the present, that may be where a blood pressure was checked or a I
child’s rash was examined, and that’s where I first ate home  t
grown watermelon. All in a days work!  I
All these years of being informed and educated in mountain  
ways by mountain people —- I love it! I-
— Sharon Koser <
I

  · QUARTERLY BULLETIN 9
Z THE FNS COURIER/ VOLUNTEER PROGRAM
Tradition. . .Service. . .Adventure
· Part Two: The Present Day
. While the courier/ volunteer program has changed considerably
 I since its inception, there remain some similarities between the
  initial functioning of the program and how it operates today. And
5 more importantly, I believe the basic tenants on which the
I program was founded are still very much the same today; hence
  the continuation of this most unique and special program.
  Though the couriers no longer care for horses, pigs or any of
. the animals that once inhabited Wendover, they remain very
involved in carrying out whatever errands need to be done. This
1 might be taking a courier car to Corbin for repairs; or traveling to
i Hazard or Whitesburg to pick up platelettes; or driving up to
`; Lexington to pick up one of the frequent visitors or guests who
come to FNS. This very much resembles the kinds of tasks
J couriers did years ago.
_ Today’s couriers no longer accompany nurses on their rounds
Z (which used to take a week’s time), but they still complete
2 "rounds" twice a week by traveling to all the district clinics
i delivering supplies and mail. Furthermore, the couriers often help
in various clinic situations by taking vitals and "working-up" the
  patients to prepare them for the practitioners. Often this develops
  into a regular experience whereby the individual courier is able to
— observe the approach to health care that is so unique to FNS, i.e.
  sensitivity in relating to people — especially when they are from a
l culture different from what one is accustomed to — and continuity
1 of care. In addition, they are exposed to the alternative modes of
 . health-care delivery offered through our midwives and family
  nurse practitioners. Thus, this is a prime example of how the
4 couriers still play a vital role in the overall functioning of FNS
  while simultaneously benefiting from the situation themselves.
 { Other duties for which the couriers are responsible include
‘ xeroxing, rolling money, helping with paperwork and projects
 ‘ and working at Wendover. Chores at Wendover vary to include
  painting, gardening, shoveling snow, cleaning gutters and ditches
Q following a heavy rain and helping with the numerous functions
  that occur in the Big House. None of it is very glamorous work, but
  ‘

 S 10 FRONTIER NURSING SERVICE ~
I don’t think people mind it very much. We realize how fortunate »
a we are to still have Wendover and to be able to enjoy it as much as
# we do. It’s a beautiful and special place.
$ Finally, there are those other duties or opportunities that are _
far more difficult to record and articulate. Such things might {
include experiencing for the first time, a baby being born; or  
I striking up a special friendship with one of the other couriers or g'
  persons in the organization; or learning something about oneself  
i that wasn’t previously realized — or confronted. For many who   _
I come to FNS, their time spent volunteering coincides with a it
I transition period in their lives and so often the overall experience  ‘
i encompasses a time of introspection, self-examination and ques-  `
tioning. One has the chance to explore not only the new, but also  j
, the old. Thus, there are those philosophical riches to be gleaned  
from the program along with the more practical kinds of skills one  
’ learns while here.  
J Certainly, those who can most effectively talk about this  
5 program are those people who have experienced it. No-one can ° 
V better document their experiences, adventures and growth. Thus,  ,
* instead of continuing in a commentary fashion, we thought it  .
j would be more interesting to share with you some excerpts from  —
W courier journals and personal pieces that were submitted to us  if
upon request. What follows are some firsthand accounts from our I? 
more recent volunteers and couriers which really capture the I
. essence and strength of this program. We hope you will enjoy i
reading them, and as you do, come to a better understanding of  .
I why this program is so special and unique.  >
  This section will begin with some thoughts extracted from my  i
own diary, (Heidi Sulis), written nearly three years ago. Between ii 
I the following individual accounts you will find brief character  L.
portraits so that you will have a little more insight into the lives of  lg
each author. .  
From the diary of Heidi Sulis '—  
, Tuesday was health day at Wendover so Danna appeared with  
j the troop of 7 kids around 9 a.m. Becky and Elissa had planned the  
  curriculum, which I thought was very good. I learned a lot and  2
  enjoyed the day, as did the kids. The first game was a good one. We *
j sat in a circle and passed around a roll of toilet paper, saying take I 
I as much as you need. Ok fine. Then what we had to do was for * 

   QUARTERLY BULLETIN ll
 A every square say something about ourselves. Everyone pretty
Q much followed one another, giving basic name, age, cats, dogs,
sisters, etc. info. Well then there was Ann Marie, whom I got a real
l kick out of. I wish I could type with an accent, but you’ll just have
 - to imagine it or remember it. So anyway, she said, "I have a
 . brother. . .he’s really mean. . .he’s away at cam this week . ..and
. P _
·· I’m reall gladl" I Just knew that that was coming and I really
 , Y
 y laughed hard! Well, the day rogressed and we d1d all kinds of
 , P
 g_ stuff. The kids seemed to enjoy lt and Dusty, my "fave", said he
Y; ` wished it were every day! He’s the pleasantest thing and his sister,
{ Candelon Shermain is a nice girl too. I want to take them to the
pool after class next week.
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`L Couriers and preschool children enjoy a finger painting session at Wendover.
  The highlight of that day at Wendover, besides the kids, was
 f the real lung that we looked at. It was a pig’s lung from the butcher
 _ shop and it was really neat, and supposedly very close to the size
, of our own. The heart was also attached as was the trachea, which
 , Elissa blew into. I’m not sure I would have gone that far (and
A clearly didn’t) but it was really neat to see those lungs expand as
_ they did. I love stuff like that. After looking at the lung, we took

 I 12 FRONTIER NURSING SERVICE Q
~ the kids back to the hospital, along with half of a watermelon and i
sought relief and refreshments in the cafeteria. We also watched a “
‘ movie there. That was the actual purpose of the expedition. The
: kids were tired by this time, but I think that I was actually more _
: tired! ~
Monday night I went to a midwifery class that’s given by Erica   _
  (Goodman) and normally, I think they go for six weeks but all 1
l these people are very pregnant so she’s doing a three-week session  .
for them. And there are four couples, all of whom, I guess, are  ‘ _
within four weeks of delivering. And it was really neat. Really
really was neat. And we watched this video of a woman who
  delivered her baby at FNS and we went through all the prenatal 4
stuff and then the delivery and it was very moving and very Y
_ emotional and almost made me cry. I would have if I hadn’t been  
I with all those people I didn’t know; and they were really a quiet,
1 withheld group. So I withheld my tears accordingly . . . maybe it j
wasn’t accordingly but I did. So that was, . . . really incredible and .
Q very moving for me and I’m going back tomorrow night and that  
should be interesting too.  {
, * * * * * .
Sarah Gates — graduated from Milton Academy (in Milton, Mas-  
sachusets) last June and is taking a year "off" before attending Yale j
University in the autumn of 1987. Sarah spent two months at FNS  "
last fall and is presently spending a semester studying in Greece. i 
i I didn’t take a year off to do something I’ve always wanted to  _
do, to earn money or to have a long vacation. I wanted time to sort ‘
out my goals and values. . .When I realized that I was probably  ’
going to go to college for no other reason than "Well, everybody  1
else does. It seems to be the logical thing to do," I knew that I had  *
to slow down and start thinking about where I was going.  ’,
Since October first, I’ve been in rural, southeastern Kentucky,  "`
participating in the Frontier Nursing Service courier program. ;
Life here has changed in many ways since the early days, but   H
Leslie County still contains ample evidence of its mountain  
heritage, and FNS still provides health care to the current  ‘
mountaineers.  
I am learning from the people here. I am learning to quilt from  ‘
a mother and daughter who live up Camp Creek and while I
appreciate all the pointers they give me, I go up there mostly ;

 j QUARTERLY BULLETIN 13
` because of their humored, gentle, acceptance of all that happens. I
hope I can absorb some of their strength to hold on to when things
go wrong, when I feel inadequate, when I can’t control my life.
I’m getting sad already, because I’m leaving Kentucky in a
· week and a half. Being at home for six weeks, earning minimum
  _ wage in McDonald’s or perhaps K-Mart, (maybe even stuffing
i envelopes somewhere) does not promise to be exciting, but I have a
- semester in Greece to look forward to. I will be on Kalymnos, an
Y _ island in the Aegean Sea, learning how to stretch my mind, not
_ because I have to but because I want to, through learning Greek
. history, poetry, and language. I will also be learning to be an
L apprentice to a Kalymnian family. I suspect that Kalymnos will
be as hard to leave as Hyden, Kentucky is.
Q I still don’t know what I want to major in, but somehow,
Z somewhere in Leslie County, Ky, I got rid of A LOT of cumbersome
self doubt.
; * * * * *
E Carolyn Mehafey — graduated from Princeton University last spring. Her
·_  major field of interest at Princeton was molecular biology. Carolyn spent
_  two and a half months at FNS last fall. She will enter medical school at the
* University of Virginia this September.
  The duties have changed since the days when couriers were
 ~ called to saddle up the horses.
  One hot October day Hazel took a few of the couriers out to dig
  some potatoes. I’ve always been attracted to harvesting the fruits
 j of a garden, much more so than I am to laying the initial seed so I
i included myself in the group. We drove along the Wendover road
· for a way and pulled off towards the river where an unseen potato
 I patch was apparently hidden. Hazel sent us off with our shovels
° and hoes down a somewhat trodden path. I was disconcerted by
  the wilderness surrounding me. This garden was not like the
 =’ square patch in the yard behind our house in Seattle. We finally
. came upon what looked like an overgrown patch of weeds
 y whereupon Hazel informed us that, "That is it." "You’ve got to be
 in kidding", I thought. She wasn’t.
 . Some of us started the arduous task of tearing down the
Y enormous jungle of vegetation and the rest of us followed along
Q behind searching for potatoes underneath the soil. The location of
, the rows was dubious at best so it really was a search. Several
times during this labor I chuckled to myself about the duties of a
¢ courier. Hacking away at small trees and carrying on what

 14 FRONTIER NURSING SERVICE f
seemed like a fruitless search for potatoes (the yield was very low): i
was this my calling? Was this the type of service I’d envisioned _
when I first thought about coming to Kentucky to do volunteer
work? I’m sure it wasn’t. Every time I think about getting i
involved in a volunteer program, I imagine all the great works I’ll ’
be performing for other people. It rarely turns out that way. i
When I first arrived at Wendover, the couriers were put to work ·
constructing a float for the parade in the Mary Breckinridge »
Festival. An endless quantity of paper napkins affixed to chicken
coop wire. Not exactly Florence Nightingale-type material. But   .
lest a reader think that I am disparaging duties such as potato _?
digging and float construction, let me make it clear that that is ·
definitely not my intention. These duties illustrate the main  .
strength of the courier program: couriers are available to do ‘
whatever job needs to be done. ;
I   `iiii I I  
  It  i
  W              
9,b   .,~     `~`i»;‘   .     —. .     —» · { .. ·
 . ». y .%;:,,,3 _· ` A   ;    
E _ .\_- ·' _.» ‘     "·':f· ék {M  
  »€’~ To _:__    [ . I   ~_   .  
  gg _ ,_ ,.,.  A  , _  »·~‘ ’ “   - L  I ‘  
  rc        T     { '$ ` ""` »·
# s   . · .   · - »»   » **: ·
A great deal of courier energy is needed to keep the Wendover gardens and grounds in _`
good condition. i
Iam glad that I wasn’t digging potatoes everyday, otherwise I
might not remember that experience so fondly. I spent the .
majority of my time as a courier in the Women’s Clinic at the Mary  »
Breckinridge Hospital. I aided the nurse, Gerrie Howard, in
taking the vital signs of the patients, restocking, and a variety of

 V x
` QUARTERLY BULLETIN 15
other tasks.