Tales from Kentucky Nurses is one of the many volumes (almost thirty) written by William Lynwood Montell, Professor Emeritus of folk studies at Western Kentucky University. In retirement since 1998, Montell has maintained his professional activity and, fortunately, he has continued to be interested in local life and culture.
History is not only found in school books and made by kings, queens, great battles, or great revolutions, but rather it runs on two apparently parallel planes: one is a history of Main Events and the other recounts common daily events. The latter is written slowly, step by step, almost imperceptibly over short periods by ordinary people whose names are usually lost over time, and who are simply referred to as “the people.” Simple ideas, habits, and customs change over the years but are only noticed and considered after several decades have passed. I do not know whether these thoughts of mine coincide with those of Montell, but maybe I’m not too far off, since he writes, “As I tell people, I could care less writing about kings, queens, and presidents, I write about local cultures, life, and times as described by persons whom I interview during the research/writing process.”
The story in Tales from Kentucky Nurses is about the birth of the Frontier Nursing Service (FNS). It was founded in 1925 by Mary Breckinridge (1881-1965), who was from a distinguished family in Arkansas. She earned a degree in nursing at St. Luke’s Hospital in New York City, and received training in midwifery at the British Hospital for Mothers and Babies in London (certified by the Central Midwifes Board, England and Wales; the first Midwives Act in England and Wales was in 1902, in 1915 in Scotland and 1918 in Ireland). The Central Midwifes Board no longer exists but has been replaced by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting.
The FNS was an organization that depended on nurses, nurse-midwifes, their horses, and couriers. The couriers assisted the nurses in various ways. They acted as escorts for visitors, treated sick and crippled horses, served as messengers, and even provided postal service. This kind of diversified service was crucial for Leslie County, the territory in which it was established. This county is nestled in the heart of the Appalachian Mountains, with elevations ranging from 757 to 2600 feet above sea level.
In Mary Breckinridge’s time, the proud inhabitants were self-sufficient, thanks to their farms, but they did not have any medical care. There were typhoid and diphtheria epidemics, and maternal mortality was high. Midwives often reached the mother after the baby had been born. It was not easy to find a doctor, much less to find one in time. It was only in 1928 that Breckinridge established the first hospital, the Hyden Hospital, with only twelve beds! In 1975, the original Hyden Hospital became home to the Frontier School of Midwifery and Family Nursing. The history of the Frontier Nursing Service and that of Mary Breckinridge are intertwined. You cannot think of one without thinking about the other, especially since Mary Breckinridge was responsible for the Frontier Nursing Service until her death.
A detailed history is presented in the first chapter, “The Frontier Nursing Service.” Subsequent chapters are thematic and are dedicated to the stories told by storytellers. First we have “Emergency Room Episodes,” chapter 3, and then “Baby Births,” chapter 4. Then follow chapters on “Nurse Training,” chapter 7, and “Doctor and Nurse Interns,” chapter 8. Chapter 9 is dedicated to miscellaneous stories. Chapter 10 describes some problems and asks for financial support that is indispensable for the survival of the FNS. Stories about relationships with the judicial system are also presented, including an episode (“Sanitary Toilets Needed,” pages 233-234) that, by virtue of its common sense, evokes laughter. Medical relationships always include two parts, one played by a nurse or a doctor, the other by the patient who can behave badly. Chapter 5 is dedicated to this argument. Reasons for reflection can be found in chapter 6, “Inspirational Tales,” all of which are set in the healthcare environment. Chapter 11 provides an overview of treatments, medication mistakes, living conditions of patients, and folk medicine. All of these become part of the vast history of medicine.
Since the stories in the book are told directly by the people who have had these experiences, the author does not forget to present biographies of the storytellers, who would otherwise fade into the dark mass of “the people” of the past. I have deliberately not commented on individual episodes (and I could name many) presented in the book, because I believe that each reader should be able to personally read and enjoy them. What is certain is that the author brought me back to my first experiences as a doctor in the Emergency Room and awakened many memories. Many of the situations presented in the book were not new to me, as will certainly be the case for any reader who is in a healthcare profession.
Times change, and calomel is no longer used in therapy, but human nature has not changed and many chapters reflect this. It is of value that this volume allows us to compare our times with times when medicine could be considered a heroic frontier endeavour.
I could care less for writing about kings and the like, writes the author. Well, I think his objective has been fully achieved. This book will be useful to many: historians, educators, medical professionals, and other scholars. But it will also be useful to those who simply love to read, regardless of their profession, and to those who do not want to forget the past.
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[Review length: 951 words • Review posted on September 29, 2015]