BOOK REVIEW
WIDE NEIGHBORHOODS
AUTHOR : MARY BRECKINRIDGE PUBLISHER : UNIVERSITY PRESS OF KENTUCKY ; 2ND ED . EDITION ( DECEMBER 31 , 1981 )
Reviewed by William T . Baker , MD
It is 14 degrees outside as I write this on a snowy February day .
I ’ ve spent the morning in the basement in my favorite recliner , reading .
No stress . No strain . Warm and well fed .
But , significantly humbled by what I have read .
I don ’ t think I have what it takes . Certainly not what it once took .
Ya see , I ’ m reading “ Wide Neighborhoods ,” the autobiography of Mary Breckinridge and the story of the Frontier Nursing Service ( FNS ).
The chapters I read today recount many of the adventures that these ( mostly ) women experienced delivering care to the mountain folk in eastern Kentucky from 1925 - 1951 ( when the book was written ).
Adventures such as :
- Mary being thrown from a young , skittish horse , breaking her back ( crushing the L-2 vertebral body ) in the fall and being immobilized in traction on a “ Bradford Frame ” for 8 weeks . Then it was 17 months before she was able to ride again .
- Fording / swimming on horseback streams that were sometimes raging with spring-rain flood waters and at other times frozen or icy cold on days like today . And they couldn ’ t avoid getting soaked in the process .
- Living in cabins that were little more than shacks providing scant protection from the elements .
- Never oversupplied with the basics and therefore always mindful of the quest to procure food , clean drinking water and funds to carry on .
All to provide service to folks who had no other .
FNS is famous for their midwifery / obstetrical care , but they did so much more , providing medical care of all kinds in the sparsest of circumstances and with little or no back-up . And that little was often miles and hours away on horseback .
The author does not spend much time giving details of their medical adventures / misadventures . But , as an OB-GYN , I ’ m intimately familiar with the situations and complications they encountered with their pregnant patients especially during labor and delivery . What I am not familiar with and am humbled by is their tenacity and courage in how they ‘ delivered ’ superb care , most often in a poorly lit cabin far up some lonely ‘ holler ’ after a two hour horseback ride to get there .
In spite of having the training , knowledge and experience , I realize that I don ’ t have the courage nor the unflinching devotion to confront the problems and challenges they encountered . Not , that is , without ( almost ) immediate access to anesthesia , blood banking , antibiotics , neonatal nurse and physician back-up , assistance from skilled nurses and technicians who provide me with all the necessary sterile instruments , birthing rooms / beds , operating theaters , ultrasound guidance , etc ., etc . And all that in a warm , clean , dry , bug , copperhead and rattlesnake free environment .
How did they do it ??
18 LOUISVILLE MEDICINE