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FRIED: It's March 3rd, 1978 at the home of Miss Betty Lester in Hyden, Kentucky. The following is an interview with Miss Lester by a group of couriers, who are volunteers for the Frontier Nursing Service. Miss Lester came to FNS from Britain in July of 1928 as a practicing nurse midwife.

LESTER: Mrs. Breckinridge, of course, was the director of the Service for forty years. You sure you're gonna hear me?

FRIED: Umhmm.

LESTER: And she was a member of a very well-known Kentucky family. She . . . her . . . her people came in . . . the Breckinridges came into the . . . into Kentucky through the [Cumberland] Gap in 17-. . . near the end of the eighteenth century and they settled near Lexington. And there are seven generations of the Breckinridges buried in the Lexington Cemetery, so you can tell they . . . they've been here a long time. Mrs. Breckinridge's father was minister to 1:00Russia and the family lived in Russia for . . . all through her girlhood. But she went to school in Switzerland. Her youngest brother was born in Russia, delivered by a midwife under the supervision of a doctor, and when they . . . when his term of office was over they came back to the States. And Mary Breckinridge married, but her first husband died fairly soon afterward, within a year of their being married. And she decided that she'd like to be a nurse, so she went to St. Luke's in New York and took her general training at St. Luke's, graduated in about 1910, something like that, and then she remarried. And she had two children, Brecky and Polly. Brecky lived to be four and a half, and Polly died about six hours after delivery because she 2:00was premature. And Brecky had been the center of Mrs. Breckinridge's life. I mean everything revolved around Brecky. When he died, of course, it was an awful shock to her. She was terribly upset about it. But she said that for every hour of Brecky's life, she would give the same to a child.

FRIED: What did he die of?

LESTER: He was . . . there was something wrong. I think he had some operations. I don't know. I never have asked. Anyway, Brecky died, and then she said for the rest of her life would be ded-. . . would be given, not dedicated, given to the service of children. Her marriage was dissolved and she took her own maiden name . . . her maiden name back again and became Mary Breckinridge. She went to France with a whole crowd of . . . of American women, wealthy women, who went to France to rehabilitate the children, the . . . 3:00the lost and the orphans and the starving children in France. And they rehabilitated them and they did all sorts of things, got them all sort of straightened out again. She always used to tell us a little story that they needed milk very badly. So they wrote . . . she wrote to all her friends and said that she either wanted the money to pay for a goat or she wanted a goat. Well, she was the one who went all around everywhere supervising everything, and when she got back to headquarters one day she found twenty-nine goats waiting for her. So they . . . the children [chuckle] . . . the children had enough . . . had enough milk from then on. Well, after that was all over, she came back to the States and her mother died fairly soon afterwards. And then she decided that she wanted to do something for the people of her own state. Well, she knew that in this southeast corner of 4:00Kentucky was a part of the country which was more or less isolated and cut off by the mountain barrier. She didn't know very much about it, but she talked to people in Lexington and . . . because most . . . a lot of people in Lexington are related far or near to the Breckinridges, and they suggested that she might . . . she would . . . she herself thought that she might come up in here and do surveys seeing really if there was anything that could be done for the . . . these . . . you know, these people who were shut away. So in 1923 she spent the summer up in these mountains going around to the various county seats talking to the judges, talking to any doctors that there were, talking to all the people and the important people. Went up and down the creeks and . . . to see what there 5:00was. And she came . . . camed right through and she came through Leslie County and she went on. And then she was going between Hyden and Beech Fork, up through that way, she ri-. . . rode it horseback, mind you. They all had to . . . all . . . all had . . . all of it had to be on horseback. Couldn't get anywhere anyway else. She came across this beautiful bend in the river and she thought that it was about four miles from Hyden and she said to herself then, "If ever I come to Leslie County to live, that's where I'm going to build my house." And that's why Wendover is on that little knoll above the river. Well, she came around. She talked to the people, talked to the judges, talked to doctors, talked to anybody. Went up the creeks, met all the various people up the creeks. Met some of the local 6:00midwives, and she found that the most isolated spot in the mountains was Leslie County. We had no roads, no railroads, no nothing. And so she thought this would be the best place for her to locate. Well, during that summer she got a friend of hers from Teacher's College, Columbia, a Ph.D., Dr. Elliot . . . Ellie Woodyard to come down here and do some . . . a survey of the children, which she did. And Dr. Woodyard found that the children in this area were as bright, and their IQ's were just as high as the IQ's of anybody . . . any of the children outside. And if they had the proper education, they could do just as well as people . . . as the children who were outside. So 7:00they . . . they . . . they had one or two-room schoolhouses and not very good teachers. And when the creeks were up and when there was rain or snow or anything, the children couldn't go to school. There was a seven- month school, which didn't give them much opportunity. But as she said, they could . . . if they were given the same opportunities, they could really compete very well with the outside children. Well, a lot of our children did go outside. They came to Hyden. There was a high school and there were two dormitories, one where [Brady] Walker's is now, and that's a rock stone house on the other side of the road. That was the girls' dormitory, and [Brady?] Walker's house was the boys' dormitory. And they could come in and they would do the chores around the place, and they would bring, well, whatever they had, a ham of meat or fruit or vegetables or something, 8:00anyway, to help to pay for their tuition. And if they got through high school, if they wanted to go on, of course, there was always Berea that they could go to because Berea is a . . . is a college for poor . . . poorer people, people of the low income bracket. So . . . and we have lawyers, senators, representatives, doctors, nurses, you name it, they . . . we have it, who went out from here and really got an education and really did very well because they . . . they could do it, if they had . . . if they had the chance. One of our first . . . one of the first nurses who helped Mrs. Breckinridge who did come in here was a local . . . was a girl from here who had gone out to somewhere in Pennsylvania and got her training. She came back to take care of her father who had typhoid. He died, but she stayed and helped Mrs. Breckinridge. Well, after this survey in 9:001923, when she was here Mrs. Breckinridge saw that the people were self-supporting, they practically all had their own little farm. They had their cow and their hogs and their chickens and their garden, everything that they really wanted except just coffee and a few things like that. And they were very proud. They wouldn't accept charity at all. But they were very proud, very self-sufficient, except they had no medical care. And she saw that's that where she could help. The maternal mortality rate was very high. They had terrific typhoid and diphtheria epidemics. They had worms, they had everything, and there were no doctors to help them out. And she saw that if she was . . . if she could come up in here, she would come up in here, that was where she would help. The local midwives did what they could. 10:00They didn't do any prenatal work, they just went to the mother when she had her baby and you know babies come an-. . . anywhere a baby will come, if it's normal whether it's [inaudible] healthy or not. But when . . . sometimes nature goes haywire and then they don't . . . no help. You'd have to wait about . . . if you sent for a doctor, you'd have to wait about six hours for one to come from Har-. . . from Hazard. Consequently, the maternal mortality rate was high, and that's where she thought she could help. To help the children, even as she says, "Even before they were born." So she went back to Lexington. She taught down there. And she decided that if she was to . . . if she were to come up here to work, then she would have to be a midwife. Well, you couldn't get your midwifery training in the States in those days. There weren't any medical schools. So all the [inaudible] delivered by doctors or by local women. So she decided she'd better 11:00go to Europe and get her midwifery training, which she did. She went to England. She took her midwifery training at the British Hospital for Mothers and Babies. She went to the General Lying- In Hospital at . . . in York . . . at York Road in London, too, and she went to the Central Midwives Board and she told them what she wanted to do because she had to start absolutely from scratch. She had no . . . no rules and regulations, nothing to go by at all. So they were all very good to her. They sha-. . . they gave her the rules and regulations of the Central Midwives Board, and they told her . . . gave her all the information . . . as much of the information she wanted. And then she went up to Scotland and there she met Sir Leslie Mackenzie in Edinburgh, and he was the head of the Scots nurses, and he 12:00suggested that she should go up to the Highlands and the islands of the Hebrides and see what the nurses were doing up there. And if you . . . when you . . . I don't know if you've been to Scotland, but if you go to Scotland you'll find that the terrain . . . the mountains are a little bit like ours. They have heather on theirs and we don't, but otherwise there . . . there is a similarity. And the nurses up there in . . . in the Hebrides, they had to go between the islands in boats. Well, the Atlantic is a bit rough and you bobbed up and down and it was pretty . . . pretty dangerous traveling between the . . . the islands but the nurses did it. And then in the Highlands, they either rode horseback or walked through the mountains to . . . to their patients. And she thought if they could do it up there in Scotland, they could do it here. So she went back to London, got all her information that she wanted, and came back to the States. And the 13:00doctors in Lexington were very interested. And all of the specialists gave her a sort of a routine that the nurses would follow. See, we nurses don't prescribe and we don't diagnose. We can make a tentative diagnosis and we can give that to the doctor, and if there's anything wrong then he'll tell us how to . . . how to treat it. So they gave us this routine of the things that we could use and the things that we could do, and the things that we couldn't do. Well, in those days we didn't have the wonder drugs that they have now, and we didn't have all the paraphernalia that they have now to do everything for everybody. It was just a simple way of life. And so when she was in France she met two nurses where she was working, and these two nurses were going to England to take their midwifery. Well, she was very interested in 14:00these two nurses and she said, "When I'm in . . . when you're in England, in London and I'm in London, I would like to meet you and talk to you about this, about if you would like to help me in Kentucky." So when they were in London they got together and these two nurses, Miss [Freida] Caffin and Miss [Edna] Rockstroh, decided that they would come to Ken-. . . to the . . . to Leslie County with her, which they did. And they did the survey and did all the work while she was getting money and that sort of thing. She helped, but they did a good deal of it. And so in May of 1925, she came up to Leslie County to live. They had a little house down the creek, down the . . . down the road there just on the corner opposite the Presbyterian Church. And she and these two nurses and one of their mothers, Miss . 15:00. . Mrs. Caffin came, and Major Breckinridge came up to help them with the horses and things. So they all started down . . . that's how it all started in that little house in . . . in Hyden. Well, she . . . they . . . she had to go out and get the money, of course, while these . . . while these nurses did . . . now, when they came in, of course, everybody wondered what these queer women were doing in here. What were they up here for? What did they want? Well, Mrs. Breckinridge came in and she said, "Now we're here, we're nurses and we're midwives. If you want us . . . if you want to come and visit us, do, and bring your children and if we can help you in anyway, we will. If you bring your children, they've got sores or anything, we'll help . . . we'll you take care of them and we'll do anything we can to help. And, of course, we'd like to visit . . . you can 16:00come and visit us and we'd like to visit you, but we are not coming into your homes unless you invite us." You know, some people come in and they say this, that, and the next thing. They're do-gooders, they're gonna do this, that, and the next and change everybody's life. But she didn't do it that way at all. She said, "If you want us to come and visit you, you just--[loud noise in background]--ask us and we'll come." I thought it was a bomb going off. [Interruption in taping] And so that was the best way to do, and people came to the little house and they invited her to go and see them. So they . . . she went. The . . . the . . . she had some nurses and she visit-. . . visited around to the various houses. And they began . . . people began to think these women knew what they were talking about, and they would talk and nurses would talk and got to know everybody. And then in September of 1925 our first baby was 17:00born. They had got . . . you see, it takes awhile to get people's confidence because they don't know what you're doing. I mean, they're . . . you're strange. You . . . they . . . these nurses were strange to them. They were from the outside. What were they doing? Did they know what they were talking about? They were young. They'd never had children. How did they know how to . . . how to take care of a woman when she was having a baby? But very soon they got to realize that these nurses did know what they were talking about. So that's . . . and then Mrs. Breckinridge, of course, had to get the money to . . . to . . . . . . to . . . she ran it on her own money for the first few months but, of course, she couldn't do that for very long. And she had to go outside and get money to get the Service going. Besides, she didn't want to stay in Hyden all of her life. She wanted to just go out . . . expand. She wanted to cover at least a thousand square miles. So she went out to form committees in the various states in the . . . more or less, in the 18:00East. Like we went to Louisville and Lexington and Boston, New York, Chicago, Detroit, Washington, all those places. She formed . . . they formed committees and people got very interested in the Service, and she never once asked for money. She always told them what the conditions were and what we were doing, and money just came in. So she was able to expand and she was able to build various centers. Before she started to build a center, she always . . . the people came and said, "We want you to come to us." And she would say, "Well, we have to do something about it. You get the people together and talk about it, and then I'll come and talk to them and tell them. And then if you decide that you want us to come where you are, to . . . to the creek or wherever that you want us, then we'll see what we can do about 19:00it." So that's the . . . people went home and they got together and they decided, and so she was able to . . . fir-. . . of course, she did have a nurse at Wendover because she did build a . . . I forgot to tell you that. She did build her own house at Wendover in 1925. Soon as she came in, she go that started, and at Christmas in 1925 that house was dedicated to the memory of Polly and Brecky. So that was all right. So then she . . . she built the six . . . I . . . she built about six outposts; Beech Fork, Confluence, Red Bird, Flat Creek, Burlington and Burgess. She also got the money for a hospital. We had to have a hospital. And she got money. People gave her money for the hospital, and the hospital was built up on the hill. Twelve beds and twelve bassinets. No, not twelve bassinets, some bassinets. And in June of 1928 that was dedicated and 20:00Sir Leslie and Lady Mackenzie came over from Scotland to dedicate it. Wasn't that nice? I h-. . . because he helped, too, see? And then they came over and that hospital was dedicated in June of 1928. Well, people began to come. We be-. . . we soon were able . . . after that we got a part-time doctor. He was part-time public health and part- time FNS. So we did have a doctor to tell us how . . . what we could, you know, do . . . that we could refer to. Before that we'd had to refer people to . . . either to Doctor Collins in Hazard or to the doctors in Lexington. And we were having some midwifery by that time. Of course, Doctor McCormick in Louisville gave . . . sa- . . . said that whatever vaccines she needed for the inoculations against typhoid and diphtheria, and the vaccine for smallpox, we could 21:00have it from the State Department of Health. So we got our . . . all our vaccines that we needed and everything, so . . . and, of course, at first people didn't want their children to have this . . . these needles shoved into them. They thought it was cruel. They didn't see any sense in having a needle shoved into a child. However, they got used to that. And after a time they began to tell us when their typhoid shots, and this, that, and the next thing, were due. So that was all right. Well, we had got the hospital. We'd got Wendover. We'd got the six outposts. Money was coming in. And then in 1931 the Depression hit us. When the Depression hit us, of course, we couldn't . . . I mean people couldn't send us any money after that because they had enough to do to keep their own house . . . own homes going. So 22:00we got to be very poor. We didn't close down, we just managed. Some of the nurses had to leave and some of us stayed and we didn't have any money but we were very happy. We had enough to eat and a bed to sleep on and our horses were taken care of. And so then when the Depression . . . when we got out of the Depression we went on until 1939 when the Graduate School of Midwifery was started, and that's . . . we'd already been doing midwifery. Now, our midwifery program, we really did a very intensive training of our . . . teaching of our patients who were going to have babies because as Mrs. Breckinridge said, "You've got to take care of the baby before it's born." We tried to get our mothers to register with us soon as they knew they were pregnant. They didn't always do that, but they . . . they did register. And then the nurses saw them. We saw them every month until they were six 23:00months pregnant, every two weeks through the seventh and eighth month, and the last month we saw them every week. If they didn't come to the clinic we had to go and visit them in their own homes because we had to watch them very carefully in case any . . . there should be anything abnormal. And if we saw them as often as that, you see, we could [telephone rings] pick up the abnormality as soon as . . . as soon as we . . . we'd find it. Excuse me. Answer!

FRIED: Sorry. [Interruption in taping]

LESTER: [Inaudible] we saw them, as I say, so often so that we could really watch out to see if anything abnormal happened. We didn't do the marvelous work that they do now with their prenatals. All we did was to take their blood pressure, their . . . their temperature, pulse, respiration, blood pressure, urinalysis and . . . and done a palpation to s- . . . and the . . . and the external measurements 24:00to see if her baby was lying all right. See that the urine was clear, see that the blood pressure was all right, and see that they weren't running any fever or anything. And then while we were doing that, we were also giving them advice. I mean advice on their diets, about resting every day, and about drinking enough water, and just giving them . . . well, just giving them the . . . the i-. . . the ideas of what we w-. . . what would be the best thing for them. The women in this country, of course, do . . . did work very hard. I mean they worked in the gardens and they did a lot of walking. Consequently, of course, their muscles were in very good shape. We didn't have the sagging muscles and we didn't have many contracted pelvises or anything like that. We did have some, and we did have abnormalities. All the mothers had to be delivered at home. In the beginning, of course, there wasn't . . . there was no hospital 25:00for them, but they . . . they preferred to be delivered at home with their own family, and it was all right with us. We had special bags for them, we had for the deliveries. We had this bag in which we carried all supplies that we should need for delivery, and those bags were sacrosanct. They weren't allowed . . . we weren't allowed to . . . allowed to use them for anything but just the delivery itself. In our general bags we could carry . . . we carried an emergency kit in case we got caught and the mother was in labor and we were way over there somewhere. And we had to do what there was to do with just an emergency kit, and then . . . while a man came to get the proper bags. So . . . and as soon as we came back from the delivery, we had to empty those bags. Everything had to be taken out. 26:00The white linings, the white bags, everything had to be taken out of those bags. The instruments washed, the gloves washed, everything like that because we didn't have these disposable things then. And they had to be repacked fairly soon so that in case of another . . . the thing coming. That was our first consideration; get our bags emptied and fixed up before we did anything else. Of course we had to write up our record. We had to write up the record of the delivery, exactly what happened and all about it. Well, now, when the woman . . . we told the woman when she had her first pain, when she really thought she was in labor, to send for us, which they . . . which they did. Sometimes they sent when they'd had a pain and it . . . they weren't really in labor, but that was all right. We had to stay awhile to see that they were all right. The man would come. We didn't ride alone at night be-. . . not because anybody would molest us, because they wouldn't. We were . . . we had our blue- gray 27:00uniform and everybody knew us. They wouldn't do a thing to harm us. In fact, they'd help us all they could if we got lost or anything. But we didn't ride out after dark alone because you might get sick, you might fall off your horse. Your horse might throw you and . . . and anything could happen to you on the trails. And if you were out there on the trail at night, you might lie for hours and not . . . and nobody come and . . . come and find you until daylight. Because if the horse was all right, he'd go home. And then we had to leave a note where we were going so the people could come and find us. The man came, took the bags. We got dressed. He saddled the horse and got everything ready and off we went. And we had to stay . . . if the patient was in labor, we stayed with them until the baby was born. And then we fixed the mother up, fixed the baby up, and you had to stay an hour and a half after delivery to make sure that everything 28:00was all right because you might be five miles away from home. And if anything happened, if you had just rushed off as soon as the baby was born, anything could happen. A woman could hemorrhage, she could do anything. A baby could get asphyxiated, anything can happen. So we always stayed an hour and a half afterwards, and then we came on home. We saw them every wee-. . . every day for the first ten days and did all the things that we should do. And then we saw them every week for the first month, and then every month for the first year. And then we carried them on. We carried our family t-. . . we had family folders. We had . . . everybody in the house had a different . . . the adults had a card, the school-aged, the . . . the tots and the babies, everybody had their own card and we had to write down every so often what we had done for them. So this family . . . so we really took care of the whole family as well as the mother and as well as the sick patient who was in the hos-. . . in the home and, as I 29:00say, we kept very careful records of it. And we followed the baby's first year and then we followed them as toddlers and then through school. Twice a year we saw them when they were in school. And then the adults, we saw them whenever they . . . whenever they needed us. But our midwifery program, at first, of course, was really the special thing to . . . I mean, that we soon were what you'd call family nurses as well as midwives then. So we . . . as I say, we took care of the whole family. And we have delivered almost eighteen thousand babies, I think, and we've only had eleven maternal deaths. And that is almost a world record because . . . and it was all because of our m-. . . of our prenatal work. That we were so careful with it, we could watch them so carefully and know that if 30:00anything . . . first thing that went wrong, we could get a doctor. And as I say, we had a part- time doctor at first, and then after that we had our own medical director who, if we needed him, he'd go out to the various centers to take care of things. But if we could get them to the hospital to him, it was much better. If there was anything wrong with the mother, we got her into the hospital. We watched here there and saw that everything cleared up. And if she . . . if it didn't clear up, probably then she would stay . . . I mean she would have her baby in the hospital. We had to watch out that the baby was lying right because if the . . . that was the thing that happened sometimes. A baby doesn't lie right and then it's a bit difficult. Well, do you want to change? [Interruption in taping] There weren't any midwifery schools in the States and everybody was . . . as I 31:00told you, Mrs. Breckinridge went to London to get her widwifery, and then if any American public health nurses came down here and wanted to stay, they had to be midwives. Because each of the centers that I . . . we talked about, had to have two midwives. Because, you see, they would . . . the . . . the districts were divided into two. One nurse had one end and one nurse had the other. And so they had their own midwifery, their own everything. And if they wanted to stay as . . . down here as . . . to work, they had to have their midwifery training. So she sent . . . any American nurses who wanted to stay, she sent over to England or Scotland on scholarship for the six months' training over there. And then they would come back and either . . . and then they would . . . they were supposed to stay for two years and . . . after having had the scholarship. Well, that's how 32:00I came because Mrs. Breckinridge sent one of her nurses to York where . . . the General Lying-in Hospital where I was doing my midwifery training. And we all got most excited about this American nurse because this American nurse had pictures and she had this album with all these pictures of horses and dogs and creeks and everything. And I . . . I was one of the midwives sitting around one day looking at this book and she came in and we got to know each other. We got to be very good friends. And she was telling me about riding up and down the creeks on horseback and all the things that . . . that we had to do and it sounded like such a fascinating life to me. And I had no home ties. I mean, I could . . . my parents had both died before I started nursing so I could do what I wanted. So I said to her one day, "Do you want any more nurses?" And she said, "Yes." I said . 33:00. . she said, "Yes," so I said, "I'd love to come." She said . . . well, she told me about writing to Mrs. Breckinridge. So Mrs. Breckinridge wrote back to me and said that when I had my diploma I could apply, which I did. And there was a furor in the hospital where I was because they didn't want me to come. And they . . . they called me into the office and said, "You think you're going to Kentucky?" And I said, "Yes, please, I want to go." "Well, do you know what you're doing?" They said, "Here you've got the day sister and day duty. You've got night sister on night duty. You've got your doctor within five minutes. Out there you'll have nobody. You'll just be by yourself. What are you going to do? You've only just got to twenty cases," 'cause we had to take twenty cases. We had to deliver twenty cases under supervision. "You don't know a thing about it. What are 34:00you going to do?" Well, I hadn't thought about that. All I thought about was having a horse and a dog. [Laughter] So I . . . so they said, "Now you can't do it. You simply cannot. We cannot send you out to Mrs. Breckinridge as an untrained . . . you may have got your diploma. Yes, you've got it, but you're not trained. You can't do an-. . . you're . . . you wouldn't be any good to her." Well, I thought, "I . . . I want to go so badly." So they said, "Well stay. We want you to stay for six months and do a six-month post- graduate course." So I stayed for six months and believe you me I worked hard those six months because anything that happened, send for . . . send for the nurse. Yes, well, a nurse went. So I learned a lot. I learned the fundamentals of midwifery and that's what we really needed. And when I came out I knew . . . I mean, if I'd come out as a raw midwife I wouldn't have been able to do a thing. But having had this six months' training, I could really do it. So 35:00riding horseback day and night, summer, winter, anytime. And we'd really . . . I mean midwifery we really have done. We're very proud of our midwifery work because we have saved a lot of lives and we're still saving them. [Interruption in taping] You sort of felt . . . I mean you knew that what she said she meant. And you really . . . she ex-. . . she was a perfectionist herself, and she expected us nurses to . . . to give her of our best, which we did. Because she was giving her best and therefore her . . . her influence and her . . . everything about her sort of gave us that incentive to give of our best. And it was really . . . but she was very small, but she was dynamic. And I mean she had . . . she was . . . she 36:00had a very good . . . a very good sense of humor. You'd hear her laugh from here to the other side of Wendover when she started laughing about things. But she . . . she did expect the best, and she did expect us to do our work properly and we did. And . . . I mean our uniforms, she expected us always to be in full uniform and look like FNSers who were proud of our uniform. And we wore it very proudly.

FRIED: One of the . . . [tape fades] . . .

LESTER: . . . met me at Confluence, they brought a horse down, and I was the fifth nurse they'd had to escort to Hyden and they were getting a bit fed up with this. [Laughter] But they . . . they let me get on ahead and then they came catching me up. And I thought, "Well, I'm not going to put up with this. I'm coming to catch up with you," because I could ride. I'd ridden all my youth so I knew how to ride and I mean it didn't bother me getting on a horse, so I kept up with them from then on to Hyden. We had a lovely trip. And when Marvin was 37:00here, you see, then that led to . . . WO

MAN: I think she must have been.

FRIED: What are some of the memories that, like, really stick out? I mean . . .

LESTER: Well, [Book?] and James stick out because they brought me up here. There are . . . well, I mean there was . . .

FRIED: I mean as far as, like, your field work or the . . .

LESTER: The field workers?

FRIED: No, your field work. I mean, you know, like . . .

LESTER: What . . . what . . . what sticks out in my memory?

FRIED: Yeah.

LESTER: Well, I can't give you any very specific things because there were so many of them all the time. But there's one that really does stand out rather a lot. We weren't supposed to go out- . . . outside the five mile limit. That was our limit. We weren't supposed to go a step beyond that. Well, I was at Bull Creek one Thurs-. . . one clinic day, and this woman came to register, and I asked her 38:00all the various questions. Then I asked here where she lived and she told me she lived over on Big Creek. "Oh, my goodness," I said, "I can't come to . . . I can't take you there. You'll have to come into the hospital to have your baby." "I can't go to the hospital." [inaudible] think the hospital [inaudible]. I said, "I'm sorry, but I can't come. It's too far." It was about seven miles. Well, tears came into her eyes and I looked at her and I said, "What's the matter?" She said, "Well, I've had one baby and my baby was born dead. And I want a baby very badly. And if you'll come and look after her, I'll have that baby." Well, what could I do? Simply couldn't do anything. My . . . tears came into my eyes, too, because she wanted this baby so badly and . . . and she had enough faith in me, in the nurses, it 39:00wasn't in me exac-. . . it was in the nurses, that if she had the nurses she'd have a live baby. So I said, "Well, if you'll come to clinic every time I want you to, and do everything that I want you to do, I may be able to take you at home." Well, her eyes . . . she brightened up at that. And I said, "Now, I'll do my best, but you'll have to promise me to come, and if you don't, the first time you miss, I shall have to say I'm sorry, I can't come." So she said she'd come and I said, "I will come over and see where you live," because I wanted to see that she would have everything ready, I mean she'd have the things that I needed. I'd have to tell her what to get ready for me. So she did and, of course, I was really not in trouble but I . . . the as-. . . the assistant . . . the assistant directors were on my tail. So I thought my best plan to do is to go over your heads to Mrs. Breckinridge, and I did. And she said to me, "Betty, 40:00you cannot leave your own patients. You cannot neglect your own patients for an outsider. If you'll promise me that, that you won't neglect your own work to go over there, you can go because you can ride. I know you can, and you've got a good horse and I know you can do it. But," she said, "you mustn't neglect your own work." Well, of course, I said, "I wouldn't dream of it, Mrs. Breckinridge. If you'll let me go just for the delivery and just for the post-partum, if she comes to her . . . to me for her prenatals, will it be all right?" And she said, "Yes." So I did go. The man came for me in the middle of one night and we had all of this seven miles to ride. Got there, she was in labor but she took a long time and she had . . . if she'd had a granny midwife--even though I say that myself as a midwife--if she'd had a granny midwife, a local midwife, I don't think she'd have 41:00had a live baby because it was a very difficult delivery and I did have quite a hard time. I sweat blood getting the baby, but I got it and I got a live baby so it was worth it. And that baby grew up. It was a girl. She married. She was pregnant and I saw her. And I went . . . and she was going to have her baby in the hospital. So I went to the people in the hospital and I said, "May I come into the delivery room when she has her baby?" "Well, you can . . . you can take the baby if you want to." The . . . the . . . the Graduate School had started by this time. "You can conduct the delivery till the . . . and . . . and . . . and supervising the student." Well, I said, "Well, I thank you very much, I'll do that then." So I did that. So we had a live baby. Everything was all right. It was a boy. That boy grew up, and it shows how old I am. [Chuckle] That boy grew up and married, and his wife was going to have a baby, and they saw me again. 42:00"Well," I said, "I'm not going to do anything about it this time, but I will be . . . I will be in the delivery room." So I went to the supervisors again and said, "Please can I observe this delivery?" And they said, "Yes." So I sat in the back of the room and watched it. So I'm a great- grandmother. [Laughter] So that's that. That's my outstanding story.

FRIED: It's a good one.

LESTER: There've been other ones, but this . . . that was . . . that's really the one I treasure. And that's that. [Interruption in taping]

COURIER: Why was the midwifery school started?

LESTER: Oh, in 1939 war started in Europe and a lot of the . . . there were quite a few British nurses here, and the British nurses felt that they should go home. Some of them felt that they should go 43:00home and help in Britain when they probably were needing nurses. So we couldn't leave the Service without midwives because we were about fifty-. . . a fifty-fifty proposition, and so we had to do something about it. So in P-. . . in September of 1939, some of the . . . oh, and also the American nurses, of course, couldn't go to Britain because we were frozen. They were frozen on this side of the Atlantic and we were frozen . . . and the nurses in England were . . . couldn't come out here. So there couldn't be any more exchange. So the American nurses had to be trained in this country. The Frontier Graduate School was started to train . . . I think they star-. . . I think they started with two American nurses and started those off to train them first of all. And some of us Britishers stayed to 44:00get them to help with that training and get them started so that there would be a continuation so that the . . . there . . . there would be a few. And then gradually, you see, more and more American nurses came down and trained. And I think now we've trained, oh, roughly between four and five hundred, I think, the American nurses to be midwives and they're all over the world. They've taken the work to other countries and to various parts of the States. So that's . . . that's really why it started, because of the war in Europe and the British nurses having to leave, and we had to train American nurses to take their place. [Interruption in taping] One thing I forgot to talk about . . . to tell you about in the . . . when I was 45:00talking about midwifery was, that all our . . . practically all our mothers, I might say all of our mothers, breastfed their babies in those early days which was what we advocated, that we wanted them to do it. And, of course, they . . . they wouldn't do anything else. They would breastfeed them. They might be on demand feeding, but even so they were all, practically all, breastfed babies. I think I ought to emphasize that because it was one of the things we did, and all our babies stayed on the breast for nine months to a year, and then that was it. But we did advocate breastfeeding. WO

MAN: Miss Lester, did they have any family planning at that time?

LESTER: Oh, yes! Oh, yes! Family . . . no, no, we didn't. If a mother wanted . . . if a mother asked the nurses what she could do so that she wouldn't have any more babies, we always had to refer them 46:00to our doctor. We . . . [End of Tape #1, Side #1]

LESTER: . . . never gave them that advice in those early days. We always said, "Well, you come to the hospital and talk to our doctor about it, then he'll tell you, more or less, what to do." But we nurses were not . . . we did not give them that advice. COURIER: Didn't I hear something about Dr. Rock and the pill . . .

LESTER: Yes.

COURIER: . . . starting down here . . .

LESTER: Umhmm.

COURIER: . . . or something?

LESTER: Yes, he started that. Dr. Rock wanted it, and they ma-. . . he did it down here. Anna Mae January was the nurse who . . . who went around and she had a lovely time. And they really did a very good job with it. I don't know much about that part of it but, yes, he did. He and M-. . . he knew Mrs. Breckinridge and . . . and they got together and he did it . . . they did it down here. But as I say, Anna Mae January was the one who did it and she loved it. And everybody . . . of course, she was so well-loved and so everybody took note of what Anna Mae said. The people in here said she was just as good . . . they'd just as soon have her as a doctor. So they would all listen to what she had to say. And anybody who wanted advice, she would give it. [End of Interview]

0:00 - Introduction / Mary Breckinridge's early history

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Partial Transcript:It's March 3rd, 1978 at the home of Miss Betty Lester in Hyden, Kentucky. The following is an interview with Miss Lestser by a group of couriers, who are volunteers for the Frontier Nursing Service.

Segment Synopsis: Betty Lester is introduced. She gives a history of Mary Breckinridge's life before she came to Leslie County.

Keywords: Ailments;Babies;Beech Fork (Ky.);Children;County seats;Death;Deliver babies;Delivery;Doctors;Family history;France;Generations;Goats;Help;Helping;Horseback;Houses;Illnesses;Isolation;Lexington Cemetery;Milk;Mountains;Nurse midwives;Operations;Orphans;Poor;Premature;Rehabilitation;Russia;Starving;Supervision;Surveys;Switzerland;Treatment

Subjects: Breckinridge, Mary, 1881-1965;Childbirth;England;Families.;Frontier Nursing Service, Inc.;Hyden (Ky.);Kentucky;Leslie County (Ky.);Lexington (Ky.).;Midwifery--Appalachian Region;Midwives--Appalachian Region;New York (N.Y.);Poor--Medical care;Rural schools--Appalachian Region;Schools;Wendover (Ky.)

5:47 - Mary Breckinridge visits Leslie County

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Partial Transcript:Well, she came around. She talked to the people, talked to the judges, talked to doctors, talked to anybody. Went up the creeks, met all the various people up the creeks.

Segment Synopsis: Lester discusses the education levels and potential of the local people.

Keywords: Children;Dormitories;High school;Intelligence Quotient;IQs;Low income;Opportunities;Poor;Railroads;Roads;Schoolhouses;Schools;Surveys;Teachers;Testing

Subjects: Berea College;Breckinridge, Mary, 1881-1965;Education;Hyden (Ky.);Mary Breckinridge

8:38 - Mary Breckinridge chooses Leslie County for her clinic

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Partial Transcript:One of our first--one of the first nurses who helped Mrs. Breckinridge who did come in here was a local--was a girl from here who had gone out to somewhere in Pennsylvania and got her training.

Segment Synopsis: Lester discusses why Mary Breckinridge chose Leslie County as the location to begin her clinic. She also talks about where midwives were trained.

Keywords: Ailments;Babies;British Hospital for Mothers and Babies;Central Midwives Board;Charity;Children;Deliver babies;Delivery;Diphtheria;Diseases;Doctors;Epidemics;Farms;Help;Helping;Horseback;Illnesses;Maternal mortality rate;Mountains;Pregnancy;Pregnant;Prenatal;Pride;Regulations;Rules;Sickness;Training;Traveling;Treatment;Typhoid;Worms

Subjects: Breckinridge, Mary, 1881-1965;Childbirth;Education;England;Europe;Lexington (Ky.).;Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services;Traditional farming--Kentucky

13:03 - Nurses come to Leslie County

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Partial Transcript:And the doctors in Lexington were very interested. And all of the specialists gave her a sort of a routine that the nurses would follow. See, we nurses don't prescribe and we don't diagnose.

Segment Synopsis: Lester talks about Mary Breckinridge's nurses coming into the area and the reactions of the local people.

Keywords: Ailments;Care;Children;Clinics;Diseases;Drugs;Fund raising;Help;Helping;Home visits;Horses;Houses;Illnesses;Injuries;Medicine;Money;Public health;Sores;Survey;Treatment;Work;Working;Wounds

Subjects: Breckinridge, Mary, 1881-1965;England;France;Hyden (Ky.);Leslie County (Ky.);Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery;Midwifery--Appalachian Region;Midwives;Midwives--Appalachian Region;Nurses;Nursing;Rural health services

17:29 - Frontier Nursing Service

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Partial Transcript:So that's--and then Mrs. Breckinridge, of course, had to get the money to--to--to--she ran it on her own money for a few months but, of course, she couldn't do that for very long.

Segment Synopsis: Lester talks about the beginning of the Frontier Nursing Service and the six outpost clinics built by Mary Breckinridge.

Keywords: Ailments;Beech Fork;Build;Burgess;Burlington;Children;Committees;Confluence;Diphtheria;Diseases;Doctors;F.N.S.;Flat Creek;FNS;Fund raising;Help;Helping;Hospitals;Houses;Illnesses;Immunizations;Inoculations;Mary Breckinridge Hospital;Money;Needles;Outposts;Public health;Red Bird Center;Shots;Sickness;Smallpox;State Department of Health;Trea

Subjects: Breckinridge, Mary, 1881-1965;Frontier Nursing Service, Inc.;Hazard (Ky.);Hyden (Ky.);Lexington (Ky.).;Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services;Wendover (Ky.)

21:43 - Mothers and childbirth

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Partial Transcript:And then in 1931 the Depression hit us. When the Depression hit us, of course, we couldn't--I mean people couldn't send us any money after that because they had enough to do to keep their own house--own homes going.

Segment Synopsis: Lester talks about the care the Frontier Nursing Service provided for mothers before, during, and after childbirth.

Keywords: Advice;Babies;Clinics;Deliver babies;Delivery;Diet;Emergency kits;F.N.S.;FNS;Frontier Graduate School of Midwifery;Home birth;Home visits;Labor;Measurements;Money;Muscles;Patients;Poor;Pregnancy;Pregnant;Prenatals;Programs;Public health;Records;Register;Supplies;Teaching;Training;Treatment;Work

Subjects: Childbirth;Depressions--1929--Kentucky;Education;Frontier Nursing Service, Inc.;Frontier School of Midwifery and Family Nursing;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services

26:51 - Delivering babies

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Partial Transcript:The man would come. We didn't ride alone at night be--not because anybody would molest us, because they wouldn't. We were--we had our blue-gray uniform and everybody knew us.

Segment Synopsis: Lester discusses how nurses from the Frontier Nursing Service helped local women during childbirth.

Keywords: Ailments;Asphyxiation;Baby;Born;Deliver babies;Delivery;Doctors;F.N.S.;Family nurses;FNS;Help;Helping;Hemorrhages;Home birth;Horseback riding;Hospitals;Labor;Medical directors;Midwifery programs;Patients;Prenatal care;Records;Schools;Sickness;Treatment;Uniforms

Subjects: Childbirth;Families.;Frontier Nursing Service, Inc.;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services

30:55 - Midwife training

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Partial Transcript:There weren't any midwifery schools in the states and everybody was--as I told you, Mrs. Breckinridge went to London to get her midwifery, and then if any American public health nurses came down here and wanted to stay, they had to be midwives.

Segment Synopsis: Lester talks about her midwife training and how she came to work in Kentucky.

Keywords: Dogs;Duties;F.N.S.;FNS;Help;Helping;Horseback;Horses;Learning;Midwifery schools;Public health nurses;Saving lives;Scholarships;Skills;Training;Uniforms;Work;Working

Subjects: Breckinridge, Mary, 1881-1965;Education;England;Families.;Frontier Nursing Service, Inc.;Hyden (Ky.);Kentucky;Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services;Scotland;Wendover (Ky.)

37:07 - Field work memory

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Partial Transcript:What are some of the memories that, like, really stick out? I mean--

Segment Synopsis: Lester shares one of her most memorable field work stories.

Keywords: "Granny midwives";Babies;Big Creek (Ky.);Bull Creek (Ky.);Childbirth;Children;Clinic days;Clinics;Deliver babies;Delivery;Delivery rooms;Families;Field work;Hospitals;Labor;Memories;Patients;Post-partum;Pregnancy;Pregnant;Services;Stillbirth delivery

Subjects: Breckinridge, Mary, 1881-1965;Families.;Frontier Nursing Service, Inc.;Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services

42:41 - Midwifery school

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Partial Transcript:Why was the midwifery school started?

Segment Synopsis: Lester talks about why Mary Breckinridge started the Frontier Graduate School. The interview is concluded.

Keywords: Advice;Babies;Birth control;Breastfeeding;Contraception;Doctors;Europe;Family planning;Hospitals;Learning;Mothers;Teaching;Training;Wars

Subjects: Breckinridge, Mary, 1881-1965;Education;Families.;Frontier Nursing Service, Inc.;Frontier School of Midwifery and Family Nursing;Mary Breckinridge;Medical care--Appalachian Region;Medical care--Kentucky;Midwifery--Appalachian Region;Midwives--Appalachian Region;Nurses;Nursing;Rural health services;World War, 1939-1945

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