Appalachian Stories

Hi, I'm working on narratives for my book about my beautiful Appalachia - this is my concept of rural health care in my mountains. Take wonderful care & thanks for everything you have done. Betty Louise Dotson-Lewis, Summersville, West Virginia

This is posted with permission from Betty:

"Hillbilly," that's what my fellow doctors called me at St. Luke's Hospital located outside Philadelphia where I was doing my residency. They would laugh and say, "Where are you from southern boy?" I would tell them, West Virginia and they would ask, "Now, how far is that from Richmond?" That is what Dr. Paul Conley told me in my oral history interview with him as we discussed rural health care in Appalachia. That made me laugh as I imagined the Philly city slickers trying to imitate Conley's slow, southern drawl.

This oral history interview came about as a result of a note from my friend, Branscome. The note read, "One of your boys got written up by the New York Times." He sent me the article entitled, "Rural West Virginia Winning Over Health Care Workers." Date of article, June 21, 2001 by Francis X Clines.

The article was based on a study tracking medical professionals who chose to remain in their native rural mountains after completing medical school training. The New York Times reporter interviewed several of those professionals including Dr. Paul Conley. During this study Francis X Clines wanted to document the high number of health professionals choosing to take up medicine in the same rural, remote outposts of Appalachia following completion of their mandatory term of residency. One medical professional practicing rural medicine reported, "It is hard to leave them without a hug."

According to the Times article, the latest craze in rural health care imitates what was once known as "coal-mining care." It is stated this type of medical practice labeled "primary care" is attracting scores of medical professionals to our mountains trained as primary-care practitioners.

The "boy" my friend was referring to was our own Dr. Paul Conley. After reading this article, rural health care suddenly became exciting to me. This family-doctor practice was being heralded by one of the largest newspapers in the country, The New York Times. Was I missing something? Was this medical practice something new and unique? Was it mystical? Did it have anything to do with mountain folklore? No, this national craze was something the people in the mountains have known for years. In fact, like me, most of us have just taken this type medical care for granted, "coal-mining care/primary care/family doctor care."

According to my research, I found this type of medicine became a necessity in the Appalachian Mountains when coal operators were compelled to provide "everything" for miners and their families in order to get workers to mine the coal in the remote, isolated area.

Realizing the importance of my find, a medical tradition carried on in the mountains for years, newly discovered by the outside world, I began my own investigation and collection of information. I immediately contacted Dr. Conley for an oral history interview for my website and now to become a part of my book, "Appalachia: Spirit Triumphant."

When I visited Dr. Conley, he explained his concept of rural health care to me and the benefits of primary care facilities. He told me of his commitment to his own people in the mountains. The importance, he felt, of bringing the best possible training in medicine back to his people even though the opportunities were numerous and the remuneration so much greater in an urban area such as Philadelphia where he completed his residency. He told me of his desire to be a part of a medical team who turned "no one away." He explained the importance of practicing in a field where the client was billed on a "sliding scale." He said, "I want to bring my expertise and training to benefit all, especially the underserved." He told me his concept of rural health care in Appalachia is "Big City Medicine with Hometown Care."

This gave me a clear concept of what I had taken for granted and caused me to seek more stories of rural health care in the southern Appalachian coalfields.

I discovered rural health care in Appalachia is not about the modular units or trailers situate across a creek on a hillside. made possible through grants. The story of rural health care in Appalachia is the saga of the medical professionals who choose or are chosen to come to those facilities day after day, year after year attending to the needs of mountain people. The rewards are seldom monetary. These professionals choose what can be achieved through deep commitment and personal service to others. According to a statement in the New York Times articles, most of those who choose to stay are "rebels or missionaries."

My own educational experiences regarding rural health care came by "spells" since I began this project.

My second big learning spell came by way of correspondence from a respiratory therapist from Holland Michigan, Jane Martin. Jane was working on her 2nd publication of inspirational stories for people suffering from chronic lung diseases. Her publisher recommended she include a couple of stories from the southern Appalachian coal-mining region. A region filled with people suffering from lung disease, black lung. She was unfamiliar with the Appalachian area but had seen my website, liked what she saw, and wanted to borrow a couple of stories. After contacting the contributors, I agreed.

A series of appearances in Virginia brought her close enough to the area for a visit. I introduced her and her publisher's advocate to my rural health care "saint" Dr. Donald Rasmussen, a doctor devoting his life to defeating black lung through medicine and legislation. We visited him at his clinic in Beckley. She was impressed with his warmness and intelligence. She loved his state-of-art laboratory used for testing patients for lung diseases.

Dr. Rasmussen recommended a trip to the primary care facility/New River Breathing Clinic at Scarbro Loop, a few miles down the road.

Scarbro Loop houses a clinic which, in my perception, is exemplary of rural health care in rural Appalachia. To get there, turn left onto Scarbro Loop while traveling north on US Route 19 about 20 miles, more or less, this side of Beckley, West Virginia You will see the turn off. It is hard to miss because of the sign, Scarbro Loop, "Dead End." This is the single lane, windy, partially graveled road you travel to gain insight into rural health care. When you get to the bottom of this hill, cross the creek on a one lane bridge, turn left and travel a few miles through the abandoned coal camp. Whipple Company Store is at the other end of this abandoned coal camp. A modular unit sets at the bottom of the steep hillside.

This modular unit houses a primary care clinic/New River Breathing Clinic. This clinic houses a multitude of components essential in health care. It also houses art work of coal miners by coal miners, but more importantly, this rural care unit is home base to one of the finest trained medical professional, according to Dr. Donald Rasmussen, you will find anywhere in the United States, Dr. Daniel Doyle, Harvard Medical School graduate, 70s. I am told he came here for his residency and could not leave.

There are many stories on rural health care in Appalachia which go beyond the doctor's offices. One such story is the oral history from former West Virginia Congressman, Ken Hechler, an Appalachian by choice. This oral history deals with the struggle of obtaining laws protecting the southern Appalachian coalminer, "The Federal Coal Mine Health and Safety Act of 1969." Dr. Hechler, like many crusaders in Appalachia, comes here highly educated, having received his PhD from Columbia University and serving as special assistant to President Truman, but he chose to leave behind all the glamour and glory to devote years toward the betterment of the people and the region of Appalachia.

The stories of rural health care in Appalachia are numerous and heart warming and all contain a common thread: a commitment to serve the underserved.

Note from Betty:

I would be honored if you were to post the narrative wherever you feel people would enjoy reading it and maybe in some small way people will gain a better understanding of rural medicine and the great, great people who serve in that capacity. Also, it could be the people who are serving in that capacity will realize how much people appreciate their dedication.

Yes, I would love to receive stories on rural medicine - I could post some of them and even begin compiling them into a format for publication for people to keep forever and hand down as well as furnish doctor's offices, etc. with real stories about real people instead of all the ads you have to read while waiting to see your doc. I would need a release - that could accompany the story - If I did compile a publication the money from the sale could go back into something for rural medicine.(you will have to forgive me -- I get all caught in this type thing - people serving people) (I don't know how many people understand what serving is all about) (I think we should celebrate the good people are doing, like rural medicine).

Thanks and take wonderful care,

Betty Dotson-Lewis

Nicholas County Schools

Summersville, WV