When I was a very young nurse, the first tenet of my professional creed was, "Thou shalt not get into a rut." New places, new patients, new duties, and new routines were, I thought, essential to me. I felt that I needed the stimulus of strangeness to keep my enthusiasm to the pitch where I could do my best work.
Grown older and wiser, I see in my own smooth rut unimagined beauties. My rut leads past the homes of my old friends. It takes me to Uncle Nathe's house in its tiny clearing in the virgin forest, where an old world patriarch rules his clan as Abraham and Isaac must have ruled in ancient days.
Sitting beneath his spruce pine, I listen to Uncle Nathe's mellow wisdom and ask his advice on the many and perplexing problems certain to trouble a "furrin" woman in her contact with that unexplainable miracle of seventeenth-century survival-the mountaineer.
"Them Holland gals, now," says Uncle Nathe in his most judicial tone, "Gee -oh, I don't know what we're going to do with them. The stock behind them is rotten, and you can't nowise rise above your blood. But they are plain, purty gals and smart too. Seems a shame to see them agoin' to the dogs like they be."
Timidly, I suggest boarding school. Uncle Nathe ponders. "It might work," he concedes, "but where's the money to come from?" "I'll attend to the money," I say, "if you'll make Bud and Sally let them go." "Bud'll do as I say," declares Uncle Nathe, and knowing the affair is as good as settled, I go joyfully about rescuing the Holland gals from their environment.
Past the two-room hut at the head of the "holler" my smooth rut leads, where my own special miracle lives. When I found him 2 years ago, he was a pitiful little crab, scooting about on his calloused hands, pushing useless limbs before him or dragging them after.
Born into the poorest and most ignorant family, paralyzed before he was a year old, he had never walked, never been "out of the holler," and lived like a little animal until Aunt Cinda called me in one day and took me up the "holler" to see him.
It was Aunt Cinda and not the "furrin nurse" who finally prevailed upon the father to allow him to be taken to the crippled children's hospital in Louisville. A year there and he came home walking, clumsily and slowly, it is true, and with heavy metal braces, but so changed that one who knew him said, "You have saved, not a body only, but a soul."
One day my rut takes me to a little one-room school where the children, who last year ran like frightened rabbits at my approach, rush out to meet me and quarrel over who is to carry my saddlebags. "See my vaccination! It didn't hurt a bit-hardly!" "My toothbrush is wore out. Did you bring some more?" "Mom says for me to tell you that the twins ate up the last baby book you sent her and can she have another one?"
Before my rut was formed there a mother threatened to shoot me if I dared to vaccinate her child. This year she is back with her whole family from "grandsir" down to the "least un" to be vaccinated "agin" small pox and diphtheria, too, and "ain't there some kind of medicine to put in children's arm to keep them from getting' this here paralysis?" Beautiful rut that brings such marvels to pass!
I stop to see Mrs. Gray, half blind, pottering around among her late flowers. She was "ahopin"' that I would come and if I didn't she was 'lowing to have Hannibal write me about Dorinda's baby. The baby, it seems, has "an awful bad cold in its eyes and the matter jes runs from it all the time."
Remembering, in despair, my constant instructions to Dorinda, who is one of our "Friday cases," to be sure the granny woman puts drops in the baby's eyes as soon as it is born, I rush to her home and find, as I suspect, a "beautiful case" of gonorrheal ophthalmia. Jim is called from the field; the baby bundled up and rushed to the eye specialist in town.
Ten hours of "specialing" in the office with a crib hastily borrowed for the baby and a blanket on the clinic table to pillow my head on between irrigations-and the fight for one baby's eyes is only partly won.
A little let-up in treatment the next day, by the doctor's orders, a painstaking demonstration for Jim, his gradual realization of the importance of the treatment, his unskilled but determined efforts to "spell" me, and in 2 days he takes the baby back home, out of danger.
I will see it twice a day, in the meantime he must go on irrigating the eyes every hour just as he has been doing. He'll do it, too, and be as proud as punch of his skill. That baby "shore would-a went blind if he hadn't worked with it night and day."
There is something comforting and commonplace about a rut. The traveling is smoother in it-and you'll find that the faces along the road become more friendly every day as they watch you pass. The grapevine telegraph of the mountains, that mysterious form of communication that sends rumor over immense distances in incredibly short periods of time becomes your servant. When your rut is once established, your friends tell their friends and gradually the people who need you come to you, rather than hide when you go to them.
My people are a strange people, reserved and shy, sometimes cruelly suspicious of motive that they do not understand. You can make no abstract appeal to them. They watch you-how they watch!-criticizing, blaming, praising. When they have watched you for a long time, they make up their minds about you. If you are friendly, genuinely interested in them and theirs, they'll like you, and if they like you they'll go their whole length for you.
What many of us forget is that the mountaineer is above everything-deliberate. His first reaction is suspicion and fear. Only time and infinite patience can win from him the liking without which his cooperation cannot be secured.
We public health nurses are prone to expect our miracles to happen on the dot. We expect to revolutionize the world in a day, and forget, as I once heard a very wise man say, that "We can't reform the world in 12 months-and if we could where would our jobs be?"
Too often we grow dissatisfied, we feel that we are wasting our time that the people about us are just stupidly content as they are, impossible to change. Far fields are greener-and we write a harassed State Board for a transfer.
And the new nurse who comes to take our place must start right where we started. In public health work, certainly in mountain public health work there is no building on the other fellow's foundations.
Here, more completely than anywhere else in the world, we have no individual existence, we are our work and our work is us, and we bless or damn it through the individual like or dislike we win from those about us. Let us sell ourselves to our people by plodding along day after day, doing our job as well as we can, making friends, striving always to understand more and to serve more.
So I say to each nurse in this work, make yourself a rut and stick to it. You'll find you always have to extend the rut that every day brings something of new interest, some tragedy, some joy that you must touch. You will find that eventually your rut will widen out and smooth down until you are traveling a long and golden highway straight into the hearts of your people.
FIGURE