I’ve just finished reading a book written by Karen Cecil Smith entitled Orlean Puckett: The Life of a Mountain Midwife (Parkway Publishers, Boone, NC, 2003). While it’s not a new book and therefore wouldn’t need a review, the information was so relevant to my research on rural, historical medical care that I thought I’d share some of my impressions from the book.

This is essentially a biography of Mrs. Puckett who lived in the Virginia Mountains from 1844 until 1939. As I learn about and reflect upon the history of the Cumberland Plateau, the stories of our past are so familiar to me that the hardships don’t often overwhelm me. But the depiction of life in those rural mountain communities seems so much more severe than our own region. Certainly they were even more remote and isolated. Their farms were rockier and steeper and their weather more severe.

Mrs. Puckett lived through the Civil War and her husband was a Confederate soldier for a while. He and a lot of other mountain-borne soldiers opted to check out of the war early. We know that the young man’s dream of gallantry and excitement is quickly burst in battle. These men returned to care for families that struggled to survive in the best of times; The War, however, brought some of the worst of times as marauding troops robbed them of the little food they had and searched tirelessly for deserters.

Mrs. Orlean Puckett1844 - 1939 — Mrs. Orlean Puckett
1844 - 1939

When she was 45 years old, Mrs. Puckett began midwifing out of necessity. There were few doctors and none that lived out in the most remote parts of the mountains. When she first started attending births, it was 1889 and everyone was traveling by foot, horse or buggy so calling a doctor from town was a very slow process. But Aunt Orlean as she was known to her whole community was right there among them and she knew well the mountain paths. So she would arrive very shortly after being called no matter what hour of the night or in what extreme weather conditions. Doesn’t it always seem that babies come at the most inopportune time that way?

She was very well respected in her own and all of the surrounding communities. Because of this, she was often called upon for medical issues beyond childbirth. She knew mountain herbs that would ease the pain of joints swollen from arthritis; and yes she knew the medicinal value of whisky. Aunt Orlean carried a satchel like a doctor’s bag and a standard item in it was always peach brandy. I can’t quite imagine the use of alcohol in childbirth but I’ve certainly watched enough westerns and Civil War movies to appreciate its value before surgery when no anesthetic was available as would have been the case in most rural situations.

The mountain people also had a fair amount of superstition and Mrs. Puckett was among them. She put a knife under a laboring woman’s pillow to cut the pain and unlocked every door in the house to provide an easier delivery.

So once again I find myself contrasting modern medicine with yesteryear. While I’m certainly partial to anesthetic and pain control, there is also something very comforting in the idea of a local healer. To have someone at your side who you’ve known most of your life and who cares for you as a person and not just a patient seems like a wonderful idea, don’t you think?

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