Marie Bartlett’s The Frontier Nursing Service takes a potentially fascinating topic and makes it — well, not exactly deathly dull, but not especially interesting either. The book focuses, as the title says, on the Frontier Nursing Service (FNS), a midwifery and nursing service established in the Appalachias in eastern Kentucky. In the 1920s the region was rural, isolated, and subject to some of the highest maternal death rates in the country. The FNS, under the leadership of Mary Breckenridge,rode in to save the day — literally. Nurse-midwives saddled horses and traipsed up and down pathless mountains to, as they said, “catch” babies. The care, subsidized by charitable donations, was virtually free, and it dramatically improved survival rates of both mothers and children in the region.
Midwifery remains an intensely controversial profession in the United States. Homebirths are only barely legal in many states, including Illinois. Moreover, the entire U.S. medical system is in a rolling crisis, providing ever more impersonal, ever more ineffective care at ever more exorbitant prices to ever fewer people. A study of the FNS — a group of midwives committed to cheap, effective midwifery and public health for all at rock-bottom rates — seems, therefore, like it should have something to say to a number of contemporary debates.
Unfortunately, Bartlett is more interested in hagiography than in analysis. She talks a great deal about how wonderful the FNS nurses were, and about the spirit and vision of their leader Mary Breckinridge. She relates many warm anecdotes, and discusses at length the personalities and quirks of various nurses — she mentions at least three times, for instance, that one of the nurses had the interesting nickname of “Thumper.” But ultimately all the feel-good high-mindedness just starts to feel gratingly saccharine — like a book-length public-service announcement.
It’s a truism that you can’t understand the present without understanding the past, but people tend to miss the fact that the inverse is true as well. The FNS had a vision of health care which has been abandoned. They are, in many ways, historical failures. Bartlett leeches their story of much of its drama when she pretends that we have honored, or have the right to honor, their memory.