In closing, I can only say, my dear, good friend, that I know your training and courage will serve you well in your undertaking. Please write us of your new life. Until such time, we will continue to pray for your well-being.

May God Bless You, Sr. Julienne

March 1935

The sun was shining, but the grass was still damp with dew. It had grown chilly overnight and Shelagh pulled her cloak tighter about her shoulders as the horse picked her way along the trail. She was a smart horse, given into her care as she knew the trails and was a smaller horse, ideal for one of petite stature. Her given name was Bailey, but everyone referred to her as Mrs. B, though the nickname's origins seemed unclear to all of the nurses and couriers. Shelagh enjoyed riding with Mrs. B, though the horse-riding of her youth seemed inadequate in the face of the narrow, dangerous trails she now climbed daily. Mrs. Breckinridge had insisted that all new nurses in the Frontier Nursing Service employ be retrained in riding, and for that Shelagh was glad. The month of lessons had given her time to acclimate to her new life, so similar and yet so different to what had come before.

The two-year contract she had signed had seemed daunting and interminable as the ink dried on the paper, yet, a month in Kentucky had gone by in a flash. Learning to ride in the mountainous area was exhausting on its own, but learning trails, meeting the people, deciphering their accents, and stomaching the food was as wearing as it was exhilarating. Every waking hour was devoted to her calling as a nurse and that was a constant she clung to. The outer trappings had changed, but she was still a nurse, with purpose and a province to care for those unwell and unborn. Yet as she rode out on her horse, in her trousers, and smart cap, she thought that perhaps her previous Sisters and patients would never recognize her. Too much had changed.

She wasn't used to the trousers. They afforded freedom of movement and yet she could hardly stop expecting to wake in the morning and dress in her habit and underskirts. A dress would be wholly impractical on horseback and so trousers were the basis of the uniform of a Frontier Nurse. Shelagh looked ruefully down at her legs, thinking of the chafed skin of her inner thighs. The cream the other nurses offered helped with the sting of roughening skin, but riding a horse straight up a mountain was entirely different than riding a bicycle over the cobblestones of Poplar.

The children of Hyden liked to ask about England and bicycles, eyes widening to learn of a large city so far away. It helped a bit with the homesickness to talk of London and also Aberdeen, but it almost seemed another life that she had lived in her cloistered community. The restlessness she suffered there had brought her to America, and she tried to keep her mind in the present.

Just now she noticed a young woman standing outside of a small cabin, hand to her back. Shelagh reigned Mrs. B and stopped, smiling at her first patient of the day. "Good morning," she said, holding to the reins and dismounting the horse. "Nurse calling."

The quiet woman smiled her assent and waited while Shelagh tied the horse in the shade. She walked into the cabin, standing in the doorway. "How have you been this week, Mrs. Polly?" Shelagh mounted the stone step at the front of the house.

"Tolerable," she said, easing down onto the quilt laid out over her bed. "I seen Hiram out on his day and just been setting outside, catching the breeze."

Shelagh smiled, placing her bag on the table and opening it. "How is Mr. Polly? Anxious for your new arrival?"

"Said he'd be glad enough for the least 'un to get here already. Said sleeping next to me is like sleeping next to three people and each with hot coal in their pockets." Mrs. Polly laughed, smoothing a hand over her large belly. "I can never seem to get cool."

"Your body is expending terrific amounts of energy to nurture your baby. The crisp mornings must be a boon for you!" Shelagh took a pinard from her bag. "Let's have a listen and then we'll get on with your normal checks. Your sugar was higher than I would have liked it to be the last time I was here."

"I been staying away from sweets. Tryin' to eat the meat and vegetables, like you tol' me." Mrs. Polly quieted for a moment. "It has been cool these past few mornings," she said, after Shelagh removed the pinard. "Little thing like you must be half-froze!" Mrs. Polly pulled up her shirt and settled against the pillows. Her lips pressed together as Shelagh placed the pinard against the skin. "You kin hear it's heart, can't you? It won't be like my first."

Shelagh smiled as the steady whoosh of the baby's heart echoed through her instrument. She placed it on the small table near the bed. "Baby's heartbeat sounds lovely and strong, Mrs. Polly. I'm here to give you, and baby, the best possible care."

"Thank you, Nurse Mannion. You nurses are doing the Lord's work. What they say over to Hyden is true. You all's angels. Our angels."

"Oh, thank you, though I'm sure that's an overstatement," Shelagh said, trying to tamp the redness in her cheeks. "We're just women, ready to serve and to care." She pulled a measuring tape from the bag. Looking up, she caught Mrs. Polly's eye. "Please remember that you can have Mr. Polly come for me at Beech Fork Center. Our clinic is every Tuesday. Or, if anything appears amiss, have him go on to Hyden Hospital. We want to take care of you."

"You already are, Nurse."

...

Waving goodbye to Mrs. Polly, Shelagh and Mrs. B continued up the windy mountain trail, an overhang of trees impeding the sun from warming the hoarfrost. Around the bend was another small cabin and Shelagh again dismounted, this time handing the reins over to a young boy who ran out of the house. "Momma!" he yelled, over the sound of a baby's cries as he looked back toward the house. "Nurse is here!" He rubbed at his freckled nose and looked at Shelagh. "My Ma's expecting ya. She's been paining some."

"Oh, dear." Shelagh took down her bag. "Thank you, Elliot. Is your father home?"

"Nah, ma'am. Pa's done down in Hyden. He's…" Elliot rubbed his nose again. He shot an embarrassed look at Shelagh before looking away quickly. "Working."

"That's fine," Shelagh said, patting the boy on the shoulder, ignoring the unspoken words. "Thank you for taking care of Mrs. B."

"We'll get along just fine." Elliot walked off with the horse and Shelagh hurried into the house.

"Midwife calling!" She took off her wraps and closed the door. "Oh, Mrs. Sutherland!" She bustled to the woman, who sat in a chair surrounded by her younger children. Her hands were on her distended abdomen and her upper lip was curled as a pain caught her. Shelagh looked to the eldest daughter. "Hello, Sara. Remember me? Nurse Mannion?"

Sara nodded, eyes huge. " 'llo, Miss Nurse."

Shelagh smiled. "I'm here to help your mother. While I see to her would you mind terribly to take your little siblings into the next room?" It was a two room shanty, and through a partially opened blanket hanging from a doorway Shelagh could see a few trundle beds made up on the floor.

Sara nodded and took up the baby, whose cries had quieted, though his lower lip quivered and tears stood fat and ready to fall on his eyelashes. The other children ran behind, snapping the blanket closed over the breadth of the door.

Mrs. Sutherland sighed, her hands unclenching as the pain passed. "Thank you, Nurse. I'da asked them to go on but the pain hit me quicker than a tick jumping a hound. I think this un's a coming today."

Shelagh smiled. "Little ones come into this world when they're ready and not a moment before!"

"You kin say that one again, Nurse. Done had six of them give me notice that I ain't the boss." She laughed. "Elliot out there was the hardest, but he was first. Little Johnny in there just slid right out, looking for the teat before I knowed he was even born!"

"Oh, my!" Shelagh laughed, and looked around the small room, idly listening to the prattling children in the next. "Let's be getting you onto the bed for a check and we'll see just what we're facing." Stepping to the bed, she looked to Mrs. Sutherland. "May I?" She imitated pulling back the quilts. "I have some newsprint to put down on the bed to save your mattress."

"That'd be fine." Mrs. Sutherland stood up on shaky legs. "My," she said, moving slowly toward the bed. "Cora said you were the sweetest little thing and from what I've seen she hain't wrong. She ought to be here at some point today. Always knows when a baby's coming on this mountain. I don't know if she has the sight or if she's just so nosy that she knows when a woman's done her duty by her man."

Shelagh's cheeks warmed. "Cora's been very kind. Many of the Granny Midwives in the hills didn't want to have much to do with us. She's been more than welcoming. She wouldn't even let me refer to her as Mrs. Tucker. Apparently it makes her feel more like we're friends if I call her by her given name. She's clucked over me from the moment we met." Plumping the bed's pillows, Shelagh waited for Mrs. Sutherland to suitably undress and situate herself against them. "I've appreciated the help she's given me, especially in navigating this mountain!"

"Lord, I've lived here since the day I was borned and there are still some trails I don't… ohhhh, here's another, Nurse…" Mrs. Sutherland grunted, clutching her hardening stomach. "You'd think this'd get easier, dealing with the pain…." She blew out a breath as the contraction eased, turning her head toward the blanket as Johnny began to cry. After a moment he settled as his sister began to sing and she turned back to Shelagh.

"It does seem unfair that it should still be so painful." Pulling on a pair of gloves, Shelagh moved to the end of the bed. "Whenever you feel ready, Mrs. Sutherland, I'd like to check your progress-"

Mrs. Sutherland moved into position, knees wide apart and feet pressed toward her bottom. "Ready, Nurse."

"Well, quite." Shelagh examined her quickly, nodding resolutely. "Absolutely perfect, Mrs. Sutherland. You're very close now. I would imagine that your waters will go at any moment and before…" she looked at the small clock that ticked on the mantle,"...the noon hour we may have a baby."

"I'd just as soon have it before that, if I can manage it."

Shelagh smiled softly, pulling a quilt up over Mrs. Sutherland's legs. "Your quilt is lovely." She lightly touched the bright circular pattern. "Did you make this?"

"My Momma," Mrs. Sutherland said, touching another circle. "She was always a-quilting if she had a moment to herself. I never did pick it up. Said my fingers weren't so nimble." She spread her hands out over the quilt, examining the boxy digits. "She were right. But I purely love these quilts. Makes me miss her less."

Shelagh thought briefly of her own mother. There were no quilts to carry on her memory. "That's lovely-"

She was cut off by Elliot trudging through the door. "Momma, I done pulled the milk out of the stream so's we can get the cream. And Clarence and Bud are wanting to know if I can go and cut some hay with 'em. I told 'em I'd ask you… oh. Is the baby a-coming today?" He set a jar of milk on the table.

"Tis," Mrs. Sutherland said. "So you go on with Clarence and Bud but come on home afore dark, you hear?"

"Yes, ma'am." He smiled and went to the blanket, peeking around it. "Sis, come on out here and separate the cream. I'm going to the fields." Looking back to Shelagh he grinned. "Your horse is fed and watered, so if you aim to leave, she's ready to go." He looked back toward his mother. "Have Sis come for me if you need me, Momma."

The door closed behind him, as Sara exited from the blanket to take up the cream from the milk.

"How are the least ones, Sis?" Mrs. Sutherland shifted on the bed as another pain came over her.

"We're fine, Momma…" Sara looked at Shelagh. "Do you want some milk, ma'am?"

"No. Thank you." Shelagh smiled at the young girl. "Are you going to make butter?"

"Momma is."

"Momma will later…." Mrs. Sutherland gave a quiet gasp. "I think my waters went. Sis, go on back in there. We'll deal with that milk later. Take some of the cream for your breakfasts…" she trailed off, lip furling again.

Sis took a bowl of cream and went back behind the blanket as Shelagh checked the bed. "The waters are clear, just as they should be. Your mother's quilt is also quite safe. She pulled it back and then worked to remove and replace the soiled newsprint. "Cora's not here yet. I think perhaps the least one will be here first!"

"I think…" Mrs. Sutherland curled her lip again. "I think you're right… oh…"

Shelagh performed another check. "Mrs. Sutherland, you're into transition. It won't be too long now."

The next hour passed quickly, as the contractions strengthened. "I think I need to push now," Mrs. Sutherland panted, breaking her silence.

Shelagh had been told upon entering the FNS that women in Kentucky labored silently, so as not to scare the children that were often underfoot during the process, but also due to their pride. Mrs. Sutherland had labored with her breath, but had not uttered a scream or any noise louder than a grunt. "Let's have a look…" She examined Mrs. Sutherland and then looked over her shoulder at the clock. "Almost the noon hour…."

A knock sounded at the door.

Mrs. Sutherland smiled through her pain. "And that'll be Cora."

...

Twenty minutes later, Cora sat rocking a newborn baby girl by the fire, cooing gently as she counted fingers and toes, exclaiming over each one. "As fine a baby girl as ever was borned," she said, smiling at Mrs. Sutherland. "You done good, Mercy."

"Thank you, Cora." The afterbirth had passed quickly, and now Mrs. Sutherland rested as Shelagh checked it. "Did Laurettie have hers yet?"

"Just yesterday," Cora said, holding the newborn close as it began to fuss. "Lord, baby, I don't have what you want." She stood and passed the baby back to Mrs. Sutherland. "Ready for the teat. Laurettie had a boy and it had three teeth already in hit's head."

"Teeth!" The baby latched on. "Oh, poor Laur. I reckon I can help her to feed him if he chews her raw."

Cora laughed. "Lord, don't they all?"

Shelagh finished with the afterbirth. "Perfect, Mrs. Sutherland. All's well. Cora, how was baby? Did she pink up well?"

"Prettiest, fattest baby you ever seen." She grinned at Mrs. Sutherland. "Mercy's an old hand." She jerked her hand toward the blanket and the noise of playing children beyond it. "Just listen at 'em. I dearly love to hear them play."

Mrs. Sutherland shook her head. "Sometimes it's nice to kick 'em out into the trail so I can get some peace!" She looked down at the newborn. "Though tween this one and Johnny, I think my days of peace are far off yet."

"Lord, don't wish for too much silence," Cora answered. "My Fount's been gone five years and what I wouldn't give to hear him snore. Never thought I'd say that, that's fer damn sure!"

"Oh, Cora," Mrs. Sutherland patted her arm. "He was a good man."

"He was. And I miss him." Cora looked at the suckling baby, smiling fondly. "Catching babies has filled my life since he's been gone." She looked to Shelagh. "And these young nurses. Once I got to understandin' their fancy talk." She grinned, reaching for her bag and pulling from it her pipe. She lit it and watched as Shelagh finished stripping the bed. "You headed up the trail oncet you're finished here?"

Shelagh tied the sheets together into a neat bundle. She began to wash her hands in a clean basin of water. "Yes. I want to look in on Mrs. Johnson and get a look at this baby born with teeth! Also, I believe there is a family with children on the other side of the creek that runs behind the Johnson home, though I haven't yet met with them. I wanted to call in and invite them to tomorrow's clinic."

Mrs. Sutherland nodded. "There is a family up there. Kentons. They keep to themselves. The wife's name is Ruth. I'd tread lightly. Maybe take Cora here with ya." She patted the newborn as it released her breast and sqawked. "Try again," she murmured, encouraging the baby back to the nipple.

"Them Kentons do like to stick with their own. Mean-like people. But hard workers. I reckon Ruth Kenton could use someone to help her look after that brood. If I recollect correct, she done lost two to the influenza and one fell out of a tree and broke his neck. Dr. Turner was called but couldn't save the poor thing."

"Oh, how dreadful." Shelagh finished washing her hands and dried them on a clean towel. "I can only hope that perhaps Mrs. Kenton will be open to preventative health care for herself and her children. Dr. Turner will be at Beech Fork tomorrow. He alternates daily between clinics. Perhaps she'd feel more comfortable coming in on the day he's seeing patients."

Cora looked at Mrs. Sutherland. "Kentons and the Turners always had bad blood. Back when I was a girl they feuded a bit, though it calmed after the Great War. Don't think the men had it left in 'em to fight after what they seen."

Mrs. Sutherland agreed, switching the baby to her other breast. "The feuds have gone, mostly, though you would never know it from the way the boys carouse and shoot their guns down there in Hyden."

"It is very dangerous." Shelagh began to clean her instruments, placing them in a bag to be sterilized back at the center.

Cora puffed out a ring of smoke. "They're showing off. Bunch of young boys with too much time on their hands and too much moonshine in their bellies."

"Well, there's a lot less in my belly now," Mrs. Sutherland said, patting the baby on the back as it fell asleep against her. "Thank you, Nurse Mannion."

Shelagh smiled and did a final check of both Mrs. Sutherland and the baby, pronouncing them both to be in fine fettle. She closed her bag and looked to the new mother. "If you need me before tomorrow, just send your husband or Elliot to the Center. Otherwise, I'll see you tomorrow on my regular rounds."

Cora stood from her seat, stretching her lower back. "I can come back, stay the night, should you need the help tonight, Mercy."

"Thank ya, but we'll be fine, Cora. You go on with Nurse Mannion." She smiled down at the baby, fast asleep at her breast. "I gotta feed my other'uns." She buttoned up her dress. "Children!" she called, toward the blanket, "come and meet your new sister!"

A whoop came up from the kids, as they galloped into the room. Laughing together, Shelagh and Cora took their leave, heading out into thin sunshine and a cold breeze. They mounted their horses and set off on the trail, Shelagh smiling over at Cora. "Thank you for riding with me. I think it's a comfort for a new patient to see and talk with someone familiar."

"Happy to do it, Shelagh. And you can count on me for clinic tomorrow. And not just to hold babies. I can help with the set up and cleaning, too. Little thing like you, running that clinic all on your own. What is Mrs. Breckinridge thinkin? I know the times are tough, but a nurse alone is askin' for trouble."

"I'm not completely alone at the center, Cora. The couriers stop in and sometimes stay overnight. Truthfully most evenings are spent on the mountain or down at the river. It's been a month and I've already delivered eight babies!"

"There'll be more come good spring, mark my words."

Shelagh and Cora rode on to the Johnson shanty, checking over Laurettie and the baby. Despite the three natal teeth the baby seemed fit and well and bonny, as Shelagh proclaimed, handing him back to his mother. Mrs. Johnson invited them to have dinner with she, her mother, and her children. Cora and Shelagh agreed, sitting down to a nooning meal of salt pork and cornbread. After leaving the Johnson's they rode down toward the creek, Cora leading Shelagh to the best spot to cross the horses. Just ahead the Kenton house stood, the ramshackle building partially hidden in a grove of trees.

Cora hello'd the house and two young boys ran out, knobby knees dirty and scratched under their rolled up homespun trousers.

"Hello, Mrs. Tucker," the older boy said to Cora. He nodded his head at Shelagh. "Ma'am. You one them nurses?"

"I am," she said, looking down at him from her perch. "Is your mother available to talk with us? It won't take more than a moment of her time."

A woman stepped out of the front door. "Paul, Matthew. Run down there and tell your Daddy that I need more sticks for the fire." She turned to Cora and Shelagh as the boys ran off. "What kin I do for you?"

Cora smiled and gestured to Shelagh. "Mrs. Kenton, I know you heard of the nursing service that set up down to Hyden. Well, this here is our own nurse, up and down this trail and down to Beech Fork. Her name's Nurse Shelagh Mannion. I thought I'd bring her out here to talk to you, see if she could be doing anything for ya or the least uns."

"I don't think so. We're not in need." Mrs. Kenton pursed her lips. "Thank you."

From inside the house a child yelled and another coughed. "A late winter cold?" Cora rubbed her hands to warm them. "Nurse Mannion can look in on him."

"My family and I get by jus' as we always have. You know that."

Shelagh could see that Cora wanted to argue, so she cut in. "I understand, Mrs. Kenton. We only wanted to let you know of the service. We provide midwifery, nursing, vaccinations, and medical care. Our midwifery services are five dollars a year, if you're so inclined. As Mrs. Tucker mentioned, I'm stationed at Beech Fork Nursing Center, should you have need of me, day or night."

Mrs. Kenton inclined her head. "I'll remember that. I got to get back to the young'uns. Thank you for riding out."

Turning their horses, Shelagh and Cora set off back down the trail. "It was a better welcome than I imagined," Cora said. "We weren't met with a shotgun!"

"Oh, Cora," Shelagh said, smiling at her new friend. "I know the young men in Hyden are rather… overzealous with their firearms, but I've not met anything like that yet on the mountain."

"And you won't. You nurses are the best thing happened to use out here. These men would rather shoot their own selves than to see a one of you hurt. Why when Mrs. Breckinridge first rode out there in the twenties she found such a kind response that she decided to build a house for herself here, over there to Wendover. Still, some places can be dangerous, especially if there's a still set up or if someone feels they've been wronged on their own land. Crossing unfamiliar land can be dangerous, too. Stick to the paths."

"I will." They stopped the horses at a fork in the road. Cora turned her horse north, toward her cabin. "I'll see you tomorrow, Shelagh. Git some sleep. I been to your clinic. The women'll be there afore dawn. It'll be a day!"

"You too, Cora. Thanks for your assistance." Shelagh waved and began the long trek back down the mountain as the sun began to descend in the sky. The day hadn't warmed much and she snuggled into her uniform jacket, thinking of the warmth of the clinic and the dinner that she would have when she arrived. The home visits were her new daily routine and she found that she enjoyed them, even as the ride up and down the mountain seemed to grow longer with each passing day. Shelagh had taken to finding landmarks to orientate herself to the trail and also to pass the time in the saddle. From the fork in the trail was a rock shaped like a turtle, and only a little further was the tree split from lightning. After that leg of the journey there was the small pond and the abandoned cabin and beyond that was the open valley, leading to the nursing center.

Arriving just as the sun was setting, Shelagh fed and sheltered Mrs. B, before heading inside. Lighting the lamps, Shelagh went into the clinic kitchen to wash and sterilize her equipment. She could never sleep with equipment that was not thoroughly cleaned, even if she had several kits to use in the case of an emergency. Once the water began to boil, she dropped in the instruments and retired into her small bedroom to remove her uniform. Gathering her notes, she went to the kitchen table to keep an eye on the boiling instruments and to write up her notes. The evening loomed long and lonely ahead of her, though at any moment a desperate father may mount the step at her door, helloing for her to follow him back up the mountain to his family home.

She placed her pencil on the table, listening to the wind outside of the Center. She had not lied to Cora. She wasn't alone in the Center, not always. In the beginning two nurses had staffed each Center. The downturn in the economy had lead to a dearth of the donations the FNS ran on, it had been decided that one nurse per Center would have to suffice. Many nights a young courier would bed down and stay for an evening to help with sanitation and caring for the horses. Though Shelagh was always kind to the young girls she never felt quite at ease when a courier would stay over. They were all still very young and eager to please, very chatty. It was far easier when two couriers might stay for the evening. Shelagh could then listen to their chatter and feel as if she were part of the conversation without having to entertain. It had been tougher than she imagined, leaving the quiet of her cloistered environment. She was used to long silences and though she enjoyed listening to the young Americans speak on fashion and Hollywood stars she didn't feel quite comfortable enough to express her own opinions on topics she knew so little about.

Yet, as the evenings lengthened into night she sometimes found herself longing to hear a nervous father knocking at her door. She found that she longed to be in action, preferring to ride the trails and deliver medical care than to sit and wait for the next thing to happen. It seemed to her that she had already waited for her life to begin and she was impatient in waiting further. She prayed daily for the ability to slow her desire for action, to allow herself to center her thoughts and achieve the peace she had once found so easily.

Frowning at herself, Shelagh picked up her pencil and finished her notes before removing the cleaned instruments to dry. Standing at the small food prep counter she prepared a sandwich, chewing as she looked out the window and into the darkened night. She was tired and yet, couldn't help a small, pleased smile. All of her life she had longed to make a difference in the world, to set things to rights for those who could not do so for themselves. The work was hard. Merely saddling up and riding straight up a mountain was daunting enough, yet delivering babies in all sorts of weather and home conditions added to the stress of the work. Learning the ropes, meeting the new patients, and growing accustomed to the new surroundings was exhausting. Providing vaccinations, delivering new life, and caring for the ill was as demanding as it was rewarding. The days and nights were long and full of work.

Shelagh loved it. She was in a unique position among the other nurse-midwives, having already dedicated herself to a life of solitude and service, only this time in a different guise. She often thought that Sister Bernadette, used to bicycling over Poplar's cobbled streets, would not recognize Shelagh Mannion, uniformed and on horseback. Though perhaps it was the other way around. One evening in the convent she had removed her wimple and cap to let her hair hang free, looking at her reflection in the mirror. It was somewhat ironic that she now always wore her hair pulled back into a bun or braid, horseback riding and nursing hardly suitable for loose hair. Reaching behind, she pulled at the pins that held her workaday bun, shaking out the wavy strands, eyeing her reflection in the darkened window.

Shaking her head at her foolishness, she finished her meager meal and set about preparing for bed. She cast aside unnecessary thoughts and turned her mind ahead to morning's clinic. She thought of Cora saying that it would 'be a day' and knew that she was right. Women would start lining up before dawn. Whispering a prayer to ask for serenity in duty and a capable hand, Shelagh fell asleep, another day in Kentucky done and dusted.