Anthony Douglas ’17 – In a recent New York Times article, a list of the 10 worst/hardest places to live in America was created. Out of the 10, 6 of those places were in Eastern Kentucky. If you’re a movie lover, you’ve likely seen a show or two that depicts the stereotypical rural Eastern Kentuckian as a moonshiner, drug addict, poor, hillbilly, and uncivilized person. “You better keep both eyes open,” “Be careful around them mountain folks,” “Don’t go anywhere by yourself,” “You’re going where? Oh, we will definitely pray for you.” This is just a small portion of some of the things I heard prior to my internship in Eastern Kentucky.

The road to Kentucky was a pleasant change from the flat lands of Indiana. The Appalachian Mountains are a sight for sore eyes, and make for a beautiful sunset. The first culture shock I received was the extremely narrow and windy roads that allow for “easy” transportation between hollers (or what non-Appalachians would call hollows). If visiting, don’t be surprised if you see equal amounts of ATV’s and 4-wheelers as cars, especially during the winter because it makes for efficient transportation and short cuts across the mountains. Make sure you take it easy going around the curvy roads, as veering off the road for a slight second may send you tumbling down the steep mountain hills. Appalachian Kentucky is a very special and unique place‑-one of the best things about it to me is how peaceful and simple life is in the mountains. Being from the city, I’ve realized how caught up we get in the hustle and bustle of city life, and how a lot of times we can become so self-absorbed that we don’t enjoy the simple things, like the people around us. You’d be surprised how much you learn about yourself, and life in general, when you’re able to come to a place like this. As I’m typing, I find myself outside of my room on the swing looking up at the mountains enjoying the sound of nature.

Douglas interacting with children from Eastern Kentucky.
Douglas interacting with children from Eastern Kentucky.

More often than not, stereotypes are unreasonably large generalizations of a group of people. The negative stereotypes that exist of Eastern Kentucky have been very inaccurate from my experience thus far. All the preconceived notions I had about this place quickly dissipated within the first few weeks of interacting with community members. Eastern Kentucky folk are about the nicest people you’ll ever meet. Everyone knows everyone, last names are repetitive because generations of family stay put due to their love for their home, and people are genuinely interested in knowing who you are and developing a relationship with you. It’s honestly one big family. Poverty exists everywhere, and although certain areas of Eastern Kentucky are poverty-stricken, I would venture to say it is not significantly more prevalent than in other areas in the country. However, the difference lies between urban and rural poverty, each of which comes with its own set of issues. For instance, in rural Eastern Kentucky those living in poverty differ from the urban impoverished based on access to clean water, safely built homes, safe transportation across the mountains, and diversity in healthy foods (beans and cornbread make up the common diet of Appalachians). Much of the poverty that exists can be linked to the mono-economy that this area is heavily dependent on: coal. As federal regulations increase, the coal industry is seeing many contractors going out of business and laying off many coal miners. This reality has been detrimental to the economy and quality of life of many rural Eastern Kentucky areas. Additionally, advanced techniques in mining like stripping (blowing the caps off the mountains to retrieve coal) pose a threat to the environment and can lead to public health issues. The topic of coal mining is a very sensitive subject in this region, especially after incidents within the last two decades of miners losing their lives in explosions.

This summer has been very informative because I’ve been able to witness these problems first-hand, and understand the societal factors that are involved due to the shadowing and volunteering opportunities I’ve had. It has also been very helpful for me to see what rural health care is like. Rural health care here in Eastern Kentucky is plagued with a lack of primary care doctors. There’s a shortage currently in general of physicians going into primary care, which is alarming because primary care doctors are often the first line of defense in terms of treating and recognizing health ailments. With the shortage of primary care physicians in this community, nurses and nurse practitioners are taking on much larger responsibilities in the clinic and hospital. Many procedures/services that you would expect to be available in the hospital like labor and delivery aren’t offered because there’s either a lack of physicians, or lack of funding to have units that cater to those needs. For certain procedures, patients must travel to Lexington, KY or other hospitals miles away.

As this past week marked the halfway point of my internship, I can’t believe how much I’ve learned and grown. In a typical week, I’ll shadow and volunteer at the Hospice of the Bluegrass in Hazard, KY, lead activities and lessons at Mountain View Elementary School about nutrition and exercise, or volunteer and participate in community engagement activities. This summer I’ve shadowed nurses and doctors, sat and talked with patients daily, worked at a local café and food pantry, collected data for community surveys, led sessions on nutrition and proper exercise, assisted in running health fairs and fundraising events, and the list goes on. My summer has been very rewarding, and has given me the space to grow spiritually, emotionally, and mentally. There has been points in this summer that have been very frustrating for me. Sometimes the feeling of wishing I could do more to help discourages me. However, I’ve come to realize that this summer experience is not about making a major impact on the community I’m serving–that’s unrealistic and naïve. This experience is about learning, gaining skills in servant leadership, and interacting with a different culture in order to effect change in my community, and future communities I find myself in. As the time approaches for me to return to Indiana, I’m very excited to take advantage of every opportunity I can to learn, and possibly spark a partnership between the Wabash Democracy and Public Discourse Initiative’s own Democracy Fellows. Through conversations with local county leaders in Eastern Kentucky, there may be an opportunity for the Fellows to come to Appalachian KY and lead conversations concerning community issues plaguing the counties.

In conclusion, I think it’s very important to keep in mind that life is very short, and can bog us down if we allow it. We must learn to appreciate the simpler things in life like kin (family) and friends, the beautiful green earth God has blessed us with, and good food. That’s the Appalachian attitude. I’ve thoroughly enjoyed my time in Eastern Kentucky, and I’m strongly considering the possibility of returning to practice medicine here one day.