Oral History Interview with Dr. E.T. Smith

Gatewood: −rural . This is sponsored by the Kentucky Folklore History Foundation, and the Oral History Commission. This is Tom Gatewood interviewing Dr. E.T. Smith. Dr. Smith has practiced here in for a number of years, since 1944. Prior to that, his father, R.M. Smith, practiced in Stearns, the Stearns coal camps. And Dr. E.T. Smith also had a brief stint where he worked in the mines himself during the war. Dr. Smith, where did you attend college? Get your medical training, rather.

Smith: Transylvania in .

Gatewood: Was your father, where did he get his training?

Smith: He went to , too, for college. And the . Same as I did.

Gatewood: When did he come, had he had private practice before he came to Stearns?

Smith: Yes, he did three or four times. The only one I really know is East Bernstadt just a little north of . Of course, all that was before I was born. So no way I could give you any names.

Gatewood: Right. Just that you remember that’s where he was before he came to Stearns. And do you know about what year he came to Stearns?

Smith: Approximately maybe 1915. I’m not sure. It was−

Gatewood: When do you begin remembering things? Do you remember any of his practice, any things about him practicing there before you actually came back from medical school? As a child, do you remember anything about the coal camps?

Smith: Oh, sure. Oh, after I was maybe five or six years old, I remember.

Gatewood: Did he have an office there?

Smith: Yes, outside of Stearns. Of course, when he first came there, he practiced in Worley. It was a mining camp. It was the biggest mining camp. That’s where I was born.

Gatewood: I see. About how large was the camp there at Worley?

Smith: Of course, a lot of the miners that mined there lived in Stearns. You see, they had a train that came into Stearns at 5:30 every morning. A lot of miners came on the train. Some went, lived around there in those small houses. I mean, it’d be impossible to say how many.

Gatewood: You did have houses there, though, in the camp?

Smith: Yeah.

Gatewood: You had the store?

Smith: Had the store. Had a good store there. It was owned by the Stearns Company.

Gatewood: Churches and things of that sort.

Smith: I don’t remember that. See, I left Worley when I was three.

Gatewood: All right.

Smith: So it’s almost impossible to remember much.

Gatewood: Then your father then practiced out of Stearns itself. After that…

Smith: …in 1921, we moved to Stearns, and he practiced there the rest of his life.

Gatewood: And what was the nature of his practice in terms of, did people come to his office? Or did he go out to the homes?

Smith: Both. Did a lot of both. Did a lot of home deliveries.

Gatewood: Did, how did he get his drugs? There wasn’t a drugstore or anything there at that time, was there?

Smith: No. He dispensed practically all. But there was a drugstore in the city. See, he was a contracting and he was supposed to (?) unless there was some kind of medicine that he wouldn’t have had, and maybe the drugstore had it, he could have given them a prescription and they can make it.

Gatewood: How was the financial situation there? Did the miners have a cut off, so much amount, and they paid him?

Smith: Yes.

Gatewood: And then he was responsible to use that money, did that money come directly to him? Or was he on a salary?

Smith: See, there was more than one doctor who worked for the Stearns Co.

Gatewood: One at least at each mining camp, and one or two in the main center, too.

Smith: One time, of course, that was maybe before I was born, there were five or six doctors. And let’s see. About the time I can first remember, I was, I would say, maybe three or four. There was a, maybe five or six there for a while. And they finally dropped some of them off. At the time I went there, which was in January of ’44, I believe there was just two other doctors there in, and I was, I made three. And there was a doctor, Dr. Meese who lived in . Sometimes if another doctor wasn’t available, the Stearns Company would pay him for being on call or something.

Gatewood: Can you kind of describe the nature of the work there when you went there out of medical school in ’44? What type of work did you do? How was the nature of your practice?

Smith: Well, it was general practice. Practically everything. Of course, delivered a lot of babies. I remember one time, in a 24-hour period I delivered five babies. And I’d say I was there about nineteen months and a half, I believe I delivered 400 babies. And of course, I worked in the office. And did a lot of home calls, home calls. Practically all the night calls for every doctor in the camp. And I can remember some weeks of being the only doctor in the camp.

Gatewood: Did you, how did you relate to the midwives? Or were there any practicing by the time you got there?

Smith: Probably some. I don’t remember. I remember more of midwives in after I came up here. See, when I left, when I first left Stearns, I went to Hazard for a little over a year. They had a hospital, and I had just a little practice, I got experience there. I helped them, assisted on surgery. And they had a little office there which I worked Sunday nights. And which was good experience for me when I came up here and I wasn’t as green. We had a new hospital at that time. It opened about six months before I came up here, over here from Hazard.

Gatewood: When you came here, were there still a lot of home deliveries and midwives? Many midwives operating at that time, when you came here?

Smith: In ?

Gatewood: Mm hmm.

Smith: Quite a few, yes. Several I’d gone out and help them. When they’d get in trouble, they’d call either me or maybe some other doctor. A lot of times, maybe I wouldn’t know about it – them – except when I was called myself.

Gatewood: Did, at that time, you all were making home calls, too, as you delivered babies. Weren’t you?

Smith: Yes, I never−

Gatewood: The hospital wasn’t−

Smith: Yes, it was common practice for several doctors at that time to be on the deliveries. And they gradually got less and less. Finally, I was the last one. And I had to quit, because I couldn’t do it. And at that time I was practicing, built up so much that I didn’t have time at all. I had less time, the whole area would keep you out of the office all day.

Gatewood: What year was that, approximately?

Smith: About ’61 or ’62.

Gatewood: And by that time, you had a big office practice−

Smith: Yes, I had a big office practice. And I lived in a big, I would average about 150 deliveries in the hospital. The fact that I was practicing, still then, I did a lot of home visits.

Gatewood: Not deliveries, but just visits.

Smith: Just home visits.

Gatewood: You know, it’s always intrigued me what happened to all the midwives. What, how did they just all disappear? Do you have any insight into that?

Smith: Well, I don’t think they all ever disappeared, and I don’t think they’ve all disappeared yet.

Gatewood: Well, not altogether. There still seem to be a few practicing, but it doesn’t seem like anywhere−

Smith: Now, (?) had one, one did all theirs that didn’t come up here to the hospital.

Gatewood: Yes. That’s right. Stephens. But I think she’s one of the few around here, isn’t she?

Smith: Probably is. There may be some around, but I don’t know. After I quit doing any home deliveries, I got out of touch with any midwives.

Gatewood: Back to the coal camp and medical work. I don’t think you ever answered me, was the physician on a salary or did he get a certain percentage of what the people paid in?

Smith: Well, it was what we call contract practice. It was, depending on whether he was working, and−

Gatewood: So he got paid so much for so many months.

Smith: Each, each employee for the Stearns Coal Company got paid so much a month. Out of his money, when I first came here, dollar and a half, maybe got two dollars. And all that went to doctors, spread out equally.

Gatewood: I see. So the money, all the money that was paid in was directly spread equally to the doctors.

Smith: Yes.

Gatewood: Rather than straight salary from the company.

Smith: No, it wasn’t straight salary. It was always a (?)

Gatewood: Now did the doctor also, work that he did on people−

Smith: He could do anything, if he treated somebody, somebody that did’t work (?) he could charge them.

Gatewood: I see. How about members of the family? Like the daughters (?) and the wives of the miners.

Smith: Oh, yes.

Gatewood: That was in the contract? He didn’t get extra pay for that?

Smith: No. Only time he ever got extra pay was−

Gatewood: Somebody outside of−

Smith: Ten or fifteen dollars.

Gatewood: Did you ever hear your father talk about some of the folk, folk type medicine? With either the midwives working with him, or−

Smith: Not really, no. Back, I remember when I was oh, from eight till, almost to when I started college, lots of times if he was going on a home call, I’d go with him.

Gatewood: The people seemed real, real at home with him, you think? I mean, I’m trying to think about this. There was a long period, well, up until the period these doctors came in, seems like they were more dependent on the old, traditional ways of health. But they seemed to really take right to the modern, the doctor−

Smith: Well, he was well liked. He had more friends, (?)

Gatewood: How did he travel around? When you would go over to these places.

Smith: Well at that time, people had pretty good cars then. Even, I think when we first got started in Stearns, he did a lot of work on horseback. And he, the Model-Ts and the Model-As. About ’35, I think, maybe he bought, maybe a better car.

Gatewood: I imagine he stayed pretty busy, didn’t he, with all those people that he had to look after?

Smith: Oh, yes. I mean, he, I can remember (last time?) at night somebody come and get him, make a call. I’d be in bed. And I wish I could, because (?) Finally I paid him back so (?)

Gatewood: Did he end his practice there in Stearns?

Smith: Yes.

Gatewood: He started doing more private practice once the mines began to play out?

Smith: Well I think, that’s the last year or two, quit, certain doctors there. They tried to prevent them to quit the system. And they did this private practice. Of course, at that time, I was away.

Gatewood: When you came in here at ’44, ’45, it was right after the war, wasn’t it?

Smith: That was during the war.

Gatewood: Or during the war, yes. How did you, did you set up practice? Did you say there was a real shortage of doctors then? Were you pretty busy?

Smith: Oh, yes. It was like I said. I did all of the home visits for all of the, even for Stearns.

Gatewood: For up here. Not just in Stearns. You mean up here.

Smith: No. I’m not talking about Stearns.

Gatewood: Stearns, yes, all right. Okay. I jumped over to this. I was starting on this.

Smith: Stearns had a motorcar that would take you to any of the mining camps. And most times, if (you’re heading over here?) for some kind of emergency, then they had a special man that drove the motorcar. He would take you.

Gatewood: I’ve heard about those motorcars.

Smith: Yes. There was a doctor got killed.

Gatewood: Was it Dr. Floyd?

Smith: Floyd. Yes, he was really (?). He just, the driver was able to jump off and run. But he couldn’t make it. that must have been while I was away in school, either in college or med school.

Gatewood: Do you remember some of the doctors in there? Besides Dr. Floyd?

Smith: Dr. Simpson, (?) family, he had boys that were pretty good friends of mine. And I met a doctor there that came there and worked, (?), Dr. (Blackeby?). Oh, he came there in ’31 or ’32 or something. (During those years?) And he stayed there until he had to go (to the army?) and then he came back (second ??).

Gatewood: When you came here, when you first came here, can you tell us a little bit about that? How you set your office up and started your practice here? You were a local person, weren’t you? I mean, you had raised up here.

Smith: No, I was actually raised in Stearns.

Gatewood: Okay. But your father−

Smith: See, I was born and (then?) raised in Stearns. Although my father−

Gatewood: Was from here.

Smith: He was born in .

Gatewood: Right Uh huh.

Smith: And decided to come there for some reason. I’m, well, not exactly an in-law of Mr. (Will?), his brother married my (daddy’s?) sister. That’s how he came, I think, through him, was the way he happened to go to Stearns and (? work for him?)

Gatewood: I see. What kind of diseases and things did you all deal with mainly down here? In Stearns?

Smith: Well, flu, measles, pneumonia, typhoid fever. Of course, diphtheria, you probably have to send them to the hospital. (?)

Gatewood: How did−

Smith: (?) patient hospital, you see.

Gatewood: And the closest hospital must have been, what, ? Or−

Smith: .

Gatewood: , mm hmm.

Smith: More, I guess, sent to . But some of the (?) patients he sent to . And even sent a lot to . He knew all those big, best doctors in . In and .

Gatewood: Did he, I guess, they usually sent them on a train, would they?

Smith: He’d tell them he was coming.

Gatewood: I see.

Smith: Or they had an ambulance. I don’t remember what year they set that funeral home up. Well they, he, I don’t know where (?) sent the train unless it was somebody that, just for a check up of some kind.

Gatewood: So you started your practice here about the time this hospital had been completed?

Smith: Yes. Not six months after it.

Gatewood: And did you, your office, did you move right in here? This building? Doctor’s building?

Smith: No. For a long time, I had an office (?) and the town, downtown got big. And the fellow that owned the office I was in, he sold it to (owner of a store?) and he wanted, my office was upstairs, he wanted the whole building. So I sat in the, just, I mean, this fellow, and this has been my office now for a long time. Must have been about 1958.

Gatewood: How do you get a practice started? It must be kind of slow for a while until−

Smith: It was, really, the way I built up as fast as I did was like I was talking about. These older doctors (?) they told me and lots of times if they liked me, they’d come in and maybe their whole families, neighbors. Especially on, home deliveries, (best way?) to build a practice. If you’d go and stay there two, three, four hours, you’ll know every woman in the community. And if they think you did a good job, first thing you know, you’ve got several.

Gatewood: Is it a kind of tradition that women would come to when the woman was having a baby in that time? Did they−

Smith: Oh, yes. Always. Practically always. I mean, not necessarily. If you’re in a pretty good community, all the women know the family, there will be four or five at that time.

Gatewood: Did they help kind of−

Smith: Oh, they’d help. They’d clean the baby. And maybe clean the bed up.

Gatewood: Did they ever get in the way?

Smith: Not really, no.

Gatewood: They knew what to do and sort of, did they knew what the roles they were going to do.

Smith: Yes. They were a big help. I mean, I remember, (?) trouble.

[End Side A. Begin Side B.]

Gatewood: What, what form of regulation do you remember that you had when you first started practicing, in dispensing of drugs? Was there much regulation at that point?

Smith: Not on the regulation. I mean, you had a form that you ordered, ordered narcotics. And I mean, you didn’t have even, barbiturates, (?) narcotics. And you had to, you had to tell if it was (?) and the (?) wouldn’t know every time it was yours.

Gatewood: So it was just, yes. Has there been−

Smith: Most mild narcotics are in the liquid form. I might give them a shot if they need gall bladder (?) or any kind of severe pain. (?) But I didn’t dispense, you know, codeine. (?) codeine

Gatewood: Has there been a tightening up on it in recent years?

Smith: Oh, yes. Well, oh, well, drug abuse (?) well after that, I haven’t dispensed in any fifteen or more years. (?) I did very little dispensing (?), just enough that I would carry in the grip to (?) patient that needs some (?) every time I (?) after that, and they need a prescription. (?) Or maybe like I say, (?) about (ten years old ?)

Gatewood: The druggist here, you worked closely, I guess, with him. Which druggist did you work with?

Smith: It was (?) bought, it over, took it over, sometime in about ’65. And I did more for them than they did, all the (?) I need today. I mean, I wouldn’t have contact with the, some of these drug salesmen to order stuff. So I just went to the drugstore.

Gatewood: Were you, I guess you left this period where with Medicare, Medicaid. And I noticed a sign out there. Do you discourage that type of, that type of payment in your practice?

Smith: I don’t discourage it. I don’t know (how to get it done?). They (ain’t going to pay?) (?) but even (?), I think, two dollars, and (?) or something like that. But I did a lot of that. But in my case, what the, the last couple of years, Medicaid got to the point that they don’t pay much. Especially, now some (?) that have a, lab work, have lab (?), lab work, can make money on. But the, right now, for under 65, we normally have one additional visit. And they don’t take care of (that?) The rest of them, only visit (seven others?), only, I mean, the work that, the secretarial work is more, worth more than that, really.

Gatewood: That’s interesting. I didn’t realize.

Smith: And lots of times, they turn you down, or they say it’s a mistake. And for the last three or four years, I quit seeing (?), and couldn’t see any on Saturdays. Because they put this (?) for them. To come, not come here on a weekend. And it’s got to the point now where I won’t see a (?) patient a week.

Gatewood: That’s interesting. That’s something that I wasn’t aware of. That’s so low payments for office calls.

Smith: Well what, who’s getting it (?) is the nursing homes. And the−

Gatewood: Lab (?)

Smith: And lab (tours?). And these, they don’t have any surgeons for these, some of these big (things?) Just (?) Medicare.

Gatewood: I don’t understand why there’s a distinction between that work, and the work of a general practitioner.

Smith: Lately, a specialist gets more. They pay them more than a general practitioner. So they just got more than that. I was trying to get out of it.

Gatewood: It’s not that you don’t, that you, I’m glad I asked that question. I was hesitant to ask you. Now I see what you mean.

Smith: I mean, it wasn’t that, it wasn’t worth doing.

Gatewood: I believe I’m (?)

[End Interview.]