Oral History Interview with Dr. William Robert Kelsay Jr.

Gatewood: We’re talking to Dr. Robert Kelsay, Jr., in his home in , . Dr. Kelsay was public health officer in the from, during approximately the middle thirties and early sixties, through the early sixties.

Kelsay: No, it was beginning September, 1940, through June, 1975.

Gatewood: All right. That’s fine. And who followed Dr. Roberts?

Kelsay: I believe I did. There may have been somebody in between there. I don’t recall, exactly.

Gatewood: What I’d like to do first is to get something of your background, where you grew up, and where you went to school. Why you came back here.

Kelsay: Well, I grew up at a little community called Gap Creek, which is fifteen miles southwest of Monticello, right on the Clinton County border. I went to school there, to a one-room school initially. And then a high school, beginning about, in the late twenties. Went to , which at that time was in its second year. Then from there, I went to down to for one or two semesters, and then transferred to , where I finished in 1931.

Gatewood: Then you, then you went to college and medical training?

Kelsay: My first year of college was over at , in . I was there one year. At that time, it was a junior college. Then I went to Eastern, what is now for about three semesters. And then, while I was a student there, I was accepted at the , at the school of medicine. However, I delayed going a year after my acceptance to complete the third year of college, which was done at the . For the most part, I guess I studied more pre-law than I did pre-medicine.

Gatewood: Were you interested at that time in pursuing a legal−

Kelsay: That’s right. I hadn’t quite made a decision on which profession to go into. I was considering becoming maybe a lawyer. And then I changed over to medicine. Perhaps my parents or relatives persuaded me to make a choice.

Gatewood: So did you attend the, what medical school did you attend after graduating, undergraduate?

Kelsay: .

Gatewood: . Of course the school at was not in existence.

Kelsay: No, no. That was beginning in, well I graduated in ’39 at , so that was four years prior to that I entered medical school.

Gatewood: Did you graduate in the public health, did you graduate with a public health medical degree? Or did you get the general−

Kelsay: No, it was just an MD degree. That was just basic training. No, it had no, really no connection, or very little training in public health.

Gatewood: How did it come to be that you got this job here initially?

Kelsay: Well, that was the vacancy, at that time, at the time I finished my junior internship, which was at a little Kentucky Baptist hospital there in . And so after a few weeks, you know, special training, I guess it would be called, there was a vacancy here. And so it was accepted just as, more or less, a trial. I really had no intention of staying, I guess, as I recall.

Gatewood: And this was in the year 1940?

Kelsay: Yeah, 1940.

Gatewood: 1940.

Kelsay: September, 1940, I began as health officer here in .

Gatewood: Could you comment a bit on some of your predecessors just generally about, what they were, what type of role they performed when we first got a board here, a health board? And what type of programs they may have had? Just know you weren’t directly involved in it, but you were in the county, around this area.

Kelsay: I don’t recall very specifically about what the program was here at that time. Except it concerned school health. Immunizations were a big part of the program, of the general program. Venereal diseases, of course. And at that time, in public health, it was just more or less a catchall. I didn’t have too much of a clear concept of what the role would be.

Gatewood: When you started your work, what type of programs, what programs were you all engaged in at that point in the forties, just before we went to war? Type of health programs?

Kelsay: Well, as I mentioned, school health was certainly a very important part. At that time, there were several rural schools. One-room schools, two-room, and a few two-room schools beside the city school. And the county high school was not in existence at that time. There were two, maybe three, high schools over the, within , that were later consolidated into the system. And during the, during the summer months, during the warm weather, the school usually started in either in July or August. Most of the time in July, I believe, at that time. And we made the most of the July through into October and November school visits, during the warm weather.

Gatewood: And what type of thing did you do at the schools?

Kelsay: Well, as I already mentioned, I believe, immunization. Typhoid fever was rather prevalent back at that time. And we did what is now DPT immunization for the children. And of course they were somewhat of a community gathering place, the rural schools were, because the parents would attend these clinics, too. It was mainly for immunization. And there were a few examinations done. Or just met what seemed to be the most urgent needs. The crippled children sometimes located, or handicapped children, there were no specific programs or projects to screen the children at that time, as later happened.

Gatewood: Just sort of an informal screening.

Kelsay: Yes. Yes.

Gatewood: Someone was having trouble with the eyes, or−

Kelsay: That’s right. There were visual referrals, and hearing referrals, and referrals to what was in the crippled children’s commission. They were sent to, the greater part of them were sent to for surgery and other follow-up.

Gatewood: The department at that time was dealing much in terms of drainage and things like that for the home environment. Was that a part of−

Kelsay: Well, that was a part of it, but rather a small part. That came to be more important, testing the water supply. That was usually done. And it was, the environmental part of it came later. That was at least a small part of it at the time I started working.

Gatewood: I understand that typhoid fever was really very prevalent and it was a horrible disease. Were there any other diseases that were, infectious diseases, that were pretty prevalent?

Kelsay: Well, the usual childhood diseases of measles, mumps and whooping cough were quite prevalent back in those days. And of course later we had epidemics of polio. And there was effort made to, but at that time, there was no measles vaccine. Either type of measles. That came later on. But we immunized for diphtheria and whooping cough. But whooping cough was rather prevalent back in those days. And I mentioned measles, which reminds me that some mothers, if their children were healthy, they would try to let them catch the disease so it would protect them later, at a later date.

Gatewood: Sounds like there was a good relationship with people in these communities that you all had when you’d go out to the clinics. Was this very, usually a pretty positive thing? That people were anxious to receive help?

Kelsay: Yes. The response was really quite good, most of the time. Of course, there were, I failed to mention the smallpox vaccination. That was a mandatory procedure. There was some opposition there. Some parents were opposed to any kind of immunization. That was against their practice, or against their religion, so to speak. They had several excuses or alibis. Didn’t want to participate. And they would be there to see that the children did not get their shots, so to speak.

Gatewood: That’s an interesting area to me. I think would be an interesting area to a lot of people in terms of public health, the way people perceive healthcare. In that regard, could you talk a little bit about the relationship you had, being a native here, you know some of the folk practices and home remedies. Not only home remedies, but herb doctors and root doctors, this kind of thing. What was kind of the relationship that you had with those types of people? And−

Kelsay: Well, we got along pretty good, I guess. I’m pretty sure that the medicine man, so to speak, was still, was prevalent back in these hills. But at that time, it was quite remote. Roads were not anything to brag about. So we had to make the most of the summer season, so to speak, the warm weather, to get to these out of the way places. I guess what you’d call the jumping off place. Up the holler, and over the hill, and so to speak. I just happened to think of a story that I think will illustrate the attitude of some of the people, which doesn’t answer your question, specifically. I have to think a little bit more about that. But this supposedly happened oh, I guess forty or fifty years ago in an adjoining county, here at . There was a supervisory teacher, I guess was her title. She might have been called something else. But she visited the different schools. The school system there was very similar to the one here in this county. So this was during July or August. It was during the noonday recess. She drove her car up to the school. And the kids were scattered about over the playground, in little groups. And this little six year-old who just started the school, he saw her get out of the car, and she was carrying a bag, a little black bag. And he watched her very closely with his eyes as she got out and went toward the schoolhouse. And as she entered, he said to his playmates, “Look out, boys. I’m going home. Here comes that shooting woman.” He thought it was a nurse, some kind of nurse.

Gatewood: [laughs] You all did have a program of training for midwives, didn’t you? (?)

Kelsay: Yes. Teague, who was here a few years earlier, Dr. Teague is a native, and he later became commissioner of health, he started work here, I believe. He had a rather extensive program on training for midwives. I believe he had perhaps as many as forty or fifty. That may be exaggerated somewhat. But I’ve seen some pictures of the−

Gatewood: Dr. Roberts said there are some pictures somewhere. I’d love to get those pictures, and get a copy of it. Of the midwives in the training program.

Kelsay: Well I think I have a little pamphlet that was published a few years ago. It was about the time Dr. Teague retired at . And I think it gives that picture you’re referring to. I believe it does. We’ll look and see.

Gatewood: So there was a broad network of midwifery that was going on here initially.

Kelsay: Oh, yes. Because there were very, relatively few physicians, I guess not more than, that particular time in the early forties, not more than three or four, at the most, active doctors in the county. And there was no local hospital, of course. And most of the births were at home. And it was whoever happened to be the neighborhood midwife, attendant, or relatives of the family, of course.

Gatewood: I’ve heard it said that there was kind of a gathering when the birth, not just the midwives, but women, that friends would come, too.

Kelsay: Oh, yes.

Gatewood: Kind of a crowd, a good group of people there.

Kelsay: That’s quite true. That’s quite true.

Gatewood: Do you have any direct remembrance of that?

Kelsay: Not too vivid, because I didn’t participate in that too much. And we made some effort, I guess, to train the midwives. But no formal program, per se, not at that time, not at the beginning of the forties. But perhaps a little bit later, we made some effort to train them. We would have them come in, and of course report their births, the birth certificate. The clerk at the health department was also the local registrar. And I guess I acted as deputy, too. And we would assist them in filling out the birth certificates.

Gatewood: Did you begin to develop some kind of prenatal care emphasis at that point?

Kelsay: Well, not really, I guess we had some so-called clinics that we, most of it was referrals, I guess, from the midwives or from the visits we made. But we didn’t have any formal program, per se, of prenatal care or prenatal clinics at that time. That came a little bit later.

Gatewood: How, how long were you, when did you move to Atwood?

Kelsay: To where?

Gatewood: When did you leave your position as officer (?) federal officer?

Kelsay: Oh, well, this is, I believe I said that. I began here in September, 1940. And then, two years later, the counties of and county were added on, or I just became the health officer of the three counties. Now each was a separate unit. It wasn’t a regional set up or district set up, as it is now. Really, each was just a separate entity to itself. And sort of here half time in . And the other half was split between the counties of and . Or that’s the way it was supposed to have been. And that’s the way it existed for the next twenty-five years or so.

Gatewood: Could you tell us what you know of the home remedy type things? Did people, even in the forties, practice quite a bit of home medicine? Various remedies and things?

Kelsay: Well, I assume they did. Because they did not have access to the physicians as they do now. Because of the roads and communication. And so then I recall this happened somewhat, several years prior to that. There were several medicine men, so to speak, or traveling salesmen, or drummers, they’re sometimes called, that made the rounds through the county and adjoining counties, selling home remedies. Liniment and laxatives and they had, it was sort of a traveling drugstore, I guess, in a sense. So one of my uncles, I remember, worked for, sold products. And I knew of another man who worked there, similar position, about that same time. About the same time period.

Gatewood: It’s very interesting. Not only did they not have ready access to physicians, but not even to drugstores.

Kelsay: The only drugstores, of course, were each county seat had a drugstore. That was it. It had one or more, usually at least two. At least, there were two here at that time. Two drugstores.

Gatewood: Are you acquainted with the community?

Kelsay: Yes, I have been there. And that’s been several years ago. So I don’t have too much recollection. It’s in the eastern part of the county, near the line, I think. I’ve been there, I know. But that’s been more than twenty years ago. And I don’t think I’ve been back since then. I’m pretty sure back in the forties and fifties, there was a rural school in that area that we visited. But that was, I guess, from here, at least fifteen, maybe twenty miles.

Gatewood: It’s twenty-five miles.

Kelsay: Oh, really?

Gatewood: The reason I know something about it the brief time I’ve been here is I was searching to interview some type of folk practitioner, you know.

Kelsay: I see.

Gatewood: Because I feel like there should be somebody that could give me a more firsthand experience type of testimonial in that type of healthcare. And someone said that a gentleman by the name of Clark Stonewall was that type.

Kelsay: I’ve heard of him.

Gatewood: And I went back and back and back, way back in the eastern part toward . And way off the roads, and then down a wagon road. And then got off and went down through the wilderness. [laughs] Into a creek, over a swinging bridge and everything. And met this fellow and interviewed him. And he is, I guess you’d say he’s a unique character. He wasn’t exactly what I was looking for because he didn’t apparently, he’s not really practiced too much. But he seems − and of course I have no knowledge as a physician, I don’t know that much about general history of health − he seemed pretty knowledgeable about things. he’s really quite a character. He claims to have done some study in in medicine. And he’s really into the organic things, herbs and barks and things. And he’s quite, I guess you would almost say hostile to what he calls the inorganic approach to medicine. But he doesn’t apparently really practice what he preaches, I guess you’d say, in the community.

Kelsay: Is that so?

Gatewood: Because he’s sort of a hermit. He just sort of lives out there. It’s strange. Have you ever heard of the guy?

Kelsay: I’ve heard of him. And I don’t recall ever having met him.

Gatewood: I can see why you wouldn’t, because I don’t think he comes out very much. [laughs]

Kelsay: I doubt that he does. I heard about him sometime ago. But I really don’t know anything about him, except just hearsay.

Gatewood: People down at the library were fascinated by him. You could tell they were, almost to the point of being kind of, kind of holding him in awe. Apparently he comes into the library from time to time. And he apparently is a well read person. And they kind of hold him in awe. And they were surprised that I got an interview with him. But I was somewhat disappointed, because I don’t think he’s typical. But he was an interesting character. And I would like to deal with a more typical herb doctor, a person that can remember back in the twenties or thirties, when they were more prevalent. So I’m going to keep trying. Hopefully in one of these three-county areas, I can get such a person to interview. Because I’d like to get different perceptions on healthcare.

Kelsay: And as I said, I’ve heard about him, is just about all. And I don’t recall ever having seen him or met him. I know I haven’t talked with him. I’ve just heard about him, is about all I can say. It does sound rather interesting. Fascinating, at least.

Gatewood: He’s an intelligent fellow. And he’s one of these type people you talk to, you don’t know what to believe, and what not to believe. And I don’t in any way disparage what he says. I mean, I take what he says, I have no way of knowing. But he’s about eighty-three years old. Full of vitality. [laughs]

Kelsay: I’ve heard he’s quite a character. And I haven’t heard him, that’s the first time I’ve heard him mentioned in, oh, five years or so.

Gatewood: But I was just really interested in that when the people at the library gave me the directions on how to get to his place, they put in the old community. And I guess I had my hopes up that I was going to find a guy that was really into that community healthcare type thing. But it didn’t appear. That’s the reason I ask you the question about the community. Because I don’t think he’s that much related to that community, although he’s plopped right in the middle of them. But doesn’t seem to have been that related to what went on there. But I’d kind of like to, I’d like to pursue it if there was somebody in that community that was into folk type medicine, so I could pursue it. But I might not be able to. It’s a hard part to get at. Was there, while you were in the health department, was there a beginnings of centralizing from just a county to a multi-county, you mentioned that you worked these three counties. But they seemed somewhat autonomous, though?

Kelsay: Right.

Gatewood: And now it’s moved to sort of a regional approach.

Kelsay: Yes. That began, perhaps, as early as twenty years ago. I don’t recall the exact dates. But there was at least a trial attempt to, at that time, we called it a regional health office. Which was an attempt to, it was a forerunner of what is called a district concept now. That seems to be pretty well taken care of at the present time.

Gatewood: What is the district here? It’s headquartered in ?

Kelsay: Yes. The headquarters are . It’s called the Lake Cumberland District. That includes ten counties, I believe. It’s supposed to include ten counties. Which includes , of course. And and would be the western border. I mean, eastern border, of that district. Going on over to and on the western side.

Gatewood: It’s almost probably parallel to the library organization, which −

Kelsay: It’s supposed to follow that. Twelve or fifteen regions that was set up in the state. I mean, in , a few years ago.

Gatewood: Back to this sort of theme of the midwifery that was here early, and which is apparently pretty well just about faded out.

Kelsay: Yes, it’s just about gone. I remember seeing just recently that one of the women who was active as a midwife back twenty-five years ago, she was in her late eighties, died just last month, I guess.

Gatewood: What did, I’m also under the impression that in the earlier period, before the transportation improved, doctors themselves delivered a lot of babies in the home.

Kelsay: Oh, yes. Yes. That was established practice then. They didn’t get too much prenatal care. But of course they would call when the birth was due. And they’d go spend an hour or two hours, or even three or four hours, for the delivery.

Gatewood: When did that begin to change? What year did that begin to change? What factors do you think were involved in the switch from home birthing to a hospital or clinic?

Kelsay: Well, I don’t know about the time period, but when local hospitals became a reality, why, of course, hospital births were practiced…

[30 minutes]

[End Side A. Begin Side B.]

Gatewood: You mentioned Dr. Teague. Could you give me just a little bit of background on Dr. Teague and when he came here…

Kelsay: Well, he came here in either the late twenties or early thirties. He was here in 1931 through, well, he graduated from in ’29. Then was in general practice for a while at . And he became health officer in , 1931, and left here in ’33 to go to graduate school at Johns Hopkins. And from there, he came back to and was health officer in . McCracken County Health Department. In the beginning of 1940, he was employed in what was then the state Department of Health as a director of the Division of Venereal Disease. And he also served in the Division of Tuberculosis Control. Then in the mid-forties, through about 1955, he was in the US Public Health Service, where he was in the regional office as assistant director. Then from , he went to , as what was called a secretary of health. Then beginning in 1956 through 1970, he was a commissioner of health in the . That’s just a summary of his involvement in public health. I first knew him when he was health officer here in the early thirties. I graduated in high school ’31, I believe I mentioned that. And then, of course, I was away until ’39. Well, until 1940.

Gatewood: Is there, do you see a real problem of developing a strong program of preventive medicine with the basically semi-private system we have?

Kelsay: No. I think that is one of the neglected aspects of medical services. It’s not completely neglected, but it hasn’t been, hasn’t had the emphasis that it should have, or could have. Beginning a few years ago, there was quite an emphasis from the federal level on the HMO, the health maintenance organizations, which were primarily private medicine, but was heavily subsidized. That hasn’t been too successful, particularly in . I noticed that the Hunter Foundation, which I’m most familiar with, based in .

Gatewood: I’m a member, yes, I’m a member of that. Now I have been reading in the paper about what’s happening, I know it’s become a pure HMO when it was before more of an OEO type thing, where it was poverty. But it’s been converted to that. And it seems like there’s some kind of movement to make those more universal. Do you know anything about that?

Kelsay: No, I’m not too acquainted with them. I’ve just read about them. And I happen to know of one doctor who I knew when he was director of the TB hospital over at that’s since been converted to other uses. He lives either in or in that area. And this was about three or four years ago, he was associated with an HMO there in . Hunter Foundation, I believe it’s called, isn’t it?

Gatewood: Right. I think it’s one of the stronger in the state. And then there’s one in . There seems to be some kind of a movement. I’m not sure what they have in mind. But there’s change going on in that area. It’s always been amazing to me in terms of preventive medicine. I wonder sometimes, I don’t know whether it’s the lack of institutionalization for it, or whether it’s the perception of the patient. As a culture, we’re very conscious of preventative approaches to caring for ourselves.

Kelsay: This may be a myth, but I guess most people, that seems to be the general concept, that they don’t think of a doctor or a physician or a hospital until they become ill or injured. It’s more or less an emergency thing.

Gatewood: That’s kind of my perception. I’m wondering if it may, maybe it stems to the fact that being a frontier so long, and living, so many of us living in remote areas, maybe we just learned to, through home remedies and things, to care for ourselves until we got really ill. And now that we’re not remote anymore, we’ve not learned anything else.

Kelsay: I guess there’s something to that. I’m pretty sure there is.

Gatewood: And now I don’t think we know how to care for ourselves as well as our ancestors did, really.

Kelsay: Well, we maybe have it too easy.

Gatewood: Probably. Now this is, this book on obstetrics of all types, about the term of the century.

Kelsay: Right.

Gatewood: This book, the publication, it’s for a practitioner at that time.

Kelsay: Yes. I assume at that time, it was more or less used, I guess, as a textbook, perhaps for medical students about that time. Turn of the century. And as a reference to practitioners.

Gatewood: Where do most people now want their children to be delivered? Where do they go?

Kelsay: Well, I guess in this particular area, most of them go to . There are no local obstetricians, per se. Well, I believe there’s one now who’s been here. He’s a native, and been here for the past three or four years. I guess the greater part of the deliveries are done in .

Gatewood: That’s a pretty specialized hospital over there.

Kelsay: I’m not too familiar with it, but I assume it’s just, would be classified as a general hospital. They have the usual departments or divisions of services.

Gatewood: You don’t know anyone over there, do you, that I can interview, that would be−

Kelsay: In regard to the prenatal care?

Gatewood: Not necessarily prenatal. Just the whole general medical care that’s available there.

Kelsay: Well, one of the older practitioners there is Dr. Jasper. He’s the son, his father died not too long ago, in his nineties. And I’m pretty sure he could tell you quite a bit. And then Richard Whittle who is a surgeon. He’s about my age, or perhaps a little bit older. He’s still active.

Gatewood: That should be very helpful. I’m sort of getting the picture that is sort of the center of medical care. Especially for illnesses, serious illnesses. And births. Would that probably be for both and ?

Kelsay: Oh, yes.

Gatewood: And Pulaksi?

Kelsay: And Pulaski. And the adjoining counties, too, north of there. And east and west, too. Where is, another adjoining county that recently added a hospital that’s been there two or three years is all. The first county in this area, specifically, to have a local hospital, is .

Gatewood: And when did the hospital, when was it established here in ?

Kelsay: That was back in, about ten years ago.

Gatewood: And before that, what kind of clinics or small hospitals did you have in the county?

Kelsay: Going back to the forties, well, even before that, I recall there was a Dr. O.M. Carter, who I believe is a native of this county. He was a general practitioner. And, I guess, did some surgery. Did some emergency work. Of course, I recall working one summer with him while I was, I don’t recall whether I was in college. Or may have perhaps, was between one of my terms, one of the school terms in medical school. He had so-called hospital, or he had rooms. He had a big frame house. Because the second floor was, his first floor, besides his living quarters, he had an office. And then upstairs, some rooms that just ordinary beds. Some people would come and stay, maybe overnight or for a few days, or even as long as a week.

Gatewood: Is that building still in existence?

Kelsay: I don’t believe it is. It was right at the southwest edge of town. That’s, and I think it’s been torn down.

Gatewood: Well, and I guess probably it was for his work, not other doctors. Other doctors didn’t bring patients there, did they?

Kelsay: I don’t believe they did. I think he was just more or less on his own. And he had a so-called nurse. I doubt that she was a registered nurse. I believe this was his wife, who acted as more or less his assistant. Or what we would call a practical nurse now, I would guess.

Gatewood: Did you have any public clinic after that? Before you got the hospital ten years ago?

Kelsay: No, I don’t recall. Well, beginning about twenty years ago, or perhaps before that, there was a Dr. Simmons here, and a Dr. McCard, who were partners, that they established what they called the Monticello Clinic. They could advise you as to the specific dates on that, when they started.

Gatewood: Is that building in existence?

Kelsay: Yes. It’s still operating. But Dr. Simmons, who is a neighbor.

Gatewood: Is that in the downtown area?

Kelsay: Yes. Well, it’s adjacent to the downtown area. South of, , what we call . About three blocks from the square.

Gatewood: I’ve been reading in the papers that the emergency ambulance service to this central hospital in is, the finance is kind of breaking down on that. Have you been following that? Seen that?

Kelsay: Not too closely. That’s still quite a problem. There was an article this week, I believe, in the Courier-Journal regarding the financial plight of the ambulance service. And it applied to all over except, of course, the metropolitan areas of and . and and the larger cities and towns.

Gatewood: Yes, that is. If a person didn’t have an automobile, it’s a pretty critical thing to have emergency service, isn’t it?

Kelsay: Yes. Yes. Most certainly is.

Gatewood: Hospital (?) And two, isn’t this basically, this is a big tourist area? National tourist area? People coming down in the summer?

Kelsay: Yes. Since was impounded it’s become quite a vacation area. In summertime, of course. Well, for year round for that matter. And of course this is on 90, which has been called the Park to Park Highway. It’s close to , and then goes down over to .

Gatewood: Did you see the article in the paper the other day, last week, about people thinking that goes north and south, rather than east and west?

Kelsay: That’s right. [laughter]

Gatewood: Coming out of here, you’d certainly think so. Cause you go north, too, and pick it up. Well do these rescue squad organizations, they come out of the fire department, or what? I guess they serve some emergency medical care, don’t they? Getting people to hospitals?

Kelsay: Oh, yes. They certainly, that’s a rather late development. Going back at least ten or years ago, most counties and towns, of course, have the rescue squads now. And disaster, natural disasters and drownings and things like that.

Gatewood: Is that basically a volunteer−

Kelsay: That’s a volunteer organization, as I understand it. I don’t know very much about it, really.

Gatewood: Can you think of anything, anything else that might add to it? I know I’ve gotten to talking about things that I realize you don’t know a lot about. But at least you’re general, probably more than the average person, could be helpful. Anything else would be, I’d appreciate it. Along the lines where you’ve had direct experience. Either when you were young, and when you were a student, or when you began your practice.

Kelsay: Well−

Gatewood: You ended up your career at Atwood, uh, Outwood, didn’t you?

Kelsay: No, Oakwood.

Gatewood: Oakwood. Excuse me. I’m sorry.

Kelsay: I was there about a year-and-a-half. I was the, I believe the first medical director was the title at that time. The position has changed since then, I’m sure. I recall going to the dedication of, it was during Governor Nunn’s term of office. And I was certainly quite impressed with the place. It was very nice looking. It had red carpets and all. And quite a contrast to what I’d heard about the old , or whatever it was called, there in . I enjoyed working there. How I happened to get interested in that, a classmate of mine who at that time was, I believe his title was the medical director at Outwood, or, no, Hazelwood. Hazelwood. Chris Jackson, who is a native of . And he persuaded me to try it out. I enjoyed it.

Gatewood: Reflecting back over all those years you’ve been involved in medicine, particularly in public, public work, can you think of anything? I think I interrupted you. I have a bad habit as an interviewer. You’re about to talk about something, and I interrupt you. Feel free to say what you’re thinking.

Kelsay: Back in the early forties, when I started in public health, I think the general concept then, I think more or less for charity medicine, it was supposedly a catch all to what wasn’t taken care of by the private practitioners, which is a misconception in my opinion. And that was a problem then, and I guess it still is, to some extent. But not, not what it was back, say, in the forties and fifties.

Gatewood: I can imagine. Yes. Yes. That’s an interesting, interesting thing.

Kelsay: And of course, we’ve come a long way in conquering the usual childhood diseases. Measles is no longer the problem it once was. Cause the immunization level, mandatory immunization law. And with the cooperation of the public schools, that has eliminated, or certainly reduced the problem that was prevalent forty and fifty and even twenty years ago.

Gatewood: Was there ever much problem with tuberculosis? You mentioned , something back…

Kelsay: Mentioning tuberculosis, I always think of Dr. C. C. Howard who is a surgeon in and the founder of the Howard Clinic there, which is a partnership set up. He was primarily a surgeon. But he was very much interested in tuberculosis control. And that is another, that is another problem, or it was a problem back several years ago. Tuberculosis, because it was quite widespread. And endemic in the mountains, and throughout the state. Throughout other states, too. But Dr. Howard was instrumental in establishing what was called the district hospital. There were seven or eight of them in when we were in the district, for the greater part of the time. And then later transferred to the district. And of course they were regional or TB hospitals in and . . , of course. And over at Hazelwood or Waverly Hills, I believe it was called. That’s where we were sent, as medical students for a few weeks’ training in TB work.

Gatewood: So you all, when you were a public health officer here, if you had any people with that, with tuberculosis, you’d send them to these district centers.

Kelsay: That’s right. Those came in, being in the forties and fifties. And it was, we had, we had the recalcitrant law that the person, if he was considered an active tuberculosis case, infectious, he could be sent for hospitalization. And I think it was usually a four-to-six months period of time. That reminds me of a story. One of my favorites. It actually happened, a few years ago, down in . I’d been working with a fellow called George for almost a year, trying to get him to enter the hospital. I made a few visits out to his home, and written him letters. And finally I was pretty well fed up with this refusal to respond. And I had, I guessed, made some threatening statements to him that I was going to get the law after him. Send him to the hospital. So this happened one summer. It was noontime. And I cut across the courtyard, courthouse yard there, going to lunch. And George was standing, talking with somebody. And he saw me pass by. And then he called to me. He said, “Come here, you SOB. I hear you’re going to send me, you’re trying to send me to the hospital. I’ll have you know that you’re not going to do so and so.” And a few words that I can’t repeat. And so I listened to it for a few minutes. I said, “George, I’m through with you. I’m not doing anything else.” I said, “You can just do as you damn please.” And the surprising part of this story was what happened just a few weeks after that. I got word from the regular reports from that he’d been admitted. So he stayed there for at least four, maybe five months. And then, while I was there in the Clinton County Health Department office, one day he came in. He’d never come in, although I’d tried to get him to come in and talk with me. But he wouldn’t do it. And he came in and I knew he had been, was back home. And he said, “I’ve got something to tell you.” I said, “Well, I’m glad to see you. How are you getting along?” He said, “Just fine.” He said, “I just wanted to say something.” He said, “I want to thank you for talking to me the way you did.”

Gatewood: That is a beautiful story. Boy, it just is, that old stubbornness is in the culture. [laughs] Sometimes it’s good to hit somebody over the head.

Kelsay: That’s getting George to do it. He finally did.

Gatewood: What was the eye disease? I want to call it glaucoma, but was that what, was that what was pretty prevalent in eastern−

Kelsay: Trachoma?

Gatewood: Yes. Trachoma. Did you all have that much?

Kelsay: Well, I don’t know too much about that. That, I guess, was maybe before my time. I read about it and heard about it. And I recall while I was in school at , right near the campus there, was the old Trachoma hospital. An Dr. Story, something like that.

Gatewood: I knew him.

Kelsay: Oh, you did?

Gatewood: He was in First Baptist. I was a minister there for a while, and I knew a Dr. Story. And I wish I could have interviewed him.

Kelsay: I know, uh, or Floyd? Was that his name?

Gatewood: Story. Story. Dr. Story.

Kelsay: Dr. Story. Yes. Evidently, that was quite a problem back in those days. See, that’s been over fifty years ago. But so far as having seen a case, I don’t know that I can. Evidently, it’s a thing of the past now. I’m pretty sure it still exists in some places. But certainly no problem like it was fifty or sixty years ago.

Gatewood: This misconception you talk about in terms of public medicine, preventive approaches, that seems to be a real obstacle. If people, I often wonder if people really know where to go even if the service is available. Did you find that to be true in your practice? That people sort of didn’t know how to go get through the bureaucracy to get to, or afraid to come in−

Kelsay: Well, I’m sure that existed, that they−

Gatewood: Or some kind of stigma that it was charity?

Kelsay: That’s right. And I think that’s one reason that the public clinics, or the clinics held by the health department, didn’t have better attendance. Because that was considered maybe for the lower class, or people who couldn’t pay, or wouldn’t pay. And they weren’t utilized as much as they could have been. And I guess that’s the situation even today.

Gatewood: Even with more money going into it, and more services being offered, they probably, probably the same perceptions as then.

Kelsay: I’m sure that still exists.

Gatewood: Well, I’ve certainly enjoyed talking with you. I think we’ve got some good information. Thank you very much.

Kelsay: Well, I’ve enjoyed it.

[End interview.]