Appalachian Passage by Helen Hiscoe: a review

While I’ve an interest in the history of West Virginia’s mining industry, the main reason I purchased this book is that I worked for many years in the orbit of the author’s daughter. I also had some interest in Dr. Bonta Hiscoe, whom I met many years ago in his leadership role as the original director of medical affairs for Lansing’s first HMO, Health Central.

Appalachian Passage is a fascinating book. Dr. Hiscoe, recently released from the Navy and looking for a temporary position while waiting for a residency opportunity, was hired as a company/community doctor in Coal Mountain, West Virginia in mid-1949. While he was hired and paid by the Red Jacket Coal Corporation, his relationship with the United Mine Workers was covered by a separate contract. Although most of his income apparently came from the coal mine’s monthly deductions from its employees’ paychecks, his patients included company officers and local folks without mining affiliations. Moreover, not all medical services were covered by the UMW payroll checkoff, which seems to have occasionally led to difficulties. Dr. Hiscoe’s time in Coal Mountain lasted less than a year, and was ended mostly by his peculiar and deteriorating relationship with the UMW. The causes of this rift are a major theme of the book, but seem not to have been fully clear to any of the participants.

Helen Hiscoe–herself a Ph.D., though it seems that the Coal Mountain community didn’t realize it–draws interesting portraits of several patients, of the mine’s manager, and of some of the key UMW activists. Much of Dr. Hiscoe’s non-routine medical practice revolved around child births, all of which seem to have occurred in homes. These were family events, of course. Every family behaved differently, and those differences are compelling. The author tells these stories well.

The Hiscoe family’s relationship with the local Mine Workers leadership was odd. In most cases the personal relationships were quite friendly, but it’s pretty clear that some of these friends were working against the Doc behind the scenes. The hows and whys were never satisfactorily explained, and in the end the family decided it would be better to leave than to sort out the problems. It would be interesting to see a similar account of the year from a mining family’s perspective, as it’s clear that the author wasn’t privy to pertinent discussions.

Barbara Ellen Smith’s Foreword provides valuable historical context for the UMW difficulties, pointing out that one source of strain was the national union’s post-WW II push to professionalize medical coverage for its members by establishing regional hospitals. That may (or may not) have contributed to Dr. Hiscoe’s problems, some of which seem to have been purely cultural. All in all, it likely doesn’t matter, as the Hiscoe family always imagined this as a temporary gig.

I’ve left a lot out in this summary. There’s quite a bit about daily medical practice, and the doctor’s relationships with his patients. The doctor, and the community, were keenly aware of the activities of the national UMW during this period, which had considerable impact on the lives of everyone in Coal Mountain during 1949 and 1950. The international situation–Soviet bomb development, especially–was of some concern to Dr. Hiscoe, a recently-released Naval officer still potentially subject to the military for his Navy-sponsored training. Two members of the Coal Mountain community proved to be lifelong family friends. The author also provides delightful descriptions of the local scenery. And of the colorful local roads.

The book is mainly about people, though, and the community those people made in Coal Mountain. On the whole, the memoir’s quite sympathetic to nearly everyone it portrays. While the book’s a portrait of a particular place at a particular time, it’s valuable both as a portrait of a mining town under stress and as a more general portrait of life in mining towns at all times.

This review was originally published on LibraryThing.

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