Appalachian Passage is based on the journal kept by Helen B. Hiscoe during the year that she, her physician husband, and their baby daughter spent in a West Virginia coal-mining camp. When he reported to Coal Mountain in June 1949 as the new company doctor, Bonta Hiscoe was young, idealistic, and unprepared for a practice in a remote "hollow" forty-five miles from the nearest hospital. With no trained help and substandard facilities, he was charged with the care of more than four hundred miners and their families.
Dr. Hiscoe found the work both challenging and exhausting and his wife was immediately drafted to assist him. Her honest, direct descriptions of life in Coal Mountain reveal a people at once impoverished yet fiercely proud, remarkably adapted to their circumstances and solidly set in their ways. Equally contradictory was the country itself, whose wild beauty contrasted sharply with its strip mines, treacherous roads, and barely adequate dwellings.
A more personal story also unfolds in Appalachian Passage, for Helen Hiscoe played three simultaneous, often conflicting roles: that of a new mother; a traditional, demure Coal Mountain wife; and a confident and competent medical assistant.
Job-related injuries, though ghastly, were not so frequent as problems related to a high pregnancy rate (families of five to ten children were the norm) and a general unfamiliarity with basic hygiene. The Hiscoes quickly learned to hold their tongues and attune themselves to local ways. Offending people not only undermined doctor-patient relations but coulds bring the Hiscoes into conflict with entire clans.
The Hiscoes' year at Coal Mountain coincided with the final stages of a bitter dispute between the United Mine Workers, the mine owners, and the federal government. Dr. Hiscoe, as an outsider and an employee of the company, was often at odds with local labor leaders. Though most of these disputes were resolved, the Hiscoes' frustrations at union politics lingered. Coupled with the news of Helen Hiscoe's second pregnancy, these feelings motivated the family to leave Coal Mountain in July 1950.
Appalachian Passage is a book to be valued for Hiscoe's revelations about herself and her family and for her insights into the social structure of mining camps and the problems of rural health care.