Passages and roadways are frequent topics of conversation in the Appalachian Mountains of Kentucky. Whether the focus is on a washed out dirt road, the Parkway, the Spur, a path through the woods, a river, a holler, or the ATV trail, a constant reminder of the energy required to create this motion is ever present. Energy in these mountains is a limited resource. Yet it is a requirement for physical function, psychological awareness, and utility. The mountains, tall and worn, confine us to the small beautiful valleys between them.

I came to Kentucky knowing very little about midwifery, fried foods, rural health care, or Mrs. Breckinridge, and expected to learn many things related to each of these areas. This expectation was fulfilled, yet I have come away with something more: unanticipated knowledge. I now possess a deeper understanding of what a “modern’ or “scientific” 21st century birth entails. I have listened to stories of how this differs from the previous era. I have become more comfortable with the idea of cultural isolation. And I have witnessed illiteracy in America, a sight that caused my eyes to swell with tears.

I was initially startled by every toothless smile, saddened by the worn out faces of so many young women, and frustrated by the diet and lifestyle trends that have opened the flood gates of illness; particularly diabetes, hypertension, and obesity. Now however, I might not even notice the toothlessness of a smile. Instead, the focus has turned to the fog rising from the valleys, the savory taste of the terrible food, and the mysteriousness of coal mining.. I have learned what is meant by the term “strip job”, and that the definition of a house contains infinite possibilities, including once abandoned shacks and old buses, that a “toilet” can be many things, that even the most distracted students have something to give and gain, and that it is entirely possible for 13,000 people to be served by 6 emergency room beds. Not ideal, but possible.

As I sit here on Mrs. Breckinridge's front porch, listening to the rippling of the river below, I am filled with a sense of inspiration, to challenge my own expectations of comfort, and to offer service to those around me. I am moved by energy of Mrs. Breckinridge and will leave Kentucky with a small piece of the spirit Appalachia stitched into my heart.

-Elia