What I Learned from My Ancestor’s Stint as a Volunteer Nurse in Appalachia

White womxn looking out onto the mountains in Boone, North Carolina.
Molly looking out onto the mountains in Boone, North Carolina.

Many of you probably have your “famous” ancestors—those relatives who were larger than life. Though she passed away decades before I was born, I’ve heard many tales about my great grandmother, Grace Councill: from her childhood growing up in an affluent family in the “big city” of Charlotte, North Carolina, to her sweet tooth and knack for baking, to her brief stint as a volunteer nurse during a pandemic.

A portrait of the author's great-grandmother when she was a young nurse.
A portrait of Molly's great-grandmother

About a century ago, my great-grandmother had just graduated from college and moved up to Boone, North Carolina, a small town in the heart of Appalachia, to work as a teacher in a one-room schoolhouse. At the time, there were no paved roads—those didn’t come in until after World War II—so kids got to school via horse and buggy. My great grandmother doubled as the school chef and cooked lunch for her students, who carried baked potatoes in their pockets on the way to school during the winter to stay warm (which doubled as breakfast). Living deep in the Blue Ridge Mountains of North Carolina was quite the adventure for a wealthy city girl like her.

Not long after she arrived, the 1918 flu pandemic devastated her community. One account reports that a single doctor in my great-grandmother’s county of about 13,000 treated more than 800 people for the disease.

Much like how the U.S. went into lockdown last year, my great grandmother’s school closed to stop the spread of the flu. The local doctor, Dr. Perry, recruited her and other young women in town to be volunteer nurses.

The nursing workforce at the time was slim: Hundreds of professional nurses had left North Carolina to serve in World War I. On top of that, my great-grandmother’s remote community probably didn’t have many health care workers even under normal circumstances. So, she did what any mountain woman would do—she got to work.

A black and white vintage picture of a bird's eye view of Boone, North Carolina.
A vintage photograph of Boone, North Carolina

But they didn’t just treat people in a clinic—they rode on horseback up steep mountainsides and through moss-covered forests to people’s homes to deliver medicine and care for those who were ailing. Much like today, health care in these rural communities was hard to come by.

Throughout the COVID-19 pandemic, I’ve often thought about my great-grandmother as I watch nurses—albeit with robust education, training and professional credentials—across the country spring into action to protect and serve their communities.

Early on, nurses in ICUs were forced to use trash bags as PPE. School nurses have worked overtime to contact trace and contain outbreaks. Hospice nurses have held up tablets so families can say goodbye to their loved ones. And this spring, public health nurses have dropped everything to staff mass vaccination sites.

These shared values I see among nurses—fairness, intelligence, ingenuity and a fierce commitment to their communities—are no coincidence. As I’ve learned through my work with the National Academy of Medicine on the Future of Nursing 2020-2030 report, nurses throughout history have rolled up their sleeves to keep their communities safe. But to be clear, they’re not heroes: They’re trained professionals doing the hard work that simply must be done.

In the 19th century, abolitionist Harriet Tubman was a nurse and treated Black soldiers during the Civil War, along with Sojourner Truth and Susie King Taylor. Lillian Wald and Florence Nightingale were addressing the social determinants of health, from low incomes to unsafe living and working conditions, long before the term was coined.

Though the profession has changed so much over the years, nurses have always been pioneers in keeping our communities safe and healthy. And the COVID-19 pandemic has forever changed the nursing workforce: It has shone a light on how critical they are, but it has also made glaringly obvious that our society hasn’t done right by them. Nurse burnout is staggering and their mental health and well-being is poor. Every day, nurses face bureaucratic and legal barriers to doing their jobs, all while hospitals and insurance companies vastly undervalue the work they do.

A modern-day view of Boone, North Carolina.

Though my great grandmother’s stint as a volunteer nurse was short-lived—she went on to become a professor at the local teacher’s college—I can tell that the experience left a lasting impression on her as well. As a privileged city girl, it forced her to grow up and come to grips with life outside of her affluent upbringing.

I hope that this pandemic is a turning point for our society, too. We can’t afford to take nurses for granted. We need to do more than laud them as heroes and need to better support them so we all can have a brighter future.