Medical Caregiving and Identity in Pennsylvania's Anthracite Region, 1880–2000

2. Professional Medicine in the Anthracite Coal Region

State Hospital for Miners, Ashland, Pa. 2 Professional Medicine in the Anthracite Coal Region Miners faced dreadful health dangers above and below ground. In addition, their families fell victim to accidents, epidemics, and common ailments. Company doctors, physicians in private practice, local miners’ hospitals, and benefits associations all provided medical care, especially to male coal miners.1 Despite the great need for medical services, company doctors, hospitals , and medical practitioners in private practice were often not the first choice for medical care for the working men and women of the anthracite coal region. Suspicion, the lack of prompt service, different cultural practices , economic differences, the focus on miners as the primary beneficiaries of care, and the desire to be treated in a more familiar way prompted the people of the coal region to consult nonprofessional caregivers such as herbalists, midwives, passers, and powwowers and to take personal responsibility for their own health care via medical self-help. the company doctor When medical complaints grew louder and household remedies did not seem to be working or when a miner fell victim to an industrial accident, the miner or another member of the family consulted the company doctor. A monthly deduction from the miner’s pay gave him and his dependents access to a physician who was hired by the mine company. Despite their need for medical care, miners and their families were generally ambivalent 34 Y medical caregiving and identity about the company doctor because of the medical practitioner’s close ties to the mine bosses, his unreliability during emergencies, and his inability to bridge cultural gaps that existed between him and his clients. If the ailing person had the strength, he saw the company doctor at his office. If the person’s condition was critical and if he lived within the geographic area in which the doctor practiced, then the physician called on the patient at home. Whether in the office or at the patient’s home and depending on the case, the doctor offered a basic array of drugs, immunizations , and first aid. Labor and delivery and the treatment of venereal disease required miners to pay fees in excess of their monthly deductions.2 Because of these extra fees and their desire to be assisted by a local midwife, many laboring mothers declined the doctor’s assistance except during particularly difficult and dangerous births. Furthermore, company physicians recommended that medications be purchased at the company stores and not at independent pharmacies.3 Despite the need for health care in the coal region, the relationship between the company doctor and his patients was strained. Although a fictionalized account of the association between physician and clients, the book The Company Doctor epitomizes the tensions that existed. The preface signals the animosity between the miners and those who provided them with medical services. In fact, the goal of author and journalist Henry Edward Rood in writing the book in the late nineteenth century was to convince Americans of “the dangers which will result from unrestricted immigration.” To highlight the threats posed by new immigrants, he contrasted them ham-fistedly with the older class of immigrants, namely, Irish men and women, whom he portrayed as clean, hardworking subordinates. He described new immigrants, on the other hand, as “ignorant apes” and “cattle.”4 Rood also highlighted the distrust that miners felt as a result of the close connection between the physician and the mine bosses. The physician’s very title, “company doctor,” exemplified the suspicion that miners had for their medical caretaker. Like the company store, the company doctor existed for the company’s benefit.5 One of the book’s characters, Albert Weeks, points out the power that the owners had over the entire mining village: “They are known as ‘Company Houses.’ Everything is company in the coal regions. You are to be a Company Doctor, you know. Then there is the Company Store, and the Company Priest—although, of course, the latter is not known as such.”6 Weeks’s assessment emphasizes the awesome authority that the mine bosses were perceived to have had over not only inanimate objects but people as well. Very real incidents in the history of mining exemplify the link between the company doctors and the mine bosses. During the 1902 anthracite coal professional medicine in the anthracite coal region Y 35 strike, the United Mine Workers of America (UMW) argued for higher wages and shorter...