The Legacy of the Stoney Fork (Tenn.) Health Clinic

from Caryl Carpenter, posted July 2023

Stoney Fork, Tennessee is an isolated area in the southwest corner of Campbell County.   Stoney Fork is approachable from three ways, all over unpaved gravel roads.  The road from the North comes in from Norma in Scott County, and at one point crosses a stream that, with any significant rainfall, makes the road impassable.  The road from the southwest is a long bumpy one that connects with state Rt. 116 midway between Briceville and Petros.  The shortest route, the one from the northeast, goes over Caryville Mountain with its 18 switchbacks where you can encounter coal trucks racing down the mountain to deliver the coal mined nearby. Weather can also interfere with this road.

Stoney Fork and the adjacent communities of Shea, Beech Fork, and PeeWee Camp were at one time in the heart of the deep mining coalfields.  Including neighboring Clinchmore, the population was about 3,000 in the early 1970s.  With the decline of deep mining, many were forced to move.  In the Spring of 1964, during a period of heavy rains, a flood decimated Clinchmore and killed six people, forcing even more people to leave the area.  There has been considerable speculation about the cause of the flood.  Many people believe it was the impact of strip mining on the surrounding mountains.

The number of students in the old Stoney Fork School decreased from 300 in the 1960s to 80 in the early 70s.  Most of the people lived in old houses or trailers on the one road through Stoney Fork.  There were two small stores still open in the 70s and several churches up and down the road.

The churches were the center of activity in the community.  Once each year, usually in early summer, there is a church homecoming where all people who have ever attended over the years come together for a day of services, singing, and home cooked meals.  There are many out-of-state people at these gatherings, people who moved away to find work but always come back for homecoming.

The folks in Stoney Fork made a living in a variety of ways.  Some worked across the mountain in Caryville or LaFollette.  Others drove trucks or farmed for a living.  Some received welfare or black lung benefits.  In 1971, Stoney Fork had a 26 percent unemployment rate and a 70 percent underemployment rate.  These rates continued to get worse throughout the 1970s.

As in other parts of Appalachia, Stoney Fork and the surrounding communities underwent significant change.  When deep mining flourished, there were jobs.  Even though people were poor, they enjoyed economic stability.  Families stayed together and children never moved far from home.  People in Appalachia have always been self-sufficient and fiercely independent.  All the supplies and services they needed were nearby.  Even though the terrain is rugged, most families had gardens.

Two factors significantly weakened the economic and social fabric of the area:  1) changes in land and mineral ownership, and 2) the closing of the deep mines.  Around the early 1900s, large corporations began to buy up land, or if not the land, the rights to the minerals underneath it.  People received what to them was a large sum of cash in exchange for their land or mineral rights, and they were told that they could still live on the land.

Mechanization in the coal mining industry put many miners out of work.  As men were laid off from the mines, there were no other jobs for them in the area.  Many moved north to Cincinnati, Cleveland, Chicago and Detroit.  It was usually young families that left.  In many cases, there were no young people to care for their elderly parents, as had been the tradition in the past.

People whose ancestors had sold the land were told to move.  People who no longer owned their mineral rights found huge bulldozers on their property, ripping up pastureland, timberland, and gardens.  Landslides caused by strip mining threatened their homes and destroyed the land.  Serious flooding occurred with each rainstorm.  Streams, wells and springs were damaged by acid and mineral seepage and by heavy silting.

Strip mining could be very profitable for the mine owners, but none of the profits remained in the area; they flowed elsewhere, even as far away as New York and England.  In the five-county area (Campbell, Morgan, Scott, Anderson and Claiborne) that supplied 80 percent of Tennessee’s coal in the 1970s, 75 percent of the land was owned by outside landholding companies.  Eighty-five percent of the coal wealth was controlled by fewer than 10 owners.

These were the factors that undermined the economic stability of the region.  In no place was this truer than in Stoney Fork.  There was no investment by local or state governments to revitalize the region, create new jobs, or provide support services, including health services.  In the early 70s, Stoney Fork had been without a doctor for more than 25 years.  Before that, the only doctor in Stoney Fork worked for a coal company that provided many of the jobs on the mountain.  When the mines closed, the doctor left.  By 1972, the nearest doctor was an hour away, over the three often unpassable roads that led to Stoney Fork.

The Vanderbilt Student Health Coalition identified Stoney Fork as a good location for a health fair and began organizing in the area in 1972.  The first health fair was in the summer of ‘72.  Unlike some other communities where the Coalition worked, Stoney Fork did not have an organized group to work with.  However, many people in Stoney Fork had heard about the health fairs in other communities.  A loosely-knit group formed to work with the Coalition workers to talk about their health needs.  Eventually the group requested a health fair.  The health fairs took place in June and July of that year.

A key player in the health fairs at Stoney Fork and other communities was the Tennessee Valley Authority (TVA).  TVA had an elaborate mobile health laboratory it used for its own employees at some of its construction sites and remote locations.  Coalition representatives asked TVA if they could borrow the lab, and they said yes.  This gave the Coalition free lab space, a place to take blood samples, do EKGs, chest x-rays and other tests.  A smaller, less elaborate TVA trailer was used as the clinic in Stoney Fork until a permanent building was completed.

TVA trailers used for health fairs and temporarily for Stoney Fork Clinic

After the health fairs, law students from Vanderbilt helped the community form and incorporate a health council.  The Stoney Fork Health Council was incorporated on August 30, 1972.  The three incorporators were Odes McKamey (who became the president of the health council), Harold Wilson, and Ruby Lawson.  They began the process of building a permanent clinic at Stoney Fork.

Odes McKamey working on construction of the Stoney Fork Clinic

Odes McKamey working on construction of the Stoney Fork Clinic

A second set of health fairs took place in Stoney Fork in 1973.  There were 62 adults seen at these events.  Only 40 percent of the adults had seen a physician in the last 3 years.  The most frequent diagnosis among the adults was some form of heart disease, followed by COPD, Black Lung disease, and dental caries.  Eighteen percent of the chest x-rays provided and 18 percent of the EKGs were abnormal. Most patients with abnormal results were referred to Coalition-affiliated physicians (48 percent) and 29 percent were referred to local doctors.

There were 49 children screened at the health fairs.  The most common diagnoses for these children were dental caries and parasites.  The majority of those seen were up-to-date on their immunizations, ranging from 84 percent for DPT to 67 percent for rubella.

Odes and Shelby McKamey were among the most cherished local hosts for members of the SHC when the health fair arrived in their remote mountain community of Stoney Fork, Tenn. Odes and Shelby both came from coal mining families.  Shelby was born at home in Rosedale; Odes was born in Lafollette.   Odes drove a gravel truck for the county.  Shelby eventually became the clinic receptionist.  Odes’ father, Walter, was one of the first patients at the clinic.

After the Stoney Fork Clinic was established, the McKameys also housed and hosted visiting doctors who came to the clinic, including Tom John. Odes died in August 2017.   

You can read Tom John’s eloquent memoirs about his time with Odes and Shelby here.   As he explains in that essay, Odes and Shelby were the “bedrock of our involvement in Stoney Fork…I know that for Bill Dow, for me, and for numerous other SHC folks, our friendship with Odes was an integral part of the profound influence that the Student Health Coalition had on our lives.”

Odes and Shelby McKamey with their two children, Sheree and Junior, and Dr. Tom John

In his remembrance, Tom John mentioned Papaw (Walter) McKamey.  The elder McKamey had worked in the coal mines, and by the time of the health fairs, he had serious heart and lung disease.  Walter’s conditions required him to see a doctor at least twice a month, sometimes more often.  Before the clinic opened, he had to travel more than an hour over the switchbacks of Caryville Mountain to see a doctor in LaFollette.  Once the clinic opened, he could walk to see a doctor.

In an interview with a reporter for TVA’s magazine, Odes said, “this is about the best thing that has ever happened to Stoney Fork.  Before we got the health center, we had to travel an hour in any direction to find a doctor, although there is a doctor within 15 miles.  Here in the mountains you don’t measure distance in miles, but in time.  The roads are steep and mostly bad.  Many are not paved.  Some are just dirt.  You don’t cover much distance very fast.”

In a 2017 interview, Shelby McKamey and their daughter, Sheree McKamey Craig, talked about the kind of leader Odes was.  He was someone who knew how to get things done.  As Shelby said, “he could charm the pants off a snake to get what was needed.” Without him, the Stoney Fork Clinic never would have come into existence.  Sheree said, “you always went to Odes if you wanted to get something done.  I’m proud of my Dad.”

Shelby McKamey, Caryl Carpenter, and Sheree McKamey Craig.

Given the challenges of raising funds, the members of the Stoney Fork Health Council (SFHC) concluded it would be difficult to operate as a solo clinic in a small town.  The SFHC decided to join with health councils in Norma (Scott County) and Petros (Morgan County) to form Mountain People’s Health Councils (MPHC).  They decided to use the model developed by United Health Services in Campbell County of a circuit-riding physician who regularly visited small clinics that were staffed by nurse practitioners.  The National Health Service Corps agreed to place nurse practitioners in each Mountain People’s community, along with a full-time physician who would visit each clinic once or twice a week.  Mountain People’s also received Federal funds from the Rural Health Initiative Program to cover operating expenses for the three clinics.  The MPHC Board also hired a full-time administrator, Duane Sexton, and a secretary, Janice Laxton, to provide administrative services to the three clinics.

The Stoney Fork Clinic opened in the summer of 1974.  Rick Davidson, a Student Health Coalition alum, was the first circuit-riding physician who visited Stoney Fork once a week.  The first nurse practitioner was Pat Karpinski.  The second nurse practitioner was Kathy Bowman, a graduate of the Master’s program at the University of Pennsylvania.  Shelby McKamey was hired as the receptionist and lab assistant.  Kathy Dougherty was hired as the outreach worker.

Shelby McKamey, Kathy Dougherty, Kathy Bowman, and Odes McKamey in front of the Stoney Fork Clinic