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Film / The Forgotten Frontier

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Making house calls.

The Forgotten Frontier is a 1931 documentary film directed and shot by Mary Marvin Breckinridge (billed as "Marvin Breckinridge") and featuring her cousin, Mary Carson Breckinridge. It is about the Frontier Nursing Service, an organization founded by Mary Carson Breckinridge in 1925 to provide medical care to the isolated and desperately poor rural mountain communities of Appalachia. The nurses of the Frontier Health Service range all over the mountains, riding for miles and miles on muddy dirt roads to tend to their patients, in all kinds of weather, fording rivers on horesback, braving rain and snow.

The film is divided into five parts. Nurses go about their rounds, delivering babies, inoculating children at a schoolhouse, tending to the sick. One segment shows the nurse at a child hospital taking in two sick babies whose widowed father can't care for them. The last segment shows a dramatic race to save a man who was shot off his horse by an enemy.

Mary Marvin Breckinridge, who had no film experience before she was recruited to make this film by her cousin, was a one-woman crew, not only directing but shooting the film as well as editing. It was shot as a silent film with Breckinridge toting around a hand-cranked camera herself. The result is one of the best documentary films of the era, one that ranks along with other early documentaries such as Nanook of the North and Chang.

Compare Stark Love, a scripted drama made four years before this film that was also shot on location in the Appalachians as a presentation of mountain life.


  • Afraid of Needles: A local tries to exploit this fear to stop the kids in one town from getting vaccinations, telling them that "It HURTS!" After a grownup steps forward and takes a shot, the kids do too. Yes, anti-vaxxers have a long history.
  • Book Ends: The same shot from an elevated point (apparently the nursing center) showing a town in the valley is seen as the first shot of the film and one of the last.
  • Death by Childbirth: All too real a problem in the hills of Appalachia in The Roaring '20s. An opening title card notes that more American women have died in childbirth than American men have died in war. In a later segment, the farmer dropping off the twin babies has been forced to do it because his wife died after delivering them, and thus isn't around to nurse.
  • Documentary: An excellent one.
  • Dramatization: Breckinridge admits straight-up in an early title card that most of what unfolds are dramatizations recreated by her and the locals after-the-fact. Apparently the recreations were true stories, though—the twins given up to the hospital grew up and got married, but the gunshot victim was shot and killed in a similar incident two years later.
  • Funetik Aksent: The title cards lean on this trope hard, with words like "paw" and "orphant" (orphan) to represent the accents of the locals.
  • Framing Device: A delegation of city folk come to visit Mary Carson Breckinridge at her nursing center. The various incidents are then portrayed as stories that she is telling her visitors. At the end the city folks express astonishment at the primitive conditions in the mountains.
  • Frontier Doctor: They aren't doctors, but the nurses of the Frontier Health Service fill this trope in every other way, riding horseback for fifty miles at a shot over difficult muddy mountain roads to deliver babies and take care of the sick. One actual doctor is shown in the last segment, going on a 25-mile ride that includes fording a river in order to tend to the gunshot victim.
  • Scenery Porn: The incredibly gorgeous cinematography—fog-bound valleys, snow-covered mountain trails, broad rivers that determinator nurses ford on horseback—is all the more amazing when one considers that Mary Marvin Breckinridge was essentially an amateur working by herself.
  • Travel Montage: An efficient one. A shot shows the North American landmass centered on the USA, the next shot shows a map of Kentucky, a hand with a pen fills in a few counties in Appalachian eastern Kentucky, a train arrives at a station, and another shot shows a sign for Hazard, KY.
  • Title Drop: The area is referred to as "this forgotten frontier", and titles point out that fifteen million people in Appalachia live in dire poverty without easy access to medical care.