First of all, what I want to know is this: Who the hell was Desjardins talking to on the phone about his murder plans? "Hi, Mom. Yes, the demonic resurrection plan is going well. I've only got one murder left, and I've already picked out the victim. Her name is Sarah Logan. But don't tell anybody or you'll spoil it!"
Anyway, to answer the original question, Deborah didn't run a switchboard to connect calls. That would have been the function of the local telephone company. This was 1970s Virginia, not 1890s Alaska. Even rural areas were served by a telephone company that provided ALL telephone service. It's clear from the dialog that she didn't take a job with the phone company. She started her own business, which could not have been in competition with Ma Bell. There were no alternatives to the phone company; it was a total monopoly.
What Deb did was run an answering service. That's why she mentions taking calls for doctors, lawyers and other prominent people. Answering services were the only way to have your phone covered when you were out in the days before answering machines, cell phones, voicemail and text messaging. When she talks about covering for philanderers and the like, she means that she would lie about their whereabouts to callers to keep their secrets safe.
I sort of vaguely remember that, at least in movies and TV shows, answering services were depicted as having mini-switchboards like the one in the attic. I don't know if you could listen in on calls on the lines you served, too.
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