For years, I promised patients, colleagues, family and friends that I would write a book about my experiences as a rural generalist family physician. Since I completed that book, Reflections of a Country Doctor, many encouraged me to write another book with more of my stories about my early life and my experiences as a doctor in the trenches of rural America. Since another single book could never tell a complete story, I have settled for more of the story that you will find in this book. While completing a student athletic trainer's course at the age of twelve, I decided that I wanted to be a doctor. Except for my teacher at the time, most folks thought I was daydreaming. Not many kids from the south side of Billings, Montana, went off to become doctors. Heck, many of these kids never finished high school. My parents did not finish high school nor had any of their fifteen brothers and sisters. Many of my one hundred or more cousins did not graduate from high school. The knowledge I acquired in my biology, chemistry, and physics classes in high school only amplified my excitement for the science of medicine. However, I believe my most motivating class was American history in my sophomore year of high school. My teacher described in detail how the implementation of sanitation systems, expanded vaccination programs, and improved personal hygiene in the early part of the 1900s dramatically reduced childhood mortality and almost doubled the average life expectancy in America by the middle of the twentieth century. In medical school, I unearthed a boundless arena for learning outside of the classroom. During my free time, excursions to the emergency room, obstetrics, the cardiac intensive care unit, and the newborn intensive care unit provided me with marvelous hands-on experiences that I would use in later years. In the medical school library I renewed my interest with some old friends including Lister, Pasteur, van Leeuwenhoek, and Koch. I found other medical greats that enthralled me including Crawford Long, M.D., the first to use general anesthesia for surgery in 1842, William Worral Mayo and his sons, William and Charles, who expanded the work of Lister and Long to perpetuate the specialty of surgery, Sir William Osler, the master of observation and diagnosis, and Jonas Salk, the founder of the polio vaccine. I was in the group of medical school graduates who experienced the last of the Ironman internships. After my class graduated, the permitted number of training hours for new doctors-in-training was reduced substantially. Many in medicine think the politicians and the educators made a mistake with these changes. Indeed, many things changed during my career in medicine, some for the better and some not. Despite these changes, however, one constant remains: people continue to need medical assistance with their illnesses and their injuries. This book spans my experiences from my early childhood through my clinical years. Like my previous book, Reflections of a Country Doctor, this book is about reality; it is about events in our collective lives that happen to our friends and our neighbors daily. I hope you enjoy the journey.