CHAPTER 7
Settling Into Practice
Goldpine
Caleb's first weeks in Goldpine proceeded through the practical business of establishing his medical practice, unpacking his considerable store of instruments and medicines, and gradually meeting the district's various families through the steady stream of minor complaints and injuries that provided any small-town physician his most reliable early patient base.
He found the work, while considerably less sophisticated than his Philadelphia practice's more complex cases, oddly steadying in its plain, practical demands — a broken arm requiring straightforward setting, a persistent cough wanting simple treatment, the ordinary business of medicine practiced without the particular weight of Philadelphia's more socially prominent patients and their correspondingly elevated expectations.
Ruth, true to her earlier offer of general orientation, appeared at his office with some regularity through these early weeks, ostensibly to assist with introductions to various families but proving, in practice, rather more useful for her considerable knowledge of the district's various residents and their particular medical histories, knowledge she had accumulated through years of assisting Doc Hansen with his own practice whenever the old physician had required an extra pair of hands.
“You nursed alongside Dr. Hansen?” Caleb asked, some weeks into their now-regular working arrangement, genuinely surprised by the depth of practical medical knowledge Ruth casually displayed while assisting him with a difficult splint.
“I did, rather extensively, these past several years.
He'd no proper nurse of his own, the position being difficult to fill in a town this size, and I found myself drawn into the work gradually, first simply fetching supplies and eventually managing rather more substantial responsibilities as he came to trust my steady hand.
I'll confess I've delivered no small number of this district's children myself, when circumstances required faster action than waiting for the doctor to arrive from whatever other emergency currently occupied him.”
“That's remarkable practical experience for a woman with no formal medical training whatsoever.”
“I'd not claim any formal expertise, Doctor, only considerable practical exposure and a steady disposition in moments of genuine crisis.
I'll defer entirely to your superior training on any matter of actual medical judgment, but I'll own I've grown rather useful for the practical business of assisting, fetching, and generally keeping a crisis organized while the actual medical decisions get properly made.”
Caleb found himself, working alongside her through these early weeks, increasingly grateful for precisely this practical usefulness, Ruth's steady presence and considerable local knowledge easing his own transition into the position rather more thoroughly than he had initially anticipated any single person's assistance might manage.
She knew which families could be trusted to properly follow treatment instructions and which required rather more explicit supervision; she knew the particular temperaments of the district's various children, information that proved considerably useful when treating young patients too frightened to properly communicate their symptoms to an unfamiliar physician; she knew, above all, how to maintain a calm, steady presence in moments of genuine medical crisis, a quality Caleb had come to value considerably in the aftermath of his own catastrophic loss of composure during Eleanor's final illness.
“You've a genuine gift for this work,” he told her, one afternoon, after she had managed to calm a thoroughly terrified young patient sufficiently for Caleb to properly examine a nasty gash requiring stitches.
“I'd wager you missed your true calling, Miss Larson, in choosing ministry work over formal nursing.”
“I'd not call it a missed calling, precisely, Doctor. I've found the ministry work and the informal nursing rather complement each other nicely, both requiring much the same essential qualities — patience, steady presence, and genuine care for whoever's suffering happens to require attending.”
“I find myself, more each week, genuinely grateful for both qualities in you, Miss Larson, whatever calling you've ultimately chosen to pursue them through.”
This small compliment, offered with more evident sincerity than Caleb's usual careful professional courtesy generally permitted, settled between them with a warmth that neither commented on further, though Ruth found herself, walking home that evening, replaying the exchange with rather more attention than a simple professional compliment likely warranted, and wondering, not for the first time since his arrival, what precisely lay beneath this careful, guarded physician's evident reluctance to consider any possibility beyond strict professional courtesy in their now-regular working relationship.
The town itself, meanwhile, had begun forming its own collective assessment of the new physician, an assessment that Mrs. Petty, as was her general custom, saw fit to deliver directly to Ruth during one of the mercantile's regular busy mornings.
“He's a fine enough doctor, by every account,” she observed, counting out change with her usual brisk efficiency, “though I'll confess he strikes me as a rather sadder man than his medical competence alone would suggest. There's something in his eyes, watching him work, that speaks of considerable private grief, whatever professional composure he manages to maintain over it.”
“I believe you're not mistaken in that assessment, Mrs. Petty, though I'd not presume to discuss his particular circumstances without his own consent to share them.”
“I'd not ask you to violate any confidence, dear.
I only observe that a man carrying that particular quality of grief generally requires considerable patience and genuine kindness to properly heal, rather more than mere professional courtesy alone can provide.
I'd wager this whole town's collective goodwill might serve him rather well, given time, same as it's served every other newcomer who's arrived here carrying similar burdens.”
This observation, offered with Mrs. Petty's usual blend of blunt honesty and genuine warmth, settled into Ruth's ongoing consideration of her own growing role in Caleb's adjustment, and she found herself, walking home from the mercantile that same afternoon, resolving to extend rather more deliberate patience and kindness toward his continued healing than her already considerable efforts had thus far provided, though she remained, at this early stage of their acquaintance, only dimly aware of how personally invested in that healing she would eventually become.
Caleb's medical practice, meanwhile, continued its steady, encouraging development, each successful treatment building incrementally toward the restored professional confidence he had traveled so far to seek.
He treated a mining injury requiring careful suturing, a child's persistent cough that responded well to his prescribed remedies, an elderly rancher's rheumatism that he managed to ease considerably through careful attention to the man's diet and activity, each small success accumulating into a growing sense that his medical judgment remained sound, whatever catastrophic failure Eleanor's death had once seemed to suggest about his fundamental competence.
“You seem more settled today,” Ruth observed, one particular afternoon, noting a lightness in his manner that had been notably absent during his earliest weeks in town.
“I'd wager your practice's steady success is beginning to properly restore whatever confidence Philadelphia's difficult circumstances diminished.”
“I believe you're correct, Ruth. I find myself, treating this district's various ailments, gradually remembering why I first pursued medicine at all — not merely the intellectual satisfaction of diagnosis, but the genuine privilege of helping people through their most vulnerable moments.
I'd nearly forgotten that particular satisfaction, buried as it had become beneath my own considerable grief and self-doubt.”
“I'm glad to witness that remembering, Caleb. I'd wager Eleanor would be glad of it too, watching you rediscover the very calling that first drew you to her father's own mentorship all those years back.”
This gentle observation prompted Caleb to share, for the first time, the particular story of how he had first come to pursue medicine, a calling that had taken root in his boyhood watching his own mother nurse a younger sibling through a nearly fatal illness, the family doctor's evident skill and compassion leaving an impression that had shaped the whole course of his subsequent education and career.
“I'd nearly forgotten that original inspiration myself, buried beneath years of increasingly technical training and Philadelphia's rather more clinical professional culture.
I find this territory's plainer, more direct medical demands rather refreshing, in their way — they remind me of exactly why I wanted to become a physician in the first place, before the profession's more polished expectations somewhat obscured that original, simpler motivation.”
“I'd wager that's precisely the gift this territory offers a good many transplants, Caleb, myself included — the chance to rediscover, away from more complicated social expectations, exactly what genuinely matters about whatever calling first drew us to our chosen work.”
“And what was it, precisely, that first drew you to ministry work yourself, Ruth? I've never properly asked, though I confess considerable curiosity now that the subject's arisen.”
“I suppose it began simply as necessity, given Josiah's own considerable youth when our parents died and his ministry training still incomplete.
But I found, over the years of assisting him, a genuine calling of my own developing within what began as mere practical obligation — the particular satisfaction of helping frightened newcomers find their footing in an unfamiliar place, of watching lonely hearts find genuine partnership, of being useful in ways that mattered considerably to people navigating real hardship.
I don't know that I'd have chosen ministry work for myself, given entirely free choice from the outset, but I've come to genuinely love the calling regardless of how circumstance first delivered me to it.”
“That's rather similar to my own eventual relationship with medicine, I think, examined honestly. We've each found genuine purpose in callings that circumstance, more than pure free choice, first delivered us toward.”
This shared recognition settled comfortably between them as the afternoon's light began its gradual fade toward evening, and Caleb found himself, watching Ruth continue her careful work organizing his medicine cabinet, reflecting on how thoroughly this quiet conversation had deepened his understanding of the woman who had become, in these few short weeks, considerably more essential to his own adjustment than he had initially anticipated any single person's assistance might prove.
He walked her partway home that evening, as had become their comfortable habit whenever the day's work concluded near dusk, and found himself, watching her animated account of some minor town matter unfold beside him, experiencing a lightness he had genuinely believed himself no longer capable of feeling, the whole weight of Philadelphia's accumulated grief seeming, for these few precious minutes, considerably more distant than the actual miles separating him from that difficult city.
They parted at the familiar fork in the road, Ruth continuing toward the parsonage and Caleb turning back toward his own small house, and he found himself, walking the remaining distance alone, whistling a tune he had not properly noticed himself whistling, understanding only afterward, replaying the small moment in his mind, that he had not whistled anything at all in the whole considerable span of months since Eleanor's death, and finding the small, unconscious gesture rather more significant than its simple, cheerful nature might have otherwise suggested.