“You wouldn’t be here at all if you’d gotten a tetanus shot. This is entirely preventable.” I say this as I swab his arm, prepare the shot.

He snorts. “Don’t you start in on the vaccination rant, lady. I done heard it all.”

I snort back at him. “Well, next time you come in with an entirely preventable illness, I’ll remind you of that.”

“Took me an hour to get here,” he says, grumbling. “And this is the closest place to my land where there’s anything like doctors. And you ain’t even a doctor.”

“I’m a physician’s assistant, which as far as your needs are concerned, they are the same thing.” I stick the needle in while he’s formulating his response, slowly plunging the medicine into him. “If someone were to come to you, would you get vaccinated?”

He sighs. “Mebbe. But what, you’re gonna get in your little red city slicker car and drive out to my homestead? I’m fifteen minutes in a four-by-four to the closest electrical grid. Your little car wouldn’t make it a quarter of the way to where I am, lady.”

My car being the only one outside the clinic, it’s obvious it’s mine, I suppose. And for someone like Mr. Crenshaw, it says everything he thinks he needs to know about me.

“You’d be surprised the kinds of roads my little Audi can handle. It has world-class all-wheel drive, as a matter of fact.”

A snort. “There’s ruts your car could disappear into, and that’s just my driveway.”

“My husband has a pickup, if you must know.” I smile at him. “I already have a handful of clients for whom I do house calls. Once a quarter, meaning every three months, I will come to where you live with antibiotics and vaccines and painkillers—a veritable pharmacy, as well as a whole medical kit. And I’ll treat you, and your whole family.”

“And charge a mint for it too, I bet.”

“I’ve been known to accept value in trade.” I widen my grin. “Eggs, sides of ham, quarters of beef, bushels of fruit and vegetables, things like that.”

He blinks. “Bullshit.”

“Not a word of it, Mr. Crenshaw. I’m taking night classes to get my MD, at which point the name on the outside of this facility, and on the side of my husband’s truck, will be ‘Nadia Fischer, MD, Country Medicine,’ which means I’ll be practicing medicine the way it has been done out in the country for…well, a long time.”

“Why in th’damn-hell would you do a fool thing like that? Ain’t gonna make no damn money that-a way.”