Dr. Richard set the boy's arm on a flour sack because he had no table. The mother held a lantern. The father held the boy's shoulders. They were kneeling on the packed dirt floor of a grain shed, because the shed was closer than the room above the tavern where Dr. Richard slept and worked and stitched and mixed tinctures on the same short bench. The boy screamed once when the bone went back. Then he breathed. Dr. Richard tied the splint and washed his hands in a bucket the father had drawn from the well. "Thank you, doctor," the mother said. "We ran to the tavern first. The girl there said you were out at the mill." "I was." He had come from the mill. Before the mill, a fever house at the edge of the plow fields. Before that, a birth. He was fifty-one years old and he had not slept a full night since the settlement passed two hundred souls. He walked back through town in the last of the light. He counted roofs the way other men counted coin. Forty-one now. Last spring, twenty-eight. Every new roof was another cough, another axe wound, another child. He was one man. One bad fever season would bury him and half the town with him. He needed a second doctor. He needed a nurse. He had written letters to three river towns asking for anyone with training willing to come. He had not sent them yet. He had nowhere to put a visitor once they arrived. No exam room. No cot for a patient to lie on overnight. No shelf for another physician's tools. A doctor who rode in and found a tavern bench would ride out again by morning. He stopped at the empty lot behind the community hall. Cut timber lay stacked there since spring, meant for a granary the council had cancelled. He had walked past this pile a hundred times. Tonight he stood in front of it. In the morning he went to the council. He offered his savings for the timber and the lot. He asked for four men for two weeks. He told them plainly: without a building, no second doctor would come, and without a second doctor, the next fever season would empty houses. They agreed before noon. The crew raised the walls in nine days. Dr. Richard worked with them between calls. He planed the door himself. He hung a plank sign above it that read First Doctor's Office in black paint that ran a little at the O. He stood on the new porch that evening. Two windows. A front room for waiting, a back room with a cot. A shelf for a second man's bag. He went inside and sat at the desk and started the letters again. Now he had something to offer. He also had, he realized, nothing left in his purse to pay whoever answered.

The letters sat in a stack on the desk. Dr. Richard had written six of them the week the office opened. He had sent four. Two had come back with polite refusals. Two had not come back at all. He knew why. He had offered room and board and a share of what patients could pay, which in a young settlement was often eggs, or nothing. No trained doctor would ride three days for eggs. He pulled the ledger from the drawer and opened it under the lamp. The numbers had not changed since the last time he looked. His savings were gone into the timber and the lot. The council had given labor, not coin. He had spent his last silver on lamp oil for the exam room. He closed the ledger and walked out onto the porch. The sign above the door still smelled of paint. He stood there until the cold got into his coat and then he went to find the sheriff. McDuffie was at the jail house cleaning a rifle. He looked up when Dr. Richard came in and set the rag down. "You look like a man about to ask for something," the sheriff said. "I am. I need the council again. Not for timber this time. For a purse." McDuffie shook his head before Dr. Richard finished. "There's no purse. The fence and the trenches took what was left. After what happened at that cabin, every coin went to posts and sharpened stakes. You know this." "Then the town will bury people this winter." "Maybe. But it won't be from raiders, and that's the vote you'd have lost." Dr. Richard sat down on the bench by the door. He was too tired to argue the point. He said, "Then I need another way. A subscription. Every household that can, pays a small sum each month. In return, they get treatment when they need it. The money goes to a second doctor's salary." McDuffie picked the rag back up. "You want me to knock on forty-one doors and ask for coin." "I want you to come with me while I do it. They'll open the door for the badge. They'll listen because of it." The sheriff worked oil into the barrel and thought. "Start tomorrow. I'll give you a week of mornings. After that you're on your own." They walked the settlement for six days. Some doors gave a coin. Some gave a promise. Some gave nothing and shut fast. By the end of the week Dr. Richard had pledges from twenty-nine households and a small locked box with enough silver in it to offer a real salary for one year. He went back to the office that night and wrote the letters again. This time he named a figure. He sealed them and set them by the door for the morning rider. Then he sat down and waited to see who would answer.