I fell out of a tree when I was in the fourth grade. It was a spectacular autumn day with leaves on the ground and a clear sky over-head—a day made even better by the fact that school had gotten out early for a local holiday. My closest friend and I had spent the day in the way curious nine-year-olds know best–riding our bicycles down leaf-strewn roads and picking apples from my parents’ orchard before feeding the cores to our horses.

Eventually, this play led to one of our favorite places—a tree house that my father had built high in the branches of a tall willow. But when I stepped out of the tree house onto a limb where I usually didn’t venture, I knew something was terribly wrong. Falling to the ground, I remembered jumping off the high-dive during swimming lessons the previous summer. A split second before I landed on my right hip, I remember thinking “I wish there was water down there.”

But there was no water underneath that high branch, only the tall grass and small stones of my father’s horse pasture, and I was momentarily knocked unconscious. I woke up to the sounds of my friend running into my parents’ home screaming “Dr. Walker! Dr. Walker! Annie is hurt,” and then moments later was scooped up as my dad carried me into the house and then to the hospital for X-Rays. My father had been in the shower, getting ready to go to the hospital for his evening rounds, so I remember his wet hair and clean skin, but because he had spent the afternoon working on our small farm—and then quickly pulled on the same coveralls he’d been wearing to come get me—I also remember the strong smells of manure and hay mixed with soap and shampoo from the shower.

Luckily my leg was not broken, just badly bruised, and although I walked with a limp for the next six weeks, I think the real reason this story has stayed with me is because of what it contains: a childhood growing up surrounded by all a rural community had to offer, and in the middle of it all, a father who, in spite of his big city medical training, was very much a country doctor.

But as a child, I never thought twice about living in the country or about my father being a physician. Both facts were simply part of my landscape and I never considered either one to be special—or at odds with each other. I figured all children’s father’s raised gardens and horses and beef cattle; and that all physicians wore cowboy boots, helped their neighbors build fences or find lost livestock, and shared garden produce with their patients each fall. I never considered it odd that my dad delivered babies or performed surgeries because I had seen him deliver lambs and knew that he could fix most of the things that broke on our farm. To my eyes being a physician and being a farmer were both roll-up-your-sleeves kinds of work, and as a child, it was pretty unclear to me where one started and the other ended.

Perhaps some of the confusion about roles came because my father’s way of practicing medicine was not ostentatious and did not call attention to itself. In his wide-brimmed hat and flannel shirt, he simply looked like everyone else in town, and although I never thought about it at the time, it seems important to me now that he never wore his stethoscope around his neck—a mark of distinction that would have separated him from those he served. Rather, he coiled it and put it in his pocket, letting it rattle around with whatever else was important for the days work: a screwdriver and pocketknife, a key to the tractor, and a slip of paper reminding him that it was his turn to change the irrigation water that ran through our farm.

Observing my dad working like this, I slowly came to understand that his way of practicing medicine also helped build community. Every summer before the boys in our town went to scout camp, they would come to my parents’ home on a Sunday evening and my father would perform, free-of-charge, the physical exams required by the camp. And long after his colleagues in urban centers did away with house calls, my father still made them. Usually they would come in the form of a middle-of-the-night phone call: someone’s father or grandmother or child was ill. Would my dad mind taking quick look to see if they needed to go the hospital?

But I think some of my best memories came when I actually got to help my dad. I accompanied him on rounds at the hospital and while seeing patients in his office. Over the years, I watched him suture, set broken limbs and write prescriptions. I also spent countless hours in the waiting room of the hospital watching family members pace while my father delivered babies or performed minor surgeries.

Growing up like this, I learned that sick people and injury were not necessarily scary, and that attending to illness could be rewarding. More important, because most of my father’s patients were people I knew—the brothers, sisters, parents, aunts and uncles of my school classmates—I came to see medicine as a thread that wove through and connected community. Because everyone’s body would eventually fail them somehow, a doctor could be a part of many people’s lives. But because these people were also my peers and neighbors, I did not see my father’s doctoring as any different from the other occupations that also connected community. People’s cars broke down, too, and everyone needed haircuts. In this setting, being a physician was not about prestige, but about being willing to play a role, and to participate in the day-to-day workings of a small town.

Initially, none of my father’s children followed him into medicine. My brothers selected careers in diverse fields and I spend my twenties in graduate school and teaching English—looking, I think in retrospect, for language and stories to contain the experiences of my childhood. But although my father never urged any of us toward medicine, I have to wonder if it pleased him that I eventually decided to go to medical school. It was a decision that seemed to bring both of us full-circle. When I returned to my hometown to do premed and then was accepted at a nearby medical school, it seemed that I had returned not only to the kind of work that influenced my childhood, but also to the community it was a part of. To this day, it is difficult to say which came first–the longing to return to my childhood home or the desire to become a physician.

Perhaps they are both the same thing.

* * *

The preceding paragraphs comprise the bulk of an essay that I wrote during my second year of medical school. I added a conclusion and submitted it to a national medical journal that sometimes publishes personal essays. It came back from the editor with a long list of questions that sounded a lot like the kinds of comments I would have made on a student paper when I was teaching College English: What was the essay aiming to be about? My childhood? Growing up in a rural community? My relationship with my father? The role of a physician in community? And how was my father-as-physician connected to all of this? Could I find a major thread and organize the other observations around it, please? In terms of these questions, I knew the editor was right on, but she also made comments I hope I would have been wise enough not to include in revision notes for a student paper, including an elaborate armchair psychoanalysis of my relationship with my dad. I had been to enough therapy by then to know my family-of-origin issues pretty well, but being the focus of amateur psychobabble stung, and I set the essay aside for a while.

Eventually, I picked it up, again, and with the help of a much more creative and insightful editor, performed the requested revision. I turned the new essay into an in-depth exploration of how watching my father practice medicine had led to my decision to become a doctor. Gone were the autumn country scenes, stories of irrigations turns, and the episode of falling out of a tree. It was a much more orderly, straightforward piece, and the journal accepted the revision for publication. “But they also killed it dead,” the kinder more creative editor exclaimed when I told her the news. “All the mystery is gone.”

I stumbled across this draft and found myself thinking about the experience of revision as I was unpacking and organizing files after my recent move back to the Intermountain West. Five years on, the draft—with all its sprawling, competing themes—means more to me than the published piece. I say this, because in its disorderly way, it holds mysteries and pieces of information I am still trying to understand—my call, in my thirties, to go to medical school; my simultaneous longing to return to my childhood home. Like many writers, I set down words not to say what I know, but to look for language that explains what I do not yet understand.

And all these mysteries seem more important because of where the last five years have taken me: to a home in a community not far from where I grew up, and to a job as an emergency room doctor in a rural town about an hour and a half away. I drive through sagebrush and desert-scape to get to the little hospital where I now practice. The nurses who are my colleagues sometimes feed livestock before coming to their shifts, and many of my patients chew tobacco and wear cowboy boots. The volunteer EMTs and paramedics who staff our ambulance often arrive in the ER performing CPR but wearing manure on their shoes. “Why did you come here?” people ask when they learn about the big cities I lived in during my twenties and early thirties, and I don’t always know what to say: That I like rural communities? That I feel at home in wind-swept, wide-open spaces? That my father was a country doctor and I am following in his footsteps? That I could not help myself?

Then I come back to the draft of this essay, which in all of its messiness is the best answer I have so far: that the reason I chose to become a country doctor is all of these things. I am a product of the landscape that shaped my childhood, of parents and neighbors who influenced me, of work I watched adults do while growing up, and of much, much more. Answers like this make for messy essays, but they also may make for richer, more mysterious lives. The truth is that I cannot put my finger on just one thing that led me to go to medical school or to pursue the job I have now. This reality frustrates me, but it also makes me wonder if tight explication of every life decision is really a worthy goal—and if living the mystery may hold truths of its own.

In the conclusion to her first, rejected draft, my five-years-younger self shows a comfort with mystery and this mess-of-influences that I envy and look to it for guidance, now: “. . . when it becomes difficult to remember why I chose this new career, I slip my hand into my own pocket and feel the cool head of my stethoscope with its snaked rubber tubing—next to a small pocketknife with gadgets for all kinds of emergencies, a tiny flashlight, and the pen I am writing with now. Like the small stones from the horse pasture where I fell, these items ground me, and remind me of who I am. They are medallions not just of medicine, but of home.”

What she might also have said–and what I am beginning to understand as clichéd, but also true–is that at least in my case, the apple did not fall far from the tree.