Brian's story reminds me of the backpacker's creed...'Take only pictures, leave only footprints', I agree that there are many who have gone before to lay trail.

I think however, that there is also a similarity to the forestry crews that come through after big storms...some trees have fallen over the path, a portion of the path has washed into the stream and the bridges have washed away. There are some areas of burn or clear cut, where new planting or growth will need to occur.

We need to make certain that patients are on the trails with the healthcare equivalent of what outdoor legend Harvey Manning calls 'the ten essentials' in Mountaineering: the Freedom of  the Hills. Otherwise they may be out there in the elements without what it takes to survive.

We need to reestablish or create some new and reliable ways for patients to get between the havens that are our medical practices.