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July is an interesting time at our small rural clinical campus. In addition to the bright faces of our new M-3 students just settling into their routine while awaiting their USMLE step one scores, we host a group of our rising M-2 students just before they return to Louisville for their second grueling year of basic science education. They spend three weeks shadowing their future faculty and working with our college rural scholars as they solve a clinical case in small groups. Also these two groups conduct free school and sports physicals at local health departments in towns of 600. The rising M-2s perform the physical exams under the watchful eyes of certified health department nurses and supervised by myself or another family medicine faculty. The college rural scholars assist during the physical exams and then take each schoolchild for individual anticipatory guidance. The students use a script they have developed as a group and provide the counselling in a room that includes hands-on props they have collected to keep the kids engaged. Both college and medical student groups leave us with wistful looks and eager anticipation of returning next summer. This July an interesting opportunity arose. One of our rising M-2s had grown up in close proximity to a rural Amish enclave and visited there regularly as the Amish men shod his grandfather’s horses. A certain bond had developed, demonstrated perhaps most beautifully and touchingly by an Amish horse-drawn wagon bearing his grandfather to his final resting place after his funeral (Figure 1). This student contacted me suggesting that we provide some kind of health screening for one extended family, with the primary contact being the pastor of the congregation church, a man in his thirties. We had just begun a cardiovascular screening project in the county that hosts our campus, and we set out to do something similar for our student’s friends who live 90 miles away in an agricultural area. On a very warm, clear summer morning, I arrived about 15 minutes late because of call responsibilities and my inability to believe that the first sign I saw for squash and tomatoes could really be my turn. My students were already busy inside. As I carefully pulled my car out of the way among buggies undergoing repair, I noticed a very large van with a conventionally dressed woman loading vegetables just bought from the Amish vegetable stand. As I approached the house and noticed the traditional garb of the men and women, they all stopped and looked up with the quizzical gaze I’ve seen among the deer with which I share my backyard. Once inside, as I watched our students work I felt a sense of peace within the strange but welcoming atmosphere. As a reflective exercise, I asked each student to put their impressions on paper separately, and what follows is an interesting summary of their perspectives. As I had hoped, each viewed the same experience through the lens of their previous life experience and their level of medical training, resulting in a rich mosaic. The closing piece by the student closest to the Amish community provides a perfect biblically-inspired summary of what we all felt as we returned to our all-too-modern lives. -Bill Crump, M.D., Associate Dean, Trover Campus I pulled up to a large, white house that was bustling with women in dresses that covered their ankles and bonnets that covered their hair, men in long sleeves and suspenders, and children who were dressed exactly like their older counterparts. To my relief, I spotted a medical student, dressed differently from the bustling crowd. Next to him was a young Amish man dressed in a blue, long sleeve button up shirt with black pants, suspenders, and straw hat, smoking a corn cob pipe. I didn’t realize it at the time, but I was looking at the two critical components in making this health screening possible. A relationship between the young Amish man and the medical student bridged the gap between our cultures and allowed us, as strangers, to enter their home and collect private medical information. The day began with our liaison gathering his Amish family in the large living room of their house. Men and women ranging from their late teens to older adults, mostly married couples, were present. These were the people that we were to screen. The screening included a finger stick that would yield blood

In the Eastern Fields of Eden