Book excerpt: In 1964, newly-minted physician Stephen C. Joseph, just out of his internship, undertakes a two-year assignment as the Peace Corps Physician in Nepal. The job has two facets: responsibility for the health and medical care of a hundred young Peace Corps Volunteers scattered over the roadless hills and valleys along the uplift of the Himalayas, and “do whatever else you want to do in medicine.” Many lessons not learned in medical school challenge his ingenuity and inexperience: Learn to carry your office in a backpack trekking two-week circuits through the countryside visiting volunteers and holding impromptu clinics in isolated villages. Struggle with the contrasting responsibilities of being both the “Company Doctor” and the patients’ trusted confidant. Rely on your own judgment without medical peers or teachers within reach to guide you. Come to grips with the realities of Third World poverty, whose determinants are not easily remedied by Western medicine. Some of the lessons are baffling. Some are brutal and terrifying. Some are humorous, and some rewarding beyond measure. And Dr. Joseph finds what is to become a life-long heart’s desire: “doing what you can with what you have,” especially in the more-remote places of the world. Later, back again in the Third World, Dr. Joseph is part of a small international team starting a country’s first medical school, and has responsibility for the crowded “Under-Five’s Ward” in the medically-primitive conditions of the Capitol City’s hospital in Yaounde, Cameroun. But it is mysterious Chad, on the edges of the Sahara, to which he is most drawn, a little older and a little wiser, but just as restless. STEPHEN C. JOSEPH’s life in medicine has taken him to residential assignments in Nepal, Central Africa, Indonesia, and Newfoundland, with shorter stints in more than a score of countries in Africa and Asia. His home-based efforts have included Neighborhood Health Centers, and appointments as New York City’s Commissioner of Health, Dean of the University of Minnesota School of Public Health, Assistant Secretary of Defense for Health Affairs, and senior positions with UNICEF and the US Agency for International Development. He is a former Chair of the American Public Health Association, a Fellow of the American Academy of Pediatrics, and an elected member of the Institute of Medicine. His previous books include “Dragon Within the Gates: The Once and Future AIDS Epidemic,” and “Summer of Fifty-Seven: Coming of Age in Wyoming’s Shining Mountains.” He lives in Santa Fe, New Mexico, with his wife, Elizabeth Preble.