This story by Adam Haslett explores the frustrations of a young government psychiatrist as he makes a house call to evaluate a remote patient. The woman, living with guilt, depression and fear after the death of her methamphetamine-addicted eldest son, wants to renew her prescriptions. The doctor strongly believes she is also in need of therapy, but faces two problems in providing it: distance (a five-hour round-trip to see her), and the woman’s refusal to participate. Themes include social change, rural poverty and lack of opportunity, shattered dreams, disillusionment, substance abuse, guilt, PTSD, alienation, biological psychiatry vs. clinical psychology.