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This fourth book in the Small Mountain Quartet is rich with detail about the medical history of the West: the doctors and their wives and their influence on Flagstaff, a small town in northern Arizona. The fabric of their lives creates on intricate pattern of the evolving western frontier.

Other pieces of the pattern are added through the voice of Marlene, wife of a Phoenix physician, who had to cope with her husband's deepening depression and its effects on her marriage and her life. As a w...