I was driving McClure Pass between Carbondale and Paonia a few months ago. Cell coverage had been spotty for much of the drive from northern Colorado, and I had turned my ringer off. Along the way, I kept telling my husband: We should live here. I loved the peaks, canyons and streams we passed. I imagined a different life: We could have animals, make gin, grow vegetables and make jam to sell at a farmers market. It was early summer, and the leaves of the cottonwoods and aspens were the color of limes, bright and small in the sunshine.
Then I noticed a text from my dad:
Mom has fallen. Her CT showed a small brain bleed of about 5 millimeters. We will monitor it and hope it does not increase. It may resolve naturally. There were no broken bones. She has a nasty black eye. Must have been quite a hard fall. She was on the back deck, which was wet with slushy snow, in bare feet. She tried to move some geranium plants and must have slipped.
My stomach sank. And my immediate reaction was anger. Why was she outside?! Why was she moving a pot in the wet snow that we’d thought was over for the season?! I sent an angry response. He wrote back:
What can I say? She didn’t tell me she was going out. I heard her call and thought she was in the kitchen. I went onto the deck, and she was lying there in her nightgown, which was wet and cold from the melting snow.
My thoughts quickly shifted to the care she needed but might not be able to get. There is a health-care crisis in the rural West. The week before my mother’s fall, she spent almost a week in the hospital, waiting for a specialist who never came. Suddenly I knew why I probably wouldn’t raise goats or make gin or have a garden full of produce to sell at a farmers market. I was scared that there was no medical care. And even in places with beautiful shiny hospitals, there were not enough doctors.
I AM FIRMLY part of the sandwich generation. I have small children I had in my 40s, and my parents are aging. One minute I’m signing my kids up for summer camp, and the next I’m asking my parents for their bank information in case I have to pay their bills. Asking for their passwords feels ugly and invasive.
Every time they visit us in Fort Collins, I ask them to move closer. My husband and I renovated our basement in hope that our parents would move in someday. We installed an accessible shower with safety bars and created a small apartment, so they’d know they were always welcome. My mother has yet to sleep there; when she visits, she sleeps in a small room upstairs to be near my girls, sharing a bathroom with toddlers.
When I beg her to move here, she says, “Why would I come live in a basement? We have a beautiful home in Wyoming. It’s where I’ve made my life.”
And it’s true: Their home is gorgeous. It’s in the foothills with an uninterrupted view of Casper Mountain. It is full of light, and they have a large garden where deer and rabbits graze. My dad lovingly plants an abundance of flowers every year. My mom has a large kitchen and a special rack for all her Indian spices. And all their friends are nearby. They have made a life in Wyoming for what will be 50 years this fall. They are rooted.
I was living in Wyoming when I was pregnant with Marigold. Because of my age, I was concerned about giving birth early. The doctors repeatedly told me not to worry. At one point, my OB asked me if I wanted to go on antidepressants. You are very anxious, she told me. But I knew there were only a handful of Level II NICUs in Wyoming, and none of them were in Laramie. And sure enough, on a night that was punctuated by the sound of owls hooting, I awoke knowing something felt off. Marigold wasn’t due for another two months. Minutes after arriving at Ivinson Hospital, I was asked which hospital in Colorado I wanted to be helicoptered to. I would not be having my baby in Wyoming.
I’ve since learned of other women who endured stress-filled life flights across the prairie to give birth, all for different reasons: No doctor, or a complex case that was beyond the capabilities of a rural hospital. A friend of mine recently had the surreal experience of going to an ER in rural Wyoming and being seen via telehealth by a doctor in Arizona.
My own mother had heart surgery in Cleveland because there was no cardiac surgeon in Casper in the late ’90s. After her surgery, she was in the hospital for six weeks. It was a lonely time, far from our community. I know of snowbirds who go to Arizona or one of the coasts for their medical care. When I was a kid, you were seen as fancy if you went to Denver to do your back-to-school shopping. Now it is medical care that the people I know go to cities for.
“Why would I come live in a basement? We have a beautiful home in Wyoming. It’s where I’ve made my life.”
HOW DO WE live in the places we love when the places we love can’t always care for us?
According to the National Rural Health Care Association, there are many obstacles facing rural care. Only 11% of U.S. physicians practice in rural areas despite serving a fifth of the nation’s population. Nearly 75% of smaller rural counties lack a psychiatrist, severely limiting behavioral health options. Between 2013 and 2020, more than 100 rural hospitals closed across the U.S. And the number of physicians per 10,000 people in rural areas is 13.1, compared to 31.2 in urban areas.
I laugh because I hate the city but will probably retire to one because the care will be better. Still, I can’t imagine growing old without a mountain or an expanse of sagebrush to look at.
Maybe the question isn’t how you make a home when a place can’t provide care for you, but what if the care just looks different? Maybe the care is a view of the mountains? Maybe it’s fat corn snow in the spring? Or being able to see friends within minutes? A life where people fill your fridge with casseroles and soup. Where they bring a branch of new lilacs to you in the hospital. Where they shovel the snow off your deck and crochet a blanket for you.
When I finally came home from the NICU with Marigold, I took her straight out to the prairie. For a whole month, all she had known was the inside of the hospital. The wind blew, and I covered her with a blanket knitted by the women in my knitting group. This is the prairie, I whispered to her. This is the alpenglow. This is the wind. Those are mountains. They will all care for you. She opened her dark eyes, and for the first time since she was born, I felt she understood. The land gives a kind of care that sustains you in ways no hospital ever could.
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This article appeared in the July 2026 print edition of the magazine with the headline “Urgent care.”
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