When young RN Kate Jacobs switches from nursing to paramedic medicine and social work, she soon finds herself in a remote area of the Appalachian Mountains, where many challenges await: technical cliff rescues and hikes into remote back-country “hollers” to remove child victims of sexual assault from their homes, only to have an indifferent judge order them back the next day. This memoir is filled with tales of heartbreak and laughter, courage and cowardice seasoned with a candid look at the early days of social work and emergency rescue medicine. Warning: Some graphic content