Dr. Sandip Mathur, born in India and trained in England and Houston, writes about his third year as a young doctor in rural Texas. The third year was very different. Dr Mathur shifted from general medicine to his specialty and treated a new set of emergencies: massive internal bleeding, swallowed explosive batteries, cancerous growths, and other challenges. Not everything went well. He faced skepticism and derision from his rivals in the big city and his plans to move there were blocked. He reconfigured and adapted an unconventional strategy to persevere and remain a specialist in the field.