This is the story of a General Surgeon in the American south, who grew up in a time when there was little or no air conditioning, accept for the super wealthy, and even some rural homes had no indoor plumbing. Following a two year stint in the Air Force during the Vietnam era, I completed my surgical training and began a long career in General, Pediatric, and finally Bariatric (obesity) Surgery in a medium-sized Southern American city. It was a sheer joy to be instrumental in totally changing peoples lives, particularly those who were morbidly obese. After doing over 4000 bariatric cases, and helping them to appreciate a new lifestyle and longevity, laparoscopy was added to bariatric surgery which almost spelled its doom initially. However, cool heads persisted, the surgeons got the proper training they needed, and open to laparoscopic bariatric surgery changed almost overnight, as learning curve complication rates plummeted. Rather than exposing my patients to same for the first several hundred cases in my late 60s, I decided to retire. Since I still had lots of energy, and realizing that one can only play so much golf, I recalled my residency days moonlighting in rural ERs. This book is dedicated to an almost endless string of characters who were the basis of the stories you will read about herein. It is certainly not meant as a how to do book in laymans ER medicine, but merely an entertaining treatise about so many things in this 9-year ER career, which brought so many smiles to my face. Not only did I get a great since of fulfillment as I realized how much diagnostic and fundamental surgical expertise is appreciated in the boonies, but also the thanks that I would get from the eyes and hearts of my rural patients. I was so privileged to see so many changes in equipment and knowledge, as well as diagnostic and therapeutic skills, compared to my past experience in early 1970s. All these things are described herein, and I hope you enjoy their descriptions as much as I have telling you these stories. Thanks in advance for listening.