And so, I too stalk with hope for a fruitful hunt for ruffed grouse. I'd like to even the score, bird (hawk) kills mammal (mouse), mammal (man) kills bird (grouse). "Fair is fair," whatever that means. However, my footsteps are hardly silent wings, nor can my vision be measured "sharp". Success for this man on this cold January day, too much with snow, too much with wind, seems unlikely. Success for the grouse seems much more likely. It matters not, for I am not in the woods today for success, but rather to be alone.

A dark, sad mood again dropped on me in the office this morning. It came with the fearful face and tearful eyes of a young homosexual. And last month too, it descended with a middle-aged man who had used IV heroin in Chicago. Twelve months ago, it arrived with a young pregnant woman whose lover used the same killing drugs. Twenty-four months ago, it appeared in the apparition of a bisexual business man: "Would the doctor test our baby without telling my wife?"

Not long ago, my subspecialty, infectious disease, was interesting and emotionally uplifting: interesting because of its biology, uplifting because most of my patients could be cured of their infections.

It is no longer that way. Now, a predatory virus stalks humans. It is a cruel, inefficient predator, slowly taking my patients' immunity and then their lives. Given a choice, I would rather fight a pneumococcus, which gives a quick winner-takes-all contest between pathogen and host. A pneumococcus is like a rough-legged hawk; with both, a clean escape can be made.

For a time I escape my morning sadness; a January hunt through the driftless region of western Wisconsin is distracting. Fields, woods, streams, and rivers; all are here to sample. And depending on the sun, or lack of it, and wind, or lack of it, these coulees can be sheltered and warm, forcing my coat open and brimming my hat with sweat. But, out of the ravine and over on the hill to the north, a very cold wind blows.

The human mind is fickle, always wanting new variety, new terrain. That can be in hunt, or food, or drink, or drugs, or sex. This drive for new experience can be our Achilles' heel. It is our cornfield above which our retrovirus hovers. "Should I take the risk? There doesn't seem to be a predator out today," think the mouse and the man.

Today, as I walk, I read frozen tracks of animals in white snow. Fox and rabbit, coyote and turkey, all have gone through their territorial rounds. I wonder where they are now, where they are going. Then, I think of my patients' futures. Where are they now; where are they going? The long-term prognosis is, to use the medical euphemism, "guarded". Seven years untreated? Perhaps, with luck, 14 with treatment? Not much time for these young adults who, until yesterday, had much longer plans.

In 15 years of practice, of treating, of caring, of comforting, there is one thing I have never done. I have never saved a life. I have only delayed deaths. So I help fight this virus with them. It is an emotional fight, a time-consuming fight, and in the end, a painful fight. It is hard to lose young people. My emotions scream, "fair is fair, not this". But I remember the tracks in the snow of the predators and prey. And I doubt grouse think of my predation as "unfair"; instead, they instinctively avoid me.

Suddenly, my thoughts are broken by an explosion of wings as a rusty-feathered blur flushes and flies straight away. It should be an easy shot, and yet, I can't react, surprisingly surprised. It does not seem so long ago that I hunted with quicker strides and more intensity. Then, I would have chided myself for not being alert. Now, smiling to myself, I watched the grouse sail downhill and into the safety of a stand of white pine.

Extremely adapted, the bird escaped easily. But, what of my patients, and my community? We will have to work hard for it. But, unlike other species, we can adapt with our knowledge, warn each other of our common danger, and help each other when illness strikes.

As I look down into the coulee, I find it changing as the midday starkness of black oaks against white snow has softened in the late afternoon light into hues of blue, purple, and pink. It is a familiar place, but I perceive it differently. Pulling two shells from their cold chambers, I drop them into my empty bag and turn toward home and office.