1997.321 pages. ISBN 0874517990.$24.95. Order phone 800-421-1561.

Field of medicine: Family medicine and primary care.

Format: Hardcover book.

Audience: Physicians, residents, and medical students interested in examining the life of a physician in a small town. The book is also directed toward readers interested in journaling as a means of spiritual insight and personal growth.

Purpose: To give the reader access to the daily routine, the relationships, and the inner life of a vanishing species: the country physician. The reader follows the physician to the examination room, to meetings with colleagues and staff, and to the sanctum of home and family. The book is also a spiritual journey of a man in mid-life, coming to terms with his career, his community, his faith, and his changing role in the family.

Content: The book chronicles a year in the life of a family physician practicing in a working-class community on the coast of Maine. It has a simple, elegant structure that consists of one chapter for each month, distilled from the author's journal. The reader is exposed to the day-to-day thoughts, feelings, and activities of an author who believes that God is in the details. Each season is introduced, and the book concludes with reflective essays, many of which pay tribute to mentors, forebears, and the fathers of family medicine.

Highlights: The most impressive feature of the book is the author's ability to paint a detailed portrait of the life of a rural family physician while reflecting on the meaning and purpose of that life.

Limitations: The book's only limitation is that it is too heavily laden with details of interest to the author and his colleagues, friends, and neighbors rather than to a wider audience.

Context: This book is reminiscent of the clinical narratives of William Carlos Williams, who was immersed in his work and in the life of the working-class community in which he practiced. Many readers will be reminded of John McPhee's Heirs of General Practice, which also chronicles a year in the life of rural family physicians in the state of Maine. Like McPhee, Loxterkamp is careful to connect contemporary rural physicians to their generalist forebears and portrays the family physician as a quietly heroic pillar of the community. Others will compare this book with the this-worldly spiritual journals of such authors as Annie Dillard and Kathleen Norris.

Reviewer: Warren L. Holleman, PhD, Baylor College of Medicine, Houston, Texas.