I’ve spent the last three years of my career as a doctor for the Amish.  It is frontier medicine.  I can regale you with stories of mangled hands immersed in cans of kerosene, arms and legs impaled with any number of small metal objects, injuries wrought by farm animals and table saws, of medical problems in states of extremis seldom seen and treated in outpatient clinics, of croupy toddlers finding relief from my breathing treatments at 2am.