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Moving Mountains: Creating the Nurse Practitioner and Rural EMS
365 pages
Published January 27, 2025
7 people want to read
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March 2, 2026
Part memoir and part anthology of tales about Idaho’s back country, in the final analysis this book is an homage to an extraordinary woman. That woman, Marie Osborn, fought her way into her position as the lowest paid, hardest working, and most dedicated nurse practitioner in the country—or at least in Idaho. In the process she opened the doors to the many nurse practitioners and dedicated physicians and physicians assistants who walked through the doors of the Salmon River Clinic to learn the art of medicine from the ground up.
Marie had already lived a rich and full life before moving with her husband and family to the remote village of Stanley, Idaho, cradled in the Sawtooth Mountains. Once there, she fell in love with the mountains, the community, and her position of back country caregiver in a region that had previously been devoid of reliable medical care. Not only did Marie establish the Salmon River Clinic and Stanley Ambulance service, she also cracked open and nurtured a new type of medical practice by becoming the first licensed nurse practitioner in the state.
Much of the text is Marie’s first-person account of her life before, during, and after her career as one-woman health complex for the remote Idaho backcountry. The eight parts of this book introduce the reader to Marie’s family. She shares a clear-eyed assessment of the toll her work took on her marriage. A host of dedicated volunteer first responders who worked with Marie during her years as director of the clinic come to life on these pages. Through Marie’s and her colleagues, we learn how she repeatedly butted heads with genderism in the field of medicine. We have a nail-biting peek over the shoulders of Marie and her special cadre of EMTs as they tend to the cavalcade of injuries both small and deadly that occur in the back country. These case studies are written in such a way that the reader feels like they are right there in the midst of the struggle. By the end of each episode when the outcome is revealed, news of survival lifts our spirits; the report of a life ended is a sucker punch. Marie’s memories are supported by first-person accounts from a slew of backcountry heroes: town leaders, EMTs, ambulance drivers, government resource managers, doctors and teachers that she worked with, as well as some of the medical school students that she mentored along the way. The coda to each of these personal stories is gratitude and respect for all that Marie did for the writer and for the Stanley community.
I felt my own life connecting with Marie’s adventures in many unexpected ways. I was surprised and thrilled to learn that she had worked at Harborview in Seattle and speculated whether she had crossed paths with my now-deceased relative whose nursing career played out at Harborview also. I could relate to Marie’s involvement with the Bogus Basin ski racing program. I couldn’t believe the number of names that I recognized from my years living in southern Idaho and even that of a retired Forest Service employee with whom I now volunteer alongside on Idaho Fish & Game projects.
It is clear that the reason Marie was so good at what she did, and was able to accomplish so much, is her innate humble approach to life. She never stopped learning, never stopped asking questions, never stopped striving for the best possible outcomes, never stopped recognizing the contributions of others. When describing her self-made position as nurse practitioner, she says, “A nurse practitioner is not a mini doctor; a nurse practitioner is a super nurse.”
Brief but heartfelt plugs from Marie and her colleagues about the many issues that small communities face in a changing world are cradled within the personal stories. A few topics include: salmon sustainability and the lower Snake River dams, dwindling funds for the already starved Forest Service and National Park Service, motorcycle safety—if there is such a thing, financial support for rural EMS, and gentrification of mountain communities. The influx of second-home owners who don’t or can’t (because they’re not present) volunteer in the way original Stanley year-round residents did threatens the sustainability of an all-volunteer health service, yet funding is ever inadequate to pay for professional healthcare.
A serious book about serious subjects, there are plenty of humorous turns of phrase peppered throughout the text, as well as fabulous photos and a solid index. My only complaint about this beautiful book is why such a text-heavy book that needs to be read from beginning to end was designed in such an awkward coffee table book format.
Marie had already lived a rich and full life before moving with her husband and family to the remote village of Stanley, Idaho, cradled in the Sawtooth Mountains. Once there, she fell in love with the mountains, the community, and her position of back country caregiver in a region that had previously been devoid of reliable medical care. Not only did Marie establish the Salmon River Clinic and Stanley Ambulance service, she also cracked open and nurtured a new type of medical practice by becoming the first licensed nurse practitioner in the state.
Much of the text is Marie’s first-person account of her life before, during, and after her career as one-woman health complex for the remote Idaho backcountry. The eight parts of this book introduce the reader to Marie’s family. She shares a clear-eyed assessment of the toll her work took on her marriage. A host of dedicated volunteer first responders who worked with Marie during her years as director of the clinic come to life on these pages. Through Marie’s and her colleagues, we learn how she repeatedly butted heads with genderism in the field of medicine. We have a nail-biting peek over the shoulders of Marie and her special cadre of EMTs as they tend to the cavalcade of injuries both small and deadly that occur in the back country. These case studies are written in such a way that the reader feels like they are right there in the midst of the struggle. By the end of each episode when the outcome is revealed, news of survival lifts our spirits; the report of a life ended is a sucker punch. Marie’s memories are supported by first-person accounts from a slew of backcountry heroes: town leaders, EMTs, ambulance drivers, government resource managers, doctors and teachers that she worked with, as well as some of the medical school students that she mentored along the way. The coda to each of these personal stories is gratitude and respect for all that Marie did for the writer and for the Stanley community.
I felt my own life connecting with Marie’s adventures in many unexpected ways. I was surprised and thrilled to learn that she had worked at Harborview in Seattle and speculated whether she had crossed paths with my now-deceased relative whose nursing career played out at Harborview also. I could relate to Marie’s involvement with the Bogus Basin ski racing program. I couldn’t believe the number of names that I recognized from my years living in southern Idaho and even that of a retired Forest Service employee with whom I now volunteer alongside on Idaho Fish & Game projects.
It is clear that the reason Marie was so good at what she did, and was able to accomplish so much, is her innate humble approach to life. She never stopped learning, never stopped asking questions, never stopped striving for the best possible outcomes, never stopped recognizing the contributions of others. When describing her self-made position as nurse practitioner, she says, “A nurse practitioner is not a mini doctor; a nurse practitioner is a super nurse.”
Brief but heartfelt plugs from Marie and her colleagues about the many issues that small communities face in a changing world are cradled within the personal stories. A few topics include: salmon sustainability and the lower Snake River dams, dwindling funds for the already starved Forest Service and National Park Service, motorcycle safety—if there is such a thing, financial support for rural EMS, and gentrification of mountain communities. The influx of second-home owners who don’t or can’t (because they’re not present) volunteer in the way original Stanley year-round residents did threatens the sustainability of an all-volunteer health service, yet funding is ever inadequate to pay for professional healthcare.
A serious book about serious subjects, there are plenty of humorous turns of phrase peppered throughout the text, as well as fabulous photos and a solid index. My only complaint about this beautiful book is why such a text-heavy book that needs to be read from beginning to end was designed in such an awkward coffee table book format.
Displaying 1 of 1 review