But her career also revealed how much the system relied on individual sacrifice.

A government could point to a reservation physician and claim that medical care existed.

That did not mean one doctor could realistically meet every need.

When Susan rode through snow for hours to reach a patient, the story demonstrated dedication.

It also demonstrated the absence of infrastructure.

Heroic labor can hide institutional failure.

The more extraordinary Susan’s work sounds, the more obvious the underlying shortage becomes.

She should not have had to be extraordinary every day.

No sustainable health system should depend on one person repeatedly risking exhaustion and illness.

Susan eventually reached the same conclusion.