I'm very happy to have landed in the Gulch...every day I work to find and create my own gulch. I read Atlas Shrugged 18 years ago for my 30th birthday and quit my job the following Monday to go out on my own...to earn for my own...to judge my own...and be accountable to my own. My wife and I are in medicine and have shared multiple copies of Atlas Shrugged and particularly John Galt's speech for 18 years now. We even have a secret weapon for identifying those who may be gulch-worthy...our youngest daughter is named Dagney Reardon Crowley. I know...I know...the spelling is different. and, it may be blasphemous that we did what Ms. Rand did not in linking these two names together (but didn't you want them linked formally...at least for a while). In case you are wondering this kid is worthy of the name. She actually exhibits all of the social prowess of Ms. Rand herself (that is sarcasm). I love to serve young physicians...but, I serve who I want and on my terms. I hope more of them will discover the moral imperative is not the Hippocratic Oath...but the code to apply their skills to a patient population for a value equation unencumbered by administration or bureaucracy.