I'm a nurse approaching my 50th birthday. Like D.C. in "Off to Africa?" (Insights on Death & Dying, February 2003), I've mused about making a difference in the lives of others.

About 6 years ago, my husband (a radiographic technologist) and I became disillusioned with the "big business" of medicine. Intending to leave the health care field altogether, we sought refuge in a small northwestern town. In our second year there, the local community health center recruited me; my husband joined us a year later. We've found our work here to be the most rewarding of our careers.

In the past 3 years, we've also been on two medical-mission trips to West Africa. The medical need there is raw, but we've experienced such an outpouring of love and gratitude that we're more than willing to go back. The work has nurtured our desire to help those who have no resources.

The interesting twist is that the medical needs in Africa mirror the needs of patients at our community health center. We've found our "calling" right here in our own American backyard.

So if leaving the country isn't your cup of tea, try working in a community health center instead. The need for altruistic hearts is great, and you might just find the most rewarding work you've ever done.