When Dr. Donald Guthrie arrived in Sayre in 1910, it was home to the third-largest railroad repair shop in the world. A small hospital, the first in the region, had opened 25 years earlier to care for those injured in this dangerous work. Fresh from surgical training at the Mayo Clinic, Guthrie brought with him a vision and the energy and charisma to make his dream a reality. He started Guthrie Clinic, one of the oldest multispecialty group practices in the nation, and established Robert Packer Hospital as the region's premier destination for hospital care. Guthrie's reputation as a surgeon grew, and the hospital cared for leaders of business, government, and society alongside the townspeople. Through two world wars, the Great Depression, and a devastating fire-in which no lives were lost-nothing slowed Guthrie's vision, and it has become a lasting legacy. More than 200 photographs tell the remarkable story of the transformation of a small rural hospital into an award-winning integrated health care system.