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In 1953 young surgeon Robert H. Ruby began work as the chief medical officer at the hospital on the Pine Ridge Indian Reservation in South Dakota. He began writing almost daily to his sister, describing the Oglala Lakota people he served, his Bureau of Indian Affairs colleagues, and day-to-day life on the reservation. Ruby and his wife were active in the social life of the non-white community, which allowed Ruby, also a self-trained ethnographer, to write in detail about the Oglala Lakota people and their culture, covering topics such as religion, art, traditions, and values. His frank and personal depiction of conditions he encountered on the reservation examines poverty, alcoholism, the educational system, and employment conditions and opportunities. Ruby also wrote critically of the Bureau of Indian Affairs, describing the bureaucracy that made it difficult for him to do his job and kept his hospital permanently understaffed and undersupplied. These engaging letters provide a compelling memoir of life at Pine Ridge in the mid-1950s.