ESMERALDA COUNTY — They’re the Thelma and Louise of Nevada’s unpeopled expanse.
Advanced EMTs Val Trucksa and Nancy Knighten race along lonely backroads to dispense what they call “medicine in a ditch,” responding to calls across 3,500 square miles in an isolated county with the nation’s second-lowest population density.
Each time they leave “the barn,” the two best friends begin another life-and-death mission rushing patients they know by first name to the nearest full-service hospital that’s not exactly around the bend.
Actually, it’s located 70 miles away — in California.
In more than a decade, they’ve never lost a patient in their medical dashes across an area the size of Rhode Island, a county with a people-to-land ratio rivaling the Australian Outback. All that despite snake bites, people slamming into wandering cows and horses in the dead of night, and violent two-vehicle collisions.
“It’s a huge, huge territory,” Knighten says. “But we have a rule: Nobody dies inside our ambulance. Nobody has a baby, either.”
The aging volunteers — Trucksa is 69 and Knighten is 73 — wonder how long they can keep going. But in a county with a population density of one resident every 4 square miles — the second-lowest in the contiguous U.S. after Loving County, Texas — ready replacements are hard to find.
Lifestyle not for everyone
With 964 full-time residents scattered halfway between Las Vegas and Reno, Esmeralda County provides a snapshot into what demographers say is a fast-disappearing rural way of life in the American West.
Residents eke out an existence in a place with no incorporated communities, no high schools, no traffic signals and just a handful of stop signs. About 350 inhabitants live in the county seat of Goldfield, 150 in Silver Peak and another 350 in the westernmost Fish Lake Valley, a 45-mile-long oasis of greenery amid the desolate spread of high desert.
In tiny Dyer, the valley’s social hub and home base of the EMTs, there are no doctors and no medical facilities. The nearest hospital is across the state line in Bishop, the closest chain grocery store is 70 miles away, the jail 84 miles distant.
Esmeralda County has three times as many miles of dirt road (1,500) as it does paved highway (458). The Fish Lake Valley has two resident deputies who can drive hundreds of miles on a call.
“When you get into your patrol car on a call, you know you have a long ways to go,” Deputy Sheriff Ken Aldrich says.
The last homicide was in 2013, the next-previous killing 25 years before that. Still, residents are used to protecting themselves. Many carry concealed weapons, and a sign posted inside the Dyer general store bears two six-shooters and reads: “We Don’t Dial 911.”
Life in the slow lane
Paved roads and electricity didn’t reach the Fish Lake Valley until the early 1960s. Even today, when any of the 45 students graduate from the elementary/middle school, they face a four-hour round-trip bus ride to the nearest high school in Tonopah in adjacent Nye County.
There’s an easy-going, don’t-rush-me approach to life. But a sense of hardship lurks. Out here, houses are dirt-cheap, but home loans are a hassle because banks are skittish about the long distances to doctors, hospitals and fire stations. Some residents are retirees, others are farmers, still others are outsiders who have come here to restart or stay lost.
The shifting state economy has eroded the population. By 2035, census studies show, that 964-person population will drop 22 percent to just 753.
And Esmeralda County has plenty of company.
“A lot of these smaller rural counties across America are facing similar issues,” Nevada State Demographer Jeff Hardcastle says. “There are fewer people because of a smaller and not very diverse economic base.”
Those left in the agricultural Fish Lake Valley point to a lack of traffic, direct contact with nature, a proud sense of self-sufficiency and a code of conduct that makes people feel not like neighbors, but family.
Around here, if somebody gets sick, people go visit or pass the hat. If a vehicle breaks down, they stop and help. Reminded there are no stoplights, one quips: “We don’t need a stoplight.”
The place has a sense of humor. One of the valley’s two bars is called The Boonies. A T-shirt for sale in the general store reads “Where the hell is Dyer?” while another shows a road mileage sign that says “ End of the World: 9 mi. Dyer, Nev: 12 mi.”
Ralph Keyes, an alfalfa farmer and county commissioner, says the county isn’t rich. “There’s a trade-off here,” he says. “We don’t expect a lot from you, so don’t expect a lot from us.”
Country life requires common sense, he says. “You have to have a hardy pioneering spirit,” Keyes adds. “If you want street lights and curbs, stay in the city.”
Still, he worries about preserving his conservative and independent way of life. Farming has its bad years, and that new lithium mine up in Silver Peak won’t boost the economy forever.
“Sooner or later, it’ll play out,” he says. “It’ll be gone.”
Every day he spends in the blissful middle-of-nowhere reminds him why he came here more than a decade ago.
“This morning, I was up at 4 a.m. I rode an open tractor and watched the sun rise. I smelled the hay and watched the coyotes trot out of the fields, with the cool air and sun on my face.”
He pauses, reliving the moment.
“Just being part of that keeps me here. The smells, the sights, the taste of dirt in your mouth.”
Roots run deep
The two Hudson brothers are taking a break from their chores, resting under the shade of an elm tree their father planted generations ago.
Rodney Hudson, now 74, remembers a time without electricity when you went to bed when the sun went down. The brothers left in the 1970s when jobs were hard to find. Now retired, they’re back in Nowheresville and loving every minute of it.
For years, Darrell Hudson, 69, lived in Las Vegas, where traffic throbbed 24 hours a day and people acted like they owned the road. He crosses his arms, leaning back on a parked ATV.
“I think our rush hour is going on right now,” he says. “We might have two or three cars an hour. If you’re lucky, you’ll see them go by.”
The brothers relish the fact their county is financially solvent, a place with so little bureaucracy there are no building or permit officials poking their noses into your business.
“You build a house out here, and if it falls on your head, well, that’s on you,” Darrell says. “You say, ‘I shouldn’t have done that. I won’t do it next time.’”
Not everyone fathoms their mindset. Darrell tells the story of a friend who visited from San Francisco many years ago. He shook hands with the brothers, looked around and said, “This is the boonies! This is ridiculous!”
Then he got back into his car and drove away.
“It was too wide open for him,” Rodney says matter-of-factly. “He couldn’t take the nothingness.”
The brothers share a laugh. “He’d still be freaked out, even today,” Darrell says. “Because not much has changed around here.”
General store owner Linda Williams moved to the valley as a girl in the late 1950s. At just under 5 feet tall, she’s a “spark plug” who fires a Type-A personality in a laid-back town.
A few years ago, at age 65, she finished off getting her law degree. Along with running the general store, she operates a local museum, is writing a history of the valley and also pens children’s books.
Decades ago, when her family sold property here, she stressed to newcomers how rough the living could be. “People would ask ‘Do you have city water? City sewer?” And I’d say, ‘No, we don’t even have a city.’”
Still, many have relocated here, moving into a small subdivision outside town. They eventually realized that at 5,000 feet of altitude, the air is thin, the winter hard and the wind often blows.
“If you can’t survive a power outage for two or three days, don’t know how to store food items or can’t light a kerosene lamp, you shouldn’t be here,” she said.
While Williams has put the general store up for sale and plans on living in Dyer only part-time, she knows she’ll miss the slow life — the kinship of neighbors and the fact she can roam the valley in a truck with a broken tail light and not get bothered by police.
She, too, worries about the future of the place. “There’s not enough around here to keep the young people from getting bored and the old people from dying,” she said.
In Dyer, life revolves around the picnic tables outside Williams’ general store. One afternoon, Phil Todd suddenly got talkative. Now 55, he moved here because of health issues. At first, the place scared him to death.
“I looked around and said, ‘Oh my God, what’s there to do?” he says. “Three months later, I realized there weren’t enough hours in the day. There’s the local hot springs, gold panning, rock hunting and old mines and ghost towns to explore.”
‘Never been happier’
Not many people owe the serenity of the Fish Lake Valley for saving their life. But Greg Dedera does.
A few years ago, while working in Colorado as an engineer for Lockheed Martin, he was diagnosed with a brain tumor. He figured his days were numbered, so he simplified his life.
“I had eight credit cards in my wallet, four bank accounts, two kids in school.” These days, he pays his taxes, cellphone and car insurance bills, and that’s it. He has no more credit cards.
He found the Fish Lake Valley on a fluke. Decades ago, he traveled the area on a backpacking trip and remembered its beauty and solitude. On the website Lands of America, he found a small cabin and 5 acres alongside a creek high in the White Mountains. All for $75,000.
Williams showed him the place. “It took me less than 20 minutes to ponder it,” he recalls.
Nowadays, he works a few freelance IT jobs around the valley, but he mostly cavorts with his sidekick, a coon hound named Lola. “This is the brokest I’ve been in my entire life. I made more money delivering newspapers as a kid. But I’ve never been happier.”
Dedera’s brain tumor is still there, inoperable. But after four years of the Fish Lake Valley life, he’s off all of his medications.
He tells his sons about the peacefulness here and calls the hammock strung next to the creek “better than a Xanax.”
On a recent evening, he sat on his back porch, Lola by his side, with a commanding view of the Fish Lake Valley to the east. He’s named one distant peak Mount Marge because to him it resembles the wife in the Simpsons cartoons.
A lot of people might consider this place the end of the world.
“For me,” he says, “it’s spiritual.”
‘We’re not spring chickens’
Advanced EMT Nancy Knighten had a plan: She was going to give up her ambulance life, quit her volunteering and retire for good on her 73rd birthday.
Knighten has been here for decades, arriving back when the ambulance was a donated family station wagon. But time rushes on.
“We’re not spring chickens,” said partner Val Trucksa, who moved here from Beverly Hills, where she worked as a physician’s assistant. “Now we don’t bounce out of bed as readily.”
But Knighten didn’t retire, she says, because she can’t. In such an unpeopled place, volunteers are rare. Many young people have jobs and families.
Older residents who might have the time aren’t in good enough health.
It doesn’t help that the requirements for becoming a rural EMT have become more stringent.
There are difficult tests. The guidebook that once totaled 400 pages now has 1,500.
Even after the Fish Lake Valley got 911 service a decade ago, Trucksa and Knighten still receive more calls on their personal cellphones than through the county dispatcher.
Residents stop by with aches and pains and ask them to come to their homes to check their pets.
Yet despite their constant pleas for volunteers, nobody has stepped forward. The pair now looks at the future of emergency care in wild Nevada, and they worry.
“What will they do when we’re not here?” Trucksa asks. “And there will be a time, and soon, when we’re gone.”
Award-winning journalist John M. Glionna, a former Los Angeles Times staff writer, may be reached at firstname.lastname@example.org. Follow @jglionna on Twitter.