I examine the use of spatial concepts by rural health care practitioners in Northern California and suggest that rural and urban spatial metaphors are important means of expressing and (re)producing problems associated with their search for legitimacy and moral authority within afield of relations defined by biomedicine. I present three broad ways in which spatial metaphors are used by rural health care practitioners to continuously enact a “metaphorical landscape.” I situate this landscape in the context of a hierarchical field of relations within biomedicine, which is itself underpinned by a distinct urban bias and the uneven distribution of material and technological resources. I suggest that this landscape is partly the result of the rural health care practitioners' position within this field of relations and partly the result of implicit and historically situated frameworks of spatial meanings derived from capitalism, [rural health care practitioner, United States, landscape, metaphor, embodiment]