I am a Palliative Care Clinical Nurse Specialist, currently based in Orange (rural) NSW and for my 4 day PEPA clinical placement I was keen to see a couple of specialist units in the Sydney metropolitan area. My first area of interest was Motor Neurone Disease (MND). MND is a challenging disease and made more so in rural NSW. The disease is rare enough that health professionals across the board get very little exposure and therefore little experience caring for someone with MND. My goal was to see what services the city units offered their patients, and to see how that could be adapted to a rural setting. I returned home having exhausted my poor brain, but very grateful for having had the opportunity to see and do so much in such a short time.