For that first day, just over a year ago, I had had my grey, slightly pinstriped suit dry-cleaned and bought new shirt, shoe laces and after-shave to emphasize a fresh start. As I drove up to the clinic (somewhat early), I weighed up the pros and cons of the job I had accepted: pros—nice part of the country, relaxed life-style, pleasant people; cons—rather professionally isolated, no university, no in-patient unit (or was this one a pro?).