Changes continue to occur in all of our lives. In the year or so since I visited the ten PSAP graduates profiled in this book, half have experienced significant changes-in their personal lives, in their practice s, and in medicine. Thane Turner and his wife have a happy and healthy new son, Benjamin. With Catherine O’Neil’s practice now staffing the University Health Service, she has taken on the added role of medical director of Bloomsburg University. Catherine and her husband also moved into their new house, further up the hill, and are expecting their second child. And Joe Nutz moved into his new computerized office and was joined by his new partner.