As part of testing candidates' abilities, patients are used in clinical examinations for professional qualifications throughout all specialties and levels of medicine. However, the patients' views on being used for these purposes have not been investigated. Examiners use the opportunity presented by candidates interviewing patients in an examination setting as part of the test of a candidate's ability in psychiatry. Psychiatric patients' experiences of such examinations may be so different from that of most clinical practice that there may be profound effects on their views of themselves, their illnesses, hospitals and of the profession itself.

For the purpose of this article, a specialist psychiatric unit refers to any community project, out-patient clinic, hospital ward or, as in the case of Henderson, a whole hospital which specialises in providing a specific type of treatment or treatment to a particular patient group(s). Specialist psychiatric units may be particularly vulnerable at this time when, because of the implications of Working for Patients, many psychiatrists' minds are focused on the need to justify and define their ‘core services’. Many specialist psychiatric units are directly funded by their hosting Region. If Regional Health Authorities do not maintain special psychiatric units directly then a high financial risk will be put on any District Health Authority or self-governing hospital which hosts them. If the latter fail to accept the financial risk, or take the risk and then suffer financially, there is the possibility that both a wealth of specialist expertise will be lost from the psychiatric profession as a whole and that certain patients will receive substandard or no treatment. It may be, therefore, that there is now a need specifically to justify the continued existence of specialist psychiatric units. Henderson Hospital, a therapeutic community specialising in the treatment of severely personality disordered young adults, is a case in point.

Having gone to the trouble of organising a day conference on ‘The Psychiatrist in Court’, primarily directed at trainees, we were disappointed to find that on the day the considerable audience was composed mostly of consultants. This seemed a pity, particularly as we knew that this was an area of concern to many young psychiatrists. Kindly colleagues assured us that it is always difficult to get juniors to attend conferences. Nonetheless we were curious to know why trainees seemed more reluctant to take time away from their normal duties than perhaps their ‘more pressed’ consultants.

In this issue of the Psychiatric Bulletin (pp 72–76), Dolan & Norton discuss the need to protect specialist psychiatric units such as the Henderson Hospital. They describe a variety of functions of these units, but only make brief reference to training. I would like to describe my six months in psychiatry spent as a registrar at the Henderson Hospital. My enjoyment of the placement may not be synonymous with the Henderson serving an important training function, but I hope that I can explain why the two may be linked.

Edinburgh. She had recently taken up a locum tenens at the Royal Free Hospital in Gray's Inn Road in place of one of the resident staff who was away on holiday. The Lancet records that she was “seen in the hospital and about the wards up to noon on Saturday 15th (August), but since then nothing has been seen of her nor had anything been heard of her up to Thursday morning. We trust that before the paper is in our readers' hands Miss Hickman's whereabouts and safety will be made known to her father, with whose anxiety in the situation we sympathise deeply”. By 29 August nothing had been heard, though Miss Hickman's sudden and apparently motiveless disappearance had by then attracted a great deal of public interest. She had been a brilliant student, attending the London School of Medicine for Women, where she had consistently gained Honours and Prizes. Her first job was as Junior House Surgeon at Clapham Maternity Hospital. Her independent life-style (there was still controversy surrounding the practice of medicine by women) and the lack of motive for her disappearance led to a range of theories and explanations being brought to bear upon the mystery. The Lancet (29 August) suggested that Miss Hickman's disappearance “may be due to that curious condition of mentality which leads to ‘automatic wandering’ – a condition that is perfectly familiar to psychologists” and recommended to the reader a paper by Dr W. S. Colman, lecturer in forensic medicine. Entitled ‘A Case of Automatic Wandering lasting Five Days’, it described in detail two episodes of prolonged automatism. On each occasion, the patient had ‘woken up’ after a period of days, many miles from home.

It is unarguable that R. D. Laing was the best-known and, certainly outside mainstream psychiatry, the most influential psychiatrist of his time. His ideas have continued to exercise an astonishing appeal to writers, film directors, sociologists and philosophers. He epitomised for many the so-called anti-psychiatry movement and its portrayal of psychiatrists as agents of social control, psychiatric institutions as centres of degradation and psychiatric treatment as a process of invalidation. His rolling Glaswegian rhetoric summoned forth once again the compelling romantic concept of the psychotically ill as bearers of a potent insight into the fallibility, the malevolence and the violence at the heart of the human condition. He was, as his old teacher, and fellow-psychiatrist and Scot, Morris Carstairs, observed in a review in the Times Literary Supplement in 1976, “a guru of our time”. Now that he is no longer with us, how will time remember him?