Any transitional stage in life is associated with some degree of anxiety in everyone involved with the transition. This will inevitably result in some regression but, hopefully, the degree of anxiety experienced by most involved when a new chair arrives will be of the level that will result in more attention to the details and an increase in the excellence of one's performance. Ideally, this will also be true for the new chair. This transitional period may be a time of introspection and reassessment of goals, objectives, and how one measures up compared to one's peers. Relative intangibles, such as how well you will like the new chair and vice versa, what transference issues will be activated, etc., may be the most anxiety provoking and take the longest to resolve. In a sense, everyone in the department is getting a new work-based father or mother figure, and this will inevitably evoke a spectrum of hopes, fears, and fantasies. Most chairs will not have been the parent before to so large a family, so reactions to becoming the patriarch or matriarch of a large and usually extended family will require a time of adjustment.The reactions to a new chair can be expected to vary widely depending upon the personality, background, and interests of the new chair as well as the organizational, financial, scientific, and clinical "personality" of the department and how these mesh. This article has provided a "snapshot" of some of the reactions of one new chair in one large, well-established, and relatively stable department. From my conversations with other chairs, it appears that many of my reactions as a new chair and of my departmental members may be somewhat generalizable phenomena.Abstract Teaser