Having worked in salaried positions throughout my career, I have now chosen to be an independent practitioner. I have a faculty appointment and do a lot of writing, editing, and speaking, but I am not a geographic academic. I have an office in my house. Not only are no 2 days alike, but no 2 days are even similar. That's what I enjoy. So here's a day chosen at random:

By 7:30 A.M., I am in downtown Chicago for a meeting of the Board of the Mental Health Association in Illinois. When the meeting ends at 8:30 A.M., I hustle over to meet with an attorney, as a psychiatric expert, to discuss a case involving an individual who has changed gender. I head back to my office at 10 A.M. and spend 2 or more hours reading, answering, and otherwise dealing with the day's e-mail. The digital subscriber line (DSL) will remain connected until midnight. I have to comment on draft contributions for Journal Watch Women's Health, a New England journal publication for which I am psychiatry writer/editor (summaries of journal articles are circulated among the specialist writer/editors for review).

While on-line, I order a present for a colleague's new baby, book airline tickets for the American Psychiatric Assembly meeting, and have a look at travel bargains for trips to visit my adult children and/or see the world. During the day, the phone rings often: patients wanting to change appointment times or medication doses, people wanting to become my patients, attorneys wanting to discuss ongoing cases. A reporter from the New York Times calls at noon. I drop everything to speak to her for 20 minutes because the reporter has a deadline this afternoon and needs information about postpartum depression for an article she is writing about a case of infanticide. Then I spend an hour finalizing the references for a paper I have been asked to write for the Journal of Psychiatric Practice.

My printer runs out of ink, and I need to dash to Office Depot for a new cartridge. That takes one-half hour because I pause to examine fascinating new office supplies, try out a laptop, and debate whether to buy blanks to print up as business cards. When I come back, the snail mail has arrived. There is a paper to review for Academic Psychiatry. I decide to read it right then and there and complete the review forms. That's another hour. I send an e-mail complaining because the review forms are not on-line, and I don't own a typewriter.

I keep looking out the window to determine whether the weather is propitious for outdoor exercise, but I don't actually get around to exercising. I don't eat all day, either. I treat myself to a mug of tea.

I have patients scheduled for 45-minute sessions at 3:00 P.M. and again at 5:30 P.M. In between, I e-mail the chair of the Member-in-Training Committee of the Assembly who wants my advice on an action paper she is going to submit. I call my daughter, who is an obstetrician/gynecologist at the University of California, San Francisco (UCSF), to work on a paper we are doing together and ask how she is feeling at 7 months of pregnancy with my first grandchild. My husband calls to offer to bring something home for our dinner. I spend a few minutes reviewing my psychopharmacology textbook to prepare for the possibility of changing a patient's medication.

After my second patient leaves, we eat the roasted chicken and coleslaw my husband has brought home and watch the news on TV. After dinner, there is all the e-mail that has arrived while I was doing other things. There is a conference call of the APA Elections Committee at 8:00 P.M. I continue to work on writing and correspondence, with a break for West Wing, which, as it embodies my fantasies of good government, cannot be missed. Then I return to work, interspersed with packing for an out-of-town meeting for which I leave tomorrow. I spend an hour or two talking with my husband about our days and our family. There is one last look at e-mail at midnight. I reflect on the many satisfactions of my day:

I need one-half hour of reading in bed to wind down before falling asleep. The taxi to the airport will arrive at 6:30 A.M.