Abstract: As department chief, Anne had to work with the hospital’s highest echelons. She learned a lot about leadership styles. Anne’s department had about 200 faculty. She was in charge of all but about 10 people. Anne started to build the subspecialty neurology services according to a model she had presented to the search committee. She helped promote the basic scientists and recruited several clinician scientists to link the researchers to the clinicians. The Mass General had made important contributions to the understanding of stroke. Adding two postdoctoral fellows to work with the team full time gave the team the manpower to see more patients and help run clinical trials. This small amount of added support allowed the Stroke Service to thrive. Similarly, Anne tried to enhance the Epilepsy Service, Behavioral Neurology Service, and Movement and Memory Disorders Service. One big disappointment for Anne and Jack was that they were not particularly welcome in the Mass General Huntington’s outpatient clinic. A diverse group of Mass General doctors saw the HD patients and the clinic provided nutritional, physical and occupational therapy advice for each patient. Anne and Jack could have joined the group whether they liked it or not but decided to just see their own HD patients.