Aren't reputations strange things? Frequently based much more on fantasy than fact, they are often completely out of our control, and - whether good or bad - often ludicrously undeserved. These thoughts were triggered by a patient who had just registered with us. He had a wealth of medical problems, and was going to be someone I would get to know well over the coming years. At the end of the consultation he said: ‘I hear you're a pretty ace guitarist too.'