Ironically, in today’s crazy world of uncaring mismanagement, the elderly have the only system that provides continuity of care. Once having chosen a psychiatrist, a person does not have to worry whom "the book" will allow him or her to see next week. This is the only group of individuals, except for the few who are well-heeled, whose circumstances allow a longstanding, productive, therapeutic relationship. Daily I see Medicare patients who have an acute problem that was resolved with the aid of "medical management" and/or therapy who continue to work through significant psychiatric problems. I hope that my chronological psychiatric peers and I continue to learn, grow, and treat with zest the assorted woes that we will find in DSM-XXI.