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To all interested in this topic, I was puzzled by the mailings about PD and keeping one's job. From my start on the list I was astonished that so many of the PWP's still have a job. In Holland many more PWP's don't. I guessed the reason was that in the USA in comparison with Holland more people can't afford to stop and so I guessed further, this makes the employers more willing to adapt and give to the employee the opportunity to keep his job. However comparing my own expe- rience with this willingness in Holland with your description about the reality in the US (I know Jeremy is from the UK, which in this respect seemes not to make a difference), this did not hold. In Holland it is very difficult or even impossible for people with health problems or over 50 years old to get a job. But having one, adaptations like working at home or making less hours is less a problem. For some years my husband worked at home two days every week and had a 32 hours week instead of 36 hours. This was permittted because of his invalidated wife (me). In my work I learned from my patients how companies handle this. Of course one can't have the same flexibility in all occupations. I myself immediately stopped working after I was diagnosed. I worked as a psychotherapist, which demands having apointments that can't be postponed. My PD started with unusual heavy symptoms. I agree with Charles that it is the interest of the patients that is the important thing for making the decision to quit and not the interest of the psych. It is clear that PWP's in Holland quit their work much sooner and with less pain than in the USA. Even without health problems only about one third of 55- to 65 year olds are still working. So beyond being free of serious financial problems not having a job any more is quite normal and does not make one a loser. Of course for older people who can and like to work this is "age discrimination". We neither live in paradise. I understand that, even if wished, a transplantation of rules from one society to another might be yet more complicated than the transplantation of nerve cells. Some time ago I saw on tv a discussion among captains of industrie. To my surprise they stressed all that the welfare state enhanced their competition power on the modern world marked. In the "information world" they need much of he creativity of their employees. For this a high social cohesion is important. Awareness of the fact that the way society deals with this problem, is not determined by laws of nature from which no escape is possible, but is in the end determined by choices of human beings, might be usefull Ida Kamphuis Holland