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Presented as part of the Ellen Skellern lifetime achievement award in 2016 this paper reflects on a career in mental health nursing and academia spanning 53 years. The presentation offers a series of key lessons learned in that time. They include observations on health care organisations, educational experiences, the nursing profession and the illusion of permanence in health care service organisations and the buildings that house them. The paper offers an account of how a profession must constantly develop to be relevant and how the demolition of both buildings and organisations have been a fact of life in the five decades reported.