Challenging assumptions seems to be in the blood of Vincent Rajkumar. Take his taste in music. Cerebral, temperate, and mild-mannered are the adjectives that spring immediately to mind as he talks fondly about his day-to-day life as Professor of Medicine and Chair of the Myeloma Amyloidosis Dysproteinemia Group at the Mayo Clinic, Rochester, MN, USA. The Lancet automatically assumed that opera, classical, or perhaps jazz would figure heavily as the conversation turned to music. But then he drops the bombshell: “I’m a major Megadeth fan”.