Julie Grimes has been living with neuromuscular disease for twenty-eight years. She has suffered disabling fatigue, muscle weakness, and respiratory insufficiency due to chest wall weakness that, two years ago, progressed to respiratory failure requiring assisted ventilation. Eleven months ago, with the care and guidance of her palliative care team, she chose tracheotomy with chronic mechanical ventilation to improve her quality of life. She is a writer and accomplished knitter, an ardent reader of literature and film, and a fine chef. She spends much of her time helping family and friends to make sense of and navigate the complexities of our healthcare system.