This month, we present a discussion between two of the field’s most experienced leaders, the process of bringing drugs from the lab bench to the bedside is thoroughly explored - blown apart - and pieced back together from a patient's point of view. We take Drs. Merit Cudkowicz (NEALS/MGH/Harvard) and Steve Perrin (CEO of ALS TDI) out of their comfort zones and ask the hard questions on the minds of those living with neurodegenerative diseases such as ALS today.