In the longest longitudinal study of acute respiratory distress syndrome (ARDS) yet, Herridge et al followed 109 young survivors of severe ARDS (medians: age 44; Lung Injury Score 3.7 out of 4) in Canada for 5 years, enrolling 1998-2001. Twelve died in the first year. At 5 years, the survivors remained below their pre-ARDS exercise tolerance; they had low six-minute walk distances (median, 76% predicted); were one standard deviation below the mean in self-reported quality of life on SF-36, and had a 5-year 50% incidence of depression or anxiety. On the up side, they had near normal PFTs and the vast majority had returned to work and were functioning “normally” despite their lingering symptoms, medical problems and cosmesis concerns. Follow up was >85%. NEJM 2011;364:1293-1304.