This week, we highlight major advances in multiple myeloma, gene therapy for cystinosis, and experimental treatments for myotonic dystrophy. We review long-term outcomes of aortic-valve replacement, strategies for secondary stroke prevention, and a revealing diagnostic case of eosinophilic disease in an older adult. A Sounding Board explores FDA approval standards. Perspectives delve into tobacco cessation, influenza evolution, and the uncertainty patients and clinicians share when facing life-altering diagnoses.