The natural history of myasthenia gravis (MG) has changed dramatically over the past century. Multiple studies have shown a steady decline in the proportion of deaths caused by MG.1 This is due in part to improved treatments but also to improved and earlier diagnosis. Greater capacity to diagnosis MG likely means that there are more people living with the disease than previously.2 Current statistics show that most people with myasthenia get better with treatment, with 10% to 15% of patients exhibiting refractory disease.3 However, the fact that most patients do better with treatment does not mean that most patients are doing well. In this edition of Neurology®, Petersson et al.4 report the findings of a large cross-sectional survey of adults living with myasthenia in Sweden that indicates that half of participants reported dissatisfaction with disease control. This means that individuals do not experience enough symptom suppression to allow them to engage in meaningful activities.