Clinically, the long-awaited baby boom bulge—the “pig in the python”—presents little that is new to physicians; only that there are more of them and they’re living longer with the chronic conditions that killed earlier generations at younger ages. Psychosocially speaking, however, these former leaders of the “rights” movements of the ‘60s and ‘70s are actively engaged in their care, they challenge their physicians and the system, and some would rather die than decline and burden their children. May authors explain that medical research, education, clinical care, and health policy must all change significantly to best serve this new breed of patient.