How is it that people develop and learn to drive their own life, their own health care journey? Our 5-year old grandson usually gets picked up from school on Thursdays by my wife – a highlight of his week. We were on vacation. The email notification from his dad to the school of the change in schedule was never received. My grandson noted the expected change, rearranged his after school routine with his teachers. Presence, confidence, comfort, acceptance. Environment, self-confidence nurtured. Driving his own life. Some don’t have my grandson’s fortune. They have tenacious, dogged, self-preservation – I’m driving my own life, dammit! Some have one of these characteristics, but are unfamiliar with American culture and language or American health care culture or language. They may find themselves in dire straits. They benefit from guides with a road map and interpretation. But can the desire to drive your own journey be created with classes and tools? Probably not. Plenty of need and opportunity for guides, classes, and tools for those whose fires are banked and need stoking.