When Mary-Anne, who refers to herself as MAD, trips & falls on a cobblestone street in Puerto Vallarta, she has no idea that her life is about to spiral out of control. In an attempt to understand & accept that she is living with ALS, a terminal illness, the author records her day-to-day experiences in a journal called End-Notes. MAD's emotionally charged journey from despair to acceptance & finally an appreciation of the joy of living each day, offers an up-beat perspective on the experience of living while you know you are dying.