For the Nephrology Oral History Project, Dr. Dugan W. Maddux interviewed Nancy Spaeth on March 8, 2010, to document an extraordinary patient perspective spanning the earliest decades of chronic dialysis and kidney transplantation. Diagnosed with glomerulonephritis as a child in 1959, Ms. Spaeth became one of the pioneering patients treated during the formative years of modern nephrology in Seattle under the care of leaders such as Belding Scribner and his colleagues. Her story chronicles more than five decades of living with kidney disease, including early outpatient dialysis, home hemodialysis, peritoneal dialysis, multiple kidney transplants, participation in groundbreaking clinical advances, and a lifelong commitment to patient education and advocacy. Through her experiences, Ms. Spaeth offers a unique firsthand account of the evolution of kidney care and the resilience, determination, and partnership between patients and caregivers that helped shape the field of nephrology.