No. 4: Hacktivists hit Harvard.

This summer, Boston Children’s Hospital was targeted in a cyberattack reportedly instigated by the group Anonymous. It had to do with a highly publicized case in which a teenager named Justina Pelletier was taken into custody by child protective services because doctors were afraid she was being abused at home. Anonymous threatened the Harvard-affiliated hospital with retaliation if it didn’t take disciplinary action against certain doctors, and the group demanded the immediate return of the child to her parents. The attack started off rather mildly: Hackers posted the personal information of doctors involved in the case. Then, weeks later, the hospital was subjected to attacks affecting its Internet connectivity. The group also employed “spear phishing” emails, attempting to get health care workers to open attachments that provided a way for attackers to get behind the hospital’s firewall. The attacks ultimately subsided after members of Anonymous tweeted calls to back off.

This was a great year for new treatment of three chronic, debilitating diseases: hepatitis C, congestive heart failure, and idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis is a chronic and ultimately fatal lung disease characterized by a progressive decline in the ability to breathe. An estimated 30,000 to 50,000 people are diagnosed with IPF each year, and the five-year survival rate is dismal. There is no good treatment; many physicians compare it with being diagnosed with terminal cancer. In May, however, a randomized, double-blind, placebo-controlled trial showed that a new drug called pirfenidone dramatically reduced disease progression, halving the rate of decline at one year of treatment. It wasn’t a cure, but it was a bright spot for patients with this devastating illness.

There are roughly 200 million people in the world with hepatitis C. Until this year they had very few treatment options, and the ones that existed—which included a gnarly drug called interferon—weren’t very effective and had lots of terrible side effects. And most of these drugs had to be administered intravenously. This year, the Food and Drug Administration approved a new oral treatment called sofosbuvir, which, in combination with another drug called ledipasvir, providesremarkably high cure rates for people infected with hepatitis C, genotype 1—the most common subtype in the United States, Japan, and much of Europe. The downside? Sofosbuvir is priced between $80,000 and $160,000 for 12 weeks of therapy. Thankfully, there are more oral treatments for hepatitis C in the pipeline, which should drive the costs down.

Heart failure occurs when the heart is unable to sufficiently pump blood to meet the needs of the body. For 25 years, the cornerstone of treatment has included an angiotensin converting enzyme inhibitor. This year, a new type of drug called a neprilysin inhibitor, which prevents an enzyme called neprilysin from degrading proteins that dilate blood vessels, was shown in a landmark trial to dramatically reduce the risks of hospitalization and death for patients with heart failure when given with another drug called an angiotensin receptor blocker.

No. 2: The Obamacare rollout.

It’s unclear what the Affordable Care Act will look like (or if it will exist) in a few years, so for posterity, let’s look at how it all started. Open enrollment began on Oct. 1, 2013, offering Medicaid eligibility to citizens with incomes at or below 138 percent of the federal poverty level in participating states. It also provided tax credits for private insurance purchased via marketplaces for people who weren’t eligible for Medicaid but had incomes between 100 percent and 400 percent of the federal poverty level. The rollout was a bit of a mess, and on April 10, Kathleen Sebelius announced her resignation as secretary of Health and Human Services.

Tens of thousands of previously uninsured Americans enrolled in health insurance exchanges, and as the year drew to a close, the Obama administration claimed victory. But on Nov. 7, the Supreme Court made the surprise announcement that it would hear King v. Burwell, the latest challenge to the Affordable Care Act. The casehinges on the legality of the Internal Revenue Service extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges. Expect a ruling in June.

No. 1: Coming to America: The Ebola Outbreak.

This story drowned out just about everything else having to do with medicine in 2014. Although it’s fading from the headlines now, the worst Ebola epidemic in history isn’t over. But rather than looking back, let’s look ahead at what’s to come.

As novel vaccines and treatments become available in the coming months, a practical and ethical issue will emerge: How should we use them? In particular, should we perform a clinical trial using a control group when the next promising, untested drug becomes available? Or should we just give the new drug to everyone? A well-designed, randomized trial would benefit medicine in the long term, but it might be at the expense of the people who have Ebola today. (If the new drug works and you have Ebola, you don’t want to be randomly assigned to the group that doesn’t get the drug; if the new drug turns out to be more dangerous than a lack of treatment, it could lead to even more deaths.) For the record, I think we should perform a randomized control trial when the next Ebola drug becomes available: It’s the only way we’ll really know if the new treatment actually works.

These were the 10 stories that rocked my world in 2014. Just missing the cut were a change in the approach to cancer screening and an unsuccessful trial aimed at treating high blood pressure. What stories were important to you?