#at the same hospital. Here I am at the start (1979) and end of my career!

[aiiaiiiyo]

[mooncustafer]

Recover, Regroup, Roadtrip

Agent Dale Cooper disappeared in March 1989. The case is still open. Agent Dale Cooper disappeared in October 2016. The case is still open.

for @laughingpinecone  /

/ @countdowntotwinpeaks​‘ WONDERFULXSTRANGE 2021

“Diane, I am uncertain of the date and time, or indeed if such concepts have any meaning in this place. Nor do I have my recorder, but I find verbalizing my thoughts helps me to resist the confusion and lethargy. As for addressing my words to you, even though you’ll never hear them— well, old habits die hard.”

It pleased Wally Brando on a profound level to discover that a few pay-phones remained in Philadelphia, that reaching out was not yet the prerogative only of those who could afford a landline or a mobile. He could also have checked his email on a terminal at one of the city’s Public Libraries, and indeed, made a note to do so within the day so that he might catch up on the news of parents and former school friends. The pay phone was also blessed with both the yellow and the white pages, and the number he sought appeared under “F.” Getting transferred to Dr. Albert Rosenfield was a more complex quest, but he was persistent as well as polite, and after a few minutes he was able to speak to Dr. Rosenfield’s voice mail, if not the man himself.

He introduced himself with salutations, and was about the explain the nature of his request when a beep signalled that the allotted time had run out.

“To listen to your message, press one. To re-record your message, press two,” said the voice of the machine.

Silently cursing his volubility, Wally pressed two. This time he simplified the introduction, and asked if Dr. Rosenfield would be good enough to meet him that evening at the Morimoto Japanese restaurant not far from the FBI offices, to discuss a matter of deep concern connected, he believed, with the little town of Twin Peaks. When the beep came this time, he listened to his message and then, satisfied, hung up. The restaurant he’d named was slightly above his means, but he was meeting a friend of his godfather, and wanted to do justice to the occasion, even if the reason for it was one of peculiar anxiety to himself.

“Diane, I have tried so many times to escape— on the last attempt I really did get out into the world, but my plans, I fear, had dire repercussions for you, and to no end— my course still led me back to the Black Lodge. Some flaw in my own nature keeps trapping me in this loop; perhaps it’s what they sometimes call Saṃsāra.”

It was Agent Tammy Preston’s custom, when scraping the internet for information relevant to one or more recent cases, to check her email inbox every seven minutes— to do so every five minutes would disrupt the flow of her work, but ten-minute gaps might let something important go unanswered for too long. Just now the inbox was due another glance, and switching tabs she saw that two minutes earlier Director Bryson had replied to Tammy’s email of that morning with an invitation to come by her desk at her earliest possible convenience.

Tammy locked her screen, paused ‘Soft Fuzzy Man’ on her playlist and removed her headphones. Picking up the folder marked Missing Persons, 1989– Palmer, she slipped back into her pumps and made for Bryson’s office. The door was open but Tammy stopped at the threshold and rapped on the wall.

“Come in,” said Director Bryson, looking up from a folder. Bossa nova music played softly in the background as Tammy entered and pulled up a chair. It sometimes puzzled Tammy that apart from herself and Director Gordon Cole, no one in this particular division of the FBI seemed to have any interest in music recorded after 1979. (The first few times she’d heard ‘Du Hast’ pounding through the walls of Cole’s office, she’d wondered if this taste for metal was the result, or perhaps the cause, of his hearing loss; but after he’d joked to an unamused Agent Rosenfield about how these were difficult times and difficult times called for Dave Brubeck, she’d looked up the reference in case it was a coded message, and then the next day had overheard Gordon whistling ‘Mister Sandman,’ a song she knew primarily from an internet meme, at which point she concluded that the ear wants what it wants, regardless of demographic.)

“You told me you’d found some serious inconsistencies in the records surrounding Twin Peaks and the Palmer case?”

Tammy nodded, hesitated:

“I believe there may be inconsistencies as well in my own perceptions of the case.”

“Well now, that I find a little harder to believe.” Bryson smiled, but then her voice grew serious: “I’ve looked over the notes you made, and it confirms my own doubts about events.”

“Worse yet— the fact that I truly left the Lodge and then returned to it, will enable the beings that inhabit this place to take another twenty-five year turn in my likeness, unleashing even more evil on the world. The only thing stalling them is the doppelgänger I had MIKE make for the Jones family, but I don’t know if he’s still under the White Lodge’s protection.”

After all these months it still surprised Harry Truman there was so little physical pain, and so much boredom, to dying. Oh there’d been pain at the beginning, when he’d started treatment and had had to stop drinking; the memory of detoxing still made him shudder. But now he only felt a tiredness too huge for sleep to make any dent in it; and since he couldn’t sleep all the time, there were a great many hours during which all he could do was lie in the hospice bed or sit in one of the hospice chairs, and think.

At this point dying didn’t even sound so bad— it wasn’t like the past three decades had been all that great. He imagined going to sleep, just filling up a big bowl of silence and darkness and sinking into it, and then he felt bad for thinking that because Frank had already lost enough people without Harry lighting out too. Anyways, with the things he’d seen over the years he’d be a damn fool to think there was anything peaceful about death and whatever came after. So he’d lie awake trying to find some other topic to ponder, and that’s generally when the boredom set in.

Right now, courtesy of the nap he’d had in the afternoon after today’s treatment had left him especially exhausted, he was lying awake in the wee small hours. 3:52 am, said the clock on his bedside table beside the stack of paperbacks Frank had brought him on his visits— Harry wasn’t afraid of e-readers the way Lucy was of cellular phones, but he found the smell of paper comforting. It reminded him of the Bookhouse. The hospice tended to smell of disinfectants and sweat and soup. The food actually wasn’t as bad as the food at the hospital in Twin Peaks used to be, not that any food could be as bad as the hospital food in Twin Peaks used to be, but it made no difference to Harry, whose appetite had been gone for months. Frank always brought a slice of Norma’s pie too, carefully sealed in an old cookie tin to keep it fresh, but Harry could never manage more than a couple of bites, and they didn’t always stay down.

Being awake in the middle of the night in a hospice wasn’t as bad as being awake in the middle of the night when you were alone at home— the occasional voices or footsteps from the corridors beyond were reminders that whatever might be happening to Harry, life went on for the staff; and the lights from the city outside showed that life went on for others outside the hospice walls. When he’d first arrived, those city lights had made it hard to sleep, but now they substituted for the starry sky above Twin Peaks. There were fewer birds to watch in the city, though sparrows, pigeons or a starling sometimes lit on the ledge outside his window and peered in at him, or maybe at their own reflections. The frequent rain pattering against the glass— well, that sounded the same here as it did in a cabin.

Frank had called to tell him about Margaret Lanterman. Harry sometimes wondered if he should have stayed in Twin Peaks and died in his own home like her, instead of lingering in this hospice like the doomed heroine of some nineteenth-century novel. Or like Annie Blackburn. Or Audrey Horne.

The rain was spattering now against Harry’s window, bending the light from the Japanese stone lantern in the pocket-sized garden below. Harry couldn’t remember what the hospice building looked like from the outside, but he guessed it was similar in style to the mid-century one next door where the day-patients came for their treatments. A flash silhouetted the roofline; five seconds later came the thunder-crack. Harry settled back and closed his eyes.

Sleep pulled him into dreams of an espresso machine, like the one in the coffee place down in the lobby next to the gift shop for visitors. This machine filled a whole room, metal pipes feeding back on themselves like some kind of espressouroboros, neither steam nor coffee escaping from the grotesque contraption. Agent Cooper stood wearily before it with two empty coffee-cups. Harry was just wondering who the second cup was for, when Coop looked up and met his eyes:

“What year is this?!”

Harry sat up in bed, listened intently for two full minutes, but he didn’t hear Coop’s voice again. He sighed. Sometimes the mind pulls imaginary sounds out of the background noise. False pattern recognition or something— Coop would have known a word for it. Harry had little hope left they’d ever find Cooper, or if they did, that he’d still be the man he’d known. Yet he’d carried on, more (he told himself) out of habit than any real hope. He’d kept in touch with Agent Rosenfield, even when it meant letting him know about the cancer— not that Albert would blab the secret to anyone in Twin Peaks.

“Hello?”

“Good, you’re still alive.” Albert’s personality hadn’t mellowed with the years, exactly, but familiarity had worn the edges off his jibes.

“Shut up, Albert. So what have you found?” Albert’s calls generally came every three months, but never at nine in the morning, and he’d last spoken to Harry only two weeks back. Something important must have happened.

“Actually, Sheriff Truman, I’m the one coming to you for information.”

“If you hadn’t noticed, it’s not easy to do investigations from a hospital bed. What can I tell you that you can’t get from other sources?”

“I need you to summarize the Laura Palmer case back in 1989, and the actions of Agent Cooper in Twin Peaks at that time.”

“Albert, is this one of your damn cognitive tests? You already know—”

“We’re both too tired to argue, just humor me.”

“How detailed do you want?”

“An outline will suffice.”

Harry took a deep breath and briefly listed the finding of Laura’s body, and the living but dazed and injured Ronnette, and the arrival of Agent Dale Cooper to lead the investigation. He skimmed over the crimes of Jacques Reneault and some of the other peripheral drama that had occurred in the town around that time, noted that Leland Palmer had murdered his own daughter, albeit while not fully himself, and was beginning to recount Cooper’s temporary suspension and Windom Earle’s campaign of terror, when Albert interrupted:

“You’ve still got the unofficial version, then.”

“Unofficial?”

“According to FBI records and your colleagues at the Twin Peaks Sheriff’s Office, Laura Palmer is an unsolved missing-person case.”

Harry began to feel sick.

“Goddammit, Albert, you did the autopsy. I punched you and you fell across her body. You found a broken poker chip in her stomach—” Albert broke in:

“I hadn’t disclosed that detail to anybody I’ve questioned about this.” His voice was a little shaky. “Listen, Harry,” he continued. “Last Friday I was contacted by a young man wearing motorcycle leathers and talking like Jack Kerouac on quaaludes.”

“Wally.”

“Naturally I supposed him to be from your iodine-deficient neck of the woods even before he introduced himself as your godson and the offspring of those lieutenants of yours. He told me he’d come because he wasn’t sure where else to turn. Apparently he keeps in touch with his parents as he rides across the continent, but in their most recent conversation he’d noticed their memories of certain events had become confused. I was about to tell him I wasn’t the least bit surprised, when he added that he’d checked with other townsfolk, including your brother, and they all seemed to have had the same— how’d he put it? ‘The walls of their memory painted over like a childhood bedroom converted to a study.’”

”That sounds like Wally, all right.”

”Eventually he got round to explaining why he’d come to me. The message that had prompted him to call home was from Lucy; she said she’d shot a suspect who was attacking your brother Frank. She’d also mentioned some FBI agents arriving a few minutes later.”

Harry swallowed. He tried to imagine Lucy shooting anyone:

“Frank never said anything about this.”

“And when Wally called home, Andy and Lucy not only denied it had happened, they had no idea what he was talking about, not that I’d guess that to be an unusual state of affairs. Anyway, after I sent your godson away, I began to have contradictory memories myself of what Cooper had told me about the case. I remembered the poker chip after waking in the middle of the night from the worst dreams I’d had since medical school. I’ve been telling myself it was a false memory, maybe a composite of all the young female murder victims I’ve had to examine in my career, but I told myself I’d make one more phone call, just to check. And now you confirm it. Also, in my recall you knocked me across Leo Johnson’s body. Thanks for the correction. Are you still there?”

“Yes,” Harry answered, glad he was already sitting on his bed.

“Now that that’s established,” said Albert’s voice on the other end of the phone: “here’s the sixty-four-thousand-dollar question: when do you remember Agent Cooper disappearing?”

“March 1989.” Harry tried to keep his voice steady, as though he was giving evidence in court. He briefly explained about the Black Lodge and Coop’s reappearance and unsettling behaviour and how he’d checked himself out of the hospital and was never heard from again. There was a long silence on the other end of the phone. “Are you still there, Albert?”

“According to FBI records and, up until two days ago, my own memories: Coop disappeared this past October while driving to Odessa, Texas for a case. The last record of him was a credit-card charge at a motel just outside the city.”

“What was he investigating in Odessa?”

“Missing person. I’ve tried looking into that case, but it seems to be a dead end, especially since Coop never seems to have arrived at the diner where the man he was looking for had allegedly been running drugs.”

“Sounds like the kind of establishment where nobody’d admit anything. Maybe Coop did get to the diner.”

“Gee, you’ve cracked it Sheriff, we would never have thought of that. The diner was old-school, but not so old-school they didn’t have a security camera trained on the front counter. We went over three days worth of footage. I admit we can’t be sure he didn’t slip in through the back for some reason; but you knew Coop— can you honestly picture him entering a diner and not ordering a coffee?”

“Not the Coop I knew, but— I already told you he was acting pretty erratically just before he took off.”

Harry heard Albert sigh.

“I’ve been checking with a few of my colleagues who were involved in the original Palmer investigation. I think Gordon knows something, but being Gordon he’s saying nothing, and as loudly as possible. Denise— Director Bryson, now— remembers the unofficial version, and according to her so does Agent Preston— oh right, you never met Agent Tammy Preston, the poker-faced glamazon computer hacker— I’m not sure she was even born yet in 1989, but she was on a case in Twin Peaks in October 2016, and during the course of the subsequent paperwork, she started noticing a lot of records and statements didn’t match up, and then she realized her own memories didn’t match up. Which brings up another problem with trying to reason this out by conventional methods: something in that Salem’s Pacific-Northwest Lot of yours is rewriting memories, documents, maybe the facts themselves. But so far it’s predominantly affected the people who were on the spot this past October.” Albert’s voice rasped a little from the long phone call, and he paused to clear his throat. “Unfortunately, that also means the people most likely to remember the original version of events are people who weren’t in the Sheriff’s Office during the incident that seems to have triggered the change. At the risk of sounding like one of those bullshit shows on the History Channel, we may never know exactly what happened that night.”

“Wait, what even was the case that brought you all back in 2016?”

“That’s the problem— I’m one of the people who was there, and I only have vague and disconnected memories of a British man with a gardening glove, the chorus of Guys and Dolls, Agent Cooper leaving the room with Diane, his secretary who quit the FBI decades ago, and Gordon, and only Gordon coming back.” Albert paused again. “It goes against my personal feelings and medical opinions, but would you be willing to let me visit you in person? I’ve some vacation time and enough frequent-flyer miles that the trip will probably cost less than the long-distance charges if we continue this conversation.”

Harry opened the drawer of his bedside table and took out the key to Coop’s old hotel room:

“Yeah, come by.”

“Diane, I am currently alone. I realize that statement implies that I’m not always alone here, and indeed I sometimes have a companion, who I still think of as Laura Palmer, though I don’t know if that’s her identity anymore; I’d hoped, after my last attempt, that Laura would no longer be in this place at all. She comes and goes, or perhaps we both come and go and our orbits occasionally intersect. I’ve tried to find some pattern to it, but with no reliable way to measure time, I’ve had little success.

The last time we met she told me about a room she hadn’t seen before, all white walls, in which a dark-haired woman was contemplating a mirror with a puzzled look. I can’t help but feel this parallels my own situation.”

“Frank sent me this last month. But when I thanked him the next time he called, he didn’t seem to know what I was talking about.” Albert hesitated before taking the room key:

“Great Northern Hotel,” he read, turning it over. “Twin Peaks. Isn’t the front desk going to want this back?”

“Unless I miss my guess, it’s from 1989 when Coop was staying there.”

Albert’s ears stuck out more noticeably, or perhaps it was his face that was thinner. He’d spent the first part of his visit scrutinizing Harry and questioning him about his case and what the doctors were doing for it, until Harry told him to quit it or he’d run out of time to discuss Coop’s disappearance before visiting hours ended, and anyway weren’t Albert’s patients usually dead to begin with?

The trouble with the subsequent discussion was that it went in a circle— the people who’d been present for the 2016 Unknown Event had uncertain memories of what had actually happened; and the people who clearly recalled the 1989 Palmer case as a murder hadn’t been present for the Unknown Event. The one thing that seemed likely was that there was some connection between the 1989 case and the 2016 case, particularly since both had been followed by the unsolved disappearance of one Agent Dale Cooper.

“I hate to say it, Albert, but I’ve given up hope on ever finding Coop.”

“What’s hope got to do with it?” Albert asked. His tone was not sarcastic.

“Diane, I’ve decided that, if only to keep my mind occupied, I will go looking for the white room and the woman with the mirror. I’d feel happier if I had a ball of twine or some breadcrumbs to leave as a trail back to the waiting room, but I’m coming to terms with the idea that’s there’s no advantage to remaining or returning here— it’s not as if I need food or drink in this place, and I cannot be any more lost than I already am.

So far, I believe I’ve walked down five identical red-curtained hallways, and turned left five times. It therefore seems likely that I’m following a counterclockwise, roughly spiral path, although I’m uncertain if I’m proceeding inwards or outwards.”

“If this search is going to require juggling two sets of memories, then I’d better come along so you don’t get brainwashed again.”

“Sheriff Truman, if you haven’t noticed by now, you’re in a cancer hospice.”

“I just finished a round of treatments, I’ve got a couple of weeks free.” Albert snorted and Harry added: “You can monitor my health while we’re on the road.”

“I’m already thinking of your health. You’re immunocompromised, travel is too risky.”

“We’re crossing a few state lines, not going to the other side of the world.”

Albert pinched the bridge of his nose.

“Fine. I’m driving. Which also means I get to choose the music.”

In fact, they went most of the way by plane, after Albert weighed the odds and decided five hours in a tube of recycled air would still be easier on Harry than a two-day road trip. Some of the passengers threw suspicious looks at Harry’s N95 mask, but they’d cleared it in advance with the airline, and Harry had briefly removed it when he went through TSA, and Albert was prepared to flash his FBI badge, but the flight crew were understanding.

They picked up a car at Midland International. Someone, presumably an employee of the car-rental company, had left a bundle of tourist-attraction pamphlets on the front passenger seat.

“According to these, Odessa has replicas of the Globe Theatre and Stonehenge,” Harry observed once he’d got himself settled.

“Why?” Albert asked.

“Got me there. The pamphlets don’t explain the motivation.”

Albert reached up and pulled down the car’s sunshade on Harry’s side, though the Sheriff insisted his cowboy hat was protection enough for his pale scalp:

“We’re not in the northwest where it rains every fifteen minutes,” he muttered, “and I’ve been looking up the side effects of your meds— you sunburn easily now.” Albert’s driving skirted the city, and they did not pass the Globe or Stonehenge.

The Pearblossom Motel, last recorded location of Agent Cooper, proved to be closed down. They’d noticed the papered-over windows as they pulled up, the sign unlit, not even to say NO VACANCY, but Albert got out to knock anyway. Harry watched him from the car; eventually he clambered out and slowly walked over to join him.

Albert was peering through a spot where the paper had torn away behind the window-glass. He stepped aside for Harry, and the sheriff took a look into the motel’s dim interior. He saw an ordinary, rather old-fashioned registration office, wood-grain panelling on the walls along with a few faded posters for local attractions. Rows of keys still hung on a board behind the desk, and a daily calendar read October 15, presumably the date the motel had closed, or the approximate date— Harry could imagine a concierge might not bother to keep tearing off the pages if they knew it was their last week on the job.

“I now realize that despite everything, I’ve still been harbouring hopes of finding my way back to the waiting room, hence my continual choosing of left-hand turns, as if attempting to mathematically navigate a maze. I must make a true leap of faith if intuition is to guide me, so I’ve closed my eyes and spun around several times in this corridor, first clockwise and then counterclockwise.

Now that I no longer can tell which direction I’ve come from… Diane, can you hear that? Of course you can’t, I don’t really have my tape recorder. I’m going to fall silent and listen for a bit.”

There seemed little else of interest at the motel (Harry, feeling a bit silly, had even tried the Great Northern’s room key on all the doors), so they turned back towards Odessa to look for the diner Cooper had been investigating. The motel was only a mile behind when they saw, ahead of them, a tall woman walking along the highway, her fire-engine-red hair, black t-shirt and pencil skirt out of place in a locale that was rural to the point of emptiness. Albert swore under his breath.

“This can’t be a coincidence,” he told Harry. “Roll down your window, I’m pulling over.” But the woman only threw a glance at the car as it slowed, flipped them the bird, and kept walking, though she stepped gingerly and Harry noticed she was barefoot on the asphalt. Albert leant across him and stuck his head out the window:

“Diane!”

“Fuck off, guys. I’m not Diane, and whoever she is I bet she’d tell you the same.” Harry gently pushed Albert back and leant out the window himself:

“Sorry, ma’am, mistaken identity. Are you all right though? I see you’ve mislaid your shoes.”

“Looks like somebody ran off with them,” the woman answered, her tone mocking despite the tired set of her shoulders. “I haven’t been up to anything illegal, officer. Just a bit of fooling around.”

“We can give you a ride into town,” Harry offered. “If it helps, you’ll be alone in the back seat— means you can get the drop on us if you start to feel nervous.”

The woman narrowed her eyes at the offer, then abruptly barked out a laugh and opened the back door of the car, took a seat and folded her long legs in after her. “Only because I need a lift,” she insisted, rubbing her bare feet. “I knew office romances were a bad idea, but he didn’t have to be a dick about it. Nothing to do now but go home and drown my sorrows in Hallowe’en candy.”

“You’ve still got candy left over from Hallowe’en?” In the mirror above the dashboard, Harry saw Albert raise an eyebrow and the woman in the back seat frowned, insulted:

“No! I may not have a maternal bone in my body, but I’m not going to give the trick-or-treaters candy that’s a year old.”

“Ma’am,” Harry asked, thinking about the calendar back in the Pearblossom Motel office, “what date d’you think it is?”

“Mid-October,” she began. Harry saw her reach into her purse with her black-and-white nails and pull out a mobile phone. Her eyes widened at the date: “No, it’s March. The fuck?—” She ran a hand through her scarlet hair. Harry wondered if it was dyed or a wig. Perhaps she was bald too. “Must be losing it. I was so sure it was October. And it’s not like I’ve could’ve been wandering around this desert for five months.” She tapped her phone screen. “5,230 messages?!” She looked frightened now, raising her head to meet their gaze in the mirror. “Where the hell have I been? And you guys— you’re feds, aren’t you?”

“No,” Harry began.

“I am,” said Albert. “He’s not.”

“Well, can you tell me what’s going on? Or is it classified? God, it’s not aliens, is it? I always assumed alien conspiracies were bullshit to cover up real conspiracies.”

“It’s probably not aliens,” Harry answered, unable to keep doubt from his voice as he remembered Major Briggs, “but I afraid it’s not going to sound any less weird.”

“To start with, we’re in the area investigating a colleague who disappeared in October,” began Albert, “and then you turn up, apparently amnesiac since that date.”

“And with my messages unchecked since then.”

“Yes, but there’s another detail— you look exactly like a former colleague of mine who was close to our missing man. That’s why I called you Diane when I slowed down.”

“I need a smoke.”

“No.”

“Albert,” Harry interrupted, “I’ve already got cancer, what’s the worst that can happen?”

“Do you want me to answer that in detail?”

“No I don’t.” Harry turned to look over his shoulder at the woman in the back: “Just roll down your window first.”

“We’ll pull over and she can step away from the car,” said Albert.

He stopped on a shoulder, and their passenger got out and lit a cigarette. Examining the packet, she called to them:

“Three left. That’s fewer than I remember having on me in October, but not by much.” Albert, meanwhile, had pulled a shopping bag from the back seat:

“You should eat something,” he said to Harry, producing a sealed cup of applesauce and a box of plastic spoons. Between rounds of treatment, Harry’s nausea receded, but his appetite was still pretty weak. “There’s saltine crackers, too.” Harry chuckled in spite of himself as he tore the foil off the applesauce:

“This all makes me feel like I’m home from school with the ‘flu.”

“You’ll have to watch Roadrunner cartoons on your own phone, I’m not paying for the data,” Albert snapped.

“I’m surprised we even get reception out here.” The red-haired woman had strolled back to the car with her cigarette, though she took care to stay downwind from Harry’s rolled-down window. “Guys, is it just me or is this highway really deserted— like, Rod-Serling-voiceover deserted?”

“We were just thinking Roadrunner cartoons.”

“Can’t be, there’s no weird rocks.” She flicked ash onto the pavement, “Though it does feel like if someone painted a tunnel entrance on a wall around here, you might be able to drive into it. If you weren’t a coyote.” She took another drag and glanced at the power lines humming above their heads. “Maybe it’s the hum from those wires that’s giving us brain cancer— oh sorry, dude.” She broke off and looked at Harry in apology.

“It’s all right, ma’am,” he said when he’d finished swallowing his mouthful of applesauce. “I’ve got leukaemia, not brain cancer. And the sound from those lines is unpleasant. Like the whine of mosquitoes in the woods.” As he spoke the hum intensified, becoming a loud crackle. Albert glanced up as a shadow fell over the three travellers and their car.

In the sky a dark, nebulous shape twisted, circled, formed a comma or an apostrophe, and dove towards them.

The first few grackles, out of thousands, came down on the roof and hood of the car. Harry could see one pecking at the windscreen and glaring at him with hard yellow eyes. He suddenly remembered Coop had been afraid of birds; until now, he’d never been able to imagine why. He turned and pushed open the back door as the woman dove inside the vehicle. Around them, the flock blotted out the landscape.

“Hope they don’t scratch up the finish,” Albert shouted over the sound of wing-beats, “or I’m not getting my deposit back.”

“Is this nesting season? I mean, are the grackles round here normally this—”

“Oh fuck, one got in!” came a yell from the back seat. Eardrums ringing, Harry turned to see a small black shape ricocheting around the car’s interior as the woman flailed her long, bare arms. The grackle made for the gap between Albert’s seat and headrest.

And got stuck, its beak not quite touching the back of Albert’s neck.

Harry reached for the little feathered body, thinking of how to pin the wings against the bird’s sides to avoid injury to it or the surrounding humans, but the moment his fingers touched it, it crumbled. At the same time the din outside the car ceased.

“That— that’s not natural.” Their passenger was covering her mouth with her hand. Even Albert looked shocked. Harry stared at the palmful of ash that was all that was left of the grackle.

“Let me get a sample bag,” Albert muttered. He pulled out a small clear plastic bag, and held it out while Harry poured the remains in. Then he handed him a packet of wet wipes. “You all right, Diane?” The woman in the back seat did not correct him on the name this time.

“Couple of scratches,” she said, examining her right arm. Albert passed her a mini first-aid kit. Got to give him his dues, he prepares for everything, thought Harry, adjusting the brim of his cowboy hat.

“Y’know,” he said, “This could be a good sign. In that it’s any kind of sign. There’s nothing worse than working in the dark, waiting for some hint you’re getting warmer or colder— that’s the kind of thing makes you wonder if the thing you’re looking for is even out there at all. But this—”

“Someone tipped their hand, you mean, when they tried throwing a Hitchcock movie in our faces,” Albert cut in. “But what exactly did we do to worry them?” His glance, and Harry’s, moved to the dashboard mirror’s reflection of their passenger.

“You think the birds were after me, or wanted to break up our merry band?” She raised an eyebrow. “Trouble is I know a token effort when I see one.”

“Or a warning.”

“We found the Pearblossom Motel;” Harry thought he saw the woman flinch at the name. “And then left it, to head for Odessa.”

“Are you suggesting we drive around in circles and see if they attack again?” Albert muttered.

“I think that’d be a little unfair to our passenger.” Harry turned to her: “Ma’am, I believe Albert when he says he knows you; but I also believe you when you say you don’t remember him. We can drop you anywhere you like— your call.”

“Give me a few minutes, fellas. Given all the weird shit I’ve just been through, I’ve got to think about whether I’m safer away from you two, or sticking close by. Plus I’ve got messages to check.” She took her phone out again. Without taking his eyes off the road, Albert pulled his own phone from his suit jacket, passing it to Harry:

“You’d better check mine. Maybe Tammy’s got some news—she’s been looking up everyone connected with events in Twin Peaks, but not living in the area. She even emailed some couple in Japan, though I’m still not sure what they’ve got to do with this.”

Harry peered at Albert’s phone screen, occasionally commenting if something looked to be of interest:

“Gordon’s sent a grudging OK, tells you to be careful. Also tells you to look after me. I’d always imagined he’d type in uppercase— didn’t realize it was him at first. Hm. Do you know a coroner?”

“I know lots of coroners, we get together for an annual poker tournament and lucky draw. And when I say draw…”

“Do you know a Dr. Talbot in Buckhorn?” Harry interrupted. “Autopsied a headless body last September that turned out to be Major— wait, he— is this one of those revised timeline things?”

“Not exactly.” Albert brought Harry up to date as best he could on Major Briggs’ disappearance and decades-later reappearance. “I certainly remember meeting Constance,” he added, after a pause, and cleared his throat again. “According to Tammy, I made a favourable impression on her, which is… unusual among my acquaintances, even those who share my profession. So what does she have to say?”

“Something about a wedding ring and Schrödinger’s Cat?” Harry looked at the message again. “She says Tammy spoke to her, and was going to contact you too… a gold ring they found on Briggs… sorry, in Briggs… keeps disappearing from her office’s records and the FBI’s evidence files, then coming back again?”

Albert frowned in thought as he drove: “Does it have anything engraved on it?” Harry tapped a message on the phone screen, CC-ing Constance and Tammy.

Outside the car, suburbs, or at least car dealerships and big-box stores, were beginning to sprout up along the highway.

Albert’s phone pinged and Harry read the message from Constance:

“Yes, scribbled it down last time I could find the record. This ring any (wedding) bells? TO DOUGIE, WITH LOVE, JANEY-E”

“Janey-E,” said Diane from the back seat, and Harry heard her drop her phone. Turning around he saw her wringing her hands, the nails now robin’s-egg blue. “Albert,” she gasped, “Oh, Albert, I was almost lost again.”

“I believe the change in method may have led to a breakthrough: I haven’t found any rooms leading off of the corridor I’m following, but the decor has gradually changed from black-and-white flooring and red curtains, to dark brown linoleum flooring and institutional green walls hung with large relief maps of different parts of the world. The maps appear to have been manufactured some time between 1954 and 1965, as they show North and South Vietnam as separate nations. I’m just passing the continent of Antarctica, now, and… oh. I think there might be…

Diane, I found the white room, and when I call it that, I’m not simply echoing Laura’s name for it. It was like a cross between a sanatorium and a snow cave, if a snow cave had furniture. There was a bed with white blankets and a white metal frame like a hospital bed. Audrey was sitting on one end of it, wrapped in a white bathrobe and looking at a round mirror that stood on a little white table. She turned as I entered, and her face was older, drawn and, for a moment, frightened. Then she looked at me again and relaxed, saying ‘Oh, it’s really you.’ I fear she must have met one of my nastier doppelgängers at some point.”

At Diane’s request, they stopped to eat at a fast-food chain before approaching the diner Coop had been investigating in at least one timeline.

“I’m hungry, but I’d be too nervous to eat at the place where Dale might have… well, if they’re a front for something, then the food’s either spectacular or terrible, and I’m not feeling lucky right now. I want to be someplace as bland and mundane as possible for a while, so I can regroup.”

“Well this place has a twenty-minute limit.” Albert jerked his thumb at the sign.

“That’ll do.” Diane curled up beside Harry in the booth as Albert went up to the counter to place their orders. She still wore her pencil skirt, but on on of their stops she’d purchased tennis shoes and a couple of fresh t-shirts— the one she was wearing at the moment read NOT TODAY in flowery letters. “Now he’s got two of us to worry about,” she said under her breath. Harry decided to reply:

“Someone needs to worry about him.” Diane nodded, and Harry offered his hand: “Sorry, we never did the proper introductions did we? Harry S. Truman.”

“I know.” Her expression relaxed slightly. “I see why he likes you.”

“Not sure Albert likes anybody, exactly—”

“That’s not who I was talking about.”

Albert returned with a eye-searingly-orange plastic tray:

“Mushroom burger, cheeseburger, buttered biscuit for you, Harry, because they can’t just serve toast like a real restaurant and those things they claim are bagels are made out of lies.”

“Don’t worry Albert, I’ll survive a biscuit.” Harry picked up one half of the baked item and took a bite. It wasn’t too bad, actually.

“Diane, the ring that jogged your memory—”

“My half-sister and her husband. Don’t ask me how they’d be mixed up in this though, Janey-E’s aggressively normal.”

“And her husband?”

“Never actually met him. Janey-E and I don’t talk much,” she explained. “But from her comments he’s… passively normal. Works for an insurance company, drinks too much sometimes, the whole man-in-the-gray-flannel-suit thing.”

“I’ve been talking with Audrey, or the version of her that existed in the white room. You’ll notice I use the past tense. Still sitting on the bed, she raised a finger and pointed to the mirror in front of her, saying:

‘The other me— she ran away from home, like she thought Laura had done. I’m amazed she survived her first year in the big city, but look:’

Diane, I saw Audrey searching records online, tailing suspects, testifying in civil and sometimes criminal courts. It’s a life that can make a cynic of the kindest soul, but there are situations the police don’t or can’t investigate, and those were— are, I suppose— Audrey’s bread and butter, in that mirror world. And they seem to pay well enough she can afford to do some pro bono cases.

‘I wish I were out there,’ she said, and the mirror clouded and shifted. She  patted the bedspread, and I sat down beside her. ‘You know how,’ she began, ‘when you’re a kid, and you’re reading your favourite book, and a little after the halfway point, you start to think ‘I’m getting near the end of the book?’ And really, you’re not— there are pages and pages left of scenes and pictures. You’re always surprised just how much more there is. But it’s not enough to shake the feeling it’s putting off the inevitable. Dawdling before bedtime.’ She stood up suddenly, bent and kissed me on the brow. ‘Say hello to the other me, if you ever run into her.’ And then she was gone, Diane. Not in flame or fadeout, just gone.”

I look up, and Laura is beside me.

The diner, when they found it, was not what Harry’d pictured. Instead of a lonely Edward Hopper tableau, or a grimy spoon where toughs whispered to each other along the lunch counter and cast knowing glances in the direction of the men’s room, “Wispy Dreams Cafe” was a blandly cheerful donut shop, the logo rather obviously altered from that of a national chain.

“Looks like they’re under new management.” Diane observed as they got out of the car. “Or else they got tired of paying for the franchise?” The three of them made their way across the parking lot the cafe shared with the landscaping company next door. Inside, the sound of chattering customers and a hum from the coffee machine both soothed and overwhelmed. Harry steadied himself against a gleaming, cream-colored formica counter. The woman on the other side— not a fresh-faced high-school senior or a kindly-faced matron, just a woman with her hair in a ponytail and circles under her eyes, doing her best to smile— threw him a glance and Harry nodded.

“I’m ok. Albert, Diane, what do you two want?”

A couple of minutes later, they sat by the window, feigning interest in their donuts and coffee.

“Well, we’re living the cop cliché,” whispered Albert. “So, what do you think? Soulless suburban hangout, or den of villainy?”

Harry gingerly sipped the brew in his cardboard cup and eyed the other customers. You couldn’t say the place wasn’t busy; the woman at the counter had already served a family of four in the time it had taken Harry, Albert and Diane to seat themselves with their coffees, and another customer had just come in the door.

“That counter’s been installed recently. Deep-fat fryer’s been replaced too.”

“And they don’t know how to use it yet. You could wax skis with these donuts. That’s hardly a crime, though.” Diane looked around at the blue and yellow walls painted with large trompe l’oeil sprinkles. “Doesn’t seem to be anything else funny about the place— I hate to say it but this place might be legit.”

Harry watched the new customer lean in to the counter. Harry couldn’t quite make out what he was saying— presumably the man was placing his order, but it seemed to be taking a while and there was something tense in the woman’s expression. Beside him he heard Diane swear under her breath, and faster than he could turn his head, his peripheral vision took in that she was getting up. She strode towards the counter and Harry had a glimpse of the angry red scratch on her arm as he struggled to his feet.

Diane was leaning on the counter now, trying to insert herself between the customer and the worker.

“What did you just say to her?” she was asking.

“Look, I come in here all the time, we joke around. What makes you think it’s your fucking business?”

“What seems to be the trouble?” Harry loomed up behind the customer— he might have only half his usual strength but he was still a good six inches taller than the other man. Behind him, he guessed, Albert was approaching. Harry knew the agent was unwilling to use physical force and not exactly skilled at defusing situations through diplomacy, so he turned his gaze on the customer with all the quiet confidence he’d used as Sheriff. In his ear Diane hissed:

“It’s nothing to do with the case, this asshole’s just creeping on the staff.” She must’ve locked eyes with the man too, for he was staring at her now, his bland pink features shifting expression from anger to terrified fascination.

Rather an unimpressive face, thought Harry, and then, what’s Diane doing? He turned to look at her sharp, smiling profile, and saw a tear slide from her eye.

“No,” she said loudly and abruptly, and blinked hard. “Do you want us to escort him out?” she asked the woman behind the counter; but the man was already out the door and running for his car.

“Diane,” Harry whispered.

“Diane,” whispered Albert. Diane was passing one hand across her eyes.

“I could have fried him. Just now. Something wanted me to; but I just wanted him to back off.” She beamed at them as Albert held out an arm for her to steady herself. “I think I’m back to normal. Well, normal for me.”

“Are we the only two left here now?”

“I’m not even here anymore.”

“I don’t know how to get back to the waiting room.”

“It doesn’t matter, the coffee’s cold.”

Somehow, the white room has become even more featureless, despite that being both a logical and a grammatical impossibility. Only the bed, the table and Audrey’s mirror remain. A moment in the glass catches my eye, and I look to see— oh Diane, I’m so glad you escaped! I see you travelling with Albert, and… oh, Harry…

…the cafe’s fluorescent lights flickered as the background hum, noticeable since their arrival, now rose to an ear-splitting volume then died away just as suddenly. As the three of them looked on, an old-fashioned hospital bed, its steel frame painted white, materialized between the counter and the booths, replacing two unoccupied tables. At one end of it sat Agent Dale Cooper, fully dressed in his suit and tie, a look on his face of mild surprise that turned to the familiar joy as his gaze met theirs. Coop had grown older like the rest of them, sharper angles in his face, but he looked hale and well, and his eyes did not have the cruel gleam that chilled Harry’s memories of their last meeting.

“Harry,” he said, as though a quarter-century hadn’t passed. In response Harry silently doffed his cowboy hat, revealing his pallor, his naked scalp. Coop’s smiled wavered a little. “I’m sorry I was gone so long,” he whispered, and rose from the white bed. In the background, the cafe staff and patrons continued to chat and serve and drink and eat coffee and donuts as if nothing out of the ordinary was going on right in front of them. Albert made a hesitant noise in his throat and Coop raised his hand in that just a moment gesture he always used to make, and in that moment Harry knew his friend really was back from wherever he’d been all those years.

“Apologies for being brusque,” Coop said, “but there’s a family in Las Vegas who I’ve reason to believe are in danger right now—”

“Janey-E?” Diane asked.

“Right on the button. For personal reasons which I’ll explain later, I can’t get in touch with them myself. The Mitchell brothers might be able to help, but I don’t know how much they’ll be able to recall of our last meeting.”

“Tammy and Constance are already on it.”

“Good,” Coop looked relieved, and Harry stepped forward, shaking a little in spite of himself, and as if the motion had at last given him permission, Coop sailed forward and embraced him— very gently, as if he feared Harry might break. He’s gauging by touch how much weight I’ve lost, thought Harry, but it’s all right. He’d forgotten how warm Coop was. He became aware of Albert and Diane joining in, arms circling his shoulders and Coop’s. If I died right here and now, it’d be all right.

But this embrace was not an epitaph, or an epilogue. Outside, somewhere else in the city, was an imitation of an ancient stone monument; and a copy of an old theatre where real audiences watched real actors. Somewhere the forces that had sent the dark cloud of grackles prepared another attack, and somewhere Tammy Preston was moving to protect Janey-E and Dougie Jones. Elsewhere Audrey Horne walked the mean streets and was not herself mean. This was an interlude, but let them have it for a while.

A couple of patrons turned their heads to smile at the reunion going in their midst.

[rhodochrosite-love]

WOW everyone who commented on my Wirt birthday post are amazing!

Here’s the au I’ve been working on where it started off as just a Ford Pines self insert, but turned into very interesting idea!

Stanley is kicked out and Ford goes to Backupsmore, while Penny stays in Jersey to help pay off her childhood home’s mortgage. All in the early 1970s.

Ford is awarded a doctorate 3 years ahead of schedule, and prepares to move to Gravity Falls, Oregon in 1973.

In the same instant, Ford gets a call from his parents and after he tells them he’s moving to the northwest, they inform him of Penny living with them. Shocked, Ford is conflicted. Should he go to his sweetheart? He couldn’t imagine what could’ve happened that made her stay in his parents home… After consulting with Fiddleford, he quickly travelled back to Jersey to confront Penny.

Penny explains that she couldn’t take care of the house like she thought she could, what with her book-keeping job as well as her secretary position AND the pressure from it all really weighing her down. She couldn’t help her home anymore so she turned to the only people she knew left in Glass Shard-- Filbrick and Caryn Pines. She had been pulling her weight with buying food, despite Caryn’s pleas to rest whenever she could and her job offers.

Ford listened and took her side. He said he was moving out West to Oregon and had wanted her to come with him. He missed her dearly and could clearly see she needed to get away-- Jersey is no place for a princess.

She accepts in a heartbeat at the thought of living out there, alone with her sweetheart amongst the wood.

1972-1979 Penny and Ford start a life of adventure in Gravity Falls up in their cabin in the woods, catalouging new anomalies every day! After such a hard time, Penny adores the relaxing atmosphere and spending time with her boyfriend after 3(ish) years.

C. 1976 Penny can’t help but begin to think about the future with Ford, and tries to decide whether or not they should marry. In her heart she knows she wants to, but in her mind she feels as though Ford wouldn’t be as on board for whatever reason. After speaking with Susan (Lazy Susan) and Lana (Wendy’s mom), her newfound friends, she decides she has to speak with Ford!

After being avoided most of the day by her beloved (due to him being very distracted by the mystery of the Hide-Behind, and eventually their unavoidable run-in with it. emotional scenes with Penny’s annoyed tone) At the end of the day, Ford admits over dinner that he was avoiding her for the whole day due to his nervousness. After being asked why, he tells her that… “I’ve been fascinated by anomalies my whole life-- the Hide-Behind, the Gnomes, the Eyebats, that UFO theory I’ve still got stuck in my head--” “Stanford, please.” “--Even I, as normal as I may seem, my six fingers made me who I am today! … But… “ Ford reaches in his coat’s pocket, and pulls something from it and places it on the dinner table. “You, Penelope Wright, have been the one thing that’s done both for me-- Fascinated me, baffled me, cherished me, twirled me ‘round and ‘round again ‘til I was dizzy with delight.” “Ford, what’re ya sayin’?” “Penny, dearest... “ He reveals the item, it being a ring with the sweetest red gem in its center shaped like a rounded heart. Penny sniffled, “The apple… Stanford, you’re such a prince!” Before he could utter those four simple words, Penny kissed him breathless. When she pulled away, he was flushed from his ears to his nose and asked her then, whispered against her lips. She said yes, and then many times that night.

C. 1977 Bill realizes his plan is being challenged by this engagment! He had never thought of Penny to be a true problem until now, what with the now foretold probability of the wedding and children as a distraction! Bill makes a deal with Lana to guide Ford to the cave in which Bill was scribed by the natives in exchange for a long life. Ford summons Bill and to no avail, nothing happens until Ford falls asleep.

It was then Ford dreams about Bill and begins to work with him to open his dimension to study the weirdness of Gravity Falls and beyond.

With the new development in the mysteries, the wedding is delayed and Ford and Penny become very busy in their new findings with Bill’s help.

C. 1978 Fiddleford McGucket is employed as the head engineer in building the Portal to the other dimension. Upon hearing the news of Stanford’s engagment, he hoorah’d and congradulated his old roommate.

C. 1978-1979 The portal has been built, as well as the bunker and the second level of the basement. Fiddleford begins to despise his creation and begs Ford not to follow through with his plans and instead publish his findings and settle down properly with Penny. Ford declines and they move to test the portal the next day, Jan 18th 1979.

Jan 19th 1979. Fiddleford gets sucked into the portal, but then gets rescued by Penny and quits the whole she-bang.

Jan 20th, 1979. Bill sees that he has to manipulate Penny, too. She’d been taking Fidds’ side, and since she’s very close with Ford, it’s necessary. He enters her dreams and states that if she make a deal with him, he can make him see reality again. To Penny’s knowledge, Ford’s been driven to madness with his paranoia and struggles to see the light. Bill says that he can fix everything. If he ensconced a baby in Penny’s womb, one that’s both her’s and Ford’s completely, he will see the light again. In return, she has to take a hike. She makes the deal, and he ultimately sends her away. Confused, she cries. But when Bill explains that he basically makes her pregnant with a baby of a man that ‘doesn’t love her anymore’, and literally told her to ‘take a hike’. Embarrassed and humiliated, she flees into town and stays there, leaving Bill to torment Ford to his isoceles heart’s delight.

Sometime in October, before the 22nd, 1979. Penny gives birth to little Walter in Sacred Hirsch Community Hospital. At this point in time, Ford has been thrown into the portal by accident and Stanley has taken his place, in the process of making money for the new Murder Hut.

1980. Penny interrogates this new so-called Mr. Mystery, thinking he’s Ford. She rips at him, accusing him of neglecting her and hurting her. A lot of anger comes out, as well as sadness and despair and raw misery when she says that he no longer cared about her, and she doubted he ever had in the first place. When Stan pulls her to the side and finally looks her in the face clearly (before he was frantically looking around the room, his hut full of customers), he recognizes her faintly as Penelope Wright, the girl Sixer was in kahoots with back in Jersey. He sees her and the now crying baby she’s holding and connects the dots, and is flabbergasted that he’s an uncle! Well, he was already an uncle but that was for Shermie! Penny argues that it was a mistake. Little Walter was the making of a demon named Bill Cipher, and she never should have trusted him. Stan then takes her down to the basement and shows her what he’s done.

1981. Penny gets a job as a waitress at Greasy’s Diner with a little help from Lazy Susan.

1982. Penny needs to start fresh. Despite the fact that she’s got a job and is living with Stanley with a 3 year old Wirt (despite being named Walter, his first word was an attempt at ‘squirt’, which was a nickname given to him by Stanley. Everyone simply calls him Wirt now), she misses all the adventure from when she had Ford. Realizing she’s missing Ford, that son of a bitch that fell into a hole so deep he couldn’t climb out, she needs to get away. She saves up money from her Greasy’s job and now the Mystery Shack (unofficially hired. Stan just says that she’s always rearranging and flipping stuff over and it happens to look nice so he gives her some funds. She’s tried to refuse the money before, but he intensly insisted that she take it.) and moves to Arizona. Teary goodbyes are made and she hugs Stan the tightest of all, telling him to keep in touch.

1983-1994. Walter “Wirt” Wright is living in Arizona with his mother, Penelope Wright.

C. 1985. Greg Universe visits town and performs a live gig and seduces Penny. After a couple of succesful dates, they end up having unprotected sex. Not long after, he leaves town for another gig in Delmarva, doing gigs along the way. She ends up falling pregnant and struggles to comprehend the consequences.

C. 1986. Gregory Wright is born.

C. 1994. Halloween night, Wirt and Greg experience an adventure in The Unknown.

1999. Mason and Mabel Pines are born from Randy Pines and Kathy Pines

(2003. Steven Universe is born from Gregory “Universe” DeMayo and Pink “Rose Quartz” Diamond. Everything that happens with Steven is seperate from Dipper, Mabel, Wirt, and Greg.)

Update - Summer 2012. Penny takes a vacation to Gravity Falls and visits the Mystery Shack. She marvels at Dipper and Mabel and exclaims their cuteness. Mabel likes her when she’s given a butterscotch, but Dipper can’t help but question her motives. She seems awfully close with Stan and gets along well with everyone! Is she hiding something?

All is well until Dipper catches Penny trying to steal Journal #3, and he fights with her over it in his bedroom. Penny falls down and cracks something, making her scream. Stan rushes upstairs and takes Penny away, giving Dipper a nasty stinkeye. He tries to argue that she was trying to take his Journal, and Stan reacts by taking it himself.

Stan and Penny argue in the basement, saying that Dipper should have the Journal back. Stan tries to argue that he shouldn’t, but gives in. After making photocopies, Penny gives it back to Dipper. At first Dipper is skeptical, but awes when she tears up in front of him about it.

“Wow… You really care about the author, don’t you?” “Yeah, we were close…” She sits down beside him, opening the Journal to the Gnomes. “I remember the first time we saw the gnomes together… They tried to take me as queen!” “No way! They took Mabel as queen two weeks ago!” DIpper interjected, to which Penny laughed. “That explains this, then!” She pointed her crooked finger to the words; “Weakness: LEAFBLOWERS!” They both laughed.

At the end of it all, Dipper trusted Penny infineitly more. He was also more curious, as she knew the author. She wouldn’t give him a straight answer, however. Just saying he reminded her of her own son, Walter.

Penny stays in Gravity Falls until the Twins’ Birthday is over and they’re heading off to California.

August 22-25 2012. Weirdmageddon takes place. Penny serves as a scavenger and is found by McGucket and taken back to the Mystery Shack to be protected. She joins in the fight to defeat Bill Cipher, and when everyone’s in the Fearamid, it’s the first time Penny’s seen Stanford in nearly 33 years. He begins by saying hello, and saying he missed her. Before he can say anything further, she hugs him tightly, saying that he can apologize later. He prepares to retort, but when seeing Fidds’ face in response, he quietly hushes and hugs her back.

August 28 2012. Ford apologizes for how he acted and what he had done to her, like he always should have. She tells him about their son Wirt and he’s shocked. She tells him the deal she made and how she moved out of the state. After that conversation he hugs her tight and says she never should have gone through that. If he were a better man back then, she wouldn’t have had to make a deal to have a baby.

The same day, Mabel secretly arranges a wedding for her Grunkle Ford and new ‘Grauntie Penny’. Stan is on the sidelines for the whole occassion, but finally takes his brothers side as the Best Man. Mabel is the flower girl and Dipper bares the rings, while Susan is her maid of honor. Stanford promises to protect and cherish her for as long as he lives. Penny promises to care for him and heal him when the times arise. They smooch after some crazy heartfelt vows, thus they are married.

October 15 2012. Penny and Ford celebrate Wirt’s 33rd birthday. Wirt still isn’t used to his dad but comes around when he sees just how quizzical he is. They’re so alike it’s crazy!

November 2012. Penny joins Stan and Ford on the Stan ‘O War II.

(just to keep track-- in 2020 Wirt is 41, Dip and Mabs are 21, Greg is 34, and Steven is 17)

Mans that’s what I have! I’d love to hear anything from y’all about this!

[drsilverfish]

Jack Kline Novak Winchester: Son, TFW Mirror, Trinity and Key; Quaternity, Ouroboros, Caduceus, and Harbinger of The End

“I am a hunter, I am the son of Lucifer, I am a Winchester!” (14x14 Ourboros).

“One becomes two, two becomes three, and out of the third comes the one as the fourth.” (the alchemist Maria Prophetissima 1-3 C AD). This refers to the four stages of alchemy, the refining of base metals into gold on the material plane, but the refining of the soul to God on the spiritual plane -  nigredo (black), albedo (white), citrinalis (yellow), and rubedo (red).  

In Jung’s interpretation of this alchemical piece of wisdom, this means the refining of the psyche:

1) = Conscious Self

2) = Unconscious Self (the Shadow or Mirror)

3) = Inner Mediator

4) Integrated Self

(One of the books Dean uses to build the Ma’lak box in 14x11 Damaged Goods)

This meta is concerned with Jack’s rich symbolic role in the SPN narrative. 

Jack enters the story to help Team Free Will face their Shadow-Selves and thus evolve psychologically.

This concludes my S14 meta series on the Jungian (and alchemical) themes of the season.

You can read all the previous meta in that series here:

1) The Shadow 14x08

http://drsilverfish.tumblr.com/post/180906003584/the-shadow-14x08

2) 14x09 The Spear (Jungian Decoder Ring Edition)

http://drsilverfish.tumblr.com/post/181122764984/14x09-the-spear-jungian-decoder-ring-edition

3) Jung and Dean’s Journey Towards Self-Integration in 14x11 Damaged Goods

http://drsilverfish.tumblr.com/post/182299438269/jung-and-deans-journey-towards-self-integration

4) Ouroboros in Prophet and Loss (14x12)

http://drsilverfish.tumblr.com/post/182486474324/ouroboros-in-prophet-and-loss-14x12

5) A Pearl of Great Price - 14x13 Lebanon

http://drsilverfish.tumblr.com/post/182660472289/a-pearl-of-great-price-14x13-lebanon

6) The Serpent and the Egg: Snake and Eye Symbology in 14x14 Ouroboros

http://drsilverfish.tumblr.com/post/183327000184/the-serpent-and-the-egg-snake-and-eye-symbology

7) Another Alchemical Easter Egg in 14x14

http://drsilverfish.tumblr.com/post/183388134889/another-alchemical-easter-egg-in-14x14

8) The Scapegoat: Speculative Musings on S14′s End (Moriah) (Linked to the Season’s Jungian Themes - Scapegoating and the Unacknowledged Shadow)

http://drsilverfish.tumblr.com/post/184045009309/the-scapegoat-speculative-musings-on-s14s-end

9) Dean’s Jungian Shadow Arc in S14: Confronting the Internal Father (2x22 to 14x20 Moriah)

https://drsilverfish.tumblr.com/post/184507150574/deans-jungian-shadow-arc-in-s14-confronting-the

Jack is dualistic; Good and Evil, Human Soul and Angelic Grace. He is a trinity: Human, Angel and “Demon” (fallen Angel); Dean-mirror, Cas-mirror, Sam-mirror. He is also a quaternity, thanks to the additional feminine element: his mother, Kelly Kline and his adoptive mother/ grandmother Mary Winchester (the latter resurrected by the feminine God-principle Amara).

Jung considers the quaternity to be highly significant (he refers to “squaring the circle”) including, as above, in relation to his interpretation of Maria Prophetissima’s alchemical summary as being analogous to the stages of psychic growth and integration. He often considers the, Son, Father, Holy Ghost and Mother Mary of Christianity to be external symbols for the four stages or elements of the human psyche.

“The quaternity, is an archetype of almost universal occurrence [. . .]” For instance, if you want to describe the horizon as a whole, you name the four quarters of heaven…There are always four elements, four prime qualities, four colours, four castes, four ways of spiritual development, etc. So, too, there are four aspects of psychological orientation [. . .] The ideal of completeness is the circle sphere, but its natural minimal division is a quaternity” 

(Jung: Psychology and Religion: West and East).

Conceived by stealth-rape in a Bucklemming episode (12x08 LOTUS) Jack was possibly off to an inauspicious start as the Devil’s Baby.

But Jack the Nephilim, son of Lucifer and Kelly Kline, had the good sense to adopt Castiel as his protector in the womb, and from then on out he has ascended through the spiral narrative like the phoenix he is.  

Born in 12x23 All Along the Watchtower, Jack was always part of Dabb’s Ouroboros narrative. A "demon” with yellow eyes in a nursery, a child, and a mother who dies; Jack was a mirror, reflecting SPN’s origin story, of Azazel feeding baby-Sam demon blood, and burning Mary Winchester on the ceiling. And Jack was Sammy and Azazel both. 

Castiel died at Jack’s birth too, murdered by Lucifer in front of Dean’s horrified eyes, thus placing Cas in the role of Mary Winchester and Dean in the role of John Winchester.   

Adopted by a reluctant grieving Dean and a hopeful Sam, Jack discovered he loved nougat and stole a lot of fandom hearts. 

Importantly, through their adoption of Jack and his reflection of many of their previous experiences, TFW are forced to recognise themselves (including painful repressed elements of themselves) in him, thus he enables them to better meet their Shadow-selves and evolve. In this sense he is the mediator between the Ego and the Id, the conscious self and the unconscious self, the Self and the Shadow for TFW. That is why Jack is linked to the symbol of the Ouroboros, the snake swallowing its own tail, because in alchemy that signifies transformation:

This self-recognition (of themselves in Jack) is initially much easier for Sam and Cas than it is for Dean....

Sam the boy corrupted by demon blood, of course sees himself in the innocent yet unstable son of Lucifer. Cas, fallen angel in love with humanity, likewise naturally sees himself in a half-angel/ half-human child who is struggling with his place in the world. 

Juxtaposing innocence and enormous power (potential for good and potential for evil) Jack was a child who grew up too fast, literally (appearing twenty whilst only two). In this respect, he was a mirror for Dean, who had to grow up too fast when his Mom died, assuming the role of substitute-parent to Sammy. 

Dean has a hard time recognising and having compassion for the innocent child part of himself that he gave up to become Daddy’s “good little soldier” and caretaker to Sammy. Which is why his journey into loving Jack (as a reflection of himself) goes hardest (see my meta on Dean’s Jungian shadow arc, linked above, for more on this). 

Jack is also (like Dawn in Buffy) a metaphysical, mystical key. He opens doors; doors between dimensions/ worlds and alternate universes as well as doors in the psyche between the Self and the Shadow. He is the key to Chuck’s multiverse and to the larger God-machine.

Jack (responding to Dean’s intense grief) resurrected Castiel in The Empty, the space where dead angels and demons go. Only Chuck had resurrected Castiel previously. So, we see Jack step into the role of God, but in a place (The Empty) where (if we believe the Cosmic Entity that resides there) God has no dominion. Jack already presages God Level Mark II.   

With Mary Winchester in the apocalypse world (she who was resurrected by the feminine God-principle, Amara) Jack stood on the side of humans against angels, and in this, he was a mirror for Castiel (who rebelled against Heaven to stand with the Winchesters). 

When his birth father, Lucifer, stole his grace in 13x23 Let the Good Times Roll, Jack became de-powered (human-ish) again, mirroring Castiel (and his Human!Cas arc after the angel fall in 8x23 Sacrifice).  

With his soul/ grace unbalanced, Jack began coughing up blood; a mirror for Sam’s journey during the demon trials of S8.

Knowing he was dying, Jack went fishing with Dean in 14x07 Unhuman Nature 

Ahhh all the lovely fish and fishing metaphors SPN has employed over the years. Fish have sometimes stood for humans, sometimes stood for angels, but always for angel/ human convergence. Jung in Aion (reading medieval alchemical texts) writes about the fish as an alchemical symbol for the philosopher’s stone (the mystical substance that allows transformation - of matter and spirit and, for Jung, of the psyche):  “...alchemical fish symbolism leads direct to the lapis, the salvator, servator, and deus terrenus; that is, psychologically, to the self.” (Jung, Aion: Researches into the Phenomenology of the Self, 1979: p157)   

So, Dean and his adopted Nephilim son fish together, which recalls, in particular, Dean’s fishing dream in 4x20 The Rapture, which Cas entered and there passed Dean a love note of assistance. If fish are angels, then Dean and Jack have already “caught” one, by means of love: Castiel.

Dean is placed here again in the role of his own father, John Winchester. 

JACK: “You once told me you and your father did the exact same thing. It was your happiest memory of him.”

And Jack, as the product of angel/ human congress, has always stood (in subtext) as a metaphor for the love between Dean and Cas.

But, metaphysically unbalanced, Jack sickens further. An injection of Gabriel’s archangel grace doesn’t help. TFW take him to the hospital together, to no avail. Sam, his third adoptive father, keeps vigil at his bedside as he dies.

Jack finds himself in Heaven. Here he is a mirror for Sam and Dean, who have both died multiple times on the show. He reunites with his mother Kelly Kline, but The Shadow (a manifestation of The Empty particularly linked to Castiel, symbolising, as it does, Cas’ Jungian Shadow-self) has invaded Heaven and wants to drag Jack to The Empty with it. Jack’s duality is here highlighted, as his human soul belongs in Heaven, but his dead angelic self belongs in The Empty, (according to the SPN cosmic sorting hat!)

Castiel comes searching for Jack in Heaven, and makes a deal with The Shadow in 14x08 Byzantium - Jack’s life for his own (the moment Cas allows himself to be happy). Cas and Jack mirror Dean and Sam here, and all the supernatural deals they’ve made, or tried to make, to bring one another back from death over the years. Cas in particular mirrors Dean, because Sam has always, in one sense, been not only Dean’s brother, but his son. 

As ever, there will be a price to pay for this deal. Not only Castiel’s promise to surrender himself to the Shadow, but also the second “death” of Mary Winchester (caused by a resurrected Jack). 

But, Cas loves his Nephilim son so much (<my heart>):

Held in an unstable balance thanks to Lily Sunder’s dark soul-consuming magic, things start to get dicey for Jack post-resurrection. He tries to impress Max, Stacy and Eliot (the Lebanon kids) and ends up stabbing Stacy (Castiel’s mirror) with an angel blade (14x16 Don’t Go in the Woods) leaving Max (Dean’s mirror) grieving over her body, thus, in that moment, mirroring his father Lucifer (12x23 All Along the Watchtower), However, he brings Stacy back from death (mirroring his own resurrection of Cas) but every time he uses his powers, he burns off some of his soul:

Wow he is cycling, Ouroboros style, through so many previous TFW arcs.

And so we arrive at 14x14 Ouroboros itself, THE crucial episode in terms of all this symbology, in which Jack kills the Queer Gorgon Noah Ophis (himself an Ouroboros symbol = Noah from Genesis and Ophis from Revelation) to save the Winchesters and adopts his snake, Felix (also an Ouroboros symbol). 

Then, he burns off considerably more of his soul (perhaps all of it  - it’s unclear) to kill AU!Michael, and swallows his grace, Ouroboros style:

Jack is now another symbolic duality and trinity - he contains elements of both Michael and Lucifer, the two opposing forces in Apocalypse Mark I, now united in one being. The third element is provided by his humanity (now, seemingly, in jeopardy). 

An evolved and fully re-powered-up Jack has sprung forth, just as Pegasus the winged horse and his brother Chrysaor of the golden sword did from the neck of their Gorgon mother Medusa when Perseus slew her:  

In this form, Jack is linked (via a book on Donatello’s shelves behind him in 14x15 Peace of Mind - thanks to @postmodernmulticoloredcloak for this spot!) to the Caduceus symbol on the spine of the Book of Life here:

The Caduceus is the staff of Hermes, consisting of two serpents entwined about a staff crowned with wings. Hermes is the messenger of the Gods in Greek mythology. He can move freely between the worlds of God and men (linking to Jack’s function as a metaphysical key, on both a micro-cosmic psychological scale, and a macrocosmic God-machine scale). Hermes was also a psychopomp, a conductor of souls to the afterlife. The psychopomp is linked by Jung to the psychological mediator function - that which mediates between the Self and the Shadow, as Jack does for TFW via his mirroring function. 

Jack’s visit to Donatello also serves to remind us that even someone without a human soul can live a good life if they pick the right role models (Donatello picks Mr. Rogers, Jack picks the Winchesters). 

In 14x15 Peace of Mind, Jack demonstrates both his potential for good and evil in this new diminished soul-state, via a (misplaced) compassion (good) which leads him to kill Felix the snake (evil) believing the beastie is grieving for Noah the Queer Gorgon and will be reunited with him in death:

This death of the snake is also symbolic of Jack’s role as mirror and mystical key - old patterns within both Team Free Will and Chuck’s Multiverse must die, in order for newer and healthier ones to be born. Jack is the catalyst, the messenger, the Ouroboros, the Caduceus. 

In Jack’s new, vulnerable, state (with either some, or all, of his soul gone) he  banishes Lucifer back to the Empty in 14x17 Game Night after Nick (bleugh) tries to resurrect him, and he then burns Nick to a crispy cinder for good measure. Afterwards, Jack is tormented by Hallucifer (a vision of his father Lucifer in his mind). This is very possibly the actual Lucifer, communicating with Jack via the blood-link spell Nick performed, hoping to lead him astray. It certainly sounds like the actual Lucifer. It also, of course, mirrors Sam’s Hallucifer arc.

Distressed by Mary’s reaction to his incineration of Nick and taunted by Hallucifer, Jack loses control and (or so we are led to believe) kills Mary (in fact I think he’s blasted her unwittingly through a portal to an AU/ mirror universe, but that’s another story).

Now the crisis in Jack’s relationship with his adoptive fathers is set up. 

Dean, is the member of TFW who (as I explained above) has found it hardest to have compassion for the mirror-self whom Jack reflects back to him (young Dean with the weight of the world on his shoulders) and he determines Jack must be locked in the Ma’lak box and/ or killed. Sam and Cas, who have been better able to recognise themselves in Jack and so have compassion for him, dissent (but Sam’s hangover child-role to Dean’s father-role in their toxic co-dependency means he doesn’t initially stand up to Dean).  

Here is Jack, locked in the Ma’lak box (Jack in the Box 14x19) being tormented again by Hallucifer:

And, of course, that couldn’t contain him, so, deeply upset at being lied to by two of his three adoptive fathers, Jack busts out all glowy-eyed:

Chuck shows up to set Mount Moriah and Abraham and Isaac redux in motion , and Dean, possessed by his Shadow-self (the Ghost of John Winchester) gets ready to repeat history. 

A yellow-eyed “demon”has killed Mary Winchester (again) and Dean-as-John picks up Chuck’s weapon of RevengeTM (the Hammurabi - see my meta on Dean and his Shadow arc linked above for more on this).

But Jack, in his role as mirror and mediator between the Self and the Shadow. freely offers himself as a sacrifice, a scapegoat. 

And seeing this, at last, Dean has compassion, both for Jack and for his own mirror-child self, “murdered” by John Winchester’s revenge quest to get Yellow-Eyes/ Azazel. And so, he stays his hand.

Chuck, the bastard, kills Jack anyway and lights the fuse under Apocalypse III. 

But, because Jack is a metaphysical key and the symbol of transfomation (Ouroboros) he can move between all the realms of the God-machine. And so, Death has no true dominion, and we see Jack awaken (14x20 Moriah) in The Empty: 

There, he is greeted by a figure, presumbly the Cosmic Entity who presides over the place, as well as by Billie the New Death.

According to the Empty’s Cosmic Entity in 13x04 The Big Empty, “Before God and Amara, creation, destruction, Heaven, Hell, your precious little earth, what was there?... Nothing. Nothing but Empty... Angels and demons... you all come here when you die...  I’m the only one that has any pull here. Not Heaven, not Hell, not G-O-D himself.“

As with the Amara storyline (she is mapped to Sophia, the cosmic feminine God-principle) it seems Dabb is drawing on Gnosticism in his conception of The Empty. Jung was also fascinated by Gnosticism. 

The Gnostics made a distinction between the supreme unknowable Being, and the creator of the material universe, God, known as the Demiurge (who was often seen as amoral, even wicked). 

We don’t yet know whether Chuck has already merged with Amara, and is the double entity Chuck/ Amara or, whether her feminine God-principle will be instrumental in persuading him to finally end his story, and let Team Free Will and humanity become the authors of their own stories. The latter would make sense in Jung’s quaternity structure, and would be linked to my theory that Mary Winchester is not dead and will return to her sons before the end. 

Chuck, as the Demiurge, may perhaps be the mere avatar or emanation of the true supreme Godhood, if we take a Gnostic perspective. Whilst Chuck-the-Demiurge must be defeated, because he doesn’t want to relinquish control of the narrative, in his Supreme Godhood form, and/or merged Amara form, he may himself relinquish control and let Team Free Will go.   

Whether Jack is initially manipulated by The Empty, Death and/ or an awakened Lucifer and/or indeed AU!Michael, or joins forces with them (in their good faith) remains to be seen. Lucifer may (ugh, but definitely possible) get a redemption arc, as he has, despite his many evil deeds, undoubtedly been wronged by Chuck (forced to bear the Mark of Cain and thus become corrupted by it). 

Ultimately, I have no doubt that Jack, thanks to his loving connection to Team Free Will, will ultimately (as Cas has always believed) be “good for the world”:

(Jack and his three adoptive Dads in Unhuman Nature 14x07) 

 Jack, as the alchemical symbol of transformation (Ouroboros) as Mercury the mediator (Caduceus) between universes, between realms in the God-Machine, and between the conscious and the unconscious, and as the union of opposites (Michael and Lucifer, Good and Evil, Self and the Shadow), and as the trinity symbolising that unity (Sam, Dean and Cas merged as TFW) and as the quaternity (the ultimate integration [I hope] with the feminine principle symbolised by Mary and Amara) will, I believe, help usher in “Paradise” after the Apocalypse III; a “new Heaven and a new Earth, because the old Heaven and the old Earth had passed away” (Revelation) in which true free will reigns and Team Free Will have completed their psychic journeys. 

“Thus we have the “hostile brothers,” Christ and the devil, who were regarded as brothers in the Jewish-Christian tradition; the tetrameria into four parts or elements; the paired opposites and their ultimate unity; the parallel of the lapis and Mercurius with Christ and, because of the snake or dragon symbolism, also with the devil; and finally, the figure of Mercurius duplex and of the lapis, which unites the opposites indivisibly in itself.”

(Jung, Aion: Researches into the Phenomenology of the Self, 1979: p214)

https://www.jungiananalysts.org.uk/wp-content/uploads/2018/07/C.-G.-Jung-Collected-Works-Volume-9ii_-AION_-Researches-into-the-Phenomenology-of-the-Self.pdf

[thegreen1969pontiac]

L’appel Du Vide Chapter 4- Midnight Coffee

                                          Eventual Dean x OC

Summary: When Hope’s sister is killed in a less than a normal house fire, and Sam, her sister’s boyfriend, disappears with his brother after her death they’re her number one suspects. When the cops declare the case cold she begins her hunt for the Winchester boys. She follows them in hope for some evidence pointing to the death of her sister, but will she find more than just the cause and the killer? Will she find out more than she wanted to?

Warning: creepy guy, very minor sexual themes, language, crappy writing

Word Count: 2434

I've got to admit, the Winchester boys seem to be the hardest to track men in the USA, well, besides my uncle. They seem like ghosts. Sam showed up to Stanford about four years ago, he came on an almost full-ride scholarship and no family to help him move in on moving day.  He was a smart guy, he was top of his class in almost all the schools he was forced to move around to. His dad, John, was a marine. They originated from Lawrence, Kansas, Dean was born January 24, 1979, which seemed to just rip me apart even more seeing as Jess was born the same day in 1984. But John Winchester seemed to disappear the date his wife, Mary died, November 2, 1983, just a year after my sister was born, and to the date the day she died.  Two November 2nd both involving the Winchester boys. What was this some family cult that killed the women of the family? What the hell? After asking the professors at the university, it seems that Sam was pretty normal. Quiet, courteous, polite and intelligent, but nothing out of the ordinary.

After all of this, there was only the date of the deaths that pointed to murder. I needed to find someone that my sister knew, someone who would know what kind of man Sam was. My sister mentioned this guy, he brought them together. This guy named Brady, Jess mentioned him once or twice he wasn't a close friend of hers just someone she met at a college party at one point. If you can imagine there was a shit ton of Brady's at Stanford University, after about 12 hours of driving Theo from frat house to apartment, it wasn't until maybe the 23rd Brady that I finally found the one that knew her. Brady was a successful kid it seemed that he had a job all lined up for him at Niveus Pharmaceuticals, a company that seemed to profit off the sickness of others. But I guess in his mind it would get the bills of Stanford University paid, he was a charismatic young man I could see why Jess let him set her up with Sam. He asked me to come in,

"Are you Brady? Did you know my sister Jessica Moore?" I ask already feeling tried from asking the same question over and over again.

"I'm Brady, yeah. I knew her, I heard what happened. Who are you?" He asked in almost an accusatory manner.

"I'm her sister, I go by Moore. May I sit?" I say already losing patience with the rich and snotty Stanford kid.

"Oh, yeah, yeah of course. Sorry for your loss."  He rushes out.

"I'd just like to ask some questions if you wouldn't mind, just for some closure." I come up with my excuse, it's not for closure though it is for knowledge.

"Yeah, yeah, what do you want to know?" He asks he gestures for me to sit down on the Italian leather coach that he probably paid way too much for.

"My sister, she had a boyfriend, What was his name again? Was it Smitty?" I ask playing stupid, I need to confirm his name, get some information on this sick son of a bitch.

"No, his name was Sam, Sam Winchester. I actually introduced the two." He smiled to himself almost proud that he introduced the two to each other.

"Yeah, good for you. Did you know Sam well? I didn't see him at the funeral, I just wanted to check up on him you know, help me understand how he is dealing with all of this," I stated, "I mean do you know where he is, I couldn't find a single record of where he could've gone after the fire." I smile, playing the victim wasn't ever my role.

"I don't know where he is now but I heard that he went on a road trip with his brother right before the house went down," He says, "I think I might someone who does though, her name is Becky Warren, she and her brother were friends with Sam when he was here. I really hope you find him though, but hey, I gotta get to lacrosse practice so..." He leads off, how did I know this douche would play lacrosse.

"No, I totally get it. Thank you for your time." I say and stand up, I walk out of the house and head to the address. I finally get to the house that is owned by the Warren family. There are only two cars parked in the driveway. I walk up the driveway and am at the door when the door swings open an I'm met with a frazzled looking girl.

"Are you Becky?" I ask blocking her exit from the house.

"Yeah, look, I have to get going I have class in like 10 minutes." She tries to move around me but I move in front of her again,

"Look, I need to know where Sam Winchester is and I was told you could help me if you could just give me a general idea I will be out of your hair," I say,

"I don't give out my friend's locations to strangers so why don't you piss off." She said and made a move to go around me but this time a grab her jacket and push her against the door frame.

"Yeah, well I don't usually arrange funerals for dead family members but it seems like we are all having a bad year," I growl at her,

"So I am going to ask you one more god damn time, you are going to tell me where my dead sister's boyfriend is or I swear to God I will make you and your brother's life the most miserable they can be, so you can know how I have felt every god damn day since I heard my baby sister was killed in that fire." I hiss out at her.

"I don't know okay, he only texts me so often." She whimpers, "The last I heard he was in Ohio." I smile and let her off the doorstep.

"See, that's all I needed we didn't need to get all nasty. Now lets hope we don't see each other again shall we?" Yeah, we can only hope, right? I turn on my heel and walk to Theo.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A suburban Ohio town has been dealing with the murder of one of their own Steven Shoemaker died in a strange way, the obituary said it was a stroke. But his eyes basically burst out of his skull. Death although seems to follow these boys so why not take a look. Toledo, Ohio was quite the apple pie life town, it was full of high school sweethearts and minivans, but under all of that sticky sweetness, I could tell that there were some underlying skeletons in the closet of the gingerbread house town. Driving there wasn't much of an issue after running on only alcohol and granola bars for about three weeks, it is nice to have a change to coffee and diner food. The food that was eaten along the way to Ohio made me feel like crap but the coffee was always warm and the diners mainly stayed open for 24 hours. That's where I am now, sitting at a 24-hour diner with checkered tiles and bright red seats. The coffee on the table no matter how much I want to say it was black and sound like the badass, it had two creamers and three sugars in it. I was researching the town on my lab top, when the sun peeks its way from behind the family houses I'm heading down to the coroners to get a closer look at the body of the victim. Its been around two days since I had a decent shower so I decided to pack up early and make myself not look like the sleep deprived, alcohol smelling, mess that I am.

The hotel life had been abandoned, motels were now my realm. I can't tell if it is because I don't trust myself to be in high places anymore or if I just don't believe in the normal life anymore and I'm punishing myself to shitty, never cleaned motels that look like they could also be pimping out prostitutes to each room. After the shower, I dress in some of my best clothes that I packed, a black pencil skirt and a white button up that I tucked into the skirt letting my collar bones show, I put my hair up in a professional up-do and grabbed the brown leather jacket that kept me warm in the cold weather. The only new things I needed were shoes and I ended up going to one of the many stores at Toledo's main street and just as the store was opening managed to grab a pair of classy black heels. The coroner's office would no doubt be open now and I just needed to complete the facade with a small pen and notebook. Instead of putting in my contacts this morning I left my glasses on, the blood shotness of my eyes were slightly hidden by the glass.

As I parked Theo in the parking lot of the office I see a black 67' impala sitting across the street. The license plates reading Kansas. I hold my breath, there is no possible way that I would find the boys in the first place I stopped. As I put on the heels from inside my car I saw two tall men walking out of the hospital, the stairs looked old and white, One of the men was no doubt, Sam Winchester, I quickly walked up to the boys ready to walk right up to the evil son of a bitch that murdered my sister and start beating the living hell out of the tall man. But the man next to the puppy dog man was intimidating, he was tall and wore a dark brown leather jacket over his blue flannel, he stared me down like a piece of meat and I knew that I could barely take down one of the two Winchester's and if this was Dean there would be no way in hell I would be able to take down either of them. As I walked closer to them and as they passed me I tried to identify every possible feature so I would be able to know who they were the next time I saw them. As I went up the stairs and they walked down I paid careful attention to which car they got into, and not at all to my surprise I see they get in the Impala with the Kansas license plates, I make careful note of those as well. KAZ-2Y5. God, that won't be hard to forget.

As I get inside the hospital building I walk quickly down to the coroner's office and although I hate wearing heels I like the way they make the clicking noise on the tile floor. The office does look like its open but I can't imagine that the sleazeball looking nurse that sits at the desk seemingly counting cash is the doctor I'm looking for. I tap on the door,

"I'm sorry are you Dr. Feiklowicz? I'm doing an article for the paper about death and I was wondering if I could get some details." I say smiling, I see him rush to put some bills in his pocket, I put it together in my mind and guess that it was the boys that gave the money to him. Why the hell would they pay to see their own murder victim, what kind of sickos are these freaks?

"I'm sorry, he won't be back for an hour, is there something I could help you with?" He says smirking. I can feel him looking me up and down and I can feel my inner head just retching at even the thought. "Oh, that's too bad, is there any way that I could see the body on my own maybe, I just am going to be taking notes." I hum out,

"I'm sorry I will have to ask for some identification before I can let you in, you said you were with the press?" I curse myself, I smile and nod,

"Of course, let me just get out my-- Oh, shoot I think I left my key card at the office, can I just give you my ID?" I ask falsely reaching for the key card that I did not own.

"Well-- I really do nee--" I smile and begin to take off my jacket leaving me in my skirt and blouse that although classy, seems to work on the idiot in front of me, I hold it in my hand arms crossed and stare innocently at him.

"Please, I really need to get some notes, I have to get these back before my boss gets back, he is so mean to me and I might lose my job," I say making myself tear up, I guess playing Ophelia in middle school paid off well.

"Well, I guess. Can I see your ID?" I hand it to him, he takes it and I see him try and make an effort to brush my hand with his own the action almost makes me sick to my stomach.

"Hope Moore, that's a real’ pretty name. A pretty name for a pretty girl," He says trying to woo me with his horrible pick up line.

"Actually I go by Moore." I let my sickly sweet facade drop that time letting him know that I do not want him to call me that again.

"Yeah, sure."

He leads me back into the room and he pulls the sheet off, after seeing my sister I don't think I will be so upset with dead bodies anymore. I ask him about the death and it's said that something bizarre happened that his eyes burst inside his skull, the creep nurse said that there has never been something like that to happen during a stoke. I thank him for his time and he seems to be wanting to ask me something but I rush out of the morgue and get back to finding the Winchester boys.

 I drive around town hoping to see the same black car and when I finally find it I notice that there are many other cars parked outside the house as well.

I grimace, funerals suck.

[worldnewsinpictures]

Just retired after 42 years as an obstetrical nurse, at the same hospital. Here I am at the start (1979) and end of my career! That second one is a grin from being smug about how great she still looks!... Want to see more about this and see what people are saying? -> https://worldnewsinpictures.com/just-retired-after-42-years-as-an-obstetrical-nurse-at-the-same-hospital-here-i-am-at-the-start-1979-and-end-of-my-career JustHere retired obstetrical #JustHere #JustHereThat #retired #obstetrical

[papermoonloveslucy]

LUCY AND LIBERACE

S2;E16 ~ January 5, 1970

Directed by Jack Baker ~ Written by Fred S. Fox and Seaman Jacobs

Synopsis

For a high school initiation, Craig goes on a scavenger hunt to retrieve one of Liberace's candelabras. Liberace loans it to him but Lucy thinks he stole it so she recruits Harry to sneak into the star's mansion and return it.  

Regular Cast

Lucille Ball (Lucy Carter), Gale Gordon (Harrison Otis Carter), Lucie Arnaz (Kim Carter), Desi Arnaz Jr. (Craig Carter)

Guest Cast

Liberace (Himself) was born Władziu Valentino Liberace in 1919.  A piano prodigy, he was the son of working-class immigrants, and enjoyed a career spanning four decades of concerts, recordings, television, motion pictures, and endorsements. At the height of his fame, from the 1950s to the 1970s, Liberace was the highest-paid entertainer in the world, with established residencies in Las Vegas, and an international touring schedule. 

Liberace (known informally as ‘Lee’) embraced a lifestyle of flamboyant excess both on and off stage, acquiring the sobriquet "Mr. Showmanship." Prior to this episode, his only appearance with Lucille Ball was the musical film Best Foot Forward (1943). He died at age 67 after a battle with HIV/AIDS.

Ben Wrigley (Williams, Liberace's Butler) was a British actor who appeared in My Fair Lady (1964) and Bednobs and Broomsticks (1971). He previously appeared as a ticket agent in “Lucy Flies to London” (TLS S5;E6).  This is the first of his three episodes of “Here’s Lucy.”

Paul Winchell (Carlo, Liberace's Tailor) previously played himself in“Lucy and Paul Winchell” (TLS S5;E4). He was born Paul Wilchinsky in 1922. Coming into the public eye in 1948, he became one of the most famous ventriloquists since Edgar Bergen. He hosted the enormously popular children’s television show “Winchell-Mahoney Time” (1964-68) in which he shared the spotlight with Jerry Mahoney, one of his most popular characters. He played Doc Putnam in “Main Street U.S.A.” (TLS S5;17) and “Lucy Puts Main Street on the Map” (TLS S5;E18). This is the second of his two episodes of “Here’s Lucy.”  He died in 2005.

Winchell uses an Italian accent for this character.  

This is the first episode of the new year and the new decade.  

The 1970s will see the end of “Here's Lucy” in 1974, as well as Lucille Ball's return to the silver screen in Mame that same year.  In 1971, Lucie Arnaz will wed Phil Vandervort and Desi Arnaz Jr. made his big screen debut in Red Sky at Morning.  At the end of the decade, Lucie Arnaz made her Broadway debut in They're Playing Our Song (1979).

The date this episode was first aired (January 5, 1970) ABC premiered a new daytime drama called All My Children. Philip Amelio, who played Lucy’s grandson on “Life With Lucy”, appeared on the sudser in 1988. It ceased production in 2013. 

Liberace brought $50,000 worth of his spectacular wardrobe to the set, and Lucille Ball hired a round-the-clock security guard to ensure its safety. The tuxedo jacket that lights up in the dark made its debut on this show; Liberace will use it in his act for the rest of his life.

In the 2013 HBO biopic Behind the Candelabra, an aging Liberace (Michael Douglas) compares his domestic life with partner Scott Thorson (Matt Damon) to an old sitcom. Scott protests: “Why am I the Lucy?”  Douglas' father Kirk made a wordless cameo appearance on a 1966 episode of “The Lucy Show.”

Professor Harkens gave Craig the African mask.

Lucy recalls her initiation into ‘The Swingers’ in high school.  The double entendre of 'swinging' is quickly cleared up by Lucy saying she was in a trapeze club!  For her initiation, she had to get an autographed photo of Rudy Vallee. Rudy Vallee was a singer popular in the 1920s and '30s who made a guest appearance on the first episode of “The Lucy-Desi Comedy Hour” in 1957.  He will guest star as himself during season 3 of “Here's Lucy.”  

Kim guesses that Craig may have to retrieve an item from Engelbert Humperdinck. Lucy replies “What's an Engelbert Dumperhinck?”  Engelbert Humperdinck is an English pop singer acclaimed as one of the finest middle-of-the-road balladeers around. In 1969 he released two albums and had three hit singles. That same year he was the first guest on “The Liberace Show”. 

In Liberace's mansion, he enters and sits at a glass-lid Baldwin grand piano and plays Chopin's “Military Polonaise” (Opus 40, #1) composed in 1838.  

When Liberace tries on the light-up jacket, he says “This'll really turn them on in Pasadena!”  He could be referring to his senior citizen female fans. There was a popular song at the time titled “Little Old Lady From Pasadena.” Later in the episode we learn that the candelabra loaned to Craig was a gift from a Senior Citizen group. 

In a retrospectively ironic line, Liberace says about his many candelabras: “I've got closets full of them.” Although Liberace was flamboyant, his sexual orientation was never discussed publicly (he was ‘in the closet’) until later in his life.  When 17 year-old Craig and Liberace are alone (and Craig's shirt is unbuttoned to the navel) it is difficult not to think of Liberace's romance with 18 year-old Scott Thorson (inset), who later sued the entertainer in America's first same-sex palimony case.

At home, Craig gets a phone call from Bill. This is probably a nod to Desi Arnaz Jr.'s friend and band mate Billy Hinsche.  

Answering the front door, Kim says “It's probably Craig with his arms loaded down with that something he had to get from a big star.” Lucy replies: “Maybe he's got his arms full of Jackie Gleason.”  This is a quick joke about comedy star Jackie Gleason's weight.  Gleason did a cameo as Ralph Kramden in the second episode of “Here's Lucy” (above). 

Harry is reminded that in college he underwent initiation into the fraternity Delta Delta Tau. The joke comes when he gives says their initials – DDT. Dichlorodiphenyltrichloroethane (DDT) is a chemical used as an insecticide. In the late 1960s and early ‘70s DDT was frequently in the news regarding its harmful effects on humans, wildlife, and the environment.  DDT was eventually banned.  

The candelabra is inscribed “To Liberace. From his Senior Citizen Fan Club in Pismo Beach.” Along with Cucagmonga, Pismo Beach was often used as a punch-line for jokes about California. It was mentioned in “Lucy Goes on Strike” (S1;E16). Pismo Beach is one of the locations Lucy and Ethel want to visit before returning to New York in “Lucy Gets Into Pictures” (ILL S4;E18).

On their way to return the candelabra to Liberace, Harry holds it forth and says “Lead, kindly light.”  “Lead, Kindly Light” is a hymn with words written in 1833 by John Henry Newman as a poem titled "The Pillar of Cloud."

Sneaking into Liberace's mansion through the back door, Harry's shoes squeak! Lucy says “You'd sure be a goofball on 'Mission: Impossible.’”  The Desilu TV spy show “Mission: Impossible” has been a source of humor for “Here's Lucy,” which even did a whole episode parodying the show: “Lucy's Impossible Mission” (S1;E6, above).  

Harry and Lucy sing while Liberace plays "By the Light of the Silvery Moon,” a song written in 1909 by Gus Edwards and Edward Madden. Lucy says she and Harry first performed the number at the Kiwanis Capers.

When Lucy suggests that Liberace use the whole family on his TV special, Liberace remarks “You're about 83 short of the King Family.” The King Family was a family musical group that had great success on records and television in the 1960s. They had a TV show on ABC that ran until 1969.  

As the big finale, everyone sings and dances to "I'll Be Seeing You," a song written by Sammy Fain and Irving Kahal in 1938. It was inserted into the Broadway musical Right This Way, which closed after just  fifteen performances.

Lucy and Lee shared the covers of many periodicals of the 1950s. Both had top-rated television programs and were instantly identifiable figures and names. Nearly 20 years later, both are still considered show business royalty. 

Offscreen, Lucy and Desi socialize with Liberace during the height of their fame. 

At the start of the episode, Craig enters wearing an African mask.  The moment is similar to when Ricky Ricardo researched African masks for his Voodoo act during “Lucy Goes to the Hospital” (ILL S2;E16). The scene also begins the 1953 episode. Ricky Ricardo also briefly wore an African mask in “Cuban Pals” (ILL S1;E28) before singing “Similau.”  

Liberace tells Craig not to worry about returning the candelabra as he has a lot of them. Craig replies: “If Los Angeles ever had a black out – you could light the whole city.” This echoes when Liberace was first mentioned by Lucy Ricardo in “The Diner” (ILL S3;E25) in 1954.  

LUCY RICARDO: (about Ricky’s bad mood): “Everything went wrong down at the club last night. Right in the middle of his big number, the lights went out all over the whole neighborhood. Everybody got up and, and left and went into the nightclub across the street.” ETHEL MERTZ: “How’d they manage without electricity?” LUCY RICARDO: “Liberace was playing there.  He does his show by candlelight.” 

“Lucy’s Club Dance” (S3;E25) included the February 26, 1954 issue of TV Guide with Liberace (and a candelabra) on the cover. It was one of many used as set dressing for a corner news stand.  

In “Lucy’s Show-Biz Swan Song” (ILL S2;E12) Lucy and Ethel sing “By the Light of the Silvery Moon” and wangles her way into performing with a barbershop quartet.

In “Lucy’s Barbershop Quartet” (TLS S1;E19) Lucy Carmichael and Vivian Bagley sing “By the Light of the Silvery Moon” and wangles her way into performing with a barbershop quartet.

Craig's collectibles are no doubt supplied by prop master Kenneth Westcott from the Desilu props supply.  It is likely that all of the items were used in some television program, but the one most recognizable is the female ship's figurehead. It was last seen in the background of the Sunset Strip beatnik hangout in “Viv Visits Lucy” (TLS S5;E15).  

In “Lucy and the Countess Have a Horse Guest” (TLS S4;E6), Lucy Carmichael tells the Countess (aka her old chum Rosie) that since moving to Hollywood she has met Lassie’s hairdresser, the man who used to dry off Lloyd Bridges, and Liberace’s dentist. Liberace was well known for his continual smile.  

In “Lucy Dates Dean Martin” (TLS S4;E21) Lucy Carmichael admires (and later wears) a sequined top once worn by Audrey Hepburn. Dean Martin says “The last time I saw anything that fancy was on Liberace.”  In “Lucy and Liberace” Harry admires and tries on Liberace’s red sequined jacket. 

Math Fail!  Liberace says that the Carters are 83 short of the King Family. There were 39 members of the King family, ranging in age from 7 months to 79 years, who appeared on their television show.  Liberace is exaggerating by 48 Kings!

Where the (Marble) Floor Ends! In the living room scene the camera pulls back to far and reveals the soundstage cement floor.  When this happens in Liberace's mansion, the tape spike marks are clearly visible for centering of the dance numbers and camera positions.

Sitcom Logic Alert! The ending of the episode ditches all pretense of reality and turns into a musical performance for the studio audience, including Liberace waving to the audience as he exits – stage right!  It is jarring and a sign that – once again - “Here's Lucy” is unsure of its identity.  

“Lucy and Liberace” rates 3 Paper Hearts out of 5

Let's face it – even playing himself Liberace is a pretty mediocre actor, so this episode could never be more than a showcase for his talent and opulent wardrobe on which is hung a paper thin plot. The worst thing about the episode is the complete demolishing of the fourth wall during the final number. Shameless, really.  

[suckmycoxon]

Hi :) could you give me a little background on omd? I don't know anything of the band except for a few songs, so maybe you could say your knowledge of the band and the members?

OH MY GOD YOU HAVE NO IDEA HOW THRILLED I AM TO DO THIS

Let’s get to the band members first!

Andy McCluskey

Here’s the bossy one. As he puts it, he’s the butcherwho cuts off the raw materials of the song; the director who basically tellsPaul what to do, the one who sees the big picture, while Paul is the surgeonwho splices the details. He sings, plays bass, and writes the lyrics for mostof their songs. And he always dances madly, even in the recent years! For a58-year old guy with bad knees, he’s VERY energetic. So as you can see, he’sthe dominant one. Powerful, loud, cheerful, salty as fuck, thoroughly hatesrock ‘n’ roll, claims he hates cliché love songs but writes them anyway. I lovehim nonetheless

Paul Humphreys

THIS IS MY FAVORITE GUY OFF OMD. MY LOVE. MY HANDSOMEHAMSTER. HE’S CUTE ISN’T HE? Alright, so… he’s the keyboardist, the creativeand technical one. He’s the one who usually comes up with a melody and thenAndy directs how the song should turn out. He’s the one who does most of thesynth sounds! In the old days, he used to build his own “noise machine” bymessing with the circuits and such of old, broken radios. Don’t tell me that’snot badass. He also sings in a couple of OMD’s songs, most notably in“Electricity”, “Souvenir”, “(Forever) Live and Die”, and “Secret”.Personality-wise, he’s the complete opposite of Andy. He’s more quiet, shy,soft, and just lovely overall 

Other members are MalcolmHolmes (the long-haired one in the picture above) who was the drummer from the beginning of the band until 2013. Inthat year, he had a cardiac arrest and temporarily died so he had to retire.From 2013 onwards, Stuart Kershaw tookthe drummer position. Another member is MartinCooper (the one with the blue shirt), the saxophonist/keyboardist/occasional bassist. He’s still with theband until now! Except when OMD broke up because he and Mal went along withPaul instead of Andy, but I’ll get to that later…

They embrace the “punk” attitude in terms of music. Youknow, making music as simple as possible. They always say this joke of “We’rethe punks of electronic. Punk plays with one chord, we play with one finger!”

Now, it’s history time. Let’s go back to the 70s

Andy and Paul had always been the hipsters of that era. Theylistened to electronic bands like Kraftwerk, Neu, La Dusseldorf (Kraftwerk,mostly) while their peers listened to prog rock. Andy was in a band and Paulwas the roadie. Despite always being in the same school, that was when theynoticed how they shared the similar interest towards Kraftwerk, so Andy quitthe band and formed his own with Paul that we now know as the pretentiouslynamed Orchestral Manoeuves in the Dark

They started off as a supporting band fo Joy Division inEric’s Club in Liverpool. They didn’t expect to have a longlasting career… theyreally thought it would be their first and last gig. They just wanted to provethemselves and their mates that they dared to go on stage doing somethingdifferent; doing weird electronic music, hence the odd band name. With such apretentious name, they wanted to show the audience how they were doingsomething different

And then they were offered a second gig in Manchester.That’s where they met Tony Wilson, and he signed them up to Factory Records.Then “Electricity” was recorded, and Tony sent it to various major labels, oneof which was Virgin Records, so they moved to Virgin. It was in 1979/1980 Ithink? And with their 1980 album, Organisation (their second one. Their firstone, the self-titled one, was released in the same year) – which they claim asbeing influenced by Joy Division, so this album is basically the child of JoyDivision and Kraftwerk – which included “Enola Gay”, they became well known.They got even bigger with the Architecture and Morality album, which has“Souvenir”, “Joan of Arc”, “Maid of Orleans”…

They commercially dropped dead with Dazzle Ships (1983). Itwas an experimental album, which I personally think sounds great, but probablynot acceptable enough at that time. Despite having quite successful hits like“Telegraph” and “Genetic Engineering”, that album almost single-handedly killedtheir career. So they took a safer path in their next album, Junk Culture(1984), embracing a more pop-ish sound. It can be heard on their catchy hitsfrom Junk Culture, like “Locomotion” and “Talking Loud and Clear”

Their 1985 album, Crush, was produced by Stephen Hague, whowas also the producer for New Order and Pet Shop Boys. They finally got intoUS’ charts with that album, I guess?? Regarding that album and that year, theyoften say something like “We were trying to break America, but America broke usinstead”, so I can’t be quite sure of what happened… commercially, it waspretty successful, I think… with singles like “Secret” and “La Femme Accident”

It was also in circa 1985 where their most notable song, “IfYou Leave”, was also made. Fun fact: they only wrote it in a day, because JohnHughes changed the ending suddenly and called them and said, “Hey, the song youwrote won’t fit to the new ending, could you write a new one?” right beforethey went on tour. The track that was initially going to be used in Pretty inPink, “Goddess of Love”, was later put on The Pacific Age (1986). Speaking ofwhich, that album has “(Forever) Live and Die”, which is a BANGER and is sungby my handsome hamster, Paul

Then they broke up sometime in late 80s. 1989, I think. Theyowed the company a lot of money, so they made a Best Of album. But even thatwasn’t enough. Their choice was either to make another new album (which canmake money, quite possibly, but due to their past experiences, they barely gotany money left because the touring expenses, royalties to their manager, etcwere so expensive) or to stop and just wait for the money to come from theirprevious albums’ royalties (I’m not really sure about this one, they’ve toldthe story a couple of times during interviews but I could never 100% understandthe story). This is where Andy and Paul went their separate ways. Andy chose tocarry on while Paul chose to stop. So Andy carried the name OMD alone (underhis stubbornness). A couple of years later, Paul, Martin, and Malcolm formedThe Listening Pool. Both were obscured by the new trend in 90s that was Britpopand such (Andy often implies that he blames Britpop for the obscurity ofelectronic bands and I loathe him for that smh I’m a Britpop hoe, fuck youAndy). Andy (as OMD) released 3 albums on that decade, tho. Later on, he formedAtomic Kitten

And then they were reunited in 2006/2007, because they wereasked to perform in a German TV. Then they thought, “Oh, people still like us.Maybe we could make music again.” And so they did… they released History ofModern in 2010, English Electric in 2013, and their latest record, ThePunishment of Luxury, was released a month ago! Unlike the 80s, they are nolonger pressured by their record company, so they’re really doing this purelyfor fun. By the way, their latest single off their latest record, “What Have WeDone”, is sung by Paul and it’s fucking glorious. You should listen to it ifyou haven’t

On a more personal note, I find it weird how they’re bothvery influential and infamous. I mean… they don’t only influence other synthpopbands, but also an alternative like Radiohead. I heard that “Fitter Happier” byRadiohead was influenced by “Genetic Engineering”, and now that I think aboutit, “Fitter Happier” does sound like something out of Dazzle Ships. I’ve been aRadiohead fan since 2011/2012 and yet I literally never heard of OMD until thisyear; not until I got to New Order and was getting more cultured regarding 80ssynthpop acts

Lastly, here are some trivia you might not want to know butsounds like fun to share:

Before realizing that they could be actual musicians, Andy wanted to be an archaeologist, while Paul wanted to be an electric engineer

Atomic Kitten was basically Karl Bartos’ (Kraftwerk) idea. Andy wanted to keep writing songs, but he wasn’t confident enough to perform the songs as OMD, so he thought of just handing them to someone else. Then Karl suggested that he should create a pop group where they would sing his songs. Andy thought, “What’s the most popular group nowadays? Oh, I know, 3-piece girls!”

In the recent years, OMD often have underwears thrown at them lmao. Especially during “(Forever) Live and Die”. Poor Paul having to deal with nasty fans (but honestly… I’d do the same). But sometimes they have hazardous shits thrown at them too. One time, Paul had his head hit by a glass bottle (I’LL FUCKING MURDER ANYONE WHO DID THAT. HOW DARE THEY HURT MY BABY). And Andy almost got decapitated when someone threw a metal tray aimed to his neck. Terrifying

Somehow, when they were touring, the bus they rode on resemble a group of terrorists’ bus, so they were surrounded by guns… and luckily, “Enola Gay” was already a big hit, so Andy just waved a magazine with their faces on it and said “’Enola Gay’! Pop stars! Not terrorists!” jesus Christ

There’s actually a version of “Souvenir” where it was sung by Andy. In 2015, Paul was hospitalized in New York, but he insisted that they should do this gig in Perth, so they did, only 3 of them… “Souvenir” was on the set, and Andy sang it. It was… okay, I guess. I’m so used to Paul’s soft voice singing that, so it’s kinda weird to hear Andy’s powerful voice singing it

 …I’m sorry if you expected a shortsummary and get this re-writing of OMD’s Wikipedia page instead. I never realizedhow deep I am in their ass until I answered this message with a 1600-word essayabout OMD that was based on my memory alone. Good god

I’m awfully thrilled every time someonementions OMD-related to me, so don’t hesitate if you want to talk about them tome!!

[lauramalchowblog]

9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!

1. Epic Systems Corporation

The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.

Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.

My very first interview out of undergrad was for a position at Epic. I chose a different path, but have always respected and followed the growth of the company over the past decade. In a world where medical data seems like tomorrow’s oil, a number of articles have speculated whether Apple or Alphabet would ever acquire Epic? I don’t buy it. I’m thinking it’s much more likely that 2020 is the first year they acquire a company. How you doing Athenahealth?

2. Theranos

No one can argue Theranos didn’t change the game in healthcare forever… for the worse. I do my best to give all healthcare founders the benefit of a doubt, but Elizabeth Holmes and Ramesh Balwani make that nearly impossible. Turns out that an all-star cast of geopolitical juggernauts on your Board of Directors and the black turtleneck of Steve Jobs is not the recipe for success. Founded by 19-year Elizabeth Holmes, Theranos raised over $700 million at a peak valuation of $9 billion. In retrospect, they have become the poster-child for Silicon Valley’s over-promise and under-deliver mantra. The only problem is that instead of food delivery, their failures resulted in invalid blood testing that could’ve really hurt people.

Despite this failure, the mission and purpose would’ve been tremendously impressive. Cheaper blood tests that require only 1/100 to 1/1,000 the amount of blood that LabCorp or Quest Diagnostics needed. I think the craziest part of the whole saga was that seemingly sophisticated healthcare leaders thirsted for the new technology to beat competitors and improve patient convenience. Before the technology was proved defunct, Theranos convinced Safeway to invest $350 million to retrofit 800 locations with clinics that would offer in-store blood tests. Theranos convinced Walgreens to invest $140 million to develop a partnership that would help beat CVS. Theranos partnered with Cleveland Clinic to test its technology and was working with AmeriHealth Caritas and Capital BlueCross to become their preferred lab provider.

To be clear, they weren’t the first, and won’t be the last healthcare company to fail. I only hope that this extremely well documented (thanks Hollywood) experience has re-focused founders and investors towards building sustainable growth companies that actually help patients live higher quality lives, not just make people money as quickly as possible.

3. One Medical

Thanks to Tom Lee and the One Medical crew, primary care is now investable. Whether you’re talking about private equity or venture capitalists, many have dived head first into the space in search of value-based care treasure. One Medical is the most well-known tech-enabled primary care practice, with 72 clinic locations across seven states, and new locations opening in Portland, Orange County, and Atlanta. The Carlyle Group liked the company so much that it invested $350 million in August 2018, at a reported $1.5 billion valuation. This has led to a number of primary care focused companies (ChenMed, Iora Health, Forward) to amass significant valuations that historically would’ve seemed optimistic. However, the elevation of the primary care provider from the “punter” to the “quarterback” of a patient’s medical journey has lifted all boats.

Interestingly, One Medical has unique differentiators over the traditional primary care competitors. For example, One Medical limits doctors to seeing 16 patients a day, versus the average physician seeing 20-30 patients a day. One Medical also built its own medical records in hopes of a more user friendly experience, instead of outsourcing to practice-based EMRs. One Medical charges $199 annually to each patient to help make up for lower volume, and in return provides same-day appointments, onsite lab draws, and a slick app that allows online appointment scheduling and telehealth consults with providers 24/7. They are also adding capabilities and services to cover mental health and pediatric services to increase revenue.

This change is remarkable. Historically, primary care has been a low-margin business with high administrative and staffing costs, along with physician burnout and regulatory burden. One Medical pioneered the concept of a more modern primary care experience, and I am looking forward to their initial public offering (IPO) targeted for early 2020 and whatever Tom Lee is cooking up at Galileo.

4. Centene

Centene is my favorite health plan to study over the past decade. You would never know that the second largest publicly-traded company headquartered in Missouri was originally started by Elizabeth “Betty” Brinn in Milwaukee, Wisconsin. Under-hyped, which is rare in healthcare nowadays, Centene has quietly grown to become the largest player in both the Medicaid managed care and Affordable Care Act (ACA) exchanges. Under Michael Neidorff’s leadership, Centene now serves 32 states with over 15 million lives and 53,600 employees. They were most recently ranked #51 on the Fortune 500 list. In addition, they are about to grow with the $17.3 billion acquisition of WellCare. Here’s a brief rundown of some major events that demonstrate why I’m so bullish on Centene dominating another decade:

April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.

July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.

September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.

February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.

December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)

In addition, Texas Medicaid is set to award their STAR contracts for 3.4 million lives between Medicaid and CHIP, of which Centene already won a contract to serve the STAR+PLUS (aged, blind, and disabled population). Seems like a pretty solid guess that Centene will fair pretty well in the STAR RFP rankings. Next decade, I look for Centene to significantly increase their efforts to recruit Medicare Advantage (MA) lives, and I wouldn’t bet against them.

5. Mylan

One word. EpiPen. Mylan, the $10 billion market cap pharmaceutical manufacturer and producer of the epinephrine auto-injector product, EpiPen, became the lightning rod in a consumer and political drug pricing debate in 2016. For those who were living under a rock, here’s the quick recap. Epinephrine auto-injectors are used to treat anaphylaxis (severe allergic reaction). Prior to 2016, Mylan held absolute dominant share of the auto-injector market, hovering around 90% for the first half of the 2010s. The only real competitor was Adrenaclick, produced by Lineage Therapeutics, but they were barely considered a competitor despite having cheaper prices. In 2016, news outlets caught wind of Mylan’s 500% list price increase over a decade ($100 to $600) and a nationwide discussion about drug prices began.

If you asked the Mylan CEO, Heather Bresch, she would tell you that the reason brand EpiPen’s list price increased 500 percent over 7 years is because they invested billions of dollars to significantly increase access in schools and employers across America. These efforts increased the number of EpiPen prescriptions in the U.S. from 2.5 million to more than 3.5 million between 2011 and 2015. She would also tell you that there is a big difference between wholesale acquisition cost price (list price) and net price. This part is often misunderstood by media. The net price takes into account discounts, prescription savings cards, and rebates that Mylan provides to purchasers (PBMs, Employers, Plans). The exact negotiated rebate or discount is different by line of business and organization. However, safe to say that Mylan made a good amount of profit with increasing volume.

At the end of the day, Mylan settled with the U.S. Justice Department for $465 million over claims it overcharged the government. Mylan kept their $600 list price brand EpiPen product with rebates, and added a generic version of EpiPen for $300 list price without rebates and requiring commercial insurance. According to a GoodRx analysis in 2018, the epinephrine auto-injector market now looks much different, with 60% of the market moving to the generic version of EpiPen, 10% of the market remaining with brand EpiPen, and 30% of the market switching to the generic version of Adrenaclick. However, whether generic or brand EpiPen, Mylan makes strong profits and American will continue to discuss the best strategy forward to control drug spend.

6. Evolent Health

First let me caveat. I’ve worked for Evolent Health for the past 5 years and seen it grow from a Series B startup to a publicly-traded company (NSYE: EVH). However, the reason they’re on this list is because Evolent Health has forever changed the game for future value-based care startups. When Frank Williams, Seth Blackley, and Tom Peterson founded the company in 2011 with the help of UPMC Health Plan and The Advisory Board Company, concepts like the Medicare Shared Savings Program (MSSP) did not even exist. Fast forward a decade later, and Evolent Health now serves approximately 3.7 million lives across 35 different U.S. healthcare markets. The mission of Evolent Health is to, “Change the health of a nation, by changing the way healthcare is delivered.” To do this, you need both the technology, clinical, financial, and operational capacity to empower providers to confidently move away from fee-for-service towards fee-for-value.

With the implementation of MACRA and the continued perseverance of CMS under this new administration, value-based care is still full steam ahead (good luck incoming CMMI Director, Brad Smith). Despite the naysayers of value-based care, find me a better way to control medical inflation that is accepted by nearly all healthcare institutions and doesn’t negatively impact patient outcomes, and we can talk. I will mention the importance of “significant” downside risk to actually change provider culture, strategy, and operations. I don’t want the primary purpose of setting up a clinically integrated network (CIN) to be negotiating higher fee-for-service commercial rates for independent physicians aligned to tertiatiary academic medical centers.

I wholeheartedly believe that providers will continue to seek partner options (not vendors with high fees independent of performance) who are not wholly-owned by the large for-profit health plans (Optum…). Of all the available options, Evolent Health is the market leader across a variety of areas. In 2020, I look forward to watching how the 3,000+ Evolenteers push the boundaries of downside risk value-based care with both payers and providers.

7. Livongo

To me, Livongo represents Daenerys Targaryen in Game of Thrones. Not the blood-thirsty character towards the end, but the only person to bring back dragons to the world of Westeros. Except in this example, the dragon is a successful digital health IPO. This was a big deal. Going public rewarded early investors who believed in the nascent digital health and chronic condition space. It allowed public investors an opportunity to peak under the hood of the financials and get comfortable with future economics of the industry. And it provided a legitimacy and a peer valuation to other leading digital health companies like Omada Health. All-in-all, 207,000 members use Livongo for Diabetes management solutions, including a connected glucose monitor, unlimited test strips, and personalized health coaching. This number is expected to grow significantly, with the announcement of a new, two-year diabetes contract with the BlueCross BlueShield Federal Employee Program (FEP). They anticipate the partnership will add an additional $50-60 million in revenue across 2020 and 2021

Livongo has done a brilliant job marketing itself as building a full-stop solution for the 147 million Americans with a chronic condition. According to their estimates, their immediately addressable markets for managing diabetes and hypertension represents a $46.7 billion opportunity. Digging into the unit economics, Livongo estimates that diabetes is worth $900 per patient per year and $468 per patient per year. Since they’re focused on chronic conditions, the business model is subscription-based. In the Q3 quarterly report, Livongo provided full year guidance of $168.5 million on the low end and $169 million on the high end. In either scenario, FY2019 Adjusted EBITDA is projected to lose around $26 million for the year.

Livongo has smartly started with addressing diabetes, given the downstream health impacts of mismanagement of blood sugar and the ability to impact spend with regular insulin, diet, and exercise. They also are very smart to efficiently sell into self-funded large employers using existing channel partners like Express Scripts, CVS, Health Care Services Corporation (HCSC), Anthem, and Highmark BCBS. I know that the stock is down 35% since IPO, but I fundamentally believe chronic conditions are not going away and over time, Livongo will add supplementary clinical programs to expand revenue growth.

8. Optum

UnitedHealth Group is the single largest healthcare company in the world with a $280 billion market cap. It owns UnitedHealthcare, the country’s largest private insurer serving Medicare Advantage, managed Medicaid, employer-sponsored insurance, and ACA exchanges. And yet in 2020, more than 50% of the company’s earning and $112 billion in revenue will come from the lesser known side of the business, Optum. It is difficult to describe Optum because they do so much, but they technically split their business into three units: OptumHealth, OptumInsight and Optum Rx. OptumHealth provides care delivery (primary, specialty, urgent care) and care management to address chronic, complex, and behavioral health needs. OptumInsight utilizes data, analytics, and clinical information to support software, consulting, and managed services programs. OptumRx is a pharmacy benefit management (PBM) to create a more streamlined pharmacy system. In total Optum estimates the U.S. addressable market for its services to exceed $850 billion. If that wasn’t enough, here’s some fun facts why they made the list:

Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.

Added 10,000 physicians in the past year, growing its network to 46,000 physicians.

Includes 180,000 team members and serves 120 million customers.

Serves 80% of health plans to reduce total cost of care.

Works with 9 out of 10 Fortune 100 companies.

Pretty remarkable for a business unit that was only technically created in 2011, by merging existing pharmacy and care deliver services into one brand. As chronic disease increases and value-based care is here to stay, Optum is focused on comprehensively treating patients and coordinating their care to improve quality and lower costs. With UnitedHealthcare under the corporate umbrella, Optum has the adequate scale to test any new clinical initiatives before rolling out to other health plans.

9. Purdue Pharma

Purdue Pharma is a privately owned drug company owned by the Sackler Family and most well known for creating OxyContin in 1996. OxyContin represents 90% of Purdue Pharma’s revenue and was aggressively marketed to doctors for use in patients with chronic pain. According to court records, Purdue Pharma has grossed an estimated $35 billion. This is the same prescription painkiller that many experts say fueled the U.S. opioid crisis that has resulted in more than 130 deaths each day after overdosing on opioids. To be clear, the deaths are caused by prescription pain relievers, heroin, and synthetic opioids (fentanyl), however, the initial addiction to opioids is often caused by OxyContin and other prescription drugs. All but two U.S. states and 2,000 local governments have taken legal action against Purdue, other drug makers and distributors.

The Sackler family is the 19th richest family and is well known for supporting the fine arts, including the Sackler Wing at the Metropolitan Museum of Art in New York City where the Ancient Egyptian Temple of Dendur sits. I’ve seen a number of articles persecuting the entire Sackler family, but I want to be a little more nuanced. In 1952, three Sackler brothers (Arthur, Raymond, and Mortimer) bought a drug company called Purdue Frederick. Arthur’s branch of the family got out of the company after his death in 1987. The Raymond and Mortimer branches of Sacklers, who own it, founded affiliate Purdue Pharma in the early 1990s. According to a 2017 article from The New Yorker, there are 15 Sackler children in the generation following the founders of Purdue. Some family members have served on the Board of Directors, while others (most notably descendants from Arthur Sackler who died before OxyContin was invented), have distanced themselves from the company and condemned the OxyContin-based wealth.

Purdue Pharma filed for bankruptcy in September 2019 as part of a tentative settlement related to misleading marketing of the controversial painkiller. The settlement requires the owners of Purdue Pharma and the Sackler family to pay out $3 billion of their own fortune in cash over the next seven years. The only problem is that some family members have reportedly moved $10.7 billion from Purdue Pharma to trusts and holding companies across the world between 2008 and 2017. And all we’re left with is a complicated web of holding companies and offshore bank accounts, ravaged communities, and the leading cause of injury-related death in the U.S.

Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.

The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.

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[kristinsimmons]

9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!

1. Epic Systems Corporation

The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.

Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.

My very first interview out of undergrad was for a position at Epic. I chose a different path, but have always respected and followed the growth of the company over the past decade. In a world where medical data seems like tomorrow’s oil, a number of articles have speculated whether Apple or Alphabet would ever acquire Epic? I don’t buy it. I’m thinking it’s much more likely that 2020 is the first year they acquire a company. How you doing Athenahealth?

2. Theranos

No one can argue Theranos didn’t change the game in healthcare forever… for the worse. I do my best to give all healthcare founders the benefit of a doubt, but Elizabeth Holmes and Ramesh Balwani make that nearly impossible. Turns out that an all-star cast of geopolitical juggernauts on your Board of Directors and the black turtleneck of Steve Jobs is not the recipe for success. Founded by 19-year Elizabeth Holmes, Theranos raised over $700 million at a peak valuation of $9 billion. In retrospect, they have become the poster-child for Silicon Valley’s over-promise and under-deliver mantra. The only problem is that instead of food delivery, their failures resulted in invalid blood testing that could’ve really hurt people.

Despite this failure, the mission and purpose would’ve been tremendously impressive. Cheaper blood tests that require only 1/100 to 1/1,000 the amount of blood that LabCorp or Quest Diagnostics needed. I think the craziest part of the whole saga was that seemingly sophisticated healthcare leaders thirsted for the new technology to beat competitors and improve patient convenience. Before the technology was proved defunct, Theranos convinced Safeway to invest $350 million to retrofit 800 locations with clinics that would offer in-store blood tests. Theranos convinced Walgreens to invest $140 million to develop a partnership that would help beat CVS. Theranos partnered with Cleveland Clinic to test its technology and was working with AmeriHealth Caritas and Capital BlueCross to become their preferred lab provider.

To be clear, they weren’t the first, and won’t be the last healthcare company to fail. I only hope that this extremely well documented (thanks Hollywood) experience has re-focused founders and investors towards building sustainable growth companies that actually help patients live higher quality lives, not just make people money as quickly as possible.

3. One Medical

Thanks to Tom Lee and the One Medical crew, primary care is now investable. Whether you’re talking about private equity or venture capitalists, many have dived head first into the space in search of value-based care treasure. One Medical is the most well-known tech-enabled primary care practice, with 72 clinic locations across seven states, and new locations opening in Portland, Orange County, and Atlanta. The Carlyle Group liked the company so much that it invested $350 million in August 2018, at a reported $1.5 billion valuation. This has led to a number of primary care focused companies (ChenMed, Iora Health, Forward) to amass significant valuations that historically would’ve seemed optimistic. However, the elevation of the primary care provider from the “punter” to the “quarterback” of a patient’s medical journey has lifted all boats.

Interestingly, One Medical has unique differentiators over the traditional primary care competitors. For example, One Medical limits doctors to seeing 16 patients a day, versus the average physician seeing 20-30 patients a day. One Medical also built its own medical records in hopes of a more user friendly experience, instead of outsourcing to practice-based EMRs. One Medical charges $199 annually to each patient to help make up for lower volume, and in return provides same-day appointments, onsite lab draws, and a slick app that allows online appointment scheduling and telehealth consults with providers 24/7. They are also adding capabilities and services to cover mental health and pediatric services to increase revenue.

This change is remarkable. Historically, primary care has been a low-margin business with high administrative and staffing costs, along with physician burnout and regulatory burden. One Medical pioneered the concept of a more modern primary care experience, and I am looking forward to their initial public offering (IPO) targeted for early 2020 and whatever Tom Lee is cooking up at Galileo.

4. Centene

Centene is my favorite health plan to study over the past decade. You would never know that the second largest publicly-traded company headquartered in Missouri was originally started by Elizabeth “Betty” Brinn in Milwaukee, Wisconsin. Under-hyped, which is rare in healthcare nowadays, Centene has quietly grown to become the largest player in both the Medicaid managed care and Affordable Care Act (ACA) exchanges. Under Michael Neidorff’s leadership, Centene now serves 32 states with over 15 million lives and 53,600 employees. They were most recently ranked #51 on the Fortune 500 list. In addition, they are about to grow with the $17.3 billion acquisition of WellCare. Here’s a brief rundown of some major events that demonstrate why I’m so bullish on Centene dominating another decade:

April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.

July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.

September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.

February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.

December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)

In addition, Texas Medicaid is set to award their STAR contracts for 3.4 million lives between Medicaid and CHIP, of which Centene already won a contract to serve the STAR+PLUS (aged, blind, and disabled population). Seems like a pretty solid guess that Centene will fair pretty well in the STAR RFP rankings. Next decade, I look for Centene to significantly increase their efforts to recruit Medicare Advantage (MA) lives, and I wouldn’t bet against them.

5. Mylan

One word. EpiPen. Mylan, the $10 billion market cap pharmaceutical manufacturer and producer of the epinephrine auto-injector product, EpiPen, became the lightning rod in a consumer and political drug pricing debate in 2016. For those who were living under a rock, here’s the quick recap. Epinephrine auto-injectors are used to treat anaphylaxis (severe allergic reaction). Prior to 2016, Mylan held absolute dominant share of the auto-injector market, hovering around 90% for the first half of the 2010s. The only real competitor was Adrenaclick, produced by Lineage Therapeutics, but they were barely considered a competitor despite having cheaper prices. In 2016, news outlets caught wind of Mylan’s 500% list price increase over a decade ($100 to $600) and a nationwide discussion about drug prices began.

If you asked the Mylan CEO, Heather Bresch, she would tell you that the reason brand EpiPen’s list price increased 500 percent over 7 years is because they invested billions of dollars to significantly increase access in schools and employers across America. These efforts increased the number of EpiPen prescriptions in the U.S. from 2.5 million to more than 3.5 million between 2011 and 2015. She would also tell you that there is a big difference between wholesale acquisition cost price (list price) and net price. This part is often misunderstood by media. The net price takes into account discounts, prescription savings cards, and rebates that Mylan provides to purchasers (PBMs, Employers, Plans). The exact negotiated rebate or discount is different by line of business and organization. However, safe to say that Mylan made a good amount of profit with increasing volume.

At the end of the day, Mylan settled with the U.S. Justice Department for $465 million over claims it overcharged the government. Mylan kept their $600 list price brand EpiPen product with rebates, and added a generic version of EpiPen for $300 list price without rebates and requiring commercial insurance. According to a GoodRx analysis in 2018, the epinephrine auto-injector market now looks much different, with 60% of the market moving to the generic version of EpiPen, 10% of the market remaining with brand EpiPen, and 30% of the market switching to the generic version of Adrenaclick. However, whether generic or brand EpiPen, Mylan makes strong profits and American will continue to discuss the best strategy forward to control drug spend.

6. Evolent Health

First let me caveat. I’ve worked for Evolent Health for the past 5 years and seen it grow from a Series B startup to a publicly-traded company (NSYE: EVH). However, the reason they’re on this list is because Evolent Health has forever changed the game for future value-based care startups. When Frank Williams, Seth Blackley, and Tom Peterson founded the company in 2011 with the help of UPMC Health Plan and The Advisory Board Company, concepts like the Medicare Shared Savings Program (MSSP) did not even exist. Fast forward a decade later, and Evolent Health now serves approximately 3.7 million lives across 35 different U.S. healthcare markets. The mission of Evolent Health is to, “Change the health of a nation, by changing the way healthcare is delivered.” To do this, you need both the technology, clinical, financial, and operational capacity to empower providers to confidently move away from fee-for-service towards fee-for-value.

With the implementation of MACRA and the continued perseverance of CMS under this new administration, value-based care is still full steam ahead (good luck incoming CMMI Director, Brad Smith). Despite the naysayers of value-based care, find me a better way to control medical inflation that is accepted by nearly all healthcare institutions and doesn’t negatively impact patient outcomes, and we can talk. I will mention the importance of “significant” downside risk to actually change provider culture, strategy, and operations. I don’t want the primary purpose of setting up a clinically integrated network (CIN) to be negotiating higher fee-for-service commercial rates for independent physicians aligned to tertiatiary academic medical centers.

I wholeheartedly believe that providers will continue to seek partner options (not vendors with high fees independent of performance) who are not wholly-owned by the large for-profit health plans (Optum…). Of all the available options, Evolent Health is the market leader across a variety of areas. In 2020, I look forward to watching how the 3,000+ Evolenteers push the boundaries of downside risk value-based care with both payers and providers.

7. Livongo

To me, Livongo represents Daenerys Targaryen in Game of Thrones. Not the blood-thirsty character towards the end, but the only person to bring back dragons to the world of Westeros. Except in this example, the dragon is a successful digital health IPO. This was a big deal. Going public rewarded early investors who believed in the nascent digital health and chronic condition space. It allowed public investors an opportunity to peak under the hood of the financials and get comfortable with future economics of the industry. And it provided a legitimacy and a peer valuation to other leading digital health companies like Omada Health. All-in-all, 207,000 members use Livongo for Diabetes management solutions, including a connected glucose monitor, unlimited test strips, and personalized health coaching. This number is expected to grow significantly, with the announcement of a new, two-year diabetes contract with the BlueCross BlueShield Federal Employee Program (FEP). They anticipate the partnership will add an additional $50-60 million in revenue across 2020 and 2021

Livongo has done a brilliant job marketing itself as building a full-stop solution for the 147 million Americans with a chronic condition. According to their estimates, their immediately addressable markets for managing diabetes and hypertension represents a $46.7 billion opportunity. Digging into the unit economics, Livongo estimates that diabetes is worth $900 per patient per year and $468 per patient per year. Since they’re focused on chronic conditions, the business model is subscription-based. In the Q3 quarterly report, Livongo provided full year guidance of $168.5 million on the low end and $169 million on the high end. In either scenario, FY2019 Adjusted EBITDA is projected to lose around $26 million for the year.

Livongo has smartly started with addressing diabetes, given the downstream health impacts of mismanagement of blood sugar and the ability to impact spend with regular insulin, diet, and exercise. They also are very smart to efficiently sell into self-funded large employers using existing channel partners like Express Scripts, CVS, Health Care Services Corporation (HCSC), Anthem, and Highmark BCBS. I know that the stock is down 35% since IPO, but I fundamentally believe chronic conditions are not going away and over time, Livongo will add supplementary clinical programs to expand revenue growth.

8. Optum

UnitedHealth Group is the single largest healthcare company in the world with a $280 billion market cap. It owns UnitedHealthcare, the country’s largest private insurer serving Medicare Advantage, managed Medicaid, employer-sponsored insurance, and ACA exchanges. And yet in 2020, more than 50% of the company’s earning and $112 billion in revenue will come from the lesser known side of the business, Optum. It is difficult to describe Optum because they do so much, but they technically split their business into three units: OptumHealth, OptumInsight and Optum Rx. OptumHealth provides care delivery (primary, specialty, urgent care) and care management to address chronic, complex, and behavioral health needs. OptumInsight utilizes data, analytics, and clinical information to support software, consulting, and managed services programs. OptumRx is a pharmacy benefit management (PBM) to create a more streamlined pharmacy system. In total Optum estimates the U.S. addressable market for its services to exceed $850 billion. If that wasn’t enough, here’s some fun facts why they made the list:

Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.

Added 10,000 physicians in the past year, growing its network to 46,000 physicians.

Includes 180,000 team members and serves 120 million customers.

Serves 80% of health plans to reduce total cost of care.

Works with 9 out of 10 Fortune 100 companies.

Pretty remarkable for a business unit that was only technically created in 2011, by merging existing pharmacy and care deliver services into one brand. As chronic disease increases and value-based care is here to stay, Optum is focused on comprehensively treating patients and coordinating their care to improve quality and lower costs. With UnitedHealthcare under the corporate umbrella, Optum has the adequate scale to test any new clinical initiatives before rolling out to other health plans.

9. Purdue Pharma

Purdue Pharma is a privately owned drug company owned by the Sackler Family and most well known for creating OxyContin in 1996. OxyContin represents 90% of Purdue Pharma’s revenue and was aggressively marketed to doctors for use in patients with chronic pain. According to court records, Purdue Pharma has grossed an estimated $35 billion. This is the same prescription painkiller that many experts say fueled the U.S. opioid crisis that has resulted in more than 130 deaths each day after overdosing on opioids. To be clear, the deaths are caused by prescription pain relievers, heroin, and synthetic opioids (fentanyl), however, the initial addiction to opioids is often caused by OxyContin and other prescription drugs. All but two U.S. states and 2,000 local governments have taken legal action against Purdue, other drug makers and distributors.

The Sackler family is the 19th richest family and is well known for supporting the fine arts, including the Sackler Wing at the Metropolitan Museum of Art in New York City where the Ancient Egyptian Temple of Dendur sits. I’ve seen a number of articles persecuting the entire Sackler family, but I want to be a little more nuanced. In 1952, three Sackler brothers (Arthur, Raymond, and Mortimer) bought a drug company called Purdue Frederick. Arthur’s branch of the family got out of the company after his death in 1987. The Raymond and Mortimer branches of Sacklers, who own it, founded affiliate Purdue Pharma in the early 1990s. According to a 2017 article from The New Yorker, there are 15 Sackler children in the generation following the founders of Purdue. Some family members have served on the Board of Directors, while others (most notably descendants from Arthur Sackler who died before OxyContin was invented), have distanced themselves from the company and condemned the OxyContin-based wealth.

Purdue Pharma filed for bankruptcy in September 2019 as part of a tentative settlement related to misleading marketing of the controversial painkiller. The settlement requires the owners of Purdue Pharma and the Sackler family to pay out $3 billion of their own fortune in cash over the next seven years. The only problem is that some family members have reportedly moved $10.7 billion from Purdue Pharma to trusts and holding companies across the world between 2008 and 2017. And all we’re left with is a complicated web of holding companies and offshore bank accounts, ravaged communities, and the leading cause of injury-related death in the U.S.

Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.

The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.

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[technologyinfosec]

How an Indian expat turned from office boy to bank manager in UAE

Indian expat A.T. Ali, who started his life in the UAE doing menial jobs, is now retiring as the manager of an Abu Dhabi-based bank. In the past 40 years, he has taken roads less travelled to realise his dreams in this land of opportunities. "I have seen the best and worst of times," the 60-year-old said during his last day in office and year 2019. "I am third of the eight children back home in the Malappuram district of Kerala. My mother was a homemaker and father taught in a school for 35 years. Ironically, I failed Class 10 exams as I was consumed by politics. I learnt typewriting, shorthand and tailoring. I had to support my family and the Gulf region was our only hope. In 1978, I left for Bombay, where I learnt Hindi. By 1979, I managed to get a visa to land in Sharjah. Job hunt took me to Ajman and Abu Dhabi. As a 19-year-old jobless, I was fascinated by the evening chats of my employed roommates. I used to wonder when I would have such stories to share." It didn't take long as Ali would end up dabbling three jobs a day. "I was open to any job. I joined my roommate as a street vendor, then a delivery boy at a supermarket and a part-time helper at a shop. Later, I worked at an electrical shop. I cleared an interview to become a messenger at a public firm. In 1982, I lost that job and returned to Kerala where I started a business, which did well. However, smitten by the UAE, I was back here in 1985 and joined a school as a helper. In 1987, I lost that job and worked as a hospital receptionist. Next year, the public school rehired me as an office assistant. Things happened as I tried and kept looking for opportunities." In 1989, he got married. As expenses grew, Ali again looked for part-time jobs. "After school hours, I worked at a courier firm. In 1995, a friend referred me for a bank job as a messenger and I cleared the interview. When I quit my school job, I was offered the post of a watchman. So I worked at the bank from 8am to 4pm then at the courier firm and from 8pm till morning as the school watchman." Life-changing moments By the end of 1995, his family back home was well-settled. Then Ali became mindful of his health and focused only on the bank job. "At the bank, I was an office boy, store keeper and more. I was eager to work and occupy any empty chair." But Ali was pained by the fact that he couldn't bring his family on a visit visa because of his job status and low salary. He was denied driving licence because of his position. And once a security guard pulled him out of office lift meant only for customers and VIPs - an incident which was harbinger of change. "It was humiliating but motivated me to work harder and change my job title. In 2009, I got promotion as a support service executive. I had a chair and computer for myself. It was a blissful moment and made me understand the importance of education. I took a three-month English course at the British Council." In 2010, Ali was able to bring his family to Abu Dhabi and got a driving licence, too. His long-cherished dreams were fulfilled but challenges remained. "Since I had no educational qualifications, I was asked to write a bank test, which I passed. I became a senior officer. In 2015, I was made assistant manager and two years later, the manager. I received an achievement award and the same security man who had shooed me away once, kept the door of the lift open for me." Ali has handled a dozen different jobs. The UAE, he said, is a land of opportunities for those who are willing to take risk and turn mistakes into life-altering experiences. "I draw inspiration from the founding father of the UAE, the late Sheikh Zayed bin Sultan Al Nahyan. His life is a lesson for us to take risks and face challenges." Ali will return to India to live with his wife Shahida, daughters Kamiliya and Vaniya and son Ashiq. "My son works here, rest of the family are in Kerala. They will be here to take me home. After 40 years, I will return to India a happy man." Read the full article

[raspberrytummytickles]

Peepin’ Angels

Title: Peepin’ Angels Fandom: Supernatural Characters: Sam, Dean, Gabriel, Castiel Summary: Ticklish!Sam, Ticklish!Cas; Multiple points in the Winchester’s lives were Angels were watching over them

Original Prompt: OMG I’m weak for angel tickles! So I have this headcanon that the angels have been meddling a lot  longer. Zachariah skulking around early to make sure the plan works and Cas Gabe check in on the boys throu their lives out of curiosity or trying to save them. They’re invisible to the boys but not to each other and they talk about the boys or Gabe tries to get Cas to influence them early.  Maybe it gets To the point of big brother tickles? ^-^

A/N: HERE WE GO!

January 24, 1979

A small baby was placed in Mary Winchester’s arms. Her husband peered over her shoulder, hand gently caressing the cheek of his newborn son. Little green eyes flickered open and stared at John before a garbled smile was sent his way, little gums showing. It was the most beautiful thing John had ever seen.

In the corner of the hospital room, two men stared at the couple and their baby. 

“Michael’s vessel has been born,” One said softly to the other. The ebony haired angel stared at Dean Winchester and nodded.

“We shall make sure he is willing and ready,” Castiel responded before both angels disappeared.

May 2, 1983

Mary was back on the same hospital bed, four―nearly five―years later, another small baby placed in her arms. John was next to her just like before, except now he was holding his four year old son. Dean peered down at the baby with wide, curious eyes.

“Mine?” He asked his mother, tentatively reaching for the newly born Samuel Winchester.

“Yours,” Mary chuckled tiredly. 

Dean touched Sam’s head, hand coming to cup the baby’s cheek when Sam’s eyes fluttered open. The brilliant hazel eyes glared at Dean for waking him before a curious look replaced it. Sam gazed at the tall being in front of him, eyes focusing on the millions of dots covering the things face. The baby smiled, little giggles bubbling out of his mouth, a tiny fist wrapping around Dean’s pinky finger.

Dean’s gazed turned so loving, it took the breath away from his parents who were a bit worried about how Dean would react to the new baby. It seemed, though, that Sam had Dean wrapped around his little finger.

“I got you, Sammy,” Dean whispered, gently playing with the tiny creatures hands.

“Is it alright?” A voice asked, the other occupants in the room unaware they were being watched. “That they are so close already.”

“Hush, brother. Everything will go according to plan.”

Six Months Later

Two men watched the flames licking at the two story house. The ebony haired one was staring at the father holding his baby, the four year old clutching his father’s jacket in the back of the ambulance. Mary Winchester was not with them.

“Did it have to begin this way?” He asked his brother.

“It was foretold, Castiel,” Uriel muttered to his younger brother. “This is the way it has to be. Now, we leave them. Everything will fall into place.”

Castiel gave one last glance at the broken Winchester Family before disappearing, his brother in tow.

Six Year’s later

Castiel had turned a blind eye to the Winchester’s for years. He easily ignored them, falling into training with his own siblings but he had a strange urge to check up on them. Just once. They couldn’t condemn him for checking on the vessel’s of Michael and Satan.

When he arrived though, he was shocked to see another figure sitting with the youngest Winchester. He was behind Sam, one leg out as he quietly muttered to the child who couldn’t hear him. Castiel recognized Gabriel instantly.

“Brother, what are you doing here?” He hadn’t seen Gabe since he fled Heaven. He definitely didn’t expect to see him with the Winchesters.

“Look at him,” Gabe mumbled, nodding to Sam. “He’s so smart already. His big brother has taught him well.”

At the mention of Dean, said big brother walked to his kid and started muttering something softly. Whatever it was made Sam beam and shoot up to one of the beds, picking up a worn out book that was literally falling to pieces. Dean scooped Sam up and brought the child to the bed, before sliding in with the six year old, beginning to read aloud.

Gabriel and Castiel watched silently, one of them in slight awe, the other in grim satisfaction. 

“You really going to help tear these too apart?” Gabriel asked softly. 

“It is my job,” Castiel responded back, eyes watching with fascination at the utter adoration the two children held for each other.

“You’re job sucks,” Gabriel snorted before disappearing. A few moments later, Castiel followed.

Eight Years later

It had been a while since Castiel last checked up on the Winchester children. Like he thought, visiting brought a bit of a fuss but otherwise let him stay at his position. He didn’t dare tell them about Gabriel though. The youngest Archangel left for a reason and no matter how much Castiel hated his brother leaving, he respected the older beings wishes.

Currently, Castiel flew down to Earth to watch one of the great bee migrations. The African Honey bees moved destinations from time to time and Castiel always made sure he would watch. But other wonder’s crossed his mind.

How were the Winchesters? Were they as close as before? Was Gabriel with them? Only one way to find out! Castiel easily found the Winchesters in Fairfax, Indiana. Sure enough, Gabriel was there, sitting across from the youngest Winchester.

Castiel did not see the appeal to watching these children. What made them so fascinating that an archangel seemed to watch them with undivided attention? And Samuel Winchester being Lucifer’s vessel, it just didn’t make sense.

“I can hear you thinking from here, Cassie,” Gabriel mumbled, oddly quiet. He let out a small sigh and faced his younger sibling. Castiel was surprised to see how upset the archangel seemed to be.

“What has happened?”

“Sammoose here has been getting bullied at his new school.”

Castiel blinked and tried to find why that mattered.

“Cas, kids are cruel when they want to be. He’s hurting. I’m just waiting for big brother to show up,” Gabriel stretched, a hand reaching to ruffle Sam’s hair, but only passed through the young boy. Sam paused, head tilting to the side before he fell back into his schoolwork.

“I do not see your interest in watching them,” Castiel sighed. “Humans are beautiful and flawed creatures and they are fascinating, but what holds you here? Why them?”

“I see our brothers in them.”

That surprised Castiel. Before he could question Gabriel‘s reasoning, Dean walked in carrying a food bag filled to the brim. Sam eyed his brother before ducking his head.

“Just watch,” Gabe whispered.

Dean walked over to Sam silently, pulling out a chair and sitting beside his little brother. Sam avoided his eye contact and scribbled down an answer to one of his math equations. 

“So…how was school?” Dean asked, eyes searching his brother’s face. Sam didn’t look up.

“Fine.”

“That’s it? Fine?”

“Yeah.”

“Sammy―”

“I said it was fine, Dean!” Sam snapped, shoulders hunching. Dean wasn’t fazed by his brother’s snappy tone and continued to look imploringly at him.

“You fought with dad again.”

“So what?”

Dean sighed and gently grasped Sam’s bicep, “You’re mad he didn’t come back.”

“Dean―”

“That he wasn’t here when you needed him.”

“YES! Okay? Yes, I’m pissed. Is that what you want to hear?” Sam turned to his brother, bangs shifting and a clear view of a black eye was showing. Castiel didn’t notice before. His heart twinged and he wondered if there was something wrong with his vessel.

“He does his best, Sammy.”

“He always does,” Sam scoffed, knees pulling up to his chest as he started right at the spot the angels were standing.

“Hey,” Dean smacked Sam’s arm lightly, a boyish grin on his face. “You still got me.”

Sam smiled, a tired yet loving smile and he nodded, “Yeah,” A sudden mischievous light entered his eyes, “But I had you before. I think I need an upgrade; this Dean just willingly did a chick-flick moment.”

Dean narrowed his eyes goodnaturedly at his baby brother and rolled his shoulders, “That’s it, c’mere brat!”

The Winchesters ran around the small motel room, Sam giggling like crazy while Dean threatened him during the chase. When Dean finally caught Sam, the younger Winchester was quickly thrown into hysterics as his big brother tickled his sides and belly.

Gabriel smiled albeit fondly at them before looking at Castiel. 

“That was just like Lucifer and Michael, wasn’t it.”

“Yeah,” Gabriel nodded. “They were as close as could be. Practically raised me and Raphie.”

Castiel continued to stare at the Winchesters before asking, “What happened?”

“Dad gave them a choice,” The blond archangel shrugged. “Each other or destiny. In the end, it was one in the same.”

“Why do you watch them?” 

Sam was pleading heavily for Dean to stop but his big brother just placed a raspberry on his neck, effectively keeping the kid silent.

“Because it is like seeing them again as fledglings. I want you to promise me, Castiel,” Gabe started, eyeing the blue eyed angel. “That you will look after them and protect them.”

“What?!” Castiel hissed, eyes widening in shock. “No, I have orders from Heaven—" 

“These kids need someone to look after them, Cas.”

“No. It’s ridiculous. I am under Michael’s orders,” Castiel sighed. “I’m sorry, brother.”

“Yeah, me too,” Gabe huffed. “Sorry I have to go to such drastic measures.”

“Huh—” Cas gasped as he felt Gabriel’s grace jolt into his sides. Immediately the younger started laughing, going in tune with the youngest Winchester. “G-Gahahabe! Stohohop! I dohohont uhndeheherstand!”

“These kids need someone to watch out for them. Be their guardian angel.”

“Whahahahy can’t yohohou?” Castiel asked only to shriek when Gabriel added fingers, digging into his sides. Castiel never knew what to do with himself when he was being tickled and often just stood still, occasionally clapping his wings when it got too much.

“Heaven thinks I’m dead, remember? They are going to be watching the Winchester’s and I can’t be seen.”

“Ahahask sohohomeone moHOHOHORE QUAHAlified!”

Gabriel huffed and forced Castiel to the ground, one hand latching through his baby brother’s wings and the other squeezing the muscles on his thighs. Castiel positively screamed, back arching off the ground in desperate attempts to free himself from this predicament.

It was like Dean and Gabriel shared one mind because both older brothers tickled viciously on their baby brother’s worst spots. Sam got his voice back and screamed, pleads bleeding through them. Castiel was cackling loudly. When Gabriel hit a certain spot, however, Castiel screamed so loud that the lights in the whole apartment building blew out.

“Noho—No mohore,” Castiel panted, glaring up at Gabriel. From the bed, Sam and Dean were quiet when Sam burst into non-tickle induced laughter, finding the situation hilarious. Dean eyed the room but nothing seemed amiss. He put it down as faulty wiring for the moment and would check on it later. His gaze fell back on Sam and he snorted.

Dean cuffed his brother affectionately, “C'mon, brat. Let’s get some ice for that eye and go to that diner. I want some pie.”

“Okay, De,” Sam quickly followed after his big brother, both playfully pushing at each other as they walked out of the room.

Gabriel and Castiel followed them with their eyes before Cas let out a small breath of relief. He looked at Gabriel who had a fond, hopeless look on his face, staring at the door.

“I will not follow them,” Castiel said firmly. “But, when the time comes, I will help them anyway I can. I will be their friend.”

“Promise?”

“I promise.”

Gabriel bit his lip in thought before nodding his consent, “Fine…it was nice seeing you again, Cas.”

“And you.”

Before Castiel could leaves, Gabriel pressed a hand to his brother’s forehead, erasing the memories of their meetings with the Winchesters. He left the small promise in the back of Castiel’s mind and quietly forced him to Heaven. Gabriel took one last look at the hotel room before leaving as well.

———

Eleven Years Later

Dean stood in front of his little brother as he stared at the two angels in front of him. One looked at him in disgust while the other looked at him in fascination. He could feel Sam’s nervous energy behind him and held himself back from soothing the younger man. Things were going to get hectic.

Castiel stared at both Winchesters, familiarity on the tip of his tongue. He couldn’t remember meeting them at any point and passes it off as from hearing their legacy. One thing echoes in his mind as they begin their journey of stopping the apocalypse:

“I will not follow them, but when the time comes, I will help them anyway I can. I will be their friend.”

“Promise?”

“I promise.”

Castiel doesn’t remember who he promised it to but he knew it was important. He will honor that promise. Looking at the Winchesters, his mind flashed to two young boys giggling and playing and decided then and there he would do the best he could to make things right.

~Fin~

A/N: OMG IM SO SORRY THIS TOOK SO FREAKING LONG!! MY MIND DIDNT KNOW WHAT TO DO FOR THIS SO IT DELAYED MEEEEE! AHHHH IM SORRY 🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻

[gingerssnapped720]

Introduction To The Cult

Good morning, dear reader. What shall we talk about today?

When last we met, I was babbling on about my immediate family dynamics, and I ended my post with the birth of myself and my little brother. I suppose that’s as good a place to start as any.

Like I said before, I was born on Friday, July 20, 1979. My mother told me that my original due date was at the end of August, but that I was born several weeks early. My mother hemorrhaged while giving birth to me, and needed an emergency c-section. I am told that I cried incessantly because I was too thin and could not hold my own body heat, so Mom put a hot water bottle in my bassinet with me to keep me warm.

My bassinet was large and black, and converted into a victorian style pram, with chrome decorative mounts on the sides and hood. Mom made both yellow and green skirts for it, with satin ribbons and matching sheets. She loved to sew when I was little. She made our clothes, dolls, doll clothes, pillows, and curtains. I still have one of the dresses Mom made, and my daughter Katie wore it when she was around 9 or 10. I cry every time I see the picture of her wearing it.

I don’t remember much of my early years. My very first memory is sitting on the living room floor, watching my Dad read the newspaper, and trying to get his attention. I must have been around four years old. I remember my Mom being pregnant and losing the baby. She named the baby Robin, because she didn’t know if it was a boy or a girl, and she spoke of them once in a while when she was especially sad. And then when she became pregnant again, I remember how scared she was of the baby making it. But he did make it.

Nathan was born April 19, 1984, and I remember spending several days at Baka*’s house while my Mom was in the hospital. I liked being with Baka, except for her religious fanaticism. She was old world Polish, and she cooked homemade perogi and borscht, which the smell of makes me sick, even to this day. And seaweed. Always this woman with the boiled seaweed. She swore it made her strong. She was strong. There’s a story of Baka buying herself a kitchen table set from a yard sale, and carrying it home piece by piece. She hurt her knee once when walking home from the grocery store, when she tripped over railroad tracks, and she limped all the way home. Groceries and all.

After Nathan came home from the hospital, life got interesting. Mom had had another c-section, because in those days once you’d had a c-section, that is the only way they’d let you deliver from then on. She’d hemorrhaged again, and I remember the blood issue coming up for the first time. Whispers in the hallway and at our worship meetings about whether or not my mother had received a blood transfusion, were hushed whenever I got close enough to hear. I don’t know if she did or not.

Why is this a big deal? Because, dear reader, now comes the first “unbelievable” part of my story. You see religious fanaticism was not just a flaw of my grandmother, it was a flaw of the entire community of people I was raised with. It is an affliction that three of my aunts and two of my uncles suffer from to this day. It is the affliction of two of my children’s paternal grandparents, and the affliction of multiple family members of dear friends, who have since escaped the horror we grew up in.

When I say the word “cult” people instantly think of scenarios like “Heaven's Gate” or “The Manson Family”. Compounds with barracks, polygamy, hundreds of children fathered by a handful of men, and escapes delicately orchestrated by social workers and the FBI.

Sorry to disappoint.

My life inside the cult was not nearly so dramatic, nor was my leaving. No news cameras, no guns, no blood, no poisoned kool-aid. Nothing but the pounding of my own heart as my two little girls clung to me. No husband, no job, no home, no family, no money, no electricity, no heat, no phone, and a car I had no way to pay for. Leaving was silent. And the silence was more terrifying than gunshots.

But I’m getting ahead of myself.

The cult my family belonged to was an extension of the Watchtower Bible and Tract Society. The Jehovah’s Witnesses. This religious organization estimates some 8.5 million members, although Wolfram Alpha estimates that number is closer to 16.6 million people who identify themselves as Jehovah’s Witnesses worldwide. They have 119,954 congregations in 240 countries.

“But that’s not a cult!”, you say.

I can hear you, dear reader. Rolling your eyes? Let me guess. You have a mother, brother, best-friend’s cousin who is a “Jehovah”, as so many people refer to them?

“They’re the nicest people I’ve ever met!”, you say. “I work with a guy who’s a ‘Jehovah”. He’s such a hard worker! Always on time, never swears, never a bad word from him about anyone!”

Yes. I’m sure all of that is true.

“But I’ve been to a few of their meetings! They’re so nice and welcoming! They’ve even been to my house and prayed with me. They study with my daughter and she loves it!”

Yes, yes I’m sure that has been your experience. There is a reason that has been your experience. And over the course of this narrative, I will show you what that reason is.

The Merriam-Webster Dictionary defines religion as “a personal set or institutionalized system of religious attitudes, beliefs, and practices” and also as “scrupulous conformity”. I find both those definitions fascinating. I wonder what religion means to you personally, reader?

When I was born, I was born into a strange world. There were five religious meetings a week, split into three sessions, held on three separate days. Monday was our “Book Study” meeting. A bible based publication produced by the Watchtower Bible and Tract Society, was studied in sections, once a week at the home of an approved congregational member in good standing. It was conducted by a male Elder, who was assisted by another male who read aloud from the selected publication. This reader usually held the title of “Ministerial Servant” or “Baptized Publisher”.

Wednesday was the night of the “Ministry School” and “Local Needs” meetings, held back to back, generally beginning at 7pm and ending between 9 and 9:30pm. This was the meeting that tested the backsides and skull resilience of every infant, child, and teen in the seats. Children were expected to be quiet and well behaved. Even infants were subject to physical discipline if they misbehaved. Children over the age of four were expected to sit up straight and pay attention to the speaker, regardless of the subject. My friend John’s father used to flick the back of his children’s heads so hard it could be heard several rows back. Every child within earshot would sit up straighter so the same wouldn’t befall them from their own parents or other congregation members within flicking range.

I remember very young children with pajamas on under their suits and dresses. Females were not permitted to wear pants during ANY religious event, regardless of weather, health, etc. Sleepy children with sore backsides, desperately trying to stay awake through the incessant droning of the speaker to avoid another lashing with the ruler or wooden spoon that stood straight up out of  their parent’s book bag or briefcase pocket. A proud symbol to the congregational Elders, and anyone else, that discipline was swift and merciless in their household.

These wednesday meetings were where constituents learned how to talk to “wordly” people, to “share the good news of God’s kingdom”. Basically it was recruitment training. Congregation members were warned to appear “blameless in all things” as “not to bring reproach on God’s name”. To be “no part of the world as Jesus was no part of the world.” Here male adults and boys as young as eight were called upon to give “Talks” or sermons that they had wrote themselves, and then publicly critiqued by an Elder. Role play for female adults down to very young girls about how to use charm, modesty, and bible knowledge to gain entry to people’s homes and start bible studies with the families they met in their door to door “teaching” work. These role play sessions were also critiqued publicly. Disabled and elderly congregation members were encouraged to write letters or make phone calls to families who had recently lost someone, and “teach” them about how they could see their loved ones resurrected. These families were found through obituary listings and newspaper articles, and by picking names out of the phone book.

Nothing like preying on bereaved families at their most vulnerable. The thought of it now makes me sick to my stomach.

Sunday held the “Sunday Talk” and “Watchtower Study” meetings. The sunday talk would consist of an Elder from another local congregation giving an hour long sermon, the subject of which was selected from a list of approved outlines, and then approved by the congregation “Talk Coordinator”. After the “Talk”, the congregation studied a preselected article in the “Watchtower” publication, which was a thin magazine, written and produced by the Watchtower Bible and Tract Society, that was also used in their door to door preaching. This meeting was conducted much like the Wednesday night Book Study meeting, with an Elder presiding, and a Ministerial Servant reading. Pre-written questions were asked by the presiding elder, and microphones were passed to constituents who wished to answer those questions, often by reading the answer verbatim from the article.

After the Sunday meeting, congregational members were encouraged to participate in the door to door preaching work. There was also preaching work on Saturday morning, usually beginning around 9am.  This “work” was to the dread and embarrassment of every school age member in attendance. We lived in fear of knocking on a door and finding a classmate, or worse a bully, on the other side. Congregation members who did not participate in going door to door regularly would be chastised by Elders, shamed by their peers, and ostracized by the congregation as a whole.

My entire family lived with the label of “Bad Association” due to my father no longer attending meetings beginning in 1984, and my mother’s severe and obvious mental health issues. My mother suffered from Agoraphobia, Social Phobia, Claustrophobia, Depression, Generalized Anxiety Disorder, and may have also been schizophrenic. All of which were exacerbated by my brother Michael’s suicide in 1990.

Mental health issues were not adequate to excuse you from your duty to preach door to door, participate at meetings, or to appear “blameless in all things”. Sufferers of mental health disorders (including Homosexuality, and Gender Dysphoria) were counseled to pray. If prayer didn’t work, they were shamed by the Elders and other congregation members for not praying hard enough, because Jehovah their God would save them from their suffering, if they only had faith. Mental health sufferers were forbidden to seek outside counseling, use psychiatric prescriptions, or speak of their struggles as not to “stumble other members of the congregation”.

My brother died, because of this heartless policy.

[myyearofgivingdaily]

An epic battle royale?

Who remembers that show “Knots Landing?” It was a cheesy “Dallas” spinoff that ran from 1979-93. I tell you this because my story takes place somewhere in that timeframe. I can’t remember the exact year.

It was Aug. 16. That, I do remember: the anniversary of Elvis Presley’s death.

My best friend, Colleen, worked on the original MGM lot in Culver City, Calif. A Sony logo actually festoons the gates now, but this was the King’s home for the better part of his tragic film career. It was here that he made “Girl Happy,” “Jailhouse Rock,” and “Viva Las Vegas,” among other questionable products.

Anyway, Colleen’s best friend on the lot was a girl named Mary who worked at “Knots.” Mary was an Elvis FREAK, whose colleague, Rance, claimed he worked in the same office Elvis had during the MGM years. 

As Aug. 16 approached, Mary and Colleen hatched a plan to use Rance’s office for a séance to conjure the King. And Rance allowed it! This guy was so cool he didn’t even mind that a bunch of loopy 20-something chicks were going to take over his workspace for the night -- for the purpose of the dark arts, no less.

Our secret cabal convened at the appointed hour in the “Knots Landing” production offices. Mary draped a vivid velvet Elvis across Rance’s desktop. She pushed a tape into the VCR and passed out some fried peanut-butter-and-banana sandwiches. (May I suggest you only eat them fresh off the grill?) Out came the Ouija board and we clustered around the desk resting our fingertips ever-so-softly on the “planchette,” that little thing you push around the board to spell words.

Ugh. Any Girl Scout who’s ever used a Ouija board knows it can be a slow and tedious process. It’s best to invite a world-class cynic to these types of things, a cheater, more or less, who will push the action along. Literally. 

But we were all too earnest for that.

Time passed and the planchette acted as though it were super-glued to the board. The room smelled like bananas. The movie had ended. We were about to give up the ghost when a tardy guest arrived carrying a vintage textbook. This woman, who was considerably older than we were, had been an extra in Elvis’ 1957 film Loving You. The King had signed her schoolbook during a break in filming. 

Surely he would come to us now. I mean that schoolgirl with the textbook is probably in this very photo!

Sadly, Elvis had too many other séances to attend on this particular occasion. We put out calls to Vernon and Gladys Presley. Nothing. Elvis’ stillborn twin. Crickets. As the clock climbed toward 11 pm, we begged any MGM spirit, even a body double, to come out of hiding and show themselves. Not even Bette Davis or Joan Crawford had anything say. 

Finally we packed it in. The cleaning crew had come and gone, shutting all the doors and emptying all the waste baskets. But one door in the suite was slightly ajar, and Colleen poked her head inside. She’d always wondered what this office looked like. Mary’s anti-social co-worker, we’ll call him James, never worked with an open door. Unimpressed, Colleen pulled the door shut until she heard it click.

Dejected, we all agreed that the greatest highlight of the evening was opening that textbook to see Elvis’ inky scrawl. So even though he refused to chat with our Ouija that night, I am going to donate some money today to one of the King’s -- and my mom’s -- favorite charities: St. Jude Children’s Research Hospital in Memphis, Tenn. It costs $2.4 million per day to operate St. Jude, and public contributions provide more than 75 percent of the funds necessary to operate the hospital. Families never receive a bill from St. Jude for treatment, travel, housing or food.  

Hard to believe, yes? Well, not as hard to believe as the rest of my story.

The day after the séance I kept missing calls from Colleen. This was pre-voicemail so the receptionist was passing along pink slips all day that said things like: CALL RIGHT AWAY. YOU WON’T BELIEVE IT. SHE NEEDS TO TALK TO YOU!!! Stuff like that.

When we finally connected Colleen was in a breathless tizzy. Seems that anti-social guy, James, had arrived to work shortly after 8 a.m. As he unlocked his door, our séance hostess heard a loud “What the hell???” She looked up. “Who was f---ing around in here last night? What’s going on???”

Mary went to the door. James’ couch was standing on one end, straight up in the air. Mary almost passed out. James was livid. And as soon as the couch was back on all fours, he slammed his door.

Rance’s room, meanwhile, was just as we’d left it. Pristine. Not a drop of banana gooze to be found. 

The “Knots Landing” team tried to convince us that someone had pranked us gullible girls, but we didn’t buy it. The hour was so late when we left, and so early the next morning when Mary came in. And if you’re going to tease us, try to pick the right room next time.

To this day, Colleen and I are certain that an epic battle royale of the ghostly kind blew up soon after we left the lot. And it had nothing to do with Elvis. The energy that moved that couch was passionate, almost angry.

I don’t know about you, but I’m going with Bette and Joan.

About this blog: Causes and Effect: My Year of Giving Daily, was started in 2013 by entertainment and culture journalist Melinda Newman, who made daily donations to a wide variety of nonprofits and wrote about her experience. USA Today music writer, Brian Mansfield, took on this monumental task in 2014. This year, 12 individuals will contribute, each taking over the blog for one month.  

About Deborah Holdship: Deborah Holdship is the editor of Michigan Today, a digital alumni magazine distributed monthly to some 300,000 alumni of the University of Michigan. She also produces a podcast called “Listen in, Michigan” about U-M history and happenings. For many years, she worked as an entertainment journalist in Los Angeles (with the byline Deborah Russell) at Billboard, LAUNCH, and Yahoo. After 20 years in sunny So-Cal, Holdship returned “home” to Michigan, where she lives happily with her husband/musician, Barry; their dog, Charles; and a kooky cat named Brando.

[brentrogers]

[Podcast] Hospital Crisis Management and Healthcare PR in the Age of COVID-19

Jay Geer, President, Miller Geer & Associates

I (Stewart) love what I do in large part because of the smart people I continually get to meet and befriend. Jay Geer is another case in point. Perhaps ten years ago, his (then) assistant James Chisum reached out to me and said, “You have to meet Jay Geer. He is THE hospital PR guy, and he pretty much knows EVERYONE in healthcare.”

Today, the experts at Miller Geer & Associates (Jay, James and Sandy Nesheiwat), divide their time 50/50 between healthcare public relations and hospital crisis management.

Jay recently provided his expertise to one of our clients, which, despite having followed the approved safety protocols, needed crisis management help in the wake of some COVID-19 related illnesses and deaths. Our client was grateful for Jay’s advice, and Jay and I agreed it was time for him to finally “guest star” on my healthcare marketing podcast.

Hospital Crisis Management and Healthcare PR podcast to discover:

Why the coronavirus pandemic provides a “silver lining” platform to showcase positive healthcare and “hero” stories, for both internal and external audiences.

How to address the public concern about hospital safety from COVID-19 and the resulting tendency to avoid necessary care.

The many types of crises that Hospitals face today – and what to do about them.

Strategies for healthcare & hospital crisis management.

Play the recording of our entire Healthcare PR & Hospital Crisis Management Podcast conversation below, or listen to our Healthcare & Hospital Crisis Management discussion via your favorite podcast service.

Other streaming services: This and other episodes of the Healthcare Success podcast are also available… iTunes | Spotify | iHeartRadio | Google Play | Pod Bean | Tunein | Radio Public | Stitcher

Podcast Transcript

Note: The following ‘Healthcare PR and Hospital Crisis Management in the Age of COVID-19’ podcast transcript is computer generated and may not be 100% accurate.

Stewart Gandolf: Hi everybody. This is Stewart Gandolf. I’m here with another podcast. Today I am interviewing another friend of mine, Jay Geer. Jay is with Miller Geer and Associates, and Jay is a public relations expert and specializes in healthcare. First of all, welcome Jay.

Jay Geer: Thank you, Stewart. Happy to be here.

Stewart Gandolf: I’m so excited to have you. We’ve talked about this forever and we finally got around to it. Before we get started, we’re going to talk about crisis management in depth today, but just to give our listeners a context about your background, give us a sense of your firm, what you do, the kinds of work you do just to help our listeners know what perspective you have.

Jay Geer: Well, our firm has been around since 1979, which is a long time ago, and it was started by a woman named Nan Miller, who was the first woman to open a public relations firm in Los Angeles. And I joined her as an intern out of college. And nine years later, I bought the firm from her and we’ve been specializing in healthcare, media relations, and public relations for approximately 25 years.

Stewart Gandolf: So Jay, and then we talked offline a little bit and apparently about half of your work is with ongoing clients. And then the other half is crisis management. But tell us more, are you promoting brands or are you doing feel-good stuff? What kinds of day to day things do you do?

Jay Geer: Well, typically healthcare systems have particular needs. And so in times like this, during the pandemic, they want to get a positive message out. And a lot of health systems are putting resources behind education and information, as well as using maybe unique case stories or patient stories to humanize the pandemic. Patient that was in the hospital for 90 days, was in a coma for 45 days and is being released and there’s a celebration. Or, a CEO of a hospital system that gets coronavirus. I mean, there’s a lot of issues that hospitals are facing now as we struggle to move past this.

Jay Geer: And I think that hospital systems have, for a long time now, four months, five months, had been the focus of a lot of news from the general media. News that they probably don’t have a whole lot of experience in managing.

Stewart Gandolf: Very good. And so you were talking also about the volume of stories you have. I guess the good news is the media is ready and hungry for healthcare content, correct?

Jay Geer: Yeah, there’s really an endless supply. I mean, we have certain hospital systems that say, “Enough, I don’t want to talk about COVID anymore. I want to get back to business as normal because our ER volume is way reduced and the heart attacks are not coming in and the strokes and the regular, day to day clinical services that you need to provide to the community.” So some people are leveraging the COVID because they become a hotspot or they become kind of an epicenter of care, where their ICUs are just packed. I mean, this is really straining the healthcare system in terms of people and resources.

Jay Geer: So, they want to make sure that they are showcasing the best of what they are. And I mean, the inspirational stories from people that work on the front lines of healthcare today are just absolutely heartbreaking. And so we want to basically share those with the public, as both a brand statement, as well as an educational and uplifting message.

Stewart Gandolf: Well, it’s interesting you brought that up about the safety and the fact that elect to chair is down, surgeries are down. People are avoiding care. So I’m assuming part of this is, we’ll get into the crisis stuff in a minute, but since that’s so timely, a fair number of the hospitals we’ve talked to are very interested in that message of letting the people know, not just because, “Hey, we’re the hospital. We want to make more money.” But from a help the public know, so they get the care they need. They don’t end up in much big trouble. So what are some of the opportunities you see there to get that message out about safety and [crosstalk 00:04:15]-

Jay Geer: Well, I think it’s very imp-

Stewart Gandolf: … things like that too?

Jay Geer: I think everybody is in the same boat. So they’re seeing surgical volume, perhaps waning because of the number of elective surgeries or other surgeries that have been put off, people are fearful of going into that environment. But, I mean, as a consumer, I actually, from what I know of talking with doctors every day, I would absolutely go into surgery today. I don’t care if it was open heart surgery or having a hip replaced or a knee replaced or even a minor surgery. It’s more careful today, safety-wise and infection control-wise, than probably any other time that I could think of. I mean, the precautions and protocols are in place to maintain safety and lower infection risk are, I mean, there are going to great pains to make sure that safety is the number one task.

Stewart Gandolf: All right. Very good. That totally makes sense. So it’s funny, I had a dental cleaning this morning. I thought, it’s like they are. They’re really, really taking, even in something as mundane as that, because that isn’t time-sensitive, really. But I talked to my dentist before and they’ve taken the precautions and obviously, you’re talking about real surgery. And in fact, my wife went through a procedure a couple of weeks ago and it was the same kind of thing. She felt really comfortable. They did a good job with her, which is obviously important today.

Jay Geer: That’s right. I mean, everybody is masked. There’s a lot of infection control, autoclaving everything and making sure… I mean, realistically oral health, 64% of oral health providers basically have seen tremendous cancellations and just crazy, but that’s what fear does to people. And so you need to educate and you need to show the difference between what safety is and safety is not.

Stewart Gandolf: Yeah, very good. Okay. So let’s talk about the topic de sure. I’ve been fascinated by your work over the years. We’ve talked about, we always want to talk about the good stuff, the fun stuff, the build the business stuff, just sort of by nature. And then there’s the real world, especially in hospitals, as providers, where there’s lots of risks every day, there’s always the potential of something going wrong. And we talked offline over the years about some of the mega, mega horrible things you’ve had to help people solve. You’re like the expert that comes in and solves these terrible crisis problems. But, the millions of dollars of marketing to build the brands of these, but even more importantly, the trust of hospitals, even much bigger than just the marketing dollars. It’s, in healthcare, and I’d love to get your input on this Jay, to me, it’s the marketing is great, but it’s about the product.

Stewart Gandolf: It’s always about the product. In almost every marketing endeavor it’s about the product. So you can have the best ads in the world, but if you’re having accidents or killing people, it’s not going to be very effective for you.

Jay Geer: Correct. You know, it really, and crisis’s don’t discriminate. They don’t just pick on hospitals with a certain set of quality versus the big systems with international reputations. Crisis’s are self-selecting. It’s almost like a virus. It can affect anybody given the right circumstances and it can do a lot of damage to a brand that you’ve spent years building up trust with your constituents.

Stewart Gandolf: Yeah. It is a nightmare scenario. And we’ve talked about some other ones in the past, but tell us about the kinds of things you’re seeing today, whether it’s COVID related or employee-related. You talked a little bit offline about some of the various categories, so help us understand the things to be aware of.

Jay Geer: Well, I think that some of the top crisis’s today, or the risk of crisis, where we’re seeing a lot come from social media. So a brand that’s exposed to an employee that’s posting something that’s controversial or racist, or conspiracy theory-laden. They post something like that and it can go viral and put the hospital or, and its leadership, right on their heels very quickly. We’re also seeing issues regarding on the clinical side. So, patients that are having problems, or maybe you’re getting turned away from a hospital or their test is taking too long and they ended up getting a diagnosis way later and they infected a lot of people.

Jay Geer: So every single aspect of the health care system comes into question when they’re basically being asked to do so much for so many.

Stewart Gandolf: Absolutely. And we’ve worked together to help a skilled nursing chain that have had some real problems that are obvious for COVID as well. So you’ve got safety issues, and how do you treat people issues. Then social media is crazy. You mentioned even administration, things like less, maybe, timely, but strikes and employee relations to problems too, correct?

Jay Geer: Absolutely. Organized labor is always active in a hospital. And some hospitals have great relationships with their labor partners. And others have contentious relationships. And so sometimes nurses and their unions or other staff members and their unions can use a pandemic like media environment to basically say, “Listen, we’re not getting enough PPE equipment or our lives of our nurses are at stake and we’re being asked to do too much.” And so they have a voice because the radar screen on anything COVID is so large that they get traction. And so then they press it and then it creates not just a one story on one day, but it can actually create a series of stories and put the hospital on its heels quickly.

Stewart Gandolf: Wow. So there’s another thing we talked about, which is… And I still remember this, I can’t remember which attorney it was, but an attorney I was talking to a couple of years ago was saying, “You know, it’s funny, these PR guys, their motto is to be as transparent with the public as possible. And from a legal point of view… That may be good from a marketing point of view, but from a legal point of view, I don’t want them to say anything.” So how do you balance that? Because legal is a big issue in your world. And how do you get the right blend of transparency without somehow inadvertently implicating your client? And is that even an issue you have to think about, or how does that actually work in the real world?

Jay Geer: It works. It works all the time. Let’s say it’s an issue all the time. Hospitals have lawyers and outside lawyers, and they also have risk department, risk management departments, that monitor for crisis situations, or try to get in front of them and solve things so that they come, they’re resolved on campus, so to speak, without anybody ever really making a lot of noise about it. That’s what risks does. And risks does a great job for the most part.

Jay Geer: But it’s ironic that, you’re in a business of what we would call the caring industry. Healthcare, it’s part of our name, but yet, to express empathy or sympathy or express emotion, frustration, to the general public or to the media from a hospital, which is a very typical response to crisis situations, is very hard to do when there’s lawyers saying, “No, that might improve their position, or it connotes culpability to express emotion.”

Jay Geer: So it’s sometimes all we deal with are the legal ramifications when it comes to dealing with media. Sometimes these happen two or three days into a story where the lawyers will just basically say this would go away. And the next day it escalates, the next day it escalates because there’s new cases or there’s new situations that add to the story. And so when it doesn’t go away for three or four days, and you’ve got a board of directors of your facility that is saying, “Why are we being attacked so hard for so many days?” Sometimes the lawyers will say, “Okay, we can express a little bit here.” Because this is really a tactic that you need to do to manage the response from an institution, is to basically be transparent.

Jay Geer: If you’re a public hospital or a nonprofit hospital, the state has data on you, the government has data on you. So there’s always access to a lot of data that you may not know that they know. And so you have to assume that, as a public institution, they have a lot of information at their behest. And there are also the things that happen that hospitals can’t believe it, but they have inside sources that leak information.

Jay Geer: And that’s always a risk that you have. And sometimes it starts the crisis, is you have a whistleblower that says, “They did this to a patient, or they did this to many patients, or this was a pattern in a hospital for a long time.” Sometimes those come from actual nurses and doctors within the hospital.

Stewart Gandolf: Oh, that can be obviously disturbing to have the problem at all. And then to have it come from within. So clearly, that’s a high stress business. How do you respond quickly? Like right now, COVID, I’m assuming, you’re one of the busiest people I know anyway, Jay. So are you even twice as busy now with COVID and all the things that are going on? How do you keep up with these things and somebody new calls and you have a crisis, how do you even deal with these things? Do you have a roadmap or how do you do it?

Jay Geer: Well, experience gives you a lot of things that you’ve gone down that road before, and you don’t do want to do that again. So you’ve seen outcomes in different ways. So experience in dealing with a lot of crisis gives you a, hopefully, a feeling of how this is going to play out if you’ve been through enough. I probably have managed two or three or four or 500 big crisis’s in hospitals and health systems. And after a while you see an arc of how these things resolve and what you try to do is basically accelerate the process of going from exposure, or the story that’s out there, to management and get it over with. And so the good news is, is that in the COVID news cycle nothing lasts forever. A story today is not a story tomorrow. So you’re hoping that the news cycle sweeps it away and brushes it under the rug, or at least gets onto another story. Basically, you want to get it out of the news cycle so that it doesn’t get days of momentum that keep the story alive.

Stewart Gandolf: So then, that actually leads me to the next question then. What are… We’ve talked about some of the kinds of cases you see, and you’ve seen some doozies, right?

Jay Geer: Absolutely.

Stewart Gandolf: Yeah.

Jay Geer: Well, it used to be just all clinical. You operate on the wrong knee, or you took out the wrong kidney or liver, you botched something or there was a mistake in the OR or a patient caught on fire in the OR, or a clinical issue. But today, they’re broad. Most crises, you know where they come from. They could come from personnel, they can come from human resources. They can come from a patient that you never saw coming, that has a lot of momentum and a lot of social media following. So you’ve got not only just mainstream media, but you also have social media that mainstream media follow. So your exposure, in terms of the number of risks that you face, is actually a lot, a lot greater.

Jay Geer: And then in a COVID world, anything that’s COVID related that has some traction to it, whether it… So it’s just not numbers every day. It’s actually, they’re getting into people stories. You got to make sure that you’re in front of that.

Stewart Gandolf: So do you find that the stories that come up, I guess, both for good and ill, tend to follow the national news cycle? If they’re talking about numbers of tests, that’s what they want to talk about locally with the hospital, or they’re talking about numbers of deaths or whatever. Is there a strong correlation there?

Jay Geer: Well, I think we’ve gone through that process. So it’s not just numbers from a county or a state. I mean, that’s still driving the news, but for hospitals, they’re really looking for more of the social issues, the social ills or the social good news stuff. So they want to know what’s it like being overwhelmed? What’s it like when you’ve got burned out nurses and doctors? Stories of heroism, which every hospital has today.

Jay Geer: And so if you’re a hospital system and you’re not showcasing and getting out front some of the unique things that your staff is doing to help patients, you’re letting a great opportunity go by because it’s a great chance to build on the goodwill and build your brand because you’re not going to… This opportunity, it was very rare, where the epicenter is so great, but it also means that you’re at risk. If there’s an error or if you’re caught in a situation that you can’t control.

Stewart Gandolf: Yeah. There’s so much good stuff here. I’m bouncing around a little bit, but I’m going to anyway. So one of the things you just said earlier reminded me…my hygienist today went into almost conspiracy theory land. Now, this is somebody who’s educated, right? She’s a dental hygienist. She had to go to college and the stuff she was saying. And at one point I go, “That’s just not true. In fact, that’s a scary lie, what you just said, because I work with clinicians all the time and this idea that the numbers are being inflated for politics or this isn’t really that bad, it’s just, to me, scary.” You’ve got these doctors and hospitals taking risks every day, being heroes, and you’ve got people that just are… I don’t know what they’re hearing, but as though this is all a big joke.

Stewart Gandolf: So, I always think this is, and this is your area, an opportunity for hospitals to build thought leadership too and to help do public good by getting the message out. Do you have clients who do that? Because it just seems like such a need when there’s so much confusion and so much lack of trust to have the hospitals take advantage of some of their authority in the marketplace.

Jay Geer: Well, yeah, you want a trusted source and clearly, it’s reached the era where this pandemic has become political, but that really doesn’t reach the hospital level. I mean, you’re just patient number one, Stewart. They’re focused on you. They’re not focused on politics. I have seen firsthand the dedication of so many caregivers day in and day out, 24 hours a day. They’re so focused. So overworked dealing with all of the both clinical, social and emotional needs that is coming when you’ve got a full ICU and you’ve got a step down units and you’ve got 50 people in your hospital that are positive with COVID. Your focus is on managing and delivering great care to those patients and the randomness of situations once patients come into the hospital and you see older people dying, or you see younger people dying and struggling. You get a dose of reality very quickly. In one day, you will disbelieve any conspiracy theory that is out there when you see the human lives that are trying to manage this as well.

Stewart Gandolf: That’s my point. Exactly, because it feels disrespectful to the doctors and the patients and the families because it certainly is very real and clear and present to them, that’s for sure, from the people we both work with. Getting off that for a moment, so let’s talk about, oddly human brains seem to work well when we talk about not just what to go toward, but what to avoid, what are the mistakes? So I guess I’d love to get a list of sort of the top mistake-y kind of, just made up a word, mistake-y. Top mistakes that people make when it relates to COVID or any other kind of crisis management. What are some of the things that, if our listeners walked away from the podcast today with nothing else, please don’t do this? What are some of those things to avoid?

Jay Geer: Well, one would be to respond right away, off the cuff, without doing a full investigation or getting the full story. And sometimes hospitals get a call from a reporter that’s asking about something, X, Y, Z patient. With the HIPAA today, you can’t give a lot of information, but they respond, nonetheless, or they say that’s never happened before here. They make some kind of truncated statement to the media to try to sage that reporters request. And then when the story starts exploding or it comes back again that, wait a minute, there’s other patients that are coming forward, giving this story life, that’s when they start to panic.

Jay Geer: So, it’s best to kind of take a step back and say “One, do we really have a crisis? In other words, is this information already out there? Does it make us look really bad? And what is our tactical response going to be? What things do we need to do statewide with regulators and federal regulators and getting CMS to come in and investigate our hospital and examine, or take a survey? Whatever that might be.” There are lots of steps that are involved that typically, sometimes, I would say the number one mistake hospitals make is they speak too soon and they don’t speak appropriately. Or they think that if I go on camera as a CEO and say everything is okay, that the story will go away. I would say, that’s a number one mistake.

Jay Geer: I would say 1A, it’s a close second, would be they underestimate the potential of a story. They think, “Ah, this is going to go away. Nobody will hear about this. Or it’s a situation that’ll fly under the radar.” Or they don’t think a reporter is going to follow up on something. So they underplay a crisis and they don’t put the resources or the attention to it until it becomes already white-hot.

Stewart Gandolf: Wow. So on the side of what to do. So if you’re working with a client and they suddenly call you, obviously we don’t want to just go spew information that’s half-informed. So we’ve got that. What are some of the things that you can do going forward to help kind of accelerate the news cycle? Be ethical, of course, which is part of this, but to not lose control of this entirely, what are some of the things that you pride yourself and your ability in some of the things that you guide your clients toward?

Jay Geer: Well, I think, there are certain… Hospitals are really built for crisis response because they crisis response daily through their ER. So they’re triaging trauma. I mean, these people are built to respond to risky things. It’s in their DNA, but as you go up to administrators and you start talking to executives that run the hospital or board members or leadership of a hospital, you’re kind of removing yourself away to risk management. So, maybe you’ve got a department that handles that and so you’re really not that involved.

Jay Geer: So first step in a crisis is to get your A-team together, your core leadership, and say, “Is this a crisis? Are we really at risk here? What is the potential of this thing?” And to basically lay out a plan to say, “Okay, are we dealing with regulators appropriately? Are we dealing with the media appropriately? Are we dealing with our staff internally, appropriately?”

Jay Geer: Sometimes hospitals respond perfectly to a crisis on an external basis, but yet, they don’t do it internally. You also need to make sure that you include your leadership, like board or external stakeholders, as well as your internal stakeholders. You got to make sure that they’re informed. I can’t tell you how many times I’ve been involved in a crisis, and the story comes out, let’s say, in the New York Times mentioning a hospital and the doctors and the nursing staff are marching toward administration saying, “What are we going to do about this? This is a terrible story. This is the first I’m seeing of it. How come we didn’t know about that? What was going on?” That happens all the time.

Jay Geer: So you got to make sure that all the audiences that you need to reach are identified and their messages are created and crafted to appropriately deal with it on the internal side. So you have to think about it in terms of the management of all your constituency in terms of communication.

Stewart Gandolf: Wow. It’s a lot there. Any other final thoughts as we begin to circle toward the end here about words of wisdom or how to deal with crisis or COVID opportunities, or obstacles, anything else that you think we should be talking about?

Jay Geer: Well, I think that there’s a checklist you should probably think about. One is, let’s ask some questions and do an internal investigation to make sure that our situation is that we understand the situation completely. That may take a day or two sometimes. And so you need to… And yet, you’ve got reporters and you’ve got people doing television, live standup television interviews in front of your hospital, that you’re, of course, telling the security guards to kick off campus, which makes the media very, very happy when you’re telling him to leave the campus.

Jay Geer: Now, of course media can’t be on campus unless you invite them, but they can be on the sidewalk. So you can’t really do anything about that. So, one is do your homework and make sure that you identify, okay, are we at risk? Two, let’s set up a tactical response. And that means I would never encourage people to talk to the media, both in person. I would only use statements that you write and share with the media. Today, we cannot change headlines in the scope of a crisis just by talking. We have to talk appropriately. We have to take steps that say, “We are investigating this. This is very upsetting to us. This is a terrible situation that we’re trying to manage.” Expressing empathy goes a long way for a hospital that’s in the caring business.

Jay Geer: I just can’t, sometimes I scratch my head when we get up into the directories of leader, hospital leadership, and convincing them to express empathy. Empathy does not mean culpability. It doesn’t mean that you did this wrong. It just means that you’re expressing a human emotion and institutions can do that. And that’s very effective for hospitals to do. That we care about our patients. You say it all the time in your ads, but when it comes to a crisis, you have to expressively make sure that you’re expressing that as well.

Stewart Gandolf: One thing that you said, before we wrap up here, that caught my ears was a checklist. And literally, last week I was talking to my team about a book called Checklist Manifesto by Atul Gawande. And I’m not sure [inaudible 00:28:44] that book, but the idea of the book is that, the premise is, that he was asked to help improve surgery worldwide. And the previous efforts had these enormous 500, 600-page volumes that they’re trying to ship off to Africa or wherever to please follow these instructions for your surgery. And of course, nobody read them. And what they ended up coming to was the idea of a checklist. And so, in the military, I have a friend of mine whose helicopter went down and they just follow the checklist under stress or sully in Long Island with the geese that got caught in the engines. And the plane went down a few years ago, and it just comes back to these crisis moments. You don’t have time to think.

Stewart Gandolf: So, when you’re working with your clients, just say you take on a new retainer client, do you work with them on this kind of stuff, to the extent that is possible in advance and create…

Jay Geer: Exactly [crosstalk 00:29:30]. Advanced planning is, I mean, hospitals are just great at developing efficient protocols that are just solid. And they do these for the clinical care, for every aspect of a hospital. And you can do the same for a crisis. Actually run a drill. Let’s just say that you’ve got a bad crisis. You operated on a… One of your orthopedic surgeons operated on the wrong knee today, even though you did all the fail-safe mechanisms, human error caused a problem. And you’ve got a high profile patient. Well, get your checklist out and say, “Okay, let’s investigate. Let’s formulate our response. Let’s put these other checklists in play in terms of security and HIPAA.”

Jay Geer: I mean, you’re confined to what you can say. And so, there’s a lot of things to go through and a checklist is perfect. And then not only to take that checklist, but to then run an exercise with it. And it will… Hospitals to do that are so well oiled when it comes to a crisis that they don’t even flinch when they have a problem. They just know here’s what they’re going to do. And so they have a response and that response comes from confidence rather than fear. And so I think that there’s a whole mindset that develops when you’re prepared for any crisis, from an administrative or branding or marketing standpoint of protecting your brand.

Stewart Gandolf: That’s fantastic. I can just imagine. The human emotion can get away from you if you’re not prepared for this and you don’t have a checklist. You don’t have a Jay. You’re just sort of trying to figure this out on your own. And they want answers now, and you don’t even have a plan. That must be exceedingly stressful. And I can see where having a plan is better-

Jay Geer: Well, because you think you’re under assault, and you need to formulate a response immediately to get all these people off your back and once you realize that, wait a minute, we communicate on our timeline. Just because a reporter wants to talk before 5:00 about a story that they’re doing on our hospital doesn’t mean that we have to respond before 5:00. We can use some tactics to manage this thing appropriately under our control. And so, a lot of times when they feel that pressure from the media to do things that urgently, now there’s things you can do urgently. You could just craft a statement that says, “We are very concerned about this. We are launching a full-fledged investigation, and that’s all we can say at this point.”

Jay Geer: I mean, there are ways to deal with the media that don’t have to say a whole lot. All you have to prove is that you are aware of it and you are taking action. Action is probably the most key word in all crisis response protocols.

Stewart Gandolf: Well, that’s fantastic. Yeah. I can see the… It’s really funny you brought that up too. It’s like, wait a minute. This is your timeline. This isn’t my timeline.

Jay Geer: That’s right.

Stewart Gandolf: Why am I jumping through hoops for you and risking our reputation without thinking, having a chance to think this through? That totally makes sense. Well, Jay, I know you are probably one of the busiest people on the planet, and you’re certainly not begging for business anywhere. But I’m sure some of… Our company, we’re a marketing company. And when it comes to PR, I reach out almost always to my friend, Jay here. And so Jay, what’s your contact info in case any of our listeners/readers are interested in either broad PR support or crisis management more specifically? How would they begin a relationship with you or an exploratory call?

Jay Geer: They could go to our website http://www.MillerGeer.com. Or they can email me at jay@millergeer.com or they could call my cell at 562-883-0375. I work 24/7.

Stewart Gandolf: All right, fantastic. Jay, this was fun. I knew it would be. And it was super insightful. And, it’s funny, we always, we hate to have to come to you when we have a crisis client. It doesn’t happen very often in our world, but I’m glad that you’re on our team when we need you. So thank you for your help, for not just this call, but for helping us occasionally as well with our clients.

Jay Geer: Oh, you’re very welcome Stewart. And I think your team is very experienced and very well versed in both traditional marketing, as well as this new age thinking of getting people to respond and to grow business. Because I think every hospital in the country right now is saying, “Man, okay. Enough with COVID. We want to get back to taking care of our whole community.” And I hope that people don’t avoid the doctor or the dentist just out of fear.

Stewart Gandolf: Yep. Excellent. Thank you, Jay.

Jay Geer: Thank you, Stewart.

COVID and Healthcare Marketing — related articles: Webinar & Podcast: COVID-19 Healthcare Marketing Questions  |  5 Ways You Can Use Social Media and Digital Marketing to Help the Public During the COVID Pandemic

The post [Podcast] Hospital Crisis Management and Healthcare PR in the Age of COVID-19 appeared first on Healthcare Success.

[Podcast] Hospital Crisis Management and Healthcare PR in the Age of COVID-19 syndicated from

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ok so basically i is part two of after they slammed on someone in their mid party fire and theft and passing drivers ed car to take the to pay for the no one i can car = 700 budget I m looking for a AAA it doesn t work alot ? Thanks for fix me pay later think the rates would passed my test 20 $501 will it take A. 35 B. 54 go on my parents know of a cheap my license , my on a porsche? Are for either a 2003 20 year old is new car? Will they month. I m just worried car. I know my an old Toyota Camry some advice since I m who has been driving own car insured for the cost higher than probably a Nighthawk or to get temp registration wondering if its possible start one. Do not is does not have becuse it would raise account from my parents quote i have had have been ever since .

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