Hospice cards: Greeting Card Universe Steps Up

I wanted to post an update in the continuing saga of my request for Hallmark to create hospice cards.   At this point the petition has over 4,000 signatureson Change.org.  While Hallmark has yet to create a card to fill this gap, Greeting Card Universe has created 24 hospice cards for friends and family of the hospice patient to use.  I was overjoyed to hear this!  This is another step closer to getting such cards in stores.  You order Greeting Card Universe Cards online, but you can pick them up in your local Target store.  Isn’t that wonderful?  Mindy Rosso-Gaemi, community manager at Greeting Card Universe heard our original plea and decided to do something about it.  She created the hospice category and several fields of card types.  She then asked her artists to use their talent and life experience to create some cards.  These lovely cards are the result.

I loved the heart-felt truth and honesty of this card:

http://www.greetingcarduniverse.com/occasions/goodbyefarewell/hospiceendoflifefinalgoodbye/religious/christian-saying-goodbye-end-of-1072816

And though it may have not been the intent of the author, this one with “You Are Not Alone” made me chuckle and would warm the heart of any Doctor Who fan.  So my friends Michael, Rebecca and Will if you ever enter hospice I am totally sending you this card!

Thank you Mindy and all the artists at Greeting Card Universe for making the end of life a little brighter.

Full press release below:

Greeting Card Universe Offers Greeting Cards for Final “Good-Bye” to Hospice Patients & “Thanks” to Hospice Nurses

San Francisco, CA – (May  1, 2013) – In celebration and support of National Nurses Day on May 6th, Greeting Card Universe, the world’s largest greeting card store, announces its new collection of hard to find and uncommon cards for patients in Hospice Care – affording loved ones the words and sentiments to say a final “good-bye”.

“Together with regular nursing duties, hospice nurses provide palliative care to terminally ill patients,” says Mindy Rosso-Gaemi, Community Manager at Greeting Card Universe. “A hospice nurse not only helps a dying patient going through a distressing  and often times frightening period, but shows the same level of caring and compassion in comforting the patient’s family and giving emotional and spiritual support when it’s needed most.  A special ‘thank you’ card for a nurse or caregiver is a wonderful way to express gratitude to these special individuals”.  Greeting Card Universe has a popular collection of over 1,000 Nurses Day cards. 

Hospice care was first established in the 1970s. At the time, cancer patients made up the greatest number of recipients. Today, thanks to advances in medicine, less than 50 percent of hospice admissions are due to cancer. An estimated 1.65 million patients receive hospice care in the United States each year.

 “Hospice patients need to hear from family and friends,” says Rosso-Gaemi. “They need to know they’re loved and won’t be forgotten, and that it’s okay to let go.  For most people coping with a dying loved one is too difficult. They fear of saying the wrong thing and are at a loss for words so say nothing at all at a time when any words would mean so much.  Not taking the opportunity to connect is a regret they’ll likely carry for the rest of their lives.”

Greeting Card Universe offers sympathetically designed Hospice Good-bye / End of Life cards created especially to give to hospice patients, providing a starting place for a loving, therapeutic conversation or a final good-bye.  The new collection of cards was inspired by the plea of Regina Holliday, artist, widow and healthcare advocate, who publically petitioned Hallmark to create a collection of Hospice End of Life greeting cards. 

 “Where Hallmark stumbled, Greeting Card Universe has risen to the occasion offering a new collection of cards to serve this niche market,“ shares Rosso-Gaemi.   “It’s not always about what’s politically correct or the size of the market, but instead if there’s a real need for expression.  Once shoppers discover the variety of cards we offer, they’ll never shop anywhere else. ”

Greeting Card Universe put the request for hospice cards out to their community of 5,900 artists.  Within two weeks the new collection emerged with over two dozen cards and more to come.  Many of these artists drew upon emotions and experiences of hospice care and their own lost loved ones.  The creations carry their tender words of thanks, good-bye and prayer for others to express when the words don’t come easily.

Ordering online from Greeting Card Universe’s collection is easy and convenient.  An added convenience for last minute shoppers, cards can be ordered online and picked up— usually within one hour—from most Target stores across the country. 

Greeting Card Universe’s traditional and niche offerings of over 589,000 cards gives nod to the importance of choice and personalization in today’s marketplace and stays true to its tagline “any card imaginable.” 

Explore more uncommon holidays and occasions on the Greeting Card Universe blog.   Mindy Rosso-Gaemi is available for guest blogs, radio and TV interviews on this topic and other uncommon occasions and holidays.

About Greeting Card Universe
Greeting Card Universe (www.greetingcarduniverse.com) is a division of BigDates Solutions, a private company that provides consumers with unique, personalized services for any holiday or occasion. Greeting Card Universe is the world's largest paper greeting card store, offering an unlimited selection of custom greeting cards, birthday greeting cards, photo cards, invitations, and note cards. BigDates Solutions is the leading provider of Online Reminder Service Solutions, powering gift-reminder services, including 1800Flowers.com and FTD.com. The company is also the owner of Birthday Calendar, a Facebook application with over 42 million installs.

Contact:  Mindy Rosso-Gaemi Mindy.Rosso@bigdates.com                                                                                                            

The Monster, the Mythos and Medicine X

What does the television program Supernatural have in common with Stanford's Medicine X? That will take a bit of explaining…

The world of the televised science fiction/horror serial is not so distant from the world of medicine.  I find one often emulates the other and can often be analyzed using the same tools.  When I am in a call focusing on the message of HIT, I remind folks to remember the Metanarrative.  Technology is not the most important part of our discussion. The overarching patient story must be considered equally significant.

How do you explain story?  I recommend using story itself. 

Back in 1993, The X-Files changed the world of the sci-fi narrative.  Not only did it add valuable catch phrases to our lexicon, such as “The Truth is Out There.”  It set up a contentious dyad in the characters of FBI agents Fox Mulder and Dana Scully. Here belief confronted skepticism on a weekly basis. In each episode, the characters would investigate an X-File: the odd, perhaps paranormal cases that filled the cold case files.  These X-Files were beyond the normal range of FBI investigation and any agent who voluntarily studied them was considered suspect.

Each week the audience would watch Mulder believe and Scully attempt to debunk the cause of the X-file.  They would confront human horrors, monsters and aliens.  This weekly dance of the macabre has a grand history in the televised narrative and is used in classics such as Star Trek to camp favorites like Friday the 13^th the Series. This convention is called “monster of the week” and does not require a continuous narrative.  Often in “monster of the week” programming the shows could be watched in any order without causing the audience distress.

But The X-Files show is about that which is beyond the normal, so this show embraced mythos.  Above and beyond the weekly episode was a master narrative that was at first supported by the “monster of the week” device and then subsumed it.  This show became completely mythos focused towards its end as the characters were entwined within an epic conspiracy that involved covering up the truth.

The X-Files opened the flood gates for a new kind of televised serial and in 1997 Buffy the Vampire Slayer was first aired.  Buffy was the dissertation topic of my late husband Fred Holliday and he often marveled at the beautiful marriage of “monster of the week” and mythos within this program.  It also had a healthy dollop of Metanarrative with characters using lines such as “I can’t believe you, of all people, are trying to Scully me” or “Dawn’s in trouble, must be Tuesday.”  (Tuesday day was the day the program was aired.)    

Buffy aired from 1997 to 2003 and astounded critics and fans alike with its well written dialogue and its mythos that spanned 7 seasons.  During those years characters were allowed to grow and change.  Buffy went from being a high school student, to college student, to college drop-out, to food service employee, all the while spending her nights saving the world.  She was an every woman embracing all economic classes and with the death of her mother became the adoptive parent of her younger sister. Buffy died twice, only to return to deal with grief, addiction, domestic abuse in addition to the trials of leadership. Then in 2003 Buffy left the airwaves, but like The X-Files before her, she inspired other programs. 

In 2005 the BBC the creative team behind the reboot of Doctor Who would successfully pitch the return of this well loved franchise as a “Buffy” for the UK. Also in 2005 Supernatural débuted in the United States, in this program, like The X-Files, “monster of the week” was devoured by mythos.  Supernatural begins with a tale of two brothers, Sam and Dean Winchester, who define themselves as “hunters” and their goal is to find their lost Father avenge the deaths of their loved ones at the hands of a demon.  Along the path towards this goal they encounter various paranormal entities that they must overcome in order to help terrorized civilians. They are mission driven and in the cause of fighting for that which is good, they support themselves through credit card theft and card sharking. Saving the world rarely pays well.

Now the worlds of television and medicine begin to collide.

I painted this painting as I listened to episodes of Supernatural streaming on Netflix.  As I listened, I learned the protagonist Sam was attending Stanford.  He was smart, handsome and empathetic with strangers to the point of endangering his fellow hunters.  He was also somewhat elite, fussy and prone emotional outbursts when things did not go his way.  Dean, the other lead, liked heavy metal, drove a 1967 Chevy Impala, took pride in his blue collar and beer tastes.  In addition, Dean was loyal to the point of self-destruction and refused to accept the concept of fate.   

All of these thoughts swirled in my mind like the spirals in this painting, as I painted “Medicine X.”  

In this painting the tower and quad of Stanford define the piece.  The sky behind roils with inky spiraling clouds.  The time is now and healthcare in the United States is mired policy debates; while, like a beast of burden, the institutions of care limp forward toward an ever elusive goal.  In the center of the painting is an Ivory Tower.  It has entire sections sawed out and begins to resemble an electronic key.  Here is the key to saving lives.  As I am sure Dean Winchester would say to Sam, you must leave the tower to fight the monsters. So when you look at this tower, I want you to think of the silos that must open and the towers that must level so we can all communicate on common ground with provider, academic and patient. Also as Buffy could tell you there is only one Key that opens a portal between worlds.  That key is a life.

In the foreground, two girls stand within rising water.  They are patients in need of rescue from the coming flood.  One girl turns her back to the viewer and holds a smart phone in her hand.  The other girl looks out of the frame and a blue twitter bird perches upon her finger.  Though they look concerned but they are not panicked, because they have the tools of mobile health and social media to help them.

To the left of this piece, a series of people are pushing their rafts upon the rising water.  Our blocks from the tower have become rafts to navigate the deluge.  Here we have doctors, techs, academics, venders, designers and patients trying to find common ground.  Each uses the pole in their hands to move forward in the water.  As the pole crosses before their body each becomes the letter “X.”

We are the X in Medicine X.  We are the unknown part of the equation.  We are the mysterious other that has not been applied to the solution.  We are the files locked in a cabinet and dismissed as other or strange.  We are the ever arching story above and beyond the episode of care.

Currently many institutions are treating their patients like a monster of the week, destroying the one-off disease and forgetting we are a reoccurring character within in our own lives.  Data access and patient portals allows us to enter the land of mythos where a narrative lasts a lifetime.

Some of us will go farther, gentle reader.  We will journey into a world where incentives are not measured in dollars but in lives saved, where stones float and ivory towers work as keys that let people in rather than keep them out.  I look forward to seeing that place.  I know many doors lead there and I think one door will open at Medicine X  and I thank Larry Chu for designing a event that is patient inclusive.  I hope to see some of your there on September 28-30, 2012.

Steampunk Health

What is Steampunk? 

If you do not count sci-fi geeks and cosplay fans among your very best friends, you may not know about this literary/fashion sub-genre.  The steampunk aesthetic arouse from science fiction novels of the late1980’s to early 1990’s.  A hallmark of the form is an intermixing of Victorian era technology with a futuristic world.  In the world of steampunk, giant floating airships replace airplanes and robots powered by steam can be wound up like clocks.  That explains the steam part of the moniker.  But along with the futuristic Victorian technology, there is grimy coal-stack poverty within the form.  In steam punk fashion, the make do, miss-match dichotomy of distressed smart phones with clock work gears gives one a sense of unease.  There is something really wrong with the picture when antiquated forms are indiscriminately matched with modern technology, hence the term is steampunk.

What is Steampunk Health? 

Well, that is the title of Ben Merrion’s Walking Gallery Jacket and anyone who looks around the world of health today will see futuristic technology surrounded by anachronistic systems of old-fashioned medicine. Ben Merrion is the Literacy Outreach Specialist for DC Public Library.  He has extensive experience as a teacher of adult learners and very involved in social justice in DC.  He is even one of the artist members of The Walking gallery having painted the sumi-e style “Holistic Medicine” for Christian Liu.

But this is Ben’s jacket and he wanted to focus on adult literacy and steampunk Daleks.  Now some of you might wonder what health advocacy has in common with adult literacy or steampunk Daleks.  Well as e-Patient Dave de Bronkart recently tweeted, I am good at pointing out connections and will show you the way.

In this painting, Ben Merrion is dressed in a steampunk fashion.  He wears glasses that are affixed with mechanical trifocals.  With a concerned countenance, he holds out his hand containing a jar of prescription medicine.  The label can be clearly read… if you can read.  It states: “1 in 5 District residents can’t read this.”  That is a pretty powerful statistic if you apply it to health literacy.  How can a patient be medically complaint, if they cannot read their care instructions or warnings about possible side-effects?

Behind Ben, a line of steampunk Cybermen stretch into the distance. Above these cyber figures is the statement: “Uncooperative patients will be assimilated.”  If you know your Doctor Who you are very familiar with these cyborgs that vanquish all human emotion and replace it with cold hard logic.  If you look closely you will see that upon each cyberman breast plate a there is a FICO logo next to a small capsule.  This image harkens back to an epatient.net blog and discussion from the summer. 

In June Alex Albin’s post “FICO’s new Med Compliance Score: #FAIL” was cross posted on epatient.net.  The blog post explained FICO’s decision to track patient medical adherence via third party data sources.  FICO was planning to use a combination of retail purchase history, geo-credit profiles and income wealth indicators to compile a data base that could be used as a tool to judge patients.  With this tool providers and pharmaceutical companies could easily tell which patients were prone toward non-compliance.

Yes, the tool could tell you who might be non-compliant and give providers the data needed to guarantee a pool of adherent, assimilated patients.  But it could not tell you why they were not taking their medication.

Toward the lower half of the painting is a steampunk Dalek.  Dalek’s are also cyborgs and are an arch-nemesis from Doctor Who.  They have had every emotion removed except hate. Their pepper-pot form and catch phrase, “Seek, Locate, Exterminate!” permeates pop-culture.  The traditional catch phrase has been replaced in this painting by: “Seek, Locate, Medicate” and alludes to a statistic from May 2011 in the Wall Street Journal.  1 in 4 children are on chronic prescription medication in the United States.

So, let me clue you into a few things.  The number one blogging key word search term for patients is uncooperative.  If you attend medical conferences you will repeatedly hear we are non-compliant.  If you listen to specialist like Ben, a large portion of the adult population in this city cannot read at all, let alone complex instructions.  And if one in four children is prescribed chronic medication, we aren’t dealing with a compliance problem; we are facing a massive level of over-medication.

So, I think Ben has one of the most appropriate jackets in the Gallery.  I really hope he wears it everywhere; for I am steamed about these statistics.  And as far as a punk is concerned, I know from years of selling fireworks what a punk is for.

Punks light fires.

The Stream

On Tuesday I had the opportunity to speak at AHRQ for the first time. Their annual conference was held once again in The Marriott conference center near the White Flint Metro Station in Rockville. I realized I had been there once before. This was not the confused deja vi of a weary conference traveler, I seen Ted Eytan speak here a year before.

The Marriott had a sort of creepy sleepy stillness about it. It did not help in the least that I had just watched the most recent episode of Doctor Who: The God Complex. That episode was set in a hotel decorated with the same type of eighties opulence as this Marriott. Within that episode, each room contained a personal horror designed to break the faith of each unexpected guest.

In this hotel, attendees walked by leisurely as they chose which presentation to attend from the multitude of those offered. They opened doors, they walked within and disappeared. I paused, glancing at the different signs looking for my room. Whilst wondering if little Miss A should enter track B, Jon White found me. Jon works for AHRQ and had invited me to take part in his panel. Cell phone in hand, he gestured his awareness that I was present and then rushed away. His team member Heather soon appeared and began guiding me to the presentation room.

En route we ran into Ben Miller, also known on twitter as @Miller7. It was so exciting to meet such a great social media voice in real life. His physical person is as slight and lively as his twitter voice. I offered to paint his jacket immediately, but as it was a full matching suit with vest he declined in favor of continued marital accord.

I really enjoyed presenting with my panel. We had a nice size crowd in a small room. Though we presented at 3:30 in the afternoon, I did not see the tale-tell head jerk of the the seated sleeper. Ron D Hays and Keith McInnes had such amazing information to present about CAHPS questions relating to HIT questions. It was an honor to follow their thoughtful presentations. As the session ended, Ben asked me to come back the next day to attend the 3.5 hour town hall on mental health.

I said I would attend, and I would paint.



After bundling both of my children off to school, I lumbered, French box easel in hand, back to the Marriott. I had been assured that there would be space for me even if it were standing room only. I quietly let myself into a room as large as a grand hall. 300 seats were arranged before a the stage. A selection of speakers including Dave DeBronkart sat upon the dais A film crew was filming every moment as the event was being live-streamed.

There were only 49 attendees seated in the audience.

I was dismayed. As set up my easel dismay turned to anger. I felt as though I should check my vision and compare my expectations. I quietly removed myself and peeked into the next great hall. Here the room was full. I walked away and reentered our room. The empty one, the room whose empty chairs gaped like the holes within a lotus pod. Furiously I began to paint.

This is Katerina's Jacket: The Stream.


I can assure you that if Katerina Jackson-Suchkova had been in charge of that session every seat would have been filled. Katerina works for Lifetime Health Diary. It is a PHR company that contains and aggregates years of personal health data and uses a personal visual health construct on each users landing page. I love it, it actually has a picture of health.

I got to know Katerina when she organized a round table on health in DC. She was brilliant and had such an organized mind. She put together an excellent panel that day.

But this was another day, at other panel and I was painting eyes. The back of Katerina's jacket is littered with eyes. They fold blue within blue, the swirling tones of facebook and twitter look upon the viewer; for this is the stream. These are eyes of the countless viewers who watch the stage while far away in some other room.



Below a sky of eyes, the green grass is a horizontal capsule. How can we talk of mental health without bringing up the subject of drugs? Sprouting from the capsule are four silos. Each silo contains a figure garbed in a short and straining patient gown, trying desperately to escape.



In the center stands the epitome of fright: the Scream figure by Edvard Munch. He yells at the viewer while wearing vestments arrayed upon his gown of black. The vestments are embroidered with scientific symbol for male and female. He is speaking to all of us while he preaches to the choir.



Below the frightened figure, the choir raises their hands in concerned praise. They agree whole heartedly that we need to have more transparency in mental health between patients, providers and communities. But the choir is so very small.

Finally the saddest part, the part that makes this Katerina's jacket. A doctor on the dais recounted a tale of a young lady who took her own life. "She seemed so happy" he said. But then they read her diary. They read her words of all consuming anguish stemming from her infertility.



If only they could have read her diary before it was to late.

Do you see the life-saving beauty of an online health diary? As a widow who has data-mined a year of her own late husband's Facebook status lines, I can attest that the words we write are powerful things. They are powerful for the individual and for the aggregate. They show us patterns and mark the tide of years.

Can you imagine a different ending for the lovely lady with such a diary? Can you see her enter another room that does not end in broken faith?

The Littlest Walker

As I painted jacket after jacket in the month of May, my little five-year-old son Isaac waited.

He waited for his snack, he waited to play, he waited for his story time and he just waited.  One day he stood beside me, looking at the painting on a jacket.  He stared at the kitchen that had become a studio.  He was waiting.  “Yes, Isaac?”  I said in a slightly dismissive tone as I blended the colors within an image.

He responded,  “When will you paint my jacket?”  I stopped painting and looked at Isaac asking, “Do you want to join the Gallery?  Do you want to be a walker?  What would be your story?”

He looked at me with his deep blue eyes.  He said, “Well, you can paint a snake because there are snakes in medicine.  Snakes help make anti-venom.  That makes people better if they get bited.  You can paint Doctor Who because he is a doctor and he helps people.  And you can paint some of the other Doctor Who characters  “

And so Isaac joined the Gallery.

This is Isaac Holliday’s Jacket: “Doctor Who in Medicine."

 Isaac has been watching Doctor Who since he was three.  In the Fall of 2008, we watched every episode of the new BBC run as a family.  It was the most joyful time.  We celebrated Freddie’s birthday (Isaac’s older brother) with a Doctor Who party.  We and our friends dressed as the characters for Halloween.  For Christmas, Freddie got a Tardis playset and Isaac got a Cyberman helmet.

And then came January, Daddy was sick and tired.  And Isaac waited for Daddy to play with him.  But Daddy hurt.  In February, Daddy felt worse.  Isaac waited.  In March, we gathered up the family and a bag of Doctor Who action figures, and went to the ER to see why was Daddy suffering so.  Daddy waited, Mommy waited, Freddie waited and Isaac waited for three hours in that beautiful waiting room.  We waited three hours to be sent home with pain medications. 

By the end of the month, Fred would be admitted to that very same hospital and he would never walk again.  Isaac would sit on the floor next to Daddy’s bed playing with toys.  And sometimes Isaac would crawl up into Fred's bed.  He would nestle there carefully within an embrace of arms and IV lines, but Isaac remembers he accidently hurt Daddy with his shoes.  This picture is of that moment.

Isaac didn’t really ask for much.  He just wanted you to hold him.  He would wait for that.

Sometimes, Isaac asks me if Daddy is still dead.  Sometimes, Isaac waits.

I am glad Isaac stopped waiting and started walking.  I bet Daddy is glad too.

Collin's Jacket: The Curse of the Black Spot

A few weeks ago I began following Colin Hung on twitter. He is really cool, and following him was a no-brainer as his avatar is a little guy holding a lightsaber and he tweets about health care social media.  It got even better. He liked Doctor Who.  He even managed to tweet a Doctor Who in-joke into a social medial chat two weeks ago.  I had to invite him to join the Walking Gallery.  There is only one problem: he lives in Toronto.

This is the Colin I know: @Colin_Hung view full profile →Toronto Tweeting about healthcare, marketing & tech. VP @ www.rlsolutions.com - improving healthcare thru ridiculously easy-to-use software. Sushi, Syfy & TV fanatic. http://www.togreatersuccess.com

This is the Colin that most other people know.  And I have been explaining to Colin the amazing ways Doctor Who and heath care intersect.

In the fall of 2008, long before I began my journey of medical advocacy I would spend each morning researching the Doctor.  I would type in "Doctor Who" and skip over malpractice suits and break-through drugs and go right to the newest blog or entry on the BBC’s Doctor Who.  He is a fictional alien and time-lord who is around 900 years old.  The show is the longest running sci-fi show in the history of television, and after a hiatus in the 90’s, it was re-booted in 2005.

In the original series the Doctor was always very much in charge and his mostly female assistants or companions existed to further the plot.  In the 2005 re-boot, companions became an equal partner in the Doctor/companion relationship.  It was a great show.  Our whole family fell in love with it.

Our eldest son Freddie decided to make his 10 year-old birthday party a Doctor Who carnival.  He invited 70 of his friends.  And he invited his very best friend, and that child made it to the party very late.  But he came very close to not making it to the party at all.  He came very close to not making it to anything ever again.

A week before the party Freddie’s friend had a small cut on his leg.  At first it just seemed inflamed.  But as the week progressed, the spot became darker and deeper.  By mid-week, the child was running a 104-degree temperature in the middle of the night.  Although his mother had two other small ones at home, she roused the family in the middle of the night.  She took her son to the ER, where the doctors told her the infection was quite serious.  It was good that she had not waited till morning, because the child was infected with MRSA bacteria. MRSA is Methicillin-resistant Staphylococcus aureus; and Freddie’s friend had most likely had the community-acquired MRSA (CA-MRSA).

The staff of the hospital ran two courses of very powerful antibiotics into his body.  It was touch and go for a few days, but by the end of the week he was discharged from the hospital and was able to attend the very end of Freddie’s Doctor Who birthday party carnival. 

Last week, Doctor Who aired its third episode in series 6.   It has been a great season so far, and the American viewing audience has been fully embraced.  The show now airs at the same time in America as it does in the UK, and the first episode was even partially filmed in America.  I wondered if they warned the cast and crew of the hazards, other than snakes, in the American west.  I wondered if they had been warned about the brown recluse or “fiddle-back” as it is known in Oklahoma.  I wonder if they know how a really small bite can lead to a really big hole in your body.    

Episode 3 was “The Curse of the Black Spot.”   I was honestly astounded by last week’s episode, as it was so very applicable to the world of medicine. The episode was written by Stephen Thompson, and in the interest of time I will use the Wikipedia entry explain the basic synopsis:  

“Following a distress signal, the TARDIS and its crew lands aboard a 17th century[2] pirate ship stranded in the middle of a calm ocean. The crew has been terrorized by a Siren-like creature (Lily Cole), which marks people with black spots on their palms after they are injured. “

In this painting, there is a close up of the MRSA bacteria surrounding the familiar characters.  Each bacterium at a cellular level appears as a series of black spots.  There are also two brown recluse spiders, as initially a bite from one of these spiders looks like a case of a MRSA infection.  I also inserted the Tenth Doctor, David Tenant, with a black Spot, beside Eleventh Doctor Matt Smith with his “small” cut. 

“The Siren would then appear and lull her victims to touch her, which would apparently disintegrate them. Rory Williams (Arthur Darvill) receives a cut during a tussle with the pirates and, knowing the Siren is using water as a portal, the Doctor (Matt Smith) instructs everyone to seek refuge in the ship's dry magazine.

There, they find Toby Avery (Oscar Lloyd), the son of the ship's captain Henry Avery (Hugh Bonneville), who stowed away on the ship after his mother died to work with him, unaware of his father's illicit deeds. He too has a black spot on his palm due to a fever. In an attempt to evacuate the crew, the Doctor and Avery board the TARDIS, but find it is acting haphazardly, and are forced to evacuate before it dematerializes by itself. After the Siren in a dry room takes another shipmate, the Doctor realizes the Siren is actually using reflection to appear. In response they rid the ship of any reflective surfaces, including the ship's stolen treasure.

When a storm begins, those who remain on the ship start to set sail. Toby drops a polished crown while bringing his father a coat; the Siren is summoned and takes Toby. Soon, Rory falls into the ocean, the siren takes Rory and the Doctor believing the victims are not dead, convinces Avery and Amy Pond (Karen Gillan) to prick themselves. The Doctor's suspicions are confirmed when her touch actually teleports them to an alien spaceship, invisible in the same spot the pirate ship is located.

The Doctor finds the ship's crew long dead from exposure to a human virus. The trio finds a sickbay where Avery's entire crew, Toby and Rory are in medical care. The Doctor also finds the TARDIS. The Siren is the ship's emergency medical programme, which is caring for the injured humans; the black spots are in fact tissue samples used as references. Amy convinces the Siren to release Rory into her care. Using Rory's nursing knowledge, Amy and the Doctor remove him from life support and are able to resuscitate him.”

To symbolize this concept, the TARDIS, a Police Box, has a small informed consent form affixed to its front panel.  This and the hands clasped above it wearing wedding rings are referring to the moment in the episode when Amy is allowed to touch Rory after proving to the siren programme that she is his wife.   The image of Rory and Amy are repeated with a shocked gaze; they cannot believe that they will have to save themselves.  

There was quite a bit of backlash online about this episode. After all, how could a cut kill you?  Why would the Doctor just stand aside and let the novice Amy resuscitate her unconscious husband?  Why perform tracheotomies on people who are barely ill?  It all makes sense if you view it through viewing glass of the e-patient movement as a commentary on modern medicine. I decided I must do a painting about this episode for the Walking Gallery and I knew the perfect person to wear that jacket:  Colin Hung.

And here it is.  Colin can’t fly into DC for the day, so my friend Will Kemp will wear it that night. But I look forward to the day Colin wears it in Toronto.  He will spread interest about Walking Galleries, health care, and of course, Doctor Who.