Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.

Emily Silverman

You're listening to The Nocturnists: Conversations. I'm Emily Silverman.

In medicine, we tend to take ourselves pretty seriously. Between the long hours, difficult decisions, and huge responsibilities we take on as clinicians, you can see why that might be. But sometimes a comedic voice comes along, and quenches that thirst we all secretly have to poke fun at ourselves, to poke fun at each other, and even more courageously, to poke at the institutions and systems that we operate within.

Oscar Wilde once said “comedy is the highest form of intelligence” – and I’ve always felt that was so true, given how sensitive and observational comedians have to be, not to mention the skill they have with words and emotion and timing.

By that measure, today’s guests are definitely some of the most intelligent people in the world.

I’m thrilled to be hosting Dr. Will Flanary, better known as "Dr. Glaucomflecken," whose online medical comedy shorts have reached an audience of over 3.5 million viewers. I’m also here today with his wife Kristin, whose stage name is "Lady Glaucomflecken.” Together, they host a podcast called Knock Knock Hi, which brings together healthcare and satire for both medical and lay audiences.

In my conversation with Will and Kristin, we discuss how they got started in comedy, the unexpected twists and turns of their career paths both as individuals and as a couple, and harrowing experience of Will’s cardiac arrest just a few years ago, which caused them to see the dysfunction of the healthcare system first hand, and then inspired them to inject more policy critiques into their comedy.

But before we dive in, check out this audio clip from one of Dr. Glaucomflecken’s sketch comedy videos:

Will Flanary

United Prior Authorizations. How can I help you today?

Hi. Yeah, I'm trying to get a brain MRI approved for a patient.

Oh, I'm sorry. We're not going to be able to do that.

What? I haven't even told you about the patient yet.

Well, we always say that at the beginning of every prior authorization, hoping that you'll give up immediately.

So, you give up?

No.

O...... okay. What did you say you want? Some kind of picture?

An MRI of the brain. I have a patient who might have a tumor.

Oh, hold on. Have you thought about an X-ray first?

Excuse me?

Yeah. According to the United Healthcare "How to Practice Medicine" pamphlet, an X-ray is cheaper, and therefore better.

An X-ray is for bones.

Huh?

(It's not what you think.)

There are no bones in the brain and we need an MRI.

Have you explored other diagnostic modalities? Like palpation?

You can't palpate a brain tumor. It's surrounded by a skull.

Huh. I thought you said there were no bones in the brain. We're not going to get very far, if you're not honest with me.

Listen, the patient has headaches and hemiparesis.

Well, why didn't you say so?

Okay, thank you. Now we're getting some...

We'll need six weeks of PT before we can approve an MRI.

What?

You never know. Maybe some leg lifts will improve the paralysis.

Okay. I'm going to need your name and your supervisor's phone number.

Okay. Okay. I'll approve your patients MRI.

Great. So I can call the hospital and get it scheduled?

Oh, no, no, no. You can't do it at the hospital.

Why not?

Hospital charges us way too much. Now there's a facility about 150 miles south of you. Patient needs to go there.

Are you serious?

Oh, yeah. There's a guy down there bought himself an MRI. It's in the back of a Texaco. Just knock on the door; ask for Mike.

But the hospital's a block away.

Listen, do you want your patient to get an MRI or not?

Yeah.

Then you send them to see Texaco Mike.

And they'll be able to get an MRI?

Yeah. Kinda.

Wait, what does that mean?

Well, the patient's plan only approves a walk-by.

What is that?

The patient just walks briskly past the MRI machine and Texaco Mike just gets whatever images he can. Also, your patient hasn't met their deductible. So, this will be out of pocket.

Emily Silverman

I am sitting here with Will and Kristin Flanary, also known as Dr. Glaucomflecken and Lady Glaucomflecken. Thank you so much, both of you, for being here.

Kristin Flanary

Thank you for having us.

Will Flanary

Nice job on "Glaucomflecken".

Emily Silverman

Well, actually, my first question was going to be... Tell me about that word: Glaucom... I don't know if I'm pronouncing it correctly. What is that?

Will Flanary

Be careful what you wish for. Yeah. It's an actual ophthalmology term. And it has to do with angle-closure glaucoma. I'm not going to go into the details. But, it's... it's an actual thing in Ophthalmology. And, when I chose that word, I was just trying to come up with the most ridiculous word in Ophthalmology. And fortunately, there are so many options in my field, but I just happened to go with glaucomflecken. And, I feel bad for the person that actually discovered glaucomflecken. Because, now when you google "glaucomflecken", it's all me and my (silly) videos. Yeah, the actual scientific thing.

Emily Silverman

Yeah, I was gonna say I looked it up earlier, but all I could find was you.

Will Flanary

Apologies to the German researcher, whoever he was.

Emily Silverman

So, I want to get into your comedy and your podcasts, in a bit. But first, maybe tell me a little bit about yourselves? Will, I know that you are a practicing Ophthalmologist. Kristen, I don't know as much about your background. Like, tell me maybe a little bit about your professional arcs, and then sprinkle in the love story of when and where you met, and how everything converged.

Kristin Flanary

Those are pretty intertwined, honestly. So that's easy.

Will Flanary

You can start.

Kristin Flanary

We met in college at Texas Tech University in Lubbock, Texas. It's very nerdy. We were both part of the Honors College. And there was an Honors dorm, where all the Honors kids would hang out. And so, through mutual friends and shared spaces, bumped into each other and got to know each other. We dated for a couple of years in college, and then it was time to graduate, and we were thinking about what's next. Long story, short: I was going to graduate school. I was looking at Cognitive Neuroscience programs and Social Psychology, the combination of those two. And I found a lab at Dartmouth that I wanted to go to, and I applied and I got accepted, and all of that. Meanwhile...

Will Flanary

There weren't a lot of options out there, though.

Kristin Flanary

There's a decent-sized field, but it's small. But Will wanted to go to medical school and our application calendars did not really align very well. So that was a nerve-wracking year of trying to do our own makeshift "couples match" prior to medical school. So, it all worked out in the end. It was a very harrowing... Like, he had the last interview spot. He got put on the waitlist. And then, two weeks before he was about to move to Houston to start medical school there, we got the call that he had been accepted off of the waitlist. And so we changed plans, and we both went up to New Hampshire together instead.

Will Flanary

I wrote Dartmouth a lot of letters.

Kristin Flanary

Yeah, we weren't above begging, really.

Will Flanary

That's really what I did. Everything short of holding a boombox outside their office.

Kristin Flanary

Yeah.

Will Flanary

Yeah, screaming that my wife was coming. Or my... my girlfriend...

Kristin Flanary

Girlfriend at the time, yeah.

Will Flanary

And that's the thing. I couldn't be like, "Hey, my girlfriend's going to Dartmouth. Can I come too?" Like, it doesn't quite work that way. So anyway, it eventually worked out though.

Kristin Flanary

Yeah, so my arc is a little twistier. I was in a PhD program. And then, a year and a half, two years in, I started to wonder, like, "I'm not sure if this is for me." Like, "I don't know if this is the career that I want." You know, I was kind of seeing everyone in the department, and what their lives looked like, and things, and I was like, "I don't know..." I was just kind of increasingly unhappy, and I'm sure my work was suffering because of it. And so I just decided, I'm going to cut my losses, and I pivoted from what I had been doing. I had finished everything except to do the dissertation. So I had done all the comprehensive exams and all of those things. And I wrote a Master's thesis instead of going on to do a dissertation. And I Mastered out and pivoted. And from there, I went into a career in gifted education. And then, within that career, I eventually kind of morphed into doing the Communications and Marketing, and recently was able to leave that career to do Glaucomflecken full-time. So I'm on my second or third career now. But, in retrospect, looking back, you can see a line drawn through it to see some common themes. But, certainly at the time, it felt like just twisting and turning, and not anything that you might plan out when you're a kindergartener talking about what you want to be when you grow up.

Will Flanary

And, like most medical spouses, she was somewhat at the mercy of my educational arc, and where Match sent us, and all this stuff. So, yeah, when we got to Dartmouth, I didn't know what I wanted to do for a career. I just knew I wanted to be a doctor. And actually, didn't decide on Ophthalmology 'til like...

Kristin Flanary

The last minute.

Will Flanary

Yeah.

Kristin Flanary

...a theme with you.

Will Flanary

... the beginning on my fourth year. I had a tough time deciding. And actually, when I showed up to Dartmouth, we all had academic advisors. It was just, like, kind of randomly assigned to us. And Day 2 of Med school, I go to have this meeting with my academic advisor; name was Susan Pepin. And she was an ophthalmologist. And I remember having this conversation with her, and asking her, "So, that's eyes, right?" Like, I had no idea. I didn't even know what that was. I've never worn glasses. I've never had, like, even the dedicated eye exam. Don't tell anybody I know. I'm recording this for all to hear, but it's true. And so I had no idea what an ophthalmologist did. So we were talking about that. And I was like, "So, it's eyeballs So it's eye surgery you're doing?" And then, at the end of that conversation, she knew that I didn't know what I wanted to do. And she's like, "Okay, well, after talking with you, like, you're gonna go away, you're gonna do all these things. You're gonna think about all these different specialties, but you're gonna be back. You'll be back. You'll go into Ophthalmology, and you'll see the light. You'll... you'll realize that that's the career for you." And she was right.

Kristin Flanary

Yeah.

Will Flanary

It was amazing.

Kristin Flanary

I don't know if she says that to everybody?

Will Flanary

I don't know. I want to say she just realized that I'm one of those strange people that want to devote their careers to the eyeball.

Kristin Flanary

Yeah. And that you didn't want to have to, you know, work five days a week. And...

Will Flanary
Hey, now. That's true.

Emily Silverman
Yeah, they used to talk. I don't know if they still do, but they used to talk about the road to happiness. ROAD which is I think Radiology, Ophthalmology, Anesthesiology. Dermatology.

Will Flanary

It's kind of sad, right? It's kind of sad that out of all the specialties there's four that are known for having...

Kristin Flanary

Decent work-life balance.

Will Flanary

...decent work-life balance. Anyway.

Emily Silverman

Are you mostly in clinic? Are you in the OR at all? And, what is your day-to-day like as a physician?

Will Flanary

Yeah, yeah. So, I did my residency training at Iowa. And then, I knew pretty early in residency that I wanted to go into private practice. That the academic life wasn't for me. The idea of doing research made me kind of want to throw up a little bit. So, it wasn't my bag. And so I went the private practice route; found a great practice in the Portland, Oregon area. I've been here since 2017. It's a four-day a week practice. So four days a week, I'm doing ophthalmology. Two to three days of that is clinic, and then a day a week is surgery (or a half-day a week). It keeps me plenty busy, you know. It's a pretty high-volume practice. There's lots of people that need eye care, that need cataracts..., especially as the population gets older. And so, I've got more ophthalmology work than I know what to do with, which makes it all the more difficult to do this other Glaucomflecken thing, that I have tried to fit into the nooks and crannies of my professional life as an ophthalmologist.

Emily Silverman

Yeah, four days a week. Wow, I am impressed that you've been so artistically prolific, while still keeping up that level of practice, even as an eye doc.

Will Flanary

That's the thing. Whatever your schedule is, if you have a creative pursuit, a hobby, whatever it is, and you enjoy it, and you continue to explore it to see where it goes, it will eventually fill up all of your free time. Honestly, whatever I ended up doing in medicine, I feel like this was always going to be the end result. Which was practicing medicine, and then all the rest of my free time, however much that might be, I was going to be dressing up as different specialties in medicine, and recording myself.

Kristin Flanary

I'm a lucky lady.

Emily Silverman

Well, tell me a little bit about comedy, and comedy in your lives - as individuals, as a couple. Did you grow up loving comedy? Like, were you class clowns? Did you do improv or stand-up? Like, how did this become...

Will Flanary

Yes.

Emily Silverman

... a part of what you do?

Will Flanary

I've always been a class clown. I love making my friends laugh; kind of known for that. When I was in sixth grade, I was in the gifted education track, you know, in, like, Junior high and everything. And that's what my mom taught at the school that I went to. And so, I ended up in her class as a sixth-grader, which in retrospect, was a terrible idea. Because she was a lot harder than me, and me being the class clown, was not open to that kind of behavior. And so, that was the first time my comedy kind of, you know... I butted heads with someone, and it just happened to be my mom.

Kristin Flanary

She... She wrote him up. She gave him like a disciplinary report, and made him take it home to have his dad sign it.

Will Flanary

Exactly. So, so early on...

Emily Silverman

Wait, what was... What was the joke that you got in trouble for?

Will Flanary

I don't know. I was...

Kristin Flanary

He was probably just being a jerk.

Will Flanary

I was... I was more... I think I was more into physical comedy back then. Yeah, I didn't have the...

Kristin Flanary

He was a sixth-grade boy with his mom as a teacher. So, you can imagine,

Will Flanary

Who knows what I was doing? Whatever it took to get a laugh out of my friends. But, early on, that was a big part of my life, you know, making people laugh. And so when I got into high school, a friend of mine, who was the best man at my wedding, is someone I really look up to. He was doing stand-up comedy. Very funny guy. And, he was a Senior; I was a Junior in high school, and he was like, "Hey, you should come with me. Check it out." And, I was like, "Oh, that sounds fun." I'd never been in a comedy club before. He was 18; I was 17. So I couldn't be in the comedy club past, like, nine o'clock at night. I guess that was the rule or whatever. So, I would go to these open mics with him. It was in Houston, Texas at The Laff... Laff Stop, which is no longer around unfortunately. But, famous comedy club on the comedy circuit. I was going to these open mics, and doing like five-minute sets. You'd put our name on the list and do a five-minute set to the five or six people who were at a comedy club at, like, six o'clock, in the early evening on a Wednesday, you know. But it was... For me, it was...

Emily Silverman

Good crowd.

Will Flanary

... Exactly. Great crowd. And it's all other comics too, which is like the worst crowd, because everyone's judging you, and... And so, it was really more just being in that atmosphere, and being around other funny people, and riffing off of each other, and running jokes by each other, and writing together. And all of that was just intoxicating. It was just so much fun. And eventually, I had to decide, do I want to do this as a career? Because I had a little talent. Like, I could tell that. Although I didn't always make people laugh on stage. And so, there was something there. And, you know, I recognized that. But, in the end, I looked around at everybody, all these people in their 30s/40s/50s, like, still trying to make it in comedy, and I realized that this is going to be a really long, hard road. So I decided to go with a much easier route of becoming a doctor, and decided comedy was just... It was gonna be my hobby. It's gonna be the thing that I just kept doing creatively, because that was very important. And so I graduated high school, went on to college; kept doing stand-up in different venues, going to... I don't know, talent shows. There wasn't much in Lubbock, Texas. That's like West Texas. So it wasn't a lot of opportunities.

Kristin Flanary

It was just like, whatever was on campus.

Will Flanary

I found them. I wrote for like a satire newsletter, briefly there. So I found ways to really exercise that comedic muscle.

Emily Silverman

And did you get to see him do a lot of stand up, Kristen?

Will Flanary

Yeah, I would go if he had open mics and things like that. And, of course, if he wrote something, I would read that. But his comedy was a lot different back then, you know. It was not medical-themed at all.

Emily Silverman

Yeah, I was missing: What was the material? I'm just curious.

Kristin Flanary

I remember a lot of Irish jokes.

Will Flanary

Yeah, it was kind of my background. You know, my family.

Kristin Flanary

Yeah.

Will Flanary

I don't know. College.

Kristin Flanary

I think your mom featured in some... some jokes.

Will Flanary

I would... if I went back...

Emily Silverman

It's a recurring theme.

Kristin Flanary

Yes.

Will Flanary

I don't remember a lot of my material, honestly. If I went back and heard the things I was saying, it would probably be maximum cringe, I would imagine.

Kristin Flanary

Probably. I mean, it was a long time ago.

Will Flanary

Just 'cause it's not... Yeah, it's... You're a different person. That was like...

Kristin Flanary

You've had a lot of practice since then.

Will Flanary

...15/20 years ago now. So yeah, it wasn't until I got to med school when I was studying... what?... the Krebs cycle, all day. And writing jokes about that, that I started to explore the medical comedy a little bit more. That was a little bit rough going, trying to translate that to a general audience at, like, a comedy club. But it was also a lot of fun, because it was this new area I was exploring. I was learning so much in med school, and then trying to translate that into something funny.

Kristin Flanary

Yeah, it was also kind of the first foray into some of the darker comedy, because he also got his first cancer diagnosis. He had testicular cancer during medical school, and he... I remember a set that you wrote just about that. So, he went to this comedy club or... I don't know, even know, if it was comedy club. But some open mic somewhere, and was doing a set about having cancer, you know, and I remember people, kind of like, not being sure: "Is it okay to laugh?" Like, "That joke was funny, but it's about cancer. Can we laugh at that?" You know. So, that's the first one I really remember. It was medical, and it was the little bit, you know, pushing the envelope. And looking back, that's kind of, I think, the beginning of the style of humor that you use now.

Will Flanary

Yeah.

Emily Silverman

I'm trying to remember when I first came across you and your work. I feel like it's been several years, I want to say, that I've been following you on social media. That's where I first came came across your comedy. And, correct me if I'm wrong, but I think it started more as tweets. Like, I remember there were these really witty biting tweets. And I always wondered, because you had the pseudonym it was Dr. Glaucomflecken. It didn't say your real name or, like, where you were located or anything. And I was like, "Who is this hilarious anonymous eye doctor that is tweeting this, like hilarious shit on social media?" And then later, the videos came. And I remember, like, "Oh, that's him." Like, "Now I get to see his face." And so, that's how it was experienced by me, as an audience member, as a fan. It was like, sort of, that evolution over time. But I'm curious what it was like on the inside. Like, did it start online?

Will Flanary

Well, it did. So the second time I was diagnosed with cancer, I was in residency. And it was around that time, I decided to start the Glaucomflecken Twitter account. Because, I needed an outlet. I was like, "What am I going to do? I need to get back into comedy." And Iowa is not exactly a fantastic place for comedy. Not a lot of opportunities. And so, I started Glaucomflecken. And it was, at first, on Twitter. But also, I was writing for GomerBlog. It's like The Onion for medical professionals. And, it was a lot of fun. It was just a way to write comedy, write humor. And, actually that experience, writing for them, which I did starting, I think, toward the tail end of my final year in med school, and also first year of residency. It was great for me, because it forced me to start thinking about other specialties outside of ophthalmology, because I was writing all these articles about Cardiology and Nephrology, and Surgery, and everything. And so, I was able to translate that pretty well into Twitter because I wasn't just writing Ophthalmology jokes. (I started doing that, and had a robust audience of about ten people.) But by having already done all this comedy writing for the satire website, it was easy for me to start thinking about jokes from different specialties. And that really helped me to grow the audience a lot faster, because I was reaching a wider net, you know.

Kristin Flanary

You used Twitter in conjunction, so Twitter was sort of your, your research grounds, you know. You would try out ideas in a tweet and see if people responded. And, you know, if not, then Okay, abandon that idea. That's not very funny. But if they do, then kind of explore that more. And then eventually that idea might turn into an article, and using this real-time audience feedback to write and revise the comedy.

Will Flanary

Yeah, it really did help. It's like going back to when I was doing stand-up in Houston. Like having a little group of people, we could run things by each other. And it helped to shape my comedy early on. And then, it wasn't until the pandemic hit, when the lockdown happened, that I started making videos. Actually, because somebody on Twitter was like, "Hey, you should check out TikTok." I was like, "Okay, what's this?" Because 2020 is when TikTok just skyrocketed.

Emily Silverman

Were you nervous to transition from anonymous tweeting, to having your face out there? Like, was that a difficult leap?

Will Flanary
It... It wasn't because...

Kristin Flanary

I was nervous.

Will Flanary

It was... It was easier... I think it was easy for me just because I was in private practice. At that point, I had been my own boss, pretty much, for a couple years. And so, I felt more comfortable shedding my anonymity, and putting my face out there. We didn't have... I think I just did it.

Kristin Flanary

I mean, I didn't have much say in it, but... I maybe postponed you a little bit. But, you know, for me, it was more like from the family perspective. Like, he'd had a decent-sized following on Twitter, by that point. And, you know, people were sending him messages, and it just started to feel a little bit like, "Okay, there's this sea full of internet strangers that are going to know who you are." And, in this day and age, that means they can Google you, and they can find out where you are. And, yeah, it just felt weird to me. You know, we have small children, and neither one of us have ever been in the public eye before. And so, it just felt like, "I don't know; I'm not so sure." I could see how it would really allow him to take his hobby to the next level, and he was really enjoying it. And I, of course, wanted to support that. But I was also a little bit nervous from, kind of, the mom perspective. We're still very careful with protecting our children's identities and faces until they're old enough to decide whether they want to put themselves on the internet. So for me, it's still kind of a mixed bag.

Will Flanary

Yeah.

Emily Silverman

It is a mixed bag, and you're totally famous in medical circles. Like, I told you this anecdote offline. But, I was in Miami visiting my dad. And I took my daughter to a playground nearby, a random playground, and I was pushing her in the swing and the woman pushing her baby in the swing next to me, she and I got talking. And her partner was an Optho resident. And I asked if she knew you, and she was like, "Oh, yeah." And, you know, it's just random person in the street. And so...

Will Flanary

Yeah.

Emily Silverman

Yeah, you do have quite the following, and quite the visibility, and certainly a degree of fame.

Will Flanary

But it wasn't like that though, initially. When I started making the videos, I actually remember this. On Twitter, I had about maybe 20,000 followers. That was a pretty good following, but it wasn't that enormous of a platform. Certainly not what it is now.

Kristin Flanary

No.

Will Flanary

And so...

Emily Silverman

You have 2 million followers on TikTok. Is that right?

Will Flanary

TikTok? Yeah. Oh, yeah. A little over two million.

Kristin Flanary

I think it's like... I was just looking this up. I think it was like three and a half million across channels right now.

Will Flanary

Yeah. Yeah.

Emily Silverman

Wow.

Will Flanary

It was the pandemic, because everyone was on social media. Right? That's how people were getting their information. And, for a while, no one was working because everything was shut down. And so, the engagement that everything was... through the roof, which included the videos that I was making. I feel like I came along at the right time, for a number of reasons. One, just the circumstances, the pandemic and the exposure that content on social media was getting at that time. But also, people in health care, I think, needed something to laugh at. They needed... Whatever - it doesn't matter what it was; just needed something to help relieve some of the stress from the horrible things that were happening in the world.

Emily Silverman

Let's talk a little bit about the types of videos that you make. Like different topics and themes? Because there are some buckets, I would say. You can almost sort the videos into different buckets. Obviously, there's the initial jokes you were doing, which were more eye-focused, and talking about the way that you hate... What is it, Visine? Or something like that?

Will Flanary

Yes. Awful.

Kristin Flanary

We don't say that word here.

Will Flanary

Make sure you bleep that out.

Kristin Flanary

Yeah.

Will Flanary

The Visine.

Kristin Flanary

It's the other V word.

Emily Silverman

So, there's like the eye jokes. And then, as you said, that broadened to include all the different medical specialties. And, if we have time, I'd love to talk a little bit about that, because you just capture the essence of the different specialties so beautifully. Like the nerdiness of the neurologist, the adrenaline junkie-ness of the Emergency Medicine doctor, and the Family Medicine doctor whose glasses are always crooked, because they're so overwhelmed and just drowning in work. And so, it's almost like the different colors or different flavors of the profession and satirizing that. And then, there's a step further, where you start to get into critiques of how hospitals and systems treat their clinicians. And there's a hilarious video that you have called "Happy Doctors' Day", where somebody hears an overhead announcement that it's time to go get their gift for Doctors' Day. And they show up to get the gift, and it's just somebody who looks at them and says, "Thank you." And that's it. And then, there's a step further, where you branch out and do more critiques of the healthcare system in general, and how it impacts patients. So you have comedic content about prior authorization, about pharmacy benefit managers, about these really, almost in the weeds, health policy topics.

Kristin Flanary

They're hilarious. Right? Everybody thinks those are funny.

Will Flanary

Those topics. Yeah, exactly.

Emily Silverman

Well, they are hilarious, when you talk about them. Those are some of the buckets in my mind, when I think about what you do and your content. I'm wondering if you can speak to that. And maybe the evolution of that, and what you choose to...to make fun of.

Will Flanary

Yeah. All the character stuff, all the specialty-specific stuff, came first. And I would take a... A lot of times, they were tweets that I would see. I'd follow people in different specialties, and I'd just pay attention to what they were talking about on social media. And so I'd see somebody airing some grievance about admitting a patient to the ICU; trying to admit a patient from the Emergency Department. And I'd be like, "Oh, I think I can make a skit about that." And so I would get my ideas that way. The characters just kind of evolved naturally. I didn't set out to, like, create this whole hospital full of characters that... I'd have one skit where the Emergency physician was leaving work, and he was putting on his bike helmet. I was like, "Well, why didn't he just always wear a bike helmet? That could be funny." And so, they just kind of, like, evolved and... And plus, it's only me playing all these. Like, I had to make them unique in some way. Right? It's just... Otherwise, this is my face, and people will get confused about who is who. And I didn't want to keep introducing every character every video, so I wanted to have some kind of physical characteristic that allowed people to just know, "Okay, the Family Medicine physician is talking, because he can't put his glasses on straight because he's too overworked." And so that's kind of how the characters themselves evolved. The critique of the healthcare system and administration, insurance companies ,academic publishing private equity, all these big things that are impacting medicine in different ways, really started when I had my cardiac arrest and we started dealing with the health care system from a different perspective. Having to struggle with the billing and...

Kristin Flanary

Surprise billing. And just...

Will Flanary

...the health insurance companies. And so, that was the origin of that. And I started to realize, as I was tweeting about health insurance, at first, whenever I recovered from the cardiac arrest, and started making a couple of videos, the response I was getting from people (not just in healthcare, but the general public), the thousands and thousands of comments that were coming in, on a video about prior authorization. It told me that this is like, this is a thing. That I'm tapping into a raw nerve here, for everybody.

Emily Silverman

I remember when you had your cardiac arrest...

Kristin Flanary

Me too!

Emily Silverman

...because... Well, I know you remember Kristin, and I want to hear from you about this in a moment, because I know this is an incredibly important story for your family. But on my end, I remember not seeing you on Twitter for a while and kind of wondering like, where is he? And then you came back, and you said, "Hey, everybody, I'm back. I had a cardiac arrest." And I think that was around the time, Kristin, when you opened a Twitter handle, maybe. Or that's when I started hearing a bit from you on social media as well, and, kind of, you were brought on stage in a way that you hadn't previously. So maybe you can tell us a bit... I mean, A: just about the cardiac arrest, because the story is tremendous. And then B: maybe reflecting a little bit about how that translated into some of this more creative work, on your side.

Kristin Flanary

Yeah. So, backing up a bit, I had started my Twitter account. He was Dr. Glaucomflecken. So I made one called Lady Glaucomflecken, and its purpose was really just, kind of, to see what he was up to all the time. I would see him on his phone. He was kind of giggling, in a chair in the corner. And you know, just it seemed like he was in this little world, right that I wasn't really privy to, and... and it seemed like fun over there. So, yeah, he would tell me little snippets of stories or conversations that he'd had or whatever. And so I kind of knew some of the names of people. And I had a toe dipped into it, but I really jumped in the pool. And it was mostly to keep up, but also to kind of roast him publicly, a little. That was...

Emily Silverman

Keep him humble.

Kristin Flanary

Yeah. Most of my early tweets were... were that. So I had been on Twitter and been somewhat active for a while before the cardiac arrest, maybe a year or something. When he had the cardiac arrest, then I was kind of a source of information for everyone.

Emily Silverman

Well, Let's also not forget about the fact that you saved his life.

Kristin Flanary

Yeah. So, May of 2020. So, it's early in the pandemic lockdowns, and we still don't know a lot about COVID at that point, and it's still very, very scary and uncertain. And we don't know if masks work; there is no vaccine. We don't really know a lot about the disease itself. So, it was sort of at the height of that big scare. And it was Mother's Day weekend. So we had a really nice little family Mother's Day to ourselves. Couldn't go anywhere, but we'd had a nice day and then went to bed and I woke up at about 4:45 in the morning, because he was making these really loud sounds, and I had been jolted awake from a deep sleep. And so, at first, I thought he was snoring. And, you know, I am not medically trained in any way. I'm not a doctor; I'm not anything. I'm just a regular lay-person. And so I thought those sounds were snoring. And so I kind of shoved him a little bit to try to get him to turn over, and stop snoring go back to sleep. But he didn't do anything. And, you know, something about that just stood out to me as odd. So I kind of tried a little harder, and he still didn't do anything. And so then I got scared, because I was like, this is not normal. The sounds are sounding more urgent, and they're not rhythmic anymore. And they just had this sort of like desperate quality and scary quality to them. In retrospect, I learned that those were, of course agonal respirations. But I had never heard of that; I had no idea what that was. I have never seen the death process in person; nothing. But I did know that something was drastically wrong. And so I called 911. And the dispatcher told me to start CPR, and she walked me through it and counted to help me keep the right pace. I was really worried about my ability to do it, because I couldn't move him off of our bed. He's got about 13 or 14 inches on me. I won't say how many pounds, but a lot. And I am somewhere on the hypermobile spectrum disorder. So I had just had a cervical disc replacement a few months before I was still recovering from, and so I really doubted my ability to do any of this effectively. And I think, because of that... I mean, I would have given it my all no matter what. But I was kind of trying to over-compensate because I was so concerned that I wouldn't be able to do it well enough. So our kids were were asleep in the next room. And I was just thinking about, like... I... There's no way I can let them wake up without a dad. Just suddenly and with no explanation and no chance to say goodbye. And just, you know, you wake up one morning and your childhood is shattered. That just kept going through my mind. And I just, to whatever extent possible, that I have control over, that I can not let that happen. So, long story short, I ended up doing 10 minutes of CPR before paramedics arrived. And then they shocked him five times. And, I don't know, gave him, I think it was three rounds of epinephrine and some Amiodarone, and probably some other things. I followed them. They took him from the bed, downstairs, to use the defibrillator. And I followed them. And I saw him... You know, when I was doing CPR, I saw him turning blue and then purple. And then, as they carried him down the stairs, then he was this like gray-white color that I'm sure you know. You are familiar with; your audience is probably familiar with. And you know, there's just something about a person's body, when they're unresponsive. It's creepy, right? There's just something that deep down, even if you're not medically trained, you know that's not right. That's scary, and something very bad is happening. So his body looked like that. And then they laid him on the floor, and I heard the sounds of the equipment they were using. And it was kind of like a TV show, right? Of all the beeps and boops and stuff, and there was a flatline in there. And so I knew that wasn't good. And they pulled out the paddles. And I had seen enough ER. Not having watched a lot, but I had seen enough to know what that meant. And I didn't think that I could watch that and remain calm. And I didn't want to be a distraction from them giving him the help he needed. And so I turned around and I went up the stairs. And as I was going up the stairs, I heard them deliver the first shock. And then I heard his body just slam on the floor in this horrible way. And that's kind of the last I remember of seeing him. Like, I was upstairs, making sure the kids weren't coming out of their room and I was packing a hospital bag in case he was going to need one. I was just trying to think of anything I could do to be helpful in some way. And calling our parents, and calling his work to say he's not coming in today; you better reschedule his patients. And then they took him to the Emergency Room in an ambulance, and I was allowed to follow. But I was only allowed in as an end-of-life case. But I found out it was an end-of-life case by seeing that written on the door. Because there were three reasons why someone could come in, and the other two didn't apply to me at all. That was the only one.

Emily Silverman

This is COVID restrictions.

Kristin Flanary

COVID restrictions, yes. May of 2020. So everyone was in Hazmat suits and all of these things. And I had a mask on, but we didn't know... Again, we didn't know if masks did anything. But they let me in. I remember... I have this flashbulb memory: They handed me an Advanced Directive piece of paper. I was like, "Well, seems a little late for that, don't you think?" So. I don't know why they did that. And then they put me in a waiting area. Like, not the waiting room. I'm not sure why they didn't put me in there. But they put me in a room in the Radiology department, where patients would get gowned up, and then sit in this room to wait for someone to come in to get them for their scans. So, they put me in that room. And again, I'm all alone. I'm the only one allowed to come in. I am not even able to be with him. I don't know where he is within the hospital at this point. And they put me in that room. But since it's in Radiology, the walls were lined with lead, and that cut off my cell phone signal. And so now I was isolated from...

Emily Silverman

God. What a nightmare.

Kristin Flanary

... all the rest of the world. Right? And I was the liaison, right, between him and our families. Like, that everyone was obviously horrified and wanted updates as frequently as possible, and that was on me to deliver. And so, I was trying to do those things. Not to mention, like, just trying to cope and process what was happening. And, you know, maybe needing a little social support to be able to do that. So I would go down the hallway a bit where I could still see the door of the room to know if someone was coming in to give me an update. But if I walked out of that section a bit, down the hallway, then I could get a little bit of signal. So I would go back and forth from the room, down the hallway to make calls, use my phone, whatever, and then come back and wait more. And I got a couple of updates from the Emergency Room cardiologist. But before very long... I think I was only there about an hour, the lady who had let me into the hospital who had given me that Advanced Directive paperwork... She came and kicked me out of the hospital. Because, she said, we didn't know if he had COVID. They had done a test, but it would take 24 hours to get results. And they didn't know if I had COVID. And so, because I was not staying in that room they put me in, she said I was making people nervous, and so I had to leave. People meaning healthcare staff, because that's all there was there. So I sat outside on a bench, and I called my parents, and like a little kid getting kicked out of school or something waiting for their mommy to pick them up. But, from there, yeah, I went home and got updates over the phone periodically. And I only got to see him over FaceTime, and that was after he woke up. So, the whole time that he was unconscious, it was excruciating, because I couldn't be there. I couldn't see... You know, what's his color look like? Is he trying to move? Are there any signs of him in there at all? So, it was really hard and... And I think there are so many people that have a similar story during the pandemic, of not being able to be there with a loved one. And we all know, but I think the rest of the world is only starting to realize just how traumatic that is, and was. And I think that we're going to be living with the aftereffects of that for a long time.

Emily Silverman

Wow, it's just such a story. It's so incredible. I mean, thank God, thank God. Thank God.

Kristin Flanary

Yeah. It all turned out okay in the end, so that's good.

Emily Silverman

Yeah. Well, and that that moment of you have to leave, you're making people nervous. It sounds like that was sort of the first obstacle of what would become many in dealing with dysfunction in the healthcare system. It sounds like later there were obstacles that came up having to do with bureaucracy and insurance, which is what motivated you, Will, to start incorporating some of that into...

Will Flanary

Yeah, yeah.

Emily Silverman

... your comedy. And then also, Kristin, did that motivate you to get more involved as a character in the universe of... I don't know what you would call it, the Glaucomflecken Creative Universe?

Kristin Flanary

Cinematic, I think is what you say.

Emily Silverman

Cinematic Universe?

Kristin Flanary

It certainly motivated me to become more active on my own social media channels, to advocate for co-survivors is the term. I found a paper by Kirstie Haywood and Katie Dainty that talked about that. And, as soon as I saw that, I thought, "Yes, that is exactly it. That is what this is. That is what it feels like. That is what I am." And, that allowed me to start talking about it and advocating. In medical trauma and critical illness, the people that are very closely attached to the patient are affected in many ways, just as much, and sometimes more than the patient themselves, you know, in different ways. And attention, very rightly, goes to the patient to make sure that they are healing and recovering. And that is all wonderful, but we are missing this other piece. There are more than one patient in those scenarios.

Will Flanary

Yeah. It really kicked off the advocacy side of what we do.

Kristin Flanary

Yeah.

Will Flanary

Just all the way around with incredible work Kristen's doing, and then the...

Kristin Flanary

Health insurance.

Will Flanary

Health insurance was a big part of that, you know. Because I was sedated for, I think, 24 hours, and then they brought me out of sedation, and all my testing was okay, and I was talking and tweeting again. That's when the...

Emily Silverman

You were tweeting again?

Kristin Flanary

In the hospital!

Emily Silverman

Not that long after this had happened.

Kristin Flanary

He had not been discharged yet.

Will Flanary

That was actually the moment that Kristin, like, knew that I was going to be myself. I was still in there.

Kristin Flanary

I knew he was alive, and he had survived. But we didn't know yet, "What's his cognitive function?" And I saw a tweet, that one that you referenced, "Boy, have I had a wild few days." And...

Emily Silverman

Right.

Will Flanary

I was in the ICU, and I was...

Kristin Flanary

And so then, I was like, "Oh, thank goodness." Like, he's still him, you know. I found out along with everybody else.

Will Flanary

You know, then I was discharged pretty quickly after. And, initially, there's just elation. There's just, you know, I'm home; I'm hugging my wife and kids again, and we're all together as a family. And then, the way the US healthcare system works is about a month later, that's when the medical bills start coming in. Right? And it's, like, a lot of bills. They don't all come at once. There's like one here from there. And there's one from the nephrologist you saw one time, and there's another one from the person who put a catheter in to do the hypothermia treatment.

Kristin Flanary

Meanwhile, you were unconscious for all of these, so you have no memory of any of these people or events or things to kind of attach to this bill.

Will Flanary

So it's all very complicated, even for me, like, as a physician. Like, I'm in the system, and it's still overwhelming, all the things that were coming in. And then I started having, you know, the surprise billing issue where some of the doctors that took care of me in the hospital, were out of my insurance network, and so they weren't being covered. And that was like tens of thousands of dollars of bills. All told, it was like nine months of angry phone calls. And we've all been there. And healthcare... Like, all the frustration that you have about health insurance companies... Like, I was dealing with all that on a daily basis.

Kristin Flanary

While he's trying to recover from the fact that he had a cardiac arrest. Like not just physically, but mentally, we as a family are trying to come to terms with all this. And that's what we have to do.

Will Flanary

And it kept occurring to me, like, man, this is what people are going through all the time. I'm fortunate that I'm a physician, so I have a rough understanding of what's going on here. And I am able to pay the bills that come, and... But, there's so many people that can't, and the financial devastation is a lot of times even worse than just recovering from the hospitalization. And so, that really is what produced that change in my content. Because, I started to pick out the things like insurance denials or co-insurance, deductibles, prior authorizations. I started picking out these little topics that I thought were kind of confusing, and wanted to make them accessible to a general audience. That was my goal. Because I thought it'd be helpful for medical professionals as well, but really, I wanted to try to shine light on this for everybody to understand, "Oh, that's what's going on?" Like that? That's the thing? And obviously, like everything I do, I have to like add humor to it. Or else, I just can't stand it. And so, I was turning these complex topics into a skit. And, if you make something funny, people are more likely to watch it. And so the engagement was better on those things. And they just were going viral, and people were talking about it and connecting with it, and they were telling me their own experiences in the health care system. It is just really eye-opening, just how much of a problem this is and how much it's affecting people's lives. And so, once I started going down that path, now we're three years later, I've done countless videos about all different parts of the healthcare system. And they're some of my favorite videos to put together, because of the education factor involved.

Kristin Flanary

And you know, especially with the health insurance companies, they rely on people not being educated about what it is that they're doing. And they make it as obscure and complex as possible, to try to confuse people so that they just pay the bill. Right? Because they're scared; they don't want to get sent to collections or something. And it seems too difficult to fight it, and so you just pay it. And so, by bringing those obscured things and tactics and strategies into the light, and making it simple enough for the general public to understand, it's a real threat to what they're doing. And we've heard so many anecdotes about various higher-ups, and some companies not being very pleased with Dr. Glaucomflecken. So we're pretty proud of that.

Emily Silverman

I don't know how you manage to make these topics funny, but you do. I mean, the whole Texaco Mike thing in that intro clip, it's just so brilliant. And what I'm wondering is, you know, you have this Twitter account, you have this TikTok account, you have all these videos, you know. They're bite-sized; they're potent. Each one, like, really packs a punch. Talk about the decision to branch out into a more long-form project. So you've launched this podcast together, it's called "Knock Knock, Hi". And you bring on guests and you know, it's an hour, or around that.

Will Flanary

Yeah.

Emily Silverman

So, talk about the decision to open up this new avenue of public communication, because it's very different from the videos. And, are you still doing the videos? Or, how do you think about how those fit together?

Will Flanary

I'm trying to do everything, which is becoming more difficult with time. But...

Kristin Flanary

Do you know any interns?

Will Flanary

Yeah, right, yeah. I need an actual real-life social media Jonathan.

Emily Silverman

Inside joke.

Will Flanary

So, the production company that we work with actually approached me to do the podcast. And it's something that we've talked about for a while, because we just wanted to have something that we do together, and explore that creatively. And also, I wanted to do something more long-form, just to have more in-depth conversations about things. And also, as a way to bring other medical professionals, people in medicine, mostly physicians, to let loose a little bit. Have a little bit of fun. Because I think that's something that's missing. It's been missing for a long time, is the ability for physicians to laugh at themselves; to talk about some of the outrageous, funny, at times difficult, embarrassing things that happen through the course of a medical career. Just to show a more human side to the people that work in health care. And so, the podcast really has that goal in mind, to just show that side of us that we all know is there. But I think sometimes the public doesn't know it's there. And I think they need to see it. And I love doing it with Kristin, because she has a very important non-medical perspective on things. And also, we like to give each other shit from time to time. So that works well on a podcast. And...

Kristin Flanary

That's how our relationship started, really. It was, kind of, witty banter on AOL, back in the day, and...

Will Flanary

Now you have to shout out, AOL is the best.

Emily Silverman

This is the deep cut?

Kristin Flanary

I know! So, the podcast feels a lot like that. Kind of circling back to that time. It's a lot of fun.

Will Flanary

Yeah, we're enjoying it so far. And it's... I see it as, like, an addition to the other things I'm doing. Because, you know, people struggle with attention span these days, so I like the... still doing the bite-sized, scripted things. But just, now we have this other thing, and just trying to fill all the hours of my day with something either content-related or... Or Ophthalmology-related. I don't know. Maybe I'm crazy, trying to do all this stuff. But, it's fun so far.

Emily Silverman

Well, I'm sure... I'm sure the path will make itself clear: the balance between doctoring and creative-ing and parenting, and... It's a lot, and I can relate to that myself, having gone through somewhat similar, although also different, journey. And, I just believe that the path falls into place. And everything that you've done so far has just been so incredible. Such an important voice in our community. And as we're rounding to a close, I guess maybe the question I'll leave you with is, what are your hopes for the future? In an ideal world? And again, not to be like too interviewy.... Like, where do you see yourself in five years? But, just creatively, you know? Whether it's creatively/artistically or more in that advocacy realm? Where do you see yourselves evolving together in this whole medical comedy career trajectory? (That's now become a joint trajectory. Which is so cool, by the way.)

Will Flanary

Yeah.

Kristin Flanary

Yeah, there's no roadmap for what we're doing.

Will Flanary

There's not. I like the advocacy road that we're on. I've struggled for a while now, doing all this stuff about health insurance, having this existential question hanging over my head: What good is any of this doing? Is it really having an impact? Because, yeah, I'm presenting all these problems, and trying to shine light on some of the issues. But where are the solutions? What's to come from all of this? And I don't have all the solutions. I hope, to your question about where do you want this to go, hopefully the solutions come. Either from me, or from others who maybe get inspired by some of the content that we do together.

Kristin Flanary

I think the first step is you have to know what the problem is before you know what you're trying to solve. So hopefully, we can be helpful in defining the problems.

Will Flanary

And that's the thing. It's not just one video... right?... that's going to make a difference. It's like a thousand little paper cuts to these insurance companies. There's no individual effort that's going to make the difference. It's going to be all of us working together.

Kristin Flanary

And I think tools like humor and storytelling, and writing and podcasting, and these more creative avenues... If you look throughout history, art plays a big role in creating cultural change and revolutions. So, you know, hopefully we can be a tiny drop in an ocean of other people working towards that goal, too.

Will Flanary

I also need some new characters. I need a pulmonologist; I need a radiation oncologist. I get reminded regularly that I need a plastic surgeon. So, I'm working on those too. On a less important scale.

Kristin Flanary

Yeah.

Emily Silverman

You have many, many tricks up your sleeves, and I can't wait to watch it all unfold. Like I said, I've been following your work for so long and, and following it in a very, like, chronic way to use, like, a weirdly medical term. But, again, like, I felt like I was there when you had your cardiac arrest. I was, like, tracking it in real-time on Twitter. And so in a way, I feel just really invested in you two, as people and as creators. And, I'm just really thrilled that you were able to come on the show today to chat with me, and I can't wait to see what you do next. And it's just so fun also to have both of you here, and it's a great energy. So thank you so much...

Kristin Flanary

Oh, thank you.

Emily Silverman

... for coming on.

Will Flanary

Thanks for having us.

Kristin Flanary

Yeah, it's been so fun.

Emily Silverman

I have been speaking with Will and Kristin Flanary. They are Dr. Glaucomflecken and Lady Glaucomflecken. You can check out their content all over social media, all over the universe. We've got Twitter, we've got TikTok, we've got Instagram, we've got it all. And then, if you would like to check out their amazing podcast, Knock Knock, Hi!, you can find that wherever fine podcasts are found.