"Tensions are on the rise in the wake of Dr. Wily's latest attack. Anti-robot protests have been breaking out worldwide! Many have gathered outside of Right Laboratories in Denver, claiming that the once-revered doctor's robots are the root of the problem. Many other robot laboratories, both privately owned and publicly traded, are seeing their share of protesters, as well. Even here at the home of the wealthy industrialist Dr. David Chou, protestors can often be found outside of his manor's gates to peacefully object to the robotics projects he funds. We tried to get in contact with the reclusive inventor but were unable to reach the doctor for comment.
Will robots and humans ever be able to peacefully coexist? Only time will tell."
–
"Aaand… clear."
"Good. The sooner we leave, the better. That robot butler of theirs gives me the creeps."
"Excuse me…"
Outside of Chou Manor, the home of Dr. David Chou and his creations, a local news company was reporting. There, a reporter with yellow hair and glasses was just wrapping up his presentation of an ongoing story: the revolution against robot-kind! As the reporter and his camera crew packed up their equipment, they found themselves approached by a tall, somewhat intimidating man in formal attire…
"Well, speak of the devil!" the reporter said, turning to face the man. "What do you want now, 'Jeeves'?"
"My name is not 'Jeeves'," the tall, steel-skinned man told him. "My name is–"
"Cut to the chase, 'Carl-tron'."
"Mm… indeed."
The man, who was indeed the butler of Chou Manor, had arrived on the scene as he had many times in the past. He had asked the news company to stop filming in front of the manor on the hill at the request of his employer and creator. However…
"Look, we told you before, 'Alfred'…"
The reporter was adamant about choosing that location.
"'Freedom of the Press' gives us the right to report the news when and where we want to," he told the robotic butler.
"'Freedom of the Press' does, indeed, give you the right to film the news as it happens. However, I must, once again, politely request… on behalf of Dr. David Chou… that you cease using Chou Manor as the backdrop for your… if I might say… somewhat biased reporting on the growing anti-robot sentiment."
"We're not actually reporting from your private property, 'Geoffrey'…" the reporter countered, "so you can just 'bugger off'. Ta ta, then! Tea and scones, wot!"
The butler did not appreciate being made fun of. Especially since he didn't have the English accent the reporter was poorly mimicking.
"I feel that we have been more than patient up to this point," he told the reporter. "If you do not cease using the manor as your backdrop for anti-robot news, we will be forced to call the authorities."
"Call 'em!" The reporter shrugged as he climbed into his news van. "We're not doing anything wrong!"
Not long after, the news van drove away.
"Mm."
And the butler returned to the manor.
"How'd it go, 'Big Sid'?"
"About as well as expected, I'm afraid."
As the robot butler entered the manor grounds, he turned his attention to something that was flittering and fluttering around his head. It bore the shape of a small girl with pink hair, insect wings and antennae, and a colorful outfit. She, too, was a creation of Dr. Chou.
"Well, chin up, pal!" the girl said as she flew around him. "Someday, all this 'no robots in my backyard' stuff'll be done 'n over wid! Then, maybe we can stop hidin'!"
"No one is 'hiding', Miss Brietta," he countered as he walked through the manor grounds. "Those of us who have jobs outside of the manor are continuing to serve the public."
"Okay, but what about da rest of us? Doc said we ain'a s'posed ta leave da manor if'n we ain't gotta! And-and-and," the fae-like robot girl asked in a cocky tone, "how's come th' Doc ain't been outside in months, neither?"
"You would have to ask him yourself, I'm afraid. He has been… as you might say… 'holed up' in his office since the recent attack on the manor grounds."
"Oh, yea'…" Brietta brought one oversized sleeve to her chin in thought. "That did happen, huh?"
"Indeed."
The butler reached to his vest, retrieving a gold pocket watch on a chain.
"Mm. I should begin preparations for dinner. Would you care to assist me?"
"Ain't that what Persis was built fer?"
"I shall take that as a 'no'. Very well."
The butler slowly bowed to Brietta.
"Take care, Miss Brietta."
"Youse too, Big Sid!"
The taller of the two continued toward the manor while the smaller robot fluttered on the spot. She had her arms crossed and was doing some thinking…
"This sucks!" she said to herself. "Bein' on lockdown 'n stuff… I wanna go flippa-flap t'rough the concrete jungle 'n catch firebugs in da woods! Wish Doc Dad hadn't told us ta stay put… Gah! I'm so jelly'a Big Sis 'Fallafly' 'n Li'l 'Spooky' Sis! Wonder what they're up to right now… Oh!"
Brietta clapped her sleeves together, then put her sleeved hands on her head.
"Maybe if I concentrate hard 'nuff, I can imagine it! Hnnnnng…!!"
–
"No way! No flipping way! I'm not gonna let some… some fake person touch me!!"
It was late in the afternoon when a familiar little clinic got a visitor. The man alleged that there was a ringing in his ears that wouldn't go away. He thought he'd hit the jackpot when a cute nurse with nice legs and a short skirt was sent to tend to him! However, after a little back-and-forth… he found out that she was a robot. At that point, chaos ensued.
"Sir, please!" an orderly said, trying to talk the man down from standing on an examination bench. "We can assure you that Nurse Farfalla Chou is one'a the most qualified practitioners'a medical science we have, yeah!"
The man swung a chair at the orderly and the nurse, intentionally missing both.
"Get away from me you robot in sheep's clothing!"
"Security! Hey, security!! Where th' heck is that security, yeah?!"
"Sir, just… just calm yourself!" Farfalla said, gesturing to the man. "There's no need for this sort of behavior!"
"Stay back or I'll… wha– whoa…!"
"Sir!"
As the man slipped on the vinyl material covering the bench's padding, Farfalla darted around and held her arms out. She was quick to catch the man and even quicker to dive forward, letting the chair he was holding fall on her as she hit the floor.
"Sir…? Ouch… Sir, are you alright?"
The man stared at the nurse, wide-eyed with surprise.
"You… you saved my life?"
Farfalla blushed a little. "I saved you from getting a nasty bump on the head, maybe…"
"But… but you're a robot!" The man scowled with confusion. "Robots can't be trusted! The news media says so!"
"Does she look 'bad' or 'scary', yeah?" the orderly said, helping the pair to their feet.
"I thought she looked pretty cute before I found out she was a 'bot…" The man rubbed the side of his mouth. "She's still cute, I guess… B-but she's a robot! And…"
He shook his head.
"No, no, even if you saved my life–"
"I didn't…" Farfalla meekly corrected, hiding her blushing face.
"– I just can't trust you. N-nothing personal! It's just–"
"'Robot bad, humanity good'. We get it, yeah," the orderly interrupted. "Hey, there you are! Have this man escorted off the premises."
A shorter man in a security guard's outfit stepped into the room.
"You want me to rough 'im up?" he said with a knowing smirk.
"Lorenzo, just… just get him out of my sight, yeah?"
"Aye aye, Mon Capitan. C'mon, you."
The guard helped the man out of the examination room – whether he wanted it or not. Once he was gone, Nurse Chou put the chair back where it belonged – in front of a desk in the corner – then walked over to the bench and leaned against it with a loud, frustrated sigh.
"Why is it so hard for people to trust me once they find out that I'm a robot?" she asked, crossing her arms and looking at the ground. "What difference does it make what I am? Does that suddenly make me less qualified to do my job or something?"
"I'd say it'd make you more qualified, Falla." The orderly smiled. "You were literally made for this job, yeah?"
She jerked her head at the orderly and snapped, "That's not funny!" The orderly just chuckled to themselves.
"Listen, hun," they began, "some people are just… dumb, yeah? They see all these news reports 'bout that Dr. Wily guy and those copycat dopes… robots runnin' 'round, destroyin' stuff all over the place… and they just start thinkin' dumb thoughts. Like I said, their brains get set to 'robot bad, humanity good'. That's how the media makes its money, yeah?"
They placed a hand on Farfalla's shoulder, offering a smile.
"Not everyone's like that… You know that, yeah?"
"Most people never even learn I'm a robot…" she commented. "But then, this one person appears every once in a while that just… argh!"
The nurse shook her head before sighing again.
"How am I supposed to help people when they won't let me help them, Brie?"
"That's one'a life's great mysteries, yeah?"
Brie continued to smile. Eventually, Farfalla found herself smiling, too.
"How's your back? Chair do much damage, yeah?"
"I'm alright," the nurse said. "Thank you for asking."
"Good, good…" Brie nodded. "Weeell… it's gettin' close to 'go time' for you, yeah? If ya wanna duck out a li'l early… I can cover for you, yeah?"
"Now, Brie…" Farfalla stood up, putting her hands on her hips and smirking. "You know that's not how I was raised."
"Your poppy didn't raise no quitter, yeah? Well… ya ain't got any more patients scheduled for today, so…"
The nurse smiled, crossing her arms. "So, I'll spend the rest of my shift straightening up and filing paperwork."
"There's that smile I like!" Again, Brie nodded. "Call if ya need anything, yeah?"
"I will. Thank you, Brie."
The orderly bowed their way out of the room, drawing a soft giggle from the nurse. With them gone, she decided to start on that paperwork she'd mentioned.
The last thirty minutes of Farfalla's shift went by in a flash. She finished her paperwork right on time and pulled away from her desk, stretching and cracking her metallic joints.
"Ow…"
One hand came to the small of her back… right where that stray chair had landed. Though she'd told the orderly that she felt fine, in truth… the pointy leg of her old, wooden chair had seemingly done a little damage to her frame. She didn't look forward to explaining that to her family when she got home, but she figured she'd cross that road when she came to it. She still had to get there, after all…
"Have a great night, yeah?"
"You, too, Brie!"
Farfalla walked out of the clinic's main building around the stroke of 6 PM, carrying her purse over her shoulder and a small suitcase in her other hand. She walked down the small stairs to get to ground level then opened the suitcase and retrieved what appeared to be a bundle of pipes, metal slats, and gears. With the press of a button, it unfolded from a small bundle of parts into a full-sized bicycle complete with a 50cc motor, solar-powered headlight, and a small, collapsible basket for cargo. It was the perfect way to get around the city without having to wait for traffic. There were even bike lanes in some of the areas she had to travel, which made things all the more convenient.
"Alright…" she said as she hopped onto the collapsable bike, putting its case and her purse into the basket. "Time to head home!"
With a flick of a switch, the small motor sprang to life. She revved the engine, making it purr, then she released the break and began her journey home.
Farfalla always enjoyed driving after work – especially during the colder months of the year. Driving home at sunset was always a treat! The lights of the city looked beautiful and even the lights of the cars driving through were somewhat charming. As it was, winter was coming up, so the days were growing shorter and the lights were becoming more prominent.
When traffic was bad, she would turn the engine of her bike off and use the bike lane, pedaling with the flow of other cyclists. When traffic was somewhat less of a mess, though, she enjoyed driving in the proper lanes, engine on. The congestion on the roads was generally a mix of both, so she usually ended up taking both the bike lanes and traffic lanes back to the house on the hill. Even if some of the drivers of the city didn't appreciate it… it made her happy.
It was around 7 PM when Farfalla arrived near the manor. She stopped to admire how majestic it looked from a short distance away.
"Picturesque as always…" she happily sighed.
The nurse drove up to the front gate and turned off her engine before wheeling up to a nearby panel. Reaching into her purse, she retrieved a small card with a magnetic strip and slid it through. Two chirps and a green light signified that the card had worked, then the gates slowly opened for her. She pedaled into the expansive grounds as they closed behind.
"I'm home!"
Once she arrived at the front door of the manor, she collapsed her bike and stored it, then let herself in. Looking around, she didn't see anyone, but the foyer was as brightly lit as ever.
"Persephone? Sidney? Brietta?" she called. "Anyone?"
"Nyooooom!!"
Farfalla squeaked in surprise as she was suddenly pounced on by the energetic pixie 'bot she called a little sister.
"Welcome home, Fallafly!"
Farfalla hugged her sister as the little lady did the same to her.
"Hello, Brietta!" she said with a big smile. "How was your day?"
"Boooring!" the pixie answered before fluttering backward. "Alls I did was float 'round da garden aaall day! I had no one to play wid! What a bummer."
"Really?" Farfalla tilted her head. "Where was Quartz?"
"Me 'n Quartz…" Brietta curled her lips, looking irritated. "We ain't on th' best of toims, right now."
Farfalla rested her suitcase on a nearby wall. "Still?" she asked.
"Dang mutt dug up my orchids!" The pixie flapped her sleeves with an exasperated look. "Dat's some 'never forgive' action, right dere!"
Farfalla frowned at her sister. "Brietta…"
Brietta threw her hands up. "I know, I know…! We're family, 'n family gots ta stick togethah… But-but-but, I woiked hard on dem flowers! It's my spe-ci-a-li-ty, ya know!"
The nurse 'bot smiled. "And I'm sure Quartz is very sorry he dug them up!"
Brietta crossed her arms. "He ain't apologized yet."
"Quartz can be… stubborn," was the response she got. "Give him time and I'm sure he'll come around."
"Hrreeen."
"Oh, come on…" Farfalla smiled. "Don't roll your eyes like that, Brietta."
"What about like dis?"
Brietta leaned in close and started spinning her eyes. Farfalla laughed in response.
"You're such a silly thing, sister!"
"Pixies be silly, 'n I be a pixie!"
When Brietta wiggled her genie pants-clad bottom, Farfalla laughed even more. The two shared a smile before moving on to the next topic.
"So, where is everyone?" Farfalla asked.
"Far's I can tell," Brietta explained, "Spooky Sis went on an overnight thing up north, Quartz is keepin' dad company, Big Sid was makin' foods, 'n 'Persis' was off cleanin' some empty wing'a th' house. What's th' point in cleanin' a place where no one goes, I ask yas?"
"A tidy home is a happy home?"
"Poisenally," she continued as she leaned in with a sneaky expression, "I think Persis is just tryin' ta keep busy so she don't get bored! Do ya know what a drag it is bein' housebound all day? It's enough ta drive a pixie mad – mad, I says!!"
Brietta zoomed around the foyer for a few seconds, swerving under the stairs and spinning around the chandelier before coming to a stop in front of her older sister once more.
"Gosh, I'm bored…"
Farfalla pulled her little sister into another light hug. "I know… and I'm sorry."
"It ain't your fault 'Zippo's' gots th' hots fer ya, Fallafly!"
"What? No. I mean, it was my fault that Dr. Wily almost got away with all of Dr. Chou's notes and his family's fortune…"
"Oh, yeah!" Brietta scowled. "You was th' one who let Zippo in here, weren'tcha?"
"N-not in so many words, but…"
"Brietta, stop."
Brietta pulled away from her sister and hovered just out of reach, looking down at the new arrival. Farfalla looked in that direction as well. A young, blue-haired woman wearing a traditional maid outfit had walked into view.
"It's okay, Persephone…" Farfalla sighed. "If I hadn't let Heatman in for repairs, Dr. Wily wouldn't have–"
"'Dr. Eyebrows' wouldn't've used Zippo ta teleport other robots in 'n attack th' manor!"
"Brietta!"
Persephone glared up at her sister. She was doing the backstroke in the air…
"Eh, pobody's nerfect!" she told Farfalla. "We all make mistakes! You didn't know that Zippo was a Wily 'bot! You was jus' doin' what you do best 'n tryin' t' heal da woild!"
She zipped down and floated in front of her brown-haired sister.
"There ain't nothin' wrong wid dat!"
Farfalla looked down. "B-but, if I hadn't…"
"Looket me."
The pixie squished Farfalla's face in between her sleeves and looked her right in the eye.
"You. Did. Nothing! Wrong." she firmly stated. "You are a good poisen!"
"S-so… why do you keep constantly reminding me of my mistakes?"
She floated back and wiggled her finger at her sister, winking. "'Cause I love yas!"
"Brietta Chou!" Persephone interjected. "There are certain things you simply do not tease someone about! Dr. Wily's attack on the compound is one of them!"
"Blah-blah-blah, Persis!" Brietta zipped over to the maid 'bot. "Fallafly's a big girl! She'll get over it! 'Sides, s'not like anyone got hoit!"
Farfalla looked away, rubbing her arm. "That's only because Oilman was here…"
"Hey, how is 'Oil Slick', anyway?" Brietta grinned as she asked, "I hear he's been keepin' ya puh-retty well oiled…"
Brietta waggled her eyebrows as Persephone deeply blushed.
"Th-that's none of your business, Brietta!" she shouted with a furious glare.
"Hey, like I'm one ta talk!" She twirled as she flew upward. "I had my hands full wid Funnyface! Ah, what a doll… Always good fer a laugh, my li'l Funnyface!"
The pixie slowly lowered down until she was at eye level with her sisters.
"We gotta get outta here… It's been so long since I been wrapped up in Funnyface's arms… An' believe me, he's got plenty ta wrap me up in!"
Persephone scowled as Brietta jingled and vibrated, hugging herself.
"Makes me all tingly jus' thinkin' 'bout it…!" she excitedly whispered.
"What is wrong with you?!" the maid 'bot shouted, clearly not approving.
"She misses her 'clown prince' dearly."
The lights of the manor suddenly vanished, leaving the three sisters in the dark. All eyes turned to the front door of the manor as they dramatically flew open. As a mysterious fog poured in, a figure began to appear from the darkness, slowly stepping into the foyer…
"Hiya, Spooky Sis!"
Only for Brietta to completely ruin their entrance by announcing them.
The lights turned back on and the fog immediately dispersed, revealing a tall figure draped in a white kimono-like top with detached sleeves and red, pleated slacks. She had long, body-length, raven hair and sleepy eyes as red as her slacks. She also wore a soft smile and emanated an air of calmness, though her eyes seemed somewhat… "lifeless".
"Hello, Brietta," the figure greeted. "Hello, sisters."
"Hello, Mikan," Persephone greeted, looking unsettled. "B-back from your trip early?"
"Yes," Mikan answered simply.
"How'd it go?" Brietta asked.
"It went well."
The tall woman closed her eyes, nodding. The doors closed behind her.
"The spirits were very grateful."
"We can see that…" Persephone dryly noted.
Mikan's gaze and her eerie smile turned Persephone's way. "Can you?" she asked.
"I can!" Brietta chimed, flying over to her tallest sister. "Hiii, spooky spirits!"
As she waved to seemingly nothing, both Persephone and Farfalla looked at each other. They knew there was something there… something only those in tune with the spirit realm could see. It was weird, having two spirit-sensing sisters… especially since one was pure chaos and the other was pure order. They did kind of balance one another out, in that regard…
"The spirits say 'hello' to you as well, dear sisters," Mikan told the two.
"Hiii…" Persephone said dismissively. "Look–"
Without any warning, Brietta suddenly burst into laughter!
"Oh, gosh, dat's a good one!!" she laughed, rolling on her back in mid-air and kicking her legs. "Tell 'em, Spooky Sis! Tell 'em what da spooky spirits told us!"
Mikan's air of calmness gave way to a sudden shyness. She rubbed her index fingers together and blushed a little, looking down.
"I'm… not very good at telling jokes…" she confessed.
"I'll tell it!" Brietta cleared her throat, looking at the other two sisters. "So… a priest, a rabbi, and a Buddhist monk all walk into a bar…"
"Thinking about it…" Mikan interrupted, "this joke does not make a lot of sense."
"Whaaaaa…?" The pixie tilted her head, then her whole body. "Why-come?"
"Buddhism encourages the avoidance of alcoholic beverages and drug use."
"Maybe da Buddhist monk ordered a glass'a water?" She shrugged. "So's anyway–"
"A second thought occurs."
"Whaaaaat." Brietta huffed, starting to lose patience.
"Is this joke an appropriate one to share at this time? The energy of the room is in flux. There is sadness and frustration within…"
"Sounds like da poifect time ta tell it! So anyways… they gets ta talkin' 'n–"
"Something else occurs."
The pixie quietly growled, flying over to Mikan. "Keep interruptin' 'n I'm gonna zap ya wid my pixie dust! Kapow!!"
"Understood. However…" Mikan gestured once more. "Our audience has dispersed."
"What?" Brietta looked around. "Whoa! Dey're gone! How dey do dat?"
The priestess smiled, tucking her hands into her long sleeves. "'How' indeed…"
On Persephone's suggestion, she and Farfalla had left the foyer and found themselves walking in the western halls of the manor. There, they began a conversation that was, in the former's objective opinion, "far more productive" than listening to their younger sisters' antics.
"How was your day, sister?" she asked as they walked through the empty hallway.
"The same as usual, I guess…" Farfalla softly shrugged. "I had someone threaten me with my own chair."
"Goodness!" Persephone frowned. "Are you alright?"
"Just fine!" The other girl smiled. "Thank you for asking."
"Why was someone threatening you with a chair?"
"Because…" She looked down. "I'm a robot."
Farfalla explained the events of the last part of her shift to Persephone. She listened intently, taking in every word and occasionally nodding…
"So, he still didn't trust you to look into his ear problem even after you broke his fall?"
"Sadly, no…" She sighed, shaking her head. "This anti-robot movement needs to end."
"It may only get worse before it gets better…"
Farfalla perked. "What makes you say that?"
"Well, think about it."
Persephone stopped walking and turned to face her sister.
"What if some deranged person comes to your workplace and makes threats against your employers? Or worse… what if they actively try to dismantle your workplace?"
The nurse 'bot covered her mouth, going wide-eyed.
"I… I hadn't thought about that!" she gasped. "C-could that actually happen…?"
"Farfalla…" Persephone gently held her sister's hands. "Every time you simply do your job, you're putting yourself… and your workplace… in danger. It would be much safer for everyone if you would consider staying home with your family."
"I-it would, yes…" She paused. "B-but, I can't simply quit doing what I love… what I was created to do… I can't simply quit my job! I would be letting down my friends and co-workers! What if someone really needs me?"
"There are humans who can do your job, aren't there?"
"Y-yes… but…"
"So…" Persephone looked somewhat worried. "Let the humans tend to their own. There's someone here at home who needs you more than anyone."
Farfalla went wide-eyed, again. "I-is something wrong with Dr. Chou?"
"He hasn't left his office since the attack… You know that."
"Is he getting worse, though?" Panic began to show on Farfalla's face. "I-is he eating? Is he staying hydrated…?"
"Farfalla…"
Persephone brought a hand up, touching her sister's face with a warm smile.
"Farfalla… you were his first. You are his pride and joy. He needs you more than any one of us. Please… talk to him."
Persephone leaned in, offering her sister a soft hug. She then curtsied before wandering off to seemingly do some more cleaning, leaving Farfalla to ponder what she'd just been told.
–
"Dr. Chou? It's… it's me. Farfalla."
Thirty minutes had passed since Farfalla and Persephone had their conversation. In that time, the little nurse 'bot had a lot of time to think.
Two months had passed since she inadvertently let Dr. Wily's forces into the manor grounds. It if hadn't been for Oilman's visit, things might have gone far worse than they did. Between him, Rockman, and Rightot, they were able to put a stop to any plans of grand larceny that Wily had in mind. No one was harmed and anything that was damaged could be replaced. Despite that… Farfalla had kept herself separate from those who would let her.
Since the attack, she had blamed herself for letting it happen. In her mind, she was the reason everything happened the way it did. If Brietta, Persephone, and Quartz hadn't twisted her arm to stay, she probably would have left the manor and found somewhere else to live. Things seemed to settle into normalcy shortly after… with one exception.
She couldn't bring herself to face Dr. Chou. Not after what she'd "done".
"Go. Away."
That was the response Farfalla got that night. Somehow… she wasn't surprised. Rather than insist she be let in… she just sighed and leaned against the door.
"Dr. Chou… We're all worried about you. You haven't left your office since… well… since two months ago. We aren't even sure you're eating or sleeping… Sidney claims the meal trays always come back spotless, but we suspect that Quartz has been eating your food…"
The nurse 'bot glanced at the doggie flap built into the doctor's office door and sighed.
"My point is that your creations… your children… care deeply about you. We're worried. And most importantly… we miss you…"
"Why?"
The question was so blunt… so simple… that Farfalla felt taken aback.
"Be… because… we're your children and we love you!
"Dr. Chou…!" Farfalla slammed her hand against the large, oaken door to her father's office. "What you're doing isn't fair! It's like you're punishing us for… for seemingly no reason! They need to see your face! Hear your voice! Know that you're healthy and alive!! Why do you keep hiding yourself from the world? Don't punish them… Punish me! It's my fault!"
"No." He paused. "It's my fault."
"Wh-what?"
"I'm sure you've read the news or seen it on TV…" the doctor continued. "There's a worldwide anti-robot movement. And I'm part of the problem!"
"Dr. Chou…?" The young woman nervously laughed. "I don't understand…"
"I. Make. Robots. Farfalla. So, I'm part of the problem…"
"You make good robots, though, not bad ones…"
"Good and evil are subjective. You remember reading about Thomas' robots, I'm sure. It was what set this whole bloody chain of events off…"
"Dr. Chou…" Farfalla whispered. "You're not like Dr. Light… and you're definitely not like Dr. Wily! You're a good man who just wants to make the world a better place!"
"Farfalla…" Dr. Chou sighed. "Dr. Wily wants to make the world a better place, too…"
"N-no!" She shook her head again. "Dr. Wily wants to control the world!"
"And… make it a better place."
"You– you can't possibly… N-no, I refuse to believe…"
Tears started to well in Farfalla's eyes.
"Are you… are you defending that evil lunatic?!"
"Good and evil are subjective," the doctor calmly repeated. "Dr. Wily thinks he can make the world a better place by leveling it and remaking it in his image. I don't agree with that…"
"S-see?" The woman shakily smiled. "That makes you good and him evil!"
"Disagreeing with his methods doesn't automatically make him evil, Farfalla…"
"But–"
"Besides," he continued, startling Farfalla, "some of his ideas do have some merit…"
"Wh… what?"
"He's right that the world powers, as they are, are corrupt. He's right that things need to change. He's right that robots could potentially be used for bad things. Most anything can! That's been the whole idea behind his attacks. Dr. Wily wants to show the world that robots should be mindless, obedient automatons built purely to serve humanity. He has no interest in robots that can disobey or revolt, much less ones that can think for themselves."
"B-but, Heatman was one of Dr. Wily's creations, right…?" Farfalla sniffled. "He might be evil and not care about humans, but Dr. Wily still gave him the ability to think for himself… If Dr. Wily doesn't believe in that, then why would he make his Robot Masters intelligent…?"
"Honestly?" Dr. Chou chuckled from behind the door. "I think he gives his original robots the ability to think because he knows it'll mess with Rockman's head."
"R-Rockman…?"
"Mostly, yes. Breakman doesn't share the kind of… uh… 'sense of justice' that Rockman has. And of course, any time Forte stops his creator, it's purely an act of egotism… With Rockman, though… The robots can talk to him… make him feel as evil as he thinks they are. It's clever if you really think about it…
"Farfalla… Everyone is capable of good deeds. Everyone is capable of evil deeds. Labels like 'good' and 'evil' are subjective, as I've said. Saving a village might seem like a good idea, but if saving one village somehow disrupts the way of life for another village… well…"
The doctor paused again before sighing.
"I'm tired… I'm going to bed, now. Good night."
"Dr. Chou?" Farfalla perked, standing up straight and turning to the door. "Dr. Chou…?"
There was no answer from the door.
"Dr. Chou! Wait! Come back!"
Again, there was no answer.
"Dr. Chou!" Tears retired to the girl's eyes. "You're… you're not being fair!"
"Life isn't fair, Farfalla. Go to bed. That's an order."
"Y-you can't do that!" She shook her head. "You can't just tell me that Dr. Wily is right… that robots… you… are part of the problem… and then… and then… just leave like that!! I… I won't allow it!! I demand that you open this door and face me! Right now!!"
A chilling air fell upon the hallway after Farfalla had made her command. She knew that she had gone way too far. She was Dr. Chou's creation… his invention… and in a sense, his daughter. She had no right to order him to do anything! Yet… she had meant what she said. He couldn't possibly stay locked in that office for the rest of his life. He had to come out… he would come out! Even if the entire family had to drag him kicking and screaming, they… she… would get Dr. Chou to come out of that office and…! And…
And… that's when Farfalla realized something.
Just what do I expect him to do after he comes out?
It began to dawn on Farfalla that Dr. Chou wasn't the end-all, be-all answer to all of life's problems. She missed her father, sure. All the Chou Numbers did! But once Dr. Chou was out of the office and they'd had their tearful reunion… then what? Dr. Chou couldn't change the world's opinion about robot-kind. Dr. Chou couldn't even stop the local news outlets from running negative stories about the potential danger of robots running wild. When it came right down to it… Dr. Chou was just as powerless to change the world as anyone else. Not even Dr. Right, the world's foremost expert on robots, could do it! And he made Rockman! So… just what did she expect from her father? And more importantly… what did she want…?
"I just want this all to stop…"
Farfalla sat against the door, pulling her knees to her chest and hiding her crying face.
"I want all the hatred to stop… I want all the confusion to stop… I want all the anger to stop… I just want to help humans feel better and lead healthy lives. I want Brietta to be able to fly around the city, making children of all ages happy with her silly antics… I want Mikan to travel the world and help all the lost and wayward spirits pass on… I want Persephone and Sidney to be able to go shopping without having things thrown at them… And, I want Quartz to be able to go to any park he wants and play with the other dogs, again."
The girl sniffled, closing her eyes.
"I want normalcy… I want peace… And… and I want love. Love for all living things. Humans… Robots… Everything. I know it sounds like a lot to ask… but I just want to be able to live my life without worry. Even if it's just… just for… a little… while…"
"You really do want to heal the world, don't you…?"
Dr. Chou stood in his open doorway, smiling down at his sleeping creation. He and his little robot pomeranian, Quartz, had checked on her shortly after she'd stopped talking.
"Of all my creations, I think it's you that feels the most at fault when the world tears itself apart, even though it's not your fault," Dr. Chou said. "We humans are just a bunch of confused monkeys, throwing mud in a panic whenever something doesn't go our way…"
The doctor reached down, softly stroking Farfalla's hair. Quartz found a place by her side and settled in.
"You'll always be there to heal the hearts of those who need it the most… but who can you turn to when your heart is full of sorrow? Sleep well, my dear…"
The doctor quietly slipped back into his office, leaving his creation right where she was. As she slept… there was a calmness in her heart… and a peaceful smile on her face.
JOLIN TSAI IS ALSO GOING TO THE TRAINWRECK AWARD SHOW OMG JOLIN AND WAYV INTERACTION ⁉️ Wait she hasnt performed in a while esp in the mainland omg what if shes ramping up for a new album guys its been so long since ugly beauty shes about to drop another iconic album and mv it's happening <- delusional
I am like an 'interpolation' in social settings—bridging gaps between diverse perspectives and finding connections where others might not see them. Much like how interpolation estimates values between known points, I thrive in understanding and blending various viewpoints to create a cohesive understanding.
ISODEPTH
I find myself akin to 'isodepth' in life, delving into various depths of interests, passions, and experiences. Similar to how isodepth explores consistent depths in a landscape, I seek depth and understanding in different aspects of life, embracing diverse interests and experiences with equal enthusiasm.
MOODBOARD
MISARUI DAVIS
I am someone who loves diving into the depths of ideas and challenges, seeking both efficiency and creativity in everything I do. As an ENTJ, I thrive on leadership and strategic thinking, always eager to take charge and bring ideas to life. My 3w4 personality brings a blend of achievement-oriented drive with a touch of individualism and creativity. I am passionate about growth, personal, and enjoy embracing the complexities of life with an organized and ambitious approach.
INTERESTS
I find solace in the pages of books, revel in the beauty of poetry, immerse myself in the enchantment of classical music, and am captivated by the elegance of various arts.
MOVIES OR SERIES
Dead Poet Society, All About Lily Chou-Chou, Fallen Angels, Gilmore Girls, The Forest Of Love, The House, Minority Report, The Innocent, Mulholland Drive, Nightbooks, Locke and Key, Criminal Minds, etcetera.
BOOKS
Where The Wild Ladies Are, On Children, Cursed Bunny, When Breath Becomes Air, Soviet Milk, Women On The Silk, Nausea, The Poppy War, etcetera.
CLASSICAL MUSIC
Luciano Pavarotti, Giacomo Puccini, Andrea Bocelli, Maria Callas, etcetera.
Antonio Vivaldi, Francesco Maria Veracini, Pietro Locatelli, Alessandro Scarlatti, etcetera.
SPORTS
Arsenal (football club), Sidney Roosters (rugby). I am a Tifosi, mainly talk about Charles Leclerc.
My favorite old jazz musician, Miles Davis.
GUIDELINES
I must admit, I have a tendency to romanticize almost everything around me. Whether it’s cherishing simple moments or finding beauty in mundane things, I can’t help but see the poetic side of life. However, this habit sometimes leads me to delete tweets or reconsider loud expressions of my feelings, as I constantly strive to strike a balance between sharing my thoughts and maintaining a sense of authenticity.
DO NOT FOLLOW IF
Please refrain from following my account if you hold racist views, Islamophobia, or any form of religious prejudice. I don’t align with any discriminatory beliefs or actions. Additionally, if you support ideologies contrary to peace or humanity, such as being against the Palestinian cause, my content might not resonate with your beliefs. My aim is to foster a community built on respect, inclusivity, and compassion.
Novembre
07. Low Jack + Sidney – Bigwax records (gratuit)
07. M.A. Beat! + Domotic – Olympic café
08. Half Asleep + Delphine Dora – Médiathèque musicale (gratuit)
08. Cold Cave + Choir Boy – Petit Bain
08. Jealous + The Absolute Never + Drone à clochettes – Alimentari
08. Dominique A – Maison de la Poésie
09. Le Syndicat faction vivante – Paris anim' Marc-Sangier, Vercingétorix & Didot (gratuit)
09. Sonotanotanpenz + Le Ton mité – Le Chair de poule
09. Words & Action – Le Klub
09. Rendez-Vous + Prurient + Silent Servant + Poison Point + Crave + Low Jack b2b Moyo + Clara 3000 & Coni – La Machine
09. Regis + Vatican Shadow + Samuel Kerridge + December – Rex Club
09. AZF + Randomer + Identified Patient + Zuli + Benoua b2b Legitime – Concrete
09. The Hacker – Badaboum
09. Porest Group + Senyawa – théâtre Berthelot (Montreuil)
09. Kikagaku Moyo + Frédéric D. Oberland – Petit Bain ||COMPLET||
10. Missing Waves – Paris anim' Nouvelle Athènes (gratuit)
10. Kink Gong + Baba Commandant & The Mandigo Band – théâtre Berthelot (Montreuil)
11. Bo Ningen + Cassels – Point FMR
11. Brothers Unconnected (Alan & Richard Bishop) + Robert Millis & Jesse Paul Miller – théâtre Berthelot (Montreuil)
13. Hot Snakes – Point FMR
13. MellaNoisEscape + Puts Mary – Petit Bain
13. Sophie Agnel, Joke Lanz & Michael Vatcher – Instants chavirés (Montreuil)
14. Cocaine Piss + We Hate You Please Die + New Favourite – Supersonic (gratuit)
14. Peter Murphy & David J jouent "In the Flat Fields" – Bataclan
14. Jerusalem In My Heart + Good Luck In Death + Florian Abou Yehia – Petit Bain
14. Tout de suite + Mr Marcaille + Le Crabe – L'International
14. Charalambides + Bridget Hayden + Jon Collin, Nina Garcia & Augustin Bette – Les Nautes
14. Blind Delon + BLNDR + IV Horsemen + Paulie Jan + DJ Varsovie + Panzer – Rex Club
15. Father Murphy + Le Jour du seigneur & Kaïto Winsé + Arnaud Rivière – Les Nautes
15. Babil Sabir 2 + L'Ocelle Mare – Le cirque électrique
15. Méryll Ampe + Emmanuelle Bouyer + Anne Flore Cabanis + Matthieu Crimersmois + Frédéric Mathevet + Colin Roche + Anton Mobin... (Extended Score #2) – Le Cube (Issy-lès-Moulineaux)
15/16. Mario Batkovic – Centre culturel suisse
16. Frigs + Plomb + Cave Story – Supersonic (gratuit)
16. Jasss + Nkisi + Bonaventure (Biennale Némo) – La Gaîté lyrique
16. Ellah A. Thaun + Love Coffin + Bryan's Magic Tears – La Station
16. Tapeworms + Carpet Burns + Casio judiciaire – La Pointe Lafayette
16. Noir Boy George + Officine + Foune Curry – Instants chavirés (Montreuil)
16. Parquet Courts – Elysées Montmartre ||COMPLET||
17. Moriarty – Librairie L'Atelier (gratuit)
17. The Damned – Elysées Montmartre
17. Jung An Tagen + Matthias Puech + Meryll Ampe & Konpyuta – 100ECS
17. Eomac + Defekt + Aktion mutante (Unhuman & Violet Poison) + ANFS + Polly F – entrepôt en banlieue
18. Ensemble Links : « Drumming » de Steve Reich – Cité de la musique|Philharmonie
19. U.S. Girl – Nouveau Casino
19. Samara Lubelski + Metabolismus + Gloria Navales – tbc
20. King Champion Sound + Pierre & Bastien + Rose Mercie – Le Klub
20. Duck Duck Grey Duck + Billie Bird – Centre culturel suisse
21. The Breeders – Le Trianon
21. Lydia Lunch & Ian White – La Station
21. Ekafaune + Badbad + Baba Yage – Le cirque électrique
22. Société étrange + Pyjamarama – Le Zorba
22. Scout Niblett + Miles Oliver – Petit Bain
22. Cookies + Trotsky nautique + Guns'n'Ganseblumchen – La Pointe Lafayette
22. Les Filles de Illighadad + Zenobia – NF-34
22. Tomoko Sauvage + Jacques Demierre & Axel Dörner + Frantz Loriot + Anna Frei & Franziska Koch (Textures fest.) – Instants chavirés (Montreuil)
22. Serge Teyssot-Gay, Christian Vialard & Éric Arlix : Hypogé – Le Cube (Issy-lès-Moulineaux)
23. Michael Nyman : "War Work: 8 Songs with Film" – Salle Pleyel
23. Ennio Morricone – Bercy Arena
23. Kollaps + Trepaneringsritualen + Verset Zero – Gibus
23. Le Mystère des voix bulgares – église Saint-Eustache
23. Les Morphogénistes + Asié Usu + Annabelle Playe (fest. Vision'R) – Les 100 ECS
23. Saravah revisité (Areski, The Recyclers, Arlt, Bojan Flames...) + Hyperculte + Waltraud Blischke (dj) (BBmix fest.) – Carré Bellefeuille (Boulogne-Billancourt)
23. Yasmine El-Baramawy + Dennis Tyfus + Les Sirènes (Francisco Meirino, Jérôme Noetinger, Mathieu Saladin & Juliette Vocler) + Denis Rollet (Textures fest.) – Instants chavirés (Montreuil)
23. Tommy Four Seven + AnD + Stephanie Sykes + VSK – Concrete
23. Steve Rachmad + Scan X + Matteo WNB – Rex Club
23>25. Anne-James Chaton & Manuel Coursin : "L'Affaire La Pérouse" – La Pop
24. Geometric Vision + Solveig Matthildur – Supersonic (gratuit)
24. Seefeel joue "Quique" + Insides – Petit Bain
24. O'Death Jug – Le Bal
24. Smode + Marti Guillem + Maries Laveau + The Shaders + Stéphane Privat + Sune Petersen (fest. Vision'R) – Les 100 ECS
24. Endless Boogie + Pan American + Facs + Von Limb + Waltraud Blischke (dj) (BBmix fest.) – Carré Bellefeuille (Boulogne-Billancourt)
24. Frustration + Twin Arrows – Rack'am (Brétigny/Orge)
24. Trentmøller (dj) – NF34
24. Arnaud Rebotini + Vernacular Orchestra + Soul Edifice – Rex Club
24. ABSL + Cem + Elad Magdasi + Mind/Matter + Moth + Nico Moreno + Paramod + Parfait + Raär + Sentimental Rave – tba
25. Satan + Kill + Necrodancer – Espace B
25. Lene Lovich Band + Morgan King – Supersonic
25. Evan Crankshaw & The Dead Mauriacs + The Mauskovic Dance Band + Waltraud Blischke (dj) (BBmix fest.) – Carré Bellefeuille (Boulogne-Billancourt)
27. Mudhoney – Trabendo
27. Etienne Jaumet – New Morning
27. Elizabeth Devlin – La Tête de chou
28. Anne-James Chaton – Auditorium|Cité de l'architecture (gratuit)
28. Adult. – Petit Bain
28. Borja Fames + Eloïse Decazes + Èlg – Instants chavirés (Montreuil)
28. Ensemble IRE joue "Nexus Entropy" d'Ulrich Krieger + Marc Baron + Lionel Marchetti (fest. Bruits blancs) – Anis gras (Arcueil)
29. SK/LR – Chair de poule (gratuit)
29. Esben & The Witch – Point FMR
29. CHDH + Mariachi + Lårs Akerlund & Sten Backman (fest. Bruits blancs) – Le Cube (Issy-lès-Moulineaux)
29. Rakta + Marée noire + Trashley – Instants chavirés (Montreuil)
29. Interpol + Nilüfer Yanya – Salle Pleyel ||COMPLET||
30. Mick Harvey – Petit Bain
30. Artus + Fleuves noirs + Hex – Le cirque électrique
30. Spit Mask + Poison Point + Lunacy + Some Ember + Offermose + Kaukolampi – La Station
30. Deeat Palace + Tamara Goukassova + Tryphème – L'International
30. Machine sauvage + Léon Denise (fest. Vision'R & Cookie Demoparty) – Folie numérique N5|Parc de La Villette
30. John Chatler + Samuel Sighicelli + Shapednoise (fest. Bruits blancs) – Anis gras (Arcueil)
Décembre
01. NAO (fest. Vision'R & Cookie Demoparty) – Folie numérique N5|Parc de La Villette
01. Nadia Ratsimandresy + Bruno Chevillon + Uriel Barthélémi + Marc Sens + Annabelle Playe (fest. Bruits blancs) – Anis gras (Arcueil)
01. Deux boules vanille + Jeff Mills + Molécule + Renart + Nicolas Horvath joue P. Glass, T. Riley et J. Adams + Ensemble Links : "Music for 18 Musicians" de S. Reich (fest. Marathon!) – La Gaîté lyrique ||COMPLET||
02. Beak> + Le Comte – Café de la danse ||COMPLET||
03. Idles + John – Bataclan
03. Pardans – Olympic café
05. Julia Holter – Petit Bain
05. Sudden Infant + Massicot – Centre culturel suisse
06. La Tène avec Jacques Puech, Louis Jacques, Guilhem Lacroux & Jérémie Sauvage – Centre culturel suisse
06. The KVB + M!R!M – Badaboum
07. Kink Gong – Médiathèque musicale (gratuit)
07. Antoine Chessex + Nina Garcia + Francisco Meirino – Centre culturel suisse
07. Heimat + Bordigaga + Bruno Billaudeau, Xavier Mussat & Black Sifichi (Semaine du bizarre) – Instants chavirés (Montreuil)
07. Nosfell – Espace 1789 (Saint-Ouen)
07. Aubadja + chdh (fest. Vision'R) – Le Générateur (Gentilly)
07. Shxcxchcxsh + W.LV.S + Wlderz – Rex Club
08. Père Ubu (Semaine du bizarre) – Théâtre Berthelot (Montreuil)
08. The Horrorist + Federico Amoroso – L'Officine
08. Jean Benoît Dunckel + NSDOS + CloZee + Kiddy Smile (Inasound fest.) – Palais Brongniart
08. Blawan + The Advent + AWB + Yogg & Pharaon + Netsh – Concrete
09. Panteros666 + Matt Black + Erol Alkan + Kiasmos (Inasound fest.) – Palais Brongniart
09. The Fleshtones – Supersonic
09/10. Moriarty – Cité de la musique|Philharmonie
12. Nova Materia – La Maroquinerie
12. Le Réveil des tropiques + France + Helio Polar Thing – Petit Bain
13. The Callas + Selofan + Hørd (fest. Magnétique Nord) – La Station
14. New Model Army – Trabendo
14. Carol Robinson, Bertrand Gauguet, Julia Eckhardt & Yannick Guedon : "Sequel to Occam Ocean" (2018) d’Éliane Radigue – Palais de Tokyo
14. Sida + Broken English Club + Toresch + Moderna + Wr2old + Shazzula (fest. Magnétique Nord) – La Station
14. Hangman's Chair + Jessica93 + Revok – Les Cuizines (Chelles)
14. Succhiamo + Air LQD + Rraouhhh + Christophe Clébard – Le Chinois (Montreuil)
14. Rebekah + Paula Temple + Anetha + Hannah b2b Charlene – Concrete
15. Gaspar Claus – Cité de la musique|Philharmonie
15. Ata + Oliver Hafenbauer + Chinaski + Last Love Pilgrim + Kilian Paterson + Slyngshot + DJ Neewt (fest. Magnétique Nord) – La Station
15. Job Sifre + Fatma Pneumonia + X1000 + Spunoff (fest. Magnétique Nord) – La Station
15. AZF – Rex Club
18. Drab Majesty – Point FMR
19. Belmont Witch + Zad Kokar + Petra Pied de biche – Instants chavirés (Montreuil)
22. Yan Wagner + Il est vilaine + Magnüm + Mayerling – La Maroquinerie
2019
Janvier
18. Francis Dhomont (fest. Akousma) – MPAA Saint-Germain (gratuit sur résa)
19. Armando Balice + Ingrid Drese + Jérôme Noetinger + Loïse Bulot + Robert Hampson (fest. Akousma) – MPAA Saint-Germain (gratuit sur résa)
20. Catherine Bir + Raphaël Mouterde + Francisco Meirino + Roland Cahen + Yoko Higashi & Lionel Marchetti (fest. Akousma) – MPAA Saint-Germain (gratuit sur résa)
22. Emmanuelle Parrenin & Dominique Regref – La Ferme du Buisson (Noisiel)
24. Rouge Gorge – Le Chair de poule
25. La Secte du futur + Shiny Darkly – Supersonic
25. Léonie Pernet – Gaîté lyrique
26. Chloé – Elysée-Montmartre
29. Dominique a – Salle Pleyel
31. Deena Abdelwahed – Gaîté lyrique
Février
02. The Residents – Gaîté lyrique
02. Shabazz Palaces + Dälek (fest. Sons d'hiver) – théâtre de la Cité internationale
06. Brendan Perry – Petit Bain
07. VNV Nation – Le Trabendo
09. The Ex : "Ethiopian Night" (fest. Sons d'hiver) – salle Jacques-Brel (Fontenay-sous-Bois)
10. Therapy? – La Maroquinerie
11. Massive Attack feat. Liz Fraser jouent « Mezzanine » – Zénith
16. Anthony Braxton + Dave Douglas & Bill Laswell (fest. Sons d'hiver) – théâtre Jacques-Carat (Cachan)
21. Mlada Fronta + Absolute Valentine + Neoslave – Petit Bain
22. Nils Frahm – Le Trianon ||COMPLET||
23. Nils Frahm – Le Trianon
Mars
02. Boy Harsher + Kontravoid – Badaboum
07. Scratch Massive – Gaîté lyrique
12. Yann Tiersen – Salle Pleyel
20. Oomph! – La Machine
22. Delia Derbyshire (diff.) + Lettera 22 + Evil Moisture + Caterina Barbieri + Drew McDowall : "Coil's Time Machines" (fest. Présences électronique) – Studio 104|Maison de la Radio
22. The Young Gods – La Maroquinerie
23. Pierre Boeswillwald (diff.) + Max Eilbacher + Andrea Belfi + Sarah Davachi + William Basinski & Lawrence English (fest. Présences électronique) – Studio 104|Maison de la Radio
24. Warren Burt (diff.) + Mats Erlandsson + Okkyung Lee + Low Jack + BJ Nielsen (fest. Présences électronique) – Studio 104|Maison de la Radio
29. Perturbator – Le Trianon
30. Marc Almond – Le Trianon
Avril
05. Beirut – Le Grand Rex
08. The Specials – La Cigale
10. Daughters – Point FMR
14. Arnaud Rebotini joue la BO de "120 Battements par minute" – Cité de la musique|Philharmonie
17. Teenage Fan Club – Trabendo
27. She Past Away – La Machine
27. Chloé : Lumières noires – Le 104
Mai
10/11. Dead Can Dance – Grand Rex
11. Christina Vantzou + Eiko Ishibashi + Jan Jelinek + NPVR (Nik Void & Peter Rehberg) – Le 104
12. Massimo Toniutti + François Bayle – Le 104
17. Philip Glass : Études pour piano – Salle Pierre-Boulez|Philharmonie
18. Bruce Brubaker & Max Cooper : Glasstronica – Cité de la musique|Philharmonie
31. François Bonnet + Knud Viktor + Jim O'Rourke + Florian Hecker (fest. Akousma) – Studio 104|Maison de la Radio
Juin
01. Eryck Abecassis & Reinhold Friedl + Hilde Marie Holsen + Anthony Pateras + Lucy Railton (fest. Akousma) – Studio 104|Maison de la Radio
02. Bernard Parmegiani + Jean Schwarz (fest. Akousma) – Studio 104|Maison de la Radio
26. Magma – Salle Pierre-Boulez|Philharmonie
Juillet
11. Masada + Sylvie Courvoisier & Mark Feldman + Mary Halvorson quartet + Craig Taborn + Trigger + Erik Friedlander & Mike Nicolas + John Medeski trio + Nova quartet + Gyan Riley & Julian Lage + Brian Marsella trio + Ikue Mori + Kris Davis + Peter Evans + Asmodeus : John Zorn's Marathon Bagatelles – Salle Pleyel
Août
23>25. The Cure (fest. Rock en scène) – parc de Saint-Cloud
Septembre
13. Rammstein – La Défense Arena (Nanterre)
en gras : les derniers ajouts / in bold: the last news
These predictions were extremely difficult to make, because everybody is so darn talented! Therefore, please don’t take them too heart. Also, I didn’t make predictions for three of the four senior divisions, because I am unfamiliar with the majority of the competitors.
Varèse’s use of sirens in the ground-breaking percussion piece Ionisation (1929–31) gestured back to Russolo and forward to the development of electronic instruments that could provide the “parabolic and hyperbolic trajectories of sound” of which he dreamt.
Audio Culture, Revised Edition: Readings in Modern Music (p. 5). Bloomsbury Publishing. Kindle Edition.
Ionisation features the expansion and variation of rhythmic cells, and the title refers to the ionization of molecules. As the composer later described, "I was not influenced by composers as much as by natural objects and physical phenomena." (Schuller 1965, p. 34) Varèse also acknowledged the influence of the Italian Futurist artists Luigi Russolo and Filippo Tommaso Marinetti in the composition of this work.[3]
Both Chou Wen-Chung[4] and Jean-Charles François[5] have analyzed the structure and timbre features of Ionisation in detail. András Wilheim has noted that only the last 17 measures of Ionisation include musical tones of the "traditional tonal system", where any five successive chords contain the 12 tones of the chromatic scale.[6]
Frank Zappa often claimed that Ionisation inspired him to pursue a career in music. It was, incidentally, the first album purchased by Frank Zappa. Jack Skurnick, director of EMS Recordings, produced early post-war recordings of Varèse; this piece appears on the first Varèse LP, EMS 401: Complete Works of Edgar Varèse, Volume 1. Ionisation had also been the first work by Varèse to be recorded in the 1930s, conducted by Nicolas Slonimsky and issued on 78rpm Columbia 4095M.[7][8] Octandre was also recorded and issued on 78rpm discs in the later 1930s, complete (New Music Quarterly Recordings 1411) and as an excerpt (3rd movement, Columbia DB1791 in Volume V of their History of Music).[8]
Sidney Finkelstein wrote in the LP liner notes about the work:
[Ionisation] is built on a most sensitive handling and contrast of different kinds of percussive sounds. There are those indefinite in pitch, like the bass drum, snare drum, wood blocks, and cymbals; those of relatively definite musical pitch, such as the piano and chimes; those of continually moving pitch, like the sirens and 'lion's roar.' It is an example of 'spatial construction,' building up to a great complexity of interlocking 'planes' of rhythm and timbre, and then relaxing the tension with the slowing of rhythm, the entrance of the chimes, and the enlargement of the 'silences' between sounds. There are suggestions of the characteristic sounds of modern city life.
Yknow what it doesnt even matter wayv is a flop bc the fact that jay chou comments on kun's posts is Such a flex like u dont even understand the number of c-ent singers and idols who would shit themselves into next year if they had regular jay chou interactions on their social media.
A comprehensive guide to the new science of treating lower back pain
A review of 80-plus studies upends the conventional wisdom.
by Julia Belluz Aug 4, 2017
Welcome to Show Me the Evidence, where we go beyond the frenzy of daily headlines to take a deeper look at the state of science around the most pressing health questions of the day.
Cathryn Jakobson Ramin’s back pain started when she was 16, on the day she flew off her horse and landed on her right hip.
For the next four decades, Ramin says her back pain was like a small rodent nibbling at the base of her spine. The aching left her bedridden on some days and made it difficult to work, run a household, and raise her two boys.
By 2007, she couldn’t so much as sit or walk for more than a few minutes without experiencing what felt like jolts of electricity shooting up and down her spine.
In 2008, after Ramin had exhausted what seemed like all the options, her doctor recommended nerve decompression surgery. But the $8,000 operation didn’t fix her back, either. The same pain remained, along with new neck aches.
At that point, Ramin decided to deploy her skills as a journalist and investigate the $100 billion back pain industry. She went on to write Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, an incredible tale of back pain and its treatment, published last May.
The big takeaway: Millions of back patients like Ramin are floundering in a medical system that isn’t equipped to help them. They’re pushed toward intrusive, addictive, expensive interventions that often fail or can even harm them, and away from things like yoga or psychotherapy, which actually seem to help. Meanwhile, Americans and their doctors have come to expect cures for everything — and back pain is one of those nearly universal ailments with no cure. Patients and taxpayers wind up paying the price for this failure, both in dollars and in health.
Thankfully, Ramin finally discovered an exercise program that has eased her discomfort. And to this day, no matter how busy her life gets, she does a series of exercises every morning called “the McGill 3” (more on them later). “With very rare exceptions,” she says, “I find time to exercise, even when I’m on the road.”
More and more people like Ramin are seeking out alternative therapies for back pain. While yoga, massage, and acupuncture have been around for a long time, there was little high-quality research out there to understand their effects, and doctors often looked down on the practices. But over the past decade, that’s changed.
To learn more, I searched the medical literature on treatments for lower back pain (the most common type) and read through more than 80 studies (mainly reviews of the research that summarized the findings of hundreds more studies) about both “active” approaches (yoga, Pilates, tai chi, etc.) and passive therapies (massage, chiropractics, acupuncture, and so on). I also talked to nine experts and researchers in this field. (For more detail on our methods, scroll to the end.)
What I found surprised me: Many of these alternative approaches really do seem to help, though often with modest effects. But when you compare even those small benefits with the harm we’re currently doing while medically “treating” back pain, the horror of the status quo becomes clear. “No one dies of low back pain,” one back pain expert, University of Amsterdam assistant professor Sidney Rubinstein, summed up, “but people are now dying from the treatment.”
Mainstream medicine has failed people with chronic back pain
Lower back pain is one of the top reasons people go to the doctor in the US, and it affects 29 percent of adult Americans, according to surveys. It’s also the leading reason for missing work anywhere in the world. The US spends approximately $90 billion a year on back pain — more than the annual expenditures on high blood pressure, pregnancy and postpartum care, and depression — and that doesn’t include the estimated $10 to $20 billion in lost productivity related to back pain.
Doctors talk about back pain in a few different ways, but the kind most people (about 85 percent) suffer from is what they call "nonspecific low back pain." This means the persistent pain has no detectable cause — like a tumor, pinched nerve, infection, or cauda equina syndrome.
About 90 percent of the time, low back pain is short-lived (or in medical lingo, “acute”) and goes away within a few days or weeks without much fuss. A minority of patients, though, go on to have subacute back pain (lasting between four and 12 weeks) or chronic back pain (lasting 12 or more weeks).
Chronic nonspecific back pain is the kind the medical community is often terrible at treating. Many of the most popular treatments on offer from doctors for chronic nonspecific low back pain — bed rest, spinal surgery, opioid painkillers, steroid injections — have been proven ineffective in the majority of cases, and sometimes downright harmful.
Consider opioids. In 2017, more than 30,000 Americans will die from opioid overdoses. Opioid prescribing is common among people with back pain, with almost 20 percent receiving long-term opioid prescriptions.
Here’s the outrageous part: All these opioids were being prescribed before we actually knew if they helped people with chronic lower back pain. It gets worse: Now high-quality evidence is coming in, and opioids don’t actually help many patients with chronic low back pain.
This soon-to-be-published randomized controlled trial was the first to compare the long-term use of opioids versus non-opioid medications (such as anti-inflammatory drugs and acetaminophen) for low back pain. After a year, the researchers found opioids did not improve patients’ pain or function, and the people on opioids were actually in slightly more pain compared to the non-opioid group (perhaps the result of “opioid-induced hyperalgesia” — heightened pain brought on by these drugs).
As for surgery, only a small minority of patients with chronic low back pain require it, according to UpToDate, a service that synthesizes the best available research for clinicians. In randomized trials, there was no clinically meaningful difference when comparing the outcomes of patients who got spinal fusion (which has become more and more popular in the US over the years) with those who got a nonsurgical treatment.
Steroid injections for back pain, another popular medical treatment, tend to have similarly lackluster results: They improve pain slightly in the short term, but the effects dissipate within a few months. They also don’t improve patients’ long-term health outcomes.
It’s not entirely surprising that the surgeries, injections, and prescription drugs often fail considering what researchers are now learning about back pain.
Historically, the medical community thought back pain (and pain in general) was correlated to the nature and severity of an injury or anatomical issue. But now it’s clear that what’s going on in your brain matters too.
“Our best understanding of low back pain is that it is a complex, biopsychosocial condition — meaning that biological aspects like structural or anatomical causes play some role but psychological and social factors also play a big role," Roger Chou, a back pain expert and professor at Oregon Health and Science University, summarized.
For example, when you compare people with the same MRI results showing the same back injury — bulging discs, say, or facet joint arthritis — some may experience terrible chronic pain while others report no pain at all. And people who are under stress, or prone to depression, catastrophizing, and anxiety tend to suffer more, as do those who have histories of trauma in their early lives or poor job satisfaction.
The awareness about the role psychological factors play in how people experience pain has grown more widespread with the general shift away from the dualist view of the mind and body toward the more integrated biopsychosocial model. Chronic nonspecific low back pain “should not been considered as a homogenous condition meaning all cases are identical,” researchers in one review of the research on exercise cautioned.
A new understanding of pain called “central sensitization” is also gaining traction. The basic idea is that in some people who have ongoing pain, there are changes that occur between the body and brain that heighten pain sensitivity — to the point where even things that normally don’t hurt are perceived as painful. That means some people with chronic low back pain may actually be suffering from malfunctioning pain signals.
Enter alternative therapies for chronic back pain
Despite the clear risks, doctors have continued to prescribe painkillers, and perform surgeries and injections, sometimes to patients who won’t take no for answer or who can’t afford to try alternatives (which usually aren’t covered by insurance plans).
Slowly, though, the tide is shifting.
Medical societies and public health agencies are now advising doctors to try less invasive options and even alternative therapies such as acupuncture before considering opioids or surgery.
Most recently, in February 2017, the American College of Physicians advised doctors and patients try “non-drug therapies” such as exercise, acupuncture, tai chi, yoga, and even chiropractics, and avoid prescription drugs or surgical options wherever possible. (If the non-drug therapies fail, they recommended nonsteroidal anti-inflammatory drugs as a first-line therapy, or tramadol or duloxetine as a second-line therapy before opioids.) In March 2016, the Centers for Disease Control and Prevention also came out with new guidelines urging health care providers to turn to non-drug options and non-opioid painkillers before considering opioids.
At the same time, research has mounted suggesting alternative therapies (acupuncture, massage, spinal manipulation) can be effective — with the caveat that they’re often no panacea and the effects tend to be short-lived and moderate.
But most of the alternatives also carry little or no harm (except to patients’ pocketbooks) — which makes them all the more appealing amid the historic drug crisis.
“We have a slew of modalities and procedures that the American College of Physicians cannot endorse — such as opioids, fusion surgery, such as injections,” Ramin said, because there’s now so much evidence of ineffectiveness or harm. “So all those things are off the table, and now they are looking for things they can endorse that will not cause harm.”
Moving is probably the most important thing you can do for back pain
When back pain strikes, your first instinct may be to avoid physical activity and retreat to the couch until the pain subsides.
But doctors now think that in most cases, this is probably the worst thing you can do. Studies comparing exercise to no exercise for chronic low back pain are consistently clear: Physical activity can help relieve pain, while being inactive can delay a person’s recovery.
Exercise is helpful for a number of reasons: It can increase muscle strength, which can help support the spine; It can improve flexibility and range of motion in the back, which can help people’s functional movement and get them back to their normal living; it can boost blood flow to the soft tissues in the back, which promotes healing and reduces stiffness.
Researchers in this 2016 review of the research on exercise for chronic nonspecific low back pain summarized exercise’s range of benefits, including these pretty amazing findings:
“Aerobic exercise for 20 min on a cycle ergometer at 70% peak oxygen uptake reduced the pain perception for more than 30 min for patients with [chronic low back pain].”
“Improving the flexibility of the lumbar spine and hamstrings can significantly reduce [chronic low back pain] by 18.5%–58%.”
“Core stabilization programs have been shown to significantly reduce [chronic low back pain] by 39%–76.8%, and a muscular strength program significantly reduced [back pain] by 61.6%.”
Those researchers suggested that a combination of exercises — strength training, aerobic exercise, flexibility training — may be most helpful to patients, and that there seemed to be no clear winners among the different approaches but that each had its own benefits.
“My general take,” Chou said, “is that all [exercise types] seem to work.” If people find a program they like and stick to it, he added, they’ll probably see benefits not only with their back but with their overall health and sleep patterns, too.
To be clear, this doesn’t mean you should play full-contact sports like football or hockey with a bad back, and exercise doesn’t always help with those short-lived acute episodes. But if you have chronic back pain, you’ll want to find ways to work through the pain and keep active. Next, we’ll turn to some more specific exercises that are popular (and well studied) for back pain.
Yoga, Pilates, and tai chi seem to help — but it’s not clear that they’re any better than other exercise
There’s lots of research on back pain and yoga. Not all of it is high-quality, but taken together, the evidence pretty uniformly suggests yoga can both decrease pain and improve back-related function. (You can read more about yoga’s health benefits — and the difficulties of studying the practice — in this Show Me the Evidence.)
The most recent Cochrane systematic review on yoga and chronic low back pain, published in 2017, sums up the results of the best available studies, which mostly focused on the Iyengar, Hatha, or Viniyoga forms of yoga:
There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance.
So again, this isn’t an end-all treatment — but the evidence we have points in the direction of a benefit.
Importantly, the review authors also noted that it’s not clear whether yoga is better than other exercises, since there were few head-to-head comparisons tracking yoga against other kinds of workouts.
As for tai chi and Pilates, the Agency for Healthcare Research and Quality (AHRQ), a federal agency that crunches the best available data on the effectiveness of health care interventions, recently published a comprehensive 800-page systematic review of research on noninvasive treatments for low back pain, including these two kinds of exercises. It found tai chi seemed to reduce chronic back pain and help people return to their daily activities when compared with no exercise, and that it was more effective in alleviating pain than backward walking or jogging but not necessarily better than swimming.
For Pilates, the evidence was a little more mixed: It was associated with small or no effects on pain and no effects on function compared with other types of exercise. Again, though, pretty much every back expert I spoke to said any exercise is better than no exercise, so if Pilates is something you enjoy, do it.
Try to find a “back whisperer,” or try these three exercises from one
Ramin, the journalist and author of Crooked, makes a compelling argument for seeking out a specialist who deeply understands the back to tailor an exercise program that targets your specific pain.
These “back whisperers” come from many different backgrounds: doctors of physical therapy with an orthopedic clinical specialist certification, personal trainers with a degree in exercise science, physical therapists.
“They are able to observe how you walk and sit and stand, and grasp what your posture and gait say about your muscles, tendons, and ligaments,” she writes in Crooked. “Generally, they focus on functional training, prescribing exercise regimens that are ‘non-pain-contingent’ (you don’t stop when it hurts, sorry), ‘quantitative’ (you will not be allowed to quit until you hit your ‘number’), and ‘high-dose’ (you will do this routine on a schedule rather than when the spirit moves you).”
One renowned “back whisperer” is spine biomechanic Stuart McGill, of the University of Waterloo in Canada, who has treated everyone from Olympic athletes to professional football players. He spends several hours watching his patients move, and identifies the specific motions, postures, and loads that trigger their back pain. He then tailors exercise programs that build a foundation for pain-free activity, so that those triggers no longer result in pain. (He’s also written a popular book, Back Mechanic, which walks readers through his process — an approach based on decades of research at his spine biomechanics lab and clinic at the University of Waterloo.)
McGill has a set of spine-stabilizing exercises — the McGill Big 3, which Ramin does daily — based on research in his lab that are targeted at people with chronic back pain.
It can be difficult to find someone with the expertise of a back whisperer like McGill, and their time can also be costly. There’s also no study that brings together research on these folks, but if you can find a good one who works for you, your back pain could be improved.
We’re learning how much back pain is mental, and that mind-body approaches can help
So where does physical therapy — usually a combination of guided exercises, mobilization, superficial heat or cold, and health advice — fit into the back pain treatment picture?
In AHRQ’s read of the evidence, it didn’t seem to work better than simple advice to remain active when it came to reducing pain and improving function. (The researchers I talked to said this lack of effect may be because of the variability in physiotherapy approaches and programs, and the difficulty in coming to clear conclusions about the variety of programs on offer.)
Nowadays, though, there are also several different kinds of physical therapies that also integrate psychotherapy or cognitive behavioral therapy, often called multidisciplinary rehabilitation.
Multidisciplinary rehab takes the “biopsychosocial” view of back pain — again, that the pain arises from the interplay of physical, psychological, and social factors. It can of course be tricky to disentangle whether mood disorders like anxiety or depression contribute to people’s pain, or whether they arise out of the pain, but either way, the biopsychosocial model views the physical as only one part of the equation. So these practitioners deal with what’s going on inside the head as part of their back pain therapy — helping patients get treatment for their depression or anxiety, or guiding them through cognitive behavioral therapy to improve their coping skills.
Perhaps not surprisingly, multidisciplinary therapy appears to work slightly better than physical therapy alone for chronic back pain in both the short and long term. Patients who get these more holistic treatments are also more likely to return to work.
Spinal manipulation by chiropractors works about as well as exercise or over-the-counter drugs — with some big caveats
Passive therapies can also play a role in helping people manage back pain, though there’s no silver bullet among them, and their effects also tend to be modest and short-lived. The research base for these alternative therapies is also generally weak: There’s a lot of variability among the practice styles and programs on offer, even within one category of treatment like massage. You also can’t blind the patients to the treatment they are receiving, and the people who seek out particular therapies — acupuncture, massage — are probably more amenable to them, which may bias the results. With that said, here’s what we know.
Spinal manipulation, the cranking and tweaking on offer when you visit a traditional chiropractor, is among the most popular approaches to back pain. Practitioners lay their hands on the patient and move their joints to or beyond their range of motion — a technique that’s often accompanied by a pop or crack.
There is some evidence the approach can help people with chronic back pain — but not any more than over-the-counter painkillers or exercise, and you need to take precautions when seeking out a chiropractor.
First, a quick look at the evidence. There are two recent Cochrane reviews on spinal manipulation for low back pain: one focused on people with acute (again, episodic/short duration) pain and the other on chronic pain. The 2011 review on chronic low back pain found that spinal manipulation had small, short-term effects on reducing pain and improving the patient’s functional status — but this effect was about the same as other common therapies for chronic low back pain, such as exercise. That review was published in 2011; UpToDate reviewed the randomized trials that have come out since — and also found that spinal manipulation delivered modest, short-term benefits for chronic back pain sufferers.
The Cochrane review on acute pain found that spinal manipulation worked no better than placebo. So people with a short episode of back pain should probably not bother seeing a chiropractor.
“Based on the evidence,” University of Amsterdam assistant professor Sidney Rubinstein, who is the lead author on the Cochrane reviews, told me, “it would appear [spinal manipulation] works as well as other accepted conservative therapies for chronic low back pain, such as non-prescription medication or exercise, but less well for patients with acute low back pain.”
As a chiropractor himself, he had some advice for patients: They should avoid chiropractors who routinely make X-rays or do advanced diagnostics for low back pain because this adds nothing to the clinical picture, particularly in the case of nonspecific low back pain. Patients should also beware chiropractors who put them on extended programs of care.
“Patients who respond to chiropractic care traditionally respond rather quickly,” he said. “My advice is those patients who have not responded to a short course of chiropractic care or manipulation should consider another type of therapy.”
While the risks of serious side effects from spinal manipulation for back pain are rare — about one in 10 million — the risks associated with chiropractic therapy for neck pain tend to be slightly higher: 1.46 strokes for every million neck adjustments.
The issue is the vertebral artery, which travels from the neck down through the vertebrae. Manipulating the neck can put patients at a higher risk of arterial problems, including stroke or vertebral artery dissection, or the tearing of the vertebral artery (though Rubinstein noted that people in the initial stages of stroke or dissection may also seek out care for their symptoms, such as neck pain, which makes it difficult to untangle how many of health emergencies are brought on by the adjustments).
The results on massage are mixed — but it’s also pretty harmless
In general, massage therapists work by manipulating the muscle and soft tissue of the back and body. There are many, many different styles of massage: Swedish, deep tissue, sport, myofascial release, Thai, the list goes on. Massages also vary in how long they last, how much pressure is used, and how frequent sessions are, which makes the evidence for massage pretty difficult to interpret.
But there’s good news here: Massage is pretty harmless, and the researchers who study back pain say the approach makes sense from a pain relief perspective. So it may be worth trying.
According to AHRQ, for subacute (lasting between seven and 12 weeks) and chronic low back pain, massage seems to improve symptoms and function in the short term (i.e., one week) — but there’s no evidence that it leads to any long-term change. At best, you’ll get a bit of immediate relief, but nothing lasting.
The Cochrane systematic review on massage for low back pain looked at 25 trials on massage and, like AHRQ, found short-term improvements in pain and function for both subacute and chronic low back pain but a very mixed evidence base.
Acupuncture seems to help too, though it’s more controversial
One of the oldest approaches to back pain is acupuncture, a core part of traditional Chinese medicine. The philosophical underpinning of acupuncture is that disease or pain in the body is the result of imbalances between the body’s “yin and yang forces.” “Vital energy circulates throughout the body along the so-called meridians, which have either Yin or Yang characteristics,” the Cochrane authors explain. Using needles to stimulate the parts of the body that are located on these meridians can modulate pain or reverse disease, practitioners claim.
A 2005 Cochrane review looked at the evidence for acupuncture and low back pain and came to a few useful conclusions: There was “insufficient evidence” to make any recommendations about acupuncture for acute low back pain — so it may or may not help people. For chronic pain, acupuncture seemed to offer more pain relief when compared with no treatment or sham acupuncture (when practitioners use needles that don’t actually penetrate the skin). The needling also improved function in the short-term when compared with no treatment for chronic pain sufferers. But acupuncture was not more effective than other treatments.
UpToDate looked at more recent research and noted that the studies on acute pain were still limited, and that evidence for acupuncture’s effects on chronic pain is somewhat conflicting. The review also noted it was unclear whether acupuncture’s benefit lies in the needling, or in the placebo effect.
The author of the Cochrane review, Andrea Furlan, pointed to a more recent randomized trial, which came out in 2009 after her review was published: It also found that acupuncture seemed to reduce chronic low back pain — but it didn’t seem to matter where the needles were placed, raising questions about the meridian philosophy guiding the practice.
This is what makes acupuncture controversial. Science suggests it might work — but the squishiness of the findings, combined with the lack of scientific underpinning in acupuncture’s philosophy, leaves room for interpretation. And evidence-based medicine thinkers and skeptics view the results of studies as suggestive of nothing more than acupuncture’s potent placebo effect.
Researchers have found that the more dramatic the medical intervention, the stronger the placebo effect. And getting poked all over the body by needles is a pretty dramatic intervention. (See this classic study comparing water injections with sugar pills for migraines, as well as Vox’s placebo explainer by Brian Resnick.) That’s not to mention you can never run a double-blind placebo — the gold standard in health research — on acupuncture, since that would involve both practitioners and patients not knowing (or being blinded to) what treatment they are giving and receiving.
We need make our default choices more back- (and health-) friendly
There’s a pretty simple adage public health officials stick to: Make it easy for people to stay healthy, and make it hard for them to get sick.
When it comes to back pain in America, we make it easy for people to get sick and hard for them to stay healthy.
There’s a complete disconnect between what insurance providers will cover for people and what actually helps their back pain. It’s still much easier to get your opioids or back surgery paid for by your insurance provider than to get a massage or exercise program reimbursed.
More states need to move in the direction of places like Oregon, where insurance payers are making the default options for people with back pain healthier by expanding access to, and coverage for, non-drug options.
For example, the Oregon Health Plan (the state’s version of Medicaid, federally funded health insurance for the poor) has ensured that alternatives like acupuncture and physical therapy are covered. It’s also expanded access to treatment for the behavioral health factors that are associated with back pain (such as depression and anxiety) by paying primary care clinics extra to be able to hire behavioral health specialists and meet patients who may not have had access to those services. Finally, it’s opened non-medication pain clinics, where people with low back pain can get a range of treatments as well as help to taper off their opioid prescriptions.
Amit Shah, the chief medical officer at CareOregon (one of the insurance companies administering the Oregon Health Plan), said they decided to move in this direction in the face of the mounting evidence of the harm opioids were causing. “Chronic lower back pain is very prevalent, and we know some people with chronic lower back pain have used opioids for it,” he said. “There’s been a lot of evidence and studies about how opioids are not necessarily the most effective approach, while other medical interventions are effective.”
This knowledge, along with “the continual realization that patients deserve more than a prescription that doesn’t necessarily work,” Shah said, pushed Oregon to experiment with a new benefit structure that might actually help people. “We’re trying to expand the options instead of limiting choice only to opioids.”
Officials in Oregon haven’t yet determined the cost of this new scheme, but opioid prescriptions are already down. Shah also said he’s confident that the measures are bound to reduce the cost burden overall, since alleviating pain can help people can get back to work and bring down the numbers of opioid deaths. If only other states would follow Oregon and take back pain this seriously.
*A note on the methods for this installment of Show Me the Evidence
There’s a mountain of research on low back pain. (Entering the term in the PubMed search engine turned up more than 31,000 results.) So I zeroed in on the highest-quality evidence: systematic reviews. (These are syntheses of the research evidence that bring together all the highest-quality studies to come to more fully supported conclusions.)
I found the Agency for Healthcare Research and Quality (AHRQ), a federal agency that crunches the best available data on the effectiveness of health care interventions and had recently (February 2016) published a comprehensive 800-page systematic review of research on noninvasive treatments for low back pain. The AHRQ review covered 156 of the best back pain studies from 2008 to April 2015. I then searched for low back pain–related systematic reviews on PubMed Health, the government search engine that specializes in systematic reviews and meta-analyses, to cover the recent period left out of the AHRQ review (from May 2015 to the present, July 2017).
To make sure I wasn’t missing anything, I consulted the chronic and acute low back pain articles on UpToDate, (a service that synthesizes the best available research for clinicians), the Cochrane Library of systematic reviews, and guidelines.gov, and sometimes followed the footnotes in these reviews to other studies. Ramin’s book Crooked was also an excellent source for thinking on back pain. Finally, I conducted interviews with nine back pain doctors and researchers, including authors of many of the systematic reviews referenced here.
Editor: Eliza Barclay
Graphics: Javier Zarracina
Copy editor: Tanya Pai
Project manager: Susannah Locke
Special thanks: Mohsin Ali for research assistance and Hilda Bastian for advice on searching the medical literature.
What is it about eric chou that has such a chokehold on kpop idols if a kpop idol covers a mandarin song its always one of three eric chou songs. I really dont get it his songs are so boring