The Top 5 Ways Twin Peaks and David Lynch Impacts My Medical Practice and Life In General

Jeremiah L Pamer, DO

11/12/2023

I remember when Twin Peaks, the television show originally aired in 1990. I remember I didn't give a crap. I didn't care about David Lynch and the only art I cared about was what was on the bottom of my skateboard.

Then came some random night, and I can feel the teenage pretentiousness even now, where some (now) faceless young men debated whether the movie Pi or Eraserhead was more in tune with the true nature of the Universe. These were friends of my girlfriend at the time, and they had graduated from college, and were clearly, as I remember it at least, my intellectual superiors and were guiding me to the next realm of art appreciation.

Of course, Eraserhead is an early offering of David Lynch, put forth in 1977 and Pi being a little remembered indy film from 1998. I'm not here to debate any such things, or cast aspersions upon any artist, but Eraserhead felt like a really important film -- like there was something behind the imagery that I needed to know, something that David Lynch just had to tell me.

I now recognize that I have an affinity for the avant-garde -- the 1990's "counter culture" (which was as mainstream as one could get) seeds were planted in me long ago. Even now, I have a simple appreciation for weirdness for the sake of being weird. In my younger years, I think I was always demanding a deeper explanation -- this is part of my life's journey to find the Universal Unified Theory Of Everything that I'm always working on in the recesses of my mind. A theory that tells us everything we ever wanted to know, stuff like:

Why are we here? Who are we? What do I do with this life of mine? Is this just a simulation? Are we just the fleeting flickers of a dying man's dream? Why do I have a knowledge of right and wrong? Why do I enjoy music but my dog doesn't? What happens when I die? Is everyone else really just NPCs? Why are cows? Is love worth dying for?

I've since had lesser demands in terms of what I want from artists I now give a crap about.

Twin Peaks had two seasons in the early 1990's and a film, Fire Walk With Me and then, for 25 years, all was quiet. Then, The Return aired in 2018.

• Number 5

The eighth episode of The Return is on my Mt Rushmore of television episodes. I've written about this episode before. Here is the fastest recap in the West: The evil doppelganger has been sprung from prison and is travelling with a fellow conspirator; when stopping to urinate, the doppelganger tries to kill the other, but the gun has had it's firing pin removed. His accomplice shoots the doppelganger but soon thereafter, mysterious, shadowy men come out of the woods and start smashing the doppelganger and ceremoniously dancing around the body. The shooter flees in terror. Then, Nine Inch Nails plays at The Bang Bang Bar -- I usually fast forward this part -- sorry Trent Reznor.

The remaining forty or so minutes of the episode serve to explain in fascinating detail, how BOB, a certain force for evil, entered the world -- the splitting of the atom.

The score -- wow: Threnody For The Victims Of Hiroshima (with Warsaw National Philharmonic Orchestra) and it goes on after this clip. There really is something so disturbing about this music, just as it is disturbing to imagine being in Hiroshima, on a Sunday morning, when the gates of hell open from above.

In my undergrad years I had to take a lot of chemistry and biology courses. You're shocked, I'm sure. A number of the chemistry courses were taught by -- well, I am trying to remember his name, and in an effort to do so I was just on the University's website and I didn't recognize even one of the professors. One cannot step into the same river twice and this river has reshaped itself beyond recognition.

Regardless, this particular professor's area of expertise was biochemistry but he had a passion for all things nuclear. The science. The politics. The humanity. The inhumanity. The philosophy. He taught a course that was loosely based in chemistry and encompassed all things "splitting of the atom" in a historical fashion. From the physicists who first dreamed of such a thing, to nuclear power, medicine and the dangerous and non-paralleled politics that have shaped our world.

Okay -- this guy was really good and a shining example of what a professor, or teacher should aspire to be. His name is coming back to me.

Niels Schonbeck, Ph.D

I found him!

He is teaching at a different University in the Denver area. I'm heartened to see that he is still teaching. He has really done some fascinating research as well, and is very well versed in the Rocky Flats Superfund project and I remember him telling us, as a class, that he would not recommend living on top of such a place. I remember him teaching us about the radioactive aspects of tobacco and to this day, I use this as an example with my patients and why smoking is such a poor idea in terms of overall health.

Surprise. Another side quest diversion -- that's okay. But through him and his efforts I've come to gain an understanding of certain small aspects of our world, and what it means, perhaps, to split an atom. David Lynch tells us that the splitting of the atom, on July 16th, 1945, on a test bombing range known as Jornada del Muerto, in New Mexico, with a project code name of "Trinity," allowed BOB, an evil spirit who we were introduced to in the first season of Twin Peaks, to enter the world.

What is an atom?

One could argue that it is the smallest piece of organization that we are aware of. It is a collection of electrons, protons and neutrons. The simplest atom is hydrogen. Here is a model below.

One proton, which has a positive charge and one electron, that is imagined to be in an orbit around the center. The Trinity test used an atom called plutonium as the target for splitting. Here is the model for that atom.

This world of ours tends towards decay. Decay as we think about it in our natural world, which, at it's essence is the same principle that rules all types of decay -- 'stuff' will tend to lower orders of organization and complexity. My house follows this principle -- the materials if not attended to, that make the structure of this house will decay to a lower level of complexity if interventions are not employed. This is not helped by the fact that we basically live in a 'universal solvent forest' up here in Washington.

Back to the atom. So, in 1945 the most basic structure that is more-than-the-sum-of-it's-parts -- the plutonium atom, was destroyed. Humans have worked to destroy everything that we have ever known. We came to know the basic unit of intelligence in the Universe and we promptly found that destroying this structure would release tremendous suffering, death in multiplicity, and allow for destruction of a whole city in the flash of an eye. Power. To harness this power, to threaten with it, to leverage, to frighten -- this is a level of power that is and remains new to the world.

David Lynch and Mark Frost felt this. In essence, much of the modern story of the Black Lodge and Bob all relate to this first splitting of that particular plutonium atom. Undoubtedly this has brought our world to a different place, a dynamic that has been known (that is, the larger the club to swing, the more power to wield) but on heretofore levels undreamed of.

The 5th most impactful way Twin Peaks has influenced my medical practice is by reminding me that art and life have a synergistic relationship, and that in many ways, the way I view the world is shaped by the art that I love, the stories that I love to read or watch over and over.

And with this story, I'm reminded that the drive of humanity to destroy all we know has always been a dangerous endeavor -- whether it be thyroid cancer from radioactive fallout or allowing BOB to enter the world.

• Number 4

I grew up in Oregon, not that far, really, from the real life setting of Twin Peaks from the television show. The weather and topography very similar, and, one could argue that the population of Portland is more like the fictional Twin Peaks characters are than the demographics around North Bend and the town of Snoqualmie. When I was in residency, The Return aired. It was 25 years after Laura Palmer told us that she would see us again in 25 years.

I remember coming home from a long day in the hospital and watching these episodes. The life of a medical intern is surreal, mysterious and otherworldly enough by itself, but these episodes really accentuated that feeling. Perhaps if I was not so supremely exhausted I would have had more criticism and pushback with the new series, but I really was in a state of acceptance of the show -- I really enjoyed it. I had already been a Lynch fan, but I felt, in a weird (and irrational) way that the show was mirroring my journey and eventual return to the Pacific Northwest -- in this case, to the actual vicinity of these small towns just outside of Seattle.

I had an interview at a clinic in the town of Snoqualmie -- this is while I was still in residency and exploring job options. I may have been foolish to do so, but I generally go with my gut when it comes to these things, but decided to bring up my Twin Peaks fandom and that being a (small and relatively inconsequential) reason why I wanted to join their medical community. I eventually did get an invite to work there, but had made a decision months prior.

The 4th most impactful way Twin Peaks has influenced my medical practice is by tempting me to talk about my love of avant-garde cinema and otherworldly whooshing and electrical static sounds in my movies and television in job interviews. I am what I am. And the owls are not what they seem!

• Number 3

In the second season of Twin Peaks, as the story goes, the network (CBS) really pushed for the the reveal of Laura Palmer's killer to be made known. We indeed do learn that it was BOB working through Leland, Laura's father. And then, shockingly, the rest of the season still needed to be written and filmed. We learn much more about the history of Twin Peaks, and of Dale Cooper, and his sordid past. Of course, we have some side stories that are, at this point, curiosities in the Twin Peaks Universe, so to speak, but at the time, was just terrible television.

The 3rd most impactful way Twin Peaks has influenced my medical practice is by reminding me to not let those without the best interest of the patient dictate the care they receive. Of course I cannot push through every single treatment option denied by the insurance company. But, know this -- the insurance company is pushing for short term results so their share holders and quarterly earnings report is healthy -- and this is often at the expense of our health.

The insurance company wants Laura's killer to be revealed even though it effectively killed the rest of season 2, and the only reason season 2 has any joy in it at all is the content creators fought back and made a weird, unconventional number of television episodes to salvage what the suits wanted. The suits in my life want the same thing -- they want Laura's killer to be found, prosecuted, convicted and sentenced in 15 minutes with the only the cheapest of tools at my disposal.

• Number 2

Laura Palmer, while in high school was dating the high school star quarter back. She was also seeing the "bad-boy-biker" dude, James. She was the Home-coming Queen. She modeled for a fetish magazine and a cocaine addict. She worked for Meals on Wheels and she also worked at One Eyed Jacks, a brothel just over the Canadian border. She had sexual relationships with at least 2 businessmen in Twin Peaks, and she was the victim of sexual abuse from what is most likely a young age.

I am a board certified Family Medicine physician and as such, see all patients, regardless of age, gender or station in life. Sometimes I have to remember what kind of things high schoolers can get up to. I doubt many of my patients have a social life similar to Laura Palmer, but when I do my HEADSS exam, it helps me be open to the possibility of untoward activity and being ready to recognize the signs and helping as one can as a doctor.

The 2nd most impactful way Twin Peaks has influenced my medical practice is by reminding me that my patients (as can we all) need to have a doctor with an open mind and open ears and eyes, too. Catching subtle signs of abuse is an important skill to have, and one cannot be fooled by a glossy exterior.

• Number 1

I have travelled and I have sought beauty in my life. It is one of the reasons that I live where I do. The introduction to the third season has a shot over and past the waterfall and the Snoqualmie valley as it pans north. My house is in the cloud cover in the distance. I can see Mt Si from my backyard on a clear day, which is the mountain implied to be the "twin peak" in the show. I have the fog, the mist, the trees, the hills, the owls and at times, the black or white lodge, or so it feels on any given day as I head to work, pulling at me.

This is a land where moss can and will grow on anything if still for long enough. Moss covers the trees like a thick green sweater. Dale Cooper talks about the trees. Interestingly, the location he gives in his report, would have him north of Spokane, which is a much different landscape, a much drier one without the forests and such that dominate the visual background of the show.

The most impactful way Twin Peaks has impacted my medical practice and my life in general is by allowing me to see the beauty of this land through another's perspective. I can't help but think that David Lynch and Mark Frost were writing a love letter to the towns, forests, rivers, and fauna that live here -- the Native American History -- which I've not even touched upon, plays a role here -- in real life and in the show. A feeling of timelessness with the trees towering above the valley floor, mixed with stark reminders of relatively recent past which had the old growth tree stumps, which would have dwarfed the trees today, nearly decayed and rotting on the hillside. This whole valley was clear cut when the White Man Came. It is growing back, and what is meant for evil by man will turn for good as the divine plan promises, but still, the beauty is but a flickering image of the grandeur of the eons past. These are the things I think about speeding along the valley floor on the way to work. Wouldn't have it any other way.