What Healthcare Can Learn From Farting on Danny DeVito
The Creators of South Park on Crafting Great Stories
As the creators, writers, producers and stars of the iconic animated series South Park, Trey Parker and Matt Stone have made a habit of taking a dump on beloved celebrities. And so, Danny DeVito should consider himself lucky.
They take an iconoclastic approach to comedy, so it shouldn’t surprise that, shortly before Parker and Stone first hit the big time, their preferred pastime was to scour Hollywood’s favorite hang-outs for celebrities, pick a target and then take a picture of themselves farting on the star. Sadly for film and TV legend DeVito, he got the worst of their antics, seeing as his face is unfortunately butt-height.
Back in 1998, with South Park fresh into its second season, Parker and Stone appeared on Dennis Miller Live where they fielded a serious question from their host. “Does it scare you that you might become the people that you made fun of at the beginning?” Miller asked his guests of their newfound success.
Parker answered with a story:
“When we came to L.A., we were such losers, like, our favorite thing to do was to go to bars and try to find someone famous, and fart on them, and get a picture of it.” Among their esteemed flatulence fatalities was Jaws star Richard Dreyfuss, whom Stone crop-dusted at a party. “The best was Danny DeVito,” Parker revealed, then commenting on the distinguished actor’s diminutive stature. “Because he’s just right there at my ass level!
Fast forward about 20 years, when in 2021, Parker and Stone signed a deal with Comedy Central, reportedly for around $900M, to extend South Park through a Season 30, running until 2027. They’re also currently in the middle of negotiating with Warner Bros. Discovery and Netflix to bring their form of “strategic transformation” and status quo “disruption” to one of these platforms…..reportedly for around $2.5 billion.
Writes the Hollywood Reporter on the self-producing economic system sparked by Parker and Stone: with its massive library of more than 300 episodes, South Park was the 20th most-streamed series in the first half of 2025 even when it wasn't releasing new episodes. Season 27 viewership jumped 638% over the previous season in the U.S. alone. The cash keeps flowing because the storyline keeps compounding.
Japan Launches “New Innovation Ecosystem”
Japan, the third-largest drug market in the world by sales ($71.5 billion in 2024) last summer launched a high-level council to "address structural challenges in its drug discovery ecosystem" amid growing concerns over drug lags and losses and mounting calls from the global pharmaceutical industry for greater policy stability.
The inaugural meeting of the Public-Private Council for Enhancing Drug Discovery Capabilities was held on June 26, 2025, at the Prime Minister's Office, bringing together 30 key stakeholders including pharma trade groups, domestic and foreign venture capital firms and government ministries. Three main topics: strengthen drug discovery capabilities, ensure timely patient access to the latest medicines, and create a sustainable social system that supports a virtuous cycle of investment and innovation.
Then Japan changed prime ministers.
Sanae Takaichi took office in October 2025, the first woman to hold the job. She won an LDP landslide of historic proportions. She brought a security-hawk worldview, a top-down leadership style that one observer described as micromanaging to the point of skipping meals and sleep, and an economic agenda heavy on strategic investment and AI sovereignty. By December, the joint statement from PhRMA, EFPIA and JPMA was already pivoting to address "the new Takaichi Cabinet's investment agenda." The U.S. Most-Favored-Nation drug pricing policy, which references Japan's prices, was reshaping global incentives and leading individual companies to change product development and launch strategies in Japan.
So the ecosystem council that Ishiba launched is now operating under a different political physics. The structural problem, though, hasn't changed.
The thing that's not working is the narrative layer. Or more precisely a fragmentary worldview, now trying to break the hold of a massive feedback loop sustaining The Standard Model. You can't invent the automobile if you're trying to "fix" the horseless carriage.
The NHS Reimagination, Now With a Workforce Plan
Meanwhile, the "biggest reimagining" of the NHS since it was founded in 1948 arrived on July 4, 2025, as "Fit for the Future," the 10 Year Health Plan for England. The three structural shifts: hospital to community, analogue to digital, treatment to prevention. A "Neighbourhood Health Service" will put pioneering teams in local communities. The NHS App will become the "full front door" to the entire system by 2028. The word "innovation" appears 122 times in the document.
The senior NHS writing team was reshuffled in May after early versions of the document were rejected for being too bland. "It just wasn't sexy enough," one source said.
Since then the plan has acquired a Medium Term Planning Framework running through 2028-29, a promise to approve the first new Foundation Trusts in 2026, the concept of "integrated health organisations" that manage entire local healthcare budgets, and a forthcoming 10 Year Workforce Plan due this spring. The BMA published a 78-page critique. Campaigners raised alarms about "technosolutionist quick fixes." One analysis noted that "reform of this type, and on this scale, has not been delivered previously."
The NHS Plan mentions innovation 122 times. It uses the word "neighbourhood" like a mantra. It promises a £29 billion real terms increase in day-to-day spending over three years. And yet the architecture of the language is the same architecture that produced the last ten-year plan, and the one before that. The plan says "earned autonomy" and "strategic commissioning" and "outcome measures" and "shadow set" and "model neighbourhood framework." It is the linguistic equivalent of rearranging the hospital waiting room furniture.
Sort of like the United States.
Back in June 2025, RFK Jr. told the House Subcommittee on Health that wearables are key to the MAHA agenda. His vision: every American wearing a health tracker within four years. Ozempic costs $1,300 a month; an $80 wearable can achieve the same thing, he said. He promised one of the biggest advertising campaigns in HHS history. Then people pointed out that his Surgeon General nominee co-founded a company that sells continuous glucose monitors, and that the MAHA base was already splintering over data privacy. Within weeks Kennedy walked back the universal mandate framing.
An entire corpus of content floats around the ether, making happy-to-glad edits in the PowerPoints, doing and saying the done thing, the words powerless to cut through the vapidity of it all.
Call it Vibe Coding
Donald Trump's inclination to swear is coarse, un-presidential, and highly effective, writes Jemima Kelly in The power and the glory of profanity, her short opinion burst for the Financial Times. She contrasts Keir Starmer's anodyne response to the Israel-Iran strikes with Trump's: "We basically have two countries that have been fighting so long and so hard that they don't know what the fuck they're doing."
By breaking free of the usual constraints of polite political language, Trump demonstrated how significant he considered the moment. By showing real passion and emotion, he brought humanity to a subject often treated as a globe-sized game of chess.
Japan's latest ambition is small bore because it is boring, the storyline is unremarkable. The ecosystem vision is bounded too narrowly, framed around the "drug market" alone and in isolation from the infinitely-expanding galaxy of other markets that add "value" to value-based healthcare. And now it has a new prime minister whose defining instinct is control, not emergence. Takaichi's micromanagement style is the opposite of what ecosystem genesis requires. You don't build a self-organizing network by insisting on approving every node.
Its strategic goals are too restricted.
Missing is the fresh take using new language, an energized narrative that makes incendiary impact, a different theory around which to build and operate an empowering network that is strategically unique, has better "gravitational pull" than its peer competitors. And in the process of becoming a new industry ecosystem ("ecosystem genesis"), win new subscribers with integration schemes that deliver what citizens most desire: predictable and unhindered access to goods and services.
When they started out, Stone and Parker knew how to make shows that were funny and shocking. Now they're worth $1.5 billion to a single platform because they became two of television's best storytellers. Not long ago, they surprised a screenwriting class at NYU to offer some writing advice, the blueprint that took South Park from crude to award-winning crude.
Parker explains:
Each individual scene has to work as a kind of funny sketch. You don't want 1 scene that's just like, well, what was the point of that scene? We found out this really simple rule that maybe you guys have all heard before, but it took us a long time to learn it. But we can take these beats, which are basically the beats of your outline, and if the words "and then" belong between those beats, you're f***ed, basically.
You got something pretty boring. What should happen between every beat that you've written down is either the word "therefore" or "but", right? So what I'm saying is that you come up with an idea and it's like, OK, this happens, right? And then this happens. No, no, no, it should be this happens, and therefore this happens.
South Park keeps getting funnier and more relevant and more interesting because its creators and writers know how to construct a coherent, provocative story where all the scenes come together in a tight rhythm of intentional crudeness, much like Trump's communications strategy. (The show is done almost entirely in-house by Parker, Stone and a small staff of about 70 people. There is enough computer animation technology in the studio to remake Finding Nemo. But early on they hired a software consultant to make the computers "retarded," as one South Park veteran put it, so that shows would have the same homemade look as the crude cartoons Parker and Stone made in college with construction paper and scissors.)
Applying the South Park method to change the beat of Japan's ambition:
"We ask all stakeholders to explore continuous investments in making Japan a hub for drug discovery" to therefore position the production of cardiometabolic health as the real wealth of nations.
Now apply the method to the NHS:
"We will deliver three shifts — hospital to community, analogue to digital, treatment to prevention" but we have no narrative engine that makes any of this feel inevitable, desirable, or worth fighting for.
Now apply it to the MAHA agenda:
"Every American wearing a wearable within four years" but the data goes to companies with no HIPAA obligations and the Surgeon General nominee has a financial interest in the outcome, therefore the storyline collapses before it compounds.
A New Narrative Layer
Nearly all healthcare content today is irrelevant. Not from the lack of output and insights, but because of it. It isn’t interesting. It doesn’t motivate. It doesn’t inspire or excite.
Regardless the industry, and the economic subsystem of vendors and advisors an industry uses to create and innovate and figure out where to go for growth, 'commercial model innovation' ultimately comes down to telling and selling a new strategy story. It is cast with unique characters in different combinations and collaborations that create space for tension and fresh dialogue.
Anu Atluru from her Substack Media and Machines:
“We are no longer designing just products or platforms or interfaces, but cognitive environments — architectures of attention that shape what people see, feel and believe. Every engineering decision is now a cultural act. Every narrative choice carries technical consequences. The stakes have risen beyond business or tech to configuring the operating system of human attention itself.”
If technology yields a flat playing field, then new power flows from a whole new taxonomy for creative leadership, a different narrative layer that animates big system strategy, therefore improving political and economic offerings (as well as the careers of this offering them).
Like the cliché-powered opus of digital transformation the writing team at NHS is struggling to craft, Japan’s Big Ambition “that all stakeholders explore continuous investments in making Japan a hub for drug discovery” doesn’t energize because it doesn’t unearth a unique throughline, different words to cut through the vapidity of it all.
It could use a few farts and F-bombs.
/ jgs
John G. Singer is the founder and Executive Director of Blue Spoon and the author of When Burning Man Comes to Washington: A Field Manual for Riding Chaos. Hardcore Zen is published weekly on Substack.