Walter Geer III’s social media feeds, normally abuzz with thoughtful commentary, had gone largely quiet. The usually effusive Geer similarly went unseen at VML, which had promoted him to chief creative officer, innovation, North America, in January.  Known for being extremely accessible to anyone aspiring to break into or climb the ladder in advertising, Geer didn’t take a single call.

There was a good reason why: For almost three weeks earlier this year, the 2024 MM+M Healthcare Marketing Influencer 25 inductee was unplugged in the wake of a life-threatening stroke.

“I’m in a good place — better, you know?” Geer said when MM+M caught up with him in May, a few short weeks after the incident. 

Alteplase, the clot buster sold by Genentech under brand name Activase, was administered — in the nick of time, as it turns out — to dissolve the clot and restore normal blood flow. Still, the stroke was labeled “cryptogenic,” or of unknown origin. 

Geer remained in the intensive care unit for several days, during which tests confirmed the cause: A hole in his heart known as a PFO (patent foramen ovale). Late last month, the 46-year-old underwent surgery to fix it. The procedure to seal the hole was successful — though afterwards Geer suffered from pericarditis, which brought daily bouts of fever and chills so aggressive he said they felt like mini-seizures.

By early June, Geer’s health had returned, as had his irrepressible energy. He participated in a pair of Instagram Lives, during which he compared patient journeys with two friends, and published an op-ed on the connection between stress and stroke.

For Geer, these exercises weren’t merely a cathartic purge. They reflected his altered outlook on the healthcare system as a whole.

“Until you get into these life-threatening kinds of experiences, you don’t really realize how broken and disconnected the entire system is,” Geer noted.

John Duffield, SVP of technology experience for Omnicom’s Wildtype, echoed that sentiment.

“There’s only so many insights, pharma ads and customer journeys we can put together without truly living one and sitting on the other side of that journey,” he said. 

During their hour-long Instagram Live conversation, the two remarked that they’re “lucky to be alive.”

Two timebombs 

Both were seasoned agency execs, with an emphasis on marshaling cutting-edge technology for creative campaigns in healthcare. And both were both walking time bombs. 

A PFO is a hole between the left and right upper chambers of the heart that exists before birth but most often closes shortly thereafter. In about 25% of people, however, the hole stays open.

Many people who have this congenital birth defect don’t discover it until there’s an event such as a stroke. Among them was Teddy Bruschi, the former New England Patriots linebacker. 

“Most PFOs do absolutely nothing, but some do,” said Dr. Paul Thompson, emeritus chief of cardiology at Hartford Hospital in Hartford, CT, and emeritus professor of medicine, University of Connecticut Medical School. 

Duffield, for his part, has an aortic aneurysm, which occurs in five to 10 people out of every 100,000. Similar to a PFO, the condition may go undetected, with symptoms developing slowly over many years or coming on suddenly. 

Duffield was strolling on a beach in Los Angeles, ahead of two days of meetings with colleagues, when he was beset by a debilitating “thunderclap” headache, one which reaches peak intensity in a matter of seconds. It turned out to be a sign of bleeding in the brain. 

Duffield recently underwent open-heart surgery to repair the aneurysm and two other issues: A fusion of two of his aortic valve’s three “cusps,” or flaps meant to ensure that blood flows in the correct direction, and a leaky heart valve. 

As of this writing, he was on the mend. “It’s not until you kind of live your own patient journey firsthand that you truly see it from a perspective that hits home,” he said.

Making up for shortcomings

Their first big realization involved the amount of work required on the patient’s part to compensate for disconnects in the system. 

“I have incredible doctors, some of the best in the world. But the fact that I am having to advocate so much to move faster when they’re thinking, ‘Oh, everything’s fine, don’t worry,’’’ said Geer.

Duffield actually had to drive records from one hospital to another. 

“I had to get my radiology scans from the medical records in the basement of the hospital, and physically drive them myself to the next doctor to get there faster than the courier so I could advocate for myself,” he said.

To make up for these shortcomings, Geer stressed the importance of having an advocate in the room with you. It’s a recommendation mirrored in Advil’s “Believe My Pain” campaign, part of the brand’s Pain Equity Project which Geer spearheaded). For Geer, that person was his wife. 

The night of his stroke, Geer was awakened in the wee hours by the disturbing sensation that he couldn’t breathe, which worsened each time he swallowed. He tried to read an email or two but couldn’t get past the first word. Geer woke his wife to tell her, but all he could muster was some mumbling. 

She quickly surmised he was having a stroke and called 911. At the hospital, she proved more than up to the task of patient advocate. 

“When you’re in one of these moments, it’s hard to grasp everything that’s going on,” Geer said. “There’s just so much detail, things flying left and right, big words. You don’t understand the papers you’re signing. Having someone who is a little bit more coherent, who can be a little more present like a family member or spouse, is massively important.”

AI a ‘lifeline’

Technology can similarly play a big part.

“AI has been my lifeline. It has been literally a key member of my support team,” Duffield noted. “I spent hundreds of hours going deep in it. So when I truly needed it for my own benefit, I was ready.”

Duffield created a custom GPT (generative pre-trained transformer) of his cardiologist, surgeon and neurologist. He then prompted the AI to create a specialists’ summit, having them query each other about his treatment plan. He also created personas of each of those specialists “to basically plan the doctor visit beforehand so I could be ready with questions.”

How did that go? The AI-generated doctors essentially arrived at the same types of scenarios as the real ones.

“AI challenged me and prepared me for where they would likely land ahead of time, so I could ask questions about their recommendations versus ‘Go off and think about it at home for a few days,’” Duffield said. “I felt so empowered, like I was hacking the system and getting the intel ahead of time.”

Through their respective ordeals, both men have also witnessed the tremendous burden shouldered by their families. Here again, Duffield leaned on his AI expertise to help relieve that burden, in this case using it to translate the complexities of his cardiac condition in ways that his children could grasp.

For his seven-year-old son, who’s a basketball fan, Duffield asked for an analogy drawing on Michael Jordan and Magic Johnson. The AI reimagined his leaky heart valve as Jordan shooting a basket and Johnson blocking and swatting it back out. For his daughter, a nine-year-old Swiftie, Duffield asked for an explanation using Swift’s lyrics and trivia. (Duffield summarizes all of the AI tools he’s used here.)

Focus on the caregiver

Geer’s experience led to a realization about the need for industry to direct more of its focus on the caregiver.

“From a marketing point of view, in the pharma space communication from brands is always to an HCP or to a patient,” he observed. “There are a handful of times where we discuss the importance of a caregiver, but it’s never a real focus.”

Now that the two men have gained a fresh perspective, they’re intent on changing the way others view disease.

“It almost makes me want to relive every moment of every patient and doctor journey campaign that I’ve worked on, and ask, ‘Did I approach this thoughtfully enough?’” said Duffield. “The benefit of a lived experience trumps any research, evidence or written narrative that we might come across as marketers.”

Lean on lived experience

The next best thing is to lean on the lived experience of others. Duffield encouraged fellow marketers to “fight tooth and nail” for focus groups with a patient or HCP to be written into the campaign budget. Meanwhile, time spent scouring patient support groups on social media can be rewarding: Duffield found solace in a private group devoted to heart valve surgery. 

Even spending five minutes scrolling a Reddit community can yield firsthand insights, he said. “Anyone can benefit from these firsthand stories and narratives.”

For Geer, it’s the stereotypes around stroke that could use a rethink. “When people think of strokes, they think, ‘Oh, it’s the person that’s obese, the person that doesn’t eat well.’ And it’s so not the case.”

Instead, he stressed the importance of understanding the signs and symptoms of stroke. 

Thompson agreed, adding, “People should know that if they have any trouble controlling their limbs or their speech that they have four-and-a-half hours from the onset to get clot busters. They should get to an emergency room where someone can help them.”

Geer similarly gained a new appreciation of the importance of access. “When we talk about accessibility, healthcare and being able to take care of yourself, what about people who don’t have insurance, who are in between jobs and kind of just juggling?” he wondered.

Culture of stress

Perhaps most personal for Geer, the stroke gave him a heightened awareness of the levels of stress he’d been under at work. Stress creates high blood pressure, which leads to clotting, which can lead to strokes. 

For Geer, the lines between work and home had blurred in the months leading up to his stroke. His schedule consisted of working from 9 a.m. to 6 or 7 p.m, being with his family for a few hours, then logging back onto his computer at 10:30 or 11:00 and collaborating until 3:00 AM. After that, he’d sleep for three hours before waking up and doing it all over again.

“We’ve created an industry where it’s the norm to feel stressed and overwork,” Geer said. “And if you’re not, then it’s like you’re not doing the work. When you start to look around…every executive that I know at an agency is on some type of medication — high blood pressure or whatever.”

This culture, of course, runs counter to the prevailing narrative that the pandemic has allowed us to be more present with our families. 

“Realistically, we’re not, and it’s bullshit,” Geer said. “So what is the price that people are willing to pay for an award that just sits on your desk? Because each time you have a stroke, they say it takes eight to 10 years off of your life.”