The first and most important thing is that I want to honor the experience and perspective of the person who has described life on the ward as very different from that portrayed in my tribute to Dean. Actually I think Dean would too. Evidence for that is the fact that the forward to the book Ward 81 is dedicated to him and Milos Forman. The reason for that was that he fully supported allowing the photographer access to the unit. To me this is a sign of a superintendent who did not want a coverup but instead wanted whatever was going on there to literally be pictured. I know too that he required full consent for the pictures to be taken and approved by the patients or guardians according to legal and ethical requirements. The state hospital museum which Dean was very directly involved in establishing includes information about the project and book. Life and cultures in institutions are complex mixes of systems and have many risks. That was in many ways the main message in One Flew Over the Cuckoo’s Nest. The elements of these risks come from individual motivations, societal expectations and leadership. This is why honoring the experiences of all, especially patients who have been there, is of critical importance. Not everything that happens in a state hospital is in accordance with the vision of people like Dean. I know this personally too from my years of responsibility for everything from the state hospitals to gambling addiction prevention. There are many things I wish I would have investigated and should have done differently. I am certain Dean would agree if we could ask him. So I respect and honor the experience she describes so articulately.