By BROOKE LEFFERTS

NEW YORK (AP) — Author Mo Willems has sold millions of books and won many awards, but the accolade that means most to him is when a parent says their child read aloud for the first time from one of his books.

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The author, illustrator and animator, 57, is best known for his bestselling picture books like the Caldecott Award-winning “Don’t Let the Pigeon Drive the Bus!” and “Knuffle Bunny.” His latest book, “Will the Pigeon Graduate?” may look like it’s aimed at children, but the titular Pigeon’s fear of failure and an uncertain future are sure to resonate with people of all ages, especially during graduation season.

Willems and his trusty friend The Pigeon (charmingly represented by puppeteer Bradley Freeman Jr.) recently sat down with The Associated Press for an interview about graduating, “Sesame Street,” and the purpose of life. Answers have been edited for clarity and brevity.

AP: How did graduation come to mind for a book topic?

WILLEMS: As I am getting older, which I am, I’m getting into a new part of my life. And I’m wondering, am I equipped to be living in this part of life? And as I ask that question and I don’t have the answers, then I think, well, what is that metaphor that kids are going through? And graduation seemed like the perfect thing. I’m graduating to a new stage in my life, and kids do this all the time. You graduate to tying your shoe. You graduate the first time you read.

THE PIGEON: Like driving a bus.

WILLEMS: Yeah, well, except for driving a bus. That is something you cannot graduate to, if you’re a pigeon, but thank you for contributing to the conversation.

THE PIGEON: Of course.

AP: People may think this is just for graduates, but could it be about any transition?

WILLEMS: I think it’s about asking yourself, “Am I equipped for something that scares me?” The real world is scary. We’re always asking ourselves those questions. And often the answer is … I don’t know. And that’s something that might feel uncomfortable to sit with, but it’s also something that’s very, very exciting. So like right now, I’m doing an interview with you and a giant pigeon. Is this gonna work out? If I’m going to get a little bit philosophical, I would say often we’re trying to give the answers, and I think kids get exhausted from it. I want to give them the questions. I want them to have a chance to live with these questions themselves and work their way into an answer rather than telling them, “Oh, you’ll be fine.”

AP: Mr. Pigeon, what is your favorite part about collaborating on this book?

THE PIGEON: I really like how all of the books are about me. I like how I’m on, like, almost every page. You know, all of these books go through an approval process, and I get sent advanced — I call them screeners, nobody likes when I call them that! — but I get to look at them. And if I’m not on the first page and the last page, it does not get approved.

AP (to Willems): Can you reflect on your nine seasons as a writer and animator on “Sesame Street,” winning six Emmys and helping to develop “Elmo’s World”?

WILLEMS: My love of puppets, my love of sketch comedy, my love of counting to 40 — all these things that I really, really love — came from “Sesame Street”! And when it came time for me to make books, one of the things that I got to do that we didn’t get to do on “Sesame Street” at the time was write about failure. Write about not driving the bus rather than driving the bus. So on one level, it was like going to grad school. I loved it. I learned so much. I met all of these great puppets and puppeteers. On the other, the restrictions of the show allowed me to find my own voice.

AP: Obviously, one of the book’s messages is you have to believe in yourself.

WILLEMS: I don’t know. I’m glad that you think that that’s one of the messages because you brought something to that book. I only write 49% of the book. You put the meaning in the book; if the book is meaningful, that is because you are putting yourself within it. I try not to have messages as much as I can. I really try to live in the question.

AP: Mr. Pigeon, do you think your participation in this makes you a little bit of a philosopher?

THE PIGEON: Yeah, I think there’s a lot of very powerful things going on up here in this little bird brain. There’s a lot of really deep questions, like, I don’t know, can I drive the bus, maybe? You know, wondering maybe if I can stay up late? That would be really great.

WILLEMS: These are all fundamental Greek philosophical questions.

THE PIGEON: And what is the purpose of life?

WILLEMS: What is the purpose of life? Why are we here? Why are people mean? Why are people nice? Can I drive the bus?

THE PIGEON: Can I have a hot dog?

Because I am easily moved by our traditional displays of patriotic fervor, a flag in the breeze, loud fireworks and Air Force One buzzing a stock car race or flying low over Mount Rushmore, I can’t abide our presidential airplane first having belonged to some potentate in Qatar, a country that can’t even settle on a pronunciation of its name.

That is our plane, not the president’s. This is our thing, not a your thing.

We pay for that plane. We fuel it, maintain it and might even indulge in a brief shiver of proprietorship when it flies overhead or lands at our airport, an event I never miss despite my lousy record of missing celestial events.

Don’t take the plane, Donald. It feels wrong. I realize it was made by Boeing, presumably in Seattle, but it was never intended for us. These guys over there who wear robes instead of suits have a different take on aesthetics. That thing might have a statue of Elvis in it, gold bathroom fixtures and thick dark draperies tied off in braided silk that suggest a madam’s place of business.

President Donald Trump said only stupid people would refuse a $400 million gift. He said it was like a favor on a golf course. A player gives you a putt and you accept it with a thank you, Trump said. You’d have to give a putt long enough to circle the Earth to be worth $400 million. Maybe that’s why Trump wins so many club championships and why Vladimir Putin miraculously scores so many goals in a Russian celebrity hockey game. That creep who runs North Korea said his father shot 18 in a round of golf. Pick that one up, boss, it’s good.

This isn’t about a gift or a favor. This is about America retaining some class in the world. Trump is certainly capable of understanding class, but I keep getting the feeling that when he opens his jacket, he has stuff hanging from the liner, watches, coins, maybe a Bible. And it’s all for sale.

Accepting that so-called gift would be like the president of Ford Motor Co. driving a gifted Mercedes or the White House replacing the presidential fleet of Chevrolets, Lincolns and Cadillacs with Audis and Jaguars. Those analogies fall short. Hard to compare anything to a president of the most powerful country in the world preening about getting a $400 million jet from a little country on the other side of the world.

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Somehow Trump rationalizes accepting the plane because Boeing has been slow to deliver a new Air Force One and he won’t use the gift plane when his term is up. He would donate the plane to his future presidential library. Great. I guess there would be a big plane out front of a building where you could go in, buy his stuff and read tweets.

Trump is exhausting. To his credit, he has unbelievable energy for a guy his age. But he either is too easy to flatter, or he demands flattery. Hard to say. Let’s put it this way. Trump is the only president in our lifetime who would actually accept a $400 million gift and think nothing of it. You might turn it around and say only stupid people would accept such a gift.

Certainly, the people around the president have warned him of the security problems. This gift isn’t being offered by Wyoming. That plane could be so loaded with spyware that we might have to spend $400 million just to take it apart and put it back together again.

Qatar is offering that plane to the president, not to the people of the United States.

The people of the United States neither want it or need it.

Joe Soucheray can be reached at jsoucheray@pioneerpress.com. Soucheray’s “Garage Logic” podcast can be heard at garagelogic.com.

By Brett Kelman, KFF Health News

NASHVILLE, Tenn. — Federal prosecutors sought a maximum prison sentence of nearly 20 years for the CEO of Pain MD, a company found to have given hundreds of thousands of questionable injections to patients, many reliant on opioids. It would have been among the longest sentences for a health care executive convicted of fraud in recent years.

Instead, he got 18 months.

Michael Kestner, 73, who was convicted of 13 fraud felonies last year, faced at least a decade behind bars based on federal sentencing guidelines. He was granted the substantially lightened sentence due to his age and health Wednesday during a federal court hearing in Nashville.

U.S. District Judge Aleta Trauger described Kestner as a “ruthless businessman” who funded a “lavish lifestyle” by turning medical professionals into “puppets” who pressured patients into injections that did not help their pain and sometimes made it worse.

“In the court’s eyes, he knew it was wrong, and he didn’t really care if it was doing anyone any good,” Trauger said.

But Trauger also said she was swayed by defense arguments that Kestner would struggle in federal prison due to his age and medical conditions, including the blood disorder hemochromatosis. Trauger said she had concerns about prison health care after considering about 200 requests for compassionate release in other court cases.

“The medical care at these facilities,” defense attorney Peter Strianse said, “has always been dodgy and suspect.”

Kestner did not speak at the court hearing, other than to detail his medical conditions. He did not respond to questions as he left the courthouse.

Pain MD CEO Michael Kestner leaves a federal courthouse in Nashville, Tennessee, followed by one of his lawyers, after being sentenced to 18 months in federal prison on May 14, 2025. ((Brett Kelman/KFF Health News)/KFF Health News/TNS)

Pain MD ran as many as 20 clinics in Tennessee, Virginia, and North Carolina throughout much of the 2010s. While many doctors were scaling back their use of prescription painkillers due to the opioid crisis, Pain MD paired opioids with monthly injections into patients’ backs, claiming the shots could ease pain and potentially lessen reliance on pills, according to federal court documents.

During Kestner’s October trial, the Department of Justice proved that the injections were part of a decade-long scheme that defrauded Medicare and other insurance programs of millions of dollars by capitalizing on patients’ dependence on opioids.

The DOJ successfully argued at trial that Pain MD’s “unnecessary and expensive injections” were largely ineffective because they targeted the wrong body part, contained short-lived numbing medications but no steroids, and appeared to be based on test shots given to cadavers — people who felt neither pain nor relief because they were dead. During closing arguments, the DOJ argued Pain MD had turned some patients into “human pin cushions.”

“They were leaned over a table and repeatedly injected in their spine,” federal prosecutor Katherine Payerle said during the May 14 sentencing hearing. “Over and over, month after month, at the direction of Mr. Kestner.”

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At last year’s trial, witnesses testified that Kestner was the driving force behind the injections, which amounted to roughly 700,000 shots over about eight years, with some patients receiving up to 24 at once.

Four former patients testified that they tolerated the shots out of fear that Pain MD otherwise would have cut off their painkiller prescriptions, without which they might have spiraled into withdrawal.

One of those patients, Michelle Shaw, told KFF Health News that the injections sometimes left her in so much pain she had to use a wheelchair. She was outraged by Kestner’s sentence.

“I’m disgusted that all they got was a slap on the wrist as far as I’m concerned,” Shaw said May 14. “I hope karma comes back to him. That he suffers to his last breath.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

This past week, the U.S. and China reached an initial trade agreement that will, in theory, halt the countries’ slide toward a full-blown trade war.

Yet the dynamics that fueled President Donald Trump’s attempt to single-handedly decouple the world’s two largest economies persist. Absent more vigorous efforts to limit misunderstandings and miscalculations between Washington and Beijing, the two countries could easily re-enter the escalatory spiral they’re trying to escape — not only threatening Americans’ pocketbooks, but risking disastrous military conflict.

History is full of examples where trade wars, boycotts, and competition over trade routes and markets led to military-political crises and conflict — just look at the Anglo-Dutch Wars of the 17th century, the Opium War between Great Britain and China in the 19th century, or the run-up to the U.S.-Japan conflict during World War II. During the Cold War, confrontation over trade and economic issues between Washington and Moscow contributed to the exacerbation of their military and overall strategic animosity.

In most such cases, conflicts or crises arose from efforts by one or more parties to use military violence to block trade routes, force open — or monopolize — a market, or apply decisive economic pressure to achieve political concessions or block technology acquisitions.

Often, those countries employing military force were acting out of a sense of desperation, or because of a false belief that they enjoyed a lasting level of military superiority. Regardless, misperceptions and miscalculations abounded, resulting from hubris, deep-rooted historical or cultural biases, poor diplomatic signaling, or poor intelligence regarding capabilities and intentions. And regular people paid the price for these mistakes.

America’s relationship with China today exhibits many similar characteristics — parallels which should chasten those in Washington who see the forced decoupling of the world’s two largest economies as more promising than dangerous.

For example, in prosecuting the trade war, Trump operates based on a wide range of largely false assumptions and images about global trade, Chinese attitudes and behavior, and U.S. strategic advantages over China. He views trade surpluses with the United States as a form of theft, tariffs as a source of painless revenue, and China as an unqualified economic predator. He also apparently believes that a tariff-generated trade war will greatly boost U.S. manufacturing, lower prices, and increase overall living standards for Americans.

And the actions he takes, based on these false views, appear to be driven by overconfidence that America enjoys a clear economic superiority in any contest with China. Finally, reinforcing Trump’s perception of Beijing as an economic predator is a broader popular image of China as a democracy-destroying, norm-busting, communist nation bent on replacing the United States as the dominant global power.

Likewise, for its part, Beijing’s confrontational response to Trump’s tariff war, although justified in some ways, incorporates a slew of equally deep-seated images and distortions about the U.S. and the West in general — some of which may be accurate, while many are not.

On the broadest level, many Chinese harbor a deep historical sense of suspicion and resentment toward the United States and other Western powers, originating from their so-called Century of Humiliation at the hands of the imperialist West and Japan.

Reinforcing this historical Chinese pessimism toward the United States is an increasingly widespread and firm belief sustained by the Chinese Communist Party that Washington is committed to containing and weakening China as a nation in order to sustain its own global hegemonic power.

In fact, Trump’s tariff attack on China is viewed by many Chinese as a weapon in that containment effort. In response, Beijing has adopted a predictably vigorous “tit-for-tat” stance, willing to meet every U.S. escalation with an equal or even greater escalation, secure in the rather arrogant belief that China is acting out of moral principle against an unjust opponent.

All of these dynamics combine to produce a volatile mix that could turn an escalating trade war into something more dangerous, with each side acting out of a sense of distrust, hostility, and resentment. Given the recent agreement, we may still be far from seeing U.S.-China trade disputes transform into any sort of military confrontation; the stakes are simply not high enough to justify the risks involved in two nuclear powers resorting to military force to resolve economic disputes.

Nevertheless, worsening conflict over trade, driven by hardening negative assessments of each side’s overall strategic intentions, could lower the threshold for smaller crises over Taiwan or disputes in the South China Sea or cause one or both sides to resort to severe, non-trade-related punishments — outcomes that could fuel dangerous political-military escalations and lead to the worst case scenario: a direct U.S.-China military confrontation.

Unfortunately, Beijing and Washington lack reliable and effective means of averting and successfully managing any such crises. A physical hotline of sorts exists, but it does not function effectively for several reasons, including the lack of a clear protocol for establishing communication as early as possible in a crisis.

In addition, the two sides no longer have mutually trusted interlocutors with deep experience in the relationship who can share views in an unofficial manner, thus reducing misperceptions. Moreover, crisis management is incorrectly treated by both sides as largely a military-to-military issue. In fact, any serious Sino-American crisis will be managed by senior civilian officials.

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Yet there is little evidence that such officials are briefed on the specific pitfalls involved in accurately assessing and responding to the crisis behavior of the other side. And yet such guidelines exist. And this is all made worse by the significant uncertainties presented by a U.S. president who does not seem to value expert advice, preferring instead to govern based on his instincts.

Persistent U.S.-China trade conflict doesn’t just pose massive risks to U.S. companies and consumers — it could help fuel dynamics on both sides that could lead to a mutually destructive conflict.

Beijing and Washington should build on the welcome progress they’ve made in defusing this trade war and urgently work to establish mechanisms to mitigate the risk that such disputes will spiral into military confrontation.

Michael Swaine is Senior Research Fellow for the Quincy Institute for Responsible Statecraft. He wrote this column for Tribune Content Agency.