The origin of “Howard Moseley M.D.” stems from Gagner’s interest in self-help books as a teenager. He always loved the voices of these books and how convincing they were in their convictions. Gagner says:

“Like most artists, I grapple with feelings of doubt—doubting my creative abilities, doubting the intentions of others, and doubting the art world itself. Howard is a manifestation of those tensions, the personification of my inner critic. He is the voice that shares too much personal information and, also, the source of bad ideas. He seems to exert a lot of control. It’s almost as if he’s the one in charge. The beauty of being the artist is that ‘I’ can alter that dynamic. After all, the artist is God in their own world. So, what better way to exert my own control than to end his existence? Rest in peace, Howard.”