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In the TV Series 'Kingdom Hospital', at the end of the series, with various things appearing to have retro-actively changed, we see the vending machines have changed from carrying Nozz-a-la to Pepsi.

I realize Nozz-a-la has shown up in a number of other Stephen King stories (The Dark Tower, for example, leaps to mind), but is there any specific indication to what it means here? I.e., has the core group switched to an alternate world or some such, or is this just a small time-travel change effect?

Said another way.. Have they really changed their past (and, therefore, their world) or have they simply returned to an alternate world, leaving theirs still intact?

Nozz-a-la machine Mrs Druse looking at the new Pepsi machine

  • Looks more like a production mistake than a story element. – John O Aug 23 '12 at 17:10
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    I doubt it; Nozz-a-la being an alternative to Coke/Pepsi item is a factor in other King stories, and they draw some attention to it. Earlier in the series someone asks if someone else want's a 'Nozzie' while at the machine, and then, as you see in the picture, Mrs. Druse takes specific note of it. It's intentional.. I'm just wondering what it's supposed to indicate. – K-H-W Aug 23 '12 at 17:12
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    @Thecafremo - That's exactly what I'm wondering about -- the Keystone world in most of his stories has Coke; the presence of Nozz-a-la usually indicates that they are in a close alternate.. That makes me wonder if they went back in time and changed things, or went back, and followed a different path, ending up in the Keystone world. Basically, did they change history, or simply return to an alternate world. – K-H-W Aug 24 '12 at 23:33
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    @Keith I cant firmly say, as I know nothing about this story, but If it were in the Dark Tower series, they would have gone to an alternate world. – Thecafremo Aug 25 '12 at 0:53
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    Or at least a more stable level of the Dark Tower. – FuzzyBoots Dec 31 '15 at 18:28
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TL;DR:

Exactly what the switch from Nozz-A-La to Pepsi is supposed to mean isn't entirely clear, but there is considerable evidence that the change is intended to serve as a meaningful hint, conveying a deeper significance, both internally (within the Kingdom Hospital story itself) and externally (in relation to The Dark Tower).

In some sense, the characters have traveled from an alternate reality1 to the real world, either physically/literally (by passing through some sort of gateway between the two realities) or by changing history in a significant way. The mechanics (i.e., exactly how they traveled between the two realities) aren't explained, but it probably doesn't matter much, because the result is the same: they were in an alternate reality, but managed to leave it and enter the real world.



About Nozz-A-La:

The Great Old Ones must have preferred Nozz-A-La to either Coke or Pepsi, since some of the cans are still kicking around End-World. Nozz-A-La may also be found in many of the Alternative Americas.
- Stephen King's The Dark Tower: The Complete Concordance, written with King's assistance and oversight by Robin Furth.



Evidence that this is more than a mere Easter Egg:

It is easy to hypothesize about why a Dark Tower reference might be inserted into the show without any deeper meaning: perhaps the producers simply wanted to please fans of The Dark Tower, and although the Nozz-A-La/Pepsi switch indicates that something has changed, it doesn't have any significance with regards to The Dark Tower. The fact that the Nozz-A-La machine became a Pepsi machine only means that, as you suggested, the characters have slightly altered history.

This may be the simpler explanation, but I also think it is the less likely explanation. Stephen King is very proud of The Dark Tower, considers it his Magnum Opus and his most important work, and he doesn't take it lightly:

I have written enough novels and short stories to fill a solar system of the imagination, but Roland's story is my Jupiter - a planet that dwarfs all the others... a place of strange atmosphere, crazy landscape, and savage gravitational pull. Dwarfs the others, did I say? I think there's more to it than that, actually. I am coming to understand that Roland's world (or worlds) actually contains all the others of my making...
- Stephen King, “Afterword”; The Dark Tower, Volume IV, Wizard and Glass

Indeed, Kingdom Hospital is actually mentioned in the Dark Tower series, so the connection goes both ways.


Other Dark Tower references in Kingdom Hospital:


Conclusion: There is no room for doubt on this point - there are a number of connections between the two works, and although some may be trivial, others are quite significant and display a clear intent to create a meaningful relationship between The Dark Tower and Kingdom Hospital.



What the Nozz-A-La/Pepsi switch might mean (and why Nozz-A-La is analogous to Pepsi in Kingdom Hospital, whereas it is analogous to Coke in The Dark Tower):

  • In The Dark Tower, Nozz-A-La is an analogue of Coca-Cola, and is found in "End-World" as well as in "Alternate Americas" (alternate realities)2. The flavor is described as being similar to Coke, with hints of root beer, and the logo is almost identical to the Coca-Cola logo; the words "Nozz-A-La" in white script over a red background:

enter image description here

  • However, in the real world, Coca-Cola has trademarks and copyrights on its logo and color scheme, and defends its property from infringement. As such, the Nozz-A-La machine and truck bear logos that look nothing like King's descriptions in The Dark Tower.

  • If we speculate a bit further, we might assume that the show deviates from the Nozz-A-La = Coca-Cola formula because either:

    • Coca-Cola wasn't interested in associating itself with King's Dark Tower-related works, perhaps because they don't like the parallels he draws between their brand and his fictional brand (and they might not be happy about the Great Old Ones' preference - shared by some of the main characters in The Dark Tower - for Nozz-A-La over Coke).

    • Or it may be a simple matter of money. If the producers approached Coke and Pepsi about a potential product placement agreement, they would probably make a deal with whichever company was willing to pay more. In other words, King decided that Nozz-A-La is analogous to Coke in The Dark Tower, but the network and producers of the show would surely be willing to deviate from that formula if Pepsi made it worth their while.

  • In any case, in The Dark Tower, the existence of Nozz-A-La is always indicative that the characters are either in End-World or an Alternate America (as opposed to the "Keystone World", which is the "real world", in which many of the most important action takes place in The Dark Tower, and in which you and I live). Thus, when Nozz-A-La exists in Kingdom Hospital, the characters are in an alternate reality, and when it is replaced by Pepsi, they have somehow entered the real (Keystone) world. In The Dark Tower, characters travel between the various worlds via magical portals (usually in the form of unassuming-looking doorways); however, it is entirely possible that altering history would have the same effect as passing through such a portal.


Conclusion: As the Complete Concordance says, Nozz-A-La is found in The Dark Tower's End-World and in many of The Dark Tower's Alternative Americas; at face value, this would seem to indicate that whenever we see anything about Nozz-A-La in Kingdom Hospital, the characters are in one of those Alternative Americas2. The fact that Nozz-A-La is analogous to Pepsi (rather than Coke) is probably best understood as a reflection of real-world (i.e., out-of-universe) considerations, and the most likely explanation is that Pepsi was probably willing to pay more for product placement than Coke was.



Verdict:

Although the mechanics and details are somewhat unclear, we can be reasonably confident that the existence of Nozz-A-La in Kingdom Hospital indicates that the characters are in some sort of alternate reality, just as it does in The Dark Tower. When the Nozz-A-La machine becomes a Pepsi machine, the characters have left that alternate reality and entered the real world; this may have happened because they went through a portal, or it may have happened because they altered history in a significant way.



Notes:

1 I have opted to use the term "alternate reality" for the sake of consistency and convenience, but the term "alternate timeline" might be equally (or even more) accurate. Whichever term you prefer, the idea is the same: Nozz-A-La existed in a world/reality/timeline that isn't quite real; Pepsi exists in a world/reality/timeline that is essentially the same as the one in which we live.

2 If you haven't read The Dark Tower, you might be thinking, "But you just said Nozz-A-La exists in many Alternative Americas and in End-World! Doesn't that mean the people in Kingdom Hospital might be in an Alternative America, or in the End World?" In short, no, they are definitely not in End-World. End-World is part of a sort of post-apocalyptic place very different from our world; it is a bizarre blend of various elements that, compared to our own time, vary between the futuristic and the historic. Advanced robots and sentient bullet trains exist alongside Old-West frontier towns; the (anti)hero of the series, Roland Deschain, is the last representative of a Jedi-like knightly order of "Gunslingers", and wields revolvers forged from the steel of the legendary sword Excalibur (and in fact, Roland is a descendant of King Arthur).

End-World is one of the three realms of what is loosely called Mid-World (Mid-World, rather confusingly, is composed of In-World, Mid-World, and End-World). It is the location of the titular Dark Tower, which is the hub of all existence and every world. Basically, there's no way you could be in End-World and not realize it - it is so unique and bizarre that it would be impossible to mistake End-World for anything resembling our own world.

This being the case, the events of Kingdom Hospital may take place in the real world, or one (or more) of The Dark Tower's Alternative Americas, or an alternate world unrelated to The Dark Tower, or some combination of some or all of the above; but they certainly don't take place in End-World.

  • I've seen a name All-World for those three together. – Mithoron Dec 31 '15 at 22:45
  • @Mithoron - The phrase "All-World" does indeed appear in The Dark Tower, and it does describe the combined total of In-World, Mid-World, and End-World, but it is used almost exclusively in reference to "All-World-That-Was", which basically means "In-/Mid-/End-World during the time of Arthur Eld" – Wad Cheber Dec 31 '15 at 22:54
  • @Mithoron - " However, the use of All-World is almost exclusively used in conjunction with Arthur Eld, being called "All-World-that-was". The definitive statement comes from The Dark Tower Concordance written by Robin Furth:" "Although Mid-World was the name of a specific historical kingdom, Stephen King uses this term when he needs to refer (in general terms) to Roland's world."" darktower.wikia.com/wiki/Mid-World – Wad Cheber Dec 31 '15 at 22:55
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"Disclaimer" I haven't watched the show. That said I have read 90% of king's books. That said I see 3 logical answers. 1. The producers needed product placement cash. Which means it means nothing. 2. It means that they have slipped into the dark tower universe. King has named it something but its been a while. 3. King wrote it in just to mess with his diehard fans....he has been known to troll his fans hard

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    No references. All assumptions. At best, this is a comment. – Daft Feb 3 '15 at 14:19

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