If you look closely, you'll see there's a glass of scotch on the first tier. Hm. Perhaps the decorator was banking on the age-old adage "Everything looks better through wine-colored glasses."
I like all the medical implements placed around the cake - particularly the little metal tray thingie. I remember throwing up into a larger version of one of those after getting my tonsils removed as a child. [gazing off wistfully] Ah, memories. 'Course, I never thought I'd associate that particular memory with cake, though.
Many thanks to my anonymous industry insider!
*And let me tell ya: I've always wanted one of those.