One thing almost totally unrelated to the previous, but still vaguely important. I bet you forgot that comment about Leeches being Trendy.
Well, keep it in mind, because it can be important. It comes out mostly whenever a new treatment comes down the line. Leeches all hear the name, their customers hear the name, and no one's quite sure what it does but they're pretty sure it does something cool, and before you know it, Viagra's being prescribed for heart problems and Ritalin's a diet pill.This aspect has minimal impact on play, except as a potential basis for an adventure -- say, the pill the characters have just prescribed to seventy eight patients between them, giving each one an average of a twelve year supply, has just been recalled for inducing psychosis in 99.8% of its subjects, and everyone's laughing at what an amusing fluke it was that the six thousand test subjects all fit in that .2%. Just one of the joys of random selection.
However, whenever you're in a group of more than three people, when more than half of them are doing the same thing, you may have to roll to avoid going along. This applies even if you started it. You can just go along with it if it looks like fun (this is known as Catching the Wave, because the very first recorded Trend to really sweep across all of Leechdom through the miracle of mass media was the campaign slogan for Meth-A-Cola), in which case, just...go along with it. However, if doing it is going to interfere with your goals, you can use your Spur/Glues to keep yourself on track...pick whichever one is appropriate (the Storytiller might have a helpful suggestion, which you would be well advised to agree with), and roll it. No Attriboats or Backrubs helping out here, just the Spur/Glue. If you succeed, you're ok. If not, you not only go along, but go along with gusto.
(For a quick example, say a Gangrene is using Hearth Mauled to start up a really raucous party. Rather than risk being seen with her own fingerprints on any broken crockery, she just gets the beer flowing, tells the band to strike up their most ear-shattering tune, and then plans to slip out...but people are already getting into the mood, and a bunch of them start slam-dancing. The poor Gangrene must now roll Control Freak to stay on track and sneak off while her rival's house gets trashed...if she fails, she'll not only join in with the slam dancing, but will be clearly visible while body surfing and striking up a mosh pit.)
Left gets you a number in the long Kiss-Up Lines.
Go right if you've been Experienced.