I tracked down the CNN image of the POTUS Letter to the original website. My attempts to show that this is not a match to the Q Drop PEN PHOTO has failed.

Reverse image search found a larger and more clear image:

https://ekstrabladet.dk/incoming/zejprv/7175152/IMAGE_ALTERNATES/p910/yvonne.jpg

"Mark Zuckerberg and his wife Priscilla Chan donated $75 million to the hospital in 2015. After that donation, the hospital dedicated itself in Zuckerberg's name."

Nurses At Zuckerberg San Francisco General Hospital Want Facebook Founder's Name Removed

https://www.celebritynetworth.com/articles/billionaire-news/nurses-zuckerberg-san-francisco-general-hospital-want-facebook-founders-name-removed/

SKY Event = May Moon Flower (Full Moon) = May 29, 2018 (Today!)

April showers brings May flowers.