Multi-wavelength studies of M supergiants have revealed atmospheric structures with alarge range of spatial and temporal scales. Focusing on Betelgeuse, these scales and theirperplexing connections from the photosphere to the interstellar medium are reviewed. Ofparticular current interest is the dynamic origin of the ubiquitous and relativelydust-free mass loss. Is it multiple plumes of convection driven ejecta, episodic ejectionof molecular reservoirs, or a more steady and uniform flow? With powerful new facilitiessuch as the VLT and ALMA we may begin to understand the connections and answer suchpuzzles, but ultimately detailed studies of a sample of M supergiants will be needed todisentangle the physics from the stars’ personalities.