You feel it, you experience it, but you can't see it. It's the dark matter of management that makes your life as a service designer so hard whenever you try to bring design into organizations. In this episode, you'll learn what these dark forces actually are, and of course how you can effectively deal with them. Because when you do, your life will not only get easier, but design will also be able to live up to its promise of making organizations more human-centered. Here's the guest for this episode. Let the show begin. Hello, I'm Marzia. This is a service design show, episode number 129. Hi, I'm Marc and welcome to the service design show. On this show, we explore what's beneath the surface of service design, what are the hidden things that make a difference between success and failure, all to help you make great services happen that have a positive impact on people and business. Our guest in this episode is somebody who lives at the intersection of design, business and organizational psychology. She's the design director at LiveWork. Her name is Marzia Arrico. Let's face it, the reality is that in most organizations, the current way of working is conflicting with design. For you as a service designer, it might be challenging to deliver the impact that you'd like. This begs the question, what is the best way to bring design into organizations that don't have an established design practice yet and sometimes might even be hostile to this new way of working? If you stick around till the end of the episode, you'll learn how you can be of more value to the people around you and just have more fun in your work so you don't get stressed out. If you enjoy conversations like this, know that we bring a new conversation every two weeks. So if you haven't done so already, click that subscribe button and that bell icon to be notified when a new conversation comes out. That's all for the intro, and now let's jump into the conversation with Marzia. Welcome to the show, Marzia. Ciao, Marc. Good to see you again. The last time we met was in... Budapest. It was a long time ago, unfortunately. It was at the Doors conference. Yeah, legendary conference. It was like 500 people, so many people in a room. Yeah, you were on stage. I was on stage there, and we didn't get a chance to talk a lot after that, but I definitely remembered your presentation, and I thought, well, I need to get her on the show one day. And now we're here. For the people who don't know who you are, could you give a short introduction? Sure. So my name is Marzia. I'm the design director of Liburg Studio. I've been in Liburg for eight years. Seems quite a long time. And I'm a bit of a hybrid. I'm a designer, but with a PhD in organizational studies. So I've always been interested in the combo between design and business. So this is what I do. Yeah, and you're an Italian living in the Netherlands right now. I am. Sicilian living in the Netherlands. Sicilian? Oh, yeah, sorry. We need to be more specific about that. Marzia, to get to know you a little bit better, I've got five questions for you that you need to answer as quickly as possible. A rapid fire question round. Don't overthink them. Just answer with the first thing that comes to your mind. So ready? Yes. All right. What's always in your fridge? The king. Okay. Which book or books are you reading at the moment? Reinventing organizations. Lalu. I will add a link to that down below. Which superpower would you like to have? Flying, for sure. Well, a lot of people. And what did you want to become when you were a kid? An architect, like my father. Okay. And now a question that I'm really curious also about is, what was the first time you learned about service design? During my master degree. Well, actually at the end of my BA, I did a BA in product design. And my final dissertation was on designing the rituals of death. And so the committee was expecting me to create a product while without even knowing it, I designed a service. And they didn't like that. They were like, what is the product? And I was like, you guys, this is way more than a product. It's a service. And they were like, no, this is not a thing. And then I looked around for a master degree that could help me understand the service side. I discovered that there was a whole thing around service design and that was my Eureka moment. Cool. Is that some of your work related to the educational part still online somewhere? I don't think so. It was in Italian. I did my BA in Italian, but I couldn't get it. OK. And you also did a PhD in which topic was it? It was the adoption of service design in organizations. And I decided to do it in a business school because I felt that I wanted to understand better that side of the story. And again, it was incredibly hard. Like, there was no business school that was willing to give me an opportunity to do a PhD there. I guess they were like, you have a design background. Go to a design school. What do you want here? I was like, yeah, I think there is something that we can share and learn from each other. They're like, no, just go do an MBA. And then if you won't come back, I was like, no. So it took me like three years. It took me three years. And at the end, I found Professor Kopenhagen Business School. There was enlightenment and it was seeing the power in the combination and was really interested in exploring the space. And then it gave me a chance. Awesome. I love the topic in the intersection of business and design. We talk a lot about it on the show and I think it's super important. Marcia, what is the topic you want to talk about today? What do we want to share with the community? Well, I was thinking to talk about a topic that I haven't cracked yet. So this could be an opportunity to have a conversation with you and try and find, you know, I guess you would be an opportunity to shed some light on some key questions and then see what others people think. And the topic is the one of dark matter. It's a notion that comes from Dan Healy wrote a book sometime ago, an excellent book I absolutely recommended called Dark Matter Trojan Horses. And he basically talks about this invisible, intangible fluid that makes the culture, the structures and the policies of an organization that makes it incredibly difficult for change to happen, and especially for design to operate in an organization. And I find it incredibly fascinating in the way he talks about it. And very recently it clicked in my mind that actually what he's talking about is very much what I've been researching in my PhD, but I was just calling it differently. You know, I was using institutional theory in my PhD. I was talking about organizational logics, but fundamentally it's the same story. What I discovered in my PhD is that organizations operate through a set of logics. And those logics are fundamentally made by practices, things that are actually visible as well as principles and beliefs that are not. And people walk carrying these logics and they fundamentally define what is legitimate to do in an organization or not. It legitimizes action. And so they are very hard to trace, to be honest, because there is not one place to go look for an organizational logic, as there is not one place to go look for a dark matter, just everywhere. It's everywhere in the way people talk, everywhere in the play, in the way people make decisions, in the way they assign budgets, it's just everywhere. So went through a process of actually trying to dig out to recognize a logic and how you define it. And in one way that hinders, if you like, the introduction of design in any given organization. Yeah, yeah. So if I may interrupt you for a second, I think I definitely experienced this dark matter. Like you said, it's often very hard to grasp and very hard to point at, but you experience it. Like you experience the resistance, you experience the language, you experience sort of the symptoms of what you call the dark matter. And often because design is something different than the existing organizational logic, that sort of the resistance becomes even more experienced, right? Yeah, for sure. But the interesting thing for me is that the moment in which you start really defining the blocks and the elements that make a given logic, and so you start breaking it down, it's way easier to start understanding what are the points of which there is fundamental conflicts that is going to be very difficult to resolve. What are the points that actually there might be some opening? There would be like an opportunity to play a game. For example, one of the logics that I recognized in some of the organizations that are really searched is the digital one. It's the digital first kind of logic and that comes with a concept of speed, comes with agile as main process, right? And although for many aspects, design is in conflict with some of these principles, something like agile and the belief of iterative is fundamentally complementary. So once you start breaking any given logic in pieces, you can start finding what are the plugins, what are the spaces that I can actually use to create a meaningful connection, rather than spending a lot of time trying to change something that is fundamentally incompatible and it's not going to work out. It's just energy draining, right? Yeah, yeah, so maybe also that's sort of the underlying theme is like, how do we bring design into organizations that don't have a strong design heritage? So design usually, I like to talk about design as a medium to achieve a goal, right? So you don't bring design for design's sake, nobody does. You bring design because you're trying to achieve something. And so what I usually say is that design walks on the legs of some other logics and sometimes the logic is the customer logic. You want to become more customer centric. You have a renewed belief in the power to put in the customer at the center of everything you do. And you recognize design is a way to do that. Or you want to become a more sustainable organization, for example. And you discover, believe the design can be a medium for that. It's not the only medium. You can do it in very different ways, but you just choose the design is the way that you want to explore to do that, right? And so the reason why design enters into an organization is already a very important thing to understand because nobody invests in design for design's sake. It's just not a thing. I hope not. Yeah. Right. And so that understanding is fundamental to create the right narrative. I recently, in the last four or five years, just stopped to talk about design with people in organizations during large customer centric transformations, for example. This is not what they're interested in, right? This is not the reason why I'm there. Sure. I can talk about design. I can talk about a million other things. They heard about Lean. They heard about Agile. Now there's somebody talking about design and design thinking. It's not a thing. It's not necessarily useful at this stage when you're entering an organization trying to evangelize and trying to convince people that your way is a better way because what sets your way is a better way. Your way is a way, right? And so what I started to try and really do is to really empathize with the people that are inside the organizational machine. And as designers, they're usually very good at empathizing with the customer, the consumer, and the user, the people that are outside of the organization. But I believe it's really important to spend at least the same energy, if no more, to really understanding what are these people trying to do? What is the reason why they behave the way they behave? What at the end of the day are you, not just measured at the end of the year, but really personally, what are you trying to achieve in this organization? And what is the narrative that you're carrying, right? Once you understand that, that is very easy to translate whatever it is that you're trying to do with design in words that they can understand and appreciate. And that is a job that takes a lot of passion and time. And sometimes it's incredibly energy-driving, but it's incredibly valuable, right? And so, for example, in one of the big banks that I've been working with lately, we had four or five different narratives of why design was there and what we were even trying to do. So for the people that were in the technology department, they had this very big problem of proving, I'm talking here about the senior leaders there, they had this very big problem of proving, what is the return on investment of our X billion technology spend that we have every year? They are no clue, right? And so my story there is to use structures to enable the view to happen, to give you a way to actually start tracking what is the return on investment of your technology spend. And you can do that by design, right? And I don't have to explain you what is the design process to get there. I'm just telling you that these are the things, and I'm going to show you the artifacts that might help you reach that goal, right? The story for a Cha was a completely different one. We were still doing the same program of work, but they were going to experience very different type of value from the program work. Therefore, the story had to be different. And at that point, when you touch the fundamental, you know, motivations of people and needs of people, then everything starts becoming easier. It doesn't become easy, but it's easier. Sure, yeah. I'm wondering, and you already gave a hint about empathizing with the people we work with next to the people we sort of designed for. But how do you get to these narratives? So if we put the narrative of design as the holy grail to solve all the business challenges at a site for a second, how do we create those other narratives? What did you do in practice, actually, to come up with a senior leader narrative, with an HR narrative? Well, a few things. First of all, I want to mention is not just empathizing with the people. It's also empathizing with the things and the organizational structures, right? It's fundamentally understanding why certain things are done this way, which is not necessarily because, you know, people like it, because, you know, most of the people might even hate it. But there is a reason why the machine is organized that way. And so empathizing also with that machine, even if you fundamentally dislike it, you know, because some of these places are fundamentally dehumanizing workers and employees and having an empathy to fundamentally understand that side of the story is also super important. Having said that, there are a few things that any, virtually any service organization on this planet is simply lacking and is at the basis of some of the fundamental problems that some of these organizations have. And one of these big issues that have been, you know, recognizing from one place to the other, at least some of the organizations that I've been seeing working with, is that it's very rarely an understanding of what is the, what are the services that we are delivering to our customers? And in what way are these services coming together? If you ask virtual to any person in the organization that would be able to tell you, they will tell you like a slice of it, right? They will tell you like a few that they know because they're connected to their role. But that is very rarely a one view of all the services that an organization delivers. And on top of that, that is very rarely an understanding of what is that kind of value that that service brings to our own organization. Very few organizations really measure things like that. And therefore it's very hard to decide where to put your money, right?  And usually it's because, you know, a senior leader woke up, started to notice something and then called and started screaming. And the person is screaming the most and has most power than, you know, budgets all of a sudden get allocated somewhere. But there is no real understanding on, you know, is that actually a priority for us against what and in what way are you evaluating that? Because there is no one view. So it's incredibly hard to actually decide whether, you know, this budget allocated here makes more sense than over there. And so this is usually one of the first things that we try to tackle in programs of this kind of customer-centric programs. And once you know that that is the problem, you cannot just go and explain the thing like that because they would go like, yeah, what is that? What are you talking about? Like, so we basically tend to, knowing that that's the thing that we would like to do as an artifact to bring, to, that could unlock a whole number of different issues. We're trying to connect that to whatever is that the people are trying to achieve. And so that usually when I start a customer transformation program I spend a few months just talking around with people. You know, having coffees, talking to the people that have been there for a long time, people that have been there for a little time, people that have been moving around and trying to understand how things are done here.  And it's not just me, of course, it's the entire team and that already, and we always ask, you know, who do you think I should speak next? What is the person? And there is always, oh my God, you should speak with Frank that has been here for 25 years and, you know, he knows this and that. And yeah, and then you start basically creating a picture of what are the routines? What are the dynamics? What are the policies that are driving certain behavior? What are the people, principles and values that really drive certain ways of doing things? And so you connect that with the thing that you know is not working with individual motivations of people that you know have the money to unlock certain pieces of the work and you circle it, right? And you try to make all of that work. Awesome. So I can imagine that it's great when you have the opportunity to... Somebody's, I think, called it like being a historian, like understanding the history of the company, digging in an archaeologist, digging up stuff, trying to create... So professional ethnography, I'm sorry. Awesome, even better. How do you... What kind of client does it take? To give you the space and opportunity to spend this time actually charting this first rather than immediately going into a solution mode? What kind of client organization? I don't think there is one type. I can tell you the types that I've been working with and we can see together whether we find a pattern. So in the case of the bank, they have no burning platform. They have a gazillion money, like they don't care, honestly. There is no real need emerging from the market. There is no real need emerging from internally. I think that the real key was individuals inside the organization, in specific line of businesses, the wet dealing with some sort of design, in a way or another, more UX, that really sense the need for a more strategic view of design for an orchestration among the different design disciplines, as well as a better plug-in between design and the rest of the organization. So they learned about service design and they decided to establish a service design practice. And so they came to us saying, we need to establish a service design practice. And I said, okay, there is quite a lot of dark matter to deal with here because this is a 250,000 people organization, I don't know even how many different countries. And so they accepted that we both, from both sides, really need to understand what is the playground here and what is the thing that makes sense to do because fundamentally, you can, historically, the way a lot of these places work is that you decide that that is your goal, it's the thing that you want to achieve and then you create a roadmap that is locked for three years and then off you go. And those stuff just usually don't work. In a few months, the thing is already updated. And so we were very honest at the very beginning saying, here there is a kind of a broad direction that we think we should consider and these are some lines that we should follow, but there are a million unknowns and there are so many dependencies and we need to understand all these different things and how they come together and we need some space to play if you want to do this right. Otherwise, you can do it as a lot of other organizations and just hire 10 people and just throw them there and see what happens. And they hate themselves and the organization and everybody else and they probably, after a while, either quit or change job. So, yeah. So I think that was the bang. Then on another side with Retailer Sports, Brenda we worked with, we were inside Digital Omnichannel and it was a very digitally driven, yeah, of course, unit. They started a quite big agile transformation but very quickly they realized that agile is just a way to make certain processes faster, probably even more iterative, but it's very much looking at humans at a user level. There is very little input from a customer or a consumer level. And so therefore what you end up doing is kind of excuse the French, the same crap, but way faster that at a meaning level for a customer doesn't really change. It's just better usability probably or looks better. So it wasn't really moving what the unit and the organization was trying to achieve and they recognized design as a way to bring that layer, strategic layer. So again, it was an individual. So I guess it's individuals. And what's, okay. But what is the threat or the characteristic or all of these individuals? Because what you're prescribing and I also strongly believe in is that you first want to slow, quote unquote, slow down and know what you're dealing with. Like you said, understand the playground before you actually move forward in the right direction. And that slowing down goes against most organizational logics that I know. So it takes a specific type of person. Yeah, good observation. And you don't slow down. You move on multiple speeds. So what usually happens is that you start a proof project that goes super fast. You know, it's a 16 weeks thing that opens up like a big problem that everybody has had that is alloying in fruits that everybody recognized that it was a problem needs to be fixed. You do it fast. You do well. You do bad research. You throw a whole bunch of very skilled designers especially to show the value of it. And people go, oh, wow, that's useful. And then at the same time, you have a second speed which is the organizational ethnography they're trying to understand. You have another team of people. Some of the people will be the same really trying to understand how you're doing things. You know, you might use some of these projects to do that or not, you know, because you might want to end up in different pockets of the organization. And so you try and move on multiple speeds so that you can feed the monster that needs speed and needs results and things and value for money. And so you feed the monster. We think that undoubtedly are useful it's just not the key, you know, because when you do, you know, usually some of these proof projects are service improvement projects.  Sure, you can improve that service then good luck implementing it because we know what are the difficulties then to take the thing and make it happen because of the dark matter story because the organization is not set up to work their way. But at least they know they can see what's the value of it. They can see something emerging tangible. And then you have another speed going on and you might have multiple of those, you know, you might have one speed with the design team but you might have another one with a group of senior leaders and you try and orchestrate that work in the right. That makes sense. And using those projects as a way to actually, it's prototyping is not the word but maybe probing the organization like feeling whether your resistance is by doing stuff rather than talking about stuff and then sort of having a second track or maybe a third track where you collect that dark matter and make it tangible, make it into an object you can discuss. I'm also curious like how do you define progress in this process? So progress is really easy when you have that service improvement thing that you're working towards, right? Everybody sees that, everybody feels that, everybody sees the workshops, the outcomes but what is, how do you find progress on that other level? It's when people start talking about other things and that might take a week. Sometimes it takes three years. Do you have an example? Yeah, so there was a moment where we managed after about six months in to create this level zero service architecture that I was mentioning before, right? This one view of all the services coming together and we named these services because they were not named so we named these services in a quite customer-centric way like from a customer perspective what the service was doing for them and we shared this view with a whole bunch of senior leaders and you could really see some of the faces going like, oh, like really clicking and then for that moment on people were referring to services that the organization was delivering with that label that we define collectively as a team with all the other stakeholders as a thing like that became the service and they were talking about it in a very customer-centric way and it was not even a question anymore which just became a thing all of a sudden, right? And so the language started to change because of that labeling that was very customer-centric they were using very customer-centric words and those things stick, right? Then it becomes part of the way you talk and the way you relate to things and the way you start thinking about stuff Yeah, I'm going to interrupt you because my key question here is this is great and when language starts to shift the whole organization starts to shift but what do you feel made made it that this message did stick and so many others didn't? What was it in this specific message? I think it was a very simple one like it was one image very little words, few words there was no big presentation there was no big deck there was no big toasters no a million sticky notes it was just a thing that was honest it was not particularly pretty but it was honest and it was fundamentally touching a pain point that they had that they couldn't even word it because no organization really operates this way very few do and it's not a common thing so I think that is what they were just ready for it and they saw how that connected to that reality and they yeah and there was no fluff around it I guess that's the thing nobody was trying to convince them about anything it was just you know an honest conversation about we think this is useful what do you think and of course for some people didn't work at all they just left the meeting and never showed up again fine, you know Yeah, yeah now well regarding that I can with these things I think we as surf designers are often able to spot these invisible forces and maybe not in a very structured way but name them and articulate them changing them is already harder but when we leave like how do we make it sustainable what did like language is an important part right if the language is there if it's adopted by the organization then even when you leave as an outside consultant that language will stay there but have you found other ways to make this into something that's really part of the organization rather than something external and you here you're talking about that change whatever that is or design well what I'm talking about here is you want to create an environment or logics like you named them that are more compatible with a design approach with a design mindset in order to make sure that design is able to deliver on its promise how do you make sure that those things stay around and how do you embed them I think it's the other way around like you know it has to be designed to adapt to whatever thing is happening here you know because nobody's gonna you know an organization that has been working like that for 150 years whatever they're not gonna adapt to design so the design can flourish nobody can ask so you know I guess the key here is to adapt design so that it's useful and you know and you know the one thing that I keep telling to my team all the time is that good enough is enough it's got to work and so it doesn't matter if it's right within your construct of design you know it's got to work within this context and it might be that you know this is not the thing that you would do in an ideal world but within this context works and that's great and it's just do that and you try till it works for the people around you within the context they are in you know it's a very different story than if you're trying to fundamentally shift the very core the very purpose of an organization right at that point the approach must be different but if you're trying to improve the way for example the level the maturity of customers interested in one organization that has to be the path design has to adapt within the context within which it operates yeah so we've used this word on the show a more often but we have to have maybe have more pragmatic approach to design rather than a theorist or purist approach to design like whatever it takes whatever helps us to get to the outcome that we're aiming for I agree okay well done did you did you identify other moments where things clicked so one moment like you mentioned was when they saw the overview when you gave them the maybe they're not so pretty visual and the language things changed were there other moments where you realized okay now from this moment on things are different at the very beginning of a few of these programs actually this is a recurring thing I usually show up and say we need to think about the operating model for design how is design gonna work within this organization but most of all how design is gonna work with other disciplines what at the end over moments and the plugins and we need to design those because otherwise it's gonna implode in our own hands it's not gonna work out a scale at least you know I can work within limited number of people in limited scope but when you start scaling then it just doesn't work and usually the answer is like now we do have an operating model we don't need to think about that and usually my answer is that okay and we're gonna see you in six months usually Rapids is like just themes become incredibly dysfunctional designers become incredibly unhappy because there is no clarity what is the remit because there is no operating model there is no clarity on the remit there is no clarity on how are they gonna work with other people there is no clarity on what what design ends with technology starts who is the product owner when you start talking about services who is the service owner virtually an organization is a role of a service owner and in a service you will have four or five different products who orchestrates that so questions of this kind the whole part of you know a design operating model and very rarely that stuck at the right time till you know things start breaking yeah and then people start to break down yeah that's the moment when concept of this kind click right because you see it in practice how fundamentally the machine does not work it just cannot scale you just stop breaking at the edges and so that was another moment where when things started to click and you know you got to experience it sometimes it's just fine you know I know it because I've seen it but sometimes you have to let it go make it happen experience how the thing breaks it's not the end of the world and then you start feeling on your own skin what is the need for that specific operating model and how it should look like because again there is no one recipe it's not the you know there is one operating model for design that you know you can just copy paste everywhere this is so recognizable I have been in so many projects in my early service design days where we just could tell at the start of the project we know what's going to happen in six months we've been through many projects we know these are the challenges that we're going to run into it's smart to address them now and usually the answer was we'll see when we get there or we'll fix that later and then like just like you described six months later you're exactly at the point but it's almost impossible to get people to worry about those things early on I'm curious how this topic relates to what you just previously said like nobody cares about design so having that conversation early on about operating models and where the handover is like nobody cares right? they didn't see the part they didn't see the relevance right now exactly so why I have an answer but I'm curious what you would say so why have this conversation at the start anyway? because you know when you let the six months pass the six months that I mentioned the six months that you mentioned that is a human price you know in those six months a few people might burn out leave the design leader might completely lose confidence in his own self right because things start breaking and it's very hard to handle and it's very hard for me to see other and over again these amazing design leaders in some of these organizations really paying a personal price but for themselves and with their own team so I think it is important to mention it and it is important to flag it and I will never stop and you know eventually I'm hoping that somebody will say oh yeah that's a good point let's start thinking about it well I think it adds to your credibility so you don't want to be at the end of six months saying yeah I told you but the next time you sort of come up with an advice or an argument maybe people are more likely to take you up on it so I think it's smart to say that these are probably the things you're going to run into but hey you know next time with regards to scaling design scaling service design the operating models I think a lot of us would already be happy to be in this luxury position where the challenge is to scale like first most of us I think are in the challenge of actually getting it done but let's say we're at the stage that we can scale it what is it that we actually want to scale? that depends as I'm going to say what you want to do okay I don't think well in your example of the sports brand yeah my answer will always be be contextual right in the case of the sports brand I think what they're trying to scale is design capability so you know there are very few service designers very few in ours at a strategic level product teams find it incredibly useful to work with service designers because you know they give them a you know for the whole reasons that we know an end-to-end perspective of what is that the actual product how to prioritize investment within you know their product how to inform the agile teams and in the backlog how to make decisions right for them as managers it seems incredibly useful but there is a bottleneck you know when you start seeing value into these things and you are you then will reach a point from push-to-pull right where you have designers trying to convince some a few product owners around the organization at least in the case of this sports brand that you know design could help you with some of the issues that you have to the point where there are 15 product owners behind the door saying hey I heard that you do service design can we do some too but then you have five designers and so how do you make this work and so I guess that he has to be critical most I mean I guess he has to be you know the work with every single individual to see the value for you again at the beginning you know what I was saying at the beginning of this conversation showing the value to you create something that is useful for you that makes a change in the way you do things and then you know you do it again and again and again you will find in a position where you don't have to do that anymore because people are just coming to you right yeah yeah and then you you sort of demonstrated that value on a local scale and then you can start to expand it now based on what you've seen like what are the two or three most important things that need to be in place in order to in the operating model in order to foster and accelerate and fuel this further adoption multiple sponsors because you know it's already difficult to find one but usually it's not enough so the people that actually are in the position to unlock budgets to unlock money to tell to people okay take 20 percent of your time and try this thing you need a few of those because you know interests change people change jobs and this stuff take years I mean I'm organizing on a transformation of this kind that I'm describing here with the sports brand or the the band these are transformations that take seven to ten years no question there so you can put all your eggs into one basket let's say into one sponsor add into one sponsor forget it so you you need multiple sponsors ideally multiple pockets of the organization so that you have multiple entry points because also one of them will fail so that's what you want the second one is a good solid design team I think you know very often I see organizations going out and just hiring a bunch of junior designers which you know great they are the lot of value junior designers I'm not saying but it cannot just be that you need people that have experience in actually bringing design in an organizational context and they have the passion to do it which is another problem that I've seen you know in teams and teams design teams breaking that they don't necessarily have a passion for it you know there are certain people they just want to do the blueprint they want to do the redesign the customer experience they want to do that side of the thing which is great that it's needed but it's a very different thing and so I think that bringing design organization the politics the talking the relationships like you gotta enjoy it otherwise it's gonna consume you and I've seen many teams just breaking because of that and then you know you start dropping balls you start refusing work you start not you know taking the opportunities that are presented because you don't have that you know energy yeah so and then yeah just to add to to what you just said most likely if you're just junior designer fresh out of college and you want to apply the tools and methods and just get your hands dirty with that more experience with that you'll probably burn out on all the additional you probably won't even notice all the additional conversations that you need to have in order to actually be able to do the work that you want to do so you need people who who have like you mentioned before who have experienced the pain of delivering stuff which isn't being adopted and then thinking I must start designing at a different level in order to get this work out into the world yeah yeah totally true and the third one the third one is you know what we call the change congestion being aware of that you know for sure somewhere else in this organization somebody's doing a similar thing or a parallel thing or an overlapping thing that they might call the same or something similar and and probably that at 35 there's an issue that you're sort of and so being aware of the change that is happening in this organization that the change programs that are happening in this organization for what reason how are they called it's super important because all these different programs will try to you know claim money attention stakeholders time you cannot do everything at once so being aware of you know change how change happens here right now it's a key thing and who are the people that are doing it actually yeah so and this comes back to again what we discussed earlier that organizational ethnography yeah that's that's a key part of our that's a key part now let's try to bring this down into maybe the reality of a smaller team whether internal or external so let's say you are two three four service designers strong what would your advice be in such a situation how do you even start with handling this dark matter stuff a small team in a large corporate a small team yeah yeah because I think that's the reality for most service designers yet we haven't we don't have an established service design practice yet we're still in the early adopters stage where do we start find friends so what I mean with that is that you know you're small and you have limited leverage and most probably you're piled up with work that is not even relevant for you they're just you know throwing it to you whatever they think is you should be doing so my advice is usually you know go around again organizational ethnography find the people that you know ever need the design can solve that they're open to try they want to experiment and make friends with these people create critical mass start making you know small changes small contribution be kind that's the other thing you know be kind for me that is a fundamental thing be kind to people around you don't go you know I absorb it I have the answer you know I know it all because most probably these people know way more than you do about the context of that organization be humble and just be a service that's the point I think that the point is being a service of the people that are around you and really trying to support them to you know use design to make the life better and and and do it in multiple places do it over time and that in itself will create a critical mass and what would you say to people who sort of feel okay I'm doing this I am kind I am trying to be of service but it's just going so slowly or even worse like I feel that the organization is working against me like all the other forces are pushing against what I actually want to try to do what would your advice be to those people transformations of this kind do not happen bottom up I mean in my experience transformation of these kinds either have a strong top down support with a flourishing bottom up initiatives great you know that's the best combination but you cannot have transformation of these kinds just with bottom up initiative so people believing in it from the you know lower ends because unfortunately the organizations that we have today in the way they are set up they're incredible hierarchical concentrating power concentrated decision making and transformation of these kinds fundamentally touched the core of the purpose the reason why the organization is here and the way things are done at large you cannot do it unless you have the kind of support I mean I you I mean I'm being fully honest here and you know I'm reading right now I was mentioning the Rembanting Organizations book from Malalu and I'm loving this book because it's really talking about that it's talking about you know the evolution of organizations the metaphors that really drive certain the structures of our organizations today and in what way they completely chop the lounge out of people and and you know within the structure there is as much as you can do and then you know there are other types of organization that it just finds you know till organizations where you know you have self-managing teams where hierarchy doesn't exist where you know self-defined roles you know those organizations that if you're lucky enough to be in it then sure bottom up which doesn't exist because there is no bottom will flourish and you will see things change for sure your great creating mass with the peers that fundamentally believe in it but if you are in you know bank in a large insurance a large manufacturing telcos utilities are large you know that's not those organizations are not till organizations what it defines orange organizations and that's it yeah to play within that game yeah and I think you have to be realistic about your expectations and that might be disappointing at some times because as service designers we see how things can be better on which scale that they can be better and if we don't have the mandate don't have the influence don't have the decision making power it can be a bit discouraging to sort of work on the small thing over here while we know that the bigger thing needs to be addressed but it's out of our control and you have to be able to put that in perspective and understand your limitations work with in them or find another job yeah anything else that you'd like to mention about this topic that we didn't discuss yet some final thoughts final thoughts I think he's had a very interesting time for design leaders and I've been actually spending a lot of time doing design therapy for design leaders these days I mean officially it's called coaching but what it it turns out to be very quickly it's really sessions where you know these people just share and vent the frustration pain the difficulty you know you really see the energy draining over time and some excellent you know design leaders that have been meeting I don't know I think there is something to be said there I'm not sure what but it's something that I keep seeing on and on and on and on yeah you know what I tend to do is just listen some day and we're like what you want to talk about today just the fact of having somebody out there the notes where your experience they can be a sparing clarity and it usually helps because it's an outsider if you like so so yeah I can fully second death and their experience I've had with the campfire for in-house service designers that's been running for over a year and with the it's it's just eight people getting together sharing stories about we call them sometimes the dirty secrets of service design like not the shiny case studies but really the the challenges and the difficulties and all the the trauma you almost have to go through like just having a place and knowing that other people deal with the same shit already helps like so I can I can absolutely second death and I think well that's maybe my insight from the last year don't try to do it alone like find somebody in a different organization different field maybe who understands what you're going through and who can sort of be your coach mentor whatever you want to call them a sparing partner sparing partner like you don't don't go into that boxing ring without having somebody in that corner like make sure that you have somebody in that corner that's yeah I've seen that with the campfire and it it it it really helps small things like that yeah absolutely good if people remember one thing from our conversation Marcel what do you hope it is think about the stuff that you cannot see because those take 90% of the work and that that makes it difficult the things that we can see but they are there so the dark matter I think the point here is that you know when you start the customer experience you know transformation you know customer-centric transformation this kind 90% is the dark matter management 10% is going to be the design work you know 10% is going to be the blueprints the journeys the personas the improvement the blah the stuff that we know 90% of the work is dark matter management is understanding the system and learning to work with it and and the system changes all the time it's a dynamic thing it's not that you learn about it once and it's just fixed and yeah and and to sort of again add to that like when people ask me how do I become a better service designer which books should I read to become a better service designer I say read any book except about service design because if you read about strategy if you read about behavior or economics like all those things hit on exactly what you said the other 90% like the 10% is important like you need to know that of course it is yeah you're not going to learn that but the change is the real change and the real impact the real difference is made in in that other 90% which you have to embrace Marcia if people want to continue this conversation with you what's a good way to reach out oh um LinkedIn I'm always on LinkedIn or email Marcia at LibrexStudio.com awesome Marcia thanks so much for addressing this topic I'd love to talk more about dark meta in our organization things it's a really catchy term I hope the language will stick and then we'll hear more about it so yeah thanks again for sharing this with the service design show community thank you for having me here it was great what is your biggest takeaway from this conversation about dark meta leave a comment down below and if you've made it all the way here you're apparently enjoying conversations like this so why not subscribe to the channel click that button over here and be notified when new episodes come out thanks a lot for watching and I look forward to see you in the next video


مرحبا بكم في المستوى انا هي هنزا الناخال اريد ان اتبعي نريما الناخال سلم عينان سيرا موسكس اليوم سوف نتحدث عن اجيبشن وانا يوجد الكثير من الأشياء يمكننا ان نتكلم كثيرا في جانوار 25 بعض الأجيبشن أو من أجيبشن وانا يتكلم كثيرا وانا يتكلم كثيرا في المستوى ومن فبري 11 وانا اريد ان اتبعي سيرا اخبري كيف اتبعي ما اتبعي هذا المستوى؟ يوجد كثيرا السابق سوف نتكلم كثيرا سلم عينان يوجد كثيرا سلمة سلم عينان سلمة سلمة سلمة سلمة سلمة ونحن نظر الوصول على مدينة أخرى ونحن نظر الوصول على مدينة أخرى في نوفمبر was the parliamentary election and there were videos that had gone around showing how corrupt the National Democratic Party was which is the ruling party of the Hasim Obadiq Regime and it demonstrated that they were filling up ballots for the National Democratic Party left and right where the poll doors would be closed and people wouldn't be allowed to vote and there was a lot of violence that was incited against anybody who desired to vote and these videos spread like wildfire it was extremely corrupt people were outraged so there were also some levels of people wanting to collaborate people wanting to get together and protest but of course those efforts were cracked down on it as well and then the last one was the Tunisian uprising in January the Tunisian people were able to oust their own president Ben Ali and they did so successfully with organization, with collaboration and a youth movement that worked very well together to topple this regime and the Egyptian people said well Ben Ali's only been in presidency for 24 years I mean Mubarak's been there for 30 so we can totally take on Mubarak so I think those are the three major factors that led to this major revolution of course coupled with the fact that Mubarak's been there for 30 years you know I was really impressed by the civility of these youth who went into the Tahrir Square and completely defenseless people and they went into struggle against a lot of forces and the military came in could you talk to us about the role of the military in the revolution yeah you know at first it seemed like the military was going to try to stay neutral because you know you had Mubarak who wasn't going to step down and you had the people who were fearless I mean they lost all fear basically you know they had gone to the point where they had nothing to lose anymore and this was all that they had left to do and because they have such huge hearts and such courage you know they were able to stay and they were able to just be completely courageous and fearless and you know the military I think played an important role in the beginning when they said that they weren't going to fire on the protestors because as fearless as you could be if you're going to be you know fired on by army tanks there's not much you can do of course so I think you know the army allowed the people to to stay there and to you know even when they were defenseless and even when they were peacefully protesting no weapons on them you know I think the army gave them somewhat of a cover to be able to do that can you can you talk to us about disability I've seen people organizing themselves even though it was really that it's that people with with no resources but I've seen them cleaning the streets and yeah when this thing started I think everybody noticed or heard that the police left everything you know and the thing started to get like a chaos and even some of the prisoners came out and I I heard from my relatives that people were so scared and they were staying at home scared trying to you know for getting out and the young were protecting the their apartment they were saying that down in front of each apartment trying to to protect it from those criminals who got out people were whether they were helping each other in different ways I heard that there is some doctors just came out just to help when they heard that there is some people who fell down during this thing and they open like a small hospital in the field and everyone was helping even they don't have any kind of resources but they were everybody was trying to help each other to to get this thing to get to succeed just it is really very emotional just to hear what these people were doing in the street of Egypt I never felt that I can see this happening in Egypt in my life I left Egypt I left Egypt of course I was born and raised in Egypt I finished my college degree there when I came here to the United States but I still have some kind of connection there my family still live there and I go visit them so I heard a lot of things was going on in Egypt and everybody was so frustrated everybody get out of college and they don't they don't find jobs people who are getting rich are getting richer and people who are poor getting poorer and it's this thing just get people to explode I'm really proud of all this young youth Egyptian who got this kind of peaceful revolution to start and get it to finish it successfully I want to tell you I'm not feeling there one day I think it was Wednesday when I called my sister in Egypt and she was crying she's 75 years old woman living by herself and I ask why she was so unsafe the police has gone out there's no police anymore and they released all these prisoners and many people from each building went down with stakes with to protect whoever living in the building so my sister she kept crying and then I called some relative went to spend the night and I think that reflected in many Egyptian families but I really want to get to you in a role of social media on this uprising I think it's really important that you bring that up relating back to what you were saying about how people were very fearful to leave their apartment buildings on Friday the 28th of January we bought a cut off the entire 85 million population of Egypt from all internet, all facebook, all twitter and this was a medium that all mobile phones too all text messages and this was a complete shut off and this was a tool that was being used to mobilize the youth to mobilize the young professionals and get them all in one place so that they knew where to gather and where they should march but in the midst of this cut off of internet Mubarak also released prisoners he also got the police out to incite violence against people and that's when that culture of fear was cultivated in the Egyptian population that's when there was kind of a strife between people that were just I'm too afraid to go out I just want this to end and a lot of people were bringing up videos where they would show how poorly the police were treating the protesters but nobody was able to see that if you're in Egypt you can't see those videos online you can't read those tweets you don't know who's doing the violence so you're just saying I don't want anything to do with it I'm too scared to come out of their apartment buildings young men older adult males the women would bring the men downstairs tea because you know they're staying up 24 hours a day trying to keep the apartment building protected they provided these great great neighborhood militias to protect their own people and then once the internet was restored the videos of the police brutality showed up the videos of the looting by the thugs hired by Mubarak's regime showed up and that's when people's fear was completely destroyed Salma was saying that they were fearless and that's when they really started to feel this unity of we know who's inciting this violence we know who's robbing the streets and who's looting and it's not the protesters so the use of social media changed their perception of fear and it turned it into a strong sense of courage unity and continue to proceed in their protests but I have to say that this was definitely a e-revolution this is something that the youth of April 6 the youth came together and created of course the April 6 youth movement it was kind of a support group by the youth to halt all activities on April 6 I think 2008 but this was one group that was already mobilized and they already had their ties together and then coupled with the group of the Khaled Said protesters who were in support of the blogger that was killed over the summer so these two groups that were both on Facebook they were both on Twitter they both had online presence they came together mobilized their membership via Facebook and Twitter and they went out to the streets what happened on January 25 I'm really it's not only the men I think the women really played an important role and I I've seen so many pictures where the women were leading if you can fill up on the rule of women in this and I noticed there were no harassment of women in the square or throughout the country there were no rubbing or stealing or people taking other people property so if you if you could tell us about the role of women in this uprising yeah I was amazing to me to see the observations that you point out which was that many times women were the ones that were on the loudspeaker you know leading the chance and you know men and women together were there you know for a common purpose there was no distinction between the men and the women the women were there for the same purpose that the men were there and really this was about Egyptian people it wasn't about men and it wasn't about women it was about everybody and we really saw that with everybody you know being together working together and you know like Sarah had mentioned you know it was just amazing to see you know the civility and the people you know the lost and found people setting up lost and found turning in money these are people who need money and you know they had so much you know pride and so men and women that they were turning in everything money anything that they found they were turning it in because they were there for a common purpose and it was it was amazing to see that the the unity like Sarah mentioned among the people and it really was something for the people everybody more recently we heard about I think the CBS correspondent Lara Lara Logan and it was a very unfortunate story that you know she had been you know sexually assaulted by you know certain Egyptian men after Mubarak had stepped down and it's very it's very sad that something like that happened but I think it's also very important to know that something like that can't overshadow everything else that you know happened the 18 days of the peaceful protest of the people working together of the men and women side by side being Egyptian people and working for one common purpose I mean out of 80 million people you know the majority really were behind this movement and you know as much as that I'm sure there are you know internal fighting you know people who would agree with different political parties and different things like that it was very amazing to see everybody come in for one one common goal which was to get Mubarak out in the regime out and it was incredible to see that amount of unity of course that's true but also the religion part was really important where I saw both Christians and Muslim working together for the same thing I saw Christians surrounding the Muslims while they are praying to protect them and I saw a Christian woman who was actually pouring the water for a Muslim to do his own before prayer and at the same time I saw the Muslim when they were then surrounded the cathedral on January first at the beginning of the new year to protect them from any attack so it sounds like the people who were citing the division between Muslim and Christian was the regime it was not the people themselves I think Mubarak wanted to create a divide and conquer tactic and he used rifts between getting Muslims and Christians separated he used rifts between getting the elderly population and the young population separated I mean he used a lot of rifts to try to divide the population up so that instead of thinking about a unified cause against him they would think about their own clashes internally and I think the Egyptian population mostly did exactly the opposite of that they said anytime there would be maybe a religious chanting from either Christian or Muslim side they would say a chant in Arabic that says Muslim, Christian we're all one Egyptian so that was kind of the show that no matter who tried to bring up any religious context they would be shot down immediately I mean not literally but their voice would be overshadowed by the strong majority very very strong majority of people that were completely against that this is just like Sanaa said one Egyptian united cause that's true I grew up in Egypt of course I went through high school and university even finished my master's degree in Egypt and I always had Christian friends so when they tell me there's division between I couldn't understand where it's coming from because I had so many Christian friends and we played together we were there were no differences and so many people didn't know whether one person is Christian or Muslim because we were just all Egyptians so now now that we have arrived to this stage now Mubarak is gone but there is still this this uneasiness of people of the existing government who can feel us on why people are so unhappy with the existing government I think still people do not trust what's going to happen after this revolution after Mubarak they said Mubarak is gone but what we heard that Mubarak is still there is just this thing in Sharma Sheikh and he is cabinet or the prime minister that Mubarak and appointed Ahmad Shafi as prime minister he's still there so I think that the Egyptian still do not trust the government right now there's still some kind of confusion about what's going to happen and of course because people just suffer for so long they are afraid that this thing is going to continue continue with the same with the same people they said that Omar Saliman is still there Ahmad Shafi is still there and Mubarak is still there and we heard from time to time that they are trying this Mubarak regime I think they are trying to get people to get confused about what's going to happen and you notice that there are some protests some company now they are protesting to get to get raise in their salary they think of course after what they heard that how much Mubarak you know his wealth how much Mubarak and his family all this thing that happened during Mubarak regime I think people still do not trust the government right now and I think the best thing just to start to try to get quickly to solve all this problem and get Egypt to go on the right path Sir if you can if you can fill us on what do we do to help Egypt in this stage I mean this revolution is going to change the whole Middle East but how can we help Egypt that's a question I think every Egyptian living outside of Egypt has thought about since February 11 you know we've allowed ourselves maybe 24 hours to celebrate but we saw hundreds of nonprofit organizations across the U.S. alone coming about saying let's see what we can do to help Egypt how can we assist what can we do and I think there are several things that can be done I think what we need to do before that is look at what the Egyptians in Egypt are doing and how can we supplement their work and how can we supplement what's being done on ground because the Egyptians are extremely intellectual we see Nobel Prize winners coming out of their Nobel laureates I mean these are very very smart people they just were trapped under a very oppressive regime that didn't allow them to vocalize and organize and mobilize the programs that they would like to see in their country they have huge dreams they are very ambitious they have great ideas because we are seeing tons and tons of groups coming about but we want to make sure that we are all supporting what the Egyptians in Egypt want to do but some of the things that have kind of noted themselves out from what the Egyptians want and also how the Egyptian Americans can help is first and foremost tourism Egypt strives on its tourism sector it is almost half of their income as a nation and after the protests began the US pulled out all of its tourists from Egypt and said anybody that's there and has been living there you need to get out and a lot of countries across the globe have done that as well so the first and foremost is tourism we need to reinstate those tourists the tourism sector and make sure that it's thriving again because I don't think any of us are going to be able to live a revolution again so financially let's help rebuild Egypt by visiting by taking cruises and of course it's probably very affordable at this point so that's my first suggestion and I think the whole country the whole population of Egypt has really emphasized that and the second one is to assist in educating the Egyptian people for what a true democracy looks like what are political parties what are campaigns what do I need to do to run how do I reach out to voters how do I register to vote I mean these are very simple things but they've been so behind red tape and lacked a lot of transparency in Egypt so we want to help educate the Egyptian people in Egypt but also make it extremely transparent and easy for anybody who maybe didn't attend an educational seminar or whatever it may be so that they have the opportunity to see those things and those are the first two things that we would like to see at least done and the Egyptians in Egypt have made it very clear that's what they would like to when I ask Selma on our government in the United States he's been helping all this different government in the Middle East now there is a new movement of democracy and the United States should consider its new approach for the Middle East that's a really good question you know we've seen America always talk about democratic ideals but then of course for the last 30 years they've supported a dictator something that's obviously anti-democratic I think moving forward it's very important for the government of America to stand by their ideals as opposed to standing by people because they have fears of who's going to step into power now now that there's a power vacuum is it going to be the Muslim Brotherhood is that going to create room for radical Muslims basically there's this fear of the unknown at this point and I think that it's important truly than standing behind democratic ideals and so we saw the discourse not really supporting what the true ideals were so I think at this point if America says they support democracy then they should support democracy everywhere and if the people of Egypt as Sarah mentioned that was one of their demands they want free and fair elections if that's what they want then we have to stand by that and support their right to live a democratic society and if they choose to elect people through a democratic process that perhaps we don't necessarily agree with well that's democracy and I think that's something we just have to step aside and really let them have those free and fair elections and choose who they want to have represent them that's democracy I noticed recently in Egypt that a lot of companies a lot of workers just been protesting and a lot of the government people just really crying for people to get back to work because of course if the economy will stay at stand situation there's no way we can pay anybody anything so if you can fill us how people feel only on getting the economy to go again I think the best thing just to get the economy to go back again I think for those people who are protesting just to go back to work and try to live like a normal life because if we close all the companies that producing like sugar like wheat whatever that you know after a while we're not going to find food for for the egyptian so they're going to start to complain that they have a shortage of food so I think we cannot like push a button just to get these people just expect or some of them just expect you're going to push a button after مباركليف that they can get the raise or you know good salaries and all this thing I think we have to be settled first and so we can correct all this thing and then we can start a new beginning and so hopefully that people understand that and I think people need some kind of education as Sarah said you know we have a lot of people who are literally in Egypt and and this is yeah just something that we need to do and you know even people who are educated there I mean truly since the time of the pharaohs there hasn't been a democracy in Egypt and there haven't been free and fair elections so even if the people know that's what they want they might not necessarily know what that even means or you know what it takes to get that so you know as far as you know educating or helping to educate you know the Egyptians there you know there's a program a group that we want to start basically creating short videos and things like that that we can disseminate in Egypt basically stating you know those very simple ideas that Sarah was mentioning even just what voting means how to vote where to vote you know how to pick from different candidates what do process means what you know separation of powers means those kinds of concepts that maybe you know they know they want some kind of you know vague end but they don't necessarily know exactly what that is because they've never had it before well I want to I want to thank you all of you you really made a very nice discussion today I want to I want to thank all the audience also for being with us and if there is any questions we have the website please contact us and we'll answer any question you want thank you very much


Now, we said earlier that this vertical longitudinal tear is one type of up-and-down tear. There's another kind of up-and-down tear that we should talk about, and that is one that starts in the inner third. And instead of going up and down, that's parallel to the capsule. In other words, that's parallel to the capsule, which we'll imagine is here in red that has some blood in it. It is perpendicular to the capsule, kind of like the spokes on a wheel, right? The spokes on the wheel are perpendicular to the outer part of this circle. Kind of like the wheels on the bus, go round and round, right? So what does that look like? Well, here's the spoke on the wheel, right here. It's coming right at you. It's coming at you. Because it makes a little V, that's a radial tear. And that goes into the screen. That also goes up and down. It's just in a different axis. Now we're interested in this tear because this tear can get a little bit nasty. Well, how come? Because it's in an area that doesn't heal. Remember, we have outer third, red-red zone, middle third, red-white zone, inner third, white-white zone. The white-white zone has no vascularity. It doesn't heal. Okay, so we have a little tear there. When do we mess with it? When it's symptomatic. But what kind of symptoms? Pain? Maybe not.  But if it's pain and clicking or pain and locking or pain and progressive arthritis, then it has to be addressed. Now in the orthopedic literature they say that if the tear has a depth of greater than six to eight millimeters, that those are more likely to become unstable, to propagate, and even to lead to consequences like fragmentation, locking, and conglomeration. But I think we've gotten a little more liberal as time has gone on and less aggressive in trying to resect these tears because there's no sewing them. You just go in with a claw and you just claw a matter there, which is kind of ugly. So what do we mean by depth? Depth is the measurement from here, the inner edge, to the outer edge. So depth goes this way. Remember, length is completely different for the longitudinal vertical tear. For the radial vertical tear, we're more interested in this character. Now we also have gapping, you know, the side to side dimension. So the tears can get a little wide and the more gap they are, the more troublesome they are. So depth is important, the measurement from here to here, greater than six to eight millimeters, but also the side to side dimension because gapping can lead to instability. Instability of what? Instability of the miscous. So where might we see a problematic area of gapping back here near the meniscus root? Remember we have a posterior horn, posterior third, a body, middle third, an anterior horn, anterior third to keep it simple. We also have in the deepest attachment of the meniscus, the meniscus root in the back and in the front. And although we haven't drawn them in, there are ligaments. So confuse the meniscus root, which is meniscus, with the meniscus root ligament. You can tear the meniscus from its root, you can tear the ligament from the bone. Now they both have the same consequence. But what happens if you have one of these radial tears and it keeps going back, back, back, back, back to quote Chris Berman and it keeps going back, back, back, back and boom it goes to the outer surface. Now we've got a problem, right? The meniscus isn't anchored to itself anymore. Doesn't matter where the ligament's still there, this is not attached to that. And so they spread apart and the meniscus starts to float this way, out of the edge of the femur and the tibia. And now you essentially have a meniscus that extrudes itself. So these very large radial root tears are problematic. The little ones, we leave all of those alone. We hardly ever touch the root radial tears that don't go all the way through. Even the ones that almost go all the way through we don't touch. But the ones that clearly go all the way from the inner third to the outer third, the meniscus is starting to gap and separate those we've got to go after. So we've learned about two very important vertically oriented tears today. The one that's longitudinal and parallel to the outer portion of the meniscus. And the one that's perpendicular to the outer arc of the meniscus. The one that's parallel is less problematic because it's in the red-red zone. The one that is perpendicular is problematic. Now if this radial tear were to arc, if it were to do something like, say, this, we would call it a flap tear. So radial tears are straighter. If it were to arc and it would get a little bit wider and a little bit longer, now we're into a parrot beat tear, which happens to like the body horn junctions. Let's draw another meniscus for a moment just so we can demonstrate one other thing for completeness. I realize my meniscus is a little bit thin here. But I think you can see it. Actually, I'm going to make it thicker because I know I'm going to get reprimanded if I don't. Let's make a thicker meniscus. Let me erase this one. Give you a little more, a little more visual stimulation here. Oh, wow, that's a really thick one. Yeah, this is for all of us out there that are over age 60.  Okay, now let's make it thinner. Let's make our line thinner. And let's change the color. And now let's assume we have a longitudinal tear and it's in the middle third. It would be a vertical longitudinal tear in the middle third. And if that vertical longitudinal tear starts to gap and get wider and wider and wider and wider and all of a sudden this portion of the meniscus starts to go inwards, now we have ourselves a bucket handle tear. So a bucket handle tear really starts out as a vertical tear usually in the center of the meniscus. And that will be a story for another day.


works and the idea is that fireworks need to like finish with a crescendo of the best ones need to be at the end and so basically this workshop is like this and so the best ones are at the end I think and so here is one of the two at the end uh no then there is another talk but this was not in the original schedule but here we have Jana and Olivia in this session who are presenting some of the most I think innovative work on Plasmid that I'm aware of so Jana up to you wow thank you uh with such an introduction I I hope not to disappoint and to go out with a bang um just to confirm you can see my screen the the proper version not the uh presenter view okay okay and let's see if we can do this different thing and again same problem okay and now it should be okay perfect okay oh perfect yeah so today I'll present some work we've done to estimate Plasmid conjugation rates and really my original plan was to um present this paper that we recently published in the journal Plasmid on methods to estimate Plasmid conjugation rates from in vitro liquid culture meetings in this work we compared several existing methods both on simulations and experimental data showed that there were some issues with some of these existing methods proposed improved methods and also tools that people can use to to estimate these rates easily I will still present this work but based on some of the discussions over the past few days I thought I would have a slightly more extended introduction on why to care about conjugation rates in the first place I think Fernando de la Cruz said that it's primarily the modelers that care about conjugation rates yes we do I think for good reasons but I think we should all care about conjugation rates also and then in the discussion more what do these conjugation rates in vitro mean for other systems or how can we translate them to in vivo or environmental scales how do they relate also to what we get from uh genomic studies and this is more a few ideas for discussion and it would be nice if we still have time at the end of the session to go into that so I probably don't need to convince any of you that plasmids are interesting and one of the big reasons why they're interesting is because at least the conjugative ones can spread both horizontally and vertically and by spreading horizontally they can spread genes genetic material into strained backgrounds in different environments where these genes weren't present before and this is primarily interesting for antibiotic resistance here in the context of this workshop but also a whole range of other virulence genes and things like that and this is often seen as being in a sort of trade-off with their vertical transmission so horizontal transmission tends to be costly because the bacteria have to build the the pilus they are yeah they open them up themselves up to predation by phage and things like that and so you see different sort of lifestyle modes developed for certain plasmids that co-evolve more with their hosts that develop a lower cost and perhaps also lower transfer or those that are really promiscuous they spread far and wide in many different hosts but perhaps are less stably maintained and yeah I think we've seen a bit of both talks this week people that are really interested in sort of the growth part of things so the interactions between plasmids and their hosts perhaps other mobile genetic elements within the same host what this means for the cost that these plasmids confer to the host and also aspects relating to selection for the genes born by the plasmids themselves as well as some talks more focusing on the infectious transfer and I think what I would like to argue here is that to really get a good idea of plasmid biology on the one hand but but also to have tools to predict sort of the epidemiology so the spread of plasmids in different environments we need to be able to distinguish the spread of a plasmid that is due to this horizontal component from aspects that are more vertical so transmission of the plasmids together with its hosts into different environments essentially so that's why I think we need really good estimates of these plasmid conjugation rates and here are just a few questions that one could be interested in answering in an experimental system where I think it's important to again distinguish effects of environmental factors on growth versus on conjugation so one is for instance how yeah sub-lethal doses of antibiotics might affect plasmid transfer this is a question that's been studied before and you can imagine that the antibiotics of course inhibit growth of some of the strains involved in transfer but they might also actively act on the conjugation machinery essentially and the transcription thereof and things like this then there's other questions about what makes certain plasmids very successful is it their low cost or their high transfer what is high transfer in the first place how do we compare transfer across different plasmids across different environments and with that can we also predict which plasmids are the most problematic for spread so with that how do people normally estimate plasmid transfer rates there's certain parts that are quite conserved let's say the main idea behind sort of the standard protocol is you take your donor and recipient bacteria you throw them together in whatever media you're interested in using you incubate them for some time during which all the bacteria grow and donors recipients meet each other they conjugate the trans-conjugants grow they also conjugate with recipients and so on and so on and then after a certain amount of time you stop this process and you somehow count the final population sizes whether that is by plating on different selective media or if they're fluorescence labeled or so you can attract them in a different way and this is kind of the conserved but this is also where the mess starts because now you have these final population sizes and what do you do with that how does this tell you anything about the underlying dynamics of plasmid transfer and so as I said the first thing we did in this paper is to sort of catalog the different methods that are out there that people have used to try to estimate a plasmid transfer from such mating cultures and this is just the first half of the table where I show some of these methods and you can already see sort of the simplest methods in a way are simple enumerations of the amount of trans-conjugants you find at the end of the experiment against other bacteria involved in transfer so for instance trans-conjugants over the donors or you could say out of the recipient population which fraction carries the plasmid and then there's other methods that are based more actively on understanding of the population dynamic models either in a heuristic way or a more direct way as we'll show in just a few slides so what we did here was to simulate certain population dynamics that we know and then compare the performance of several of these different methods on those simulated dynamics and see if we can recover sort of the truth that we put into it so here I'll show you a few results on a scenario where all the bacterial populations have a plasmid that conjugates at exactly the same rate but in my different treatments I get an effect on the growth rates of different strains that are involved so green in a way is the control donors recipients and trans-conjugants all have the same growth rate orange is now a situation in which the plasmid confers a cost to the bacterium that carries it so the donors and the trans-conjugant strains and the purple is a scenario in which the recipient grows faster than the donor so both recipients and trans-conjugants grow faster for instance because it's a different species and if you now look after either four or eight hours with this trans-conjugant per donor method you immediately see that we get qualitatively different results so first of all we see that the time when we stop the experiment matters so after eight hours we get higher conjugation proficiency than after four simply because there's more time for the trans-conjugants to grow which maybe within a single experiment is not so much of a problem but becomes a problem if you want to compare results across the literature and obtained by different labs and for different incubation periods and things like that without the growth rates mentioned of the strains involved you cannot really compare these things and measure them back the second thing that we see and I think that's even more problematic here is that we would now infer we would draw the conclusion that our plasma is transferring at a higher rate to the faster recipient and this is caused by the fact that clonal growth and horizontal transfer are confounded in this particular scenario because the recipient or the trans-conjugants are growing faster after the initial transfer into these bacteria we just get more resulting trans-conjugants at the end of the line and this is being seen as some higher level of conjugation proficiency. Luckily this was already seen as a problem back in the 90s by Lorna Simonsen at all who developed a method based on considerations of the population dynamics so they effectively modeled what's happening in such a mating culture both these conjugation processes and growth processes going on and they devised what they call this endpoint formula with which you can actually get the conjugation rate given information on the population growth rate of all of the strains together as well as measurements of the final population sizes at the end of the experiment. So this is already really good because now there's no more dependence on when you exactly terminate the experiment but we and there's also some other advantages like it doesn't depend on the initial densities of the strains as strongly anymore but what we still see and it's a bit hard to see on this depiction is that there's a slight difference depending on our growth rates because effectively this method is taking into account one combined growth rate for all of the strains involved so that's one assumption that we relaxed simply by allowing all of the different strains involved in this process to have their own individual growth rates and that means that you need to measure those individual growth rates that's additional work for an experimentalist but with that you also get more precise estimates and we finally recover here that in each of these treatments we actually had a plasmid conjugating at exactly the same rate and very similar to the Simonson method we basically derived what we call an endpoint formula so you only need to measure sort of at the beginning and at the end of the experiment and you don't need measurements all through time. So growth is one thing that can happen in these experiments but another thing that might be confounding are measurements of the conjugation rate from these donors to the recipients is that at some point in the experiment trans conjugants are there in such appreciable numbers that they also start contributing to these conjugation events and they might be conjugating at a different rate than the original donors in fact in other work together with Fabian Benz and Erik Bakeren we found that the donor identity strongly affects the rate of plasmid transfer and in this case we had a first generation conjugation experiment as we call it from clinical donors into a recipient strain and then we took the trans conjugants resulting from that experiment and mated them together again with the same recipient strain in what we call a second generation conjugation experiment and we found that for this particular strain that difference was two orders of magnitude and now this is not a difference to transitority repression but really due to differences in strain identity and yeah you can think for instance of different restriction modification systems and so on that are suddenly the same now between the new donor and the new recipient. So just to get back to our method to estimate plasmid conjugation rates we don't actually remove this problem we cannot say okay this is the donor conjugation rate estimate and this is the conjugation rate estimate from trans conjugants but what we did manage to do is derive within which time window you should measure the first experiment so that it's not troubled yet by the contribution of trans conjugants to this conjugation process because initially they are at very low concentration as they are arriving in the mating experiment and it takes a while until they start dominating what is visible in these cultures. So we developed an R package and a shiny app so that's a web application that allows people to estimate conjugation rates on their experimental data. The idea behind it is that it should be as easy as possible to use I really hope that's the case but please please try to use this if these are experiments that you carry out and let me know what you think of yeah the way this is usable and so on just send me an email or add an issue to this github page it would be very nice to know how it's being experienced by those that that are actually using it. So all of that was to say something about plasmid conjugation rates in vitro but what does this actually mean for dynamics in more complex settings because as we've discussed also for the past few days in vitro you're always looking at just one very specific situation and in the environment maybe the plasmids are experiencing a very different surroundings and dynamics and it's I think important to look at what the rates of plasmid transfer might be at these environmental levels because this is exactly where we would want to intervene and do something about surveillance first of all like in the hospital which plasmids could be problematic which plasmids are spreading our antibiotic resistance from one type of bacteria to the other but also which environments might be introducing resistance or actually sort of absorbing resistance and how can we stop or like target those environments where where it's needed the most. So I don't have any answers to how to do this the best but I thought I would at least mention a few different ideas in this direction that we can then discuss further. So one thing is the translation of in vitro rates estimated for a very particular plasmid maybe a very particular donor and recipient pair as well from in vitro to in vivo models and again in this study with Fabian Benz and Erik Bakeren we did exactly that we took two plasmids that we had previously conjugated in vitro and put them into a mouse and we found that qualitatively we saw the same plasmid performing well in the mouse as we saw also in vitro and performing at a higher rate basically than the plasmid that was doing worse also in vitro but we did not actually map the rates onto each other because one problem for instance in doing this is that we don't know whether the mouse guts represents a well mixed liquid environment it probably does not so there might be contributions of plasmid transfer on surfaces which we know for some plasmids happens at a different rates than it does in liquid for instance and also a lot of the meeting dynamics so that the kinetics basically of which bacteria find each other and have the opportunity to mate is likely different in the guts than it is in flasks or test tubes so this is something where I think modeling can help in the future to try to describe those settings more realistically additionally there's evidence from other experimental systems that this translation from in vitro to in vivo on a qualitative level doesn't always work so this is from Lofty Eaton et al where they studied transmission in zebrafish and they actually found different conjugation partners playing a role in vivo than in vitro simply because of different abundances so I think in their in vitro experiments they didn't see one bacteria at all that was there in sort of low prevalence in vivo and actually played a large role in the onward transmission or maintenance of this plasmid also because it was the host where the plasmid could persist better over a longer time and I think that's another key difference in translating in vitro results where often conjugation experiments take 24 hours or maybe if you have slow growing strains two to four days or so versus in vivo we're really talking more on the scale of weeks to months of this plasmid being present in a particular environment and also being maintained in a certain strain then secondly there's this evidence from meta analysis by shepherd at all of just the sheer range of rates conjugation rates that plasmids occupy and here this is all as measured with the Simmons and Endpoint method so in principle it should be comparable methodologically and they find a plasmid transfer rates in vitro again that's sprung from 10 to the minus 16 to 10 to the minus 8 and more specifically for a single plasmid that's been used in many studies or one they find data points that span again from 10 to the minus 18 to 10 to the minus 6 which is crazy it's unheard of 10 to the minus 12 or 12 orders of magnitude difference for a single biological entity across different experiments and I think we really need to find out as a community what is causing this is it just differences in experimental setup like mixing and again interaction possibilities between conjugating partners or is this all caused by environmental factors and temperature and things like this biotic factors and knowing better when a plasmid is at the bottom or the top of its possible range is going to be really important for predicting spread also again in more complex environments yeah and lastly this is just because we have a lot of people interested in genomics here if we're thinking about genomics and the presence of a particular plasmid in a particular strain and what that is telling us about the plasmid transfer rate I think we're actually talking about something very different than when we're approaching it sort of bottom up through in vitro measurements of plasmid transfer and I would argue in a way that what we're observing through sequencing is maybe bringing us back to this very beginning point of both growth and selection in particular environments as well as plasmid transfer of course we need the transfer to initially establish into a strain but then the fact that it can actually be observed there and be present in high enough numbers to be picked up by some random sequencing study is probably because it's at least partially selected for and I think this is also something that we could potentially even target with specific sequencing studies and so on whether we can try to disentangle some of these effects more maybe over shorter time scales or where also the phylogenetic tree of the chromosome of the bacteria that they're in has a lot of temporal resolution and the plasmid is just sort of jumping in and out and then you could start saying more about plasmid transfer rates so with that I'm at the end I really hope I didn't go too far over time I lost track of where we were I showed you this paper that we wrote to estimate plasmid transfer rates in vitro I hope I could also trigger some thoughts and discussion about what we need to do to translate these rates into more complex settings and that would be something that I would love to to discuss with you more didn't do this all alone I would like to thank my supervisors Tanya and Sebastian I recently finished my phd with them I'm also looking for a post-op position so if anyone knows anything please do let me know and I would be happy to answer questions wow that was amazing so any questions for Yana I think there are questions now so what about we let Olivia talk because I don't have like questions on the talk but I map for the discussion but maybe it's better if we let Olivia talk and then we discuss I don't know Olivia are you here I also see a question from Cornelia and is there a question for yeah okay well it's also a quick question so your transfer experiments they're always done in broth or were they done also in service meetings because it's a question of mixing because in my lab we typically do surface meetings because they are more relevant for soil systems or plant systems but you use liquid yeah yes exactly so this is all for liquid media and there's this nice paper that shows that under very very particular conditions I think if you have really high density liquid and you put it on a filter for a very short amount of time that it can still be roughly approximated but there's there's no real good measures that I currently know of to do this on filters and that's exactly part of this this discussion that I think we should have is how we can create measures that do take into account some of this spatial structure for instance this different interaction indeed and maybe relate some of the transfer rates we measure on filters to those that you would get yeah in in liquids for instance thanks