Laurent Jauré in Paris and this is the museum that was built around Monet's life-sized water lilies. Monet painted these massive water lilies that are the size of that hole back well over there and they basically built a museum around them. This is what it looks like. It's curved and you're just immersed in water lilies on both sides. It's got a white roof, white light. It's really pretty cool. These are life-size water lilies. If you like Monet, it's great. If you don't, just close your eyes and go to sleep. But you can see that there's various different paintings all along here and there are several different rooms shaped in circles. You can go and look at the various different paintings that are there. This just shows you have to go to a wide angle to get it all in. So it's actually pretty nice when you do that. Right outside of that, of course, is the gates leading to IMP's pyramid, leading to the Louvre. Or as they'd say here in Utah, the Louvre. So there's a Louvre where you get to see all the good patrons there. And there's the pyramid that IMP built later. So it's kind of interesting to see a modernistic glass pyramid in a 200-year-old glassy museum. But this is where you line up to get in. Actually, you go in underground now, right here. And you've got some really beautiful fountains there. So, orbit. Alright, so we talked about orbit a little bit last night. Now you can't really talk about orbit without realizing what makes up the orbit. One of the things that we always like to go over here is the bones of the orbit. And so, how many bones are there in the orbit? Reach out. Seven. Seven. Let's start. Name one. Frontal bone. Frontal bone. Alright, hang on. Axillary bone. Axillary bone.  I'm Cole. I'm the new intern. Oh, you're Cole. You're the intern. Oh, I thought you didn't start till next month. Alright, why you at the va? Yup. Alright. Well, welcome. Well, you get a reprieve for one lecture. But next week, read on tumors. Okay. Sphenoid. Sphenoid. Alright, that's three. Ethnoid. Ethnoid. Four. Lachromo. Five. Palatine. Palatine. Six. No, no, we'll get you good. I won't do it. Lachomatic, good. Alright, so, people often forget the little palatine bone. That's really one that people do forget about. But, the other thing that you've got to realize is what's around the orbit. And so, again, when you're looking at the orbit here, medially but also inferiorly and superiorly, there are sinuses around the orbit. So any diseases, any infections, any inflammations, any tumors that affect the sinuses can affect the orbit. And of course, we talked a lot last night at orbit conference about the orbital apex, a very busy layer where nerves and things go out of the eye, nerves and vessels go into the orbit. And so very, very busy area here. And then, of course, behind that, you've got a lot of busy anatomy back here. So the key thing when you want to think about the orbit, there's not a whole lot that goes on in the orbit, except for the fact that the orbit houses the globe, which is the most important thing that we think about with the eye. This just shows a little bit in a sagittal section. Now, Arianna, how do we subdivide the orbit? What are the main areas that we break the orbit into? And what's the third potential space? So periosteal. So if you look at the extracutor muscles, the muscles in the intramuscular septae make a cone. And so basically the base of the cone is at the apex of the orbit, and then it forms as the muscles go on to the posterior part of the globe. So this is intraconal. Extraconal is the area outside of the muscles in the intramuscular septum, which is not a whole lot going on in there, some fat and a few little vessels and nerves and things. And then the periosteum lines the bones of the orbit and there's a potential subperiosteal space where you can have, again, infectious processes coming from the orbits, hemorrhages, things like that are coming from the sinuses, I mean, and things like that that can form this potential subperiosteal space. And this shows that in an MRI scan, the most important thing in the intraconal space is obviously the optic nerve and the vessels and nerves that go through here and then the extraconal space and then the subperiosteum is a potential space. All right, what are we looking at right here, Ally? All right, so we've got these eccrine glands that are forming this little assener pattern. Why would I be showing you these in an orbital lecture? Lacrimal glands, good. So you're not, my mind would have been stimulated had you not done that. I would have been crying up here, but so the lacrimal glands, you remember there in eccrine gland, they've got this assener pattern where they form this circular pattern and they do their secretions into the central part of the lumen right here. You'll see that they'll often have this little kind of the acidifilx staining granules in them. Now, what else goes on here besides just the glandular part of the lacrimal glands? Brad, what other cells are in there? Well, not many fat cells in the lacrimal gland. What other cells are there beside the sacrum? Oh, we were talking about it inside the lacrimal gland. Mesenchymal cells. Mesenchymal cells, and what are those usually comprised of? Yeah, little myoepithelial cells. So little cells that kind of surround these asseni, these little spindly shaped cells. And I like to think of them in simplistic terms. So my simplistic way of thinking about them is these are little cells that squeeze the gland so that the secretions can get out. That's way too simplistic, but remember not only are the lacrimal glands made up of the epithelial cells that make the secretions, but also the myoepithelial cells that surround them. So those are both in the lacrimal glands. There's another type of cells that kind of live in the lacrimal glands. Sneha, what other cells live in there?  Anybody, people forget this all the time. Lymphocytes live in there. So wherever you have mucus membrane exposed to world, you'll often get some little gatherings of lymphocytes, almost like pyrus patches that you have in the gut. So not uncommon in the lacrimal gland. You have these little, almost pyrus patches, groupings of lymphocytes, and they are mostly more T lymphocytes than they are B lymphocytes. Right, we're looking at, you know, that's the hardest thing about orbit. Orbit is the one part of the eye we can't see. And so oftentimes when we're looking at the orbit, we almost have to infer something going on. And so before we jump in and order an MRI scan, we wanna look for subtle findings now. The one thing nice about it is orbits, there's two of them. And so we can often compare. Do we see anything very subtle that we can compare to? Boy, this is really subtle. And this is hard when you're looking at orbits, because if you look at it, look at that little light reflex, where that is in the pupil. And you look at the light reflex here, just a little bit higher. And it's very subtle, but you don't quite see the wrinkles as much here as you see here. And so you almost get an idea that there's a vague fullness there and that that eye may be pushed down a little bit. And we look at the scan here, the CT scan. What do we see in here? Exactly, and people would call this a coin lesion. By coin it means it's kind of rounded and it's pushing the eye in and down and it's got a little bit of a border around it. So what would you be concerned about here? All right, so you'd be concerned about either an inflammation and infection or lacrimal gland tumor per se. And we look at the path and this is what it looks like. What do we see in here? Exactly, so you see that this is almost like glandular. Some of them are more tubes than small glands, but it's glandular. But then there's all these kind of little spindly cells proliferating with this ground substance in between. What do you think this lesion would be? Exactly, pleomorphic adenoma. The other word they call this is sometimes they call it a benign mixed. So it's a pleomorphic adenoma. And this is the most common tumor derived from the lacrimal gland tissue itself. It's a pleomorphic adenoma where we call it a benign mix. And so it's a mixture of this proliferation of the little glandular epithelial cells themselves and then the little cells that surround it. So that's the name benign mix. Here's a close-up. You've got this proliferation of these glandular cells. Sometimes they'll form round, almost look like lacrimal glands. So sometimes there'll be these little elongated, almost tubes. So they form these little tubes of the lacrimal gland. That's a bad one. Let's see if we've got a better one. It's weird. It shows up really nice on mine and not so, not so well here. All right. Now I know it's hard, Ariana, but this is a person. They had a pleomorphic adenoma, a benign mixed tumor. They removed it. Patient came back, you know, six months later, swelling, lesion in that area, and they did this. Sheets of blue cells with some cystic species or some blood vessels. The recurrence is more concerning for blowing the process. So I'm looking, I could imagine that some of these cells are in many tubes. Oh yeah, I'm sorry that doesn't show up. If you guys came and looked up here, it shows up really nice up here. You can certainly see there's nucleoli, there's clump chromatin. It's still attempting to form glands, but look at that, look how active these cells are. So what does this tumor become now? And so what we call this, if the other one was a benign mix, we call this a malignant mixed. So much less common, but the key thing when you see an initial pleomorphic adenoma or benign mixed tumor, those often have a pseudo capsule around them. They grow slowly, they kind of push out and have a pseudo capsule. So if you can get the whole thing out, this is where you want to do a complete excisional biopsy, then you can cure it.  So it can go from a benign mix to a malignant mix. So that's what you worry about.  All right, Allie, what do we see in here? We see some hypoglomus. To get the idea, something's here, it's pushing that eye down. Again, what area is that in? Lachomobland. And we look at the scan here, and you can see that it is, it's still attempting to be round, but you kind of lose the tail here, you don't quite have as good of borders there. And this is the pathology. What do we see in here? The center, there's lots of like a collection of cysts, new tissue, and then there's also bone on this path. Yeah, this is actually even going into bone a little bit. There's a little bone there, and it's kind of invading in. What would your concern be here? Exactly. Now, adenoid cystic carcinoma is much more aggressive than the polymorphic adenoma. The adenoid cystic can actually invade bone. It can metastasize. This is one of those cells, one of those types of tumors where people use the term disarmingly benign, meaning you look at these, they look benign. There's not nucleolau over the place. There's not mitotic figures all over the place. You look at me and say, yeah, this is pretty benign looking, but it's not. So this is really, really, it's hiding. It's a wolf in sheep's clothing, if you will. So it looks disarmingly benign, but it's really not. And there are various different ways this tumor can present pathologically. All right, so Brad, what is this? Growth pattern is this. Now, that's really not what they call it. What do they call it? Basalloid pattern. That is one of the patterns. Is this a basalloid pattern? I thought so, I guess not. All right, so this looks kind of like Swiss cheese. And so this is what we call a criberform or Swiss cheese pattern to it. So you see it's got these little spaces in it and it's got the tumor cells around it. So this is called the criberform or Swiss cheese, these little spaces all through here. And so this is fortunately the most common form of the adenoid cystic carcinoma. There you see a close up, these little Swiss cheese spaces in between cells around them. And again, don't look really benign. All right, what pattern is this now? This is the basalloid. And so you see it almost looks like a basal cell carcinoma. It's really cellular. You kind of lose the glandular pattern to it and it becomes really cellular. Why is this important? Exactly, these are the nasty variant. And so when I said that you can get some really aggressive tumors that can actually invade into the bone, they can invade out of the orbit, they can metastasize distantly. It's usually the basalloid ones that are the ones who do it. If you see this basalloid pattern on this, you know, adenoid cystic carcinoma, these are the really bad actors. So these are the ones that you don't want because this is the basalloid pattern. These are the bad ones. So if you see that pattern beware, these are the really bad ones. All right, what are we seeing right here, Sean? So what would your differential here be? So we look at it. Now if you look at this, it's a little bit different. So this is what we call almost a pancake lesion. So instead of that specific coin or round-shaped lesion, this one, it's almost like silly putty. It goes around the globe and goes around the structures. And if you look, not only is there some over here, but maybe there's even a little bit some over there. You look at the pathology, what do we see in here? All right, so a big lymphoid proliferation and we do an immunoperoxidase stain and it stains like this. Do you think that they're lymphocytes? So don't forget, you can get lymphoma, the lacrimal gland also, but you can also get decryladinitis with lymphocytes in them, so you can get inflammatory lesions. And so back in the olden days, when I was a resident, they used to have what's called the 50-50 rule. And they said, okay, 50% of all lacrimal lesions are epithelial derived and 50% of those are benign mixed, pleomorphic adenomas. Well, it turned out that that's really not correct. When the Schiels and Wills looked at all of their lacrimal lesions that they biopsied, turns out almost 80% of them were lymphoid-derived somehow. Either lymphomas or decryladinitis or lymphoid hyperplasia. So really, in reality, about 80% of the lesions of the lacrimal gland are lymphoid-derived, not necessarily lymphoma, but lymphoid-derived and only 20% are epithelial derived. But of those 20%, half are still benign mixed. And then, of course, the rest are the others we talked about. So half of the 50-50 rule still takes hold. So remember, when you see a swelling in the lacrimal area, chances are it's gonna be more lymphoid than it is an epithelial derived tumor. What are we seeing right here, Mike? Caroidal folds. So what do you worry about when you see caroidal folds? All right, so those are the two things. We used to be taught, again, that this meant that there's an intraconal mass. So you'd worry there's an optic nerve tumor or another tumor that can occur in there. But when you really looked at them again, it turns out short eyes with a flat posterior sclera can give you caroidal folds too. And those turned out to be even more common than intraconal tumors. But let's say, for example, that you looked at this and you said, wow, this is a concern. Maybe there is an intraconal tumor here. So you worry about it and you do a scan and you see this lesion. What are we seeing here? What are we seeing here? Thus the name, cavernous hemangioma. So for some reason, these tend to occur intraconally. That's the place they usually occur. The symptoms are vague.  And then you look at them and when you do the scan, they'll be well circumscribed. So again, these are ones that they grow really slowly and they tend to slowly push out. So they don't have a real capsule per se, but it's a pseudo capsule. So they push on the connective tissue, which kind of gets condensed. And so these really do have a pseudo capsule around them. So when you go to remove these, these really do just shell out. You just pop these out and they've got these large so-called cavernous spaces with the fiber septae in between. Catherine, this is a little higher power picture. What does this tell me about this lesion? Why am I showing you this picture? Yeah, a lot of red blood cells. The fact that there's red blood cells tells you there's low flow. What tells you there's low flow? If you look right here in each of these spaces, here's the red blood cells down here. Here's the serum up here. And so the red blood cells have settled down to the bottom. The serum has settled up to the top. So when you get separation like that, it tells you that they're stasis. And so it tells you that these are low flow. And so the nice thing about these when you take these out, they don't bleed like crazy. You know, when you have a capillary hemangioma, they're usually more in the lid than the orbit, but boy, those things, they bleed like crazy. But these have stasis in there because the red blood cells have settled down. So like this guy's hematocrit is 60. So they're a blood doper, you know? So they really got water. Man, that's too early in the morning. You guys just, just, just, just. That's humor or, or, or, or, all right? So. That's our story. We're looking at a guy here, Rachel. Dan, one of those things, what's the, you know, what's the side that's affected? These are so hard. That's what Boopie always does this to you guys.  And so again, it's very subtle, but there are some changes here. The fold there, as opposed to the fold here. And look at the space between the lower lid and the limbis there and the lower lid and the limbis here. You kind of get the idea and look how it's fuller there that maybe there's something behind there pushing that right eye out. Very subtle, but again, it's a little bit more prominent here. And if you were to do a hotel, this eye would be more proctotic. But this time it's not down or in, it's out. So as if there's something behind it. And then we look at the scan and we see this. What the heck is this thing? It's fibrous materials. Exactly. You see these kind of long vascular channels, but you see a lot of smaller vascular channels here. And these are called staghorn, like a deer. So the deer horn sticking out. So staghorn spaces, lots of blood vessels. And then we look at a close up. Some of these have this funny irregular shape to them, but not only are these all, these plump endothelial cells proliferating, but look at all the cells in between that are proliferating. What do we call this lesion? Exactly. So this is not a hemangio, it's hemangio pericytoma. So it's a proliferation, not only of the endothelial cells, but also of the pericyte surrounding them. And so you can see in the preactive, look at the little nucleoli in there. So this is a hemangio pericytoma. What's this? And this is a close up here.  Now what does special stain we can do that can help us tell for sure that's what this tumor is? Reticulum stain, I'm sorry. Close up showing you how they can be. Now the other thing that's interesting about these is they can be kind of benign, intermediate or more malignant looking. But just when you memorize that, you see, okay, we're gonna look at this, we're gonna see how it behaves. It's not necessarily correlated with how these behave. And so these are one of those ones that's really tricky. You can get some that don't look that bad on the path and they come back aggressively. Others look pretty aggressive on the path and they don't do much. And so it doesn't really correlate, but sometimes you can see where you remove these they come back, they come back a little bit more aggressive looking. And so we try to categorize them, but it may not mean anything. And so this is one that is more malignant looking. You can see how it's got these nucleoli in here, the cells are growing more, got clump chromatin all over. So it can go from a more benign to an intermediate to more malignant appearance with the Imangio perisatomas. And again, the stain that you said is reticulum stain. Why? Why does that stain? Well, it stains the reticular network around the little capillary channels, which is really what the perisites make.  And so this tells you that it's making this reticular network around the cells. And so it's really helpful to do a reticulum stain. What do we see in here? Allie, what you're calling a heterogeneous? Would you be concerned about when you see something it's heterogeneous. There's almost some fluid levels in here. It's really kind of mixture of what's going on there. All right, so let's give you, I'll give you a little bit of history. This patient is 10, 10 years old. Does that help any? All right, so when you see this heterogeneous, especially in a child, you want to start thinking more toward lymph angioma rather than immune angiomas. That's kind of a misnomer. It's not really just lymphoid channels perforating, but when you look at these, you'll see these large, almost like large lymphoid spaces. They have kind of this incomplete, spindly, flattened, endothelial lining around them. A lot of connective tissue. And then again, you get almost these little pires, patches of lymphocytes seen around these lesions. The reason that that's important is, these are interesting. Sometimes when these kids will get an upper respiratory infection, these lesions will grow, which is weird. So they'll get more proptosis. Chris, what's happened here? Another reason why you can get rapid increase of, ah, God, I did it. I called you Chris for a year, I'm sorry, Brad. I knew I was gonna, God, I knew I was gonna get, not get through the day without saying that once. All right, sorry, Brad. Sorry, Brad. You were just too nice to correct me when I called you Chris for like six months. Brad, what is that that we're showing you here that could also cause a rapid increase in proptosis? Well, so you could get bleeding into these spaces, which just looks like it has occurred here. Exactly, so sometimes these will have all these little vessels in between and one of them can bleed. And so you'll get blood into these channels and you can get a pretty rapid increase in proptosis. And so sometimes as the blood sits there for a long time, red blood cells degenerate, they turn almost brown. And so they call these chocolate cysts. And so if it's really bad proptosis, it's threatening division, people will often go in with either an ultrasound guide or a CT guide, put a needle into some of the big cysts and drain them. Then you get this chocolate goopy stuff come out of it. So it's broken down red blood cells. So you don't necessarily have to do emergency surgery on these, but if you get this rapid proptosis from this acute hemorrhage, then they're a problem. You need to treat them. Here you can see again, blood in these spaces. And then here you've got these, almost like pyros patch lymphocytes. And these will grow when the kids get an upper respiratory infection. So again, that can cause increased proptosis. As the plastics guys will tell you, the orbital guys, these are really tough to remove because they're not encapsulated. They send little fingers all over the place.  And oftentimes they'll just grow back just as bad. So these are really difficult to treat. So even though they're benign tumor, they can cause significant issues with the child. If they keep growing and you're getting proptosis, you can actually affect the vision with these. Here's a close-up of those pyros patches lymphocytes. So this is the lymph angioma. Now, some people will, are splitters, some are lumpers. And I happen to be a splitter. And so my brain works like an OCD brain. And so I like to have a hundred mailboxes, like upstairs and each little thing goes into a slot. But some people like to split them up. And so we'll split these up and we'll split them up among AV malformations and venous malformations. We'll split them into different categories. Other people will lump them together and say, you know what, this is all one thing. It's all just kind of this pseudo vascular anomalies. And so, you know, any kind of varices, AV malformations, lymph angiomas, they're all these variations of the same thing. And so in the old meetings we had where you'd have the orbit guys and the path guys, they would argue for, you know, hours on this. And there was, you know, letters of the editor would go back and forth for years. And so still there's kind of two camps. You know, the camp in England really likes to lump them all together in the camp over here and in Canada likes to split them all up. And so I'm a splitter, so I like to split them up. I just realized some people think it's all a big continuum of lesions. All right, what are we seeing here? Sneha. And what do you make of the age of the patient? Child. So what do you worry about when you've got, this is rapid onset, rapid onset of proptosis like this in a kid. All right, so Rhabdo's the one you really worry about. This is her scan. Now look at this huge tumor. Look at this huge tumor right here sticking out. Now, really, really, really, really big difficult tumor here. So this was a kid that when I was just started here and had this, you know, rapid onset. They did a biopsy. They said, this is a Rhabdo. We need to give you chemotherapy. We need to do surgery on here. And the mom and dad were going through a bitter divorce. Mom checked the kid out of the hospital and took her to Mexico where she had leitural treatment. So you guys are too young to remember leitural. That was the magic cure at that time. And, you know, the mean old medical establishment who likes to suppress new treatments in the U.S. wouldn't consider it. And so people go to these clinics in Mexico and they pay a fortune and they give them leitural, which is derived from the almond pits or something or whatever they came from. But at any event, it didn't work. And so they'd give them steroids and they'd give them this magic leitural. Of course it would start to shrink when they'd give them the steroids. And so in any event, dad hired a private detective, found out where mom had taken the kid, went to Mexico, re-kidnapped the kid, brought her back. By the time she came back, the tumor was twice this big. They had to do an exeneration and they had to do radiation. It was really horrible. And so these are tumors that are treatable, but you have to treat them with the right stuff. And that's the key thing. All right, so of course we've got this, we made this up for Orbit Conference once and so it's got the nice things. But tell me, what's the most common variety here, Sean, of these tumors? All right, so embryonal is the most common. And when you look at the embryonal, they'll have kind of round to oval cells. Some of them look like little tadpoles. They've got little tails on them. And so this is fortunately the one that is the least aggressive and it is the most common. Still aggressive, but there are some that are even more aggressive. So the embryonal and embryonal type. And when you look at them again, they've got these big fat nuclei and they've got these little tails that sometimes come out of them. And what do we look for in these? Mike, exactly, some striations because as the name implies, what are these derived from? Muscle. And it's not mature skeletal muscle. It's kind of embryonal muscle cells. So when you look at these, you can often see cross striations in these tadpole-like cells when you look at the rhabdomin. And you can see, you can do what kind of stain shows these real well. Trichrome, yeah, trichrome is amazing. So, trichrome will stain the cross striations. This is trichrome stain. And look at those little tiger stripes. Look at the little tiger's tail here. You can see the cross striations from the muscle in a nice embryonal. So that's the most common type. And that's beautiful. You see kind of the tiger stripes there. So fortunately, I mean, these are still aggressive tumors, but again, they're the least bad and fortunately the most common is the embryonal type. And you can do some special stains and obviously you wanna do the stains that are stains that stain for muscle-derived cells. So a desmin, bimentin, actin, muscle-specific antigen, any stains with immunoproxidized stains that stain muscle-derived tissue will stain these tumors brown. And so the immunoproxidized stain will stain them brown. All right, Catherine, what pattern is this? So this looks to go with it. It's acts with tumor cells in them. Exactly. So this is the alveolar type. So if you think about it, pathologists spend a lot of time, usually pathologians are in the basement, they're poorly ventilated, sniffing a lot of formalin. And so they get pretty imaginative. And so this does kind of look like the alveoli in the lung. And so this particular growth pattern looks like kind of alveolar spaces in the lung with tumor cells in them. Why is this important? Exactly. So of the types that you get, this tends to be really aggressive and nasty. So this is the one that you don't wanna have is the alveolar type of the rabdomyocercoma. And again, this just shows you this happens to be a muscle-specific actin stain. And so it does the immunoproxidized stain. But look at these cells. Look at the little nucleolianin. Look at that. Three, four nucleolianin, clumped chromatins of really aggressive, nasty-looking cells, and they behave that way. What do we see in here, Rachel? What would you be concerned about here? Gets. You can get. You can. That's really not, I mean, I always wanna keep rabdom in the back of your minds. But again, hoof beats, you know, you think horses not zebras. And so, you know, most common thing when you're seeing a youngster with this unilateral swelling, they may have history of a fever, maybe some upper respiratory symptoms you'd think about. Exactly. Cellulitis first, infectious or inflammatory. So what we used to call pseudo-tunamerm now, we call it idiopathic orbital inflammatory syndrome. But so you wanna think infectious, you don't wanna miss a cellulitis, especially, now this looks pretty anterior. You wanna do a scan, but if you've got a cellulitis anterior to the septae, that's not quite as bad as posterior to the septae but your orbital cellulitis. So you wanna worry about infection, you wanna worry about inflammation. And so this particular one, when they do biopsy here, what do we see in here? No lymphocytes here.  So more inflammatory. Here's a close-up. You see there's the lymphocytes here. They're mostly lymphocytes. And when you look at them, they can be a mixture but a lot of predominant B lymphocytes. And then you've got, of course, the vasectomal cells and the little fibroblast proliferating around it. And here again, you can see it's very diffusely infiltrating at this point. Now, sometimes what can happen is, let's say you've had a person who's had orbital inflammatory syndrome and you treat it on and eventually it settles down. Mariana, what's going on here? I see a lot of fibroblasts all over. Yeah, in fact, even literally fibrous tissue here, what do we call this? Yeah, so the word we use is sclerotic at this point. So people used to call this a sclerotic pseudo-tumor. So sometimes when you get an orbital inflammatory syndrome, even when you treat them, as it settles down, you can sometimes get this fibro, fibrosproliferation, not really vascular, more fibrosproliferation.  And so in the days before we had cortical steroids, people would go blind from these because they'd get this mass in there and they'd just get this whole frozen globe in there with this fibrous tissue around them. So it's called a sclerosing pseudo-tumor, we used to call it. So sometimes once the inflammation calms down, you can actually get even a sclerosing pattern to it. All right, Allie, what are we looking at here? A dude, I love the mustache. A external photograph. Left eye looks like it's actually got some hyperglobus. Look at where the reflex of the line is. Exactly some diffuse fullness there. And you look at the scan and again, kind of this diffuse, not really heterogeneous, kind of a diffuse lesion there. And here are the cells. What would you be concerned about here, lymphoma? So realize when you're looking at these lesions, there's a continuum. So there's lymphoma here and there is the orbital inflammatory syndrome, pseudo-tumor here. In between there's what's called an atypical lymphoid hyperplasia. And they're not just this and this, there's kind of a continuum in between and so you wanna look at things. So when you look at lymphoma versus inflammatory lesions, first of all, Allie, in lymphoma, what kind of cells do you usually see? Be what? Be lymphocytes, right? So you see lymphocytes and when you do immunoperoxidase stains, they tend to mostly be B and they tend to be monoclonal. So lymphoma, they tend to be monoclonal, B lymphocytes. Chris. Sorry, Brown. In the inflammatory lesions, what kind of cells can you see? So in inflammatory lesions, you get more of a variety of inflammatory cells. So you get macrophages, you can get B lymphocytes, you can get neutrophils, you get germinal centers. Well, less neutrophils, but certainly you can get plasma cells, lymphocytes, you know, maybe some epithelial type cells. You get germinal centers, whereas in a lymphoma, it's a sheet, whereas in the inflammatory ones, you can get germinal centers, you can get a mixture of cells. And if you do immunoperoxidase stains, they're polyclonal, they're not monoclonal. And so you wanna try to see which end of the spectrum it's on when you're looking at these. And this particular one, it's got a sheet of lymphocytes, no plasma cells in there, no follicles. And indeed, you do the immunoperoxidase stain and turned out these were all B cell capy. So they tend to be monoclonal, and that's the end where you get the lymphoma. All right, gosh, this is a really ugly specimen. What kind of surgery did this patient have here now? So this patient somewhere buried in there is actually a glow, and so this is an exenteration. So they remove the whole orbital content. So when we think of the orbit, I mean the orbit can be a repository of cells from somewhere else. And so we worry about there can be metastatic tumors that go from elsewhere in the body to the orbit, or there can be tumors that can arise around the orbit that can go into the orbit. So you can have superficial malignancies from the lids, from the conch conveyed into the orbit. You can have malignancies from the sinuses that can invade into the orbit secondarily. So what's the color here on this particular lesion? What are you worried about here? Yeah, so kind of dark, almost black here throughout the orbit. What would you be worried about here? Exactly, so this could have been a superficial melanoma of the lid or of the conch that then secondarily invaded the orbit. And when you look at it, at higher power, this did indeed turn out to be a malignant melanoma. Now, you can also have other sin malignancies, either metastatic or locally invasive. So again, the orbit, it's pretty rare that you have primary malignant tumors of the orbit itself, but it is again, a place where you get secondary tumors. And here you can see these are these big melanocytes, big, ugly-looking melanocytes. So this was a superficial melanoma. I can't remember if this was from lid or conch, then secondarily invaded into the orbit. So big, nasty malignant-looking cells. All right, this is what Sean looks like when you say it's your turn. Okay, Sean, what is this? What are we seeing here? See, I'll have a problem. What would you be concerned here? Yeah, so you can see whenever you have that surprise to look you, I just gotta think thyroid because the lids retract, the eyes get proptotic, you can see sclera above and below. And you see this injection here in front of where the muscles insert medially and terribly. So this is classic for thyroid upfilmopathy. And you look at the scan, you can see here are the muscles right here. Mike, what's the difference between a myositis and a thyroid muscle when you do a scan? Exactly, so here the tendon is spared, but the inflammation is in the body of the muscle. Now, looking at this CT scan, would this be worrisome at all? Yeah, look at those fat muscle bodies here all the way to the apex. So one of the things you worry about if you've got a really crowded, fat inflamed muscles is they can start putting pressure on the optic nerve at the apex, you can even get a scheming from these. And so this would be particularly worrisome in this case. And this is just, this is an autopsy eye. Just showing you, look at this muscle here, tendon spared, big, fat, juicy muscle here in thyroid. So when you look at the thyroid, they'll often have this lymphocytic proliferation. They'll have a lot of edema, it'll be kind of a myxoid inflammation, edema early, but late, just like some of the inflammatory pseudo tumors of the orbit, you can then get scarring. So initially you'll have edema, but then later on, if you can't call them quickly enough, you can actually get scarring and then those muscles will scar down, people will get diplopia, they won't get good movement of the muscles. All right, what are we looking at here, Catherine? That is this thing. Yeah, now what looks weird there is we're shining a bright light over here. It's shadowed a little bit there, but you see a lot of almost, you know, illumination inside that. What would you be concerned about here? Some sort of cystic lesion. All right, so this is a young child. All right, so you'd worry about a dermoid cyst. Now remember when we talked about those conch lesions, there's different, we use the term dermoid really randomly. This is what we really call dermoid. This is a dermoid cyst. So the orbit superiorly, where the, you know, bone fissures sometimes are. And so what you see when you look at this is it's filled with, what is all this stuff in the middle here? Looks like keratin.  We had a dermoid cyst yet, since you guys have been here this year. They're really pretty disgusting. They're filled with the smelly keratin stuff. It's really yucky. And when we look at the lining, what are these lined by? All right, so it's a stratified squamous epithelium that lines these and they make keratin here.  Well, dermus half right, what lives in the dermis? Exactly, so what the term we use is dermal appendages. So not only do you have the epithelium in a dermoid cyst, but you have hair and sebaceous glands. And so that's important so you don't, you know, don't just have the epithelium, you have the epithelium with these dermal appendages here. So that's a true dermoid cyst. And there's a close-up. There's a hair follicle, there's the shaft, there's the sebaceous glands, and there's the epithelium with the keratin in them. So when you remove these, you gotta be really careful because if you remove them whole, the kids do really well. But if they break, that keratin spills in there. Keratin can really induce nasty inflammation. So you get this granulomotus, you get these giant cells, it's really a difficult to control inflammation if these cysts break. So these are, again, something you wanna try to get out whole. And there we say goodbye to the Louvre with the fountains and the pond and the, that's the side pyramid. That's over one of the subway stations that's there. So next week we'll be tumors. And so not only is it tumors, when we talk about childhood tumors, we talk about differential diagnosis of leukocorea, white pupils. So know that for next week. And interns, now your day of reckoning is coming. So read up on the tumors, okay? All right, any questions in one minute? Nope, all right, great. Thank you. You bet.


Good day! Oh my gosh, we're almost there! Strong! So, we're really looking forward to celebrate everything. Today, the conference is past year with you tonight at the banquet, which is going to be at the Treasury Ballroom. If you have any confusion about where to find this, just grab me, grab a volunteer, we can walk you through it. But it's going to be at 326 SW Broadway, which is in your handbook. And when you get to the main door on Broadway, it's going to be the door to your left, but we'll have people directing you too, just in case. But we hope you will all join us there. Thank you. And just to add to that, if anybody could use transportation help if walking to the venue is difficult, would you let Coriana or I know, and we'll figure out how to facilitate that from wherever you are. Thank you. Thank you. So, since we only have four mics, I'm going to start the panel here. We are here to celebrate the second year of the Bly Grant recipients. And as a special treat, the folks from Spider Web Show down there on the end have brought a bunch of technology and backstage, offstage right in the green room, after the panel kind of pre-GM, they invite everybody back to come experience what it is they're going to try to explain during the panel. And I caught some of it as they were setting it up, and it's really super cool, so I encourage you to go back and see what they're doing. So, I'm going to just kind of introduce everybody by name quickly, and then we're going to jump into letting them talk about their projects and we'll hopefully do some crosstalk and some crosstalk with you. So, to my immediate left, no introduction needed is Mr. Mark Bly. Next to him is Sally Olive. Next to her is Kelly Kerwin. Next to her is Sarah Elkeshev. Next to her is Allison Bowie, Joel Adria, and Michael Wheeler from Spider Web Show. And because of the complicated technical nature of their project, we're actually going to start with them and then they're going to slip out to go prep for you guys to come. So, I'm going to turn it over to the three of you. Tell us what the heck it is we funded. Okay, hi. First of all, just thanks for having us here and thank you for this grant. It's been really instrumental in getting this started and very valuable. So, thank you very much. I'm actually going to talk mostly just about what Spider Web Show is and how we got to the Digital Creation Studio, which my colleagues will talk more about. Spider Web Show started in 2013 and it started as a website that was asking the question, what is Canadian theater? And it was brought about because we had a new artistic director at the National Arts Center in Canada, Context that's kind of like our Lincoln Center if it was in a town of 500,000 people. And Jill brought on Sarah Stanley as her associate artistic director there. And Sarah was in charge of something called the collaborations which was funding small pieces of Canadian theater across the country. And one of the things that both Jill and Sarah were interested in was how could the internet connect theater creators. And so they came to my theater company Praxis Theater and they said, how could we use the internet to answer the question, what is Canadian theater? Not definitively answered, of course, but look into answering that question. So, the website just started with Sarah and myself. We kind of had a blog and we commissioned some video projects and there were some podcasts and it really took off and we found that it was actually too much work for just two of us to do it and also we couldn't really answer the question, what is Canadian theater? Because Sarah was based out of Ottawa and I was based out of Toronto and Canada is a big country. So, we found collaborators by adding New World Theater in Vancouver, Alberta Theater Projects in Calgary and Allison joined us from Montreal and so then we kind of had nodes in the four biggest cities in the country and the project started to evolve and I guess probably the five kind of core things that Spiderweb show started to do over the course of the last three years are one is a bi-weekly magazine called CDN Cult and that's my primary job as the editor of that magazine and the way the magazine works is we commissioned three Canadian theater artists to write on a given theme every two weeks. So, that has proved to be super helpful as a framing device as opposed to just having a blog where just things are coming out as people send it to us but actually having a focus to it so we can say, what do we think about this controversy that's going on in this particular city and we can be very specific to an issue or we can have a national issue and commission three artists from across the country to get different perspectives on an issue and so that's the magazine. We have podcasts, everybody knows what podcasts are, we've had a couple of different contributors to podcasts from across the country. We also have a thing called the performance wiki which Allison will speak about more but basically wiki that's attached to a map which is a searchable database of Canadian performance and I'm missing one thing, what am I missing? Thought Residencies. I have to give Sarah a total credit for this, it's a really interesting idea where basically we all have iPhones or whatever kind of smartphones with us and you can use those to just record a thought whenever you have one and so we commission a different artist each month to just record their thoughts on their phones and then they're uploaded to SoundCloud and then you can go to our website and hear all the thoughts that a given theater artist has had over the course of a month. Some of them are interesting, some of them aren't but I actually think dramaturgically it is a really interesting question because like 10 or 20 years from now people will be able to go back and search a given artist and find out what all of their thoughts were in a month and I think as a historical digital document it's an interesting project and then the last thing that I'm quite proud of that spiderweb show has done so far is actually the curation of a hashtag. So we use CDN Cult, just like everybody here uses LMDA 16, CDN Cult kind of as a national hashtag to which to send interesting cultural conversations about what's going on in Canadian theater and you know for about the first year, year and a half Sarah and I were the only people using that hashtag and it was kind of an inside joke amongst us but I'm really proud of how much it's taken off and people across the country now when they're tweeting about Canadian theater they will end it with CDN Cult and you can really kind of check out that hashtag and get a sense of what's going on in Canadian theater through that hashtag. So that brings me to the Digital Creation Studio which we're here to talk about today and that came from, Sarah was directing a show in Canada called Helen Lawrence, really massive show, ended up going to BAM and it was very high video design and part of the video design required actors to perform without seeing their partner, just perform with the camera and the video design would transform what the audience would see and at the same time we were having weekly Google Hangouts for spiderweb show and she kind of put the two ideas together to understand that oh my goodness, maybe people could actually use all the technology now to rehearse in different locations at the same time and so that's when we were at LMDA last year basically and so we saw the Mark Bly panel last year and we thought let's pitch that as an idea. So that's what spiderweb show is and that's how we got here and now I'll turn it over to Joel, he's our technologist and he can explain the nitty gritty. Hello there, I'm not going to get too technical on all these details but so that was actually, speaking of Helen Lawrence, that was kind of how I got involved with the project and how I sort of met Sarah. I was acting as the video technologist on that show and sort of endured all the very interesting complexities of that show with her and so she sort of invited me to contribute on this project and so as Michael mentioned, we're creating a digital creation studio that we're calling CDN Studio and the goal of it is to sort of create a virtual space online to rehearse and really allow different people in different geographical locations to rehearse virtually and the best way to describe it would be sort of an advanced Skype call or video conference but instead of seeing sort of an image of each person's face, you're really getting to see a composite image of everybody who's participating in their room and I'm actually just going to show a couple pictures of our test setup that we were working on this afternoon. Here's sort of an example composite image we have a few people composited together. So we have Michael in one of the rooms and we had a very gracious volunteer participating so you can see they're all in three different rooms but they can see each other in the same virtual studio and so this is not terribly new technology we're using basically green screen technology to achieve what we're doing here just like a weatherman who might stand in front of a virtual map for TV CDN Studio composites other members of your team members into that background instead of a map of the western United States or something and so where we're at today is that this is our first time together Michael and Allison and I are from three different cities and we've never actually met in physical space before but we've been coordinating and experimenting with different software and so this is our first time together it's the first time actually testing it out we're using a prototyping software called Touch Designer that's allowing us to do this and it's really sort of an alpha test it is, we're not quite on the internet yet but we are routing it through a network and so we're sort of testing the possibilities and the limitations of that and our goal is to eventually scale this to use open standards there's something called WebRTC which is basically allowing us to do a Skype-like experience just within a web browser without the need for plugins or flash or anything like that so you'll actually be able to once we've continued to develop it you'll be able to access CDN Studio from any web browser and so our next phase will be to sort of develop this out develop the web software involved and once it's all complete you'll be able to join a studio using a high speed internet connection an inexpensive green screen kit a webcam and a set of headphones so we've set up three stations in the dressing rooms backstage and after the panel we'd really like you to come join us and test it out, see what it feels like we really want your feedback to sort of see what does it feel like to rehearse in virtual space it's not a huge area to explore you're somewhat limited to this amount of space that you can walk in but we want to get your opinions and sort of what your thoughts are and just sort of first impressions this is an early prototype so don't expect the holodeck quite yet but our goal is to continue improving it and just to make it as immersive as possible there's some really great technology coming down the pipe that involves virtual reality and Microsoft HoloLens and we certainly see that as down the road a possibility to really encourage the possibilities so I'm going to let Allison talk a little bit about the sort of dramaturgical ramifications now of what this technology might allow us to do so just to give context of how I joined Spiderweb Show in the first place I was an MFA Dramaturgy graduate from the University of Massachusetts so I'm coming back to the States for the first time actually as a dramaturg in the professional world which is kind of nice I moved back to Montreal and went what am I going to do now and I started harassing Sarah Stanley until she met with me in Ottawa and I started translating and came on as a grant writer actually writing Canada Council grant and the Mark Lye grant I worked with the team on a lot of those grants and now I'm one of the associate dramaturgs on the team so I'm really interested in this project because a lot of my work looks at digital dramaturgies and how as a production dramaturg I can continue the conversation with audience members outside of the performance space but also how digital technology within a performance can affect the story of the narrative that's being told and what can we do differently with that so that's sort of where my interest lies in this project like Joel was saying this is the first time that we've physically been in the same space but we've spent a lot of time backstage not being in the same space to make this happen which is kind of ironic one of the big questions that Spiderweb Show is asking is what is the Canadian dramaturgie that exists and right now it's very localized because it's such a big geographical country we have dramaturgies that exist in Vancouver that's very specific to there or Calgary or small towns so while we have a series of dramaturgies that exist they're very either culturally oriented or geographically located so what CDN Studio is able to do is allow us to look at what happens to the dramaturgie in Canada and what happens to the Canadian theatre identity if we take those boundaries away if we make theatre accessible and theatre creation accessible across the country how can that change what we understand Canadian theatre to be if an artist who is in Nunavut can collaborate with an artist who is in Toronto what stories can they tell what narratives can emerge out of that experience and one of the things that Michael mentioned is performance wiki I was on the team that developed the map that actually goes along with this and this allows us to track the entries that are put into the performance wiki we have different categories so we have non-profit community for-profit theatres events and festivals university and then we also have categories that are specific to First Nations creations so that's the Aboriginal peoples in Canada and we can track and look and see where stories are being created where theatre is actually being created in those different categories across the country so what CDN Studio will allow us to do is see how that map changes where are those stories going to be created or how are we going to be able to visually track when a story is being created in a multiple of locations all at the same time so those are some of the big dramaturgical questions that we are embarking on and we're so excited to be part of this so thank you so much again for the opportunity for us to get started on this we really appreciate it we're going to be there until 5 o'clock so please come and join us and explore this with us thank you so much I'm going to jump to Kelly in part because David Copeland and I were hanging out this morning and one of the things that we were talking about was that I have a slight obsession with following like big pop culture trends so whatever you know trashy book you're supposed to be too embarrassed to read I love to read because I'm like why is everybody reading Twilight which is what we were talking about why is everybody reading Fifty Shades of Grey you know when the Harry Potter books came out I loved being able to chat with a 7 year old on the subway because we were both carrying around a Harry Potter book and it was reminding me of the conversation you and I had in a more intellectual realm about you saying your interest was kind of having your finger on the pulse of what was going on in the field about the changing shapes of what theater was and clearly everything about your project is exploring that so do you want to tell us a little bit about pop and kind of how that stemmed out of that interest? Yeah absolutely thank you so much and thank you for Mark and Beth and the LMDA selection committee it's just been awesome to have the opportunity to pull the trigger on this wacky idea like I have so pop is a pop-up performance festival that's going to be taking place in Bushwick Brooklyn in September 23 to the 25th and what is a pop-up performance festival? Well that's a great question myself and so it's it's like really stemmed from this idea of just like I was in grad school you know just like indulging my senses and like all this like great stuff and also learning all this like classical shit and a lot of my peers and I were also making a bunch of weird stuff that wasn't really fitting in a box or in a black box theater or you know so a lot of people I was seeing not just coming from Yale School of Drama but from elsewhere you know had learned how to direct Chuck-Off and Shakespeare but also they have this weird idea where it's like a headphone play and you walk down the street with it and like what is that about and so it's kind of like how do we provide a home for like the island of misfit toys that like exist in like the current culture of like I have this like crazy idea that the man on a bicycle and you follow him around so pop is a series of like theater experiences that are happening in public places in venues most of those venues are bars in basements there's like a wacky basement theater I've come across on accident and it takes place the best way I've kind of learned to describe it is a theatrical pub crawl kind of where the audience has a map and they can kind of go around to whatever place they want to go to and see different things and they get tapped on a shoulder and they go to a secret place or they're walking down the street because they live there and they happen to like get asked to go into U-Haul truck and there's a drag queen and there's a dance party and so you know it's kind of two fold of like the people that are in the know kind of can go around and go see all these different experiences and be a part of that and like be really close to it and also there's maybe somebody that was just trying to go get a cup of coffee and the next thing they know they're you know in some basement watching a 20 minute piece of theater that's a movement piece about what it means to be a pop man in America you know and so that's kind of like a very like sampling platter of what pop is I'm happy to even like talk further about it but I know that's kind of like the introduction to the idea. Perfect thank you. Sarah I don't know if you were in the networking session this morning but there was a dialogue that came up about finding mentors and a young Turk spoke I thought very intelligently about saying not all every mentor has to be a theater person and in point of fact the example that was used was I love science you know maybe I should make a relationship with a doctor and I of course instantly thought of you so can we maneuver for you to talk a little bit about what you're doing? Sure thank you just to start off by saying thank you to LMDA and to Mark Bly because really without this grant the things I'm going to describe to you that I've been doing I would not be doing it would not be possible for me to be in the room so it's been a massive opportunity so just a little bit of context about the project it's called the High Z Project and it's a project to create an immersive installation based on the 2011 Nobel Prize winning discovery of the accelerating expansion of the universe so in the late 90s there was this race among astrophysicists to find the rate at which the expansion of the universe was decelerating and what they actually discovered was that the expansion is accelerating and in a very simplified to simplify what they were doing they were observing really distant supernovae which are stellar explosions and finding that they were fainter than they thought they should be and that is because they were further away and so this project is occurring because it's being led by this incredible team, sister team so this comes back to your question Beth and they are Naima Crystal Phillips who is an interdisciplinary artist and a playwright and her sister Lara Ariel Phillips who is an astrophysicist she Ariel is also married to a scientist named Karnovich who is on that team that made the discovery and so together Ariel and Naima came up with this idea to explore the discovery in terms of not only the science but also what it means in human terms to make a discovery like this so the the output of the project will be an installation in a planetarium type space and it will be a real combination of digital projection but also very tangible elements that you can explore that will express anything like the work stations that you that you might sit at during a period of observation and you'll be able to explore what those stations might have looked like and felt like in the 90s when the discovery was being made I think I'll just let you know who else is on the team because that's also extremely important there's five of us in total I've talked about Naima and Ariel also on the team is Keith Davis who's also an astrophysicist he and Ariel are both based at the University of Notre Dame which has been a massive supporter of this project Naima and myself are both based in Montreal where we're supported by Playwrights Workshop Montreal which is a nationally Canadian play development and creation centre and Yale Presant who is a dramaturg who used to be at the University of Notre Dame and is now based in Italy which was a move that happened after she was working on the project so not unlike the scientists who were based all over the world collaboratively while they were making this discovery we are also mainly in three international locations Keith also at the University runs the DVT which is the Digital Visualization Centre which is a kind of planetarium so together we are all have embarked on creating this installation and we are in what we're calling Phase 2 of the project which is really the creation of the blueprint the narrative the story and some of those pieces Keith has been working on creating digital animations of in particular all the supernovae discovered in the last two to three hundred years Naima and Ariel have been all over the world interviewing almost all twenty of the scientists on the team to date about everything from the discovery to their childhoods what inspired them to become scientists in the first place which is figuring out that intersection between science and the imagination is one of the big themes that we're exploring Naima and I we also have access to about three thousand emails that pass between members of the team during the course of the seven years of the discovery which we've been using as text and story elements and rituals that go into the process of observation so the two parts of this project that have been made possible by LMDA are in June Naima and I were able to go on a professional observation run to the Vatican Advanced Technology Telescope just outside of Tucson I say just outside but it's actually at ten thousand feet and I really got a sense of what it is like to go on that process to stay up all night the how mundane it is and also how exhilarating it is when things line up and you might have found a piece of science that goes into one step closer to proving this your theory or your unknowable outcome of the road that you've sort of set yourself out on and it was an incredible experience and we really feel that actually part of our job in the installation is to be able to convey to our audience something of what the experience of observing is like at least that was the entry point for me in terms of the thing that I was most curious about and most excited about that would give me access to scientific understanding that I don't actually have access to. In this case I really am the most ignorant person in the room and it's if you are looking for a consultant on this subject to create this I would be at the bottom of that list I think it's really about the dramaturgical work here is really about the storytelling and actually in a lot of ways it's an asset to have nothing but questions and then the second thing that this grant is enabling us to do is to meet in residency for the first time all five of us in the same room in the Digital Visualization Centre at the University of Notre Dame so that's going to happen in August we'll actually be able to get in the room and start the blueprint experiment actually be under the dome see some of the things that have been created and to start setting up pieces of the installation so we can start figuring out how they work and continuing to design that audience experience. That's great thank you Sarah So Sally I kind of saved you for last because in a really delightful way you combine a lot of the kind of story that we're unpacking here both and that you're dealing with a non-traditional form but you're also dealing with international points of connection in the really old fashioned way you're getting on an airplane and traveling to them so tell us a little bit about what it is that you're doing Great so first of all hello Thank you So I work in Cabaret and it is very difficult to talk about Cabaret at 3pm in the afternoon when you're all sober So would you please for a moment you're all dramaturgs so I know you have powerful imaginations if we can just move the clock forward to about 11pm if you can imagine that you have a drink in your hand or a vice of your choice alongside you like no I'm actually being serious please do this For those of you who are underage that's it thank you can you imagine you have an imaginary fake ID thank you and then don't tell me about it because I don't want to know Can we also take our imaginary drinks for a minute if you wouldn't mind indulging me in this to raise a glass and thank the Bly Committee and LMDA for providing these amazing I mean it's been amazing to hear about everything else that's happening and it's certainly been really powerful for me to have this opportunity because Cabaret is an art form that is often we call it an underground art form it's a little bit about being in the know is how you find it because you've heard about it or you know someone who's like let's go see this weird thing and that way I think it's sort of a lot like what Kelly is talking about people tend to stumble into it which is how I found Cabaret as well I am the associate artistic director and resident dramaturg of the Philadelphia based company called The Bearded Ladies Cabaret anyone here know us Thank you Philadelphia Excellent and I met them about four years ago they had been working in Cabaret and we call ourselves a queer experimental cabaret company and those are terms that we interrogate constantly so if you want to know what they mean come find me later and I'll tell you what they mean what they mean to me today but what I want to focus on I think is sort of interrogating the idea of what Cabaret is because when we started and when I first met this company I didn't know very much and they were learning by doing and so we we stumbled together into this form and started defining it for ourselves using our base knowledge of what we thought the form was about and the mentorship of some Philadelphians if any of you are familiar with Martha Graham Cracker yay yes and if you've never seen Martha Graham Cracker she's at Joe's Pub a lot and I highly recommend checking her out she's the alter ego of Dito van Rijkersburg for folks who know Dito so through mentorship of people like Dito we started to figure out for ourselves but we also learned that that process was very difficult because I think we've talked a lot about how theater communities can feel very isolated and it is even more isolating I think for Cabaret artists because they're in this underground form that is so much about being in the know to find them and so embedding in a community we can find out slowly who our fellow Cabaret artists are in the city but if I transplant to Portland it is very difficult for me to locate people like Carla Rossi for those who heard Anthony speak yesterday and most importantly while there has been a lot of scholarship on historical Cabaret and not even a lot actually I'm going to say there's been some scholarship on historical Cabaret focusing on the century of France and Weimar Germany there's not been a lot of writing on Cabaret in contemporary performance by practitioners and in fact a lot of those practitioners don't even know that others like them exist outside of New York City I would say is the exception and so what I my company and my research partner John Jarbaugh who is the artistic director of the Beaudel ladies are trying to do is we're trying to create a digital space for people to find each other and then we're going to try to turn that digital space into an immersive performance and so what that involves for us first is doing extensive research by actually going to these cities and trying to meet artists we're interested locally so if any of you have Cabaret connections I would love to talk to you in your own cities but we are also interested in reaching back to the ancestors of our form which means going to Paris and going to Berlin and figuring out not only what the history there is but also how that history has led to the contemporary performance in those places and then hopefully sharing that information with the practitioners that we've discovered and also hopefully the larger theater community so that we can become a voice to talk about what is truly exciting about this form that is really having a moment right now I think and has been for about the past five to ten years in America and what we can share from what we've learned as Cabaret artists with the larger theater community so that's part one of my projects and that's the part that I'm embedded in right now I'd say is doing that kind of research the second part is that I am a Cabaret dramaturg and I have been investigating for the past year or so I'd say I've been in this free fall questioning of what that means because so much about being a Cabaret artist is a lot about performer being a performer and I do not perform have you started as actors oh my gosh I knew there'd be a lot of you but that is a way that's much higher percentage than I was expecting I did not I have never wanted to be a performer which is not a knock against performers I think they're amazing it's just not part of my DNA and yet I've become aware in the past year and a half of how much performance goes into my role as a dramaturg how often I am performing I've heard you I know that it's pop I know I do this and I would imagine some of you do as well to use metaphors to explain like what you do anyone want to shout out some of their favorites favorite metaphors so I might say like I'm somebody's sometimes I'm a personal Wikipedia consultant great midwife that's one of my favorites Sherpa I've never right hand man right hand man what was that hand holder play whisper I love all of ladies great so I think we could obviously we could keep going and I want to hear the more as we get more drunk on our fake drinks I want to hear more anyway but and I think that depending on the project we all know that different things are demanded of us at different times depending on who we're working with how we're working which contract we're using and and so I became aware of how that started to impact my presence in the room how I was entering rooms how I was behaving within those rooms I wear a lot of different hats as a freelance artist and even the different personas that I take on with different companies that I'm in and so I started deconstructing my performance as a cabaret dramaturge and then I read the call for fly applications and then I wrote this grant and so in addition to exploring the research part of cabaret I am using the vocabulary of cabaret to explore myself as a dramaturge what it means to be a non-performing cabaret artist what it means to be a cabaret dramaturge what it means for me to be a dramaturge in this moment and in December I'm going to embark on a two week workshop that uses some of the techniques that I've discovered in this cabaret research to explore performative dramaturgy and I'm still not really I have to be honest I'm not really sure what I mean by performative dramaturgy that's what the workshop is for and that's what some of the funding is helping me figure out and what I have determined is that I can't do it by myself and so there's we're going to do a two week workshop where I invite a number of different kinds of artists to spend some time with me exploring that question from my fellow company members who are performers and designers to playwrights to voice people to choreographers to costume designers and also I'm going to spend some time with some dramaturges thinking about what that means and asking them to perform performance dramaturgy how these two things will eventually hopefully resolve and fit together is that so we're doing this project that we called the poison cookie project which comes from reaching down to get this quote comes from this beautiful quote by a Weimar era cabaret composer named Friedrich Hollander who wrote in an article that cabaret like nothing else suddenly dispenses a poison cookie suggestively administered and hastily swallowed its effect reaches far beyond the harmless evening to make otherwise placid blood boil and inspire a sluggish brain to think I'll just let that quote sit because it's amazing and so one thing that we're trying to do when we gather these different cabaret artists that hopefully will be meeting is we're hoping to bring them to Philadelphia to work on an immersive performance together in which they perform their current existing cabaret work but are also invited to perform historical cabaret works or pieces that are inspired by historical cabaret work so perhaps somebody like just an example because if we could get this person that would be so somebody like Taylor Mack who's writing a Weimar Berlin for example in addition to performing Taylor's own and part of that process will incorporate performative dramaturgy in some way to help audience navigate the historical research and the contemporary performance so I hope that wasn't too confusing but that's it. That was great, thank you Sally Thank you so Mr. Bly two years ago when you and Cindy Sorrell hatched this project and I'm sure a dark and smoky bar somewhere or maybe not so smoky one of the phrases that the two of you lit on that we've shared with the membership a lot is that you wanted to breathe fresh air into dramaturgy and one of the things that excites me having been on the selection committee is that every single project we've talked about is about different forms of what it is to make theater it's about different forms of what it is to be a dramaturge it's frequently reaching audience members and non-traditional places and so I'm just wondering having kind of had a couple months to sit with some of these projects and now to have met everybody and to have heard them talk what's rumbling through your head? One of the things that excites me about this is that there's something about the physics of dramaturgy that somehow is rumbling through this a couple of them are obvious I suppose that somehow I mean we started off with one group that literally has decided to transgress the boundaries of time and space and I love that just said the hell with it we're going to use some mechanisms to transgress the boundaries of time and space and dramaturgy is going to lead the way well that's exactly the point of what I wanted and early on when I assembled a group of people old friends in many cases but more than friends people I would trust my life with you know beyond volunteers these are people I'd trust my life with in case of Liz Engelman I did as we drove through the mountains of Mexico through a rainstorm once it was worse than romancing the stone if you've ever seen that film but seriously I mean that's exactly what I meant when people said well aren't you going to give examples and with great love for these people I said no that will limit what people will come up with and this is a perfect example of it this is a perfect example of it I did not want cookie cutter ideas these are not cookie cutter ideas and I just I'm thrilled by this as I was thrilled with the first year group and perhaps later on if people have questions about what's happened to that first year group so the liaisons who are in the audience here can talk about that like Jeff Prohl two of those four have resulted in books not bad not bad but back to this notion of the physics of it I mean this is really exciting for me that this is helped to generate some things and back to that notion this is thrilling here but at the same time this morning I don't want to sound like I forget who it is through the looking glass some character says everybody's a winner everybody gets prizes Nora Elgis was talking from the point of view of the umbrella project and she said I was really to say I was touched was beyond the statement she said that she had applied for this and she didn't get it but it didn't matter she somehow in filling out the application realized this is what she wanted to do anyway and she went forward with it and somehow I realized sitting there this morning I sat there and I went that was exactly in a way it was part of a conversation that early on Cindy Sorrell and I had had actually I wish it had been in the smoky bar it was long distance phone calls I realized early on that was part of our conversations where I had said something like yes we were using phrases like breaking boundaries all of these phrases which have meaning of course they have meaning but we always think about those in terms of the outward boundaries you know pioneering boundaries all of those things and I realized that Nora was speaking about something else which is actually just as important that we all have these interior boundaries that we have to break too and Nora as a mature artist broke an interior boundary that was equally important than getting some award some check she said nevertheless I'm going to still achieve something and for those who in the audience didn't get a check you know you can achieve something too and I think that's the big lesson and I just want to make sure in the midst of a celebration in quotation marks that you take that away today I think it's really really important it's so important to remember that I just want everybody not to diminish everybody smiles up here but I think it's so important to remember there are boundaries out there and there are boundaries in here that we all have to break really important does that answer your question I did have some other things I wanted to share though as well and this sort of goes with the future can I move into that so that we can also have plenty of time to go back there and also have you guys have questions we were talking a little bit about the past we're in the present but there's a big future coming up we've got some surprises I need to share some things how to say this well I'll go back to physics a lot of times with my playwriting students but with playwrights that I work with who will always come to me and say oh somebody is asking me what the play is about someone is asking me what the scene is about an actor is asking me whatever and I'll say you're in the midst of the act of creation and I'll share with them a cosmological metaphor a cosmological paradigm and that is you'll appreciate this Sarah that that at least today at this point in time God knows in 10 years the idea will change as science advances or moves forward there's the belief from the moment of Big Bang the Big Bang theory that within a factor of a few nanon nanon nanoseconds of time moments of time that as matter expanded or what we would call particle matter expanded whatever you want to call that outward that matter of the creative matter actually expanded faster than light and I always say to the playwright you know sometimes it's more important that matter the density of that matter expands faster than the illumination so don't worry about explaining the illumination or the light on that matter it's taken us two years to get to this point and it took us a while there were seven of us to create this black creative capacity grant and it was hard as Beth can tell you we didn't have a plan that was instantaneous it was not fully formed there was a lot of struggles and the seven people that helped me put it together oh my god the long hours that they worked were endless Jeff Prole Cindy Surrell Beth Blakers Brian Quirt Liz Engelman Cindy Surrell and myself that's seven to say that they worked a couple hundred hours is an underestimation no people who worked on a committee have ever worked so hard as those people can we give that group of people a applause no NEA committee ever worked so hard and I've been on plenty of them I'm bringing that up because at this moment in time and I've met with all these people I've talked with Ken our incoming president you'll always be a president you'll always please I've shared all this information with Ken Ken I've had several meetings we've had wonderful meetings talking about all of this Jeff, Cindy, Vicki and Beth are formally rotating off my creative capacity grant so that they don't die in early death if nothing else coming on Brian I, Liz Engelman are staying on Ken is coming on of course as the new president I'm bringing on two new people perhaps you know them Yvette Nolan yes extraordinary person a couple years ago I had the extraordinary privilege of being part of the howl round interview conversation that we had my remembrance of that was one of the most special remembrances to the point that I don't even remember the audience I just remember sitting with her and having a conversation it was so special also an extraordinarily gifted playwright dramaturge TCG blogger artist Jacqueline Lawton I don't know if you know her or not she too is also going to be coming on the committee so we're adding two more people as well to that group selection committee starting for the in effect the third application group now having said that hold that in your brain because we're now going to shift gears into warp nine Ken has kept this all in his brain he's been amazing you're going to love him as a president he's kept this all in his brain I don't believe in discarding people I just don't believe in that a couple months ago I was sitting in best office and we were having a great conversation and I just said so I've got some ideas four years for this Bly creative capacity grant is not enough I think we need to do a year five and six and we talked about the idea Beth I have a lot of friends a lot of former students of mine who've gone on to do exceedingly well in television who have promised they will do anything for me and they can and what I've asked Beth to do as part of her rotating off and having all presidents have some task as they leave well she really does I'm putting together a list of about X number of people former playwriting students of mine at Yale and other friends people who taught for me at Yale for many years who've also done exceedingly well that she's going to become and here's a new title Bly creative capacity grant ambassador at large in fundraising again I share this with Ken and we've had great conversations about this and so she is going to be doing that she because she is nationally internationally known even among all of these playwrights and the agents is quite capable of being the pitch person to these agents and to these playwrights for me representing me so that I don't have to go and do that and they are targeted to go forth and raise more money in the name of the Bly creative capacity grant for years five and six so that's part one of this so we're not discarding this person she's too valuable part two Cindy Sorrell again so invaluable about the work that she did in helping to create this created another position called the Bly creative capacity grant ambassador at large in publishing and having discussions and again in deciding this I want to make sure you also know that Brian and Liz had a great deal of input in this I also shared with Ken and Brian and Liz the notion of I want another position Bly creative capacity grant ambassador at large in publishing and again Cindy because of all the work she's done I said I think Ken and I had some really great discussions about this transparency issues this harkens back to my metaphor that I started with about the playwright that sometimes matter is created and the matter expands faster than the illumination the transparency if you will the light not everybody knows about everything we're doing well now you will Cindy is going to create a Bly creative capacity grant guidebook an A through Z of it that will be online for everybody to know the A through Z of how we've created this the application everything the history of it and it's going to be online for you and also for funders so that this will be there she's also going to be in charge of a creative capacity grant in effect chronicle a history of this so all of this stuff is going to be chronicle so we're not going to lose the history of this and she's going to be tapping individual people young and old members to do articles interviews that will be in the LMDA review newsletters and outside publications it's about god damn time American theater theater forum maybe funding type publications as well so the message gets out about this this is not just about fucking me this is about LMDA and the kind of work that's being done the kind of work that's being done that's the point it's always been the point it's always been the point oxygen it's always been the point it's always been the point I think I think that was all I had to say it was too damn much anyway but thank you Mark so we just have time for a couple of questions from the audience if you have anything that you want to ask Kelly or Sally or Sarah or thoughts you want to share in terms of non-traditional art forms traditional dramaturgical forms we invite stories from your own life adventures as Mark said if people who are here who are the spokespeople to the first year recipients want to throw in an update from the group they're reporting to we would be delighted to hear from all of you so we've got some volunteers running around with mics anyone want to throw their hand in the air raise hands high please thanks I'm really excited about all the projects hearing about I'm curious with pot because I think I might be in New York so I'd love to hear the dates again and I'm also curious about how you're ticketing it and since people can encounter it by chance how those logistics are working for that style of festival totally the dates are September 23rd to the 25th and it's free so you can happen upon it if you're there except for one which is I really hope it works out it's a puppet dinner party so you get food and drink so because of that we're going to charge tickets because it's like a restaurant you get some stuff with it and it's a capacity issue so but otherwise it's also I'll give you one of these I brought a lot of them this is like how I'm kind of like getting the word out this is it's a zine I made and it's kind of been like the best way I've learned to like tell people about it because I'm like hitting up bartenders talking about and I'm like here read this so this kind of is how I've been kind of getting the word out it's like here's the dates, here's some like extra details here's some like big picture stuff and here's like the website you can check out and then eventually this kind of idea is going to become the map and this kind of came out of I didn't want to spend any of the buy money on just like a glossy postcard because I'd rather buy something weird like a weather balloon or something I'm just like no so I just like went to the Yale school drama in the night and like used their color copier for free so yeah so anyway but yeah so I've made a bunch of these while watching Orange is the New Black so I'm happy to like just burst them around as well but if you can't see them because you're way over there they're gorgeous and you definitely want one it's us on Hi Sarah, it sounds like a fascinating project I'm just really interested in what narratives have come out and how you are working with science and the science is working with you really great question I think one of the things that I've really been wrestling with is what is the meeting point between the science and the imagination so how how do we because the science might see if you're not familiar with the science it might not necessarily seem to affect your everyday life although it affects has affected everything that we have believed to be true about the universe how do we express the significance of the discovery in those terms and so one of the things that we've really been thinking about and talking about is actually how how the science affects the imagination and what is the connection of the elements of the night sky that we become familiar with and sing about as children how does that connect to the science which connects up to the stories of how the scientists became scientists or astrophysicists in the first place and actually what they tell their children and what their relationship is with the sky and the imagination as well as with the science so figuring out how that might be translated is something I've been thinking about a lot well I'm just wondering if I need to be worried that the universe is expanding only in good ways dramaturgically okay great they are expanding the universe so can we say congratulations and thank you and we look forward to hearing from them in the coming years as these projects come to fruition I'm going to end this section a little early because I don't know that every single person who's going to want to check it out backstage is going to be able to fit there in one round so we may have to cycle through in a couple of groups so the AGM starts at 4.15 Coriana I believe that's accurate I'd love for you all to be here so go ahead and go backstage right oh actually there's going to be volunteers out in the hallway there's going to be volunteers they will lead you to the green room go have your mind blown on the holodeck and then come on back and hear from your board and exec thanks all


This research found that there is a positive correlation between self-regulated learning and digital literacy, both of which are important factors in achieving better understanding of the excretory system. This article was authored by Rusty Rusty, Rizzle Hendi Rustonto, Gabriele Octaviani Prabowo, and others.