This is a video about functions first. We'll begin with a relation which is a collection or set of ordered pairs and Then a function now from x to y is a relation that associates exactly one element of y and take each element of x To break this down a little bit. This just means that x values do not repeat amongst the ordered pairs that are given Function notation uses f of x, g of x, h of x in place of y So don't let the notation of function scare you The domain of a function includes the x values or input values The range of a function includes the y values or output values. So x is input y is typically output All right an example one I give you a group of ordered pairs and I want to know if each set of ordered pairs is a function if so We will state the domain and range Looking at part a they give me four ordered pairs But notice one four and one seven each have an x coordinate of one So one repeats as an x value So that means it is not a function that's what we mean by saying x has to be unique part b Look at the x values negative one zero one and two the x values do not repeat. So this is a function Since it is a function. We are going to state the domain and we will state the range Since there's only four points We will just list the four x values from the points as the domain Remember the domain would include x values only and then the range or the y values you have three Five Two and then three again So include that within set bracket check set brackets 352 this is actually written more nicely as 235 Ordering the numbers is always nice Next if we're looking at a graph we can determine if it's a function using the vertical line test This means that if we walk across the function or go across the function with the vertical line We cannot touch more than one point at the same time For instance in part a with the circle I touch multiple points vertically at the same time in many places For instance, I have negative two negative one And then I also have negative two five X is not unique. That's why the vertical line test works So the answer is no for part a and for part B if you go across the graph with the vertical line Well, you never touch more than one point at the same time vertically. So part B is yes That's what you call a quadratic function actually, but the important thing is it's a function Next all lines are functions except for vertical ones. Those are of the form x equals some number So in example three Part a you have x equals seven. This is a vertical line Because it's of the form x equals a number. So the answer is not a function Part B. It is not a vertical line. So it is a function Y equals 3x plus 5 is a function Finding the domain and range of each function Or of each graph we should say because part A is not a function Remember the domain would be x values. The range would be y values We want to give the answer in ways known as interval notation So here's the trick to find the domain or x values, which the graph is defined You look at the furthest left point of the graph What's the x value? Negative five and look at the furthest right point of the graph What's the x value one so negative five comma one enclosed within brackets? Because you have points at negative five and you have a point at one That would be the domain the range. How low do you go in terms of y values? Remember range you need to be in a y mode. So negative one is the lowest you go vertically And the highest you go would be a y coordinate of five So we enclose within brackets because there are actual points to find that those y values Next part B Remember the domain would be the x values the range would be the y values So how far left through good well, let's look at part B We have arrows this left side arrow has both leftward and upward direction The right arrow has both upward and rightward direction So the furthest left you go well since there's an arrow going left. It's negative infinity the furthest right you go Since there's an arrow going right. It's positive infinity and you always put parentheses around infinities range How low do you go? Well the lowest point has a y coordinate of negative three and how high do you go? Well arrows with upward direction mean that you go all the way up to infinity Parenthesis around infinity bracket around negative three because there is a point at the y value of negative three so that's finding the domain and range of Graphs one of which was a function and one of which was not Next we can evaluate functions at x values For instance example five f of x equals three x squared plus four But they want you to find f of two that just means in the equation let x equal two So this means I have three times two squared plus four That's three order of operations two squared is four plus four Multiply three times four is 12 plus four You end up getting 16 Part B f of negative one be careful here because you're squaring x that means you have three times x squared or three times negative one squared plus four That means I have three times negative one to the second powers one plus four Three times one is three plus four Which is seven Example six same process except we have g of x equals two x minus one So when you see g of one it means in the function g let x equal one So g of one is well two x minus one that's two times one minus one That's two minus one. That is one part B. You're gonna let x equal negative four G of negative four. That's two times negative four minus one That's negative eight minus one That's negative nine. So that's how you find function values and last but not least If you plug a certain value Into a function and then you get a certain value out Well, that value you input is the x coordinate and that value you got out of the function It's called your output value for instance if f of three equals seven then three seven is on the graph of the function f So for instance example seven write each of the following as an ordered pair part a f of 12 equals negative one Get this means that your input is 12 And your output is negative one The ordered pair would be 12 negative one. That is all Part b h of negative three equals six. The ordered pair would be well inputs negative three output six So not much work to show there at all But it's an important concept that what's in the parentheses is input and then the number on the other side of the equal sign As output. Well, I hope you enjoyed. Thanks for watching


Hi, welcome to the All Things LGBTQ Interview Show, where we interview LGBTQ guests who are making important contributions to our communities. All Things LGBTQ is taped at Orca Media in Montpelier, Vermont, which we recognize as being unceded indigenous land. Thanks for joining us and enjoy the show. Hi, everybody. I'm here with distinguished professor and author, John Weir, who has just produced a new collection that we're here to celebrate and promote called Your Nostalgia Is Killing Me. And John has been kind enough to join us to talk about it. But before we begin, let me read a little introduction of John. This is his formal introduction. John Weir, winner of the Grace Paley Prize for Short Fiction for Your Nostalgia Is Killing Me. Congratulations. Oh, thanks. Is the author of two novels, The Irreversible Decline of Eddie Socket, winner of the 1989 Lambda Literary Award for Gay Men's Debut Fiction. And What I Did Wrong. He's an associate professor of English at Queens College CUNY, where he teaches in the MFA in Creative Writing and Literary Translation Program. That's an interesting field. In 1991, with members of ACT UP New York, John interrupted Dan Rather's CBS News to protest government and media neglect of AIDS. He lives in Brooklyn, New York. Welcome, John. Thanks for having me. It's great to see you. Great to see you. Very happy to be here. One thing I want to note before we continue is that your first two novels are going to be released by Fordham University Presses in Fordham University Presses Relit Series in the Empire State Editions. So congratulations on that. That means Regress can get current copies. Are you going to write new introductions or are they just going to be re-released? I mean, the first two books, the first one came out in 1989, Eddie Socket, and the second one, What I Did Wrong, came out in 2006. And they've both fallen out of print. And this delightful guy named Richard Morrison, who works at Fordham University Press, kept asking me on Facebook. We became Facebook friends, and he kept saying, do you want us to re-release your books? And I don't know, I'm perverse. I ignored it for like three years. And then I finally thought, I'm not getting any younger.  So both those books are out with this series that he initiated, which is meant to focus on novels and fiction that takes place in New York City. So it's the texts of both, the original texts of both books. They just reprinted them and repackaged them. So and coincidentally, the three books came out like all at once. So it seems like I've been writing furiously for the past two years, but that's not really the case. Well, speaking of Facebook, let's start with the dedication of this collection of short stories for 5,000 Facebook friends and 2932 followers at last count. That's a fabulous dedication, and I feel personally affected because I know you through Facebook. We must have mutual friends in New York, but I became aware of your posts and they're so smart and contemporary and analytically astute that I sent you a friend to request and you were kind enough to accept it. And that is how I learned about the publication of this collection. So Facebook is working for me in other words. It is. It is. I also have to add that I'm not really on TikTok, but I saw your TikTok reading. Oh, yeah, I started doing some TikTok stuff. And then I think TikTok is mostly for like romance and sci-fi and young adult novels. And so I wasn't I'm not quite sure I'm reading. I'm reaching my target audience there, but but I've been posting things off and on to TikTok. Absolutely. Well, why not? Why not? How long did it take you to assemble this collection? I'm sorry, what did you ask? How long did it take for you to assemble this collection? Well, that's a really good question. I mean, it took both 30 years and 15 minutes by which I mean that I had written a lot of those stories over maybe since about 1997. I had been writing all of those stories along the way, publishing them here and there. And at some point, I was sitting in my office at school like on a cold night in February. And I saw that there was a contest that the Associated Writing Programs sponsored for the Grace Paley Prize. And I and the deadline was like 24 hours away. And I thought, huh, I probably have enough stories for a manuscript. So I've kind of flung them all together and sent them off and more or less forgot about it. And then very much to my surprise, the following August, they contacted me and told me that they'd selected my manuscript. So that was kind of thrilling. I mean, I had previously queried like 10 different agents. I don't currently have an agent and ask them if they would look at whatever I had and none of them got back to me. So I thought, I'll go the contest route and see how that works. And it worked out. So I'm suddenly a big fan of any of those writing contests that you can find in the back of poets and writers. They list that magazine. They list various contests. You can enter month by month.  So that worked out. And Red Hand Press is a lovely small press in Pasadena. And they partnered with the Associated Writing Programs to publish whatever book they chose for that prize. And so and I've had a great experience with them. They're really nice people. And I kind of like small, working with a small press because they really get behind their books, whereas a giant mainstream press doesn't necessarily unless they know you're going to sell a lot of copies for them. They don't necessarily back you up. So I think in some ways, small presses are better. Well, Red Hand was lovely to me. You know, they sent me a copy of the book without a lot of Pooha or PDF file. I mean, they were really very generous about it. So, you know, I agree with you about small presses. They're sort of small presses. Why short stories?  I probably I think just because I had all these stories and I wanted to have another book out in the world.   Yeah, so long since I published something. And and I just happened to have these stories available. But also I think that even with the two novels, I think in terms of writing kind of in self-contained blocks and then like sewing them all together with a novel, there's there's an arc you have to think in terms of, whereas with independent stories, you don't have to. But but I like short stories. I read tons of them and I teach a lot of them because I teach in a creative writing program. And it's it's it's really easier to work with a short story in one class than an entire novel. So so I've read tons of short stories. And and and I guess I didn't realize until I started assembling them until one manuscript that it it was the same narrative from one story to the next. You know, I'm I'm my main subject. I'm my main topic of fiction, apparently. And I and and I thought, OK, there's a kind of progression here. So so they so they work as independent stories, but they can also feel like, I think, a kind of cohesive narrative over a period of decades following this one guy from one part of his life to another. So that's why I'm calling them linked stories, I guess, because I think I don't know. Did it read novelishly to you or did they really seem various independent from each other, those stories? But as we since we're talking about it, why don't we pause and give the audience a sense of the writing and the story? And you've agreed to prepare a reading for us of about five minutes. Maybe. OK, great. Good time if you wouldn't mind. No, not at all. So I'll so I'll read from the story in which Charlotte Sheedy appears. It's called the scenes from a marriage. And it takes place in 1994. When the the speaker, John, is living through the last couple of years of his friend, David's life. David is also a writer based on a historical figure I read in an interview, but you don't. Yes, absolutely, based on my friend, David Feinberg, who was a novelist and a story writer. He wrote a book, a novel called Eighty Sixth, and he died in 1994. And very calamitously. I've I've I've I've I've never known anyone to die like that. And sadly, I've known lots of people who died, but David took it to a whole new level. And and so it really didn't have to invent anything with him. I could just write what happened. He was already so theatrical and the events surrounding his last couple of weeks were, I don't know, the stuff of fiction. So to your point about the nonfiction fiction thing. I know I often feel like I don't really need to make things up because the stuff that happens in my real life feels fictional already.  So so so it is it's meant to feel like it's nonfiction. But but it's it's also not. There's stuff that I, you know, compressed in events that I merged together and the time sequence is different.  But but but I but I kind of want you to have that. Is did this really happen? Is, you know, did he invent this? I kind of was the effect I was going for. That's very successful. Oh, OK. You've succeeded, Admiral Boy. Oh, well, OK. So do you want me to read it then? Yes, please. OK, Groovy, here it comes. It's called Scenes from My Mind. I'm reading off the screen. So once you have this goes. The second to the last time he gets out of the hospital, the last time being his death. My friend, Dave, goes on a farewell tour like share. He's just published his new book, his third, his last. It's an it's an account of the final year of his life. And it's impossible to read, partly because I'm in it, doing nothing to keep him alive and and partly because he won't stop kidding about the worst thing that happens. My T sale count is lower than my IQ. He says, if I were Dan Quayle, I'd be dead now. Two weeks before he dies, the publishing company sends him 30 copies of the book and I load Dave and his book into a cab and we drive around town handing them out to every agent or editor or cute boy who ever rejected him. He's also trying to get someone to publish the diary he kept while he was in the hospital. It's a black mead composition notebook and it's an aborted novel, a toilet joke, an archive of AIDS obituaries from the New York Times for September and half of October in 1994, a list of results of blood tests, CAT scans, MRIs, bone marrow tests, colonoscopies and bronchoscopies, a document of rage and a draft of top 10 lists, top 10 most embarrassing public bowel movements, top 10 cutest male nurses. And it's an autobiography in the form of a questionnaire. There are 500 questions which Dave has written in block letters and his careful third graders print number one name with a blank line next to it. Number two, age, number three, religious persuasion, number four, number of lifetime sexual partners in thousands circle one and the options are zero to 10, 10 to 20 and a lady doesn't tell number five, life expectancy and so on for pages. Of course, he supplied the answers. There's scribbled in his barely readable cursive script. His name is Legion, his age is you should die like this. You know what aging is for religious persuasion. He has written Liza. He doesn't answer the question about sexual partners next to life expectancy. He writes, I've got 10 minutes to live. But who's counting? Now I've got nine. We take this diary to several literary agents. David already has an agent, but he fired him because he brought ice cream to the hospital room. Ice cream for God's sake. Ice cream is dairy. Dairy goes right through me.  We visit Charlotte Sheedy, Audrey Lord's agent, also Ali Sheedy's mom. In the future, I won't work with anyone who hasn't ripped a lesbian and raised a movie star, Dave says, when our cab pulls up to her building on lower Broadway.  He's always meanest in cabs. I'm getting money out of my pocket. I've been broke for my whole adult life, but I took a steady job just as Dave started getting sick. And for the first time in a friendship, I can pay for things. Lately, I'm paying all the time, which fine. He's always paid for me, bought lunch, taken me to Broadway shows, orchestra seats, shelled out a cash loan for a month's rent. Several times, I'm happy to pay. I can't keep him alive, but I can pay. He, though, hates the shift in power. Paying his paying is his job. His privilege is his way of his way. He jokes of making people love him. Don't overtip. He screams to me. Jesus, get a receipt.  You're not. Guess why? Guess why you're not a Rockefeller? Rockefellers have money because they don't tip and they save their receipts. We climb out of the cab. He weighs 97 pounds. So he walks slowly, his death walk, all bones. The skin at the back of his neck is creased and dry sinewy. His hair is pin straight, slipped against his skull. One arm goes out to the side for balance. The other ends in a fist that clutches the waistband of his jeans.  Let go when they fall. He knows this and he'll drop them to shock you. And he leaves his zipper open to show his diapers.  He's a little diapered man in a blue shroud, holding his pants up and moving stiffly and delicately across the sidewalk. He's 38 years old. Now we're pushing through the door to Charlotte Sheedy's office. And there is the surprised assistant at her guard post. She stands up, then darts back, freaked out by what flew in. It is as good for something, a way to get access to anybody. Push past office lackeys waving his hand. It says we have an appointment and we keep walking through the door to the intersanctuary, straight to Charlotte Sheedy's desk. Dave sits in a wooden chair, sits, slides. The chair is slippery or he is or both, or the problem is his coat.  Then he pulls himself up again and again. Such a little figure slipped quiet from its chair. That's Emily Dickinson. It's on my mind. Did I say it out loud? More poetry, my response to loss. Dave hates me because I can't help or I can only a little bit. And right now. Dying is a series of instant victories over nothing immediately fatal in preparation for complete loss. Will he not die if I find there are a poem?  Now he's a pair of shoulder blades in a T shirt and above them a face. Huge head, shrunken body. His glasses are Dr. Echelberg's a billboard that stares at you. There's a narcissistic boon in watching David die because he lights on you with an urgency and directness that no one else has ever spent his gaze. Sure, it indicts you, but you're hot and lit. A movie star in your key light floodlights on Charlotte Sheedy, who's been sitting behind your desk and watching calmly waiting for the best moment to speak. Oh, Charlotte Sheedy, David says, I brought you my new book and also my newest book. I'm standing behind him. He's a film director and I'm his people. He raises his right hand signalling me and I step forward and hands Sheedy his two manuscripts, the new book and the hospital diary.  Charlotte Sheedy is spectacularly cool. She opens Dave's new book, the published one, congratulates him, thumbs through a few pages and then sets it aside with a palm flat on its cover, both stamping it with her approval and absorbing its contents through her fingertips in an apparent flash of superhuman appraisal. Then she takes up Dave's diary, which in her hands is which in her hands is not a not a receptacle of rage and rubber or hospital gloves and blue pills, but an ordinary book proposal. She's so smooth. I want her to be my agent, too, possibly my mom. One page of the diary is entirely black and she stops there. Dave inked it solid with a magic marker one hospital afternoon frowning while he told me that he hoped he didn't go to hell because he was tired of running into me, even in hell, I'd have to buy you lunch. She says of the page and says, I see. Then she closes the book, looks up, our eyes meet over Dave's head. I'm trying to make my face say, sorry, sorry, sorry. Charlotte Sheedy is nicer than I am, though. She doesn't collude with me in silent commentary about a man who is clearly at the end of his life. Instead, she looks at Dave. I'm not sure this is ready to be shown around, she says.  Maybe all writers are ten minutes from death. Please keep me in mind, though, when you have something that's finished. Dave Grins showing all his teeth, darling, I completely agree. He stands slowly and heads around her desk for a hug. They meet by her chair and do a quick theatrical cheek to cheek air kiss. And then we're listening to Dave breathe his fierce breaths.  I haven't dared to help him because there's nothing wrong. That's the story he's telling. He's not a man with just days to live. He's a potential client with a literary property he's shopping around. And what am I then? His people, his development girl, his chauffeur, his longtime companion, non-sexual, his stock boy, carding books, his pocket change, hailer of calves, his walker, as if I were a woman in fur on the upper east side. His George Hamilton accompanying Linda Bird Johnson, the president's daughter to the Academy Awards, which Hamilton did in 1966 in white tie and a spray tan. Dave would get that reference. He loves anything tacky and obscure. He loves failed and minor stars. Three months ago, it would have made him laugh.  And all I have is George Hamilton in a fake tan. Dave is breathing in Charlie. She's office. We're all breathing. She breathes. I breathe. We listen to Dave breathe. We count the breaths, which come slowly with labor. Breath, pause, breath, pause. We stand there waiting for what's next. That's it. I hope that wasn't too long. Thank you. It was lovely. It was wonderful. I love the story, too. It was quite a thing to happen in real life. Let me tell you. Oh, I bet. I left out lots of stuff. But it's so like I would not have known how to respond in that moment. But she was just completely professional, but also kind and compassionate at the same time. She she was pretty amazing. It's really an incredible story and part of an incredible collection. So let me ask you about the audience. You mentioned in the last story called It Gets Worse, which is a wonderful, excruciating story about high school. You mentioned that your audience there. Is the parents of the bullies? Is that an accurate? I mean, it's a funny thing. I read that I had said that and I thought, huh, is that true? But. Certainly, I mean, I know the kids had get bullied in high school for all kinds of reasons. And I hope it doesn't. I hope it's not as misogynist and homophobic as it was when I was in high school, although I'm guessing that depends on where you grew up and who your parents are and so forth. But but I felt like. People who've been bullied like that have a have a sense of what that feels like. And and and I mean, I'm gratified if they feel some catharsis and reading about it, although I don't know, maybe it would traumatize them. But but the the the people that I've pretty much my whole adult life wanted to communicate with were the the people who bullied me and harassed me and flung homophobic slurs at me all day long. And and and, you know, I often wonder, like, who are they as adults and what are they doing now? And do they ever reflect on that moment? Were they really aware they were doing it?  It's kind of the same psychology, I think, by which when I teach a college class, I immediately focus on the person in the back row who seems the least likely to care about a single thing I have to say. I don't know, I always go for the the person in the room who's the the least likely to be interested in anything about me. I mean, that's not quite the same as being harassed by 16 year olds. But but I but I don't I'm not sure that enough in particular straight people, I think, have a sense of their complicity in in making gender non binary or or or gay or queer teens. Feel like outcasts, I feel like they're not safe walking into a classroom and and and, you know, there's been a lot of talk about bullying and so forth, but but I don't know if there's enough focus on my complicity in that, you know, if people would ask themselves, what am I? Well, what did I do? And what am I doing now that that allows this to happen? You know, even if you're not actively harassing someone, you might just buy your Sarah Schulman has written about this, about being a bystander to someone else being abused and how the bystander has a complicity in that. And maybe in a way, I'm trying to to reach the bystanders and say, take a stand.  And and I I mean, I know I was you know, mean to various people at various points because they weren't cool or for whatever reason. So so I also want to acknowledge my complicity in that in, you know, any of those stories.  Who's the audience for that, do you think? Well, certainly anyone who knew David Feinberg. I remember the publication of 86. Yeah. And and his nonfiction book was called Queer and Loathing, which I don't think I've ever read, although I mean, I read it while he was writing it, but I don't think I've read it since he died because he refers to me repeatedly. I mean, he writes similarly to what I'm doing with him.  So and he had tons of fans and lots of lots of readers who really liked his writing. And so I'm happy to, in a way, give a shout out to David, even though he doesn't always come across as the nicest guy. He was a very, very sweet guy, but also a very acerbic guy, sort of a fun kind of one or two. But all the sweetness went away when he got really sick, which, you know, I can't imagine what would happen to me if I got that sick.   But anyway, I do want to document that period of time. I'm sure that you were talking about reading Sarah Schumann's book there's there's a lot of literature and movies and TV news reports now about the first 15 years of the global AIDS crisis, like 1981 to 1996 ish and. And some of it, some of it gets to the truth of it. But I think a lot of it treats it as kind of a theme park that we can visit and think, oh, it's so sad what happened to those people, but everything's fine now. And I wanted to I wanted to give the most painful possible depiction of what it was like to live through that and how it's still affecting people, you know, if you go through that kind of loss.  And it was very isolating and left people very much on their own to manage catastrophe. It's as if it's as if with covid. I mean, as bad as Trump was, at least he was saying the word covid. Ronald Reagan didn't say the word AIDS until in the early in his second administration. So at least everyone knew covid was happening to people and people were talking about it online and how do we manage this? And so there so there was a sense of community happening around what is covid and how is it affecting us? And with AIDS in that moment in New York City, it was just the people who were dying and and everyone else was kind of oblivious. So I didn't want to represent I didn't want to say look what happened. So so it's both for people who lived through that and for people who want to know about it and have maybe gotten slightly sugar coated versions of it from from TV news reports. Not that you can really sugar coat it, but so I think it's a really important project and you do it beautifully and it's very pretty and real. I mean, you lived in New Orleans during that period. Yes. What was it? Oh, and I was living in Boston in 81 where as it was just being, you know, the community was just forming. Right. And I remember vividly Gay Pride March in 81, where the newly formed a act up. Well, act up came up came later. But all these men were coalescing and showing strength. And a lot of them appeared on the quilt afterwards. Right. Right. Right. So then I moved to Madison, Wisconsin and New Orleans. And I mean, that whole period certainly marked everybody's lives really deeply. So you're bringing it back because it's so important. I want to see there was a broad revival of Larry Kramer's of a normal heart. I don't know, maybe I saw it in London. Oh, wow. Recently. Well, no, it was so interesting. I saw it in 1986 and then I went to a talk back afterwards. And it was like in England, they were just learning about age or something. It was the strangest. It was like a culture shock kind of thing. Yeah. Yeah. Yeah. But it means to interrupt you. Go ahead. No, no, no, I just I saw the original normal heart, I guess in 86 at the same time you did. And I hadn't seen it or read it in. I didn't see the TV version that I went to the broad revival in 2011, maybe I'm thinking I can't I can't remember exactly when it was. But but I was sitting in the audience with a bunch of people my age. I'm assuming there were lots of out of towners. And and I was watching it felt like a home movie because I had known a lot of the guys who were first involved in gay men's health crisis, whom Larry sort of made into composite characters and wrote about.  And and the audience around me, I could sense them being like, how could this have happened? You know, who knew this happened? And I was like, where were you? It was all that was happening for me. But it's funny how something that huge and catastrophic can can still stay kind of a secret to a lot of people. So so I'm really wanting to explode that secrecy and then and make it more present for people. And another strength of the book is that the second part is called, I think, survivors, lone survivors. And you're able to suggest long term survivors were able to suggest the impact that the irrevocable impact that it had on people who were there doesn't go away. No. I mean, Act Up had a Act Up New York had a kind of reunion in 2012, 2013. It's some NYU building and everybody who had been involved in Act Up New York, I mean, a lot of people in Act Up New York came together and and talked about their feelings, basically, like what they were feeling while all that was happening, because Act Up was so focused on getting the government's attention, you know, intervention, street activism. And there kind of wasn't time for feelings in a weird way, or maybe it was a way also to distract yourself from from the trauma you were experiencing, because you could go lie down on the street and chant and get arrested and show up in the evening news and feel like you'd accomplish something. And but all these people were still left with a kind of PTSD, I think, from watching so many people die. And that was that was part of the motivation behind that story, was thinking about what it's like for people now in their 50s and 60s and 70s and 80s to have gone through this experience and still hold all these feelings about it. And, you know, what that has done to them, how that's shaped the rest of their lives and so forth. It's a really important book, John. I really thank you for writing it. Oh, well, thank you for reading it. Let's switch gears a little bit. What are your current projects? My next projects. Well, I have like three different books that I've been writing since the last century that. Every so often I open a file and look at it and think, oh, this isn't so bad. And then I write a page and then I put it away for another six months. But but my immediate project is to write about my mother who shows up in two of the stories in the book. She died in 2018 and she was. I mean, I say in the book, I think she was a movie star without a movie to star in. I mean, she was the most theatrical, funny, smart, mean, capable. Like she was a cowboy on the one hand, but she's also like a Rita Hayworth beauty queen, on the other hand. So she was this weird combo of like Henry Fonda and Rita Hayworth. She rode bareback in the woods and her tennis shoes. And she swore like a truck driver and and a Taurus. So very forceful and very sure of herself. The most person I've ever met, way more certain than I am. And I spent she and my father for some crazy reason, moved to a retirement community outside of Philadelphia, where no one had ever been. They grew up, they lived in New Jersey for 50 years, I think. And suddenly they were in this retirement union and my father promptly died. So my mother had eight years of living along with just her dog. And so I spent and then she had broke her hip and had a stroke. So really for the past five years of her life, the last five years, I spent pretty much every weekend with her. And and she regaled me with all the stories about her childhood in Denver. And and she she was like David Feinberg.  And she would start talking and I would just be pretending to like looking things up on the internet. But I was actually transcribing every word she said. And so I have, you know, 80 pages of of my mother's monologues.  I'm spending the summer in Denver, where she grew up, where I've really never been. And I'm trying to sort of find out stuff about her past her childhood and see what was myth and what was actual and figure out a way to record that all on the page. She's so easy to write about because I have her voice in my head. So even talking about stuff that she would like she died before COVID happened. But I have her voice in my head telling me all about COVID. So I don't really have to I can just take dictation, basically. Oh, my mother's talking to me about COVID and I can start writing it down. So but I really want to introduce her to reality. And I feel a kind of obligation to record her story, which I think she wanted me to do because she she fed me all her love letters before before she got to give me this giant packet of all the love letters she'd written to all the guys she'd been in love with before she married my father. So there was a sort of a tacit admission that she was expecting me to use them you know, after she died, of course, so she couldn't sue me. Is it going to be a memoir? I haven't quite figured that out. I mean, I think it's going to be similar to some of the stuff in You and His Knowledge is killing me in that I kind of wanted to feel like documentary, but at the same time, I don't want to feel obligated to write down things exactly as they happened. I mean, I want to be free to make stuff up or change names or compress time or move stuff around in time and space. So if it were a memoir, I would feel way more like I had to say actually what happened instead of instead of fictionalizing it in a way that that worked fictionally.  So so so I do deliberately want to write that line. And I think there's more room in publishing world lately for hybrid work or stuff that blurs those lines. I mean, I don't know, have you found that that? Yes, I have. Yeah, absolutely. Speaking of time, we're getting to the end of our time. Oh, OK. Are there any last words you want to share with our audience? You know, by my book. I'll read it. Hi, it makes sense to me. Hi, everybody. Welcome to All Things LGBTQ Interview Show today. We're speaking with Rage Hezekia and Hezekia. And she is a well known and quite published poet living amongst us in Vermont. And so we're going to talk a little bit about her work and who she is so people can get to know her. You're living in Bennington, right? I live just I'm like, what direction from Bennington? I live one town over from from that. Oh, that's OK. Yeah. And you're originally from Massachusetts, I know, from Salem. Uh huh. And how long have you been in Vermont? My wife and I moved out to Western Mass from the Boston area about four years ago, and we've been in Vermont for three. We were in we're in North Adams before we just moved over the Vermont border. We really like it here. And you're working in that area, Bennington, right? Could you tell us a little bit about what you do there? Yeah. So I work at Bennington College and I am the Associate Director of International and Academic Services, and I work to support first year and international students in their transition to Bennington and just kind of offer holistic support and visa and immigration support and all of that kind of stuff. And what kind of students go there? Is it is it a working class school? A commuter school? Is it a, you know, any kind of students do you encounter there? That's a great question. So it's a it's a it's a private liberal arts arts college. It's really small. We definitely have a we have an organization on on campus called Flow, and that's her first income working class, first generation students. And so there's a large population of students that are that are in that bracket. It's about 20 percent international students, about 20 percent students of color, students from from all over the world and throughout the U.S. for predominantly, you know, the the coasts, a lot of a lot of New England folks and a lot of California and Northwest folks. Sounds great. Yeah. So let's talk a little bit about your poetry and I'm going to read a little introduction and about your work and all the great awards you've gotten, and it's very exciting. So Rage is a New England based poet and educator who earned her MFA from Emerson College. She has received fellowships from Kava Kahnem, McDowell and the Ragdale Foundation. And it's the recipient of the Saint Bataugh Foundation's Emerging Artists Award Awards. Her poems have been anthologized, co-translated and published internationally. And you have two books and one chapbook. So this is your second volume and it's called Your and and it will be coming out July 2022. Yeah, it's it's in pre-orders now and then it'll be be out in just a few months in July. OK, and we'll we'll put up something telling people where they could pre-order your book. And so Rage and Rage is a Hezekiah's impressive collection pulses with the deep emotional intelligence. This book is filled with space and beautiful verse that manages to explore the erotic, the familiar and the mundane with stunning wisdom. From the masterful use of the centro to pause in the transition in the tradition of Lucille Clifton and Dinez Smith. This is a book that sings a necessary song. We are all richer in the world where urine can exist to help us consider these questions in consent and contemplation. So that is a beautiful introduction to your work. Thank you. So your first chapbook. It must have been really exciting. Did you get it right when you graduated or and could you tell us a little bit about your first chapbook? Yeah. So, you know, I think publishing poetry is such a it's like it's such a strange journey. So I finished my MFA at Emerson College in 2015 and Stray Harbor, my first full length collection and the Unslakeable, which is a chapbook that's essentially an excerpt of Stray Harbor, were kind of published simultaneously. I think that made I think Unslakeable came out like, you know, maybe like three months before Stray Harbor or something like that. But both of those collections were essentially my MFA thesis. So I finished I started writing those poems in 2012 and probably the last of them was written in in 2016. And then the book came out in 2019. So there was a lot of a lot of space, a lot of, you know, iterations of that book. It took a it took a while for me to publish and I think it's I don't know, I think it's harder to publish your first collection. I've heard that it like, you know, publishing your first collection kind of creates space for for future books. So this new collection year and got picked up really quickly, like within a few months of me submitting it. So it's it's really lovely because I feel very connected to the work. It still feels like what I'm writing right now, whereas when I was when I published Stray Harbor, I felt like I was reading from a book I had written, you know, five years ago. It felt very different from what I was working on when the book came out. And so the transition to what you're writing now reflects, of course, who you are now and, you know, what you've gone through and how you've established yourself in the world. Do you how do you write? Do you get up in the morning and say, OK, I got an idea? Or do you just kind of spontaneously write and, you know, how do you do that? Yeah, it's it's all over the map. I'm really grateful, you know, I work on the academic calendar, which means that there's there's a lot of space in, you know, what we call non term time at Bennington, but between semesters, essentially, you know, for me to just have more space to invest in my work on a daily basis. I get up in the morning, I meditate, I pray, I make a cup of coffee and I sit down at my desk and a lot of times that space is taken up by like scheduling readings and submissions and kind of the more like administrative parts of being a poet. But that's when the majority of my writing takes place, too. I actually had. I'm very fortunate in that Bennington College has one of Robert Frost's old house and old houses and I was able to spend most of the day there working on edits for my book. And that's very generous.  Yes, sit in his living room and work on my book. It's a tremendous privilege. So I feel really, really grateful. So I gather from this introduction that you have been influenced by Lucille Clifton and Danez Smith, you feel like you. And Cento, do you use some of their work in conjunction with yours, like using their words or maybe idea? Could you tell us a little bit about that? I don't think many people would be familiar with what that actually means. Yeah. So so it's one of my favorite forms to write. It feels like it's kind of cheating as far as writing forms and poetry, because they're my understanding, my interpretation of a Chento is a poem that's comprised entirely of lines from other people's poems. And so there are three Chentos in the book. And I really love writing Chentos because it it kind of feels like I'm a knitter, but it kind of feels like quilting to me. It feels like I get to kind of take take pieces and and find the commonalities and the things that I'm drawn to in poems, you know, tend to be pretty consistent. And so when I'm reading, I often write down lines of poems I really adore on index cards. And then I just have a bunch of index cards with lines on them and the author on the back and I can kind of like move them around and create a poem and then know where all the lines are taken from. So that's that's where that's how I've how I've been able to write Chentos so far. And I'm I'm grateful that it's a form that I've come to love, in part, because it feels like, you know, I get to use other people's work in an in an ethical way. But it must be something that really moves you, right?  Yeah, there's water, I think, too, for the person you're writing, you know. Yeah, yeah, I am a lot of the book deals with my my challenges with fertility and trying to get pregnant. And it a lemon wrote a book recently called The Carrying, where she kind of talked a lot about her own fertility journey. And one of the lines that that I borrowed for one of the Chentos that I wrote was I am a hearth of spiders these days, a nest of trying. And I just was like so shaken by that.  Like that's so bleak. And it also gets like, oh, so true. And so there's something really beautiful for me about being able to appropriate that language and and fold it into the language of other poets that I really admire and and create new work from that.  So congratulations. Thank you. Thanks. And then I want I was reading some of your poetry and I came across. My wife is always right. And I laughed, of course, because my wife is always right.  Eat their own, but you use kin and I just found that like, wow. Just the use of language and the sparseness of the language. It's just beautiful. So would you mind reading it for us? Sure. Thank you so much. I pulled one poem out and not both of them. Let me just find it really quick. And then I'll ask you to read another poem, too. Beautiful. My wife was right. My wife was right when she said the mice would burrow back into the deep bin, reaching my hand into the barrel's hovel, their nest skittered, cottoned in selvedge. We tipped the tiny family into damp oak leaves on the lawn and rid the bin of seed. I'd filled our feeders, beckoning goldfinches, black capped chickadees, suic for the sap suckers. My wife worried they'd return. I dismissed her fears. Days later, black dust littering the cover. Evidence of reentry. Three starved bodies, huddled in the bottom. One faceless, consumed by her own kin. That's incredible to, you know, to express that kind of feeling. Would you read us another poem of your choice and and the first before you do that, how did you come upon this idea? Is this something that sort of happened? My wife, of that poem, my wife was right. Yeah. Did it. Yeah. Oh, yeah. Yeah. And it's like it's it's wild because I think living in Vermont, I've talked a lot with other poets about how how where you live and where you spend your time just kind of like funnels itself into your poetry, like it feels like, you know, by osmosis. There's chickadees and gold finches and sap suckers. And, you know, I have a poem right now with a Phoebe in it.  And she said, oh, poets love birds. And I thought, yeah, we're cool with birds. But this book, Yeren has multiple poems in it about mice because there are just, you know, living in living in Vermont. I have a cat, like the interactions between the cat and mice, like the inside, the outside, it's all in there. So that, yeah, that did that did happen. And there's lots of lots of other disturbing mice poems taken from taken from real life. You know, but it has so much, you know, besides, I mean, just as a venue for, you know, the mice, but it has so much more in it. Yeah, that is, yeah, really touching. Thank you. So do you want to read another poem for us? Sure. Yeah. So you mentioned Lucille Clifton and that blurb, which I'm so grateful for. And Lucille Clifton has a poem called Poem to My Uterus. So this is this is after Lucille Clifton. And this is the last poem in the book. Poem to My Uterus after Lucille Clifton. Bright wanderer, homing station set for the gathering. One tiny studded heartbeat.  I thought I've trained you how feeble my attempts to control my body, my worry and still you bear in home. Empty of anything resembling family. Each try, frozen and fresh, familiar and foreign. Anonymous men I chose from glossy catalogs. This one plays basketball. This one plays piano. I bring them all to you. Laven bear, divide my thighs, hoping. But you stubborn and polyped, pocked with fibroids, ever unwilling. I strive to line you with rich blood. One book says fresh pineapple. One says avocado.  Maybe I've ruined you with acutane or decades of ortho tricyclin, pummeled the entry to your home with bleached water from public tubs. You worried caraff, sweet doomed hubble. Show me what you need to make a life. That was beautiful. Thank you so much. Yeah, thank you. And on that note, is there anything else that you would like the audience to know? Your book is coming out in July. People can pre-order and where would they pre-order? You can pre-order from my website, richhazakaya.com, and I'll put the link to the pre-order in the show notes as well. And my website and my Facebook page also have a full list of events for the next few months. I'll be teaching workshops and touring around the Tri-State area. So, yeah, come see me. I will. Definitely next. And I hope you come to the Malkylia area, or even Burlington. We can get to Burlington. So thank you so much for coming and joining us. And we'll see you soon. Thank you for joining us. And until next time, remember, resist.


What follows are some highlights for the last mission that I needed to complete as part of the upgrading and engineering of my L6 rocket launcher. It's a mission to recover an item from a strongbox at an abandoned settlement, whilst the plan was that the settlement would be empty upon arrival it became clear that some more unsavory spicy types had moved in instead and they needed to be dealt with before the mission could be completed successfully. I've said this before and I'll say it again, I love how this game just happens to look amazing on occasions because when you were there, that thing happened to be there. That planet hasn't been placed there for me to see when I'm landing at this star port, that's just what it happens to look like at this particular moment in time. A developer hasn't been involved in that, it hasn't been hand placed, it just happens. I love how Elite is accidentally gorgeous and jaw-dropping on occasions. It's one of the things that keeps me coming back to this game. The plan here was just to park nearby, get out into the SRV and have a little scoot around before finding the thing that we needed to recover. Elite being Elite, sometimes things don't often go that way, as was the case here. I thought I'd found somewhere I was going to park and it appears that there are what I like to call some local colour already at the installation. The ship isn't in any danger but it's better to hang back, have a quick look at the situation before deciding what to do. This ship is kind of my second tier sort of BGS ship so it's well equipped for most situations. I've got missiles here that could easily deal with squashy targets at settlements like this but it's a lot more fun quite often to get out and shoot them in the place under attack again but like I say, not a problem. I'm going to launch the SRV, job number one, dismiss the ship and then get the SRV out of harm's way.  There's a beautiful, stark quality to this moon. It's in the Ocellus Primus system if you want to find it. So leave the SRV out of harm's way just over the Brawler hill. They'll have forgotten about me already at this point but I'm about to give them a sharp reminder that I'm here. All the gear I'm wearing is completely upgraded and engineered. The AR-50 that you'll see me using throughout all of this is an absolute cannon. So I often do this. I've got no hope of really seriously damaging them but from this range but a couple of rounds behind the left ear I find brings them closer quicker and you can do that. As you can see my shields are not really in any kind of danger from that. So I'm acutely aware that I've obviously been very noisy at this point so I'm now looking for surprises. That's the next contestant and toast. Once their shields are down that's it. You catch a glimpse of your shadow doing this every round then and you just look so mean and so purposeful. The ambient noise often keeps me on guard as well. I'm always a little bit nervous that a ship is going to drop a few surprises in. It does happen occasionally which is what I was checking for then. I think it was just ambient noise but it got my attention for a second. If you catch them in that particular as in that situation where they haven't got their shields up they sustained fire from this thing even at long range. They haven't got a hope. So I'll often pop barrels like that just because it brings the locals closer. I'm in a nice elevated position here so it's extremely unlikely that I'm going to get attacked from behind just to make sure. It's nice of them to put their shields on when it's dark like this. It makes them a lot easier to kill. The one thing this dominator suit hasn't got is an awful lot of battery capacity so I tend to use the torch. And honestly the shields only when I need to really, particularly in a situation like this, it's a bit different a conflict zone that obviously the shields will be on all the time then because you've just got danger everywhere. But in a situation like this I'll often flip the shields on and off as I think it becomes necessary. A quick look on the SRV scanner there and it's blindingly apparent that I've only really got one more target left. I know I've got a bust open a secure container so I've grabbed myself an e-breach and as is my want normally I've grabbed the high ground again straight away just to get a good overview of where our bad guy might be. In a situation like this before I've completely cleared the settlement out I won't even think about looking for the object that I'm here to recover. Job number one is always rid myself of any problems and then I can deal with the actual mission at my leisure. Shields on because I know they're nearby and because my quarry's location is not immediately apparent you can see them on the radar there. I decide to deliberately make some noise just to bring them out of the shadows really. So now I'm looking for the thing I'm actually looking for the actual reason I'm here. So job number one is find myself a terminal. The site's obviously powered down. You don't have to power up the whole site to use a terminal however. There we go so quick look at the facility exterior. There's the thing I'm looking for. All the bad guys that you've just killed will have bounties if you're in the business of collecting bounties if you need the money. So you can do that as you're going along. I tend not to bother these days honestly. Here's the thing I'm after e-breach time and there it is. So this settlement is obviously empty and powered down so you can you can loot the rest of the settlement if you so desire pretty much at your leisure. There is a slight chance I think that bad guys could be dropped in. More often than not it doesn't happen though. That noise is my ship coming back. The scorpion. Not a fan of the scarab but I've not made a secret of that but I absolutely love the scorpion. There are scenarios obviously where the scarab's better but the scorpion for most stuff that I tend to do. The scorpion is the SLV for me. And there we go as I mentioned at the top this was actually the last mission the last piece of material gathering that I needed to do to get my engineering finished on my L6 rocket launcher. I've yet to use that in anger but I'm looking forward to that. It's also the last bit of engineering I needed to do for all the major primary weapons in the game so I've now got one of everything suits included that's upgraded and fully engineered and good to go. That's it for now. If you enjoyed this video be sure to like and subscribe to make sure you see all our content and if you'd like to help support our work here at the Burpit you can also become a patron just like the wonderful folks you see listed on screen right now. Gaining access to exclusive perks, content and community events. We'll see you next time.


So let's let's get started Our first speaker is going to be young Kim Young's going to what is the optimal surgical approach for my upcoming kidney cancer surgery? I understand that many of you have already had your surgery But I think it's important for you to understand how the field has changed Just I met young first when we were UCLA and he was a urologic oncology fellow Young went then went to Roswell Park where he was a professor at Roswell Park Cancer Institute in Buffalo And came back to Cedars. How many years ago? Five years ago to lead our our kidney cancer surgical program And he's the co-medical director of the urologic oncology program and the associate director for research in the Department of Surgery young Yeah, thanks Bob. So It's a very nice to see you here. Welcome. You know I trained at UCLA a number of years ago now and when I went to UCLA for my fellowship I already knew I wanted to study kidney cancer because I felt it was a disease that at the time there was a Where you had a lot of room for discovery and improvement in patient care And then of course when I got there Bob was one of the faculty members I met and he was very instrumental in Teaching me about kidney cancer and helping to get my career on the right foot Now I'm a surgeon I Treat patients with urologic diseases, but my focus in my practice as well as in my research Remains kidney cancer So I'm going to talk to you a little bit about surgical approaches. Some of this may be review for you since Many of you have already had experience with kidney surgery Here's a picture. It's a picture from a from the operating room. This is how open surgery is done So for open surgery you have to make an incision We don't do operations this way very often. In fact, we do it so rarely I had a trouble finding a good picture and this one actually just came off the internet It's not even my picture, but it shows you how the operation is done you have a retractor a big metal device that's placed over the patient and you have these metal blades here you have these metal blades that are pulling on the On the skin and the rib cage is here and you're pulling the rib cage apart in some cases and It's very traumatic. It's hard on the tissue and it explains why patients have pain after surgery This is a picture of laparoscopic surgery It seems a lot gentler on the tissue You can see that Troll cars are placed and the openings that you end up with are about the size of keyholes The human hand is never in the body You use long instruments with little graspers at the end the television camera is placed and so this allows for a less traumatic and a minimally invasive operation Now you may have heard of robotic surgery Robotic surgery is really a just another way of doing laparoscopic surgery And I know many of you have had surgery five ten fifteen years ago So the robot may or may not have been available to you at the time But the robot doesn't operate on its own. It doesn't move on its own There is a surgeon who is sitting at a console and controlling the robot and This the robot essentially mimics the movement of the surgeon's hands So the surgeon sits there and whatever he does the robot mimics But the robotic hands are tiny there on their size of laparoscopic instruments. And so again, this allows Operations to be done in a less invasive fashion. This incidentally this Device was designed or conceived originally for the battlefield the thinking was If you're in battle, you don't want the surgeon to be operating on the front line where he he might get shot or Or bombed so you send in the robot and the robot gets attached to the patient and the surgeon can be Somewhere safer behind the front line doing the operation It didn't quite work out that way This is a two and a half million dollar piece of hardware and it was just too sensitive and delicate for battlefield situations But it found it's found a home and and you and and it's being actively used in modern operating rooms So here are some pictures of scars You can see that you know after an open operation. You might have a big Incision either in the front or along the side here's someone who's fully healed after laparoscopic surgery And if you look carefully you might see some scars, but they're barely visible now all your pain fibers are on your skin so that You know the size of your incision really translates into how much pain you have following the surgery And so you make a big incision you're gonna have more pain after surgery You're gonna have a longer recovery and you have to deal with the scar afterwards Now here's a a short video clip of of an actual operation where we're doing a laparoscopic Partial nephrectomy so you can see the tumor here and the tumor has now been cut off and This is the tumor bed Most of the kidney has been saved because we've just removed the tumor and a little margin of normal kidney and then you can see that you know, we're suturing and repairing the tumor bed and And we do this so that you don't bleed or leak urine from the side of the repair Right now you're not seeing bleeding because the blood supply to the kidney has been cut off We clamped the renal artery and vein and then once the repair is complete. We'll restore the blood supply to the kidney so and Robotic surgery if you were looking at a video would look very similar to this So here's the clamp the renal artery and vein are Are now patent and blood flow has been restored to the kidney and the operation is over So what do we know about minimally invasive surgery and when I talk is when I use the word minimally invasive surgery I'm talking about either laparoscopy or robotics It leads to faster post-op recovery What we do know now is that the cancer control Seems to be equivalent to that of open surgery the complication rates are pretty similar The operative time is a little bit longer with minimally invasive surgery because you're working with smaller instruments You can see here the changes in our use of various technology So right here on the x-axis you have here so 2005 to 2009 and you can see the percent of nephrectomies that are either partial nephrectomies or radical nephrectomies and You can see that over time We're doing more and more partial nephrectomies. What that means is in the olden days We would take the entire kidney out if it had even a small tumor on it The current standard is to take just a mass out and preserve as much of the normal kidney as possible Here's a table that really explains our rationale for doing partial nephrectomies so this is a study that was published in the New England Journal of Medicine back in 2004 and what it shows is that Your kidney function which is measured as GFR glomerular filtration rate decreases your risk of cardiovascular events such as a stroke or a heart attack increases so as your GFR starts to drop The risk of cardiovascular events goes up now. There is some controversy about this relationship It's not clear if it's a cause-effect relationship or simply an association That hasn't been nailed down, but I think many surgeons like myself Have decided we're not going to wait for the final answer if we can technically preserve Your kidney that has the tumor on it. We're going to do it Here's another important piece of data if you look at The National Health and Nutrition Examination Survey what it shows us is that Amongst patients over the age of 60 Reno pre-existing Reno and sufficiency Occurs in 40% of patients So if this is in the general population If you look at patients who have diabetes type 1 or type 2 again 40% already have Reno and sufficiency, so if you look if you look at the typical patient who develops a renal mass They're often over the age of 60 and they're often Diabetics and so we're often dealing with patients who already have Slightly decreased or significantly decreased kidney function and that would certainly argue for a partial nephrectomy rather than a Radical nephrectomy This is a study. We did a couple of years ago. There's a lot of information here But I've circled the numbers that I want to draw your attention to You can see that after a radical nephrectomy if you had normal kidney function Eventually almost 60% develop Reno insufficiency If you define Reno insufficiency as GFR less than 60 Now if you do that for patients who have had a partial nephrectomy only 15% Ultimately develop Reno insufficiency again showing that with a partial nephrectomy we can preserve kidney function and And that seems to make a difference long term Now this is a a normal grant we created a couple of years ago and you can actually access it online and It predicts for you what your kidney function might be after surgery and you can specify whether you do a radical nephrectomy or a partial nephrectomy you can put in the tumor size and If you've already had surgery and you've had a partial your surgeon may be able to tell you how long the blood supply to the kidney was Cut off during the operation and that information also gets put into the nomogram and it'll give you It'll predict your kidney function following surgery I'm going to shift gears a little bit and talk about kidney cancer and the risk of Recurrence following an operation for what was staged as a localized tumor so if you look at Just an example of a risk stratifier You could tumor grade is shown here You can look at patients with various grades of kidney cancer and you can look at their Survival over time and you can clearly stratify patients into different survival groups now For patients in this group Surgery alone may be sufficient But what about for patients in some of these lower groups where you know that the risk of recurrence even with surgery remains quite high Is there anything else we can do to try to prevent the risk of the cancer coming back? now this is a Slide that shows you the The therapeutic options we had you know ten years ago and This is certainly the situation when I was Training at UCLA and Bob was there as the faculty and and the Person leading the way and trying to develop new therapies for metastatic kidney cancer we had interferon and interleukin 2 and The situation is now quite different We have many more options for metastatic disease I've listed some of them here for you and these are small molecules targeted therapies that really Target the underlying disease mechanism Now these drugs are all approved for patients who have Established metastatic disease so lung meds bone meds But what about for the patient whose had surgery has no visible disease? But simply remains at high risk for recurrence. Can we use these drugs for those patients? The answer is maybe and in order to answer that question There are clinical trials that are being actively conducted. So this is a diagram of one such trial One of the largest if not the largest study that's ever been conducted or is being conducted in kidney cancer So this study takes patients who have had an nephrectomy, but remain at high risk for recurrence So they don't have no they do not have known metastatic disease But they're at risk for developing metastatic disease and they're randomized to Receive either sunitinib, soraphenib or placebo for a year, and then they're asking the question Does the drug decrease your risk of recurrence now? This study has enrolled all the patients they need for their trial and now we're in the follow-up phase to see if they Patients recur or not so in a few years We should have an answer from this study This is just a list a few of the other studies that are out there as well looking at other agents But the design is similar there. It's taking patients high risk for recurrence and asking if These various drugs such as soraphenib, sunitinib, pazaphenib, everolimus can be used in what we call the adjuvant setting But at this time we don't have an answer, but we should have answers Coming coming through very shortly There is another approach that I just want to mention to you you can give treatment after surgery But if you give treatment systemic treatment before surgery is called neo adjuvant therapy And I just want to show you one a couple slides that illustrate what neo adjuvant therapy may do It can decrease the risk of recurrence following surgery, but it can also decrease the size of the primary tumor in the kidney So here's a one of my patients that had this tumor in the left kidney and the tumor is very big It's going right to the middle of the kidney here And this is a tumor for which you would need to remove your entire kidney now this patient got sunitinib for two months and the Tumor shrink nicely, and it also takes on a much more Capsular up, you know well-defined Appearance with the nice capsule and this tumor was now amenable to a partial nephrectomy So here is the postoperative CT scan the tumor is gone There's just a little bit of bleed blood there from the operation But we were able to Preserve the kidney and this that was because we were able to give sunitinib before the surgery rather than waiting to give it after surgery and This is what we call a waterfall plot it Shows what happened to patients on this study if the bar is going in the negative direction It means the tumor shrink the bar is going in the positive direction the tumor Increased in size and so in this study that we did the majority of patients had some Amount of tumor shrinkage some had very dramatic tumor shrinkage and some had a little bit but And then there were even some patients where the tumor continued to grow but the majority of patients had tumor shrinkage and it's possible that First many of these patients the surgery was easier and And perhaps you could convert from a radical to a partial nephrectomy Here is a anatomical diagram of The kidney and the lymphatic drainage of the kidney This is a picture that we drew but it was based on Anatomic drawings from almost a hundred years ago our understanding of the lymphatic anatomy hasn't changed in many years But it shows you that you know the kidney has these lymphatics and that's why when you have a tumor on the kidney often the the lymph nodes get enlarged and the tumor spreads to these nodes and One of the important questions when doing surgery is do you need to sample the nodes or not? And here's a study that we did which shows that if you don't do a node dissection You're not going to find positive nodes But if you do a node dissection as part of your kidney surgery you find nodes even though the Preoperative CAT scan was negative so it clearly leads to better staging and knowing the node status Improves your ability to Determine prognosis Another way to determine prognosis is Molecular markers so As we In talking about molecular markers I need to tell you a little bit about what's been happening with our ability to measure markers so the human genome project Sequenced the entire human genome for one person who lives who lived in Buffalo, New York and the cost of the project was 2.7 billion dollars and A couple years later a study was Published where they did it sequenced the one individual and his tumor and that was in 2008 and the entire project cost $700,000 now the Back in 2011 it was possible to do a sequence the entire genome the entire blueprint for an individual For $5,000 and it took two days now We're actually at this point where you can do that same work for a thousand dollars and one day So what is this allowed us to do? Well, it allowed us to take tumors that are stored in our biobank so this is an example of a Biobank that we have where you store blood and tumor samples and You can sequence them and here's an example of a paper that just came out in One of the leading journals nature and they took over 400 kidney tumors and sequenced them all so not only are we not we're not talking about the sequence for one individual but the sequence for Hundreds of tumors and this allows us not only to understand what's happening in kidney cancer, but understand the variability amongst tumors and We take that information and apply it to tissue from clinical trials like this one. This is a study that was done a number of years ago and patients either received inner furan or inner furan and Bevizuzumab or Avast and and this is a study that led to FDA approval of Bevizuzumab so in one of the studies that we're currently working on we took tissue from this trial from patients who went on the study and We profiled molecular markers using some of the newest genetic Techniques that are available to us and here's an example of a marker that we discovered where the Where if the marker is high you are better off getting Interferon if the marker is low you're better off getting inner furan plus Avast in so we're discovering Markers that can stratify prognosis as well as teach us what kinds of therapies might be best for patients so this is just an example of how we are using modern technology to go beyond things like Assessing live node status and and and to determine prognosis and pick therapy So I want to just leave you with these concluding thoughts I believe that a partial nephrectomy should be performed when it's technically feasible and it doesn't it's Whether it's done laparoscopically or using an open approach is probably of second importance, but of course laparoscopy will lead to faster recovery and And I believe that people should consider clinical trials of adjuvant and neo adjuvant therapy so we can You know you have an answer soon as to their effectiveness and we do know that a retro perineal lymph node dissection improves staging at the time of surgery and We're actively working on molecular profiles and molecular markers to try to personalize therapy and go beyond the traditional staging Systems that we currently have Thank you for your attention We have time for one or two questions if there are any from the audience the microphones in the front Maybe I can start young Many people who are now presenting with katsuki and evidence of small renal masses Sometimes undergo procedures that are not surgical. Can you make a comment about that? Yeah, so what we also what we now know is that many of these small tumors that we find incidentally May never grow or may take years and years to grow and so if you have an older individual who maybe has a Limited life expectancy you may not necessarily have to treat and so what we recognize is not everybody needs treatment and certainly not everybody needs treatment right away and so You know it's important to ask your doctor what the prognosis is and if treatment is absolutely necessary Thanks young so let's move on


All right, we're gonna get started. I am the first one of this morning's lectures And I'm talking about an iris anatomy. So there's just a Histologic picture of the iris. So there's two ways to think of anatomy. There's the clinical anatomy and then the The histological anatomy. So first let's talk about the clinical anatomy. There's two main zones the pupillary zone and that Contains the, let's see which one's the laser again. There we go. The pupillary zone, which contains the rough and the reflected area of posterior pigmented Area, and then you have the ciliary zone, which is on the outside of the rough It contains iris crypts and they're separated by this collaret, which represents the blood vessels running through the iris So the other way to look at it is more histologically. There's five layers that we Classically talk about the anterior limiting layer or the anterior border and that is Interrupted by a connective tissue that burns with ciliary body, and then there's a stroma which is sort of the meat of the iris that has melanocytes, the vessels, and Different things that we'll talk about more detail. Then the muscular layer There's the smooth muscle at the pupillary margin and the smooth muscle deep in the iris stroma. You have the anterior pigment epithelium and posterior pigment epithelium Here's kind of the cartoon version of this So you can see All right, but this anterior border the stroma with all blood vessels and Then the muscles and the posterior pigmented area So the anterior border is a condensation of fibroblasts and melanocytes. It's really really dense where you have the crypts it is absent and from what I read the reason for that is so that the Aqueous humor can more fully bathe the stroma in those those crypts The stroma itself contains pigmented cells, melanocytes, clumped cells, fibroblasts, collagen, hyaluronic acid, blood vessels on the nerves Next we have the muscular layer This is kind of The bulk of the iris anatomy we get in medical school is that there's the stinctor pupillary and the dilator The dilator is more central, more medial and the stinctor is more medial and the dilator is more lateral and you can see in this drawing the way the fibers run So smooth muscles, autonomic innervation and they're derived from the anterior pigment layer of the iris So I'm just going to touch on this a little bit I think it's going to be explained in more detail when we talk about some of the abnormal findings, but on the dilator muscles innervation Synthetic innervation, alpha one-adrenergic stimulation starts in the ipsolatohypothalamus synapses to the T1 level spinal cord and then it travels from spinal cord over the pulmonary apex, which is something I always think about with thoracic outlet syndrome and things like that and then it runs up the superior cervical gain, nanglion and Runs it along the internal crowded plexus through the cavernous sinus and then through the Ophthalmic division of cranial nerve 5 to the dilator muscle and then there's also some parasympathetic innervation. That's inhibitory The stinctor muscle is parasympathetic Mostly with the musculinic receptors starts in the editor Westphal nucleus Runs through cranial nerve 3 through the cavernous sinus the superior oblique branches to the superior oblique muscle and synapses in the ciliary ganglion and it then Terminates the short ciliary nerve to the ire stinctor. You can see the sympathetic innervation there that helps inhibit the stinctor muscles So the anterior pigment myopathylium specialized myopathylial cells The apexes of the anterior and posterior face each other and the bases face out It's continuous with the pigmented epithelium of the ciliary body one thing Dr. Manlis always talks about in path reads is The way to tell between the iris and the ciliary body is the iris has two pigmented layers that you can't differentiate Whereas the ciliary body just has the one so this is continues with the pigment and ciliary body layer Then you have posterior pigment epithelium This is the part you see coming through the pupillary rough that I on especially people with like called Pupillary atropian where you can see it coming posterior to anterior and So in summary you have five layers that important to keep in mind when you're Thinking about iris anatomy the anterior border layer the iris stroma the muscles and the anterior posterior pigment epithelium


My name is Manuel Mayerhofer, I'm actually a graduate from the master's program and I'm lecturing with Park Coalition for some two and a half years and I graduated from the master's program in international management. Now I'm originally from Germany and back in Germany I did a dual study program where you do your bachelor's and you're employed in a company and essentially in a block of three months you're studying and then you're for three months again in the company and you get to see all sorts of departments and back then it was right after high school I wasn't really sure in what direction I would like to go so it was great to go in a more general direction of business administration and whilst working in the company I started I think it was in the second year back then I started working in the export department was a manufacturer for varnishes and paint and I started to really enjoy it and when the graduation was approaching I was looking for new options but also while I was studying abroad I had noticed that I was looking for something say a bit different perhaps something where I could develop my skills a bit more because I had the experience of being at a state university that's all great and it's fun but I felt that there was more learning than I could draw somewhere else so I found Park College I remember having my interview in that case with Stefano in person and who's the head of the school and really the first couple of weeks at Park College were very much eye-opening it was tough in the beginning obviously moving from another country starting to study in English and so forth but nevertheless I think the support from the lectures was just absolutely amazing and they helped us to cope with all of this kind of new stress that we were under and they helped us really grow and not only develop our skills but to hone these skills further and in my case I upon graduation took a direction towards academia I will probably submit my PhD dissertation next year if all things go well and by graduating from the master's program I was really equipped with everything I needed to ensure such a smooth transition so I remember my modules with Dave back then on research methods and starting to kind of get an idea of academic writing how to write papers how to analyze papers and so forth and I've really started to like it and now I mean I'm doing my doctoral studies and I could not be happier really now you might also say well but Manuel is working for them and so he just says that I wouldn't be working for Park College if I was not really if I wasn't really happy about the approach that they are taking so I'm very glad and I'm very honored actually to be part of this amazing university while we were preparing for this talk I had a look at my master's dissertation again which back then I mean I was absolutely amazed by it and so forth I think it's still a good piece of work but nevertheless seeing how far I've come and how far I've progressed I can really just emphasize that you can expect a steep learning curve


I felt good. I feel good today. It was just nice to get to get out there in that game situation.  So, I mean, it was just nice to kind of get the adrenaline flowing a little bit and just getting that game atmosphere. We can go next to Pete Caldera. Chad, I wonder if you've been able to observe some of Luis Severino's rehab in just the last few weeks and just how he's feeling. You know what I'm saying? He threw a bullpen for the first time a couple days ago. Yeah, I mean, I wasn't aware they threw a bullpen, I guess, but just being over at Himes, I was able to watch him throw a few times. So I can just go off that. But I mean, I thought the ball was coming out really well.  I mean, everything looks honestly looks like he's ready to go right now is what kind of what it looked like from just playing catch. But I didn't see him throw off the mouse. I can't really speak on that. We can go to Ken David off next, Kenny. Hey Chad, do you want me to try the details right? So this was the only time you're at Simon or feels when you're pitching in the game? Not right now. I think we just got over here and switch. We were at Himes at first, but now we're at Steinbrenner full time now. But you are okay. So do you stick around for the games we're now pitching or because of COVID protocols you encourage to not stay around? Yeah, because of COVID and and fans being in the stands and stuff. So we're not many guys stay for the game just just because of COVID. Kenny, just to be clear, so yeah, the pitchers and catchers were exclusively at Himes up until the day after our off day, which I guess was Tuesday. And now we've got there's some shuffling of the decks, basically a good chunk of the pitchers and and I think three or four catchers are here. Some of the position players that were here are now over at Himes. Yeah, just to continue with, you know, just couldn't overflow GMS with bodies. Of course. Yeah. Okay. Yeah, you got it.  Chad, is there anyone you haven't met yet? And it was on the team who ordinarily would have these protocols not been in place? I think the only two guys that come to mind are Jay Bruce and Derek Dietrich. So I've crossed paths with with them a few times, but haven't had the chance to have a conversation with them. So that's something I'm looking forward to having in the future. But it was just nice getting around, getting around the guys, seeing some of the position players just beating my first game yesterday. I wasn't able to come over here and just just talk to him. So it was nice to see some faces. How unusual has that been, that that part of what you guys are dealing with at this point is not being around the entire team? Yeah, it's just been different.  I mean, for the two or three weeks, we were over at Himes. So it's, I mean, it was just different and just something that we had to adjust to just like we adjusted everything last year. It wasn't anything crazy and guys handled it pretty well. So yeah, it's just, it's nice to be back in the same clubhouse. Eric Boland, please unmute. Kevin, you kind of indicated where you're going to throw some of the line VP. What please do the most with your outing last night? I think just throwing strikes. I mean, I think that was kind of my main goal going in was just trying to pound the zone and whatever happens happens. Didn't want to get into where I wasn't in good counts or not controlling the zone. So that was just kind of the main focus for the first one. So we'll just continue to build off that and pick the intensity up as we go. But that was just kind of the idea. And then in your bullpen, you, including yourself, have a lot of guys who throw hard. Does a guy like Darren O'Day jump out at you because it obviously goes about things a lot differently than most of you guys have done? Yeah, I mean, he's fun to watch. I mean, he was just to watch him throw from down there. I played against him for the first time yesterday and it's just different. So it's just, I mean, you can see why he's been so good for so long because the way it comes out from that arm slot is just different. So it's, yeah, I'm excited to watch him from a up close perspective. So yeah, he's definitely a good guy to have around. And I think a lot of guys are going to learn a lot from him. Thank you.


but the real learning occurs when the students have to apply what they're doing. So if you are delivering virtual classes and you really care about what the students are doing to increase learning outcomes, a lot of times people do it with a video conferencing system, but we do have tools built in that make it easy for the teacher to apply themselves, to have the students apply themselves, and as the students use these tools, it generates a live analytics, and it tells the teacher, hey, there's maybe a student that is not applying themselves or participating, and it gives them a chance to call that student or encourage the student. So you take that focus on pedagogy, applied learning, feedback, you marry it with a deep integration with Moodle, where we share analytics back and forth, and now you have a solution that really complements Moodle. Moodle being the asynchronous part for the learning, big blue button being the synchronous part, and we build them together so they look like one complete application.