Good day fellow investors. Despite the fact that the SAP 500 has been going nothing but up, there have been a lot of companies that have seen stock prices significantly decline. We'll use a few examples and we'll derive 10 rules how to catch a falling knife. To catch a falling knife is Wall Street slang for buying a company that has seen a steep decrease in their stock price and trying to pick the bottom before the reversal, if there is a reversal. It's always nice to buy something at the bottom and see it shoot up, however it's very difficult to time. We'll try to discuss 10 rules that will show you how to catch the bottom if possible. A nice example of a stock that bottomed in January 2016 is Capstone paper and packaging. They are in the business of producing corrugated paper and there has been a slowdown in the sector and they have had some issues with their last acquisition. This lowered their temporary earnings, analysts become very negative and the stock price dropped from above 40 to below 8. Nevertheless the sector returned, it's a positive sector and the stock price quickly recovered to the current 23. Those who bought like me in 2016 have enjoyed a very very nice return. So the first thing to look when catching a falling knife is whether the sector is temporarily in trouble or there are structural issues. If the sector is a growth sector then we know that supply and demand will be stronger, will be weaker but the trend is strengthening and increasing demand which is always good for stocks and there is a higher probability that stocks that are currently in a slump will be saved. However if the trend is declining like retail food stocks for example then it's very difficult that their news that those earnings will improve. So always first look at the sector and the trends in the sector. A great stock to show how there doesn't have to be always a bottom is GoPro. Sometimes the bad news keeps compounding, compounding and the stock price drops hugely. GoPro was a stock trading above 90 a few years ago, now it's trading at 9. That's a 90% decrease over the last few years. And GoPro is an excellent example to explain the the psychology of catching a falling knife. According to Daniel Kahneman, Nobel Prize winner and the author of a great book Thinking Fast and Slow when catching a falling knife investors tend to take action based on intuition rather than on analysis. So you see the stock price dropping quickly, you think oh it's a bargain, it's a bargain and you intuitively buy instead of sitting down and analyzing what's going on. Take your time, don't rush it, if you miss an upward trend okay you have missed but don't rush, analyze the stock first. Secondly going back to GoPro another behavioral element is that investors anchor their investment decision on past prices. When you see GoPro at 9 and you see that it has been at 90 you think oh it's a bargain, I'm buying 10 cents on the dollar. However there is no guarantee that GoPro will return to 90. Thirdly investors tend to think that they have something special that others don't have. For example if you are a GoPro user you like the quality of the camera you will think that the same quality will apply to the stock which is the wrong way to approach investors. And thirdly according to Kenaman is that the market is fundamentally unpredictable. You can perhaps predict what will happen next quarter but seeing what will happen especially in such companies like GoPro with very variable results and a lot of competition it's very hard to predict what will happen in the next six months and then it's very hard to predict how will Wall Street react. What's very funny with GoPro is that they beaten estimates, beaten earnings per share but nevertheless the stock price dropped with their last earnings. Very very interesting to see the behavioral part and the economic part of investing in stocks. So before buying a declining stock rule number two analyze your own behavior. Am I in love with the stock? Am I anchoring myself to past prices? Am I intuitively buying or am I buying on great analysis? Am I thinking that I'm smarter than the market and that I know much more? And am I able to estimate future earnings? If not then skip and go to the next stock. So Nobel Prize winner Richard Taller showed that buying losers leads to higher returns. So there is an overreaction in the market and if you buy when the market overreacts you will probably do better than the market. However Richard Taller analyzed only one month returns, not five, not ten years, not quarterly returns. So if you want to take advantage of the overreaction be sure to take advantage in the short term because in the long term next quarter there can be even more bad news coming. So be quick if you want to take advantage of sharp price drops. Now there is a cliche on Wall Street you should never buy a falling knife. However if everybody thinks like that then when something starts dropping nobody wants to buy it and it just drops drops drops until it becomes an extreme bargain. So what do you have to do? You have to become the specialist in the field. You have to know the sector better than anyone else and you have to know the stock better than anyone else. Seems overwhelming? Well it isn't. With my experience on Wall Street I can tell you that there are some stocks that perhaps have one or two analysts following them. So all you have to do is know more than they know about the company and the sector which is not difficult especially companies from emerging markets that are not covered they put the worst analyst on that stock and you can easily beat that with a lot of research. And if you do a lot of research and you find that the trend is negative just buy put options or short the stock so you will get rewarded for your efforts. And this leads to rule number five. Manage your risks carefully look at what can happen in the worst case scenario and see perhaps if it's better to buy options for low risk high return investments. Those are very volatile investments catching falling knife and you have to see what's the price of the options compared to a normal investment in stock and where is your lowest risk for the highest return. When seeing a falling stock you try to calculate the intrinsic value of the stock and then in the long term that price should come to that intrinsic value. However when you calculate your intrinsic value assume that the negative trend that the bad news that have lowered the stock price continues in the future and then get a negative intrinsic value really pessimistic intrinsic value. And if the stock price is below that pessimistic intrinsic value then it's definitely a buy. However try to think negatively and try to think like the market. You will miss on some opportunities that will rebound sooner but you will definitely lower your risk. Number seven diversify. If you diversify on more falling knives and you're really patient because every month every week there are a lot of falling knives you can diversify you can lower your risk and increase your returns because if you're right just in 50% of the cases let's say five of the falling knives you buy double three stocks do nothing and two go bankrupt your return will be 30% in one year which is an excellent return and you were right just in 50% of the cases. If you put all your money on one stock and you're wrong you lose everything and that's very bad in investing. Number eight when you buy at the bottom and the stock price starts rising apply the same principles that you have applied when buying at the bottom to the trend upwards. What's the most positive scenario how long can the trend go because you want to take advantage of the positive trend as well as you did with the negative trend. So really look what's going on will there be more positive news or bad news positive scenario negative scenario and try to ride the trend upwards don't sell after 10% if you have bought a stock that has fallen 90% you want to take advantage more than 10% if the trend reverts and if you have bought on sound healthy fundamentals. Number nine learn to say no the more falling knives you analyze the better you will become into finding the right ones and then allocating your capital to the ones that bring low risks and higher returns. No no no no every day the stock market will offer you a new opportunity if you look at 400 opportunities in a year and you pick just five imagine the quality of those opportunities the criteria that those five opportunities meet and the possible returns at low risk that you can manage. If you look at five companies and buy them just because the stock price is down you're buying intuitively not based on analysis so the more you research the more you say no the higher will be your returns. Number ten the most important rule look for a margin of safety in the worst case scenario if there is complete safety be it cash be it book value be it a takeover be it something even if the CEO resigns even if there are accounting issues even if I don't know there is a recession then you know okay I can buy this falling knife and in the long term there will be no capital loss for me so always look at the margin of safety. So the point is the more effort you put in the more knowledge you have the higher will be your returns the lower your risk. It simply takes time a lot of years of learning but if you like it and if you're willing to do the work you can achieve great returns by buying falling knives. If you're not willing to do the work then simply say no and let the business to somebody else. Thank you for watching looking forward to your comments and I'll see you in the next video.


Thank you, Noah. Sorry, the lights are a bit bright here. So, it's a bit hard for me to see you. Anyway, I think they probably have to be like that. Well, we'll get started. Thanks for coming. Thank you very much to the organisers for inviting me, for doing all the work to put on this conference. I know how much work is involved in something like this, so when you see them, say thank you to them. They're wearing the yellow shirts like Noah, so they're all volunteers. I'll tell you about me. This is me, that's what I look like, as I am Python software, as you can see. I work for a company called Divio, a Swiss company. We have a Django cloud hosting platform. We'd love to talk to you about that if you're hosting Python or Django on the web. Come and talk to me. It's based on Docker. Basically, we do your DevOps for you. I'm a member of the Django core team. I'm vice president of the Django software foundation. I always tell people it's not nearly as glamorous as it sounds, although I hope it sounds at least a bit glamorous. The other thing that I'm really involved in that matters a great deal to me is Python in Africa. It's one of the things I've had the greatest privileges to be involved with with PyCons. These are my friends from Namibia where I go every year for their PyCon. I've been involved sometimes more or less directly in other PyCons in Africa. I'll be going to the first PyCon Ghana in a couple of weeks time, so I'm very excited about that. We have plans for a PyCon Africa. There are a lot of amazing things happening thanks to the global Python community and the enthusiasm of African programmers who want to be part of it. I'm the conference director of PyCon UK, which is coming up in September in Cardiff. You can get in touch with me, email or I'm on Twitter and so on if you prefer that. We'll get started on business. I want to talk to you about the naive programmer. That's not the bad programmer or the incompetent one. It's just the unsophisticated programmer. Everybody starts being a naive programmer because nobody is born sophisticated. Even the most sophisticated ones were once naive. The naive programmer is everywhere. There might be some in this room. In fact, I'm quite sophisticated, but as a programmer it may be less so. Here's the naive programmer. Keep in mind that I'm self-taught so that my code might be a little bit messy. We'll come back to this because that's important. To understand what sophistication means in programming, we have to understand programming as a craft. Programming is an art, a craft, a skill.  I just mean that it is a practical skill, just like maybe shoemaking as an art or a craft or a skill. Everybody who engages in any craft wants to be better at it. Of course they do. Even the best programmers want to be better programmers. They want to be better craft people. Now there are different kinds of crafts. In some crafts, some crafts are aesthetic crafts. They're measured against human judgement. They're quite nice, these aesthetic crafts. If your critics don't like it, they might be wrong and you might be right. Maybe they haven't caught up with you yet, so you might be at the avant-garde. You can engage with your critics and argue with them, but in other crafts, in practical crafts, the exercise of your craft is measured not against human judgement, but against the world. If you get it wrong, you can't argue back so easily. It's not a critic that says whether your bridge was any good. If your bridge falls down, you can argue as much as you like. Programming in two is this kind of craft. The Python interpreter is a very implacable critic. You can try pleading or threatening or tears, but it doesn't care. If you've got an error in your code, it won't run. This is just to help understand what kind of craft we're involved in. Here's another difference between crafts. Here's another one. Some crafts or arts are repeatable, so flying an aeroplane. You're supposed to land the aircraft in the same way every time. You're supposed to remove the appendix in the same way every time if you're a surgeon. You don't invent new ways of doing it on the spur of the moment because you feel like it. This is a checklist for landing an aircraft. A pilot will follow that every single time. Some arts are creative and programming is one of them, like painting or music or photography, where you start with this terrifying blank page and then have to come up with something new that has never been come up with before. That's one of the great things about programming. It's a creative craft. We're bringing something out of nothing. You go to the theatre, you go to the theatre to see a brand new improvised performance on the bleeding edge of dance. Great. That's really exciting. You go into the operating theatre and find out that somebody is going to do an improvisation. It's less reassuring. That helps you understand the different kinds of crafts. You don't want to know that your anaesthetist is going to be going into uncharted territory. Programming is a creative craft. That means that even though programmers are not painters or photographers or musicians, in one important respect they're doing exactly the same thing which is practicing a creative skill. Each of these figures represents a story about artistic naivety, which I'll come on to. We'll talk about them soon. Artists want to be better at what they do, as I said. This is literally one-dimensional, worse to better. That's not a very good way of thinking about things. All kinds of things matter in art. We judge technique, creativity, judgement, sophistication.  If you lack technique, then you're inept. If you lack creativity, your work is dull. If you lack judgement, you're uncritical. The artist who lacks sophistication is naive. To be sophisticated in your craft is to be educated. Not necessarily to be formally educated in it, but to be brought along by the culture of it, to understand its traditions, to be able to measure up to its traditions and standards, and to be able to engage with them. You can't become, it's impossible, by definition, to become sophisticated on your own. You can only become sophisticated as part of a culture, through a culture, through participation in it. The sophisticated artist is in dialogue with their own art, with the practices and theories of their peers and with the history and traditions of their art. Let's meet a sophisticated artist. This is George Rack, the French... He was all kinds of things. He was a painter, a sculptor, a collagist. He exemplifies every kind of artistic sophistication you can imagine. He's the epitome of artistic sophistication. As a young man, or even younger than that, he had a very obvious talent. But then in the 20s he encountered the fovis, he encountered Paul Cezanne, and those encounters turned him into a world-changing painter. So he took off from Cezanne's innovations in form and structure and so on, and then together with Picasso, George Rack invented cubism, which is probably the single most significant movement or innovation in art in the 20th century. And cubism is not just a style of painting or a new way of painting, it represents a theoretical and intellectual struggle with questions about reality and representation. And it's an engagement that reaches into back in time to tussle with the history of painting, across the arts to engage with developments that were happening at the same time in fiction or poetry and music, or across cultures to engage with African or Asian art. And it draws in understandings gleaned from scientific and mathematical discoveries, or political currents, or technological developments, and philosophical arguments. So it's not just about paint on a canvas, it's a whole way of looking at the world. So Brach was an artist who had all those qualities and abundance, creativity, technique, judgment and sophistication. He was able to pull everything together in layer upon layer of intelligence and meaning and then speak back to the world and speak back to his art about them. And he brought something so compelling to this dialogue of his art that it was never the same again. In fact, he changed not just art, but helped change the world. He's one of the pillars of the 20th century. So he's an example of sophistication at the highest possible level of matchless artistic invention.  Now, maybe it's a bit unfair to start introducing giants like Brach so early in the morning because I'm not expecting everybody to measure up to George Brach. But in one respect to be a complete craftsperson, if you're a programmer, you need something that Brach had, which is the ability to address your art, to address your craft with sophistication. So programming is not painting, but sophistication applies to programming too. And it's an essential dimension of the mastery of the craft. And there are programmers who are sophisticated and have this mastery. And faced with any challenge, they can draw upon wide resources, not just draw upon their own intellectual resources, but from every direction they can bring things in to apply to the problems they face. They see parallels and connections and relationships that other people might not even have access to. Or they work with concepts and ideas and vocabularies that other people can't get hold of. So they draw from a deeper well because of their sophistication. And that's the programmer that we want to be. We don't just want to be technically good or creative or have good critical judgment. We want to have this kind of educated, sophisticated intellectual power too. So if the sophisticated artist helps us understand the sophisticated programmer, then I think the naive artist will help us understand the naive programmer. So I showed this picture earlier. This is Henri Rousseau, the French painter sitting in front of one of his absolutely ludicrous paintings. And he was the quintessential naive artist. I think the term naive artist was invented for Rousseau. He had no education in art. If he was influenced by anything, it was by advertisements that he thought looked nice, or pictures in children's books. We're not talking about somebody on George Brack's level here. So there's many things wrong with this picture, and I think the top of the list is that it's absolutely hideous. His work was coarse and buffoonish, and he painted it in this flat primitive style with a child's grasp of perspective. Even the subject matter was childlike or even childish, and that was the only way he could paint. If you had a decent art teacher at a high school, your art teacher was probably considerably more sophisticated than poor old Henri Rousseau. So he was a painter of, let's say, immense deficits. I mean, that other picture was horrible, but at least some of these pictures are actually really charming, even if they're not very sophisticated or they have their other deficits too. But as an artist, he was completely oblivious to what it means to be an artist, and critics felt that his work was so empty of thought or intentional direction, they couldn't say very much about it, and there was nothing to interrogate or understand or interpret in his work. He was completely clueless, so according to the legend at least, he was asked which of the artists in the Louvre he preferred, and he said, well, there are too many. How can you remember their names? So he had no framework for understanding his own discipline. I think I like this term, he was being accused of having an intention deficit disorder. He just put paint on the canvas and in a completely shallow way, there was nothing beyond the layer of paint, nothing deeper in there. So he had a hobbyist bungler of a painter, but he was absolutely desperate for recognition. He wanted to be part of the art world, he wanted to be on the inside, he loved those painters, he loved their works, and he wanted to be one of them and considered one of them, but he was at the same time oblivious to his own deficits. He thought he was a painter of great importance, and he exhibited relentlessly, and people would literally queue up, not metaphorically, they would literally queue up to laugh at his paintings when they were exhibited, and one critic said, he paints as if with his feet and a blindfold over his eyes. So that's the naive artist and his naive programmer.  Oh, by the way, this is a comic strip from XKCD, I'm sure, a programmer's mix, of course, you would think. Often quite insightful. This is the amateurish bungler at work in front of the computer. The naive programmer is as ripe for a good laugh as the naive artist, limited and unaware of the limitations at the same time. The problem here is not style, the problem isn't the code is a bit messy, even the reviewer here has not picked up on the problem. The problem is that this programmer has limited intellectual resources because of a lack of sophistication to apply to the problem of programming. And the naive programmer's thinking is shallow and narrow and impoverished, and it comes out in their work. So the naive programmer is weaker and less effective and less complete as a craftsperson who will always be limited. And it's not a thing to be proud of. Nobody wants to be that kind of artist or craftsperson, but this is a funny thing.  And Picasso was absolutely fascinated by Rousseau because Picasso, of course, like Braque, was one of the giants of art, but Rousseau had something that Picasso wanted and didn't have. So Picasso saw in Rousseau's naivety, not just a lack, a deficit, something negative, but something positive, a new way of seeing and representing what is seen. So Rousseau, of course, lacked sophistication, but he did have other things. He had a powerful artistic vision and he burned obsessively with it. He developed, in spite of his lack of sophistication, a language, a style of painting, all of his own. He may have been confined and limited to his style, but it was his style, his invention. He was genuinely, and actually quite powerfully, creative. He may have been oblivious to the problems in art that other artists were trying to solve. He may have been unable to articulate his problems in any useful way, but I think it's fair to say that we can identify a kind of private problem field that he was struggling with, like all artists or craftspeople must do. So he's naiv, he's unable to connect with the dialogue or the history of art, but artists of greater sophistication such as Picasso were able to see something in Rousseau and make those connections on his behalf. So without ever developing sophistication, Rousseau came up with something new out of nowhere and in fact did become a painter of major significance. He was an influence on Picasso and on the Cubists and on the Surrealists, on the German Expressionists, on people like Kandinsky, and he became an important figure for modernism more widely. And so now we've got two models for dealing with naivety in craft, two models for the encounter between sophistication and naivety. We have a story of Rousseau in which even the most naïve things can be understood and learned from and added to the discipline. And then we have this one, which is ours. And I want to know what happens next in this story because the fact is however naïve this programmer has built a house. Maybe there's something new in that building, maybe there's something valuable amidst the eccentricity and the bungling. What did they discover along the way, doing things in their new way? So despite the lack of education or sophistication, the naïve programmer was able to create something that was worth reviewing in the first place. Maybe that's evidence of creativity or vision or just plain perseverance and all of those things are of value. Maybe there's a natural talent there and it compiled without errors. He's not asking for help to make his code run. He's asking for help to make it better. He's trying to open a dialogue. So I think that this naïve programmer deserved much better than that sophisticated dismissive reviewer who will never see past the lack of sophistication to what actually is of value. And Rousseau is one of many artists of complete naivety who has made a serious contribution to art because they were people able to see past that lack of sophistication. Art is alive and sensitive to what the naïve has to offer. Now, what about in programming? What about naïve programmers? If there are naïve programmers with vision and creativity and invention, maybe the world of programming should be aware and alert to them in the same way the world of artists. Okay, here's another naïve artist. This is Mike Disfarmer. He was a small town photographer in a rural Heavar Springs in Arkansas. He had a portrait studio in this town of one and a half thousand people. He made what were called penny portraits, actually three for fifty cents in his completely basic studio. He was so naïve, he didn't even know he was an artist. In fact, nobody knew he was an artist until some decades after he died when thousands of his negatives were discovered in a house that was being sold. He became one of the photographic sensations of the 1970s after he died. All he did was take photographs, studio photographs of local people in his basic primitive studio. He wasn't even up to date with photographic developments, so he made contact prints from glass plate negatives for about thirty years after everyone else had started using film. That would be like meeting someone saying, well, here are my punch cards. He wasn't completely out of date and out of touch with things, but the work is utterly remarkable. These unassuming portraits of ordinary and often quite care-worn people. He was just doing his job. He wasn't creating art. These pictures are intimate and they're moving and they're startling and they're composed with immense skill and care. He was a master of lighting and his only source of light was a single north-facing skylight in his studio. I think these... They're immensely sad in moving these photographs. They're a story, so this is during the war. Her husband's in the navy, hence the navy cap. And they're a thousand miles away, a thousand worlds away from the usual small town portrait studio output. There are no cliches, there's no retouching. He doesn't use any standard forms or poses. Probably because he was so naive. He hadn't even learned those cliched forms. So, it's like a song of beauty and sadness and he only had one song, but such a beautiful work. And the only resources that he had were his own. He had nothing else to draw upon. Even Rousseau was aware of a world of art. It seems that Mike de Farmer wasn't even aware of the rest of photography. He wasn't part of any artistic culture. He had no pretensions to it, unlike Rousseau. And these pictures, these extraordinary pictures come from nothing else, but his astounding eye for photographing people. I can assure you, you do not make pictures like this unless you know exactly what you're doing. So, they're pictures of elegance and power. So, in their form, they hold the eye because of the balance and tension in them and in their content. They speak directly to the human heart. And, as I say, this was his only song. It was the only thing he knew how to do. He didn't have versatility or range. He wasn't aware of the rest of the world of his artistic discipline. He lived in his own little world, just doing his job, making pictures for his customers. And maybe there are Mike de Farmer's in programming, working away on their own, unknown, unnoticed, disconnected from everyone else, producing little masterpieces as part of their everyday work. Now, not every programmer is or should be a software professional. Some are just completely normal people who have started programming for some reason. And think about the offices, the workplaces, the factories and laboratories where somebody might have written a computer programme to make some part of their work better or easier. They allowed themselves to imagine they could solve a problem with a computer programme. And we meet people like these. They don't tend to come to PyCons and EuroPythons and so on because they don't know about us. They've just been working in their own little world. But occasionally we meet them. They've done some things in a very peculiar way because they didn't know any better or they didn't know otherwise. Nobody was around to show them anything different. And they haven't heard of things like version control or separation of concerns and they don't do testing. They've been doing things like writing their code in Windows Notepad because they didn't know there was anything any other way to do it or using an online Python environment because getting Python to run on their Windows 98 was just too difficult. But software development is a profession and of course we have to have standards for that profession just like all professions because it has to be a bit exclusive. It has to put up barriers to protect the profession and to guarantee quality. But if we can help it be using inadequate tools or following poor practices. So as programmers we pay a lot of attention to how people work and we don't hesitate to make remarks about how they use their tools. But this is so important. Not every programmer needs to be measured by the standards of professional software development and there are more of these naive programmers working quietly than you think. And they don't come to our software conferences. We don't know how many of them are out there solving their own problems in whatever way happens to work for them and we don't know what things they might be inventing and what things of value they might be coming up with. So what are the implications for them of this, even if it's not directed at them personally or even statements like this. I mean this is not meant to put anyone down. This is Jacob Kaplan Moss, one of the creators of Django actually code without tests is broken by design.  But I think that's not true. I challenge that. Because if a Django girl goes into work the week after her first introduction to Python and writes a program that solves a problem at work is it broken by design because she did it without tests or did it in Python 2 or didn't use version control or if a graduate student in a science lab realises that she can solve a problem with some code can we call it broken because it's deficient in some ways by the standards of the professional software developer. So I think that we cannot. I don't think we're entitled to call things broken because of how they're done. I don't think there are circumstances, well at least we should be asking under what circumstances may I declare these things broken in such a confident way. For most people programming is just a means to some end. Starting with children in primary school we're putting programming into their hands asking them to do things. We don't expect them all these people to become professional software developers. They would all be trained formally as programmers. We just want them to be able to do a bit of coding as a tool for life and their work to understand how computation works. And if we're going to put programming into these people's hands we're going to encounter naivety in their work. We're going to encounter more and more naive programmers because rightly these people will consider programming to be only a means to their ends. And I think we had better get used to as a community of programmers to having a lot more naive programmers around us and I think we better get used to making fewer statements about what we consider to be broken. Here's my final choice for examining artistic naivety. Now when I was a teenager I discovered the records of... Oh, does anybody... I discovered the records of talking heads as a teenager and it turned out to be really important for my education. She was their bass guitar player. They heard the four talking heads. I chose her because I was a bit in love with her. They were famous, they had really long necks so as you can see they're amazing necks. People admire their necks immensely. Now between 1977 and 1988 they released 10 albums of exceptional creativity and quality and as artists they absolutely hit the ground running. They were already quite sophisticated. They'd been to art school and they followed their first record with three more that they recorded with Brian Eno and they went deeper into complexity. It digs deeper, reaches further. The development in sophistication is really apparent. Firstly, I just liked the sound that they make which is quite reasonable when we're talking about music. Later, especially through reading about them I realised that something else was going on as I became a more sophisticated listener that it was my first real understanding as a young teenager of sophistication as an artistic quality and you can play these records one after the other and trace this development. After the initial immediate response to the music which is great there's another level to explore that itself yields more as their sophistication as an artist grows. By the time of their fifth studio album they were masters of their craft. They were important enough to be reviewed in the Wall Street Journal for example and they followed up speaking in tongues their fifth studio record with a tour from which the concept film Stop Making Sense was made which you may well have seen directed by Jonathan Demi. It's described often as being one of the best concept films ever made which is not a genre filled with masterpieces to be honest it's a genre filled with mostly complete junk but still as a piece of film work it is itself of the highest quality. So here they are with their expanded nine piece band captured at a moment of total artistic triumph. I think God probably watches this film sometimes just to remind himself how good it is and what makes artistic work like this worth returning to over and over again is the multiplicity of layers and dimensions in it the depth it contains and it has the same kind of depth of artistic and intellectual curiosity that you will find in an artist like George Bruck and for talking heads an important part of their sophistication was attention to practice attention to how they did what they did and this is something that programmers are very interested in programmers are fascinated by the process of programming sometimes it seems more fascinated by how they work than what they actually produce and so they are forever talking about strategies and methodologies and workflows and processes so I found a nice joke about this his craft work inventing electronic music standing desks and scrum meetings all at the same time so programmers are convinced that if they just find the right process everything else will just work sophisticated programmers do that but attention to practice is the same thing the same kind of thing in programmers and in artists of any level of sophistication that talking heads worked with Brian Eno so Eno collaborated with Peter Schmidt an artist they produced a set of cards called oblique strategies anyone heard of oblique strategies? they had to help artists by suggesting a change in thinking or a new course of action so you just deal some cards randomly and they'll say things like what wouldn't you do abandon normal instruments give way to your worst impulses so Brian Eno used these cards when he was recording with David Bowie's three albums that they recorded together in Berlin now talking heads recorded three albums with Eno but they didn't use the cards because talking heads as I said they'd already been to art school they were already interested and aware of practice they had their own strategies to fresh and stale habits and unblock stalled creative efforts and they deliberately embraced the naive in order to further their creative process their favourite technique was to swap instruments in the studio so that each musician was playing something they weren't very good at and that they'd often improvise like this but they'd make sideways turns they'd do wrong things unexpected things by swapping instruments it made them less sophisticated and more naive so out of that naivety brought forth something new and the story of talking heads is one of continual reinvention and serious surprising creativity for their entire existence and one thing that made it possible for them to sustain that was their understanding of the power of the naive so it's not a coincidence that you have concepts like beginner's luck or beginner's mind in Japanese Shoshin where the naive person approaches something and because their mind isn't already running on rails because of the education and sophistication they come up with something new and unsophisticated so being naive doesn't make you better at doing anything it doesn't make you more sophisticated but being able to draw upon the naive might be something valuable so for their speaking in tongues record Talking Heads explored this tone of paranoia and menace it's absolutely seeding and the song the record opens with a song burning down the house which itself opens with a warning so it's sinister and it's dark and the songs seem to be conjuring up images of madness and sin and flames looking at the edge of the world and madness on every side so the band are doing exactly what they want they're in complete command of all of these forces but the last song on the record is called This Must Be The Place and it takes a funny turn it's the most beautiful song on the album and the simplest, smallest one of them all and it's so simple and unassuming that most people kind of missed it when it first came out it's just got three chords all the way through and it's got a parenthetical subtitle this song that's wholly accurate and it's unlike almost any Talking Heads song until that point and the most tender so you've got this whole, this huge slab of swampy, side-winding funk and then you emerge blinking into daylight with this it's like spending the night in the company of demons and exorcists and then coming into a clean fresh morning so the song, the record Speaking in Tongue starts with this slightly terrifying song about burning down a house and then ends with a song about being home and for the band you can see it as a signpost or the next direction of their two albums where they explored naivety even further now what's interesting about this song is in the 35 years since it came out it has taken on life of its own it's been rediscovered there's a film named after it by Paolo Sorrentino with Sean Penn in it I've not seen this of the Talking Heads songs it's one of the ones that has been the most recorded by other artists I discovered that by chance I didn't know that mostly by people I haven't really heard very much of it's not the song I would have expected to become one of the most recorded of their songs it's such an unassuming simple song but there's something in it that people have been able to pull out and I think it probably because of its naivety and simplicity maybe it allows people more room to make their own interpretation maybe it's like one of those disfarmer portraits that it speaks more directly to people now I said earlier that being naiv in itself is not a thing to be proud of sophistication is necessary to be a complete programmer or an artist and if you lack it, that is a deficit but sophistication is not the only thing that's required to be in command of your craft it's not a substitute for technique or creativity or judgement and worse the pursuit of sophistication can come at the expense of these and the history of artists littered with artists who pursued sophistication and found they'd left no room for those other things their work becomes tired and jaded and stale their sophistication grew so much it became a burden they couldn't set aside and I am sure the same thing happens to programmers and if I had to choose I would rather be a naiv inexpert programmer with a creative vision than a sophisticated expert who could solve all the standard problems but who had seized to invent any new problems of their own to explore so my own code I think was messy and a little bit inelegant and didn't have tests and so on perhaps it was some way it was like a botched effort by a child it was naive but it worked and I built a house once with my code and it stood and it did a job that where I worked that solved a problem that other more sophisticated programmers had not solved it delivered the institution I worked for something that was badly needed and saved many thousands of pounds over several years so it was only a means to an end but it was a success as a means to an end it served the institution it served the people who worked for it however naive, however bungling, however botched and amateurish it was of real value to someone and I can be proud of that even if I can't really be proud of the naivety so all these figures and stories represent different models of the relationship between naivety and sophistication and of all of them I think this is the only one that has value at all however sophisticated you are I think you need to be able to recognize something that lies beyond sophistication if your only response to naivety is dismissiveness or ridicule what harm will you do and what will you fail to learn so without sophistication you're incomplete but you don't need to be the ultimate sophisticat to be in command of your craft as a professional you don't need to be a George Brack and probably you're not going to be the George Brack of programming, I'm sorry to inform you of that you're not going to be a Picasso but you can be like Picasso sophisticated practitioner who's able to see past the deficits and limitations in the naive to its power and its gifts to take advantage of them you could be like talking heads you can be sophisticated masters of your art swapping instruments in the studio to draw upon the naive as a creative resource finding new ways to be and remain fresh and inventive or maybe you're never going to be a sophisticat in that case you could be a an honorary rousseau and it would be prouder to be a rousseau whatever your limitations producing work of incandescent invention than to be a tired old sophisticat those people who laugh at him we don't remember their names so their mockery of him was a bit premature and if you're a programmer you have every right to be proud of what you do when you exercise your powers of creativity and invention to solve a problem even if they're some old ones and even if the itch that you scratch is entirely private or you could be a disfarmer so naive that you're barely aware of the culture and traditions of your craft but working quietly producing modest creations of beauty as a programmer creating work of small but real value doing it in whatever way you know how however naive and limited so these are useful ways for us to think about the relationship our relationship with our craft and if I said one thing that makes one programmer feel better about their lack of expertise or makes one programmer hesitate before pouring scorn on the naive that's worth something and in modern art in the early 20th century the naive has had an important and influential place in the world of art the adventures of Henri Rousseau took place over a century ago and he lacked sophistication he was incomplete flawed a lesser artist but whatever his artistic deficits we now judge him much more kindly than the ones who poured scorn on him at the time because he lacked artistic sophistication but they lacked something much more which was artistic vision so long live the naive programmer because I can't wait for programming to learn the same lesson that art learned in the 20th century thank you ok, thank you sorry great speech and also is there a question anyone have a question hi, just wondering if you could if you had any examples that kind of came off the top of your head of kind of naive approaches to programming which have kind of caught on and become influential well, Django itself two of the four creators of Django were, one was a journalist and one was a student of literature so I think in the early days of Django they did many things wrong and they rapidly became sophisticated they learned very fast and they worked with sophisticated programmers but partly because of their naivety I think they dared to imagine oh, we can solve this problem with some code and being naive helps you not be put off by the huge task that's maybe ahead of you so I think that could be one example perhaps I'm sure there are others there was a question at the back and that was the last question because we have a normal time hey, Halle, thank you for the talk I think that we are in an environment where we are pushed to sometimes pretend that we are sophisticated and I think that a lot of us do pretend that we are more sophisticated than we are what would be your recommendation to talk to someone who obviously pretends he is more sophisticated than than they are and tell them no, it's okay to be naive and please stop this I don't know, maybe you can tell them the story of only Rousseau or Mike Despama because people will see that in other contexts even if they can't see it in their own perhaps I'm not quite sure it's a good question okay, sorry so let's welcome thank you


Welcome to our DNA Day 2021 virtual celebration. My name is Kim Jacoby Morris, and I will be moderating today's conversation with our panelists. All opinions shared today are our own. I'm honored to share this space with my fellow adoptees, Damon Davis, He-Wan Lee, and Tim Houlton. Today, we will have the opportunity to discuss genetic ancestry testing, identity, and the adoptee perspective in celebration of DNA Day. DNA Day is a global movement to mobilize, energize, and empower communities, educators, and students to innovate, collaborate, and discover the promise of our shared humanity and connection to the natural world. This panel brings together adoptees with unique experiences and expertise related to the accessibility of direct-to-consumer genetic ancestry testing. We're excited to have the opportunity to have a conversation about the power of community, the limitations of technology, and the ethical, legal, and social implications of genetic ancestry. First, some guidance for navigating the shared space today. Practice, reflect, and respect. Everyone is coming to this space with their own unique experiences. Terminology use, such as birth mothers, biological family, first family, and others, is not meant to cause offense. This is a space for all members of the adoption constellation. If harm is caused during our conversation, please stay for the post-program so that we can address any issues. Questions will be answered during the Q&A portion of our program. Please place questions in the Q&A box on your Zoom window. The program will formally conclude at 7 p.m., but the conversation will continue for those who wish to stay. Please raise your hand, and our moderators will unmute you. Today, we are discussing direct-to-consumer genetic ancestry testing. This is a fancy description for kits that people can purchase and send a sample away for analysis. You can gain more insight on topics such as genealogy, disease-associated risk, and lifestyle factoids. Many commercial companies use a method called genotyping. Although we are 99.9% identical, positions of variation are called SNPs, single nucleotide polymorphisms. This technique provides information about specific positions and is highly dependent on the reference samples used in analysis. This is not the same as sequencing. We will learn more about this later on. But now, it's time for a poll. Gerald, could you please post the poll? Did you know there are approximately five million Americans that are adopted through foster care, inter-country adoption, or domestic adoption agencies? With the decreased costs and increase in accessibility, many people are considering using genetic testing or have already submitted their samples for analysis. Our audience here is about split. So we have 43% who said yes and 55% said no. And the poll, great. So I hope we all are excited to learn something today from each one of our panelists. Let's stop sharing. And now I'd like to invite author and podcast host, Mr. Damon Davis to introduce himself and share his personal story with us. Damon, welcome. Of course, I did the classic thing on mute. Kim, it's so good to see your smiling face. Thanks so much for bringing us together. I really appreciate it. It's good to be here with you when you wanted, Tim. Again, I'm Damon Davis. I'm the host and producer of the Who Am I Really? podcast where I interview other adoptees like us here on this panel about our own adoption journeys. I take everybody through sort of the beginning of the adoption journey with how you grew up in adoption or even foster care. And then eventually reach a point where we talk about how you may have gone about trying to find your biological family. And many times that journey is, part of that journey is through DNA testing and consumer DNA testing. So I should probably tell you a little bit about my own story. And then I'd love to turn it back over to Kim. So part of what happened for me was I was about to take a job in the Obama administration back in 2008, 2009. And it was at that moment that I was sitting at home with my son who was an infant, the first blood relative I had ever known when I realized this is an impactful thing for me. Like I've never known anybody else I was related to until my wife and I produced somebody. And so it was then that I decided to go on a search from my biological family. I was very fortunate that my social worker in Baltimore City was able to find my biological mother, pardon me, working around the corner from me in Washington DC when I finally took the job at HHS. And I had a fantastic relationship with her. I was able to see her almost daily anytime I wanted to. And what that afforded me was an opportunity to get as much information as I could from her. And one of the things that I naturally asked her was my origin story, what happened in chapter one of my life before I was adopted. And what she told me was that she got pregnant in Detroit and that she fled and she never looked back. And I asked her who my biological father was and she named a certain individual. But I could see the pain in her face as she sort of recalled what happened to her so long ago. So I decided I would hold off on trying to find this guy. I was having a great relationship with her. I didn't need anything else. But then unfortunately she passed away several years later. And what I realized was I can't hurt her by resurrecting this guy's presence. And so I sought him out to cut a long story short. I made contact with this individual. I tracked him down using internet resources and things like that. And after some correspondence back and forth, I didn't really get along with this guy. I wasn't really feeling him. He sends me a note and he says, I apologize, my phone's ringing. He says, I'm not the guy. And I said, I can't believe this. And so how could he possibly know that? Moving on, my wife's mother, my mother-in-law, she is also adopted. And so we were doing some DNA testing to learn a little bit more about her as an adoptee and therefore how she relates to my son. And it was in that DNA testing that we submitted samples for everybody in our immediate family. And what ended up happening was I'm sitting online one night and I'm looking through our ancestry DNA results. And as I'm looking through the results, I saw something interesting in my family's results. So I decided to look over at my own results and see the sort of same interesting factoid there. And as I was scrolling through, I noticed I had all of these family relationships that I had not acknowledged before, but one very specifically stood out and it said, this person is your father. It was a very unequivocally undeniable, just very stark proclamation for this person who I had accidentally and very randomly discovered when I wasn't even searching for him. To cut to the end, fortunately, it was a great reunion. His name is Bill. He's been an amazing individual, welcoming, warming, warm and accepting as was my mother Ann. And it's been sort of, it was a fascinating journey partially because I wasn't expecting to find this person. I was doing DNA testing for a completely different reason, not expecting the result that I got. I did not have hopes for the submission of my DNA test. As a matter of fact, I had already done another DNA test through 23andMe and I met Ann Wojciki who handed me my test. And so I was not enamored with my results as much when I did my ancestry DNA. But what I wanna say is that I find that it's fascinating that you can make some of these random connections accidentally and some of them can be small, third, fourth, fifth cousins. Some of them can be huge, like me finding my biological father. So that's my personal story. Let me be quiet for a moment, turn it back over to Kim and see if you've got any questions. Thank you so much for sharing that. I am always just so amazed with your personal story and it's I think a story that so many people long for and connecting with biological family. But I wanna return to this phrase that you actually taught me and explore it a little more. You often use the term adoption constellation. And I think it's a really beautiful way to describe the complexities and how families are structured, our connections to people. So I'm wondering, how do you see genetic relatives, those third, fourth, fifth cousins fitting into the constellation? It's a really great question and it's timely because just over the weekend I was on a Zoom call where my paternal family is arranging a family reunion to which I'm invited. And I remember thinking, this is gonna be weird. I've never met these people before, but we are family. And so to have that genetic connection to strangers is a very weird thing. I love the word adoption, the phrase adoption constellation because as I was writing my book and as I've come to interview well over 150 guests on the Who Am I Really podcast, what I've come to realize is there are so many people who are part of a person's journey through adoption. They're birth parents at conception. It's the decision to give birth to the child and then where does the child go next into foster care to a relative. There may be a kinship adoption where a relative adopts the child and is not raised by their biological parents. There are court systems involved and representatives who have the child's interest in mind.   And then there's this whole other set of people that you don't know that are biological to you. They're out in the world somewhere. You feel like you could pass by them on the street or you might feel like you'll never ever see them again. And so I think it's challenging to only speak of a triad because there are so many people involved in adoption. My social worker was a component of my adoption when I was younger. There was a social worker who came to evaluate my adopted family. I had a separate social worker who supported my search for my biological mother and located her in Washington DC. There's social workers, court systems, families of all kinds that are all part of this constellation. I think that's beautiful. Thank you so much. So before we get to any deeper questions, I'll leave those for our group discussion a little bit later, but I'd like to now welcome Mr. Tim Holton, our next panelist to introduce himself and share his personal story. Welcome, Tim. Good evening. Thank you, Kim. Good to hear from you, Damon. That was a great beginner. I am going to talk about, well, first let me start off by saying my name is Tim Holton. I live in Maryland. I grew up in Maryland and I was adopted from Vietnam in April of 1975. I've basically grown up in Maryland. But my point of view on the whole DNA thing is it probably won't come off as rosy as some people think because I'm more of a person that's, I wouldn't say negative about it. I would just say that I look at it with caution and discretion. I, for the longest time, I was against giving my own DNA done. My mother would keep harassing me and asking me why I didn't want to get it done. And I would just nonchalantly tell her because I didn't really care to get it done. I was, what, 34 or 35 when I actually had done it. And at that point in my life, I was like, well, if I haven't found any relatives at 35, would it gonna hurt me not to know any longer? The other thing is as I look back and people ask me why I was so hesitant, I was more concerned about the fact that I don't actually trust, I know this sounds horrible to say, I don't actually trust the people that actually have my DNA. I don't know if they're gonna use it in some nefarious way or if they're gonna use it for just things that I haven't agreed to that my DNA would be used for. The also the other thing is, is what happens if I'm connected with somebody and they show up at my door or I would actually shut up at their door and they're thinking that this is a surprise and it's an unwanted kind of welcoming. So for me, it was also a privacy thing, like do these people really want to be sought out? Do these people really care to see me or know of me? I'm sure that they probably giving up adoption was hard and everything, but at the same time, what gives me the right after 35 years at that time to walk right back into somebody's life. I also didn't want to think of it as an identity thing considering the fact that I grew up thinking oh, my past was heritage is Vietnamese and what happens if the DNA test comes back and says I'm completely something different? Not that being another culture or race would be different, it's just that if you've grown up your whole life thinking you're Vietnamese and then all of a sudden somebody says well, you're actually from Korea, not that that's bad, it's just that it's like, well, I spent all those years growing up trying to learn about Vietnamese food, the culture, the language, and then I get told that I'm not. But long story short, when I did get the test, I did come out 100% Southeast Asian so that put my mind at ease on that. But then the next question my mother had was why don't you pay the extra amount of money to see for any genetic, I wouldn't say flaws or deficiencies, but more like history and I said no. And the reason I said no is because I don't want to know if there's a history of Alzheimer's or some debilitating disease and I really don't want to know because I worry about things just naturally and to find out if Alzheimer's runs in my family that would really freak me out and I would spend most of my remaining life obsessing about something like that. So I guess to bring this to a close, my whole standing is that I was totally against it for privacy reasons, also for personal reasons and that I didn't really feel safe or comfortable with knowing my own past, I guess, genetic wise, but I did do the test again and I just stopped at knowing if there are any people related to me. I have found a few people, but they're either really distant on the chain or I have recently found somebody who's second cousin. So we've been speaking more like through texting and everything, but I don't think I will ever feel comfortable knowing my DNA is out there in some data bank just, you know, waiting to be, I know I've probably watched too many spy movies or things like that, but I just, again, I just feel paranoid about our DNA being falling into the wrong hands. Unless they clone me and then they can do the work and I can stay home, that would be the good part, but seriously though, I do think about that and I do think about that unexpected, you know, reuniting with somebody and then finding out that they didn't really wanna reunite or finding out that I didn't wanna reunite. So it goes both ways. Thank you so much for sharing, Tim. I think your concerns and considerations are very valid and things that we'll be able to discuss a little more in depth in a moment. I'd like to ask just one follow-up question and right now, why do you think your mother kept pushing you to take a test? I think in her mind, because I lived in Vietnam in my early 20s, I took some time off from college to discover myself and work in orphanages and while I was there, we did have a translator so we did, took my paperwork, went to the Mekong Delta where I was born, tried to find some answers in closure. I always tell my mom that my closure was just standing foot in Vietnam. I didn't really need to go that whole route of seeking. I think I view life in a more pragmatic way where I was just like, I'm here, I've dealt with this in the past, I don't know if I'll ever find my biological parents and that's okay. So I left it at that but then my mom kept pressing and saying, well, wouldn't it be interesting or wouldn't you wanna know if you had brothers or sisters or any living relatives? And I said, yeah, I guess that would be cool but I'd also view it as just because we're blood doesn't necessarily mean I'm gonna get along with you or I actually wanna hang out with you or we're actually gonna look the same. I do believe that family, blood is people, in my mind, I feel like family is who you wanna be around, family is who raises you, family are the people that you surround yourself with and you call a family, it doesn't necessarily have to be blood.  So I think part of her whole thing too was just trying to help me find closure when I kept saying that I'm really okay, not knowing. And if something comes along and I find somebody, that's great. But again, it's just like, I've been part of the adoptee community for Vietnamese people and I've spoken on numerous panels and I've met some adoptees with similar backgrounds as mine. Being adopted from Vietnam doesn't mean I get along with them. So at the same time, what makes me think I'd get along with somebody who's biological. Thank you for sharing your personal story. I'm so excited to dive a little bit deeper in a moment but I'd like to welcome our final panelist, genetic counselor, Huan Lee. Huan will be sharing some slides during her opening remarks as well as her personal story to provide a perspective from a healthcare provider in this space. So thank you Huan and welcome. Thank you so much and it's been just a pleasure to listen to Tam and Damon and your stories and Cam and everyone to thank you for having me. So yeah, so I'm actually coming from a slightly different perspective. I'm Korean, I'm adopted as well. And way back before I became a genetic counselor and went back to school, I actually was really very curious about my genetic biological family and actually thought like, hey, I'm gonna start a company and see if we can connect adoptees. And this was actually before 23andMe and Family Tree and Ancestry are really popular. And I did some research and I actually was starting this nonprofit and trying to get a board together. And I just realized, you know what? I do not have the education and the background that I really wanted about genetics and connectivity and community. And so I actually went back to school and became a genetic counselor. And I'll tell you a little bit more about, you know, what that involves. But, you know, it's one of those things where I really do respect, you know, what Tim was saying too, like sometimes you just don't wanna open the door. Sometimes you wanna kind of make sure you can kind of keep what you wanna know in a space that feels really safe and comfortable. And, you know, I think some people really wanna go the full gamut and find everybody and fourth cousins and other people really don't. And so I think with genetic testing and genetic counseling, whether it's, you know, through clinical or direct to consumer, it's really important to respect kind of how you're approaching it and what your feelings are about it. One of the things that I say for, you know, when I'm approaching it from hell, so I'm a genetic counselor in oncology. So I'm coming from kind of a cancer risk perspective. And so I'll kind of be framing a lot of, you know, some of my slides, just a few slides, I promise it's not a long presentation, but I'll just kind of try to go through it quickly. And then, you know, we can talk about it later as well. Next slide please. So some of the common issues that we adoptees face, especially if we don't have a lot of, you know, biological family history, is that we just don't know what our risks could potentially be for cancer, heart disease, et cetera. And then many of us are getting older and we have biological children. And so we may think, well, what about their potential risks?  And so there can be a lot of closed doors for screenings and interventions that may be offered to other people with family history. And then finally, you know, genetic testing, whether it's direct to consumer, whether it's in the clinic, it's really varied. There's a lot of different types. There's a lot of things out there. And so how do we choose the most appropriate test? Next slide please. So as far as this is just a really, you know, top level, not nitty gritty, but just some of the basics things I wanted to kind of go over with genetic testing is that, you know, a lot of us are very familiar with the direct to consumer.  And so it's really self-directed. You can choose which one you want, which type of information you'd like, you know, for traits or ancestry or health or none of that. Just maybe sometimes people want to just find out if they have biological relatives.  And then kind of back to direct to consumer testing, a lot of people really like how affordable it is. It's, you know, it can be under a hundred bucks even. Some of it's a little more, but, you know, generally it tends to be a little bit more affordable than clinical genetic testing. So some people really like to take that route. One of the things that I talk about as a genetic counselor is that sometimes when we, Kim had mentioned genotyping in the beginning and SNPs, and it's kind of like direct to consumer testing is like if you look at a page, direct to consumer testing is like looking at little words on a page. But if you, on the flip side with clinical genetic testing, it's more comprehensive. You're reading through all of the words, you know, in a sentence or the entire paragraph. So, you know, sometimes people will say, hey, I took a direct to consumer test and I'm negative for these, you know, traits or conditions. But they're only just looking at little pieces of common variations that have been found in people. But if you do clinical or medical genetic testing, you know, you're gonna be getting a comprehensive read, a lot bigger and more information. So less risk for that false negative. One of the downsides for direct to consumer testing is it can be little to no support for a genetics professional. So sometimes they offer genetic counseling with some of these companies and sometimes you don't, sometimes it's not built in whereas, you know, on the other side, you would have that support from a genetics professional or genetic counselor and then kind of know what next steps to take for a follow-up. As Tim was talking about, there can be a lot of privacy and security issues. I think many of us have heard of the golden state killer and some of these other very, you know, widely publicized cases where DNA was found on a cup or a napkin and then, you know, it was found through all these third party databases. And definitely you just don't know how your DNA and your information might be used with some of these, you know, larger companies versus, you know, there are some protection laws with medical and clinical genetic testing like I'm listing HIPAA and Gina and those are two different ways to protect, you know, health information and prevent discrimination. And then finally, consent is not transparent. So you don't may not know or may not read all of the fine print when you're consenting for a direct to consumer test but hopefully the goal for a clinical genetic testing is informed consent. So sitting down with a professional talking about risks and benefits and really just kind of understanding, you know, what you're getting into and kind of how the lab is using your information. Next slide, please. One of the things that I, you know, when I became a genetic counselor and I really started understanding how the medical profession uses family health history, it can be really great if you have family health history, but if you don't, it can be really alarming.  Now let's say we don't know anything. So let's say we're an adoptee, we don't have family history, then we would start at 40 or 45.  Same thing for colonoscopy. So let's say you had a bioparent with colon cancer at a certain age, then 10 years prior you'd start your colonoscopy. And so that's even a more dramatic, depending on, you know, how if you knew your bioparent's actual age of onset for colon cancer, but again, you know, adoptees are left out of some of these screenings because we just don't know. And I really feel like that's a disservice. So while family health history can be wonderful, it's the gold standard. How do you contextualize somebody? If we don't have it, it doesn't seem really right to just be like, well, now you're back to average population when maybe some of us are not. Finally, the last example I have is like, let's say there's a recessive condition like cystic fibrosis or some other kind of, you know, condition where it takes two parents to have a non-working gene that gets passed down to a child. If you don't know about that, you may not even, you know, it might not even be in the arena to consider like, well, maybe before I get pregnant or do family planning, I'm, you know, maybe I'll get that preconception genetic testing, but if we don't have family history, we might even not consider it. Next slide, please. So one of the things that just a really brief overview with genetic counseling, it's, you know, we get a master's degree when we get training in medical genetics and counseling, and we really talk about, you know, inherited conditions, how that affects a person and potentially their family. It's really about education, it's a conversation. There's no pressure to get testing. Sometimes I get patients coming in really worried about that. And we're licensed and credentialed in many states and as well certified, you know, we're board certified. And so it's just a way to go many different areas with cardiovascular, prenatal, cancer, pediatric. So there's a whole host of areas that genetic counselors can help. Next slide, please. Some of the benefits and limitations, I just wanna keep it quick. So I'm not taking up too much time here, but really again, like the benefits of genetic counseling with a genetic counselor would be informed, you know, decision-making, having that education and understanding what you're getting into. And then, you know, the discussion of testing, the next steps, and then if there is a positive result talking about appropriate referrals for screening and like what do we do next with interventions, potential life-saving, risk-reducing surgeries. You can help with family planning if there's something that's discovered that you person doesn't wanna take the risk of potentially passing that down to a biological child. You can have assisted reproductive technology or at least explore that. And then there's typically a lot of support for that patient or person and their family if they're biological, you know, what to do next and kind of next steps for them. And of course there are limitations. It's not perfect. Genetic counseling and genetic testing cannot cover every condition. And even if you're positive, it doesn't say for sure that you'll get the condition or how severe it might be. So there's definitely some limitations there. It's not a, you know, be all and all. Sometimes results are inconclusive. You know, it's really the worst thing to get back from a test, but you know, there are ways to sort of sift through that and figure out how to take next steps even if something isn't a, you know, stranded black and white positive negative. There's some psychosocial concerns. And, you know, Tim touched upon a few of them. Some people don't wanna open the door or maybe they kind of do, but then when they find out they wish they didn't. So it's really, you know, we really want people to feel supported and ready to take that, that, you know, make that next step if they want testing, but also have proper and good support because you're gonna have a lot of feelings come up. There is a fear of genetic discrimination, you know, how could an insurance company like life insurance potentially use a positive genetic test result? So we have federal laws to protect against, you know, employer and health insurance, but there are some private entities that don't, that may be able to look at, you know, a person's test. And so that does cause some trepidation for people. And then finally, you know, there might not be published guidelines or screening or treatment. So sometimes we'll get a result but not yet have anything to treat or have a next step and that can be frustrating as well. Next slide, please. So one of the things people have asked me and Kim actually asked me before this presentation or talk is just, well, how can health providers be sensitive and open that door? Number one thing that I hear from adoptees that I've talked to anecdotally is just read the chart, look at the forms, prep.  Oh, I couldn't fill out all those forms because I'm adopted. It's, it can be maddening.  You know, don't ask about the adoption story. I've had a lot of people just say, oh, you're adopted, well, how did that happen? And that's a really personal thing that I'm willing to share with people I know and trust but not just right off the cuff, you know, person just taking intake. And so sometimes it can be really traumatic for people to talk about it and to sort of address it every time they go to the, you know, the doctor or a provider. I really would hope that healthcare providers take adoptees seriously and explore like what are their goals and motivations surrounding their health.  That's just, that's not good enough. That really needs to be, you know, new training on how to sort of like, what can we do next? How can we help? Which leads me into thinking outside the box. So if there's no family health history that we know of, you know, what kind of screenings can be done for the person? How can we start building a medical and health history for you with the adoptee? Which could be helpful if you have biological children or other relatives that you, you know, come and counter with. And then finally, I really would love healthcare providers to say, you know, this is a little bit out of my wheelhouse. I'm gonna refer to a genetic counselor. And so if they wanna know about cancer risk or cardiology or neurology, you know, I refer them to the appropriate person. Next slide, please. And then lastly, this is my last slide. Thanks for hanging in there. So really how can adoptees open the door? So I, number one thing is be really proactive about your very own screening. So that would be routine screenings like mammograms, cholesterol, diabetes, colonoscopies, like get your colonoscopy. They just, American Cancer Society just changed to 45 instead of 50. So that would be something to get that jumpstart on. And then there's risk calculators that can be based on your personal health, like the American Health Association, the Heart Association, and advocate for yourself. If someone's like, oh, sorry, you're adopted.  Here are some ways I'd like to get screened. You can seek your own certified genetic counselor by going to the National Society of Genetic Counselors. There's a whole bunch of counselors throughout all of the US that can be there to help you. One of the caveats though, is that many times because insurance will not cover you, if you don't have a personal history of a condition, you may have to pay a cash price. So, and that can kind of range depending on what area you're in, but just to be prepared to talk about that. And then to really talk through with your genetic counselor, a genetic professional, some of the benefits and limitations of going through that process. So thank you. I'm sorry, it was a little more formal than everyone else, but you know, I really appreciate this opportunity to share this information. Thanks, Kim. Thank you so much for that very informative talk. I am sure that I learned some things and I'm sure the audience members learned some things to take away for sure. So at this point, I'd like to bring everybody, all of our panelists together and have a little bit of a conversation between the four of us and then open it up for Q&A from our audience members. So getting back to Damon's story on using ancestry.com to find connections between your biological son and your mother-in-law, I believe. So we've sort of touched on, there are different cost benefits for folks to consider. Can you talk about that experience and when you were participating in that, did you have any hesitancy? Yeah, it's a great question and it's funny as I listened to the others on the panel, I think to myself, man, I probably should have been more cautious about this.  I was gung-ho about it because I came into DNA testing from kind of an odd angle. I mean, quite literally, I was traveling for work with HHS. We had a meeting at 23 and me and Anne Wojcicki handed me my DNA test. Had she not done so, I probably would not have purchased one myself, quite honestly.  And so I went through all of the initial sort of excitement about what does a DNA test potentially show me? And I had all of that, the big reveal of what's culturally in my background. For example, I learned that I've got some Irish in my background, never would I have guessed, right? So there's this, I was curious about it from that perspective. I'm sensitive to what Tim and Hewan have underscored, which is the opening a door that you didn't know was there. So move over now to my ancestry DNA test. I'm sitting there at home, I've submitted the sample. I know I've got a result coming back that's gonna say something about me. A door was opened for me in that it, the system connected me to my biological relatives. And you'll forgive me, I don't recall if there's a checkbox that says, do you or don't you want to be connected with biological relatives? I feel like that could be a stage gate for people entering into a DNA test because if I was Bill, my biological father, it's possible that I did not want to be reunited with long lost people that are looking to connect with me. And it might not be a son, it could be some long lost cousin that he's just not interested in meeting other people at any point in his life. But here this 30 something year old son comes back out of nowhere that must have been pretty jarring for him. And I would imagine it's similarly jarring for a person who steps forward and submits a DNA sample and they end up being a undiscovered, unrealized sibling of someone else. And then that person is starting to question their father's, you know, what their father did when he was a teenager, what their mother may have done before they started that nuclear family. So there's this entire cascading effect of submitting a DNA test and not necessarily knowing all of the things that you have to consider. A lot of times people are, they put a lot of stock into a DNA test in the hopes of making connections and getting nothing. And then there are folks that stumble into it like myself and have an entire world open up of reunion. So to answer your question more directly, I did not go through sort of an analytical process of if I do this, what happens on this, you know, if I turn left at this, you know, decision tree. And if I don't do this, what happens if I turn right here, I didn't go through any of that. I just kind of dove in, but I realized that there are significant factors that need to be considered. I was thinking when Tim was speaking that, you know, I'm gonna make an analogy here and I hope that you will forgive me if it's not exactly correct, but the same way that you might submit your DNA to be, you know, tested and matched up with people, you're submitting a piece of yourself, you know, into a company that may do something with it that you, as he has said, don't know what they're going to do. Similarly, you know, the apps, tools and services that I have on my phone are listening and triggering and pulling back stuff for me and offering up. Hey, I heard you talk about Adidas, here's some shoes.  Don't connect me to things that I don't necessarily feel like being connected to in this moment. And there's a whole sort of consumer side that has potential for DNA results that I think we deserve to be a little bit leery of, given some of the things that have happened in the past in the medical and clinical industry. You know, I think there are elements of what Tim has said that are right. It's not necessarily something you should just jump wholeheartedly into and not think to yourself. I've just submitted a piece of myself, is as he won, I think said, is my insurance agency now going to have access to that and say, oh, he's at risk for colon cancer. We're going to cut off his insurance at an earlier date or whatever the thing is. Like there's a lot to be discussed there and to have strong thoughts put forth about because we don't want to just go ignorantly into the dark on something like this. And so now that you've already submitted a sample and participated in some analysis, there for most companies, I feel like there is a way to go in and kind of review the privacy policies and kind of walk that down. Have you ever considered revisiting those policies or it's just kind of like off in the past? You know, those policies are not dissimilar than any other policy. When I get a pop screen on my computer, I have never read any of them. And I scroll to the bottom because they make me do it so that I can click accept and then I can get onto what I was trying to do. And it's ignorant. I'm not informed. I will admit that, right? I'm being lazy because I came here for this thing. I didn't come here to read the rules of the thing. You know what I'm saying? And so, but I think there are ways to help consumers better understand more clearly what is happening with the DNA that they've submitted, what is possible in terms of its research use, its resale or what have you. It's benefit to you. By giving us your DNA, we are able to tell you more about yourself if you're interested, right? You might not be. So there's, but I feel like there's a lot of, there should be some more sort of very digestible ways to convey to the consumer out there. Here's what we do by signing up I'm telling you right now, these are the sort of high level things that we're doing and be transparent about it so that these companies don't end up getting themselves in trouble by selling off something they thought was on mundane and finding out that the consumer base was completely against that and is not in support. Well, I don't think you're ignorant. I think it's all by design, right? I think we're kind of conditioned to just scroll through these things and get to the product that we want. That's very, that's correct. So I'd like to, Tim, ask you a little bit more about what you shared in your story. You said that you were adopted from Vietnam quite young and you had mentioned that it was really important to your identity and your personal narrative and being Vietnamese. So will you share with us, what does it mean to you to be Vietnamese and can it be quantified? Growing up, I grew up in a mixed family. I have a brother and sister from Korea, not related until they were adopted plus my parents biological. So I always tell people I'm Irish, Norwegian because that's what my adopted parents are. Like, growing up, my mother would give me books and we would talk about what it was like to be from Vietnam. She had friends that were also social workers and director of adoption agencies who were either in Vietnam at the time of the end of the war or before. Look at postcards, pictures, and just go through all the history. So I guess identifying past as being Vietnamese was more of being told you're from Vietnam and this is what the food looks like. At the time growing up, I didn't think, but I don't think anybody knew that Vietnam was going to open up to the Western world again to be able to travel. It didn't happen until like, I forgot if it was the late 80s, early 90s, but I do know that it is opened up so everybody can go travel. But when I was growing up, I tried to, I mean, of course I was American and I wanted to be as white as possible, sorry, Caucasian as possible because that's the area I grew up in, but I also knew that I had a history of being, my background was from Vietnam. So I tried to find things to be related to Vietnam was important to me. Yet at the same time, I just wanted to be your typical teenager, trying to fit in like everybody goes through that, trying to fit in and just knowing that I had a different experience than most of my classmates and friends kind of, maybe just suppress the whole feeling as I got older of trying to seek out any biological family or anything because I honestly grew up in a small town and I wanted to get as far away from a small town because I wanted to be not as identifiable if that makes sense. When you're one of three Asian people in the whole school and two of the others are your brother and sister, I wanted to be more like in Silver Spring, Maryland where I am like one in a thousand or more Asian people in the area. I don't know if that really answered your question but I would like to say follow up on something that Damon had said in the fact that take Facebook for example, I think you said that how you feel like you're talking about something and all of a sudden you get an ad. I personally feel like there's only a matter of time before our DNA is monetized, where we are the product, where somebody out there is genetically finding out, if I take this sequence from somebody and take this sequence, maybe we'll have the best opium drug possible or best medicine, not seeing that medicine for humankind or humankind would be bad. I'm just thinking that it's only a matter of time before people start digging into the DNA and coming up with these cocktails. And the next thing you know, they're using your DNA to do something and you haven't really given consent and I don't want to be part of something like that. I mean, I know it sounds selfish but I don't want my DNA out there for anybody to just use. And Damon, you said you just scroll to get to the bottom and I'm guilty of that at times as well but I do believe at times the information, the details, the devils are the details, right? So maybe these companies are saying we're gonna do this to you.  And it's probably at the smallest point in the print where they're like, by the way, we're gonna sell all your information to every company just so for ads and sponsorships and to make our revenues higher. And I don't want to be a revenue generator for people. And unfortunately I'm already in the system but that's where I'll stop. So I don't want to find out anything else. I don't wanna know if I'm gonna die of cancer because I'll cross that bridge when I come to it. I'm not going out there poking, don't poke the bear, right? I don't want the answers right now. I'll deal with it when it comes. Ewan, I think your poise to answer this first question from the audience. What is the average cost of a clinical genetic test in DC? Oh, well, I don't know what the clinical genetic testing would cost in DC, but some of the bigger labs depending on your specialty. So I can answer kind of from the cancer realm. If you have to pay out of pocket, if your insurance won't cover the test, it's like 250 for some of these large panels for clinical genetic testing for cancer risk. I think preconception might be like 350. Don't quote me on the preconception, but depending if you're in pediatrics or if you're exploring something in a different realm, the cost can definitely be higher than 250. But that's always something that when you sit down with your genetic counselor or your medical geneticist or however you end up deciding where to go and what to do, that cost can be explored at that point. That's a good question. Thank you. So at this time, I'd like to go through several of the Q&As that we've received from the audience already. The first one, how important do you feel that DNA verification is when reuniting with biological family? I'll jump in. Honestly, I think it depends on you. It's a personal decision as to how important it is. And I'll give you an example in my own story. When I met my biological mother face to face is this incredible moment of riding the elevator down to go meet her on her floor, but she was coming to meet me up in the lobby. So when the elevator door opened, she's standing there and I'm looking right at her. I've never seen this woman before, but in my introductory letter to her, I included a picture of myself and a picture of my son and my wife. So she knew what I looked like. But when I looked back at her, I immediately saw my face on her and I knew it was her. And I didn't need a 23 and me DNA test to confirm it. We did it because I got one for free, but I didn't need it. It was clear, obvious and evident to me that that was the woman. However, I will say that in my paternal search, I would have probably had, I made an actual connection with the first guy. I could see how I might have questioned it if I didn't look like him. I found, even just in talking on phone with him, that we had very different personalities. He was very, very sort of boisterous, overbearing, like not what I consider myself to be sort of a more relaxed, laid back kind of individual. And I could just feel that we weren't connected in the way that I felt connected to Anne. When even when I spoke with her on the phone before I saw her, I could feel her essence coming through the phone. And I knew that this, I was connected to this woman. And so I think, again, it depends upon you and what you need. So with Anne, I didn't need it. With a paternal connection, I could see how I might have needed it. I'll tell you that I look incredibly just like Bill as well. So when we smile, I smile and I squint my eyes like he has that squinty eye look, which is really funny to me. I might not have needed, but I could see how I could have questioned that. And so I think it's a very, very personal choice that each person has to make for themselves. And I'll close with one final thing. It was validating for me anyway, right? I was born, I was taken off into foster care and never was there a connection. It was actually nice for science to say, hey, just wanted to let you know, you're actually a match. I found that validating, even though I didn't actually need it with my natural mother. Thank you for sharing that. The next question is, has direct to consumer testing normalize discussions about genetic testing and ancestry? What do you think, Yvonne? Well, I mean, I was just thinking about that. I mean, I think it's really come out into the media. It's a lot of different stories, the great ones, horror stories, the whole spectrum. I do think that, you know, people talk, one thing that I always feel really nervous or give warnings about and people are like, hey, do you think I should do this test? Like an ancestry test.  Do you want to open that door? How do you feel about, you know, knocking in the door of somebody else? Like, you know, metaphorically and also, you know, there's some donor and ethical issues for donor raised children or donor created children. But I do think it's out, it's out there. We talk about it a lot. I guess I just feel like, you know, I once saw a couple who like did 23 Me For Fun and then found that they're both carriers of cystic fibrosis and then came to me and they're really nervous and scared about it. So that's kind of that caveat is like, you know, make sure you're comfortable with opening the door to multiple things. If you sign up for it and read the fine print, but I know I don't read the fine print either all the time. But I mean, if I'm answering the question, I mean, I do think it's good to be out there and ask for a talk about it. People know about it. You can have a point of reference. But for me as a genetic counselor, I often have to like backtrack and like be like, look, you're not going to be in a crime database if you have a clinical medical genetic test or, you know, there are privacy or laws and there's, you know, federal laws to protect you from insurance discrimination. So I have to do a lot of that to be like, don't worry about that part, at least from this thing. But if you go and, you know, order a test online and, you know, maybe do a direct consumer test, you may not have that same protection. The next question, did any of you experience any family or friends caution you against doing genetic testing for any reason? Not me. No, our genetic testing adventure actually started with my sister-in-law. She lives in California with my mother-in-law.   We should totally do DNA testing. And so we all dove in. It was, I don't think anybody really had any trepidation on my side. My brother did the DNA testing and he was totally opposite than I was. You wanted to know, I believe he wanted to know more. He wanted to know, like, what could he do to make sure his health was better and, you know, what the history of his biological parents had, or, you know, to make sure that he was living a good life healthily. You know, opposites in so many ways. And DNA is one of them. I'm more reserved and cautious about it. Whereas someone who I thought would be more cautious about it wants to know the answers. But I guess everybody wants to know to a certain extent of, you know, their health and how the past, how their generations have fared when it comes to living and, you know, dying. But me, I just, it's a Pandora's box, right? Once you open it and you can't put it back. And then if I find out something horrible, like I said, I don't want to live my life worrying. I just wait, let it happen. So this question, I can actually answer this one. Isn't the thought process different for domestic and for international adoption? I'm thinking of, oops, it just went away. I am thinking of a birth parent. I'm thinking a birth parent in Korea who has tested must have gone out of their way to try and connect. So the risk of rejection or being treated like an intruder should be low. So I can share that I have been in reunion with my birth mother from South Korea for two years. And they initially wanted to connect and then kind of rescinded that author and didn't want me to meet my half sister and adopted brother who lives in Korea. So I think it's just, it's a very complicated dynamic that can be evolving over time. But I think this brings up another point that maybe we can briefly touch upon and that is that you can also download your raw data from some companies. And I know that people do upload it across platforms and some of these organizations that do kind of collect this map on mass of the raw data don't have as good of a privacy protection or they kind of compensate the idea that, well, you can increase your chance of connecting but at the risk of your privacy and data security. Well, we are already at the top of the hour. I know we have a bunch more questions but at this point I'll formally conclude our formal program and then invite folks to stay on and continue the conversation. We have probably like 12 questions still in our Q and A so it's a very lively, engaging discussion. I'll thank our panelists and thank you for our IT support, Gerald, Mani and William May and I'll give folks a minute to transition and then we will go back to moving through the Q and A. So thank you for joining today's webinar.