The final speaker of this session and of the conference will be Dr. James Kirkpatrick. Jim is an assistant professor of medicine, medical ethics and health policy at the University of Pennsylvania. There, Dr. Kirkpatrick directs ethics and professionalism education for the Penn and Cardiovascular Medicine Fellowship Training Program. He performs ethics consults, coordinates ethics educational outreach initiatives, and serves on the leadership team of the Ethics Committee of the Hospital of the University of Pennsylvania. Today, Dr. Kirkpatrick will talk to us on the topic, death is just not what it used to be. Jim. Thanks so much, Mark, and I know you've all been dying to hear this presentation, that's why you're still here. I want to thank Mark and the McLean's, especially for this opportunity, and I thank all of you for staying really to the bitter end. I hope this is not the bitter end because of the quality of this presentation, but because this has been yet another fabulous conference. I really want to thank just the organizers and table women and Christian for the great work in really putting this all together. This has been a phenomenal conference. Christian, we're really the glue behind the conference. I just can't agree with you more. They really did a great job. Hopefully, at the end of this, I'll basically give you some roast topic to think about on the way home, but I'm also going to review a lot of things that have already been said, and I think this point has already been made already here, that it said that there are only two things in life that are certain, death and taxes, but maybe only taxes at this point. Especially in Illinois, it's a good point, Mark. The question is, how do we define death? How do we think about death? What shifts us from being alive to being dead? Is it a lack of sentience? Is it a lack of personhood? Is it a cessation of all spontaneous biological activity? Is it a departure of the soul to bring in some of the religious and spiritual questions that we've grappled with? And that's really different than this idea of how we diagnose death, right? Because diagnosing death involves things like saying that there is a cessation of cardiopulmonary activity, such as a lack of pulse or a lack of spontaneous respiratory motion, or how about brainstem reflexes? That's one thing that we look at a lot. How do we determine that even? Is it by physical exams? Is it by apnea testing? There's a whole host of other things that we use to diagnose death as well, imaging things to look at cerebral blood flow and other markers we can measure as blood tests. Maybe it's this lack of consciousness. Maybe some of the people who actually have a pulse and spontaneous respiration and have some of the physical exam findings consistent with life, but they lack consciousness so they're actually really dead. And we have really grappled with this over a long period of time. I want to add another sort of component to this, and when is death and does it depend? Many of you are familiar with the fact that traditionally there's been this idea that after 20 minutes of CPR, if it's ineffective, you can essentially stop and say that the person is dead. We recently wrote a paper that examined this. I'm not going to go into a lot of details, but one of the things we bring up is does it depend if this is a younger person without a medical history, or maybe it's a stage 4 cancer patient with a DNR order, or maybe it's a patient with after a massive interest cerebral hemorrhage or an Alzheimer's patient. Does our criteria for diagnosing death change when it's the changing patient? So I'm going to give you a very brief history of death. Some of you may recognize this up here. This is a charnel house, and essentially that idea there was that if somebody wasn't responsive anymore, that you would put them in a charnel house and wait for putrefaction to occur or decomposition. And that was the sign of death. That's a pretty good determination of death at that point. Obviously with concerns about an understanding of how infection spread after death, there was a need to bury people a little bit faster, so charnel houses kind of went out of fashion, but we still have this idea of the wake. Wait around, make sure the person's not going to actually auto-resuscitate. In each of Greece, apocrates recommended that at the point of death, as death's coming near, the physician should actually withdraw himself, allow the family to actually determine when death occurred. And that created some problems. Oftentimes they would use a cardiopulmonary criteria here, but that came into fashion a bit more because there was a recognition that if someone is not responsive, it could be to psychiatric illness or toxins. They might have had a drowning effect in cold water and typothermia, metabolic arrangements, traumatic brain injury, all these things can look like death, but they're not really death. And then of course, you recognize this person. This is Edgar Allen Poe, who wrote Buried Alive, a very influential short story, but it was actually reflective of one of the hysterias in the late 1800s. People were very much afraid of being buried alive. They would find claw marks on the inside of coffins when they dug them up, and so it was very concerning. People put in escape mechanisms so that if they were buried alive, they could get out. Poison pellets in some cases were put into there with poison gas that escaped. Some people actually wrote into their advanced directives or wills at the time that they should be decapitated prior to being buried, just to make sure. So out of this, one of the first sort of official recommendations for diagnosing death came from the Society for Prevention of Burial Before Death. You can see all these different things that they used. This blistering to hot iron would be a pretty bad one to undergo if you weren't in fact dead, but a lot of them again rely on these very definitive markers of being dead. So then we had really the rise of brain death. So we sort of went from something you could call brain death, not being very responsive to cardiopulmonary death, because the non-responsiveness didn't work so well, but then we realized there were some problems because we developed CPR. Really the first CPR dates back even to the 1600s, so obviously it didn't get well used until the 1960s. In the 1920s and up to the 1950s, we had the rise of defibrillators and ventilators. Molore and Golan actually came up with this idea of comode passe, this idea that you could basically look like you're alive from cardiopulmonary criteria, but you were brain dead essentially, and then with transplant coming in 1965, and then the Harvard criteria, which has been mentioned in 1968, really coming up with this idea of brain death, which then obviously accelerated and justified transplant. So in 1981 in JAMA, it was published this Universal Declaration of Death Act, and essentially used these two very important words, irreversible cessation of either heart and lung activity or of the entire brain, and we'll come back to why that's important. More recently in 2008, the President's Council on Bioethics actually considered this whole idea of brain death, and they changed the, after considering a lot of different critiques of what had come out in the literature, they actually sort of redefined this idea of irreversible cessation of brain activity and said that instead we should think about this in terms of commerce with the environment. So receptivity, if you're able to respond to the environment, if you have a drive or ability to act on the environment, and in this document they also basically reaffirmed the idea as been mentioned earlier, that the dead donor rule we cannot transplant or cannot harvest organs from anyone who's still alive, they must be dead. They reaffirmed that. Our problems, and we've seen some of this, I think all of you are probably familiar with therapeutic hypothermia, hopefully you understand this sort of came out of some of the recognition that when people were submerged in cold water, they actually survived surprisingly. So now we are routinely cooling people after cardiac arrest. This is just sort of what it looks like here for 24 hours. And basically it's a long period during cooling and then rewarming that actually occurs. And this has shown some good outcomes in cardiac arrest patients. Now we did a study of looking at this earlier, and we found that when we went back to the charts, we found that rather negative prognostic remarks were made in the charts of therapeutic hypothermary patients. And interestingly, many of them were made during the time the patient was under therapeutic hypothermia or right afterwards. And these are the ones in which all the patients lived and these are the ones in which patients were died, all of them died. And the thing that began to worry us a little bit is that perhaps these negative prognostic indications were causing care to be withdrawn and that perhaps there was a self-fulfilling prophecy that was occurring. And you can see all of the cases in which care was withdrawn. And again, some of it during the hypothermia protocol.  But now there's increasing recognition that you really have to start the clock over after the rewarming has occurred. Again, as been mentioned earlier, there are now machines that can be plugged into patients and to basically keep their cardiac and respiratory drive going through a mechanical standpoint. And this has been used particularly in Asia now. They really are putting people on these peripheral bypass, essentially ECMO without the breathing component, in the ER after cardiac arrest and are keeping them alive. This is becoming a resuscitation technique. And so when we think about this, I think a lot of us would do just like this couple who is having a very good advanced reactive discussion, just so that you know I never want to live in a vegetative state dependent on some machine that ever happens, just unplug me, okay, okay. And you know, we don't want to be too hasty about these things necessarily. And the reason I bring this up is that all of these patients have what's called a ventricular assist device. And they're all dependent on the machine to some extent. Now it is true that at least one half of their heart is working. The other heart is being assisted by the machine. But now we are planning quite a few total artificial hearts. And those people have irreversible cessation of their native heart function. In fact, they don't have a native heart anymore. So are we going to use that definition anymore? It becomes problematic. So perhaps we have to get rid of this idea of irreversible cessation of cardiopulmonary function rely on brain death. Well, as has been mentioned, there's problems with that as well. A lot of the original brain death justification basically was saying, well, this is the type of physical exam findings and other lab values they have right now. And then they died.  And this, of course, raises problems with a number of pregnant women who have been maintained until fetal viability. This idea of irreversible loss of integrative function, the brain is supposed to integrate all the functions of the body. If that ceases, then the person is brain dead. But we know, as has been mentioned, that pituitary integration continues for quite some time even after a person has met brain death criteria. This idea of disintegration of personhood has been a sign for defining brain death. But what is that leave patients in persistent vegetative state or anencephalic infants? Are they, in fact, dead but they don't look like it? And then there are a number of brain resuscitation techniques that are in the infancy at this point. Deep brain stimulation has been helpful to some patients or has been purported to be helpful in some cases to patients with persistent vegetative state and controlled brain reperfusion, part of the damage that happens after cardiac arrest is when the reperfusion state happens in patients in their brains. And so if you actually control that and put in the right kind of fluid in there, it can actually limit the oxidative, as they say, damage that happens to the brain after you get the heart started again. All of this is looking very promising but of course leads to some problems with using brain death as a criteria. And so this idea of uniform declaration of death act, the universal sensation of heart, lungs, and entire brain, they also mention this very interesting point that a determination of death has to be in accordance with acceptable standards. So it leads to the conclusion that perhaps like politics death is actually locally defined and there is some evidence to suggest this. This was actually a study and it's from a while back in 2008 but essentially there were these American Academy technology guidelines for determining death, brain death. And they went around and actually looked at a number of different hospitals and looked at their protocols for determining brain death and saw to what extent they agreed with the official definition. You can see that the agreement was all the way across the board. So you could certainly be dead in one hospital and not in another. This raises the question then are we really talking about death or are we instead talking about futility?  And at this point I'd like to bring up an article that I think Dan missed in his last thing in discussing all of this. This is a very important article from 1975 New England Journal of Medicine and if you haven't read it you really need to. In it Mark argues that although it's very common for physicians to hang crepe, in other words give a very negative or bleak prognosis to the family in the hopes that if I'm right, if the patient dies then the family will say I'm right, I look good, I was correct. If however the patient survives then clearly I did something good. I'm a miracle worker and everyone's happy with me. He said that there's some problems with this. Not only is there some questioning that comes into the physician's integrity but there's also issues of putting families through unnecessary suffering that perhaps prognostication is better to do that. And when we actually did some qualitative work with the rest survivors we found that a similar thing happened. In this vignette that patient describes a case of the cardiologist being extremely negative and said that you'd be a vegetable for the rest of your life and be living off machines, the neurologist came in, don't even need the respirator, took them off and there the patient is. Another quote that we had I know there are certain time constraints when you can say something that someone is plausibly and truly dead. I think I prefer the medical personnel didn't use that especially since I was in such a state and my family was there. Now Dan gave a really great overview of the ethical issues with donation after cardiac death. It will allow me to go very quickly through this. He already mentioned sort of the general protocol and also this concept of do we really use this term irreversible or should we actually use the term permanent? Bernat really talked about this eloquently in a somewhat recent article. Argued that we really need to talk about permanence. And one of the issues here is the Lazarus phenomenon essentially is auto resuscitation after 10 minutes and you basically cease resuscitation measures. The person looks dead and 10 minutes later they wake up and auto resuscitate. Exceedingly rare. But nonetheless it does in fact happen and calls into question whether we should be using a 75 second donation after cardiac death rule. And as Dan mentioned, the fact is these organs are not irreversibly dead. They are restarted in the recipients. And so it really is an issue that resuscitation is possible but it's just not intended and it's not done. So it's really a permanent. In a sense though the person is dead because we say they are dead and not because of some external standard necessarily. I think it's important that we get this idea of a Lazarus phenomenon from the Gospels and we have this very poignant statement and if DCD is not this then I don't know what is. So I would agree with Dan that we may be a little uncomfortable with it but it really makes it a very strong social statement of altruism. But so wrapping up, does this really leave us with this idea that perhaps death is about, is really relative? You can choose your own criteria for death and maybe we should be talking to patients more about futility. Maybe we even need an advanced death directive. What sort of criteria do you want to be used so that you can declare that you are dead? This would be helpful. We get rid of the dead donor rule. There's no time delay. We don't have to wait 75 seconds. We can take the organs right away. No universal declaration of death and these ideas of near death and brought me back to patients use all the time. We can basically accept those and say, yeah, actually you were dead rather than kind of rolling our eyes as we tend to do. There are some conflicts of interest here. There's sort of a classic society versus individual conflicts of interest. We talk about the organs but also about healthcare budgets and get people out of the ICU if they're dead, they're much cheaper. It also puts ER docs at a difficult position. Are they a patient or are they a donor? Unconscious social biases may play a role in how we decide this. Again, a young person versus an old person, a mom in a minivan accident versus a drug user on the street. So, yeah, there have been issues that come up with this. There's an organ recovery ambulance that goes around in New York and finds the organs. I think there may be some problems here. They have a lot of nice things built in there to try to prevent it from causing problems but the reality is I think it will show up in some neighborhoods and not in others. There are other some problems too and maybe if people choose future fraction as their diagnosis of death we're going to have to go back to charnel houses and that may not be the right way to go. Death, is it just an ethical, legal and clinical fiction that allows us to justify transplantation? I don't think so. It may not be perfect but it's kind of the best that we have at this point and I would agree actually with the President's commission that we need to keep the dead donor rule. We need to talk maybe not about irreversible but permanent cessation. This gives us continuity with what's happened before. It gives us stability and certainly it gives us a social sanction for transplantation which is something that I think all of us would agree is a good thing. So thank you very much for your attention. So I brought to the group Nepal and I've tracked many times in the Himalayas and it's a Tibetan Buddhist culture. This summer I also took a course on Tibetan medicine and they believe that the body is not dead until the soul re-enters and that period can take anywhere up to 45, 60 days and the body is absolutely left in a quiet state until the monks are certain that that soul has re-entered which creates an enormous wrinkle in your concept of what it really means to be dead. Absolutely and I'm sorry I didn't have time to even bring up the concept of other cultural perceptions on this but I would ask you how have you dealt with that in the ethics courses in the hospital? That's an area that we have not yet tackled. Partly because most of the students are Hindu and some are Buddhist and they are learning western medicine. They speak English in all their courses and these are traditional Tibetan Buddhist beliefs and at what part do we invade those cultural beliefs with another very different model of medical illness while also preserving the beauty of the spiritual, the religious, the cultural you know, things that exist around the world. Absolutely thank you. I want to thank the audience for attending the 26th annual McLean Center Conference and being hearty and staying till the end. It's always wonderful to welcome you back to the university and to the center. The weather this time was colder than at any time that I can remember in the history of the 26th McLean conferences. I can guarantee you the weather will be warmer next year. Thank you all for coming.


Yeah, we just needed not turn the ball over. That's the whole thing, bro. I've seen enough. This is it. This is it. I've seen enough. I've seen enough. I've seen enough. Come on, Badger. Oh, come on, Jamal. Yes, sir, ski. Let's go, man. I've seen enough. Oh, my God. The best defense. Oh, my God. That was so lucky I got hit. Yo, the drag just stopped for him. Oh, man. Oh, man. That hurt. That hurt. That drag just stopped in its tracks, dude.  Oh, we got to kill him. Ramsey got the littlest. Ramsey, good hit, kid. Live with it. I want to just beat this. Oh, my God. No, Huttlesnip is like, oh, my God, man.  Like this a guy that should just never score touchdowns in Madden. He should never be allowed to score touchdowns. I want to, you know, give me a response. You know, I got to be able to move my guy, bro. Oh, yo, I need a punching bag for real. I really need like, I need a punching bag. Stick. Oh, that was a good defense, man. I'm not mad at him on a defensive side of all boys.  I don't know how covered sky matched, bro. I swear to God, these zones, dude. Bro, come with somebody. Like the way he could just throw this is pissing me off, dude.  My life on defense is the way you're right fighting for my everything, my livelihood, my life, everything. Yo, y'all ain't see it. Y'all playing defense though. I'm definitely a defense. The nickel normal is better defense. Definitely. Bro, like, that was a great defensive call. It was a great that he was bagged and Dion literally just full sent to the middle. He just full sent. Like he didn't even like drift. Yo, he full sent to the middle. Like he forgot his wallet in the Uber or something. Ain't run like he forgot his wallet in the Uber, bro. Oh, it's like the worst case scenario, dude. Where did that safety come from? Oh, that's the worst case scenario for me though. Yeah, if you're going to hold me to three and get seven, just throwing the ball at somebody. Thank you, bro.  I'm going to just, bro. Ramsey, are you kid? Defense is so hard, man. When you make a play, I need you to make a play right there, kid. Holy. Yo, Landon Collins, dude, I am like, cause, oh, I'm going to just lose it. Like it's being lost right now, boys. It is being lost right now, boys.  Here you go, truck. I'm Louis Ryan. This is, this is, this is rough for me right now, man. Thank you, man. Holy man. Can I play better defense, bro? Oh my God, Landon, you got to hit somebody right here. Did I press that time? No, I must. Just like, oh man. I mean, bro, I felt like my defense was better that game, boys. Confirm or deny, we played defense that game. I'm just like, it's so hard to play defense. And when like they swatch, it's so frustrating, dude.


Hey, when we talk about working to one market, one of the number one objections that we get from agents or questions we get about one market is, dude, I've exhausted it. I don't know what to do. It's toast, bro, and I don't know how to make any money, right? I'm telling you, your one market is not exhausted.  It ain't true, right? So instead, I want you to create your list.  When you take off a name, if they buy, die or don't buy, take them off and add another name. Every time you take a name off, you add a name, okay? But also you gotta think about it. Your warm market is this. The people that are in your warm market also have, guess what? As Tiki Kiki said, a warm market as well. So start to realize that your warm market isn't exhausted.  She has a family. She needs help. She could be on your rolling 100. It never ends.  You quit. Let's not quit, right? It goes on forever. My warm market grows and goes as long as I want it to go. If I want it to end, it's over. If I don't want it to end, I want it to keep freaking going, right? It'll keep going. I'll ask for referrals. I'll add people that I meet. I'll think outside the box. I'll realize that my warm market, they also have a, guess what? A warm market, okay? It doesn't have to end. It only ends up here.


What is going on everybody as Stas here welcome back to another video So in this video, we're going to be talking about moving average crossovers and how you can use these to your advantage to determine the trend of a stock and index and ETF in the future so you can better understand where to get into the position right when to buy when to potentially sell and Really what your plan is going to be with that? Position right so let's just hop right into it This is something that a lot of you probably already know and a lot of you don't know since you did click on To this video. So let's just talk about very briefly to start off this video. What is a moving average? What's an SMA? What's an EMA? Let's just briefly get into that before we do hop into how to determine the trend based on Moving average crossover so to put it in very brief terms guys a moving average is Really a smoothed out trend of what the price action of the stock index ETF or future has been Over a specified period of time, right? So this chart that you're seeing right here You notice three different lines right this light blue line this green line and this yellow line This yellow line is the 180 day simple moving average. All that is it's taking the previous 180 day Closing price of that stock and averaging it out to give you this smoothed out line, right? This 50 SMA or this green line rather is the 50 SMA It's taking the previous 50 closing days price Averaging it out over over this chart so you can get an understanding of the price action, right? And this EMA is the 10-day EMA it's taking the 10 days prior closing price averaging it out And what you need to know is the 10 EMA is the quickest reacting Moving average because it has the smallest data points to work with right the 50 SMA is the second quickest Because it has the second largest amount of data points to work with and the 180 is obviously the slowest because it has the Most data points so all you need to know about that is the more data points your moving average has the slower Reacting it is which is why we use the EMA more for smaller term time frames Usually day trading because again, it's quicker reacting if you're looking at an intraday chart You know if we hop over here on Apple you want to day trade Apple and you want to see okay Is the EMA pointing up pointing down what direction is it heading in that can better? You know help your decision and what you're going to do in terms of that on an intraday Basis right and if you guys want to see a more in-depth video on Indicators and what I use and think or swim just type in the YouTube search bar Stasur fests think or swim indicators I'll probably have a card up here click that after this video if you want to see a more in-depth video I believe that's about a 20-minute video so go check that out, but let's get into it right now What do you need to know in terms of moving average? Crossovers right we need to see or rather there's there's multiple different benefits of seeing crossovers one of them is Determining a bullish potential bullish trend in a stock ETF index or future The other one is the flip side right determining a bearish trend in a stock index ETF or future And this is very simple guys. We're going to look at a couple of different stocks here We're going to look at Apple We're going to look at Tesla and then we're going to look at elf stock ticker symbol ELF So pretty much all you need to know is a bullish trend a bullish sign a bullish moving average crossover is when the 50 simple moving average crosses above the 180-day simple moving average like we see here on Apple at about a hundred and fifty seven dollars per share You know, this is when we saw that crossover and from there the stocks gone up to nearly 205 dollars per share and just to say this here guys It doesn't necessarily have to be the 50 SMA the 180 SMA in terms of a bullish It could be the 40 SMA the 160 SMA All you need to know is the smaller simple moving average the smaller time frame whatever it is What however you guys have it set up when that smaller one crosses above the bigger one? That is a bullish sign right however you guys have it set up when it crosses above That's a bullish sign right but for me I'm using the 50 and the 180 just simply because that's my preference and that is how I have it set up here So we can notice on Apple stock right? We noticed how during this time period of selling off the 50 SMA was acting as a resistance So the first reversal of pattern that we noticed here where we could have entered as a swing trade, right? Was when we started to see higher lows being formed and us breaking out of that 50 SMA Resistance now holding it as a new support and when we saw that bullish cross That would have been the perfect time to enter into Apple right not only were we holding it as a support at this point But once we crossed over we saw that big pop We broke out of the 180 SMA and it's been nice nice push ever since there, right? So that is how you can determine a bullish sign to simply look for the smaller simple moving average in this case Being the 50 crossing above the larger one in this case being the 180 And you can also look at this on many different time frames, right? You can look at it on the one year time frame the 30 day time frame the 20 day time frame Let's just hop into some different time frames so you guys can see what I'm talking about, right? So the 90 day time from here you saw the bullish cross and from there It's been nice and up in terms of Apple right 20 day, you know It's mostly all above here because the bullish cross happened a couple weeks before this 20-day 1-hour chart So it makes sense that the 50s already above the 180 here But if we're hopping into the 10-day, this is where you can see a bit of something different, right? We noticed that Apple was selling off from this point from 202 back down to 196 and at that point the 50 SMA actually crossed below the 180 SMA very briefly Which again is a little bearish sign, but we pop out of there and the next two days after the pop We add a 199 push all the way up to 204 Dollars so that is an example of a bullish You know cross here and what I you know what I typically do and what you guys should be doing Especially if you're new to this is just go through a bunch of different stocks try to analyze them and see Okay, where did the bullish cross occur or is it about to occur for a potential entry, right? So again at this point in time, I was looking at Apple especially when we got that bullish cross I was like, okay This could be the reversal trend to the upside for Apple based on the moving Averages so on the flip side we can also determine a bearish move, right again That's when the 50 SMA is crossing below the 180 SMA and just to put it out there guys again Whatever smaller timeframe SMA you're using if it's crossing below the larger time frame. That's a bearish pattern So let's hop over here to Tesla which has been battered right over the past couple of months so we can see the bearish pattern here So Tesla we all know has been a near $400 stock right from there We saw the big sell-off to $250 and what did the moving averages do here? What did the SMAs do? Well, the 50 SMA crossed below the 180 SMA at about $323 per share in terms of Tesla, right and from there It's been nothing but red since we actually got the reversal and pattern where we actually got a bullish cross here Right we saw the support at about 247 250 ish on Tesla. We popped up this day, right? I'm guessing it was due to earnings We saw the 50 cross above and from there We had a little bit of bullish sentiment in terms of Tesla over the past or really for this period of time for the for this two three month window or actually more like a You know a month and a half window here and what do we notice a bit after that guys We saw the bearish cross when the 50 cross below the 180 and since then we have yet to Recover right so this is really a roller coaster Pattern here or roller coaster stock where you can really use the simple moving averages to your advantage Right you could have profited on the upside here to 380 and then once you noticed how the stock was aggressively selling off You saw the cross you could have sold off there for a profit waited to the cross again And then get in on the cross up here from let's say 306 maybe up to you know 368 you noticed an aggressive sell-off the bearish cross that could have been a signal to sell, right? So now we're seeing that this is still in a bearish pattern, right? So what am I waiting for real time now, right? This is you know, this is the closing day yesterday I'm waiting for the bullish cross on Tesla to potentially get in on one of these big waves to the upside that we've seen in the Past right so now that we're seeing it's in a bearish Formation all we need to see is a pop on you know the 50 above the 180 for it to get to the 280 290 level to get into Tesla on the reversal trend right so that is what I'm looking at here and That's how you can determine bearish signs right when the 50s crossing below the 180 and Bullish signs when the 50s crossing above the 180 and again You can use this on many different time frames guys You can literally use this on the five-day five minute You can see here the 50 crossed above very briefly over these past couple of days when it's been pushing up from the 258 level and since then guys you've seen a nice little bit of bullish move, right? But now it seems like this wants to cross below the 180 so keep an eye this upcoming week You know for Tesla stock and specific are we going to potentially cross this bullish cross here to maybe head back down to the mid 260s, you know, this could potentially happen based off of what the moving averages are doing as of right now So let me just do one more quick example on elf stock ticker symbol ELF This is a makeup company one of the hottest stocks over the past couple of weeks It's literally doubled in price But what we can see here and this is going to be an example of a longer term time frame is on the one year one day We've noticed how elf has gone from $20 down to about $6 per share, right? And now we're noticing a huge reversal in trend, right the elf Candlesticks here are breaking out of the 180 simple moving average resistance and we're noticing This is about to be a bullish cross on elf on the longer term time frame, right? So if this does end up crossing this could be a huge bullish move on elf that can send it up slowly start to send it up Maybe to the 15 level maybe to you know, the $20 level maybe to the $25 level. These are the trend You know trend reversals that we need to be keeping an eye on in terms of these simple moving averages to determine Entry points on stocks, right? If we go here to the 184 hour It already did the bullish cross a couple of weeks ago and take a look at that guys literally from about $8.90 $9 when it did form that bullish cross elf has gone from 930 up to about $13 per share and this is these are honestly just real life examples of Stocks right so that is just something to keep an eye on guys. I'm sure again a lot of you already know this But it doesn't really hurt for me to go over it again and hammer it into your head And if you're new I guarantee you this will help you in terms of swing trading Especially swing trading and some shorter term day trading. So let me know in the comment section down below What are your thoughts on this? I would love to know if you enjoyed this video hit that like button Let's try and get this video to let's say 75 likes let's see if we can get this video to 75 likes I challenge every single one of you out there to get this video to 75 likes and again if you watch the whole video I really do appreciate for all of you guys out there honestly for watching the video. It does mean a lot to me I'll catch you all in the next video.  I really do hope you enjoy that. I'll catch you all in the next video again Thanks for watching peace out


Michelle yo has finally married her longtime boyfriend Jean Todd and based off this photo and this announcement a lot of people got a lot to say Let's talk about it. Yeah, maybe surprisingly or unsurprisingly This sparked a firestorm on all the Asian Instagram some people said this about Michelle yo some people said that All I want to say is congratulations. Congratulations to her Jean Todd Who I believe is the son of Polish Jewish immigrants to France obviously Michelle yo was a superstar in Hong Kong has more recently become a Superstar in the West or like, you know, she always was known but like really increased her profile a lot All right, David Let's talk about why people are even talking about this photo Why does anybody care that she married her 19 year long? Fiancé yeah, I just think that people need something in pop culture to open up a door to a more serious discussion Anything that happens in pop culture, you know Some people overrated Hollywood this way or some people underrated or some people fairly ready whatever But like it just opens a door should it have been the incident to open that door I don't know but it did and when I'm talking about the door I'm talking about maybe the societal gender imbalances or mayor out marriage rates, you know between Asian women Asian men you're talking about the white man Asian woman couple, right? This is what this now. This is what a lot of people aren't using this as that's what the discussion and arguments and You've even devolved into name calling in the comment section. Yeah So I think it's really interesting that Michelle. Yo of all people obviously But anyways, we're gonna get into the comment section Please hit that like button and check out other episodes of the hot-pot boys If you guys enjoy our commentary in the news that we cover.  I mean, I think my thoughts are like what if she married like a Richard Branson like a really rich cool white guy Like would people be more okay with it? Or is it because visually? He's like shorter. He's not as good looking He kind of looks like a gnome I'm sure he's a nice guy and probably loves her because listen at his age and of that wealth A lot of guys could be marrying and dabbling in younger women You mean exactly like Richard Branson? Yeah, Richard Branson or Dan Bills-Arian or Richard Branson is busy with like 30-year-old women versus 70-year-old women You know and John Todd probably loves Michelle Yo, so I guess I'm saying like if there's no like I can't find any evidence of like self-hatred or anti-Asian Guiness or anything like this around this situation in particular Well, I do understand that happens and we should have a conversation about it I just don't know if this right you're saying that you don't know if this is the right key to open up that door But there's a lot of valid discussions probably to be had in that door Of course We all know the statistics like brought up by this guy named Brian shoe this tick-tocker who talks about the stats about how Kind of imbalance it is statistically speaking about interracial marriages white male Asian female is improbably the most common interracial couple they are a quarter of all interracial marriages despite Asian women being only 8% of married women they almost our number Asian male white female white male black female black male white female white male Asian female couples are Statistically weird, but anyways guys, let's get into the comment section because other people had a lot to say somebody said oh my goodness I'm just here for the comments. They're about to be a mess I know the comments are about to be problematic, but I just can't help but lurk This is sort of like the classic popcorn comments, right because they knew Andrew. This is explosive Somebody said oh my gosh some geriatric white man. Congrats though Somebody said he there's not even gonna be a honeymoon unless there's a very potent blue pill Not all these comments are from Asian guys right by the way some of these comments are from other white people Somebody said he looks so old and feeble. He must also smell. I can't believe this Asian queen God with a guy who looks like this Yo when the person was like yo a geriatric white guy congrats though.  She's an award-winning actress She was a model.  I actually feel like his situation. It's almost like It's hard to say that she's just going with a Chad Brad Cody Dominant super tall Anglo, right? Right. Yeah, it doesn't seem like it just seems like to me too old people And then one woman happens to be prettier. Yeah, somebody said not every white plus Asian couple was a product of fetishization I'm literally mixed with parents like this and I know that there's nothing but true love in between them He waited 19 years for this woman. I doubt it was anything close to fetishization This was a very moderate truthful comment. You know what I like about this comment She's acknowledging that inside of like we always say Andrew inside of a reasoned pizza There's just different slices and I just do not think the michelle yo Jean Todd thing falls into a problematic slice, but there are problematic slices possibly in that pizza Dude, you're engaged for 19 years First, I don't even know what them getting married means if they were like engaged for 19 years at that point I don't know. Yeah, I mean, and there's a lot of problematic things. First of all, I do think that like I said There's real problematic places, but like that that Anna Nicole Smith You know a thing with the older rich oil billionaire from back in the day That's problematic too taking the race out of it Right. Yeah, because they clearly what did she was she attracted to him? Somebody says Seeing people getting upset at how she's not married to an asian man really shows how internalized racism and generational trauma and prejudice Still lives strong in millennials and this comment was left by a girl to be honest. I look at her profile I think she was like 21 Do you think there is generational trauma and prejudice more amongst the millennials than there are would be I guess amongst gen z Okay, for sure They're from a different generation, right? So they've seen different things. It's pre internet. It's pre iphone, but uh It they're throwing a lot of terms out here. I'm not saying that I don't kind of get what they mean But there's a I feel like the devil's in the details Yeah, because they like there's a way to have that discussion in that door that's problematic And there's a way that's less problematic But the problematic people are making even the reasonable people not want to have that discussion Or maybe there is no discussion to be had because power is power and power levels are power levels And also michelle. Yo, this is not it I'm more concerned with these like gen z TikTok Asian girls who are out dis in asian dudes or something like that to me is more like A little bit more questionable than what michelle.  Oh, you're calling me sexist, but i'm you're dismissing the Trauma that asian women grow up with so she's referring to the reasonings for this gap. Yeah I feel like on both sides. There's people being oversensitive about michelle. Yo first of all You can marry whoever you want Obviously if michelle. Yo has a history of hating on asian men or speaking ill about asians which she doesn't I'm just like then that then then it's not really an issue But I think that also for the women to be replying back and and and assuming that every man Whoever brings up this conversation is like an in-cell weak insecure asian man I think is super wrong and that's super counterproductive Right well both people are being kind of toxic. Yeah both people are being counterproductive I mean it's sort of like the toxic left and the toxic right right now politically. That's why nothing's getting done It's all gridlocked.  You're a toxic insecure asian male And i'm like no that's not necessarily true either, but yeah, no dude should be accusing Women of anything right off the bat right because every case is different everything is situational and you know The details here they shift to this case that case somebody said I don't understand how asian men will praise other asian men For getting a woman outside of their race, but we'll tear down an asian woman as the same. I'm not asian So please enlighten me. It just seems hypocritical. I mean, okay. Here's my thing I think tearing down asian women For no reason, especially when the asian woman has not done anything to asian people Is wrong completely wrong And I do think the reason why there's the double standard why you congratulate asian men for dating outside is because it's just simply statistically less probable And it's considered more difficult. So just like I would congratulate lana condor if she married timothy chalamet What do you as an asian guy? When am I going to say I'd be like, oh shoot lana condor guy with timothy chalamet That's cool for her, you know, like that's like a hot top white guy. That's great, you know Because that that would be like I guess considered difficult So in the same way like an asian dude who gets with like a good-looking non asian woman It's just more difficult somebody said wow so many insecure asian men in this thread And uh this turned into you know, like we said even more arguing going back and forth Uh, I definitely think here's an interesting concept and let me just posit this. Okay If your social positioning in the western world is not secure Wouldn't you have a lot of logical reason to be insecure? I'm not saying that it would be right for your life or you know What you need to do and get done as a man, but if literally your positioning is super Unsecured like not secured by anything. It's not tied down by anything. Wouldn't you logically be insecure? I think it is tougher for a lot of asian men to feel secure Now part of that is in their head, right and obviously but also part of it is the things that they've experienced I think it is more difficult And unfortunately, I do think that a lot of asian guys have to bust more moves in order to feel more secure Whether that's travel around they do this and that they work out. They practice this Unfortunately, that is the situation and I just you're just sort of like minus points off the red So you got to dig yourself out of that hole Yeah, you have to spend a little time digging yourself out of the hole first And that's the unfortunate truth for a lot of asian guys But I think that there's so much literature and conversation about it that what I wish is that a lot of asian dudes Would find the spaces where they can like work on themselves to do that. You know what I mean or figure things out Yeah, I really recommend I honestly this is like a little bit of an inside like just moving to an enclave for like A lot for a just check it out. Hell. Yeah somebody said uh He proposed less than two months after they met and then they engaged after 19 years What's going on here? Somebody said convenient timing waited for her to make it status wise to pop the question Um for all the comments about why they brought the oscar to their wedding It maybe it was an inside joke that they would get married when she finally won an oscar I actually think that this is true like that she was like waiting to make it Uh, and I'm not saying that she was searching for validation from the western world But sort of like make it in the west. Yeah, I mean I don't think it's beyond to say that michelle. Yo cares about winning an oscar guys I mean, yeah, I know she's a western person Like I heard she grew up speaking english with her parents in malaysia because at that time Kuala Lumpur and Penang there were such strong British colonies that you could actually like it was almost like You you could just speak english with your parents even or maybe your grandparents. Someone said uh yikes We need to stop putting her up on a pedestal of asian representation And then someone else said all these pro asian female celebrities always be with white men on the down low Yeah, I mean i'll say this I do think that we got to stop looking at people In hollywood to just be the markers of anything You know what I mean like that's a very particular system It's a great skill set to have you have to be above average looking to even ensure that fishbowl to begin with but uh That's one thing that definitely I think in america We generally look at hollywood because we don't like follow that many other worlds or like You know, I mean some people do some people don't it depends on how asian or mainstream eyes you are But you know what I mean, yeah, but I think this actually comes to the conversation about like Do like can you do a lot for a group of people? Can you impact that group of people while you still being different from them? It's kind of like having all these half filipinos on the women's Soccer team in the filipines that they won their world first world cup It's like they're a half filipino. They never grew up in the filipines at all Maybe a lot of them don't even speak to golly at all But I'm saying can they still represent and do a lot for the filipines as a country I think given the situation you have to look at it and say, you know Uh Whatever you think is like right or wrong. What is the reality of this situation? What is progress from this realistic point, right? Yeah, and I think michelle yowl has done a lot for asians in media regardless If she's like with an asian guy right now. Gemma chan or whoever, right? Um somebody said uh, this is actually a hoppa guy I believe his mom is asian his dad is white, but he identifies as asian This guy said interracial dating is fine. He's a product of it himself, but the ratio is definitely skewed And you know what's always interesting is the guys that are hoppa sort of speaking up on behalf of asian guys Do you think that their comments are taken differently than a full asian guy saying it? Uh, yeah, I mean I think that um Yeah, I think it's important for people to just point out the stats I mean listen once you have the stats, how can you argue with the stats? You just have to have a conversation about it to me There's definitely a worthy conversation to have but I just know that a lot of dudes in the comment section They kind of ruin that conversation by starting off being very very bitter and emotional right off the bat But i'm telling you guys we can have a lot of these conversations if we're not so emotional about it But if people get inevitably toxic defending either side, can you have the discussion? I think there needs to be a there needs to be a more higher quality discussion with like more I guess, uh Good faith actors somebody said, uh if asian men are labeled as the undesirable toxic unattractive asian women claim They support poc and pro asian despite dating white men and then comparatively put down asian men based on their own daddy issues While ignoring that the ish asian men had to deal with from the exact same type of parents Then uh, what if the roles were switched around like they are in uh somewhat They are in the black american community then what would asian women say right they're just saying Yeah, because uh What is this comment saying well basically it was saying like if the you know It's kind of all over the place people are dumping their emotions and their feelings But this guy was basically saying like what if just the roles were flipped? How would you guys like that, huh? You guys wouldn't like that very much because obviously he was referring to in I guess in the black american community Black males statistically have a much higher out marriage rate than the women. Yes. Yeah, so he's just like asking that question Oh, yeah, I mean of course you could always yeah flip the role role reversal man. It's uh Always right. Yeah. Anyway, let's get skin to our takeaways. Andrew this discussion goes on forever It weaves into so many derivatives that are not fully relevant. Uh, michelle. Yo getting married is jontad But uh, why why do you think it is man? It's just like every opportunity that this discussion gets brought up by this thing whether it fits or not It's just shooting that gap. Yeah, not every White male Asian female couple, uh, does this apply to and is there a conversation to have about it? Um, but yeah, of course guys the stats are there watch brian's video brian shoes video He would be different if he was a tall british guy to be honest because melasia was a british colony And then you could be like you could draw some colonial geopolitical things But uh, like a polis jewish Refugee to france. I don't know 19 years man. I think they love each other man It's just love at that point plus she did marry a hong kong dude before this So you can't say she doesn't like asian men or that she never liked asian men It just didn't work out in the long term. Yeah, I mean, what do you think? Do you think that there's gonna be just I guess is this discussion ever gonna Get into a quality range? Yeah, I mean I almost feel like there is more discussion because he's this guy Jontad is not good-looking like I almost feel like if he was good-looking, maybe more people would understand You think so I almost to me and I'm not saying that you might be right in terms of the majority of people I almost want to say what happened with like monologue divorcing gary lock and going with like a super tall white You know Chad was almost like you could argue that was more So what I don't know rattling what if she went with like a short white guy like that wasn't as good-looking Would it seem less fetish? Right? Yeah, it would seem less like But then conventional hollywood SMV power metrics I don't know and this is a larger conversation let us know in the comments down below But I guess if they're short and not good-looking white guys Then does that mean she married them more for being white or if they're tall and good-looking and they happen to be white It's almost like aren't they just tall and good-looking at that point depends on how I don't know I think it might depend on how nerdy they are Okay, I don't know guys now see this is a tough conversation guys Anyways, let us know in the comments down below what you think shout out to michelle.  She is uh, I guess the asian queen like asian actress queen I would say right right but anyway, man. Congratulations to everybody. It's a it's a discussion, man Until next time we'd hop out boys keep it civil in the comments section. I'm serious till next time. We out. Peace