See One, Do One, Teach One

This is the refrain you would often hear in medical school and medical residency training. Once you learn a new procedure, you are obligated to teach someone who doesn’t know how to do it. I think this is also good advice for living a fulfilled life if we expand its meaning to insights handed over to us from people with greater wisdom than we have.

Unfortunately, we find so often that our negative internal voice, that little devil on your shoulder, the “evil inclination” spoken about at length in ancient Hebraic writings, comes and says that we aren’t qualified or are not knowledgeable enough to hand over and teach others. I can almost hear the thousands of sighs that take place when people who wish to make a difference to others, stop, listen to that negative inner voice, and become despondent over not feeling ready, qualified, whatever, fill in the blank with the adjective or rationalization. Recognize that this inner negative voice, isn’t even you. Yeah, you heard me right! This is just a function of this brain we have, probably some kind of evolutionary protective mechanism that in our day and age, hinders us. Regardless, hear but recognize it doesn’t represent you and rarely gives you good advice. It’s like the random thoughts that pop into our minds, we are not those thoughts. Who we are is much deeper.

The Chassidic mystics have said “One good deed is better than a thousand sighs” and in commenting on this, the Lubavitcher Rebbe, a great mystic and spiritual leader of the second half of the 20th century, said that in this case “sadness is always unacceptable and harmful . . . Especially since naturally when a person sighs, he feels a bit of satisfaction that he is upset about something, and it does not add to his motivation to work to fill what was lacking.”

The life affirming alternative is to work on keeping your mood up and recognizing your obligation to share both your elevated mood and the new insights, techniques, skills, you have gained. And when that little devil on your shoulder made famous in cartoons starts speaking and telling you that you are not an expert enough, good enough, etc to share and teach what you have learned, grab a big cartoon hammer in your imagination and smack him in the nose 🙂 then “teach one.”

First, Find Your Direction

The last several posts were inspired by the book I am currently reading by Jonathan Sacks, Morality. I find that many of the ideas in this book can be directed towards understanding a healthy path for healing in general. I would say that he would describe his book as a way of healing society and I would say that the lessons of healing society can also be reflected on the physical and psychological healing of people and communities.

In an interview about the book, he describes what it was like growing up among Holocaust survivors in the area of London, I believe, he grew up in. One of the many things that stood out to him was that they all focused first on building the future before tackling the enormity of what happened in their past. This choice would ensure survival for them and for their newly created families, a choice informed by both Jewish values and practicality,

In media, we have all seen scenes in movies and TV that show the person visiting their “therapist” endlessly rehashing what happened to them in the past as a way to gain insight into the present. My main teacher, Gerald Epstein, MD was initially a psychoanalyst but eventually changed once he met his teacher. His perspective on working on people’s “stories” of the past, fell away to work with people on their being more aware of the present and actively working to let go of the past.

When it comes to health of the body and mind, I am not neglecting factors of the past that play a role. Taking a good history is a starting point in any medical examination. What I am suggesting is that when it comes to making decisions for today regarding your health, a focus on finding a direction to move towards after letting go of your past tends to be most effective for individuals.

Forward movement becomes much easier when you have let go of the past. The past can be an anchor dragging you backwards. It’s dead and gone, now is the time to focus on forward movement and the best you can do is to decide on a direction and take your first step. It is liberating and is what your body needs. Take baby steps, it could be after a few baby steps you will need to re-adjust. Maxwell Maltz, MD used to explain that people on pursuit of a goal are like a self-correcting missle that endlessly corrects. In the beginning, you may zig and zag before finding the true direction. The key is to get going and a baby step is the way to go.

And with all I have just said, dealing with your past can eventually be done just as those Holocaust survivors eventually started to discuss their experiences many years later. Gerald Epstein, MD taught many strategies for “reversing” how your body reacts to past memory so it neither defines you nor affects your movement towards the direction you want to go. In fact, whenever I would start to reflexively hypothesize why something was the way it was based on the past, he would just utter the word “STORY” to bring me back to the moment so that I could get back to the present moment to focus on the direction I wished to go. We are quite good at constructing endless narratives / justifications / rationalizations to find reasons why something happened. Perhaps, this endless search for answers to the problems of our past are better left in the past. First, find the direction that is healthy for your mind and body and then take the first step.

A Covenant of Health

There are quite a number of well known physicians who have spoken extensively about how public policy (read politics) should be used to change the dietary patterns of the population to improve the overall health of the nation. Perhaps, there is another way.

In his book “Morality : Restoring the Common Good in Divided Times” Rabbi Lord Jonathan Sacks, describes 3 general ways in the public sphere that one can lead people to a desired goal. There is economic, where one pays for someone to do something. There is political, where one makes one to do something. And there is moral sphere “where we persuade them to do so because they and we are part of the same framework of virtues and values, rules and responsibilities, codes and customs, convention and constraints.”

The problem with failing back on politics and economics to implement change is that it ignores the moral dimension even if that very intention in the first place comes from a place of deep caring and concern for the health of the nation. The economic sphere has also been used through tax penalties to avoid certain foods and then there is the whole world of food subsidies from the government which exposes all too well how families’ health has been damaged by the influence of special interests.

Sadly, like all big institutions the healthcare system tends to depersonalize both those it seeks to service and the service providers, not out of a some evil conspiracy, it’s just the nature of huge institutions like healthcare, big business, big government, large organized religious institutions, and large educational institutions.

Many years ago I read a book on a program called the White House Fellows. Many names you know went through this program. I don’t recall the name of the book. Two names that come to mind that went through this program are Colin Powell and Sanjay Gupta, MD. This program gives talented men and women access to see the workings of government in ways unprecedented in civilian life and those who come through the program go on to make significant contributions to public life. My point here is that there is most certainly a role for people who understand government influence and want to use that system to achieve change. It’s one route to change just like financial. I’d like to look at change from another perspective, the moral one.

In his book Rabbi Sacks talks about society needing a shared morality. This can be extended to the health sphere as health involves alleviating human suffering. While the news everyday makes it difficult to understand dietary guidelines, everyone basically understands what junk food is and that they need to eat fresh or fresh frozen produce. So how do we extend our sphere of influence by including the moral dimension?

I think we do so by empowering people to be able to make their own choices when it comes to health. The first step is clearing up the conditioning around health. As Jonathan Sacks explains, we can’t outsource our morality to the state, and I’d like to add, we can’t outsource our bodies either. It is this mindset that robs our fundamental responsibility we have to ourselves, to become our own authority. We need experts and specialists who understand that the force and effectiveness of treatments and health guidelines are heavily influenced by how involved the person is in their own care not just for themselves but for their loved ones and for society as a whole. Dr. Kelly Turner, in her remarkable book, Radical Remission documents 9 features of people who healed from cancer despite the odds. One of the 9 is “taking control of your health.”

How can we, then, reconfigure the healing relationship between doctor and patient. I think again Rabbi Sacks in his book, Morality gives us an idea in his discussion of the family. The solution is to transform the contractual relationship into one where there is covenant, meaning where 2 come together to form an “us.”

In this relationship, there can be profound healing. I have deep gratitude for the patients I am privileged to establish just such a relationship. Each one changes me forever and allows me a glimpse of the immense possibility, miracle and learning that comes with healing. It recalls to me something from Ethics of the Fathers. “And this is what Rabbi Ḥanina said: I have learned much from my teachers and even more from my friends, but from my students I have learned more than from all of them.’ Just change “students” to patients and it expresses just one result of a covenantal doctor / patient relationship.

What is needed are healers who see and cultivate the covenantal relationship with their patients. Patients also play a role, the depersonalization of the healthcare model and the advertising of big Pharma has led to a situation where patients have very high expectations of immediate cure for most of the problems that plague them.

Healing as my teacher, Gerald Epstein, MD would remind me often comes from the root of a word that means wholeness and even holiness. That does not come from a pill but in establishing a relationship with your healer where your healer understands and respects your primary role and the ongoing journey to wholeness that needs to be undertaken.

Relative Health

In my dealings with patients, I have come across a phenomenon that needs explaining. People who feel fine are often unaware that they are in fact not functioning at a very high level of biological wellness. An MSQ (medical service questionnaire) can be helpful to bring some objectivity to the evaluation and also to track process.

My teacher of blessed memory, Gerald Epstein, MD used to pay very close attention to the images evoked by peoples choices of words. Expressions like “a weight on my shoulders” or the like express things in a way that can be very deep to the underlying issues. This can often highlight other issues that might be pertinent to the problem at hand and point me towards getting to a deeper root to helping people heal.

He was also very fond of explaining that tackling one aspect of your life and health often has significant ripple effects on other aspects of your being, those being physical, emotional, intellectual, spiritual, and social.

The challenge here is a profound one, identify one aspect of your life, perhaps it is some aspect of your health and with gusto correct it. Don’t worry about all the things in your life that seem to be awry, “that’s life” as Frank Sinatra said. Life is tough and as that saying goes “Be kind for everyone is fighting a great battle.” The other side to this quote is, forget the great battle and focus on that aspect of your life / health that you can fix. It could be as simple of avoiding sugar for 21 days or walking 20 minutes a day, or even getting rid of some food in your house that is no good for you.

Then, watch what happens. First, expect some resistance, this is the nature of this world. Second, let go of expectations of when and what the positive change will look like, just be patient and know that it will come. Third, be on the look out for an additional simple thing you can do to improve your health because what will happen if you follow the above steps is that with time, you will imperceptibly be taking on harder and harder challenges.

The reward is that you will find other aspects of your life start to open up. You also start to realize that how you felt before in many cases was far from vibrant! Could that one first challenge be the first domino to fall in a change where your whole life transforms? Yes, in fact it is the only dependable way change ever happens.

Please comment below. I am seeking to become a better writer and appreciate critical comments on the presentation of this short blog posts. Personal attacks will just be deleted so please stick to the ideas and the writing.. Read my post Speech as Spiritual Practice for my thoughts on that.

Speech as Spiritual Practice

“Men and women range themselves into three classes or orders of intelligence; you can tell the lowest class by their habit of always talking about persons; the next by the fact that their habit is always to converse about things; the highest by their preference for the discussion of ideas.” — Henry Thomas Buckle

Over the last 2 weeks, I have spent some time on Twitter to see what that platform is about. After following quite a number of people, I then unfollowed for the negativity that I was exposed to. In the Hebraic tradition, there is something called lashon hora, evil speech. It is said that when one talks negatively about someone even if it is truthful, 3 people are harmed, the one doing the speaking, the one listening, and the one that is being spoken about.

It goes even further, shaming one in public is akin to murder, murdering their name and causing shame. Since a great deal of twitter is about this unfortunately and it is quite clear that people don’t really see the potential negativity, it is a platform with considerable risk to your health, as it opens you up to negativity which has an absolute direct effect on your immune system. Additionally, it normalizes negative pathological association with others which is degrading to your self-identity, as it associates you with people who are not good for you.

So, now, when I am on twitter, I unfollow as negativity comes.

What about the negative things that are happening in the world? What if I want to engage in discussion about that? To this question I would respond by reminding you of the quote at the top of the post.

I was very naive in thinking that following noted health authorities would keep me from such evil speech. On Friday I came across a few posts about a new book coming out by a noted author. Remarkably, noted physicians spoke disparagingly about the man, questioned his motives, and degraded the book without even reading it. This was evil speech, intended to harm the reputation of the man and cause financial distress by making sure that others didn’t buy his book.

It’s irrelevant whether it is true or not, in this case, I know it to be untrue as I had the opportunity at a conference in Montreal last year to discuss his modalities with his head nurse and was impressed and know that he does good work. Similar posts showed another well known physician heard on many podcasts literally throwing another authors book in the trash and mocking the author of the book on personal terms. I happen to know the author of the book that was in the trash and know every personal claim made about him to also be untrue, but again, it doesn’t matter if it is true or not.

So, now I find myself unfollowing even noted health authorities. What is one to do with the anger against some individual for espousing ideas that one finds harmful or detestable. It’s simple, engage the ideas and not the person, even if the person’s personality is somehow intimately linked to his ideas.

This is a spiritual practice, it takes work, it takes considerable thoughtfullness, it takes commitment especially in this age. The end result is a sense of inner calm and a palpable increase in self-awareness of your speech, which is the most sacred aspect of your interaction with the world.

In the Bible in Deuteronomy, it says that one should appoint Judges and Police at the gates of the cities. The Hebrew mystics said that the body should be seen as a small city. The gates are of course, the eyes, ears, and mouth. The problem we all face is that we don’t realize that who or what we let in can cause damage to the our body, the little city. Use platforms like twitter carefully and when you need to allow some ideas or people with bad intentions into your city, please make sure that your inner police are watching that they don’t infect the city.

Honoring Genetic Variation

Use of the word honor in this case should be read as having a high degree of respect. The path that your ancestors travelled is built into you in mysterious ways molded from the challenges they received from the environment. These crafted you in perfectly unique ways, such that you are unique and beautiful.

Epigenetic influences from the environment can turn genes on and off like a switch. There are however, certain genes that code for enzymes that are your unique fingerprint and don’t change. The funny thing is that while CURRENT influences (food availability and choice, stress, hormonal levels etc) won’t significantly change some of these in your life, over many generations they can change. Let me explain with an example.

There are enzymes, FADS1 and FADS2 that convert plant based fatty acids to become long chain fatty acids found naturally in seafood, what you might know as omega 3 fatty acids like DHA and EPA found in an omega 3 supplement. It is hypothesized that as populations started eating more plants genetic pressure led to individuals who could convert better, the plant based fatty acids into the long chain fatty acids. Certain Inuits in Greenland who were eating nothing but seafood and land animals had the opposite pressure. They didn’t need any more of these long chain fatty acids as they were already getting the final product without having to convert plant based fatty acids to long chain fatty acids already found in the seafood and organ meats they ate.

Ancestral cultures even had some knowledge of supplemental importance of these for pregnancy and brain development. Reference needed but I was told by a mentor of mine that there were certain tribes that would send the young men hundreds of miles to the sea to gather fish eggs for the women of the tribe who were pregnant. The basic science of brain development demonstrates the critical need for DHA and is the reason why DHA is incorporated into baby formula.

Similar adaptations, of course, can be found in the genes responsible for processing dairy, which arose due to the need by some communities to rely on dairy as a critical source of calories in certain historical periods. Unfortunately, due to the diet wars, I have to state the obvious, that even if you have the gene to encode for digestion of dairy, doesn’t mean it is healthy for you, it just means that you can digest it better than someone who doesn’t. If you lived a thousand years ago and didn’t have access to Whole Foods and you had to rely on dairy and didn’t possess lactase, it is likely you would have been quite ill. The main difference is of course, that DHA and EPA are what are called conditionally essential nutrients meaning you do need to have them in your body whereas there is nothing in dairy uniquely needed for the body.

As I have discussed at length on my youtube channel and briefly here, there is a very specific difference in physicians like myself who love personalized medicine catered to the beautiful uniqueness that is you and those physicians who advocate for a specific diet for the the masses. As an example, there are doctors who feel that since there is no common absolute disease state from avoiding seafood or omega 3 supplements, that there is no need for even the discussion of supplementation. (Of course, an Greenland Inuit on a vegan diet would absolutely need an omega 3 supplement) One flaw with that logic among many is that as we have learned thus far in other posts, while an overt disease state with a specific ICD-10 code and a chapter in an internal medicine textbook to describe it might not exist for the common individual with even poor conversion rates and a low omega 3 index, failing to thrive, depressive symptomatology, and not functioning at your optimal capacity is also a disease / dis-ease state that can be seen as a result, even if it is not in the majority.

It is why I love personalized medicine and love the evolving field of genomics and advanced diagnostic blood testing. You need to become your own authority in health and for the advanced thriver getting a genomic analysis done (or in this example, an micronutrient analysis also that includes essential fatty acids) and having a sincere conversation with someone who has guided others in understanding the results can be so wonderful. Incidentally, I do these for free, maybe when I hit 300 or 400 of these genomic analyses and feel myself an expert I might charge for the time 🙂 This knowledge can turn for example, non thriving vegans into thriving vegans due to this analysis and yes, one of the many interventions could just be a DHA supplement based on genetics and symptomatology. There are other genes that impact beta-carotone and vitamin a as well as genes that would influence the choice of which specific type of b12 supplement to take and many others. The field is growing by the day and data shows that changes made as a result of this analysis “stick” more than kind hearted suggestions from a well meaning doctor 🙂

And yet, those with a population wide mindset will look at these suggestions and say, you are working with such a small population as to be insignificant!! And that even I state that the suggestion for supplemental omega 3’s is very narrow! And to that I would say, each individual needs to be honored, and one person who goes from merely feeling good to great and now thrives can change the world! When you can take a person who is feeling fine and is now feeling great, most never realized that they could feel the way they feel now. There are levels of wellness that most people have no clue about. This, of course also pertains to people who are omnivores like myself. A vegan poster on twitter influenced this post and so I am using this very narrow example to illustrate a point. Population wide suggestions are very important but they intend to move people over the finish line but they often fall short even if major societal health statistics improve. To bring a person over the finish line, though, they need to be empowered to work with their own uniqueness and it is my job to empower them. This is where the magic of medicine starts in my opinion. Once they pass that finish line, new horizons of wellness and achievement open up and quite frankly they start empowering others. Being a part of this process is my path in life.

When Tolerance is a Vice

How could tolerance be a vice? Isn’t tolerance a virtue?

Let’s start with the definition :

Tolerance – “the ability or willingness to tolerate something, in particular the existence of opinions or behavior that one does not necessarily agree with.”

When one uses it as a way to feel superior since one is showing “tolerance” and continues to look down on another, it is clear that it is a vice.

What we see here is the tyranny of conclusions. When one “tolerates” another, he has often ceased the act of trying to understanding the other. He has made a conclusion that he will merely tolerate the other. Following this act, either indifference follows or festering hate or superiority.

In this case, raising the practice of tolerance to the highest value in society can have the complete opposite effect. It can stop understanding in its tracks through the act of a well meaning person feeling as though through the act of tolerance he is acting in a civilized manner, meanwhile internally conflicted or completely apathetic with no further desire to actually understand the other. The opposite of tolerance in our day is probably not intolerance, but sympathy, understanding between people.

And what about when it comes to health? What about the role for the rebuke? Do we merely tolerate those who we know are making poor health decisions? I’ve been taught that people are free to make their own decisions about their health but that it is my task to report to them what could be harming their health. It is not about tolerance, it is about preserving the freedom of the other to not listen. In ancient Hebraic teachings it is clear, one is not allowed to hate the person making bad decisions, nor avoid, nor disparage, nor harm, but it is allowed to rebuke and as the great medieval sage Rashi said commenting on the biblical verse about rebuke, it should be done in private.

In the archetypal sense, the healer / doctor should not be tolerant by our societies definition, but should strive for sympathy all the while reporting / rebuking in a healing way what needs to be corrected in the context of a private doctor/patient relationship. At that point, it is out of your hands and you must realize that the patient can choose to do otherwise and no judgement is needed. If you do not rebuke you have failed at your sacred duty. Use your heart and creative mind to learn how to do it with the most sympathy possible.

As for the healers of society who we lack, we shouldn’t look to those in politics who are motivated by ideals and power, not sympathy and healing. Nor should we look at those who strive for more and increased tolerance as it has been described above which results in internalized hate, lack of sympathy, and in many indifference. What I think we really crave is people who love us who aren’t afraid to rebuke us with sympathy and caring.

Competence Downshift

“Be careful about the government, as they approach a man only when they need him. They seem like good friends in good times, but they don’t stay for him in time of his trouble.” Ethics of the Fathers 2:3.

Competence downshift describes the change in language that white liberals use when talking to minorities. White liberals “presented less competence to Black interaction partners than to White ones.” (Dupree, 2018) Reading the whole article is enlightening. I am not questioning their motives, I am more concerned with this phenomenon and what it means for health and the information presented to you.

I have frequently seen this downshift occur based on race, education, and socio-economic status in the medical profession.

Dr. Robert “Rhondell” Gibson taught that there are 4 games being played in the man-made world and this downshift happens in all 4. They are :

  1. The organized religion game – this one tells you who is “good “and who is “bad.”
  2. The power policies game – this one tells you who is “in” and who is “out.”
  3. The healing arts game – this one tells you what is “normal” or “abnormal”
  4. The big business game – this one tells you what is “ugly” or “pretty.”

Competence downshift is not just an isolated peculiar phenomenon of white liberal politicians speaking to minorities, it is rampant throughout society and appears to be more common in liberal minded people. The reasons don’t matter. Be aware of which game is being played and how you are being spoken to / lectured to based on what might be perceived to be your identity regardless of the reality of it. It matters because to become our own authorities in making decisions health or otherwise, we seek to not be caught in these games and not held to abnormally low expectations based on the high priests of these 4 games.

What we seek and sometimes need to demand is what has been taught in all traditions, the presence of a real world interaction and connection where each person is unique and each acknowledges the spark of the Divine in the other and makes them neither higher or lower in terms of their ability to make decisions on their own. Yes, there are experts and mentors that we should seek for help, but the great teacher is one that doesn’t downshift and doesn’t hold expectations. They are the patient teachers our great traditions have spoken of for thousands of years. We sure need more of those! With the above in mind, it certainly isn’t a wonder, is it, that these teachers were held in contempt by those playing the 4 games.

The End of Hobbies?

Well, maybe not the end but how many people now use all of their extra time on social media instead of cultivating a new or existing hobby? Do you think that you will ever regret not spending more time on social media? Let’s look briefly at some of the benefits of a hobby.

1. Sense of mastery and mystery. Hobbies can elicit both. Awe at how good someone’s skills can get and how it is never-ending. Hobbies that involve mastery of skills or competition like chess or game playing. Then there is mystery, where you struggle to understand something that is very hard to understand, but you know in that struggle is benefit to the mind and maybe soul. Things like Talmud study in my tradition, which is an obligation but for many is also something that is done daily in the spirit of a hobby that fosters growth. Gardening, for example, can be both mastery and mystery. Reading can also be both. Meditation, also can be both.

2. Connection with like-minded people. Anytime one aspires to a great skill or knowledge, one needs to connect with others to gauge skill level and make connection.

3. Elevating consciousness. Like it or not, we are not meant to live in one active mode of consciousness and are meant to go between various states of higher consciousness.

I used build small model cars as a child and the concentration like consciousness of those hours I look back very fondly on. Why? Nothing else mattered, time become non-existent, I felt centered completely in my body and in my movements and craft, I craved even harder and harder challenges as my skills increased, and my mind and body was pursuing an aim that was beautiful to me. Maybe, our Creator would want most of life to be this way?

Now it is religious texts and medical literature that does that for me. I also study qigong now which is definitely in the mystery and mastery category as the movements elevate my consciousness to another level of seeming unending progression and discovery. I also now do hydroponic growing at home which also is a mystery and mastery hobby as I engage with the lives of my plants. This is time well spent and though my work during the time of seeing patients and running my food business doesn’t spur in me the benefits of the above as often as I would like, it is the time spent in my hobbies that give me the strength to pursue the goals in this other arena of my life. I feel a definite lack when I don’t engage in my hobbies.

And what among many things is it that detracts from this? Time wasted on social media, in gossip even if true, and on gluttony of the senses which also includes overly indulging in entertainment. There also seems to be guilt in some that you are being selfish by taking on a hobby. You aren’t!! So don’t crucify yourself on someone else’s ideal who sees pursue of mastery or time devoted beyond work as useless. Filling your life with knowledge, skill pursuit, and connection makes you have a richer life. Nuff said.

Photo by : https://www.pexels.com/photo/art-artistic-arts-and-crafts-background-1153895/

The 4 Errors of Experts

Here are 4 main problems you should know about when it comes to the conflicting advice one finds on nutritional and disease in the modern media.

  1. Emphasis on public health vs personalized health. You can’t generalize public health suggestions down to the individual. Each individual is different and has different needs. Public health suggestions are only a starting point even if very valuable for overall health statistics.
  2. The “experts” the media brings out are usually medical doctors, who are only reading the medical literature. Often, they are not familiar with the nutritional literature. Doctors are busy, they read the medical literature that comes across their desks. There is a whole world of nutritional literature that has nuance, depth, and remarkable work in it. This doesn’t necessarily contradict the medical literature but its emphasis is different. Doctors usually rely on a review article on the impact of nutrition and draw firm conclusions from that. I can’t tell you how often, I have read a review article and then looked into some of the studies they quote and find remarkably promising lifestyle or nutritional suggestions that are disregarded.
  3. Genetic variation can be an explanation for varying results of trials. In the near future, very specific genetic marker testing (snp’s) will be used to tailor medication and even supplement suggestions. When that field enters the mainstream which will probably take another 10 years, everyone will see the folly of making public health recommendations the end point instead of the starting point.
  4. The final error, is either from pure graft, protecting an opinion that the expert has held firm to throughout the years, or funding from various biased sources.

    So next time, you hear conflicting health advice, you can be sure, that one of the 4 above errors is being made.

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