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November 8, 2009 · Leave a Comment

051109BER713

Giant Party at the Brandenburg Gate

20 year ago tomorrow, the Berlin Wall was breached.  The first East Berliner to make it across – legally – was a woman named Angelika Wachs (news to me…old hat to everyone over here).

thefirst

Algelika Wachs

My favorite band of all time – U2 – performed a live show in Berlin this past Thursday to start the festivities, which will continue through this week.  We live 3 hours from Berlin, and may as well still be in Olympia, unfortunately.  The celebration isn’t history…but it will get close and I’d love to be there.

The U2 show was free.  All you had to do was get a ticket via the internet.  And you had to do it within a 3 hour time-span because that’s how long the 10,000 available tickets were available.  Being a free concert, you might find the need for tickets a bit ironic.

Even more ironic:  if you didn’t have a ticket, you couldn’t see the show.  Why?  Because MTV (the show’s producers) had erected – you guessed it – a WALL to obscure the performance.

crowd

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Danger: Broccoloi

November 7, 2009 · 2 Comments

 

broc

An R-rated food. Must be 17 or accompanied by adult to eat safely.

Highly-intelligent child holds up half-eaten stem of steamed broccoli:

Dad, will this make me dead?”

 

Family doctor Dad replies, “ABSOLUTELY, son.  Some stuff just wasn’t meant to be eaten by 3-year old boys.  Put it down quietly before you mom sees, and go get the chips.”

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Collapse!

November 3, 2009 · 2 Comments

can't take it

I'm SO sick...can't taxpayers just pay for my life?

Patient: “I think my body is shutting down” (but really I just want you to write me a doctor’s note saying I never have to go to work again d/t incurable back pain)

Me:  ”No, you’ll be fine. And sorry, but you need to go to work.  Neurosurgery won’t see you any more.  Pain management won’t see you anymore.  Things are as good as they’re gonna get.”

Patient:  Ok.  Well, thanks for try…try…uh….”

Stands half-up, then collapses on the floor.  ”Unresponsive”

Nurse:  OMG!  Call the ambulance.

I lift up her arm, hover it over her face, let it drop. “Limp” arm performs a curious “S” shaped drop maneuver, conveniently missing her face.  Vitals: 121/87, HR 84

Me: “You’re fine, ma’am.  Just let me know when you want to wake yourself up and get off the floor of my office.  I’ll be over here charting.”

Patient:  Suddenly revives…miraculously.  ”What hap…happened?”  Gets off the floor and returns to her chair.

Me: I have no idea.  See you in two weeks.

Her little episode didn’t even make it into my note.

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Numb and Numb-er

October 27, 2009 · Leave a Comment

I’m happy to announce that I now drive a Mercedes-Benz.  It’s true.  A real in-the-steel-and-glass Mercedes.  The model is a C-180, which is the 4-cylinder, 4-door model.  The smallest engine they make (great gas mileage).  To boot – it’s green, my favorite color.

I’m a doctor now, people.  Apparently helping sick people entitles me to the high-life.

Truth is, here in Germany, the term “hooptie” is a known, legitimate noun.  The term is used to describe nice German cars that are (usually) bought by Americans and then run into the ground.  You can pick up BMW and Mercedes hoopties for 500 euros.

 

merced

Mine looks just like this one...but way cooler.

My car isn’t exactly a hooptie.  In the States, it would probably have cost at least $5,000, maybe more.  I don’t really know because I’ve never been in the market for Mercedes-es.  But I got mine here for a few thousand bucks.  It’s still in good shape and as long as I take care of it (an expensive proposition in Germany), it should get me around for at least a few years.

That is…unless it takes a few years until my new monument to affluent living is allowed to take me anywhere.

Take the Army’s torrid and longstanding love affair with bureaucracy and combine it with 1000 years of rulership of the masses in Europe, you get the process I dealt with just to be allowed to drive a car.

Buying the car is easy.  But in this Germo-Americo Funkenthink, the quagmire starts there.  You first need a special driver’s license, which requires a half-day class and then a 130 question test ( which I immediately failed by about 15 questions).

You also have to have insurance on a car before you actually register it.  And, the car needs to be inspected.  But you can’t drive it to the inspector’s unless you have it registered and insured.  But if you fail the inspection, you’ve just registered and insured a car that sucks.  So, you have to de-register it (I did that – twice – before I settled on the Mercedes).  De-registering requires a trip to the local customs office (American) plus a second trip to the other customs office (German, 35 min drive), numerous forms, money, waiting and…all the while you still need the insurance.

So, I’ve been a little reticent to drive much unless I have to.  I’m always wondering if I actually have all the paperwork and proof that will allow me to stay out of jail were I to get pulled over.

Instead, I came up with an alternative (heh, heh):

Through some highly unfortunate events in my brother’s life, I ended up with his Harley motorcycle.  Now, make no mistake – I owe him for this very expensive bike.  It was a ‘take-care-of-my-hoss-for-awhile’  kind of proposition.  Of course, being a deeply loyal brother, I immediately agreed to “help out”.  But, not being a big Harley-lover, I…well, I sold it.  And I bought a BMW motorcycle instead.  Initially, I sold it to help fund out trip out here, and a portion of the Harley money was a HUGE help in getting us here.  That said, I GUESS whatever money we had left over should have been sent back to my saintly bro.  But with all these fantastic German road machines around, you sorta just get Beemer Fever.  What was I supposed to do?

And anyway, my bro is about 10,000 miles from me.  Is he really going to come get me when he realizes I sold his Harley?  I mean, c’mon, I did the guy a favor!  BMW vs. Harley is a no-brainer.

 

bmw

Mine's just a LITTLE less shiny and has panniers.

So I now fly along the German Autobahn on a R1150 RS BMW.  Riding a bike like that, in this part of the world (any part of the world if you worship BMW bikes) is an experience that is hard to replicate.  Harder to describe.  At 80 miles an hour, I blow by stunning autumn trees, taking in their blurred resplendence in shimmering hues of gold and yellow and red.  ”My” bike purrs along effortlessly.  When I lean over the gas tank and duck behind the faring, the engine sounds something like a sewing machine, but even softer, maybe more like two feathers rubbing together.

There’s only one problem…Germany is COLD.  The other day I left for work in the dark, road sparkling with frost, at a temp of -2.5 Celsius.  Buh-rrr.  And this is only OCTOBER.

The night before, I had received a notification in the mail that my car did not have the correct license plates due to a dating error in the – you guessed it – insurance policy.  So, should I be pulled over in my esteemed Mercedes for any reason, I could expect to be hog-tied, whipped and sent back to the States crisply folded into a shoe box.

Thus, while my longsuffering wife dealt with the paper-pushers in Hiedelburg, I rode the bike to work, frost and chill notwithstanding.  I do have some decent riding gear I picked up when I first got the Harley.  I have a jacket with armor in the shoulders and arms, and pants with knee and hip pads.  I have big thick gloves – also a “gift” *ahem* from my bro – and good riding boots.  All the gear is made to withstand serious wind and rain.

 

jeff_daniels1

"Got a little nippy back there going through the pass, eh Har?"

But I’m not sure any gear will hold up for long when receiving a direct 80 MPH sub-freezing air blast for 40 straight minutes.  Mine didn’t.  By the time I got to work, I was so cold most of joints wouldn’t bend.  I walked into the clinic like I was in a body-cast.  I don’t think I even spoke to my first 3 patients that day because I couldn’t unclench my jaw.  I just nodded compassionately with my hands buried in my armpits and gave ‘em whatever drugs they wanted.

I probably should have just sold the Harley and given whatever money we didn’t need back to my brother.  But instead I chose to buy a Beemer with the extra cash and freeze my face off in Germany.  If you love BMW motorcycles, you’ll understand completely.  You’ll probably applaud me for such a wise and intelligent idea.

I’m cheering, anyway.

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Sunday Church, German Autum

October 25, 2009 · Leave a Comment

Unforgettable….

20091025105519

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At Least Insurance Is Unhappy

October 14, 2009 · Leave a Comment


The day that medical insurance execs and medical malpractice lawyers are screaming that their sky is falling, is the day that the U.S. has gotten serious about health care reform.

It sounds like half that equation is at least whining, so maybe some modicum of real reform is coming.

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If You Want to Learn English…Move To Germany

October 10, 2009 · 4 Comments

The German village where we now live – Bruchmulbach – is surrounded on all sides by American military bases.  And we’re not talking quaint Alamo-throwback musket armories, either.  The bases around here are the real deal.

ramairRamstein – 10 minutes from us – is the largest Air Force base in Europe.  A totally self-sufficient fenced city, the installation comes complete with a 2-level mall, restaruants, sports bar with the requisite 38 flat panel high-def T.V.’s, 18-hole golf course, fast food, a police and fire force, grocery stores, gas stations, brand-new 10 million dollar pool facility (I’m lovin’that), preschool through high school and a wide array of corresponding sports teams, as well as a full-sized airfield with trans-continental military flights leaving and arriving daily.

Just up the road from us is Landstuhl Regional Medical Center, which is one of the largest military hospitals in the world and one of the largest hospitals in Europe, military or civilian.  As mentioned recently, I got lost in there and wondered if I would ever escape without the assistance of a space-time wormhole (I did, but it was close).

Oh, another thing your tax dollars fund is a complete bussing system to get all the civilian kids from their outlying German villages to the schools on the bases.  This made our initial choice to put all the kids in base schools a pretty easy one.  Teachers are shipped from the States all credentialed and up to the exacting standards of the U.S. Dept. of Education.  Schools have playgrounds and dry-erase boards and gyms and cafeterias.  The whole thing.

landstuhlLittle America.  Right here in the south of Germany.

But just the other day, I saw a patient who has lived in Germany for 40 years…and doesn’t speak anything but rudimentary German.  Clearly, you can live an entire life here and never really learn the local language, the customs or the culture.

The military, actually, is trying for this.  Most of their people have been moved here, will move again in 3 years, and so the more like America their lives are, the better it is for these families.  You even spend U.S. dollars on the bases, even though everyone for hundreds of miles in every direction uses Euros.

But for people like me, who came here volitionally and want to intersect with this new world, this re-creation of where I just came from, isn’t such a welcome thing.  Cindy Lauper had some chops 20 years ago, but do I really need to hear “Time After Time” as I drive across the pastoral German countryside on my way to work?

Since the bases here are such a huge part of the local economy-  wait, amend that: They ARE the economy here.  They’re it.  We’re talking millions of dollars every year from these military operations.  As a result, along with all the completely Americo-centric base workings, the local area totally caters to Americans too.  As soon as you say you want to speak English around here…they just switch over from their German to usually a very well-learned English.  Walking down the street in Portland, if some guy came up to ask you a question and said he only speaks German, could you switch over and cordially address his needs in his own language?

I couldn’t.  Not in ANY other language on planet earth.  MY ways are the ways of the world, right?  I should mention, in my defense, that for a few ultra-geeky years in Jr. High I might have had some hope using Klingon, but again, we’re talking about this planet.  And if I did meet a monolingual Klingon speaker in downtown Portland, we’d have much bigger problems than mere cultural ignorance.

stoneAnyway, our big decision (among what seems like a gagillion of them lately) was to pull the kids out of their American schools…and HOMESCHOOL them.  That’s right.  We’re pullin’ em out.  They can learn the 3 R’s in the AM, and work on German during the afternoons.  I’m hoping to find some nice German grandma who misses her kids to come over 2-3 times a week for cheap to tutor them as well, and we just bought Rosetta Stone, homeschool edition (created for monolingual parents with visions of grandeur).

If I leave here bankrupt and sick with some strange German microbe that ate the flesh off my face and all tips of my body…but my kids learned fluent German, I’ll be perfectly happy with our time here.  I promise.  No complaining.

Don't worry about German, kids, just keep up with your AMERICAN

Don't worry about German, kids, just keep up with your AMERICAN

The military base schools have a German “appreciation” class, but they should be ashamed of it.  It makes no attempt to actually teach the German language.  It’s just meant to let kids know about life in Germany (makes sense, if you live in Thailand).  The first class consisted of some guy opening up his laptop and reading off Bill Gates quotes – in English – about following your dreams and not letting anyone tell you you’re a loser.  Frankly, if enough people tell you you’re a loser – in, say,  French, German, Farsi, Hindu, Arabic, Japanese, Chinese and Russian – at some point, we Americans might want to listen.

And, when approached critically, I have to say that much of American school is laughable.  So much time is spent lining up, obeying, filling out forms and being entertained…I’m not sure that kids learn much at all.  We’re certainly not keeping up internationally (AGAIN!  Health care, education…what ELSE can the rest of the developed world do better than us?).

Hey Man, I'm an ARTIST, man!

Hey man, I'm an ARTIST, man!

In France, for example, every village kid is entitled to real, genuine, music training in their local villages.  As part of their taxes, every kid gets a solid hour a week of actual music theory.  I’m talking just the bookish part of music for an hour every week, no instruments.  The boring stuff.  The hard stuff.  The stuff nobody has to learn in the States unless they REALLY want to do it, go to college to learn it, and spend 2 years on lower-level classes before they’re allowed to jump into the real thing.  This is America!  Learning is FUN!

Back to France:  THEN, kids get an hour a week of training on an actual instrument.  This would be the fun part.  The payoff for muddling through a weekly hour of theory.  They learn with a private instructor, in small groups of 4 or 5.  THIS is the way to actually learn music.  For American taxes, kids get some goofy music appreciation class where 55 kids sit around listening to “Bridge Over Troubled Water” while making sure to keep their legs crossed.  In my 6th grade music class, I got to listen to a recording of Janis Joplin mumble in a drugged stupor on stage until she collapsed.

germangIt’s true that our 4 kids could end up total imbeciles.  I don’t think the U.S. Education system is totally worthless, and there are some good things about the schools that we will lose.  We worry about that.  But I think, given the options, that our Rosetta Stone + Grandma approach holds out at least as much hope of truly teaching our kids another language and culture than what is offered on the military bases.  With good curriculum and focus, we should be able to get them up to speed on the academic topics too.  We aren’t the first one to plow this field.

Then again, we’ve been at it a week.  I’m still all filled with principle and certainty.  We’ll see where we are in a month.

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Get On the Plane!

September 25, 2009 · 2 Comments

Jerry reluctantly entered the WTU, the unit I oversee as a doctor, just recently.  This soldier has achieved about as much as anyone in the non-officer ranks can achieve.  He’s been in the Army for 24 years.  After 20, you can retire with full military benefits, but this guy hung on by voluntary extension for another 4.

He entered my unit because of a health problem list that runs to 6 or seven issues.  The primary ones being kidney disease and hypertension.  He’s had both for years.  All untreated.

“Why haven’t you taken care of this stuff?” I ask, ready to get all righteous on the Army.

“Well, you can only do what you can do, sir.”  He says, politely pretending that I would outrank him if actually a soldier myself.

“Um, do you know how long you’ve had hypertension, and how bad it’s been?” I say, trying a different angle.

“Listen son, I know exactly what my blood pressure was averaging before my last deployment downrange.”

“How many times have you been deployed?”

“3.”

Making no effort to hide my surprise, I reply, “You’re peeing out half a bicep in protein every 24 hours, your blood pressure is 190-101 today, and you’ve been deployed 3 times?  Each time for over a year?”

“Son, when the time comes, you gotta get on the plane.”

“So, you knew about all of this prior to deployment?”

“Which time?”

“ANY time!”

“Well, sir, yes I did.  But I told my men, ‘When it’s time, I’ll be getting on that plan.  If I don’t, I’ll be dead.  If YOU don’t get on that plane after me…I personally hunt you down, I will find you, and then YOU’LL be dead.”

“There’s doctors downrange, though, right?  Couldn’t you be seen by one of them?”

“Look, I cain’t treat myself too well with the boul-ets whistling over my head.  And I’m not gonna tell nobody that I got problems at a time like that.  They’ll send me back home and leave all my boys there to fend for themselves.”

“Right.  What was your blood pressure prior to your last deployment?”

The thin, muscular man thumbs through a huge stack of medical papers, “Hmmm.  I remember that day.  Headache, bad.  Seeing spots and stuff.  Hmmm.  Oh, here it is:  224/112.”

“That was your blood pressure before you left for a war zone!!??

“Son, you won’t understand because you ain’t never worn no uniform.  But when the plane is for you…you get on that plane.  It’s pretty simple, really.”

“Do you think, just maybe, I can get you to take some blood pressure pills now?”

“Oh sure, doc!  You bet.  Army brought me back safe and sound, see?  Doing fine now.  I’ll take them pills.  Hooah, boy!”

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Ode To Mr. Fingerprint

September 18, 2009 · 1 Comment

We can’t figure it out, exactly.  There isn’t one thing that we can point to and say, “Yeah!  That’s were everything became too much.”

But somewhere along the way, this little adventure piled up and reduced both of us to tears.  How the Army manages to organize itself enough to go around the world killing people – unless through excessive paperwork – still mystifies me.  But I can say that if they just stuck to the paperwork – threatened to attack the terrorists with administrative paperwork – world peace would be ho-hum news. 

“We give up!  We recant!  Never mind all that Allah stuff!  We’re Americans now.  Look, look, we’re buying Hummers and we all have flat-screen T.V. in our camel-skin tents with only CNN and Disney channels on them.”

I will say this:  With exception of the laudable fingerprint dude, I have never been to an Army office and gotten done what I came there to do on my first attempt.  Never.  And, for the guy to do my fingerprints that day, he had to overlook 2 reasons to send me away. 

If I’d had a trophy, I would have given it to him.  I DID sing his praises; describing his feat in a halting, emotional, too-grateful voice.

“I….I….I just want to let you know that.  *AHEM!*  Sorry, something in my throat.  Some sort of lump.  Anyway….”

Corpulent man in too-short square tie knit by kids in Taiwan R.O.C. funded by Wal-Mart stares dully, shifting slightly in his creaking office chair.

“You’re the first, EVER, to give me what I came to get on my very first attempt!  It’s a record.  Over the past 6 months, in dozens – maybe hundreds – of office visits my wife and I have needed to make just so I can do a job, you’re the first to not send me away on my first request.”

“Huh.  That’s good.  Fill out an I.C.E. card, alright?”

“What’s that?”

“A card.  You know, a card.  Tell ‘em how I’m doin’.  Let ‘em know I set you up.”

Right.  I.C.E. card.  I took that thing home, spent 45 minutes filling it up with love and gratitude toward the first man EVER to spare me making 2+ trips just to get a simple administrative task done.

Then I realized it would take another trip to that office to put the card in the guy’s box.

And I shredded the thing.

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Escape From Landstuhl

September 7, 2009 · 1 Comment

Cross the Death Star with a human lymphatic system, throw in your average garden-variety octopus…and you have Landstuhl Regional Medical Center.

The hospital twists, turns, slants and echoes so much that a NASA-sanctioned GPS would probably get lost in there.  I sure did.

I took my first of many computer security classes there yesterday.  In a rush to make the class on time, I never really took note of where I entered the building.  Thus, getting out became quite a challenge.

As I “toured” the hospital megaplex after class, I kept a stern “I know exactlywhere I’m headed” look on my face in an effort to avoid appearing lost.  Looking, or being, lost on military facilities – thanks to Bin Laden and Friends – can lead to security checks involving 3 forms of ID, fingerprints, sphincter tone analysis, rectal probe, tongue samples, etc…if you’re lucky enough to get the “abridged” check.

Most big hospitals are labyrinthine, torturous and seemingly infinite.  LRMC is the largest military hospital in Europe and fits that bill perfectly.  Frankly, I think the place is actually some form of mushroom, with tentacles that connect it to other hospitals all over the world.  Take a wrong turn, ride the shuttle, cross the sky-bridge aaaand…you’re at Tulane.

Anyway, as I walked briskly along a hallway that quizzically descended – in an innocuous manner reminiscent of C.S. Lewis’ gently-sloping road to hell – for at least 2 city blocks, I began considering the possibility of an extended stay.  When I finally reached a turning-point I looked back and took in a disquieting view of the hallway disappearing upward into the dim horizon.

There were some maps on the walls, occasionally.  But the Army seems to disdain those little ‘you are here’ flags/dots/emblems.  I can imagine their indisputable logic running something along the lines of, “If we told you where you were…why would we need to put up a big huge map?”  Anyway, since I didn’t, in fact, know where I was, each map I passed looked exactly like the one I just left.  Eventually, the maps took on the appearance of wall art: cheerful, engaging, useless.

Thus, like Gretel leaving bread crumbs behind her in the forest, I started making mental notes of landmarks and where they were in relation to where I was going.

At one point, I passed a cafeteria.  ”Note to self:  as with all hospital cafeterias, you can smell it before you see it.  Shouldn’t be too hard to make it back here.”  Later I passed an ATM, “You can now access cash.  Just remember this location relative to the waning smell behind you.”  Eventually, I found a bathroom, with a lockable door.  ”Good.  All the essentials.  You can survive for months if necessary.”

10 minutes later, I happened to glance sideways on my way into yet another crooked, sloping hallway, when I noticed the security station that took my ID when I entered.  Just happened to be sitting there.

Staring dubiously at the surprise security station, I found myself willing to give sworn testimony that no such station existed in that location each of the previous 3 times I’d passed through the hall that day.  Therefore, the only logical explanation for such phenomena, I sagaciously surmised, was that the security station appeared and disappeared on some mystical space-matter time loop much too multi-dimensional for my simplistic 3-D brain.  Quickly, before the portal closed, I escaped through it and found my car.

Sure, I could have just asked someone for directions.  But I didn’t for three reasons:  First, and most understandable, is the whole ‘men don’t ask for directions’ thing.  Some genetic force I couldn’t hope to resist simply forbade me from getting help.  You can’t fight Darwin, people.

The second is that I had no idea how to explain to someone where I wanted to go.  My car sat patiently waiting for me in a parking lot the size of a Boeing hangar, somewhere on the hospital grounds.  Which lot?  No idea.  Which door did I come in through?  Never thought to look.  Plus, I wasn’t even confident that the security station wasn’t actually some sort of  translocating plasma-like substance only remotely related to common matter anyway.  How am I supposed to describe that to someone?  ”Hi, Dr. SW101 here, could you please direct me to the nearest undulating plasma worm hole exit portal please?”

The third reason relates to my initial concern: security.  Ask the wrong guy where the front door is, and I really COULD end up locked away in that place with pressure probes under my eyelids for the next 10 days.  Better to just find the space-time anomaly on my own.

I won’t be working here with any regularity, so I may not ever learn the twists and turns of that hospital.  Then again, I’m fairly certain that, actually, nobody knows where they’re going in that hospital.  They just wander around, doing the jobs their certified to do, until they see a door to the outside world.  Quickly jumping through the worm-hole, they take a breather, check in with family, then eventually cross back into the tunnel-world and start over.  After a few years, it probably works out to 8-hour days.

I imagine all kinds of hospital staff probably just wander into any open room they find, and act like this is where they’re supposed to be, ”Oh!  Hello, uh, I’m YOUR DOCTOR today.  Looks like you got some…uhhhh, let’s see here on the chart…renal failure.  Great!  Ok.  I can handle that.  Of course, bummer for you and everything.  Ahem!  Well, umm…peeing yet?”

“No.  And you’re the 14th doc I’ve seen in 3 hours.  Last week when I was on 3337L, I didn’t see a doc for a week.  What’s up with that?”

“3337L?  Where the heck is that? No wonder nobody rounded on you.  But I know why doctors are seeing you now.  Probably nurses and social workers too, huh?”

“Yeah.  And 3 chaplains, a medical transcriptionist, a zoologist, some guy playing a harp and 8 phlebotimists.  What’s the deal?”

“Take a deeeeep breath.  Smell that?”

“Hospital cafeteria, right?”

“Exaaactly.  You’re right next door.  Lemon chicken with tossed-in beenie-weenie and pineapple chunk sauce today.  Don’t worry, dude.  You’ll always have plenty of people dropping by to see you now.  Everyone can find thisroom.”

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