Wombats, Platypi, and Kangaroos.... oh, and people, too!

OK, so the only wombat I saw was stuffed, the platypus was almost certainly a duck, but there were more kangaroos than I could count.

Friends are asking for my travelogue of Australia. I am finally awake and caught up on laundry enough to try!

The trip over: via Abu Dhabi. Desert after desert. I've never flown over such aridity. A moonscape. It was overwhelming and disorienting. It swallowed up the endless ocean before and made me less intimidated by the ocean to come.

Boarding flight for Perth spied two other women with blue hair. Good sign.

Arrived Perth pretty spry and giddily smug: my back didn't hurt at all. All credit to Dr. Charles Seal at Blue Ridge Orthopaedics and Julie Royal and the team at Innovative Physical Therapy. I went to them with the worst possible idea: despite chronic mind-altering back pain from a torn disk I would still like to sit for 48 hours round trip on planes and yank around heavy baggage and sleep in five different beds and be very busy all day for two weeks, okay? They all said "why not?" and helped me with the pharmaceutical and exercise and stretching regime to not just get through it but to return home BETTER than before. I was prepared to return to my home airport on a stretcher but instead was simply and appropriately confused by the time zones. My lifelong dream of going to Australia and the great generosity of my hosts could have been spoilt but instead were saved and I am so deeply grateful.

Arrived Perth to see my name on a sign held by the estimable Don Irvine, my host and sponsor who felt like an old friend already. From a stubborn insistence that since I was already going to be in the country I need to stop by and "meet parents" in West Australia, he waved away my feeble objections and created a day-long event for local parents! He embodies "no worries!" combined with "get 'er done."

I arrived in the afternoon to a Swedish massage, a gorgeous sunset over Scarborough Beach, room service dinner with a cold beer, and a view from the balcony that staggered my confused but happy mind. Such spoiling is not the norm in my life. Man, did I enjoy it!

Sang for my supper the next day, where I learned far more than I may have shared, at the Bridging the Gap: Collaboration with Clinicians and Carers" eating disorders forum put on by Bridges and F.E.A.S.T., with partnership from EDTEC, Centre for Clinical Interventions, the EDP at Princess Margaret Hospital, the Body Esteem Program, and the Hollywood Clinic, and sponsored by the Mental Health Commission. I mention all those partners because it usually takes almost two years to put on a conference, especially to build a coalition to do so. Don and his collaborators pulled it off in about three months for a very engaged, well-attended room full of Perth area parents. 

my first Australian sunset
I learned important facts about Australians that first day in the country. One: Australians are incredibly polite. I have been around the world and spoken to many audiences. I've never seen any other place where people are so generous to the speaker and fellow audience members. I did not see one glance at a cell phone. Not a single loud candy wrapper. No loud whispering. No coming in late or stepping out early. No fidgeting or self-important speeches in the form of a question. Talks started on time and ended on time everywhere I went.

Two: this politeness meant that if I wanted to see a roomful of completely silent slightly worried faces all I had to do was ask for general comments. 

Three: something I should have remembered knowing my Australian friends and colleagues already -- do not take large sips of anything you don't want to go up your nose when you laugh, which you will, often, because the Australian sense of humor is both dry and mischievously timed. I cannot tell you how often I had to wipe my eyes after a laughing fit. There is no mascara equal to this problem.

video
The next day, after another blissful night's sleep, I solved the mystery fruit (persimmon!) in the breakfast buffet with the help of Facebook friends around the world in real time and finally the kind kitchen crew at the Rendezvous Hotel. I walked the beach at dawn. Picked up some shells and stood enjoying the exuberant surfers and realized (this SHOCKED my Aussie friends) that I'd never actually watched surfing up close. Weird but true: I grew up around skiing not surfing, and somehow missed this essential people-watching experience. It's similar: compulsive controlled falling on H2O. But surfing does look like more fun. No sharks on ski slopes, however.

That morning some F.E.A.S.T. families put on a buffet picnic at King's Park, where I got a tour of flora and fauna and memorials and the view from above the city of Perth. At the end of my trip a young friend insisted I declare my favorite city in Australia. It was Perth. Sorry, Melbourne and Sydney, but really, Perth is gorgeous and she was my first.

My mom used to sing me a song with the line "Kookaburra sits in the old gum tree, merry merry king of the bush is he..." Well, I now know exactly what a gum tree is. And, I know why the kookaburra was so full of himself: he steals! Gordon, a F.E.A.S.T. dad and able MC for the Perth conference, was gesticulating with a piece of bread when an enormous dark bird swooped down to snatch the whole piece and fly off with it! Tell this story to an Australian and they know it all too well. Tell it to an American and we say "Kookaburras are birds?" Yes, and what a bird. I loved the magpies, though. The trill of magpies were my favorite sound of the trip.

The Kings Park picnic was my first experience of Australian kids curious to hear me speak American. I'm sure I was a disappointment, though, because I later realized they expected Marge Simpson. Sorry kiddies! My favorite comment about my American accent, however, came from a friend who declared it to be more pleasant than she thought it might be, almost, Canadian....  High praise. I managed not to say that most Americans assume all Australians -- male and female -- look, sound, and carry large knives like Crocodile Dundee. Who I think would be a good partner to Marge Simpson, really.

this is not a snake.
The park was my first chance to examine Australian nature, and now I make my confession. I flew over with the belief that there is A Eucalyptus tree, and A Kangaroo. Hey, I'm only 54. Now I can spend the second half of my life properly schooled with the knowledge that there are many types of both. 

On a stroll of the park I lost at least a year of my life to fright over a Kangaroo Paw plant, because when someone enthusiastically points behind me and shouts "Look!" I expect a python, not a plant. But it probably made my blue hair stand on end like Marge, so...

Picnic over it was to the airport for flight to Melbourne, after only 48 hours on the ground. Happily, some of the WA friends would be joining the At Home With Eating Disorders conference, too, so it was partly farewell and partly good-bye. Thank you, Don, and Perth friends, for the welcome and the tour and the cookies and the beautiful present and, of course, the Kookaburra.

I've never been flown around the world and taken care of as on this trip, but I again arrived into the arms and hosting of a new old friend, Belinda Caldwell, with baggage behind me and no idea of what was ahead. I'm surprisingly good at this princess-like oblivion, it turns out. I may have been meant for it, because I noticed that my iPhone only needs the letters "P-R" and it autofills "PRINCESS." Just saying. Belinda gave me an evening tour sweep of Melbourne and installed me at a guest house near her family home in Richmond. Rotherwood is, indeed, "elegant accommodation close too the heart of Melbourne," and to my surprise I was the only tenant. Way above my station, I went ahead and enjoyed the heck out of it: the art, the luxurious furniture, the lovely sounds of the neighborhood. It was like a Victorian poetess stepped out in 1885 and never came back, but her retinue keeps things in working order for her return. I got to know the local shops, had my flat whites outdoors, and managed not to get lost when out on my own.

Belinda, who aside from being busy on the conference committee was also my guide and chauffeur and friend throughout, drove us out to see the author, June Alexander, at the Geelong Clinic where she guides a diary-writing workshop for the eating disorder wing there. There I had my first taste of both Vegemite and Lamingtons. (Not in the same bite!) Vegemite struck me as thick gravy spread thin. Lamingtons were lovely and multi-layered. So were the diary-writers, whose questions and observations and insights were an ideal first stop in my tour of Australian clinics. I enjoyed learning about their work, their recovery program, and June's diary project. Then fish and chips on the water. Bliss. I admire and adore June, so having time with her and Belinda was one of those quieter moments of "wow. I'm here. we're here. amazing." I had a lot of those moments these past weeks.

Hit the wall that afternoon and slept for 11 hours waking up for the first time feeling really human. The indefatigable Belinda, juggling conference duties and navigation and multiple schedules and phone calls, got us to three clinics in dizzying speed. First we had a meeting at CEED, the Victorian Centre for Excellence in Eating Disorders, where she serves as a Carer Consultant, and we had our first of the many teas (coffee breaks, American friends). I am excited at the work she is doing there and the wonderful collaborative model I see. I have a vision now of what could be if care teams included not only families but had the involvement of a Carer Consultant just as teams have psychiatrist and dietician and therapist around the table. The respect that the CEED team has for the carer perspective, and for Belinda's particular skills, offered a view of what could be happening elsewhere. I'd like to see where this goes!

these are meerkats at the
live human child
exhibit. 
Then it was a run over to Royal Children's Hospital where we sat in on a meeting of the eating disorders team over a Gold Coin Tea. Although I was childishly anticipating the meerkat enclosure in the outpatient waiting room (Adorbs!) I was instead disarmed and moved by the ED team's professionalism and focus. 

One thing I want to observe about that visit that I found consistent among those clinics in Australia that offer Family-Based Maudsley Treatment is the unapologetic manner in which they talk about it. One of my pet peeves in our field is the "it doesn't work for everyone" and the "when I think it is appropriate" and "only for young compliant patients" wording that many use. None of which is necessary because no one thinks FBT is "for everyone" or always appropriate. It's refreshing to hear people say "I do FBT" just as any doctor would say "I prescribe penicillin" without having to explain when they don't. FBT should, at this point, simply be part of the toolbox for clinicians treating eating disorders. No one should be treating EDs without being able to offer or refer to FBT. Period. No apologies or provisos. It's a tool. It is a set of clinical skills and principles that inform treatment that doesn't fit neatly within the researched populations. It isn't "controversial" any more and doesn't need to be apologized for.

Not that FBT is widely offered in Australia but I have to comment on the confidence with which those who do are able to talk about it. We need more of that elsewhere.

Last clinic of the day was a CYMHS clinic. I'm going to confess that when I arrived there and when I first sat down to hear about the program I was quite clear in my mind that eating disorders are always best treated in eating disorder specialist services. If you had told me that I would, by the time I stood up again, have a basic belief altered, I would not have believed it, but I did. My prejudice on this topic is twofold, really, or was. I have not seen non-ED specialists do well with eating disorders. But I also think most ED specialists are not doing appropriate eating disorder care. My personal solution has been to focus on getting ED specialists up to speed on the science. I had not thought, and yes I'm sorry, that going directly to non-specialists was going to work. Well, I'm now seeing a new vista of possibilities. The fact is, most ED specialists are quite set in their way of viewing the disorders and treatment. Unteaching is hard. But non-specialist mental health providers have a lot going for them: larger practices and therefore experience, more resources, and a broader sense of mental health care. Modern mental health care, especially for children and adolescents, assumes family involvement. Modern mental health care is increasingly integrated with larger psychiatric and medical and community resources. Eating disorder care is often in small, roped off, closely guarded practices surrounding a visionary leader or philosophy or diagnosis rather than the larger picture of overall mental wellness. 

The fact is, if eating disorder patients were assumed to need full nourishment, family support, to have a condition that is not their or their family's fault, and that their care should be aimed at both full recovery and healthy family functioning then would we really need to have them in specialist clinics? 

The problem isn't just that patients are not getting ED care it is that they are not getting good ED care in the community. So, I sat down believing that non-ED-specialists shouldn't be treating EDs and stood up thinking that what we may need to do is get ED patients into the care that is readily and more widely available and already has most of the principles of care in place and needs only to be trained in the particularities of these particular mental illnesses. Suddenly the possibilities for treatment expand a great deal (not enough, or nearly enough, because mental health services are "thin" on the ground all over the world, but certainly far, far more than just ED specialists).

So that was my Big Moment of that day. Better than the meerkats. And that's saying something.

FOUR different ways.
I ended my evening over dinner and then Golden Gaytime ice cream bars with my friend Cate Sangster's three darling daughters. They did somersaults and handstands, literally, for me. The girls put on the friendship bracelets my son chose for them: friendships symbolically tied across the seas. Should he end up marrying any of them we'll consider this the first act of courtship.We all experienced our first Custard Apple and declared it unripe and/or unpalatable, but I was beyond tickled to have that "first" with them. Apparently my face when offered Four Different Ways to Have a Gay Time was memorable to their mother.  Thank you, Cate, for an unforgettable evening. Also, for explaining Australian rules football. And no, I still don't get it.

By my fifth night in Australia I was no longer making people laugh by trying to get in on the wrong side of the car. I was still alarming them by stepping into the wrong side of he road. Belinda ferried me over to my next accommodation: the venue hotel Bell City. Fantastic sparkly view of the city. On the way we stopped at the Butterfly Foundation offices to help stuff the delegate bags with goodies and brochures.

OK, so when I travel I have this extraordinary opportunity to meet people with whom I have had, often for many years or many years ago, significant relationships or connections. The F.E.A.S.T. dinner, held at a restaurant training school, was one of those experiences. I catch the eye of someone who is unfamiliar to me by sight, and often me to them, but then when introduced we both "recognize" the other. There's a rush and tumble to explain, then total recognition. THIS is Bronwen, HERE is Claire, YOU are Alison, is THIS really Martine? But it is much more than names and contacts. It's recognition. It is having an honored place in someone else's life, some email on a significant day, some way one of us helped the other, a shared joke, a shared friend, a revelation or moment of vulnerability. I am nourished by these moments. I doubt my "real" friends in my "real" life can possibly understand why meeting a "total stranger" could be so meaningful and so deeply important but it is. These moments are why people like me do what people like me do, quietly at keyboards, without asking for a response, without requiring an update. It is those moments when you lock eyes with someone with whom you have shared important connection even if only for a short while or at a great distance or simply by introducing another person or idea then forgotten. These moments are why we "pay it forward" as fellow advocates. For each of us there are countless such moments out there that, if you are as lucky as I am, you get to have. This trip had several for me. You know who you are.

I don't really remember the food that night. I do remember meeting people who made me feel I'd come home because we knew one another already. Also, Cate brought the dreaded and much discussed new Vegemite chocolate for me: a gift or a punishment I'm not sure. Which I shared. Dear Claire was the first and bravest among us. Others had to be coached through it, which THIS crowd knew a thing or two about doing!

Sleep. Have I ever enjoyed sleep so much as during and after this trip?

Thursday: Belinda and I gave a workshop for clinicians first thing in the morning if only because the dear woman had two MORE presentations to give later. Sleep? I don't think so. It went well, I think. I enjoy presentations to professionals. Every single clinician has the opportunity to change the course of many, many lives. With good information they can save patients and families. Almost all are eager to add to their knowledge and skills. They ask important questions. They add important observations for their colleagues. Especially happy that Nicki Wilson and Rod McClymont were there to amplify and exemplify the principles both Belinda and I have learned and were there to share.

Saw the other conference keynote, Carolyn Costin, in passing. She and I have a longtime conversation going on how our different points of view about ED and treatment intersect and how they are incongruent. She set me the challenge of taking notes on that for us to discuss after the events, which I did. Most people in the ED field, and most fields I'm sure, don't actually listen to or try to understand conflicting or contrasting views. Carolyn does, and I like to think I do. Wish more would. It's easy to rant to your fans, harder to have a respectful discussion with others, but really: where does progress come from?

Cheered throughout, and stifled sniffles along with the Around The Dinner Table parents beside me, through a very moving workshop on refeeding in the afternoon. The audience's questions were heartbreaking, though. Too many had never, despite many treatment environments, been given basic information on the role of nutrition and methods for dealing with resistance. Too few were familiar with basic concepts of modern treatment. But that was the beauty of the moment: watching eyes open and notebooks fill. Lightbulbs were going off and courageous people on the last fumes of hope were inspired. The three INCREDIBLE parents who told their stories in the context of the background given by Belinda and her colleague and co-presenter, Michelle Robertson, put the lie to many myths about ED and about parents being powerless. Parents are POWERFUL. Good treatment that involves parents and understands the role of nourishment in eating disorders is LIFESAVING.

I used to be shy, especially in crowds. Would avoid them and sit in corners with a book or notebook observing. This reticence is not a luxury I can afford as an activist, so I've become quite the social butterfly. I can march up to folks I don't know and start a conversation with anything breathing. I couldn't do it for myself but I learned to do it for A Cause. And eating disorders treatment is a Cause I believe in. So I met a lot of people at the social that evening. Lovely people. Then enjoyed drinks and dinner afterward so much. I was like a kid out of school. A princess with her slippers on.

fans at Bondi Beach ask for autographs.
(or, probably, fish and chips)
I was asked many times to sign my books, which were available. That's fun. I love talking about Charlotte, for one thing, so my blue hair streak and blue book gives me that opportunity and on this trip I was able to hear from so many people who knew and cared about and were grateful to her. She was toasted many times. My first book was also available, reissued with a new cover and foreword, and I was tickled to hear anecdotes about that one as well. 

Best story: a mum told me she was glad about the reissue because for years she wanted to lend her original copy out but just couldn't find it. One day her daughter confessed that she had torn it up page by page! Love this! 

I didn't have either of my newer books with me, because they have nothing to do with eating disorders, but it was fun to talk about them as well. After a long time of being only an ED parent advocate I'm finally "all of me."

Friday morning: my keynote presentation for At Home With Eating Disorders. My PowerPoint will be available from the conference committee soon but since it is mostly pictures and visual puns it may not make sense. I'm working on an audio narrated version. 

The conference featured an excellent combination of information on the science of EDs and lived experience by parents and families. I was struck by the enthusiastic questioning of one panelist, a recovered patient, and some of the later comments by parents that showed how keenly they needed to see examples of fully recovered people and their families. This is a tough one in our field, and one on which I have mixed feelings. On the one hand OF COURSE we all need to see the reality of recovery. We need to normalize that and fix our sights on it. On the other hand the burden on the recovered people can be overwhelming and there is an expectation that the recovery of one person has lessons for others. Recovery CAN mean insight and inspiration. But it can also happen without insight or answers for others. I worry about recovered patients being overwhelmed, having their experiences overanalyzed, and there is a risk that patients feel pressured to have answers. In my opinion the best thing that recovered people can do is get on with their normal lives, and their normality be the goal. They don't need to be heroes to be OUR HEROES. In this case the young woman who talked about her experiences with recovery was everything anyone could hope for: healthy and comfortable in her well-being, realistic about the struggle, positive about her family's involvement, engaged in a life that doesn't involve having an eating disorder. While the other panelists were fascinating and insightful this young lady captured the hopes and fascination of the parents -- especially parents who were searching for hope for their own still quite ill loved ones.

So, my bit done, I was free to enjoy the rest of the presentations and workshops, which I really did. I know most speakers come and do their bit and then leave, or go sightsee. I am really such a geek: I want to get the entire experience and I want to meet as many people as I can. I learn so much, even after a decade of attending ED events. If not about the science or techniques I still learn by listening to the questions and by watching how familiar speakers evolve over time, and of course to learn how to better do the job of advocate and public speaker.

At Home With Eating Disorders was rich with topics, with a real emphasis on the usable, practical, and science-based. This was the kind of event that will change parent's options and actions starting that day, not a lot of theoretical overview. There was some of the latter but I really felt the parents there -- and many were just starting or just starting over -- got true help and guidance from the podium and genuine friendships from their fellow delegates (attendees, for us USians).

I won't describe the specifics, but will recommend that you check out the PowerPoints and videos when available online. One thing about the parent community is we are all about sharing as much information as possible at lowest or no cost. This has been basic to F.E.A.S.T.'s ethos and this, the second AHWED conference, was a shining example.

A quick word on New Zealanders: there was a nice contingent there for the event, which made me glad. I'm largely tone deaf on the difference between Australian and New Zealand English, but I've improved, aided by the fact that they themselves often trade exaggerated examples of one another's ees and eyes. The banter is light-hearted but helpful to me in keeping track. I find that if I simply fix on one person's speech patterns as my example it helps. My favorite example for New Zealand is Nicki Wilson of ANZAED. Except she has the most lovely voice and manner and although I know she is unique (and someone I deeply admire) this regard gets extended to all those who are from New Zealand! Nicki and her daughter, Emma, gave a beautiful presentation near the end of the events that did me in, really. The two of them remind me so much of me and my daughter and they warm my heart.

The AHWED conference was a real success. Parents were welcomed, informed, empowered, and surrounded by new friends. Really. I'm not just being nice. I overheard many conversations about proposing projects and research and get-togethers. It was a dynamic event: part of an evolving ED parent community and joining the collaborative nature of ED advocacy. I am genuinely impressed, and left knowing that Australia and New Zealand have some important ideas and successes that the rest of the world can benefit and learn from. I'd like to see many things that are going on in both countries spread to others, as well as more widely inside those countries. I was refreshed and energized by the experience and really admiring of what is happening, and rapidly, in both countries.

My trip coincided with Australia's Reconciliation Week, and my friend Robyn sent me a gorgeous bit of music to share in the experience, Wiyathul, by Geoffrey Gurrumul Yunupingu.

For the last few days of my time in Australia my dear friend and host, Dr. Rod McClymont, got me out of the urban and into the landscape of New South Wales. Zounds. Although I also got two sweeping tours of Sydney, it was my time with his family up toward Bathurst that made me feel I was truly upside down and around the world. And what a tour! We Americans think an hour or two of car travel requires provisions and a heating pad. Not these Australians.

It was largely a matter of going up high to look down, and higher to look across, and down low to look up, sometimes involving lots of stairs. I have taken in epic sights all in a row, each as cool as the next. Between destinations kangaroos and wallabies and a few Lyrebirds just posed in front of the car for visual interest. on behest of some cosmic Tourist Bureau. We'd just be driving along and stop the car and walk over and Oy Vey the earth opens up and there's a postcard view and staggering experience, and no lines. It's quiet and the few human beings in sight wave. There's no trash. No tickets. Then down some switchbacks into a cave of your choice, followed by watching for the platypus. I have totally got to up my game on when my Aussie friends come to visit.

Australian children, or at least these parents' children, gambol like goats on the edge of precipices, kindly not laughing at the whimpering American lady whose vertigo was only kept in check by the casual conversation one must pursue when terrified because if she bolts into the bush she will be killed by her just that much deeper fear of snakes.

But here's the story my family keeps making me repeat:

On alighting into a cathedral-like canyon featuring an idyllic waterfall and fern-festooned walls, I took in the experience from a flat rock in the sun. It was cool, but the water colder. Being my clumsy self I should have known not to fuss with my sunglasses but I did and, crack, dropped them on the edge of the rock where they ever so slowly but too fast to catch fell into the icy pool. I made a weak cry of dismay, more for leaving debris in a pristine place than the loss of my sunnies, on which the 14-year old in our midst dove onto the rock and plunged, soaking to the shoulder and with half his face immersed, worked a few moments until he quietly retrieved my now far more precious possession. Astonished, I declared Felix my hero, to which he replied standing in the cold air wringing his shirt and jumper (sweater to us Yanks), that it was "no worse than a rugby game."

This, my friends, is Australian youth.

I think the kids, really -- and I met quite a few of my friends' kids -- were the finest part of my travels. I'm grateful to all those who paid for and organized and chauffeured and promoted the conference and all the other events around it but I'm particularly touched and grateful for the opportunity to meet so many of their children: young and adult, ED affected and not (one clever girl answered the inevitable looks of inquiry with "I'm the OTHER one"). When you spend time away from home at conferences you get to know folks pretty well and sometimes even meet their partners but so rarely their lovely, deliciously real children.

Better than wombats, which everyone told me have square poop (they do!), which I didn't see. Better than the Jenolan Caves platypus who is waiting until my next visit. To all the kids, my home is yours. No kangaroos or wombats and I'm no Marge Simpson but I'm sure I can find some very American experiences for you to carry home. I owe you that.

I owe a lot of you a lot. Thank you.

Comments

  1. Thank you for this great post! Several things stuck out but the two most important in my mind were the team carer coordinator and the broader vision of a non-ED specialist who is very knowledgeable about eating disorders and the facets that need attention and who is at the same time skilled to see other aspects of the person's behavior/thinking/physiology that all too often specialists do not recognize. The two points I highlight here are linked, of course. As a side-note Walter Isaacson notes in his book Steve Jobs (p 545-550) that Jobs recognized that his treatment for pancreatic cancer was "...fragmented rather than integrated" something that he would not have permitted at Apple. Jobs lamented that too often in the Health Care industry there is a lack of caseworkers/advocates who make sure all members of the team know what's going on and who communicate with each other.

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    Replies
    1. That is so much of the problem, isn't it, Jennifer. Integrated care would keep everyone on the same page and amplify all their efforts, not to mention build professional expertise for the benefit of later patients!

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  2. What a wonderful round-up of your trip!! No wonder you've taken so long to recover.
    And you are welcome at our place anytime you want to return. I will try to come up with another equally unintentionally awkward dessert to share with you next time xxxxxxxxxxxxxxxxxxxxxxxxxxxCate

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    Replies
    1. Awkward Desserts. That would be a great name for a band!

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