Tag Archives: Motherhood

Floating

backyardAlmost seven years ago, I was sitting in a dive bar* with some friends from college. We had moved to different cities after our various undergraduate experiences, and rarely got to see each other. I sat across from them and another mutual friend and coasted on bliss. I relished the comfort and joy of having beer in a bar playing punk music with people who shared so many touchstones with me – concerts, people, places, parties. People with whom I could talk in shorthand. I felt connected in a way I hadn’t in years, years that seemed brimming with pregnancy, parenthood, divorce, work, classes, exams, but not a lot of effortless connection.

But, underlying that social happiness was a buzz of elation because I had just found out that I got accepted into medical school. It was an unexpected, against the odds, fantastic dream fulfilling surprise. I applied late in the application cycle, and had to fight to even get my application considered. I was told to retake the MCAT due to the scores being just too stale to count, even though it was safely within range to be considered. I crammed for the exam in 6 weeks. I hadn’t had a physics class in 5 years. I somehow even improved my score, but was told the application window had just closed. I begged my plight to the young chipper voice at the other side of the phone line who told me just to wait until the next cycle, and I would surely be invited to interview. “Please,” I pleaded. “I’m 34.” I got the interview. I brought the application administrative staff home baked cookies. No joke. And I make awesome cookies.

So, I sat there in the bar with a stupid grin on my face, and I was hyper aware of everything. The delicious beer, the laughter, the music, the horrible overpriced art in the decor, and the strange elation in my chest of a scary dream coming true at that brief, delicious moment in time that the dream is true, but isn’t reality yet. Medical school was just a bunch of fantasy and hopes, not grueling hours of studying and gross anatomy. I was able to spend a night out with my friends on a Saturday still, without the endless string of Monday exams to come for the two years. I promised myself to hold on to that moment, and to never take for granted how wonderful it was to have a dream come true.

Today, I am sitting in my back yard. I recently moved. My house is finally mostly settled. I have a lovely little spot just outside my kitchen on my tiny patio under the awning, with my fragrant potted rosemary bush and subtle wind chimes. The breeze still has a touch of that gorgeous March coolness to it that lingers every year in Miami just a few weeks longer than my cranky cynical mind thinks it should. There are birds and butterflies and bustling neighbors in the background. I have things to do – dishes, laundry, shopping, even more unpacking, but I have time. I don’t have the kids this part of spring break. I am on a light outpatient rotation. I was able to sleep in. I took a deep swig of my coffee and closed my eyes, and felt the breeze. I felt elated. Yes, it’s wonderful to relish these last lovely mornings before Miami gets unbearably hot and muggy. But, I have an underlying elation in my chest.

I got accepted into a brand new obstetrics and gynecology residency. I found out during the shortest and most wonderful interview of my life this Friday afternoon. I am more than halfway through my second year of a family practice residency. I applied to a very geographically limited number of obstetrics programs when I was finishing medical school. I interviewed at several, but didn’t match at any. There’s only one program within 500 miles of where I live and share custody of my boys. The next year, I applied again, and got invited to more interviews. These interviews were at wonderful programs in places where I didn’t know a living soul, like Macon Georgia and West Virginia. In the meantime, I was struggling through 80 hour workweeks that included 6 night shifts in a row. I rarely saw my kids. I rarely saw my friends. I rarely saw daylight. I slowly cancelled all of my out of town interviews, one at a time, as they approached, because I couldn’t see surviving an intern year in an obstetrics and gynecology residency, which would be more grueling than the one I was in, and not have the family support I did here. I also wasn’t willing to move and leave my boys behind. Again, I interviewed at the only local obstetrics and gynecology program. Again, I didn’t match there.

I worked through my second year of family practice residency this year without thinking of reapplying to obstetrics. A new program opened up in Kissimmee, which is about 4 hours north of here, and my oldest son said he wouldn’t move with me if I applied and got in there. This is the first time he said he wouldn’t even go. The interview season came and went, merely a wistful blip on my radar. The osteopathic match drifted by, and the allopathic match started releasing results this week.

Except, I just found out a week ago that a new program got approved. I have heard rumors and rumbles of new at least six new obstetrics programs being opened for over seven years of medical school, fellowship and residency, and none of them had materialized. I never heard a whisper about this program. What’s even more bizarre, I had done a 4th year rotation with the director of obstetrics there, and she must not have known of the possibility yet, and I just finished a four week rotation in their family medicine department with one of their medical directors, who didn’t mention it. Oh, and one more thing. THIS SITE IS LESS THAN A MILE FROM MY HOUSE.

After a flurry of emails, research and phone calls on my part, I procured a phone interview with the new obstetrics residency director and graduate medical education director. It was a five minute interview with two of the nicest people I’ve ever known for five minutes. They had my CV. They had been told about me by the director of obstetrics at the site, by the clinical education director at my medical school, and others. They wanted me, I wanted them, and the match already happened, so they could recruit me directly.

I was ecstatic. My dream came true, again. In fact, my dream from that night 7 years ago included my eventually becoming an obstetrician. That was the promised land at the end of my reverie that night at the bar. It was becoming harder and hard to access that place of joy and thankfulness when I struggled as a family practice resident. Part of the dream had not materialized. I hated to say “Sob, woe is me! I’m going to be a family practice physician!” and realized how stupid and obliviously privileged and ungrateful that sounded.

But today, the dream is realized. It’s still sinking in. And I still have a day well rested and quiet to sit and relish in the fantasy of getting my dream job.

“My goal in life is to unite my avocation with my vocation,
As my two eyes make one in sight.” – Robert Frost

So, one more cup of coffee. One more pause before I get to the dishes in the sink. Because this is the feeling I will be tapping into when I’m exhausted on the labor floor, when I’m struggling with learning a new surgery, when my kids and I are fighting because I’m exhausted and they are resentful because I don’t seem to have quality or quantity time with them. The breeze, the calm, the sounds, and the elation.

*I love that when I googled the name of the bar, a box popped up with information about the hormone prolactin.

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Things that brighten my night

It’s been a long day. I came home feeling like a not-good-enough resident, mother, woman, housekeeper, dog owner, driver, you name it.  I have loved ones in the hospital in other states. I have friends hurting in other states that I wish I could help, or at least hug. I haven’t bought one present. I haven’t put up a tree.

I shared  this old post about things  that brighten my day with one such friend. Then, I let go for a moment. I let my teen son sleep on the couch, I left the dishes, the bills, the evaluations and logs, the laundry, and I stepped onto my back patio. I plugged in the Christmas lights my sons and I put up yesterday. I felt the cool breeze, listened to it rustle through the palms, and took in the twinkling lights and the full moon.

patio lights

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Should I go to medical school? An advice column.

Check out my post over at Mothers in Medicine:

Should I go to medical school?

It is an answer to a series of emails I have received over time asking me advice about the whole single parent medical school doctor used to be in the natural birth community thing.

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“Life” as a single mom in internship

It’s life, Jim, but not as we know it…

I am blowing the cobwebs off of the blog once again. I have a rare moment to write. Well, it’s not like I don’t have a lot of other things I could or should be doing, but I can’t pass up this quiet pause.

I am just over two weeks into my intern year. I am doing a traditional rotating internship at a local hospital. I volunteered to be on nights first. For the night float, I am working 6 nights a week, and an average of about 10 hours a night. Our team does admissions into the hospital from the ER, handles house calls, and helps run rapid response codes and code blues. As busy and frustrating as the job can be, it is not horrible. I love the people I work with. We have a great team, and I really like the people in the graduate medical program in general.

I am happy because I have gotten to handle a few emergency night gynecology admissions for my favorite attending physician in the hospital, a gynecologic oncologist. I also have gotten to handle a few psych admissions. Psych is my second love. The other members of the team gladly let me handle these cases. I know what to do on a lot of basic house calls now. I got to help save a woman’s life, a patient who coded and ended up having a massive heart attack.

I am naturally nocturnal, so the nights thing isn’t killing me so much. It is really difficult to have a life outside of the night float, however. One of my sons is mostly traveling with his father, and my other son is in camp and is spending nights at his grandmother’s house. That is why I volunteered to do my 4 weeks of nights now. I try to see them every day that I can. Sometimes it is only for a brief visit, after I wake up and before I head in for my next shift. I have one day off a week. The last one I spent dozing off on the couch. I had to spend the day today at an excruciating orientation. I had to flip my schedule to days for two days in order to attend it. As my friend and fellow expert in scatolgical therapy told me, this kind of sleep deprivation would turn her into a “drooling turd sandwich”. I am officially there.

I am gearing up for the match again. I am not looking forward to going through the whole process again, except with less spare time and optimism. I am also facing the harsh reality of residency as a single mom, without the benefit of doing what I love – ob/gyn. So, the application process is especially horrible.

Today, after orientation, I stopped by to see an old friend whose brain cancer is, unfortunately, messing with him again. He is now suddenly mostly blind, and will find out soon if he will be having his fourth brain surgery, and will most likely be starting chemo again for the umpteenth time. I picked up the kids, and made it all the way to the grocery store parking lot. I looked around in my wallet and purse for a Visa gift card I had been saving for such rainy days. It is pouring, my friends. I am waiting for a check to clear, and a deposit to show up in my account. My cushion between the two is $10. I couldn’t find the Visa card, so I took the kids home.

When I got there, I was so emotionally, mentally and physically exhausted, I couldn’t even bear the thought of looking through my cluttered, dirty house for the gift card. I, luckily, am quite a food person. Even though I have not done a decent food shopping trip in more than a month, I have a kick ass pantry and reserves. I had defrosted catfish nuggets (yeah, mama is buying cheap) already, and had hoped to buy the ingredients for the beer batter today. I also haven’t had any bread for over a week, and I have to make breakfast tomorrow for the kids, and Seb needs a lunch for camp.

I put together a breading for the catfish out of flour, cornmeal and plain yogurt. I had vegetable oil for frying. I had half a bag of onions, so I made onion rings with the rest of the breading and oil. I also had half a packet of yeast, and just enough flour and milk to make dough for bread. After the kids and I ate the interesting, slightly tart but definitely edible dinner, I passed out on the couch at about 8 pm. I am officially a drooling turd sandwich, and am on the exact opposite schedule I need to be on to resume a stretch of seven night shits in a row as of tomorrow night.

I didn’t clean the kitchen, which was wrecked. I didn’t bake the bread. I didn’t dry the laundry, which included stuff that S needs for camp tomorrow. I did manage to wake up intermittently to tell the kids to shower and brush teeth. I got Z into bed, and eventually got myself from the couch into bed.

I woke up at 4 am. Initially I was annoyed, since, as I said, this is the exact opposite schedule I need to be on. But, now I am grateful. Even with only half a packet of yeast, the bread dough rose beautifully. I kneaded it and put it in the oven. I put the wet clothes in the dryer and started a new load of laundry. I tackled the oily, breading-y mess of a kitchen. I started a load of dishes, cleaned all the pots and pans, I swept the floor, wiped down the counters and some surfaces, and I am now on the couch, enjoying a cup of delicious coffee and the aroma of freshly baked bread.

S made me a pot of French press before he went to bed last night, and it was waiting, full and gorgeous, on the kitchen counter amid the oily mess this morning. It was quite a love letter from a thirteen year old. He and I share a love of French press. He offered to try to help me out, since my fancy coffee maker decided to finally die about a week into my internship, by making me pots of French press when he was home. But, we got in a big argument about it the other day. I was exhausted, he was feeling very thirteen and had been juggled from his grandma’s to his dad’s and then back to my house. We got in one of our worst arguments in a while over him making me a pot of coffee. It was the first hour I had seen him in three days (his dad had him for the whole weekend), it was the first time he had spent with his brother in a few weeks. We spent it fighting about him plunging the coffee, and he was reduced to tears. So, it meant a lot to me to wake up to a fresh, full pot waiting for me, unbidden.

So, the kids are still sleeping. The washer, dryer and dish washer are humming. The sun is coming up. My coffee cup is empty, and I am going to pour myself another love offering and I’m going to walk the dog to the lake and drink it and the sunrise in. The bread is cooling and will be ready to enjoy for breakfast. I may even get to my presentation for the VBAC Summit.

Could be worse

Could be worse.

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Reply turned post, single mother in medicine style

I am a contributor at the wonderful site Mothers in Medicine, and this week a guest poster wrote in to ask Do Single Mothers Go to Medical School? Please go read her original post and the other comments. Here is my very long-winded reply:

Hi! I am a single mother who just finished medical school. I would be happy to chat with you through email, if you’re interested. Please feel free to let KC know, and she knows how to get ahold of me. Also, you can read the posts I have written on here (click on the MomTFH link in the labels to the right–>) or read my blog at http://momstinfoilhat.wordpress.com. Not all of my posts are about being a single mom, obviously, but it is my constant reality as I write. As I hope you have discovered, it is easier and harder to be a single mom than you may have expected, and it does not dominate all of my thoughts, conversations and interactions.

OK, on to your questions. Let’s start with the simpler one. I took the MCAT after being out of the basic science classes for several years, too. I used a single review book and did OK. I happen to be a good test taker. If I had a time machine (Oh, geez! the things I could fix!) I would have taken a review course and probably scored higher. I think taking a targeted MCAT review would be higher yield for you than retaking all of your premed. That will also take quite a while. But, if you think having domestic good grades will improve your chances of admission, it’s definitely an option.

As for RN vs. NP vs. being a physician, that is really up to you, and I don’t think there is an easy answer to that. There are many days in which I wish I had the time machine and could go back and be an NP, but I may be a unique case. I am older than you, I want to go into obstetrics, and I didn’t match into residency last year. If I was a nurse practitioner / midwife, I could be working already, no residency required, and be doing everything I want to do as a doctor (I am not super gung ho about being a lead surgeon and am more interested in low risk obstetrics, obviously, but there are plenty of NPs that assist in the OR, just don’t lead surgeries).

Obviously, yes, single mothers do go to medical school. I was pleasantly surprised at the diversity in my class. I sat next to a grandmother all of 2nd year, and I was not the only single mom in my class. Also, single mothers do a lot of things that take them away from their kid(s). Many single moms work outside the home for long hours and have to rely on different forms of help and childcare. And, most of these single moms are not pursuing a life long dream, one that will most likely provide financial security and a fulfilling career. Moms have guilt, single moms have guilt. I don’t let that keep me from pursuing my career in medicine.

Medical school is not a bad situation to be in as a single mom. Especially the first two years. There are many schools that even stream most of the classes online, and do not have an attendance policy for many of the classes (mine did). Your clinical years may be more difficult. Your schedule can change from month to month, and I have had to ask a caregiver to show up at my house at 4:30 am some months so I can get to my rotation on time. Even more difficult, my schedule would change in a month. My kids were in school and had after school care from a trusted family member, so my main issue was the early mornings.

As for being able to handle it, I was the president of more than one extracurricular club. I won a research fellowship and full tuition scholarship. I was recommended and inducted into the humanism honors society by one of my attendings / professors. I qualified for the regular honors society, but I won’t go into the political BS that kept me from that group. I aced my boards and never failed a class. I am not just tooting my horn here; I am telling you that, if you work hard and have the aptitude and right attitude, you will do well.

I have written on my blog about my sometimes frustration with some of my former classmates. These are things my single, childless classmates have told me: I gave up using any washable dishes or glasses during medical school because I don’t have time to do any dishes. I gave up my dog to my parents during board review because I can’t take care of it. I don’t have time to do _____ activity or ______ club. I didn’t have time to take the required scrub class before rotations started because I wanted to go on a vacation. I need to take off a month because I am planning a wedding. I can’t make the meeting at that time because that’s when I nap. (Yes, for real) I would see some of these same students go to yoga 3 times a week, or party frequently, or get their mani/pedi once a week, or watch every episode of the Jersey Shore, or make what ever bargains or compromises they chose. So do I. (Make compromises. I don’t do any of those things on the list. I have a dog and two cats, I cook and use real dishes and plates, and I don’t get to work out often if at all, watch much TV, or take care of my fingernails, hairdo or other beauty routines often. I also schedule my naps, rare as they are, around my obligations, not the other way around). So will you, compromise, that is, regardless of your path.

As for divorce, moving, family support – that stuff is not easy. If you email me and are up for it, I can regale you with the soap opera that was my divorce and coparenting (they don’t call it custody anymore) agreement, and the sacrifices I had to make to be able to move if I matched out of the area. Single parents relocate all the time for many reasons. It is not fair to expect every single parent to remain, forever, in a 50 mile radius of where they divorced. There are a lot of moving parts to this, and I could write more words than this entire post already (seriously not kidding) about it. A lot of this depends on your ex. This battle was infinitely harder than medical school for me.

Anyway, I hope this wasn’t too much, and was helpful in some way. Good luck, and please keep us up to date.

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Career day embarrassment

I am one week and three days from graduation. WOOOHOOOOOOOOO!

I am incredibly busy, which means I am also paralyzed in the face of all the crap I have to do, and procrastinating on the internet. Hello!

Yesterday I was a presenter for career day at my 7 yr old son’s school. I wore my white coat, wore scrubs, and brought my stethoscope and other tools. I presented in six classrooms (exhausting!), but started off in my own son’s first grade class.

I had an apron with sort of anatomically correct removable velcro body parts, which I used to play a matching game with the kids. If a kid guessed which organ I was describing (this organ is a muscle that pumps blood to the body!) then that kid got to put that organ on the volunteer kid who was the “body” wearing the apron. It was especially fun when we got to the kidneys and the large intestine. Poop! Pee! “EWWWWWWWW!”

There were only seven body parts, though, so I brought in my ragtag collection of toy doctor tools. Several people bought toy doctor sets for my kids when I got into medical school, so I had four plastic stethoscopes, a plastic syringe, toy otoscopes, etc. I passed those out to the kids who didn’t get to put on an organ, so thy could guess what they were used for, and was one kid short. So, I gave that kid my coffee mug. I made a joke about how that was the most important doctor’s tool, since it helps keep doctors awake, and remarked on how much coffee I drink.

My son rose his hand, and offered, “She drinks beer, too!”

I said “And, goooodnight everybody!” and quickly defended myself. “I didn’t drink any this morning! I didn’t have any last night!” and spent the rest of the half hour trying to convince my son’s teacher that I don’t have a drinking problem.

*facepalm*

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Reply turned post, blame the mom or the system? style

My buddy Jill of The Unnecesarean has launched an awesomely Rad Pitt (inside joke, you’d get it if you were from San Diego or South Beach) new project called CesareanRates.com. She shared a top ten list from my lovely state of Florida on Facebook, which got, as expected, an avalanche of disgusted responses.

It is hard not to see rates of 50, 60% + without choking on your third cup of coffee. OK, maybe I’m the only one on my third cup of coffee. And I didn’t really choke, since I was well aware that some hospitals down here have had rates higher than that, as you can see by Jill and my silly little guerrilla action here, which was when we first became partners in crime.

Well, in the flurry of comments on her Facebook page, many people followed the familiar line of – blame the moms. Blame the women for not educating themselves. Blame them for choosing a hospital birth over a homebirth. Blame them for being all Hispanic (Mexicans and Brazilians in particular were blamed for our cesarean woes) and wanting a cesarean. Blame them and the OBs for creating an atmosphere of fearing birth, and forget about changing that system, because it’s a lost cause. There are plenty of good replies to this, but I am sharing mine here:

OK, diving in. First of all, the Mexican and Brazilian population in Miami and Broward County is pretty low. Cubans are by far the majority of the Hispanic population. Also, research shows that maternal request and ethnicity as factors influencing primary cesarean are both way overblown.(1) In fact, some research indicates that being Hispanic decreases your chance of having a primary cesarean in the United States.(2)(3)

Training as an OB in residency and insurance are not the primary reasons why OBs in South Florida don’t want to do VBACs. My assertion is based on as yet unpublished research from my fellowship project. Residency sites are probably the most consistent place you can get a VBAC in Florida – note that someone on this thread is going to do a VBAC at Jackson, which is the only OB residency in South Florida. Most OBs cite malpractice concerns as their reason for not doing VBACs, and that was very consistent with responses in my research. And, no tort reform is not the answer, because Florida has had some of the most extensive tort reform for OBs in the whole US – OBs here can and often do “go bare”, which means they don’t even have to carry malpractice insurance, and can limit their liability totals in various ways. Jackson has immunity as a public hospital, also.

I have to say, I am not fond of blaming moms, either for their site choice or their cultural backgrounds. I also don’t think it is effective to turn our back on changing the system. As Jill said, almost all women choose to birth in hospitals. Even with out of hospital birth rates increasing, we are still talking rates around 5%. Of course, I have to believe on changing from within, or else my life’s path is a waste of time.

(1)http://www.childbirthconnection.org/article.asp?ck=10372
(2)http://www.ncbi.nlm.nih.gov/pubmed/19788975
(3)http://mchb.hrsa.gov/research/documents/finalreports/declercq_r40_mc_08720_final_report.pdf

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Mommy wars, revisited

I am sure you have heard or read about the recent kerfuffle over a comment made by a Democratic party lobbyist and strategist Hilary Rosen on Anderson Cooper. She opined, very validly, in my opinion, that Ann Romney may not be the best person for Mitt Romney to be consulting about the plight of the typical American woman. This is covered well here. Hilary Rosen was, I think, obviously referring to Ann Romney being way too privileged to understand what economic issues most American women care about. But, when she said Ann Romney has “never worked a day in her life”, that got seized as being anti-stay at home mom. My Facebook got cluttered with many people who already ideologically agree with the Romneys using this as a relished opportunity to say “Look! Something right about Romney and women!! Something about Democrats hating moms!!”

I do think Hilary Rosen did need to apologize and clarify what she meant. She did provide context to her statement immediately, when she said “She’s never really dealt with the kinds of economic issues that a majority of the women in this country are facing in terms of how do we feed our kids, how do we send them to school and how do we — why do we worry about their future?” She could have been more precise, and said she has never worked at a paying job outside the home. This can be a very sensitive topic. However, she was pretty clear with her follow up explanation. And, she does not work for Obama, and does not represent the Democratic party. She is one working mother who was discussing a very sensitive topic with some imprecise language that was hardly the worst I have ever heard.

I think all motherhood is work. The Romneys had to claim five housekeepers on their 2010 tax return. I think some moms work harder than others. I respect mothers who stay at home. I was happy to get to work from home with my second son, and wish I had more time at home with my first. I was lucky to get to take him with me to work. I happen to find work outside the home very fulfilling, and those two scenarios may have been the best of all possible worlds for me. Financially, my family could not have afforded my taking any more unpaid leave than than the six weeks I took after my older son, and the four weeks I took after my second son. Both of my maternity leaves were completely unpaid.

I also think Mitt Romney should explain why women with two year old children need to know the “dignity” of going to work, but only if they are below a certain income.

Anyway, as this is being discussed in many, many arenas, I think it is a good time to post a link to my New Improved Mommy Wars Bingo. Feel free to play along when this is being discussed on the news, twitter, Facebook, blogosphere, etc. I’ve already managed to fill in quite a few squares.

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Countdown one week

Interviewing time is quickly approaching. I have my first interview in one week.

Eek.

I have four interviews scheduled so far. I would like more. I am thinking of applying to more programs. I haven’t gotten an invite to my local program yet, which will most likely be my top choice. But, I am doing a full month there next month, and they invite and interview late.

I am preparing for the interviews, clothing wise and mentally wise. I have no idea what to wear to a mixer with the residents.

I just wish I could fast forward to match day.

In the meantime, it seems like I may be taking a leave of absence this month. I am entitled to a vacation month, which I wanted to take this month, but I was assigned to emergency medicine this month, and I have February and April still open. While my site was willing to have me switch my ER month to February, but my school has a policy that you can’t change your months without actually switching with another student. But, no other student will have a vacation month they set up and then want to switch. So, I am finagling it as a one month leave of absence. I will work out the details tomorrow. And then, I’ll get to interview twice this month, and even spend Thanksgiving with my kids!

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Happy Mother’s Day, and a post up

Happy Mother’s Day to everyone! I am going to be spending it with my kids and extended family.

And, I have a post up at KevinMD.

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