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From Issue Eighteen, January 2012 Next Article »

Life, Death, and What Really Matters

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Throughout my career as a family physician, I have been a student of human suffering. I have had the opportunity through the lens of medical practice to observe and participate in various crisis points in my patients’ lives, and as a result, I have learned about the many ways in which we humans cope with the tragedies of our existence. In addition, my education in suffering was abruptly accelerated several years ago when my father took his own life, leaving me in an uncharted abyss of grief, guilt, and loss. I began working with hospice patients as a means of healing my devastation over his suicide, immersing myself in death and grief in order to find a way out of my pain. While I expected to encounter even more sadness and despair as I sat at the bedside of the dying, I discovered that some of those patients were actually more fully alive during their final moments than most people I knew. Through my work with the dying, I was gradually transformed into a student of life, which ultimately led me to write my book, What Really Matters: 7 Lessons for Living from the Stories of the Dying. It is both a call to awaken to the spiritual aspect of this life on earth and a guidebook for navigating tragedy.

Without a doubt there has never in our history been a greater need for guidance than there is today. We are facing an unprecedented global economic crisis, degradation of our natural environment, widespread war and societal conflict, and human suffering that includes poverty, sickness, starvation, and exploitation. The threat of extinction looms large in this final year of the Mayan calendar. We have come face to face with the unknown and must focus our attention and energy on what really matters because time may be running short. Each moment is of great importance.

Yet the lessons learned from the dying have illustrated that all of life should be lived as if it could end at any moment. The true value and meaning of life are found when it is viewed from the perspective of its final days. So this precarious moment in time, when destruction hovers nearby, is a true gift. It is an opportunity to find our way back to what is most essential, to rediscover joy, and to rise to our highest potential. Because the dying have already navigated their difficult last days and found abundant life in the midst of decline, they are perfect teachers for us now as we face our uncertain future.

Embrace Your Difficulties

The first concept to learn from the dying is that suffering is a universal and necessary component of existence. In fact, every living thing suffers in its own way, and every living thing eventually dies. The reason suffering must be embraced is so that it can be used as a vehicle for learning the deeper lessons of life. To reject and resist pain is to prevent the growth suffering offers and actually results in more misery in the end. Yet our society teaches us that we are entitled to a life free of difficulty and struggle. We expect to have things go our way and are deeply offended when that doesn’t happen, as evidenced by the plethora of personal injury lawsuits in this country. Some of the wasteful spending in healthcare occurs for the same reason, as costly diagnostic tests and unnecessary treatments are utilized in a futile attempt to eliminate all suffering and to forestall death.

Of course we should work to improve conditions for all of humanity—and for our own situation as well—whenever possible, but that work must be done from the perspective that life’s suffering is a teacher and that learning from it is the most important thing we can do. This is a tricky balance, requiring energy and focus to see the difference between embracing suffering and becoming apathetic to suffering. We must be open to feel the pain of our difficulties while we remain actively engaged to rise above them. On a practical level, we can utilize the following recommendations to embrace our difficulties:

Eliminate self-pity. Watch for responses such as “It’s not fair!” or “Why me?” when things don’t go well. Those reactions often reflect an attitude of entitlement that is common in our society. Consider instead that some of these situations are a gift, not a punishment.

Cultivate patience. During challenging times, allow circumstances to unfold before making judgments. The passage of time can bring about many changes. Use journaling, contemplation, meditation, or prayer to learn the virtues of patience and endurance.

Manage fear. Use deep breathing, yoga, guided imagery, or bodywork practices to decrease anxiety and pain. Uncontrolled fear can cause regression to unhealthy behaviors and worsen the experience of pain.

Let Your Heart Be Broken

This lesson taught by the dying is an admonition to experience true, deep, and heartbreaking love. In our society the word love is used in many superficial ways—such as to express our preference for one kind of hamburger over another or our devotion to a sports team—that do not represent the meaning of true love. From the perspective of the dying, love is the force that connects us deeply and vitally with other living things. Love breaks our hearts because inevitably we always lose those we genuinely love. But the essence of love is choosing to open ourselves to the pain and willingly becoming vulnerable to loss. This is an important lesson because it pushes us to expand our capacity to give to others and to take risks in that giving, which is the source of our spiritual growth. So to let our hearts be broken by expressing true love to others exposes us to the possibility of more suffering and more learning. Step into the practice of genuine love in the coming year by adopting the following guidelines:

Give first. Focus your attention on what you can give to others rather than on what you are receiving from them. Journal about ways in which you can show love to those around you.

Be of service. Find volunteer work in an area that interests you in order to practice bringing love to every situation.

Join a group. Learn to work with others by participating in a shared process such as a support or therapy group or a spiritual or social organization. Strive to be authentic and fully committed to any projects you pursue.

Hold No Resentments

This is the lesson of forgiveness, which teaches us that it is necessary to let go of old resentments and bitterness in order to grow and face the challenges of life. The dying spend a great deal of time in their final days working on forgiveness and overcoming the negativity of past wounds. When we harbor anger toward others in our hearts, we are not truly free to move forward in our lives. We can become stuck and stagnant as our energy is consumed by negative thoughts and emotions. During difficult times, such as those our world is currently facing, it is necessary to make available as much energy as possible for creativity and problem solving. Forgiveness is the means for releasing the life force that has been bound up internally, keeping old anger and animosity alive. To jump-start the practice of forgiveness this year, try the following practices:

Acknowledge mistakes. One of the initial steps toward releasing others from your anger and blame is to focus first on your own behavior and take responsibility for your mistakes. Forgive yourself and recognize that everything that happens can be used as a source of growth.

Create a ritual. Sometimes performing a tangible act that signifies forgiveness can help you to accomplish this emotional task. Plant a forgiveness garden, write a poem, light a candle, build a small shrine, or draw a picture to symbolize the act of letting go of old negativity.

Clean the slate. Use meditation, journaling, guided imagery, or prayer to imagine wiping clean the tally sheet where you keep track of wrongs that have been done to you. Try each day to clear away any new resentments, while you also continue to work on the old wounds.

Dwell in the Present Moment

One of the gifts those who are dying experience is an enhanced ability to live in the present moment. Because the future does not exist for them, each moment is significant and every breath is precious. Many spiritual teachers have emphasized the importance of remaining in the present moment, for growth occurs only in the present. But this is an extremely difficult task because our minds are accustomed either to dwelling in the past, conjuring up old memories, or to projecting into the future, dreaming or worrying about possibilities. We must learn to bring our energy and focus into the here and now, for creative solutions to our problems can only emerge in the present moment. Of all spiritual practices, those that help us remain in present time are likely to be the most productive toward our growth and awareness. Though it is a challenging lesson, any progress at all toward residing in the here and now is significant and helpful. Here are some suggestions for improving your ability to dwell in the present moment:

Heal grief. Our old memories of loss and pain can keep us trapped in the past, so it is important to work actively to heal those wounds and free up the energy they store. Use journaling, counseling, group therapy, or a letting-go ritual to help release old grief.

Practice mindfulness. Use meditation to practice bringing your awareness over and over again to the present moment. While performing everyday tasks, such as washing dishes, doing laundry, or eating a meal, bring your full attention to the activity and notice every detail to improve your ability to remain in the present.

Spend time in nature. The rhythm of life constantly unfolds in the present moment, so spend time in the natural world, where you can tune out distractions and join with the flow of the present. Practice gardening, walking mindfully in the woods or a park, or simply meditating outdoors in the elements to find a connection with the energy of life.

Living from Within

These four core lessons—embrace your difficulties, let your heart be broken, hold no resentments, and dwell in the present moment—represent just some of the wisdom conveyed to us by those who are facing the end of life. When viewed together, these lessons actually describe for us a way of being in the world, a perspective on life that propels us toward wholeness, integrity, creativity, and awareness. At a time when we stand at the edge of disaster, uncertain of our future, it is imperative that we listen to the teachers who have gone before us to brave the unknown. Their message is actually simple: focus only on the things that are most important while there is still time to make a difference. The solutions to the problems we face are already within us. We have only to bring our energy and attention to them. Let the lessons from the dying become our guidebook, our map for the uncharted territory that lies ahead.

Finally, these lessons have directed me on my own journey out of the abyss of grief and guilt over my father’s suicide. While I found no answers for his death, I did find the inner resources to live peacefully with my questions. I found the beautiful light that shines through my heart, broken open with love. I found the exhilaration of releasing every strand of tangled resentment I carried within me. I found the rhythm of a single breath and the stillness of this one and only present moment, and I found the deep meaning of our shared suffering, as it was transformed, word by word, into a tribute to life and death and what really matters.

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  • Anonymous Icon

    Scotty9085 Jan 04, 2012

    Dr. Wyatt,

    Thank you for this beautiful article. Its important to keep being reminded of the growth that comes from our difficult times

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    Chieko Jan 04, 2012

    Dr Wyatt,
    Thank you for having the courage to continually explore and share what Love is. I am grateful you were able to hold that vision/feeling all through medical school and admire your commitment to bringing this to us at this time in human history. In the end only love expressed matters. I look forward to reading the book.

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    thoromli Jan 05, 2012

    Lovely, recognizable and agrees.


    Thank you...

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    Tina Mertel Jan 05, 2012

    Dr. Wyatt this is a beautiful article. Thank you for your service in this world. I hope this article reaches many, and I will do my part to pass it along.

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    cwayneking Jan 05, 2012

    This is a wonderful checklist - it helps me as caregiver to remember, Am i doing all I can to stay in the now? But truthfully, I'm so exhausted that there's not much time or energy.

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    nbtruthman Jan 05, 2012

    " must be done from the perspective that life’s suffering is a teacher and that learning from it is the most important thing we can do." Death is an opportunity "to rediscover joy, and to rise to the highest potential." So we are supposed to work hard on ourselves to eliminate self-pity, cultivate patience, manage fear, heal grief, live in the present moment, and numerous additional wonderful psychological/spiritual affirmations.

    The problem here is that the underlying perspective is still the materialist message that ultimately death is total destruction, and there is ultimately no such thing as soul and spirit other than human imagination. This message is all wrapped up in secular humanistic terms but the bottom line is that we must come to grips with a reality in which notions of human spirituality are entirely human imagination, and learn to love it.

    Charles Tart's The Western Creed expresses this worlview quite well - in part, "I believe in the material universe as the only and ultimate reality, a universe controlled by fixed physical laws and blind chance. I affirm that the universe has no creator, no objective purpose, and no objective meaning or destiny. I maintain that all ideas about God or gods, supernatural beings, prophets and saviors, or other nonphysical beings or forces are superstitions and delusions. Life and consciousness are totally identical to physical processes, and arose from chance interactions of blind physical forces. Like the rest of life, my life and consciousness have no objective purpose, meaning, or destiny. I believe that all judgements, values, and moralities, whether my own or others', are subjective, arising solely from biological determinants, personal history, and chance. Free will is an illusion."

    The worldview of materialist secular humanism leaves no room for any notions of a nonphysical human spirit, survival of physical death, or ultimate meaning, purpose and morality. If death is total annihilation and scientific materialism is the ultimate truth I am not persuaded that there is any point to the efforts and aspirations exhorted in the article.

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    Tomasar Jan 06, 2012

    But of course, nbtruthman, your view is entirely subjective which is by no means discounting the inherent values to be found in secular humanism.

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    nbtruthman Jan 06, 2012

    Materialism (along with secular humanism) inevitably lead to pessimism and despair in those who allow themselves to truly consider the implications. Here are some quotes from great sage Bertrand Russell:

    "That Man is the product of causes which had no prevision of the end they were
    achieving; that his origin, his growth, his hopes and fears, his loves and his
    beliefs are but the outcome of accidental collocations of atoms; that no fire,
    no heroism, no intensity of thought and feeling, can preserve an individual
    life beyond the grave; that all the labors of the ages, all the devotion, all
    the inspiration, all the noon-day brightness of human genius, are destined to
    extinction in the vast death of the solar system, and that the whole temple of
    Man's achievement must inevitably be buried beneath the debris of a universe
    in ruins--all these things, if not quite beyond dispute, are yet so nearly
    certain, that no philosophy which rejects them can hope to stand. Only within
    the scaffolding of these truths, only on the firm foundation of unyielding
    despair, can the soul's habitation henceforth be safely built.

    "Brief and powerless is man's life; on him and on his race the slow sure doom
    falls pitiless and dark. Blind to good and evil, reckless of destruction,
    omnipotent matter rolls on its relentless way; for man condemned today to lose
    is dearest, tomorrow himself to pass through the gate of darkness, it remains
    only to cherish, ere the blow falls, the lofty thoughts that ennoble his
    little days--proudly defiant of the irresistible forces that tolerate for a
    moment his knowledge and his condemnation, to sustain alone a wearily but
    unyielding Atlas, the world that his own ideals have fashioned despite the
    trampling march of unconscious power.

    "The life of Man is a long march through the night, surrounded by invisible
    foes, tortured by weariness and pain, towards a goal that few can hope to
    reach, and where none may tarry long."

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    Sungon9 Jan 06, 2012


    Materialism says nothing about the universe we live in. It is neither right or wrong. Therefore believing in materialism is the same as believing in nothing. The reason for this is that materialism leaves no room for ideas, like the ones stated in the article. But without ideas, what would be the purpose of anything, even life? Why would the world spin in the first place?

    Take the game of chess for example. The horse piece is, realistically, just a piece of stone (or marble). I would never know how to move it if I never knew what chess was. However, the chess rules state that the knight moves in an "L" shape. These chess rules are abstract truths about the game. Sure, the chess rules might be written down somewhere, but materialistically speaking that would just be ink on a paper. The abstract rules of chess give reason for how and why the pieces move.

    Now look around. Surely the world is not standing still. If people did not have any reason to live, why would they do anything? Materialism can't be wrong, because surely happiness can be attributed to a number of neurotransmitters. But there would be no reason for people to live without meaning and abstract ideas. That is what is meant by "what really matters."

    I hope you get what I'm trying to say. By believing in materialism you are effectively believing in nothing. Which almost sounds like circular logic. The ideas presented in this article are rules to our lives on Earth as the rules of chess are to pieces. So we know how to move.

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    nbtruthman Jan 07, 2012

    I don't absolutely believe in materialism - I am unsure, an agnostic you might say. My point was that the article appears to be based in the scientific materialist paradigm, dismissing notions of there being a real human soul or spirit not one with or identical to the physical brain, and of there being survival of physical death. The writer clearly avoids any reference to soul, spirit or afterlife. The writer of the article apparently feels that by carrying out the ideas and exhortations presented, a deep thinker can find meaning and purpose and joy in the prospect of death, within the scientific reductionist materialist worldview. The author says the lessons of embracing your difficulties, letting your heart be broken, holding no resentments, and dwelling in the present moment describe "a way of being in the world, a perspective on life that propels us toward wholeness, integrity, creativity, and awareness." Lyrical and kind of mystical, but in the prospect of ultimate meaninglessness and annihilation? I disagree, and cited Bertrand Russell's writings for some profound thoughts on this.

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    stevew Jan 08, 2012

    This is a deep article. But there is one of its prescriptions I must question. It advises to "Dwell in the Present Moment". To be sure, that is all that dying people may have. But for the rest of us, I think that is most certainly not the way to live one's life all the time. Some of the time it is, for example when we are present to ones we love. But certainly not all the time. We all have goals and aspirations, and these, quite rightly, guide much of our lives. But this means that our thoughts and actions are oriented toward the future, not the present.

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    stevew Jan 08, 2012

    To nbtruthman: You have simply asserted that in order to view life as having a meaning and purpose, one must believe in some form of life after death. But that is simply an assertion on your part. I believe that life does have a meaning and purpose, but I do not believe that I in any way survive my physical death. True, this is simply an assertion on my part. But this is to point out that this is a question on which people may differ, not one that has a clear and unequivocal answer.

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    EthanT Jan 10, 2012

    "Living in the present" does not preclude having goals. After all, where/when do we set up our goals? In the present! The goals you set up do, in a way, reflect your state in the current moment.

    However, many worry about achieving their goals, whether these are goals they have set up themselves, or if they are goals forced upon them via society, work, or recovery from injury/disease. Or, they may not went to set up goals in the first place, because they picture a future that does include them being able to achieve them.

    Rather, living in the present, learning the most you can from the current moment, can actually help you achieve the goals you currently have, and perhaps make you more likely to take on goals in the first place.

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    EthanT Jan 10, 2012

    oh, and nice article! ;-)

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    EDinWAState Jan 12, 2012

    The following is not directed to anyone in particular who posts on this forum.

    I am a seventy year old male who has been interested in IONS since it's inception (in fact, I was a charter member but got lost in the science vs. philosophy of it all) and I have never felt the need to communicate my opinions until now.

    This article, by Karen Wyatt, is a rather strange phenomena inasmuch as it stresses the concept of existence with purpose.

    As some have stated here there is no purpose to existence. Others, on the other hand, state that without purpose... what is the meaning of life? Indeed! What is life?

    I see both sides of the argument as based in selfishness and ego based. Regardless the lofty phrases or seemingly super-philosophic reasoning everything boils down to the conceptual "me". And I realize that I am not immune in this situation. I have, however, allowed myself the leeway to surmise my apparent existence with a bit of personal, anecdotal evidence.

    Three days ago I was relaxing in my favorite chair when I suddenly felt as though a crushing weight was pressing down on me. Pain radiated throughout my chest, into my neck and down my left arm. I immediately thought and believed quite strongly that I was suffering a heart attack. Remarkably, I did not panic. I was not afraid. I did not call nine-one-one. I, simply, acknowledged that I was dying and waited to see what happened next. I saw, without trepidation, that if something else did happen and experience of some sort continued... fine... I would strive to understand it and thrive in it. If, as the other side of the argument insists, nothing at all happened I would never know it for "I" wouldn't be around to realize it.

    Either way was and is quite alright with me.

    I do not believe that this is fatalism in full bloom as some would suggest. To my mind, the fact that I believe that I do have a mind implies that existence is like a self-fulfilling prophecy.

    Descartes is famous for stating : "I think, therefore, I am." I would correct him with "I think, therefore, I think I am."

    It's all relative and everybody and everything wins in the end... whatever that means.

    Yes, everything dies but does anyone actually know what dying is? Or, for that matter, does anyone really know what being alive is? In that exact point between the two ideas is the "now". The now cannot be avoided or circumscribed nor can it be created; it can only be experienced by default... as long as I live and breath I have no choice but to be somewhere "now".

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    EDinWAState Jan 12, 2012

    Addendum: For the interested.

    Obviously, I did not die. When I was waiting for death without expectations, either way, I fell peacefully asleep! I slept for nearly ten hours and when I awoke the pain was gone and I resumed my daily routine.

    So, I ask you... did I die and all of this is my experience of "The Other Side" or did I not die and all of this is the same, hum-drum world? Either way, what difference does it make?

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    Sungon9 Jan 15, 2012


    First, I assume all your questions are rhetorical. And second, if so, it seems to me that you have embraced many of the concepts of Buddhism, such as "living fully in the presence," "embracing change," and realizing that every emotion, thought, pleasure or pain in life is fleeting.

    Thanks for your input.

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    EDinWAState Jan 16, 2012

    @Sungon9 said:

    "First, I assume all your questions are rhetorical."

    Why assume my questions are rhetorical? I, honestly, cannot answer them... can you? If so, please enlighten me. (that is not to be read as a challenge or put-down of any kind)

    As I think about it, you are correct in sensing a Buddhist flavor to my thinking. I was not aware of it in terms of a religion or anything that is organized; I, simply, have learned over the years that everything works out in the end and not to sweat the small stuff. By seeing everything, including my existence, as small stuff life, as I define it and know it, is less hectic and less stressful by leaps and bounds over that of my younger years.

    Please respond if you care to. Thanks.

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    juliel Jul 17, 2012

    I find this discussion somehow confusing when it veers off to the topic of life after death. The people with whom the author speaks, hence grants insights, are elders, mostly. They are those who have lived long lives, and are blessed with time to reflect and come to a thoughtful space wherein they really understand what matters.

    Time, each ticking second, matters immensely to them. Even though likely they are in pain. And their wisdom isn't 'fall on your knees and beg God entrance." It isn't go to church and feed the orphans and shut ins. Though some of the advice might lead to such endeavors. It is rather live a life rich and textured in this space and time you have been blessed to experience here on earth.

    How does this bring about a complaint for an agnostic or a discussion or whether there is a life after this? And how does it invite challenge from those concerned about the plans for tomorrow? Do those of us who work into our schedules noticing the pleasantries around us and take moments to savor our meals not also have five year plans and well maintained financial planning and book keeping?

    It seems to be this is simply reinforcing what most of the better time management courses - with the caliber of years and critical life circumstances these voices bring - tells us. There are four piles on your desk at all times.

    Urgent and important

    Urgent but not important

    Not important and not Urgent

    Important but not Urgent

    And far too often we let the Urgent but not important take over and the Important but not Urgent fall between the cracks. The message I read from the above organized and helpful article is that this is a big mistake. One I should avoid making.

    And that if I am unsure what falls into those categories these experts have laid out their own conclusions from a life's worth of research - at great cost now - to help guide me in making sure I get the right things under the right headings.

    just my 2 cents.

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    bpa001 Dec 07, 2012

    My life would have been so damn boring were it not for the enormous challenges I had to overcome. Don’t get me wrong, I hated every single one of those challenges. Additionally, most of the challenges I learned to overcome have been overcome repeatedly by millions before me and under much harsher conditions. Nevertheless, without something to overcome in my life, I would have been worthless as a being in this world. My life would have held zero meaning without the frequent pain and endless joy. The joy part, regrettably, is the part that I most expertly refuse to see (because joy exists in the smallest of things). It’s not just me that grew from my many experiences. Rather, everyone I’ve touched has been left with an imprint (and vice versa). I’ve left behind good and I’ve left behind bad. I’ve felt hatred for others. I’ve most definitely been hated. I’ve experienced joy from others. I’ve brought joy to others. I have given and taken. I was selfish sometimes and other times giving. I’ve given love, betrayal, hate, joy, selfishness, generosity, hopelessness, and I have renewed hope. I’ve had all of these things taken from me and gifted to me. The past defines you from one moment to the next. Who you are right now in this moment is a culmination of your past. Your past is your present, but only for a moment. The present is ever changing from moment to moment. From moment to moment, you change as do all around you. The future is indefinable and beyond our control. If there’s a God, he knew we’d all start out as total morons, would somehow grow into somewhat less, yet more socially acceptable morons, and then die closer to not being complete morons. If there’s no God, then I’ll die with the gift of gratitude, all the while pissing off whoever is unlucky enough to experience my passing. My only hope is that whoever I die beside gives me a healthy dose of crap on the way out. I hope this person has suffered greatly in life and is also grateful for having lived. It is these people that are most worth knowing and the hardest to lose.

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