A Simple Procedure

It was a simple procedure. 

A simple procedure.

I would be admitted to the hospital overnight.  I had to be fasting.  Except for some clear liquid that the nurse would have me drink every four hours.  It contained some stuff that the doctor called “fixers.”  She explained that they were meant to help boost the efficiency of the procedure and help my recovery go faster.  Then she joked that they would “fix” me.

If the procedure went as planned, then I would be able to recover and check out a few days or so later.

Aside from the need for physical recovery, there was one major side effect that they had observed in every person who underwent this procedure.  The machine that they used, it caused the patients to feel very nervous and restless. 

Who could tell the difference? I thought.  Wasn’t everyone nervous and restless before a major medical procedure?

One of the nurses in the evening shift chitchatted with me as she took my vital signs and gave me my fixer drink.  I felt a swell of nervousness ballooning up in my chest.  I made an “o” shape with my mouth and exhaled.  I asked again about the side effects.  Nervousness and restlessness.  Was that really it?

“Hits some patients harder than others, but yes, that is it,” the nurse said.  “That’s all we’ve observed so far.  My grandmother called it ‘the fantods,’ you know?” 

I frowned.  I’d never heard the term.  “Is that anything like ‘the willies’?”

The nurse laughed.  “You know I think it’s exactly like ‘the willies.’”

“And how many people have been through this treatment—uh, this procedure—so far?”

“At this hospital…almost a hundred.”

“Almost,” I breathed.  I gave a forced laugh.  “If I were the hundredth person, would I get some kind of prize?”

The nurse smiled.  “The biggest teddy bear in the gift shop?”

“Forgiveness of my bills.”

That made her laugh.  Nurse Kim.

She was the first person I saw when I woke up from the procedure.

***

When she asked me how I felt, I was still too woozy to answer with more than a sleepy groan.  My muscles felt jittery, but I was able to make a loose fist with my right hand and pop up my thumb.

Nurse Kim smiled and gave me an “attagirl.”

When next I woke, it was a normal waking, except that I was still in the hospital.  It was early evening.  The ward was bustling with visitors and nurses checking on patients. 

I had no restrictions other than needing to stay admitted.  I was able to get up and go to the bathroom.  I was able to eat—which I did because I was hungry.  I was able to see visitors, so I saw my family and assured them I was okay.  Then I saw my friends and assured them I was okay.  I got out of bed and walked around.  I felt a little tired, but otherwise okay.

And I sent everyone home because I was…okay.

I later wondered if I would have been able to figure things out sooner if I’d let someone sleep in my room that night. 

I had no trouble falling asleep. 

A sound woke me.  The sound of children’s laughter. 

It was the middle of the night, three-something in the morning.  Visiting hours were long over and there were no children in that ward.  I figured I must have been dreaming, even though I couldn’t remember my dream, if I had been dreaming.  A creepy dream about creepy laughing kids.

And I noticed something then.  I felt something.

My muscles were still jittery.  If I’d been sitting at a desk, I was sure my knee would have been jigging up and down.  Little gasps rippled through my chest. 

This must have been it.  The side effect.  The nervousness.  The restlessness.

I tried to lie down and go back to sleep.

Ripples.  Jitters.  Ripples.  Jitters.

I felt the urge to go to the bathroom.  I went.  I returned to bed.

Ripples.  Jitters.  Ripples.  Jitters.

I shook my head. 

I reached for my phone and checked the time.  I was tempted to unlock it and start watching a movie or something.  My cousin had brought me some earbuds.  I sat up in bed and looked for them.

Then I sighed.

I still had at least a few more days to go before I was discharged.  Sleeping for half that time would make those days go by faster.

I’d been able to fall asleep like normal that night because I’d been tired from all the visits and the walking around. 

So I got up and went to the elevator. 

***

I rode down to the first floor, managing to take a few elevator selfies, and I walked outside.  I sat down and flicked through the pictures, thinking if I got a good one, I could send it to my mom to show her I was in good spirits.  In the morning though.  If it was timestamped in the middle of the night, she would notice, and she would worry.

I walked around a bit.  I passed by the gift shop and the waiting room on the ground floor, where people seemed to be talking much more loudly than I thought was appropriate about the personal medical issues that they or their loved ones were suffering. 

I thought about climbing the stairs.  But when I opened the door, the staircase seemed dreary and dark.  So I went back up on the elevator.

I passed by the nurse’s desk on my ward and shared some small talk with the nurse on duty. 

I climbed back into the hospital bed, tired, yes, but also still jittery.  I kept turning over in bed, and every time I did, it felt as if something were crawling over the skin of my neck and my arms. 

I thought I dreamt that there were newborn babies crying in the maternity ward, people moaning and wailing in the emergency room, machines softly beeping in the intensive care unit, doctors consulting each other over a patient’s chart, patients breathing and breathing. 

And I smelled sharp odors.  Ammonia and iron.  And bitter electricity.  And I smelled cloying odors.  Sweet roses that were starting to wilt.  Perfumes clashing in the waiting room.

It became one of those nights when I think I fell asleep a few times, and then just woke up again.  At last, I noticed the light of dawn glowing behind the window shades.

***

When the nurse came to check on me in the morning, I told her how I’d slept.  I remembered what woke me, the children laughing.  I told her about my dream, though I could have sworn that I didn’t have any dreams, that when I heard all those things and smelled all those things, I was awake.

“That’s a side effect of your side effect, I’m afraid,” the nurse said.  “You feel nervous, you can’t sleep.  You can’t sleep, you get punchy.”

I nodded.  “Yeah, I kept thinking something was crawling on my skin.  But there was nothing.  Not even a stray hair trying to trick me.”

“Don’t worry, hon.  The feeling will fade once your post-procedure treatment is finished.  Unfortunately, we can’t give you anything to help you sleep.”

“Yeah…it’s weird how specific some of the dream was.  Like, is there a Doctor Murdoch here, and is he an oncologist?  I dreamt I heard him talking to a resident about scheduling a patient for a second biopsy, to be sure about something before they operate.  He said something about ‘mitigating risks.’  Is that…that almost seemed real.”

The nurse pressed her lips together and shrugged.  But I noticed her shoulders stiffened a little after that shrug.

***

My post-procedure treatment consisted of my going under the machine at least once per day during my stay, to stimulate the “fixers.”

So I went under the machine.  Even though it wasn’t invasive or painful, it was hospital policy for patients of this treatment to be wheeled back to their rooms.

I didn’t think it was necessary until we were halfway back.   I started feeling warm.  I felt sweat forming at my temples.  Sweat dripping down my back.

Suddenly, I got tunnel vision.  And the world went grayscale in that tunnel.  And my ears started ringing. 

I’d felt this way before, once, when I almost passed out at my cousin’s wedding reception.  I’d been exhausted and sleep-deprived and stressed from planning seven different events ahead of the wedding.

“Stop!” I called out.

The nurse who was pushing my wheelchair stopped.  He came around and knelt beside me.  He asked me what was wrong.

We were in the middle of the hallway, facing the elevator banks.  I saw the elevator open and a man stepped out, pulling a balloon behind himself, and carrying a bunch of flowers.  They were daisies.  I could see them.  I could smell their freshness.  I heard the balloon bounce once against the elevator door as he yanked at it to get it out before the doors closed.

I blinked as rapidly as I could to restore normal vision, knowing it didn’t work that way.  I squeezed my eyes shut and those little gasps rippled through my chest.

And then, just as suddenly, the ripples stopped.

I opened my eyes.  The hallway looked normal.  My ears had unclogged and sounds were normal.  I turned my head slightly to the right to look at the nurse.  His hand was on my arm.  His brows were contorted in an expression of concern.

“It’s passed,” I said.  “But can I have a moment?”

He nodded and went to grab me a glass of water. 

And in the moment he stepped away, the elevator doors opened.

With my normal vision, I saw the man stepped out, pulling a balloon behind himself, and carrying a bunch of flowers.  They were daisies.  I could see them.  I inhaled through my nose.  They were too far away for me to have been able to smell them, but I could smell them.  I could smell their freshness.  I was too far away to have been able to hear the soft sound of a balloon bumping against the door, but I heard the balloon bounce once against the elevator door as the man yanked at it to get it out before the doors closed.

“Déjà vu?” I said when the nurse returned with my glass of water.

“What’s that?”

“I just saw that man come out of the elevator after I saw that man come out of the elevator.”

The nurse didn’t look at me as if I’d said anything crazy.  He just nodded and said, “That sounds familiar.  You just came from a treatment.”

“I thought the side effect was nervousness and restlessness, not…hallucinations.”

“Well, the treatment is taxing.  It’s taking a lot out of you.  It hits some people harder than others.”

“So…are my symptoms more extreme than most patients of this procedure?”

“That I don’t know, but I’ll talk to the doc about it, and have her come see you as soon as she can.”

“I’d appreciate that.”

***

The doctor didn’t have any more to add to what the nurses had been telling me.  She did take a lot of notes—or seemed to be taking a lot of notes—about the symptoms I described.  She thanked me for sharing my experiences as it would help them understand the machine’s side effects better and in that way, help future patients.

After we spoke, I felt dissatisfied, so I walked around again.  I wasn’t expecting any more visitors until people got off work later in the day. 

And it happened again.  I wasn’t standing or sitting still this time.  I was walking. and I suddenly started feeling hot and sweaty.  I stopped right away and my field of vision shrunk and grayed, and my hearing faded to a muffle.  I leaned against a wall just in case I did pass out.  I turned my head so I was looking at the front desk, the nurses’ station.

My vision blurred, and my eyes felt as if something inside them was pressing outward.  It was how my eyes felt when I’d been staring at a computer screen for too long.  I blinked.  The blurring cleared up, and the nurse who’d been sitting was now standing.  There were two women standing on the opposite side of the desk, with a little girl between them.  They looked agitated.  One of the women was gesturing.  She was speaking fast.  She was looking for her husband’s room.  I could smell the remnants of conditioner in her hair.  I could smell the peppermint in the other woman’s mouth.  I could hear the little girl’s teeth clicking.  The nurse nodded and said, “He’s in room eight-oh-three.”  The two women rushed off down the hallway, pulling the little girl along.

My vision blurred again.  I closed my eyes, and suddenly my body cooled down.  My ears opened up and I heard normally.

I opened my eyes and the nurse at the front desk glanced over at me, raising her brows.

I gave her my old thumbs up.  “Just resting,” I said, trying to breathe normally through the uneasiness rippling through my chest.

She tilted her head as if to say, “Are you sure?”

I found my way to a chair just outside one of the rooms.  I was okay.  Anxious, but okay.  I could have continued on.  But I wanted to check something.  I watched the front desk.  I sat there for a minute, two minutes, three.  Five.  I folded my hands over my lap and just watched, my right knee jigging up and down.  The nurse took a couple of calls.  Someone from housekeeping walked over and turned in a key.

Ten minutes passed, and I thought about moving on.

And then I caught a whiff of peppermint in the air.

I turned to the left and there, emerging from a blind corner, appeared two women and a little girl.  They approached the desk.  They looked agitated.  One of the women began gesturing.  She spoke fast.  She was looking for her husband’s room.  I could smell the remnants of green tea conditioner in her hair.  I could smell the peppermint candy in the other woman’s mouth.  I could hear the little girl’s teeth clicking.  The nurse nodded and said, “He’s in room eight-oh-three.”  The two women rushed off down the hallway, pulling the little girl along.

I rose as I watched them, my eyes widening. 

That was not a hallucination.

***

“I know it sounds crazy, but I get tunnel vision and—like I’m about to pass out—but then I…see something.  And a little bit later, that same scene actually happens.  I see it happen in real time.  But I’d already seen it happen in…I guess, my vision.”

I was sitting in the chair beside my hospital bed.  The doctor in charge of my procedure and follow-up stood before me, nodding and taking notes again.  I couldn’t read her expression.  Either because she had a good “neutral face.”  Or because I was too agitated and distracted to make a solid assessment.

“I…”  I gave a nervous laugh.  “I’m seeing the future, it would seem.”

“How many times has this happened?” the doctor asked.

There was the man with the balloon.  The two women and the little girl.  And before I made it back to my room and called for the doctor, there was the huge family who couldn’t fit in one elevator, taking someone home.  It would have been a touching and happy sight to see if I hadn’t first seen it in my tunnel vision a full twenty minutes prior.

The doctor asked me if I had any lost time, if I was aware of having actually lost consciousness, if I was experiencing any pain or discomfort, loss of mobility, and several other questions to which I answered “no.”

I asked her if these were side effects of the procedure, of the machine, these visions of the future.

The doctor said that as long as I wasn’t indicating any dangerous symptoms or experiencing any major pain or discomfort, she would like to just continue monitoring me and taking my statements.  She said my experiences were more intense than most patients, but she wasn’t concerned so far.

I asked if we were still going ahead with the treatment the next day.

She said we were, unless I wished not to.  But if I didn’t go through with it, I’d have to stay longer in the hospital.

I didn’t understand why.  I was healed already.

I felt healed.

***

I went through the last treatment. 

My body tensed up as soon as I felt the wheelchair moving.  But nothing happened on the way to my room.

I had to stay two more nights.  They had to ensure that the side effects were at least starting to go away.

I had done as much research as I could about the procedure and the machine before I ever stepped foot in that hospital.  I hadn’t found anything that seemed like a red flag to me.

The previous night, I had resumed that research, still finding nothing.

When I went back to my room, I searched again.  I tried different terms and phrases for the side effects. 

I don’t know if that’s why it happened.  If I triggered it by looking for signs of doom.

I was already feeling anxious. 

I started sweating.  I started blinking, expecting the tunnel vision.

But I gasped and almost dropped my phone when I suddenly realized that I was going to die.  Right then.

My heart was thudding.  I glanced down, expecting to see it burst out of my chest.

I couldn’t breathe.  I grabbed my chest. 

The call button.  I remembered it.  But I couldn’t reach for it.  I had to breathe.

I couldn’t breathe.  It hurt to breathe.

I knew I should try to slow my breath.  But I couldn’t do it.

I couldn’t breathe.

I couldn’t do it.

In front of me, my room vanished.

I was suddenly sitting in front of a window, looking down at an operation.  There was a patient on the table.  Their chest was opened up and two doctors had instruments inside the chest.  They were talking.  Nurses were handing them tools and calling out vital signs.  Monitors were beeping and blaring. 

I couldn’t breathe.

But I could see that something was wrong.

I tried to smell, to hear, to see.  But I couldn’t focus.  I couldn’t breathe.  Something was crushing my chest.  I was dying. 

The doctors said something.  They did something.  And it all went wrong.

They were scrambling, but it was too late.  Their patient was dying.

Just like me.  I was dying.

I blinked.

The operating room vanished.  My hospital reappeared.

I blinked.  The pressure crushing my chest vanished.

I gasped in a breath, and another, and another.

The pain in my chest.  Gone.

I breathed in and out.  In and out.

I felt tears running down my cheeks.

I pressed the call button.

***

I had friends who’d had panic attacks.  On the regular. 

I never knew…

I didn’t even realize that’s what was happening.

“It’s because of the treatment…right?” I asked my doctor, my eyes and face puffy, my hand still on my chest.  My shaky hand.  I was afraid it would happen again any minute.

I was surprised when my doctor nodded and said, “Yes.”

She sat down across from me.  “Your reaction is among the most severe that I’ve observed.  And your vision, whatever you can remember from it, I need you describe it.  It could be very important.  But first, we owe you an explanation of what’s actually happening to you, to your senses.  The truth about the side effects of the treatment.”

I glanced over my doctor’s shoulders to Nurse Kim.  I hadn’t seen her for a few days.  She’d taken time off for a family thing.  She held my gaze.  She was the one who began to speak.

“We call it a ‘foreshadow.’  What’s happening is that your senses are heightened and sharpened and they have—for lack of a more accurate term—advanced.”  Nurse Kim stepped forward and sat down beside my doctor.  “These visions you’re having, these foreshadows, they’re happening because your senses are doing an advanced version of what they normally do.  Normally, our senses send information about our current environment to our brains, and our environment is defined by the reach of our senses.  You can see a long ways down a road, for example.  But if someone puts an obstruction in front of you, you can maybe only see ten feet down that road.  As a result of this treatment, your senses are able to reach further, even past obstructions.  They are extrapolating information based on that reach, but it’s happening in fits and spurts because they didn’t evolve to be able to do what they are doing now.”

I glanced between Nurse Kim and my doctor.  Obviously, Kim was no ordinary nurse.

“Most if not all of the other patients have seen these foreshadows,” Kim continued, “but not to such an extreme extent.  That’s why we’ve been able to explain it off as déjà vu or temporary hallucinations.  And once the treatment is over, these foreshadows stop.  The patients leave the hospital none the wiser.  But in your case, there’s no denying what’s happening.  Your foreshadows are getting longer and longer.”

“After every treatment, it got more intense,” I said.

Kim nodded.  “And this last time, you didn’t just experience presyncope.  You experienced a full panic attack.  And you’ve never had one before?”

“Never.  And I never want to again.”

“I have to ask.  While you were in the midst of that panic attack, you had a foreshadow, didn’t you?”

“I think…no, I did.  But I don’t remember much.  I couldn’t focus.”

“Tell us what you do remember.  It sounded very important.”

So I told them.  And now that I was relatively calm, now that I could breathe and think, I could close my eyes and picture what I’d seen.  I could stop talking and listen for the words I heard and the sounds I heard.  I could relay.  I could describe.  And I could do something else that I couldn’t do, or maybe didn’t know I was doing, during my panic attack.

I could remember the smells.  I smelled blood.  And I smelled body odor.  And I smelled something foul. Something I’d never smelled before.  Something that smelled wrong, twisted.  I smelled it all until the moment things went wrong.  Then I smelled nothing.  Nothing at all.

They had made a choice, the surgeons.  They had agreed on a choice out of two options.  They had chosen what they believed was the safer more reasonable more probable option.  They had not done anything wrong.  But despite them doing everything they could humanly do, they were going to lose their patient.

I couldn’t tell when this would happen.  I hadn’t seen any clocks or calendars, or if I had, I couldn’t remember.  I told my doctor and Nurse Kim that I could let them know if I remembered any more details.  They wouldn’t tell me anything.  They couldn’t violate another patient’s privacy.

***

Thankfully, I didn’t get any more panic attacks that day.  And I hoped I never would again.  I went to bed hoping that I would sleep a night of dreamless sleep. 

I woke early in the morning with the urge to go to the bathroom, the urge to leave the hospital.  But I had to wait for my doctor to release me.

Nervous little gasps rippled through my chest. 

Earlier than I expected, a nurse came into my room.  It wasn’t Nurse Kim.  It was one of the other nurses who was caring for me.

Her eyes were wide, and they looked shimmery, as if she were about to cry.  But her mouth was parted in kind of the beginning of a smile.  Her brows stretched up and she looked at me as if I were someone she’d been waiting to see for a long time, hoping to see, praying to see.

“You did it,” she said quietly.  She took a step toward me, and now she was fully smiling.  “You saved him.”

She told me that she wasn’t supposed to tell me.  But she knew about my vision, my foreshadow.  It was about a surgery that had been scheduled for early evening that very same day.  Nurse Kim and my doctor had warned the surgical team that they had information that might help.  They asked if they could view the surgery.  And when the moment came, the emergency that forced the surgeons to decide on one or two courses of action, Nurse Kim and my doctor urged them to take their second option.  It was riskier.  And it deviated from standard practice.  If they took it and the patient died, everyone in that operating theater would have hard questions to answer.  And my foreshadow would not be a valid answer to any of those questions.

But the surgeons heeded the warning they were given.  They used all their skills to make the riskier option as safe as possible for the patient.  They still had a tense five minutes while they worked and the patient lay still on the table.

But they finished their work.  And the patient stabilized.  They watched.  And the patient remained stable.  All through the night he remained stable.

“Something might still go wrong,” I said.

The nurse nodded.  “Yeah, but he made it through the surgery.  Thanks to you.”

I felt a swell of something in my chest.

And for the first time in many days, it was not the swell of nervousness.

***

“You want me to…what?”  I stared at Nurse Kim.

We were not in the hospital.  I had been discharged fair and square.  Five days prior.  I had gone back to work even.  I was still a little fidgety, but I was sure that would fade. 

“That man you saw in the vision, you really did save him.  He’s got a long recovery ahead of him.  But he’s already at home right now with his family.”

“I’m happy to hear that.”

“You can do it again,” Nurse Kim said.  She was wearing a cool blue suit and low-heeled shoes.  And before she walked into my apartment, she had showed me a different badge than the one I’d seen her wear in the hospital.  “The machine isn’t meant for healthy people, but it doesn’t do them any harm.  If you take more treatments from it, you will likely have more foreshadows.  You might save more people.”

“And have more panic attacks?”

Nurse Kim dropped her gaze.  “That’s likely.”  She looked up at me again.  “We are working on reducing those side effects.”

“How long will that take?”

“I truly don’t know.”

I exhaled and looked down at my hands resting in my lap.  “What if I have a panic attack and the foreshadow is just about…I don’t know, something that doesn’t need to be fixed, like a soldier coming home to family or a team winning a baseball game, or something?”

“That’s still extraordinary,” Nurse Kim said.  Her eyes gleamed.  “It’s still extraordinary that your senses can extrapolate the future.  It wouldn’t be a waste.  We would be able to gather so much valuable data.”

“At the cost of my health.”

“Yes, it’s a high price to pay.”  Nurse Kim rose.  “You don’t have to answer now.  I just ask you to think about it.”

I stared ahead.

I had already been thinking about it.

Kim took a step toward my front door.

“It’s a lose-lose situation.”  I glanced up at her.  “Isn’t it?  Either I refuse and live every day for the rest of my life knowing that people might die or suffer specifically because I refused to help.  Or I accept and I live every day for the rest of my life in a low-level state of anxiety at best, and at worst…without warning…”  I slammed my fist on the coffee table.  “Panic attack.”

I’d tipped over a teacup that was still half-full.  The tea ran along the table and dripped over the edge.

Nurse Kim righted the cup and used a few napkins to soak up the tea on the table and the carpet.

I didn’t help.  I sat there, feeling the tears track down my face.

~***~

I couldn’t focus on work.  I cancelled any plans I’d made over the following week, as I waited for word from Nurse Kim on how it would all work.  I imagined I’d be like an outpatient, periodically going in for treatments.  I’d be monitored, so that was good.  There was some kind of stipend that I could use for transportation so I wouldn’t have a foreshadow while driving.

My heart froze when I heard the doorbell on the day I expected Nurse Kim to come and give me my orientation.  I felt familiar feelings I hadn’t felt in the two weeks following my release from the hospital.  Ripples in my chest.

I opened the door.  We exchanged pleasantries.  I offered a seat and tea.  I jokingly promised not to spill any.  The whole time I felt a cold sweat lying on my skin.

When Nurse Kim started talking I wasn’t quite listening at first.  I kept expecting her to pull out a packet of materials for me.  A “welcome” packet.  I didn’t quite understand what was happening when she apologized and told me that I was not a candidate for their program.  While my health profile was good, and there didn’t seem to be any security risks associated with me, there were some required criteria that I didn’t meet. 

“I’m sorry,” Kim said.  “I know you wanted to help, and we appreciate that you volunteered, but you are officially discharged.” 

My comprehension caught up, and I began to feel a few conflicting emotions, apprehension mixed with hope and excitement. 

I was off the hook?

I shook Kim’s hand and showed her to the door.

I was off the hook.

Kim nodded and began to turn away, but I summoned enough presence of mind to say something.  My comprehension had caught up even further.

“Wait…is this really real?  The reason that I’m being let go?  Or…did you make this happen?”

Kim smiled politely.  “I’m not at liberty to disclose the details of the discussion that led to your discharge from our program.  But I do wish you well.”

I opened my mouth to speak.

Kim beat me to it.  “If…the parameters of the machine’s operation should change, would you be open to our reaching out to you again?”

I understood what she meant.  “Yes, I would.”

She smiled, nodded, and left.

I closed the door, and I felt waves of energy radiating off my shoulders.  A burden being lifted? 

Maybe there were other ways I could help, I thought.

I remembered the panic attack, even though I hadn’t had another one since.  I remembered the anxiety, even though it had faded almost completely.  It returned after Nurse Kim’s first visit.  But it was different from the anxiety I’d felt after treatments.  It felt like something I could deal with.  But there was one feeling I’d felt during my time in the hospital that I didn’t remember, or hadn’t until now. 

Don’t let me forget.  Don’t let me forget what it felt like…not the pain.  But the other thing

What it felt like when the nurse walked in with her eyes so wide, looking at me with gratitude and…that other look.  You saved him, she said. 

But I didn’t save that man.  I helped to save that man.  Maybe there were other ways that I could help.  Ways that would not hurt me or anyone else.  Ways that I could endure and maintain.  Ways that I could feel that feeling I felt when I learned I had helped save someone.

Something went quiet and calm inside me then.  A rupture sealed.  A wound was healed. 

 

Copyright © 2019  Nila L. Patel

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