Research Talk Series, Fall 2020 Speaker: Eana Meng, MPhil Student, University of Cambridge, UK Produced by the Harvard University Asia Center This is the …
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Hello, my name is James Robson and I'm the
Victor and William Fung Director of the Harvard
Asia Center. I'd like to welcome you to the
Asia Center's Research Talk series, which
is part of a new series of virtual programming
at the Asia Center. The research talks are
aimed at showcasing some of the fascinating
research that is being done on various facets
of Asia by Harvard students, Graduate Students,
Faculty, Asia Center Affiliates, and other
specialists. We very much hope you enjoy learning
from these talks.
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What do you think of when you hear the words,
“Chinese medicine”?
Likely something like this, acupuncture. Or
maybe this, herbal medicine.
This is what I thought growing up hearing
stories about my grandmother as a Chinese
medicine practitioner.
But what about this? The first time I saw
this, I was baffled: what was I looking at?
So this is ear acupuncture, and more specifically,
these five needles in these exact points is
a particular treatment largely used for anxiety,
stress, addiction, and behavioral health conditions.
My previous video covers how this protocol
was surprisingly developed out of the South
Bronx in the 1970s at a place called the Lincoln
Detox center. Early forms of it began with
revolutionaries such as Dr. Mutulu Shakur,
a member of the Republic of New Afrika who
worked with the Black Panther Party, and others
part of the Young Lords, another revolutionary
group. In 1985, the treatment was given the
name the National Acupuncture Detoxification
Association protocol or the NADA protocol
for short by Michael Smith, then director
of Lincoln.
Yet is it correct to say that this five-point
ear acupuncture protocol originated at Lincoln?
Does it originate with Smith, who gave it
a name and completed the five points? Or with
the revolutionaries like Dr. Shakur, who put
in the first points of the protocol? Or with
the research that the revolutionaries read
about with a Bangkok doctor and Hong Kong
doctor that discovered how stimulating points
in the ears helps with withdrawal? Or does
it go back to France, where a physician named
Paul Nogier sparked a global interest in ear
acupuncture in the mid-1950s? Or all the way
back to China where Nogier had gotten a lot
of his inspiration and texts from hundreds
of years ago and even thousands include putting
needles in the ear?
It’s hard to say, and origin stories are
hard to pinpoint, but instead of trying to
figure out the start and endpoints, I want
to look at the connections and transmission
of the practice and knowledge. Just like acupuncture,
the way to understand the following stories
is to look at the unexpected connections.
Connections between 70’s revolutionaries
in New York to present day prisoners in England,
from recovery clinics in Hungary to police
officers in India and even first responders
on Ground Zero post 9/11.
When I first saw those five points, I thought
how can just five points in the ears be effective?
But then I learned I was asking the wrong
question – I should have asked: what wasn’t
I looking at? I realized that it was what
I wasn’t seeing that mattered tremendously,
how the treatment was administered, in what
context, and by whom. I learned that what
we see is often not the full picture, and
even things that look the same, often aren’t.
Where I learned of the NADA protocol in the
US and the UK, I also learned of other forms
of five-point ear acupuncture treatments such
as the SMART UK protocol.
To understand the differences and similarities,
I spoke to different practitioners. Here is
Elizabeth Ropp, a community acupuncturist
and NADA practitioner, who first introduced
me to the protocol at a New Hampshire recovery
center on how the protocol works in her experience.
–Elizabeth speaking –
I think it's not so much what it does, it’s
just what it allows your body to happen. And
so when I put the needles in someone’s ears
and hear them just suddenly take a deep breath.
I’ll put some pins in and then I hear the
*exhale*, the deep breath. Their energy is
dispersed, it’s allowing everything to come
back together, recharge their batteries, and
almost press the pause button for a really
long time, like a reset. People were telling
me that they felt better in ways they didn’t
expect, and I’m limiting myself more and
more to just the five points in the ear. And
people are saying, “my migraine is gone,”
or “hey, I was really nauseous and now I’m
not,” or “my body aches are gone.” When
my friend invited me to offer practice, offer
treatments at this respite, it was this shelter
basically for people to wait for open beds
in recovery programs and they didn’t really
have anything to offer to people who were
going through withdrawal. I just gave everyone
seed treatments and I treated this young trans
woman who said, “my body aches are gone,
my headaches are gone, I’m not nauseous
anymore, what did you just do?’ So that
was a great story, because at that time I
said, “I don’t know if I believe in seeds”
but I know this won’t hurt anybody and I
can teach you to do it, I can teach the whole
staff to do it, you don’t need a license,
so let’s just try it. And then, I would
show up once a week to do treatment, and keep
reminding people and [my friend] said, “the
nights that you come and do treatments, we
know that you’ve been here because it is
so much quieter, everyone is more relaxed,
everyone sleeps better.
Laura Cooley, also an acupuncturist and NADA
practitioner, explains that it's not just
about the five points but everything behind
it, in what she calls the style of engagement.
– Laura speaking –
So there is a basic attitude of nonjudgmentalness
towards the individual, there’s a basic
attitude of understanding that society’s
ills are resting upon these people that are
in despair. So the style of engagement, it’s
your attitude towards the person. You don’t
get in their business, it’s not your job
to talk to them about their process. You know,
we say in the treatment room, you are chilling,
you are being with yourself. Something comes
up, that’s to take to your counselor, that’s
not for the practitioner to be discussing
at that time. Another style of engagement,
if you’re working with a population, you’re
expected to understand their culture, to do
your homework. NADA starts from a compassionate
place of understanding society’s influences
on how people’s lives go. Under that compassion
is that we assume that the patient or person
we’re serving has intuition and intelligence.
And again, intuition, trauma divorces us from
our instincts so part of our job is to reconnecting
a person’s instincts. Holding hope for people
who don’t have it, right. Your job is to
hold hope and to be optimistic about a person’s
future when they aren’t because they have
a lot of experiences telling them there’s
not much hope. So, you know, you’re to hold
this space and say, no there is hope. You
can recover. And what they do to recover,
they’ve done it. You know, we have a tool
bag, we can assist, but their recovery was
done on their own steam. We say that the person
is the expert of their own experiences, like,
that is a basic attitude we’d like you to
have. They are the expert on their experience.
We as the “professional,” we might have
a lot of good ideas, we might have very accurate
diagnoses, but if they don’t feel it from
the inside, you know, us telling them, does
nothing. As the person that’s serving people,
when they make progress, it’s theirs. We
don’t take ownership of it, because what’s
empowering is the idea that they have the
power to do that. Our basic job is to empower
people and create resilience. And that happens
the quickest if you follow their lead, and
you help them reconnect with their strengths
and their instincts. That is the fastest route
there.
This treatment is like a reset button and
allows patients to take a moment to pause.
Furthermore, where both Elizabeth and Laura
are licensed acupuncturists and can put needles
in other points on the body, they find that
the majority of patients respond well to the
simple five points. This simplicity allows
the practice to spread widely with more people
being able to train only in how to do the
five points, instead of going to traditional
acupuncture school. This makes the treatment
more accessible to all kinds of communities,
especially marginalized communities that might
not have access to acupuncture before. Most
of all, the hope of practitioners like Laura
and Elizabeth is to empower communities. So
what communities is the protocol in?
– Laura speaking –
Where has it gone? In Texas, at the heart
of Texas, Waco state agency, we had a program
there, that in order to get into that program
there you had to have been institutionalized
for five years of your life. The Atlantic
chapter of sickle cell anemia trained the
people in the chapter to do themselves. Hungary
has integrated it into every detox unit in
the country, it’s gone all over the world,
it’s all over Eastern Europe. There were
trainers in Saudi Arabia like forty years
ago, or thirty-five years ago. So it’s gone
all over the world. It’s being used in so
many different situations, anything related
to trauma. Job corps programs for youth at
risk, At-risk youth programs in Mexico City
with homeless kids. Rape crisis centers, In
India, our colleague Sunil he started a program
on the 7th floor of the New Delhi police department
with the cooperation of the police department,
Wendy Henry was at Ground Zero, she managed
to get through three levels of security, into
the trailer, I should check, I think it was
the FEMA trailer because there were several
trailers there. But Wendy Henry managed to
get into the trailers at Ground Zero and do
ear treatments on firefighters there. They
would stop to take a break, to get water,
they did not want to take all their gear off.
So with this treatment, they could sit in
chairs, get ear acupuncture, get restored,
and go back out there. So we also, after Katrina,
we worked with Louisiana firefighters and
with the peer counselors for the first responders.
Because we, and particularly Wendy, had been
working with the search and rescue teams,
we’d go to their trainings, get the training,
and on breaks, we’d needle people. So they
offered us their training for free, and we’d
give them services. So Wendy managed to get
into the disaster zone during the disaster.
This is first aid, this is psychological first
aid, it should be in everybody’s medicine
cabinet, and I see it as leading the way to
a holistic process.
– Elizabeth speaking –
– It’s first aid! That’s it, it’s first
aid.
This is a list that Laura compiled of all
the various places the ear acupuncture protocol
is used in, almost as a first-aid measure,
and Laura and Elizabeth just mentioned. I
call this concept toolkit care, a self-assembled,
essential mobile, community-based care often
in response to the dire situation, whether
its emergency situations such as 9/11 or the
ills of poverty and marginalization. And there’s
a DIY spirit to this toolkit care.
Ear acupuncture has gone all around the world,
in the toolkits of various practitioners,
and my journey led me to the United Kingdom
next, where I had heard that the five-point
ear acupuncture protocol was being widely
used for addiction, and it was brought over
by practitioners who visited Lincoln Detox
in the mid-1980s to 1990s. There are at least
20, 000 practitioners that know the protocol
in the United Kingdom. And what I found most
remarkable was that so many of them were patients
first. I talked to a number of patient-turned-practitioners,
including Tim, who began ear acupuncture treatment
in 1999 at a charity ear acupuncture service
called Pathways to Health. A few months later,
he began to learn how to do ear acupuncture
himself with a practitioner named John Tindall
who had visited Lincoln Detox in the mid-1980s.
Here is Tim’s story.
– Tim speaking –
I had addiction issues myself, kind of how
I started with it. I just thought my willpower
was weak, that’s when I started having the
acupuncture. I was actually waiting outside
somebody’s house to buy drugs, and I just
had this “Eureka!” I’ve had enough of
this. I’ve had enough of this, you know,
I just want some change, I just want to move
away from all that. And that was when I went
and had my first treatment. Yeah, it’s quite
life-changing for me. At the time, Pathways
were doing two clinics a week and so I kept
that up. I wasn’t sure at first, I knew
I quite liked it, then after about six or
eight weeks, doing it twice a week, I got
up one morning, looked in the mirror, and
I
thought, “Wow you’re a different person.
So much changed, so much moved.”
Just felt completely different really, just
felt more in control of myself, and more,
I dunno, grounded. I think yeah, it was after
I did about eight weeks of the ear acupuncture
and they could tell that it was working for
me and that I was coming to the clinic, this
lady who suggested that I could work for Pathways.
And then someone suggested that I went and
do the course, it was only
the NADA to start with, and yeah, I did my
two-day course with
John and I was doing the qigong with him,
and from then, oof, it completely changed.
Yeah, it was quite a turnaround for me. When
I first started going for the ear acupuncture
I was smoking a lot of cigarettes, and I hadn’t
even really thought about cutting down, and
then I think about, after about six weeks,
I looked at my packet of tobacco, and I thought,
I bought that about a week ago! You know,
I was just smoking a lot, lot less, and I
hadn’t made any conscious effort. Just sort
of happened. I think you just become more
aware of what you’re doing to your body.
Massage, exercise, diet, just sort of being
nice to yourself. And I quite like when I’m
treating people I don’t always know why
they’re in, whether they have a major crack
cocaine problem or whether they just ate too
many biscuits or whether they’ve just got
work-related stress, or, you don’t really
know, and you don’t really have to know
it either. I mean, that was one of the, part
of the beauty of it, is that you can give
acupuncture to people who are not in the kind
of social group that see an acupuncturist
and it’s like 40, 50 pounds an hour. It’s
not something that everyone’s really got
access to. So just to be able to treat people
paying, I dunno, 2 pounds or whatever, it’s
brilliant.
Like Tim said, one of the things about ear
acupuncture that he loved was that it was
so accessible by all kinds of people. This
is how he was able to try it, and this is
also how the next practitioner I spoke to
was able to try it too. Liam was also trained
by John Tindall, and his path to acupuncture
began with his recovery from alcoholism. He’s
originally from a small coastal town of Scotland
and here is his story.
– Liam speaking –
But I decided in my thirties I had to get
out of there, you know, because alcoholism
is a big thing, and I saw that’s the way
that my journey was going. I came to London
and got even more heavily into drugs, I put
myself into rehab, for something like 360
days of the year they offered ear acupuncture.
Amazing, yeah, absolutely amazing. I just
lived around the corner from the place. So
I just used to nip up there on Saturdays and
Sundays. There was a woman there who used
to administer the acupuncture, she said to
me, I know just the man for you. And that was John!
And then, one day I was having,
I went in for a treatment, there was an ear
acupuncture course on, this would be just
about 2001 or something, and he said, “yeah
you fancy it? You can have it for free!”
So, I was like yeah okay, I just liked the
idea of spinning needles, and of course, being
a work class kid, I end up just treating poor
people, that’s basically who I treat.
I come from a strong working-class background,
I’ve been a … I don’t know what you
call them in America, but they call them shop
stewards here. People who support workers
in factories basically come to me if there’s
any trouble with the management they come
to me. I never felt comfortable with wealthy
people, treating them, I’ve tried it a few
times, but it doesn’t suit me, so I tend
to, so I never ever make any money with acupuncture,
because the people that come to see me, never
have any. So there’s a time where I really
tried to walk away from it, but I just can’t
do it, I can not do it. I want to help, I
want to be part of any kind of solution. Acupuncture
is just so amazing, just you see such amazing
things happen with it, yeah amazing, people
getting well. So I was still using needles,
I always love that, makes me, it tickles me
think, it makes me laugh. So I’m not using
syringes, I’m using acupuncture needles,
but I’m still using needles.
During my research in the United Kingdom,
I also met Sue Cox, the director of SMART
UK which stands for Substance Misuse Acupuncture
Register and Training. Her recovery process
from her struggles with addiction at a young
age had led her to acupuncture, not just ear
acupuncture but full-body acupuncture as she
lived near and later attended a Chinese medicine
school. She visited Lincoln in the early 90s,
to learn more about ear acupuncture for addiction,
but strongly believed that it was crucial
to explain everything with both Western science
and Chinese medicine. The NADA organizations,
especially in the 90s, had been split on the
importance of explaining acupuncture in scientific
terms. So Sue decided to create her own program
which combines Western science and Chinese
medicine, as she wanted to remove the mysticism
around the treatment, which she believed was harming
its reputation. Thus while the SMART UK protocol
is also the five-point ear acupuncture treatment,
it is distinct because of how it is taught.
Sue is extremely passionate about helping
people with addiction and her ear acupuncture
program focuses on explaining in depth the
complexities of addiction and she only teaches
people who have backgrounds in the addiction
field. She explains that ear acupuncture helps
with balancing chemicals in the brain and
stimulates the vagus nerve, but emphasizes
that ear acupuncture is part of a much larger
holistic process for a person’s recovery.
Her program has gone all around the United
Kingdom, and even into 128 of the 150 prisons
in the country, where she teaches prison officers
how to treat inmates with acupuncture and
she even teaches acupressure to the inmates
with all the same theory. She attributes the
success of her program to a strong focus on
explanation and research.
– Sue speaking –
We teach, we do teach Chinese medical theories,
so the yin-yang theory, the Five Element theory,
I teach them so they can start to look at
themselves in a different light and to get
some understanding of being part of the universe,
as an equally important part of the universe,
and that all of these things that change the
seasons and everything, they’re happening
to them, too. So it’s a. simplified way.
Then we look at the brain in-depth because
that is the target organ of addiction. When
we’re doing this treatment it’s wrong
to call it a detox treatment, livers detox,
ears don’t detox, it’s nonsense. We teach
about the brain, we marry the two together
so it’s a lot about translation, it’s
about translating Chinese medicine into science,
and then into a language that we all speak. So,
not keeping the elitism of saying, of using
terminology that they don’t know about,
not baffling them with a great deal of physics,
but translating it all and putting it together,
makes sense to them. They’re not stupid
people. It’s more of a collaborative process,
you know, we’re doing this together. So
I do teach the background of ear acupuncture,
I tell them about my time in New York, I now
emphasize quite a lot about the Black Panther
movement and the Young Lords, because I think
that’s a really important part of history.
And then I tell them how we came into being
and what we feel about it. So, there are so
many differences, far too many, but I do talk
to them about which part of the brain serotonin
is manufactured in, what part of the brain
the ear points stimulate, why we think there
is endorphin production, so I tell them the
whys of it. And then if I’m teaching the
acupuncture, I teach them the practical skills,
health and safety, and boundaries, they’ve
got ethical codes, something they have to
adhere to. We give them an exam, then they
go on a register, they have annual supervision,
and its become like a community of like-minded
people, all trying to do things the best they
can, and they still write to me and say, “Gosh,
I had this man came in today, and he’s told
me this has happened, that has happened, the
others happened.” And I’m still thrilled
to pieces about it, but I also know why it’s
happening, and so do they. I think anybody
can learn to stick a few needles in ears,
I taught my grandson to do that in rubber
ears actually, but that’s not the issue.
The issue is understanding why you’re doing
it. Otherwise, it’s a bit like, anybody
can stick a hypodermic and give somebody an
antibiotic injection, but unless you know
what you’re doing, you might do more harm
than good. So it is more to me about understanding.
You know all of the anecdotal things, I mean,
I’ve got thousands of those, thousands,
and you can go on doing that, but you’ll
never gonna be able to replicate that and
evaluate it properly if you don’t really
know what’s going on. It’s the way forward,
it’s why it’s worked so well. It’s the
most unlikely thing, to go into a utilitarian,
harsh environment like a prison, and take
in this fluffy, touchy feeling world of acupuncture.
It’s been remarkable to be able to gel the
two together. I mean, the prison that you
saw is one thing, but that’s a very, very
mild experience. I mean if you were go to
into some of the higher category prisons,
it is very different. And to consider, psychopaths
with two personality disorders who are in
for life, ask for acupuncture treatment, but
not only that, they ask why it works. They
want to know what’s happening to their brain,
and they understand it, and they welcome it
and embrace it because they’re having it
explained to them. I’ve had some amazing
stories, loads of life-changing things but
not because just because they had a few needles
in their ears. Starts of the process, but
then it gave them the ability to work. I often
say that it’s a bit like fuel. You’ve
got a long journey to go on, you’ve got
a lot of hurdles to go over, you’re going
to need to be able to have some fuel in order
to maintain that journey. I’ve got a patient
whose epileptic, but her epilepsy is anxiety-induced,
so she has a fit because she’s anxious.
So she’s had quite a lot of ear acupuncture,
she’s had other stuff, but she’s had ear
acupuncture and she’s found that she’s
had fewer, a lot fewer, fits. Now, the ear
acupuncture isn’t fixing, it’s not curing
the fits, it’s reducing the anxiety, which
is then not allowing… so you know, it’s
understanding that. But you know, if you don’t
understand it, people put needles in ears,
epileptic fits stop, magic! Wave the magic
wand, this stuff cures epilepsy. Not true,
you’ve got to understand it. It’s like
blood pressure, it’s perceived that the
treatment will lower high blood pressure,
which it will if it was caused by anxiety.
It won’t lower low blood pressure, and it
won’t lower normal blood pressure. It will
only lower blood pressure that’s caused
by anxiety. You’ve got to understand how
treatments work. And giving that information
to patients actually empowers them because
they will do all the right things because
you’ve actually said to them. You’re not
saying “don’t do this,” you’re saying
look, this is what is happening, this is why
it’s happening. Also, over the years, people
have said what about diet, what about this,
so we do teach a whole package, so we do talk
about what foods are good for the brain. We
talk about smells, and sounds, and all of
those things that you can improve your well-being
by things that are just around you, which
I think is also empowering. And also, we talk
about the importance of sleep, the importance
of a dark room. In terms of how I see the
ear acupuncture, I teach it as a very valuable
adjunctive treatment, but not a magic bullet.
[The important] thing to me is to make sure
that the man in the chair is being looked
after, that nobody is throwing a bit of parsley
at him and saying, “There you go, this hocus
pocus magic will fix your life-threatening
condition.” I don’t think we’d get hardened
prison officers, who are very intelligent,
and very highly trained in this country, you
wouldn’t get them doing a fluffy treatment
if it wasn’t something they could understand and relate to, they just wouldn’t do it.
They don’t do needles, no, but they know
all the theory, they use the pressure points
and they learn other points they can use,
just to use the seeds. They sign to say they
understand the limitations of what they’re
doing, they get a nice certificate, and they
want to do it properly, so they don’t abuse
it. But the men learn the reasoning behind
it, so they know why the acupuncture is being
done in the prison and they’re more liable
to encourage their peers to access the acupuncture.
They seem themselves as first aid, they see
themselves as supporting the acupuncture trained
staff. But they’re more liable to be able
to talk to their peers in their own language
to get them into the acupuncture program.
I visited one of Sue’s programs in a prison,
and here were my field notes. In a rural town
in the north of England, I sit with seven
young offenders as Sue tells us, “We are
all made of stardust. You are made of the
same thing as the prime minister, as Albert
Einstein, as Gandhi, and everyone else.”
The young men look at each other. “Really?”
One of them asks out of disbelief.
“Yes,” Sue replies. “And anyone can
be addicted. Addicts are ‘creatures of excess’.
This sets us apart. Nature selected for addiction
– it was a way of survival. The hunters
and the gatherers who wanted more would be
the ones that survived. Addiction isn’t
a weakness or an illness. It is a strength.”
However, addiction can kill, Sue goes on,
and shows scans of brains damaged by substances.
Some of the boys have never seen brain scans
before. We continued with a detailed neurobiology
lesson, down to neurotransmitters being released
into the synaptic cleft. Sue doesn’t leave
any detail out.
“Things like ear acupuncture or acupressure
change the way of how you feel, and it helps
you gain back control. It can empower you
and it gives you fuel,” Sue says as she
begins a lesson in Chinese medicine, which
she describes as metaphors, rather than literal
natural forces. Yin and Yang represent the
importance of balance in the universe and
in ourselves. It is possible to find balance,
retrain the brain, and redirect the addiction
towards something positive.
I finished my journey by doing an ear acupuncture
training myself with John Tindall, who had
trained Liam and Tim. I wondered who was going
to be there and how was I going to learn ear
acupuncture in 4 days? It was deeply intense
with so much practice and needling other people’s
ears and getting my own ears needled. There
were many differences between this training
and what I had witnessed in the prison with
Sue – here the focus was on practice, practice,
practice. We would learn much more than just
the five points, upwards of fifty points in
the ears. But what stuck out to me the most
was the camaraderie between me and twenty
other strangers, I have just met; people from all
walks of life – math teachers, electricians,
nurses, doctors – we came together to learn
ear acupuncture in hopes of helping others.
Not only that, we converged on each having
chronic illnesses ourselves or having close
ones who did. At the community training clinic
on the second night, I remember observing
trainees and patients interact, patients with
all kinds of conditions, sciatica, pancreatic
cancer, anxiety, addiction. One fellow trainee
asks if she could give me facial acupuncture.
I’ve never tried it before, so I agreed.
People were quietly whispering to each other,
catching up on their weeks, or simply meditating.
The space was comfortable, caring, and welcoming,
accepting of whoever’s there. It felt like
a space held together by trust, of others,
and oneself. But most of all, it felt empowering
because so many people there were trying to
figure out how to pursue health, together.
That’s when I deeply realize and feel that
the five-point protocol, in whatever form
it takes, is much more than just that.
It is amazing to see how something developed
in the South Bronx in the 70s has gone all
around the world and changed the lives of
so many. In turn, the treatment has also been
shaped by the people – all the practitioners
I met use and explain the practice differently
even if the treatments look the same. I learned
to see beyond what may seem obvious.
This heterogeneity emphasizes how medical
practices are really a reflection of us, our
needs, and local contexts. There is no one
form of ear acupuncture in specific and Chinese
medicine in general. Medical practices constantly
evolve. There is no real start point we can
determine, nor even an endpoint.
Yet, one key aspect remained constant in these
unexpected connections, and the focus of all
the practitioners I met with ear acupuncture
in their toolkits was on empowering patients.
These different practitioners are dedicated
to serving patients, and especially those
that are often disregarded and ignored by
medical institutions and societies at large.
As a result, echoes of the revolutionary spirit
from Lincoln detox continue to live on in
the hands of these modern practitioners.
(Light guitar music)

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