Doctors Reveal Which 'Do Not Resuscitate' Patients They Think Would Have Pulled Through
A DNR is a last resort for people who are terminally ill or injured and can no longer expect any quality of life. Although there are a few exceptions to this, end of life conversations are something that all families should have at some point.
YourBestNightmare asked doctors and nurses of Reddit: Was there a "DNR" patient that you knew could have made it? What's the story?
Submissions have been edited for clarity, context, and profanity.
First, some perspective.
I'm a doctor. I love this question, it's a great place to start. But, I can't answer it the way it's worded.
(DNR = Do Not Resuscitate, just so we're all on the same page)
The real question you have to answer first is this: How are you defining 'made it'? Is that just having a pulse? Breathing without mechanical assistance? Getting your nutrition from a surgically implanted tube? 'Making it' is different for different people.
So, that said, I think you're asking if a DNR order ever stopped us from saving someone that could have walked out of the hospital and lived a 'productive life' for a while longer.
No, I've never seen that happen.
DNR is usually requested by patients that have significant, ultimately terminal conditions. ( Don't confuse DNR with a 'living will', these are not the same thing). These patients have recognized that they've come close to the end of their lives and 'heroic efforts' are, at best, going to prolong their suffering.
It's a huge topic, it deserves much more time than we can give it here.
Also to add to this, there are a good number of times we could "get back" a DNR but the question that gets posed is "how is their quality of life".
Sure 90 year old grandma with cancer could have lived for another 2-3 months but is it going to be that great if we end up breaking all of her ribs to do CPR? If we need an artificial airway do we think she will ever get off or will she need a trache and never eat a solid meal again.
I have worked in the ICU for almost 5 years now and I can honestly say there has never been a case where I said "I wish <patient name> wasn't a DNR" though I can say on the flip side that at least once a weak I mutter to another medical professional "<patient name> really needs to be a DNR"
I've taken to working in variations of the phrase "I can do a lot of things TO your loved ones, but given their overall poor chance for a meaningful recovery, the question is whether I would be doing those things FOR them" into my goals of care discussions. Seems to get at least some people to understand that just because I can artificially extend life using machines for sometimes months at a time, should we actually be doing that.
DNRs are used in extreme situations.
Doctor here.
One important thing to consider is that otherwise healthy people usually don't die and definitely don't have standing DNR orders.
That's usually only a code status you get tagged with if you're terminally ill and/or terminally elderly.
We only assign that designation when the patient, family, or power of attorney agrees, and when the patient has demonstrated a trajectory of illness toward unsurvivability.
Some examples of terminal conditions would be:
widely metastatic cancer refractory to treatments, end stage dementia plus acutely life threatening medical condition, cascading multiple organ system failure. Multiple successive critical care admissions over a short interval of time. Progressive failure to thrive at the end of life despite medical interventions and a potentially terminal event. An unsurvivable traumatic injury such as one that results in brain death or uncontrollable hemorrhage or widespread crush injury. Sudden cardiac death with prolonged hypoxia and anoxia brain injury, A massive acute stroke at an age exceeding recovery potential. Diffusely ischemic bowel beyond rescue confirmed surgically. Organ system failure with refused replacement therapy such as someone with Severe COPD that refuses ventilators support or someone with end stage renal failure that refuses dialysis. Patients already in hospice care.
Patients have a right to natural death without heroic interventions and associated expense to their estate should they so choose.
"Making it" doesn't mean having a quality of life.
I'm an emergency doctor, and DNR means do not resuscitate, the decision to place a patient in palliative care or label them DNR is when they have advance disease that cannot be improved or cured as their illness slowly progress and make their living harder and more painful, good examples are advance cancer , advanced COPD ..etc
You know a patient that could've made it? Probably most of them, but what do you mean by made it? Living under mechanical ventilation for weeks in the ICU and not able to wean them off until they eventually die, or living in severe pain/discomfort until they pass away? That would be the outcome if they were resuscitated,
The decision of DNR is not made on the spot, usually by the primary physician who knows their condition very well and know that there is absolutely no improvement or treatment to their current health condition and they try to make them as comfortable as possible.
Most patients/families that I encountered they understand and accept that they know it is a reasonable decision.
Hard pass.
Cardiac nurse here. Most people I know probably could've made it, but the quality of life would be so low that living would be worse. Hooked to a ventilator, tubes in every hole, immense pain, TBI, brain dead etc. Very rarely do I see someone make it through a code and be at the same quality of life as they were prior.
My dad had his heart stop for less than 10 min. (Complications after surgery for his cancer). After he came back he was never really the same. The doctors helped him live another year and a half but he suffered a lot and his mental state and capacity were diminished. At the time there was no reason to believe he wouldn't make it and live a long life but the cancer ultimately spread and slowly took him.
Do I regret the extra time spent with him? No. However what I do know is that he would have had way less suffering if he never came back from that code.
With a few exceptions, death is often the most humane option.
Yes. Many patients are DNR plus DNI because many times you can't really do CPR in a hospital without also establishing an airway. We had an elderly gentleman in good shape/health in for severe pneumonia. He coughed up so much phlegm that he plugged his own airway. After multiple failed attempts to suction him orally and nasally when he turned gray we turned to the wife and offered to intubate him solely to remove the plug then immediately extubate him. She refused because she wanted to respect his wishes and he was vehemently opposed to being intubated or resuscitated. We watched him die. That's the only one that really sticks with me as being basically completely avoidable.
The truth is that far more patients should be DNRs but aren't than the other way around. Families really need to start discussing end of life care and expectations BEFORE they need to make that decision. Grandma won't live forever. I'm always a little amazed when people are so confused and dumbfounded that their 88 year old grandmother is dying.
Also it's a total myth that we won't work as hard to save you if you're a DNR or we just want your organs.
DNR does NOT mean don't treat. Even palliative care doesn't mean don't treat it just means that treatment options are more limited and the doctors are really looking at benefit vs risk. Comfort care means don't treat, just make them comfortable and let them die naturally.
Not enough families have the "talk."
It's usually the opposite in my experience actually. More often than not I have patients who are full codes, 90+ years old, advanced dementia, multiple co-morbidities, complete failures to thrive etc etc. And rarely do they have a family member who will advocate for them.
There are a handful of hospitalists that can't seem to bring themselves to know when enough's enough. And they always end up with these patients, and before you know it this poor old man or woman has an NG tube that we all know they goddamn well shouldn't be forced to have, and IV antibiotics for the pneumonia they're now drowning in and and and and.
There is nothing that breaks my heart more than when I admit a patient who's 95+ years old with a broken hip.
There's no telling how long someone will last.
Depends on what you mean by "made it". A decent amount of the patients with DNRs who stop breathing and go into cardiac arrest could be resuscitated and placed on a ventilator, but it's hard to say how long they would last, and their quality of life is usually already pretty grim by the time they get DNR paperwork filled out. I've never provided care for an otherwise healthy patient who stopped breathing and who had a DNR on file with the hospital, and finding a patient who fits that criteria is probably like finding a needle in a haystack.
And then there are the anti-medicine religious nuts.
I'm going to answer this question with a slightly skewed (and perhaps biased) answer.
I saw a young patient (20+) who had been in a trauma whose parents refused to allow us to treat him appropriately, basically allowing him to die. He had lost a significant amount of blood and needed to be transfused. His parents were Jehovah Witnesses and refused to allow him to be transfused. He was given so much saline to bring his volume and pressure up, that when you drew blood for chemistry, it looked like cherry cool aid. It was so serious that they were using vials designed for preemies instead of adults for blood draws. He died of a heart attack because he couldn't oxygenate anymore.
I find it hard to believe that was legal for his parents to make that decision. I know if he were a minor, it would've definitely been illegal, emergency care would've been provided, and it could've been pushed up the ethics chain if the parents strongly disagreed.
Medical staff have to respect a patient and family's wishes, especially religious. This sort of thing happens less and less as there are new alternatives to maintaining life without using blood products but it absolutely happens and is ethical.
You're right. If it had been a minor, this would have been quickly taken in front of a judge to appoint a guardian ad litem. In this instance, the parents of this adult can always say that these were his wishes too, at which point our hands are tied.
This is precisely a case why you need to appoint someone you trust as a medical POA, someone who will respect your wishes even though it may conflict with their own personal beliefs.
(As a side note, this was 20+ years ago and technology has improved)
Those who sign DNRs don't plan on coming back.
As others have said, but maybe I can put it more succinctly, people who are DNRs are not strong, healthy people. Sure, you might be able to revive them for some time, but their quality of life would be abysmal, which is why they chose to be a DNR: they don't want to live with tubes coming out of every hole, artificially keeping them alive.
So can a healthy person request DNR just to be an assh*le?
To be an assh*le to themselves? No skin off my nose if someone healthy wants to be a DNR. I'm not here to judge. It's their life.
This is pretty cool.
My sister was a foster child and the state tried to place a DNR on her due to a seizure disorder that hospitalized her many times. My parents fought them to have it removed. She had a hemispherectomy at age two, learned how to use her body all over again and is now living a very productive life for someone with half of a brain.
I've heard enough of these stories that I push back on the QOL judgement in healthcare. While they're working off a great breadth of info, it's not perfect. Hell, they discovered a woman with no cerebellum that could walk. She was described as "a little unsteady."
Sometimes you only need to experience something once, to know it's a never again situation.
I always say, try everything once.
Well, now that I'm older, a caveat to that is... try it all within reason.
How many things have we all walked away from saying the one time experience will suffice?
In fact, knowing when to say no is one of life's wisest choices.
Redditor Croakied wanted to discuss the times we've all said... "once was enough!" They asked:
"What is one thing that you will NEVER do again?"
Love. Did it. A few times. Moving on.
Stay Still
"Jump off a moving train."
DenseDriver6477
"My dad used to jump on a train when he was little to go to school. He broke his nose like twice doing it. He also would not recommend."
Darphon
“vaportini”
"Smoke alcohol. Me and my friends bought something called a 'vaportini' in college where you could pour alcohol into a bulb and after low heat separated the alcohol from the liquid, you could inhale it thru the glass straw you inserted into the bulb. Basically you got drunk directly into your bloodstream/brain and it never hit your stomach."
"If you did too much, your body wouldn’t make you vomit or something, there wouldn’t be a simple self regulation/safety measure. You’d just get alcohol poisoning. Felt very dangerous, the drunk wasn’t a regular drunk feeling. We used it once and were like okay, never again. I’d be surprised if you could still buy it, although it would be incredibly easy to replicate at home."
michelangelho
It’s heartbreaking...
"Fall in love with a drug addict."
Rains_Lee
"Good call, don’t do it. The drugs will always come first. Can’t go out unless their 'ok' with how much drugs they have and money left over if any, cant make love unless they have their fix for the night and even still it never feels normal, can’t trust them after the lies to get drugs and the manipulation they put you through, and you can’t change them no matter how much you try and wish they would. It’s heartbreaking."
Cvilla411
More me time...
"Give up my life for work. F**k going the extra mile for a place that doesn't value you and pays you crap even though you go the extra mile for them. You have 1 life with only so much precious time to enjoy it and slaving away at some job is not worth it. Do what you can to reduce your workload and find better employment, or hell try to change the working conditions at your current job to improve things for everyone if you can."
Mrhappytrigers
Well Obvi...
"Donate a kidney."
ToffieMonster
"Well, you could donate the remaining one. You just won’t be around to say anything about it."
shavemejesus
This is definitely list I can relate to. No thank you on a lot of this!
I Quit
"Smoke cigarettes, it's been two years since I quit."
SuvenPan
Forget It
"Climb mount Kilimanjaro. Toughest thing I've done and it's not worth it. I'm all about tough treks and camping but to put yourself under tough conditions and suspectable to altitude sickness only to get to the top for 10 minutes for a picture. No thank you."
Monks_
"I agree, it was memorable. Once was enough for my husband and I. Thankfully we stayed at American style hotel run by the US Navy with a hot tub and bar. Alcohol was definitely needed after all that."
Whatsherface112
I'm living alone!
"Sign a lease with a stranger without hanging out with them a few times beforehand. My past roommate experiences in college were terrible. Roommates either ignored me, hosted parties til 3 AM on weeknights, made the house the hangout and drug-den for them and their buddies. Meet up once and they'll put on an act for you. If you can, try to see how they act drunk or frustrated."
"Try to hang out with their buddies too so you can see the type of people who could be coming into your future place of residence. As soon as I can afford it, I'm living alone! Now, I investigate a potential roommate's social media and hang out at least twice before signing a lease with them."
fleursdefer
Stay Away
"Take back a cheater. Know your worth my brothers and sisters."
santichrist
"Ughhhhh going back and forth on this one. My boyfriend of 5 years has cheated on me. Several times, actually but says he’s really changed and is ready to settle down and wants me to move in with him. I’m on the fence. So they never change???"
madlecroy
Sleeptime
"Take a laxative and sleeping pill at the same time."
karmaredemption
Once, twice, three times... I'm out. Bye.
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People Imagine How They'd React If Their Significant Other Wanted To Sleep With Other People
There is an age old question that has been getting more traction surrounding sex for partners the last decade or so.
And that is... "is just one enough?"
Were we really meant to only be with one person forever?
There are so many flavors to taste.
What if your partner wants more cookie dough with your strawberry?
Redditor Pineapple-Status wanted to hear everyone's thoughts on opening the bedroom to others. They asked:
"What would you do if your long term SO suddenly wants to have sex with other people?"
I say I'd be ok with it, but I'm remembering my last relationship and I feel like I'm not a "put my $ where my mouth is type" on this issue.
Bye
"Wish her well and spend the next 2 years getting myself back to a place where I am ready to get hurt again."
wickedblight
It's Time to Roll On...
"Personally I would leave them."
"I think they're the ones leaving you. I don't think the relationship changes at that point; I think it ends. If you have a monogamous relationship, they are telling you they want to end that. They might be suggesting starting a new, non-monogamous relationship, but that is a separate thing. The original relationship is over."
octopoddle
ethical non-monogamy...
"OP, it's no different than anything else they want: you either agree and stay together, disagree but stay together, disagree and break up, or even agree and break up. What you're talking about is called 'ethical non-monogamy.'" The seminal book to read is called The Ethical Sl*t."
"It basically boils down to be whatever you want, just don't lie about it. The tricky thing is that this is something that was not present before, but is present now. So it's a potential fork in your road. If you're against it, it's up to your SO to decide if sex with other people is more important to them than a life with you."
Tokugawa
a different story...
"I think it depends too how intently they're interested. If it's a thing they bring up because they're curious but it's not a dealbreaker for them, I'm fine with that even if I don't want to proceed. A solid relationship involves open communication, and it'd make me happy if my partner trusted us and our bond enough to voice that curiosity with me."
"If it's something their heart's absolutely set on, then it's a different story. Either way, it's kind of strange to me how these posts always assume simply asking your partner how they feel about opening the relationship means they're now wholey invested in the poly lifestyle and they'll resent you or cheat if you say no."
donkeynique
Others
"Happy that we have common interest, sad that it's different 'other people."
i_lick_icicles
Sex is always an issue. Remember when it was just fun?
Mine
"Leave her. I’m far too possessive and jealous to be able to mentally accept polyamory. If she has a desire to be with other people I’m not going to stand in her way but I’m not going to be there when she gets home either."
Thiek
Not Me...
"Break up. My parents were poly and it's just not for me. I've been honest with every relationship I've been in that I'm not interested in any type of open relationship. If they want to be with someone else that's fine but we'll be over. My husband is aware of this and on board (and has been for over twenty years!). So if he came to me with this yes I would be heartbroken but I'm not willing to budge on this and it would be the end of our relationship."
GoldDustWitchQueen
Let's Talk
"Counseling time! We're married. I'm chronically ill (stage 4 breast cancer) and have no libido. We try to make intimacy work, and obviously in that case it wouldn't be working. So. Time for a pro to sort out the marriage, and possibly a sex therapist for me."
insertcaffeine
Awkward Positions
"I’ll put myself hypothetically in this position. My partner and I only want each other. We’ve made this abundantly clear to each other. However, if she came to me with desire to open our bedroom and she wanted to sleep with people outside our marriage."
"I would simply express how I vehemently do not an open bedroom and that it would kill any desire I have to want her, be with her, love her, etc. Our couple dynamic has been working well through our ups and downs. Involving some stranger in the ONE thing I find most sacred with my partner is the best way for me to lose any interest or passion for the relationship."
RedFlaim
Farewell
"Break it off, because they definitely already have someone in mind and you telling them no won't change the fact that they were only one step away from following through with it."
Caressticles
Well it feels like a lot of people still believe in one partner, happily ever after. Good for y'all. But big props to these couples who have open and honest conversations about their wants and needs.
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Many of us sometimes fantasize about what we would do to our worst enemies, especially in the moments when they're actively making our lives worse.
While most of us would never actually do any of the things that we contemplate instead of screaming at that super annoying person at the office, we do get pretty creative with the ideas.
Redditor take_me_there_ asked:
"What WOULD you wish on your worst enemy?"
This One Would Hurt
"A conscience. Let her realize the horrific things she’s done."
- Jenny010137
"Seriously. Introspection, self awareness, and empathy are traits that would improve a lot of sh*tty people."
- el_muerte17
"Oh I wish I had thought of this one. If my enemy had a conscience, wow life would be much different."
- Shelbysouth43
No Pearly Whites For You
"I’d like all their teeth to turn really yellow and stay yellow no matter what they do."
- toothfixingfiend
"What did I ever do to you?"
- Spideredd
"I don't even know you! Give me back my enamel!"
- AngryMustache9
Everything You Own Is Orange Now
"Permanent Cheeto fingers. Just orange cheese dust getting on everything."
- cocoapuff1721
"This has to be one of the most evil things I ever heard, yet absolutely hilarious."
-Merk0411
"The Midas Touch: Snack Edition"
- MaryVenetia
Ouch, But Forever
"Stubbing and breaking their toe and right as it’s about to be done healing it happens again over and over for the rest of their pitiful time on this hell we call earth."
- No-Bee-2971
"Sisyphoot"
- Alpha_6
"More of a Toemetheus imo"
- PykeTheDrowned
Self Reflection
"For them to realize how big of an a-hole they are."
- mayhemanaged
"Same for me. The trouble is mine probably knows what a tremendous a-hole he is, and just doesn't care (it's what defines him, is his outlook more than likely), so, give mine a conscience as well, he undeniably lacks one."
- RhoadsOfRock
"a crushing moment of self realization is something that can destroy you mentally. I wish that on them."
- chancetodream
Bury Them Under A Mountain Of Minor Inconveniences
"Always being hungry two hours after eating no matter how large the meal. Slow internet. Traffic jams no matter the location. Self doubt. Allergies. Favorite shows spoiled."
"Nothing major enough to be life altering but constant, low grade inconveniences that wear on your soul every day."
- I_Love_Small_Br**sts
"Every bite of food they eat/drink they drink being slightly the wrong temperature."
"Coffee? Warm but not hot. Cola? Cool, but not cold. Muffin? Ever so slightly frozen."
"Not enough to ruin their life, but just enough to not quite have full enjoyment of anything.."
- HappiHappiHappi
They'll Never Be Able To Use Their Computer Again
"Quick scan with McAfee on their computer."
- halflife_3
"You f**king monster."
- Orion_2kTC
"The constant pop-ups from McAfee is too far."
- _Land_Rover_Series_3
That's A New Level Of Evil
"Bed bugs."
- thrawn1825
"Currently dealing with bed bugs, and I can absolutely confirm this is the kind of thing I would wish upon my worst enemy. It is miserable and painful, and I've tried everything to get rid of them at this point."
"I would easily wish this upon my worst enemy, x10."
- ArbitrarilyStagnant
"Oh hell no, you went there... Hopefully they aren't living in an apartment complex or you've cursed everyone in the building."
- expect_less
Well of course I know him. He’s me.
"$100,000. I sure could use it."
- Sparklesperson
"'It’s no surprise to me I am my own worst enemy'"
- FishyVonFishenHymer
"Lol I thought this was that deep sh*t like 'pray for those you resent to have all the things you want in life….' Then I realized."
- No-Chipmunk9527
Forever Constipated
"That they can never have a satisfying poop. They always feel like they have to go to the bathroom and when they do nothing comes."
- [User Deleted]
"Wow. That's evil. Always feeling the need to pee would be good (as in horrific) too."
- ipakookapi
We definitely don't recommend implementing any of these plans (not that most would actually be possible), but here's some new ideas for the next time you're stuck in a meeting with your most annoying coworker and need a little fantastical escape.
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I grew up poor, and I remember the little things that made me smile when we just happened to have enough that week.
The little things that a truly rich person would not think twice about.
Ah, the luxury of it.
What spells luxury for you?
Redditor ConAir161057 wanted to compare notes about the things in life that feel like items only money can buy. They asked:
"For people who grew up with little money, what always felt like a luxury?"
New clothes. I had so many hand me downs and thrift store clothes... new seemed like a dream.
Anxiety
"After growing up in a home where every unexpected problem was a financial emergency, my idea of wealthy became 'I just want enough money that if something breaks I don't get anxiety about how to deal with it.'"
Obiwan_ca_bl**me
Literature
"Getting to buy something from the scholastic book fair."
Rich*itch3232
"My school, at the end of it a bunch of books were 'donated' and then spread out on a table in the library. We all got to go pick one book. So even if kids didn’t get to purchase a book, in the end they had a chance to still get a book. It’s actually how I got my first Harry Potter book. Was a cool idea for any school staff or parents active in their kids’ schools."
glass_pillow
Christmas
"Getting new clothes at Christmas from relatives. I don't know if that is exactly a luxury or the kind of answer you are looking for, but we never had a lot of money when I was in middle school. I went an entire year wearing the same pants everyday. The funny thing was my parents didn't even buy them for me."
"I got them for Christmas from my Grandparents. All the kids use to give me so much sh*t for wearing the same pants everyday. I always told them that I had 5 of the same pair which made me feel good inside and kind of made them ease off even though I know they didn't believe me."
"I remember I fell on the school bus one day and the jagged floor cut a hole right in the knee cap and the panic that went over me was just insane. It was one of the worst feelings of my whole life because I knew that I didn't have any other pants to wear and that now all of the kids in my school were going to know that I only had 1 pair. Needless to say I could not wait for the last month of school to end."
themagicman_1231
I'm Away
"Summer camp, or basically any school trips that had to be paid for. At my school the kids who couldn't afford to go on trips that happened during school hours still had to come to the school, we just sat in a room and did extra work like it was detention."
Helpful_Yams
"I was lucky. If you taught at the day camp your kid could go for free. That was just day camp though not sleepaway camp. My mom found a camp teacher who had no kids of his own and he signed me up as his kid so I could get free day camp. Did that all through elementary school."
randtcouple
Big Deals
"Going out for pizza was a big deal. Those free mini pizzas for reading books were huge."
Shroom4Yoshi
Food is always an issue when you're broke.
Damage
"Being able to turn on the heat in the cold and pay a professional to fix damaged appliances, plumbing, and other issues."
Liggettef
Spoiled
"When my grandma would come pick me up and spoil me. My parents didn't have much money and were addicts so when my grandma would come get me I would come back with new clothes, video games, toys, etc. I used to think my grandma was rich but she actually just had a stable income."
nawlepen
"I was in this position when I was younger. I always thought my grandma had SO much money… but all she did was go to work everyday. Always made sure I had clothes and all my school supplies. I miss her pretty bad."
Keywork29
Water
"I am from a small island in the Pacific. While I mostly still take cold showers, I have always felt that a hot shower is the finest luxury one can experience. I had my first hot shower when I was 22 years old and I can never forget it."
FSMPIO
"This is the kind of luxury I think people take for granted, I always avoided showers in the winter as a kid since most of the time they where cold showers and the temperature here was around 12c° during those times."
PowerfullDio
Showerware
"Towels. Honestly, I was almost 10 When I realized people didn’t just put back on their dirty clothes after a shower because my family was so large (12 kids total including myself) and extremely poor. I thought towels were just for hotels or were maybe a prop on television. I went to a friends house and she asked for my help folding her towels. I remember laughing and thinking she must be rich."
"Long story short, I wasn’t sure which way to fold the towels, and begged my mom to buy them after I revealed that my friend, Simone, had them. She bought a box of used ones from a local auction and I walked around with them on my head feeling like a frigging empress after that, even though—-let’s be clear… these were second hand towels!"
shakezula1025
Or BK...
"Grew up poor and when I was a kid I used to think you were rich if you had a dishwasher and a millionaire if you had one of those refrigerators that have a button for ice. McDonalds was also a luxury, a couple times a year on our birthdays."
chinderellab*tch
Everyone should have access to all of these things. Why is life unfair?
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