The New York Times
The Shaking Woman, or A History of My Nervesby Siri Hustvedt
In this unique neurological memoir Siri Hustvedt attempts to solve her own mysterious condition
While speaking at a memorial event for her father in 2006, Siri Hustvedt suffered a violent seizure from the neck down. Despite her flapping arms and shaking legs, she continued to speak clearly and was able to finish her speech. It was as if she had suddenly become… See more details below
In this unique neurological memoir Siri Hustvedt attempts to solve her own mysterious condition
While speaking at a memorial event for her father in 2006, Siri Hustvedt suffered a violent seizure from the neck down. Despite her flapping arms and shaking legs, she continued to speak clearly and was able to finish her speech. It was as if she had suddenly become two people: a calm orator and a shuddering wreck. Then the seizures happened again and again. The Shaking Woman tracks Hustvedt’s search for a diagnosis, one that takes her inside the thought processes of several scientific disciplines, each one of which offers a distinct perspective on her paroxysms but no ready solution. In the process, she finds herself entangled in fundamental questions: What is the relationship between brain and mind? How do we remember? What is the self?
During her investigations, Hustvedt joins a discussion group in which neurologists, psychiatrists, psychoanalysts, and brain scientists trade ideas to develop a new field: neuropsychoanalysis. She volunteers as a writing teacher for psychiatric in-patients at the Payne Whitney clinic in New York City and unearths precedents in medical history that illuminate the origins of and shifts in our theories about the mind-body problem. In The Shaking Woman, Hustvedt synthesizes her experience and research into a compelling mystery: Who is the shaking woman? In the end, the story she tells becomes, in the words of George Makari, author of Revolution in Mind, “a brilliant illumination for us all.”
The New York Times
"That Siri Hustvedt is a splendid writer is well known. The news is that life conspired to have her seek a working mastery of neuroscience. In her wonderful new book, part memoir, part mystery story, she explains this unexpected turn of events and offers the reader a wealth of valuable facts along with personal perspectives on the neuroscientific scene. Not surprisingly, the book is a pleasure to read." —Antonio Damasio, University of Southern California
"Armed with her great gift for elucidation, the novelist and essayist Siri Hustvedt has omnivorously devoured and digested complex debates from neuroscience, psychiatry, philosophy and psychoanalysis and journeyed into the mind/body problem. In The Shaking Woman, her quest to understand her own mysterious troubles becomes a brilliant illumination for us all." —George Makari, author of Revolution in Mind
"I was very struck by The Shaking Woman. Not only does it demonstrate nearly complete mastery (by a non-specialist) of the highly specialized field of neuropsychiatry, it also displays greater understanding of the underlying philosophical and historical issues that are at stake in this field than is displayed by most of my colleagues." —Mark Solms, author of Brain and the Inner World
"This is a work of dizzying intensity. . .eloquent and vivid." —Don DeLillo, author of Underworld
"As Hustvedt tries to remember pivotal medical and psychological moments in her life—she heard voices as a child, as did a couple of her sisters, had an early quaking fever, suffered from fierce migraines, tried various drugs—she segues smoothly into a wonderful section about the nature of memory…. Self-absorption can be grating in memoirs by lesser writers; in Hustvedt’s capable hands, it opens a door to revelation." —Kirkus Reviews
"Fascinating.... Hustvedt compellingly illustrates both the fragmented nature of her treatment, with the fields of psychiatry, neurology and psychoanalysis offering up conflicting views, and the difficulty of making a conclusive diagnosis. She asks fascinating questions about what it is that actually causes a physical ailment, and shows that our sense of the separation of mind and body has been generated in part by the medical establishment…. She leaves the reader thinking about his or her own bouts of illness in a thoroughly fresh way." —Lorna Bradbury, The Daily Telegraph (UK)
"[The Shaking Woman] is a personal investigation, a philosophical inquiry, and a pithy, compacted consideration of how both psychiatry and neurology have evolved in the last two centuries.... Fastidious yet engaged, intimate yet detached, Hustvedt’s exploration of mind and body embraces material that is interdisciplinary, complex and contentious. Her clean intelligence is equal to the challenge. Her frame of reference is wide and she does not condescend to past explorers…. Hustvedt is an ambitious, cerebral novelist, and the links between this book and her fiction are overt…. She brings both knowledge and an artist's insight to her discussion of memory, language, personal identity. Readers of Oliver Sacks will rate this book highly; as with Sacks, scientific knowledge and a powerful capacity for empathy are closely linked…. It is Hustvedt's gift to write with exemplary clarity of what is by necessity unclear." —Hilary Mantel, Booker Prize-winning author of Wolf Hall (in The Guardian)
"This investigation will appeal to fans of Oliver Sacks and those interested in the peculiar twists and turns of our mysterious minds." —Library Journal
"In our culture, telling the world that you, a woman, suffer from migraine or other mysterious and difficult-to-treat disorders is still tantamount to telling the world you are mad: unstable, unreliable, moaning, self-obsessed. So it’s a brave creature who announces such a thing, let alone writes a book about it…. The Shaking Woman is the product of voracious reading and deep thought, and you register its author’s sanity in every sentence." —Rachel Cooke, The Observer (UK)
"[Hustvedt’s] eloquent account flits between philosophy, science and anecdotes from the writing classes she runs for psychiatric patients, as well as her own experiences of those seizures, migraines, voices in her head and a heightened perceptual awareness. Hustvedt explores many grey areas—between mind, brain and body, sleep and wakefulness, consciousness and reality, truth and confabulation. In the process she shows how hard it is to study the mind objectively. How apt, then, that her account is stitched together by a delightfully subjective novelist's pen." —New Scientist
"Hustvedt’s deeply personal narrative reads at once like a detective novel, a medical history and a scientific critique. Through her own medical mystery, she keeps the reader engaged in the science by drawing connections to fascinating case stories from the medical literature." —Frederik Joelving, Scientific American Mind
"Hustvedt’s account of the diagnostic mess surrounding puzzling physical symptoms is very accessible. It’s also extremely fair-minded, especially regarding psychoanalysis." —Anouchka Grose, Financial Times
"Siri Hustvedt’s subtle novels have long manifested a fascination with the mind-body duality…. Hustvedt’s new book is a journey into this perplexing terrain, using the maps and signposts mind doctors and philosophers have provided both past and present…. Her own convulsing self may act as the spur to Hustvedt’s investigations, but it is the lucidity she brings to these which mark the strength of this new book. She thinks her way through complex subject matter with the effortless clarity of a poised and skeptical outsider who has little time for nonsense or the blithe reductionist certainties of supposed experts. She moves from Charcot to Freud and Janet, with a side-step into Luria and memory work, sifts and marries this with the latest research in neuropsychiatry and neuropsychoanalysis, while bringing to bear on it all her own experience with patients in a psychiatric ward—as well as her prize test case, herself. The result is a short book with an encyclopaedic breadth, one that recognises the ‘terrible strangeness’ of the inner life. THE SHAKING WOMAN is an invigorating antidote to the emotional squelchiness which too often inhabits misery memoirs and illness narratives…. it deepens understanding." —Lisa Appignanesi, The Independent (UK)
"In this far-roaming neurological memoir, Hustvedt, a writer of psychologically complex fiction, chronicles her quest for a diagnosis after she was seized by powerful convulsions while speaking at a memorial for her father… With exceptional gifts for translating dense medical discourse into lucid and supple prose and for conducting fierce and revealing analysis, Hustvedt pinpoints the perceptions underlying contradictory theories pertaining to a host of neurological pathologies… Fizzing with uncommon facts, case studies, and profiles of migraine-afflicted and epileptic writers, Hustvedt’s inquiry into some of the most baffling aspects of human life is graceful, intense, and curiously affirming." —Donna Seaman, Booklist
"Compelling." —Jackie McGlone, The Herald (Scotland)
"She has an amazing capacity to process large amounts of information on complex topics and to re-present it in a form that is understandable without seeming oversimplified." —Molly McCloskey, The Irish Times
"[Siri Hustvedt] embarks on an exploration of the fuzzy area where trauma, emotion, and the body meet, and her peregrinations take readers from the history of hysteria to the grey areas of modern psychological diagnoses. Hustvedt knows her material—her lyrical, learned narrative is a joy to read." —Seed (Books to Read Now)
"A harrowing and heartfelt memoir that is also a history of medicine, a critique of psychiatry and psychopharmacology, and a study of the curative powers of words, dreams and memories…. Hustvedt has read deeply and widely in the scientific literature as it relates to her various physical ailments, but she always returns to the first-person experience that informs her book…. Every observed and remembered detail of human experience has meaning if it can only be retrieved, scrutinized and understood. That’s a tool of psychotherapy, of course, but it also describes exactly what writers do. In "The Shaking Woman," Siri Hustvedt has done it exceptionally well." —Jonathan Kirsch, The Jewish Journal
"Illuminating the core question of her history, Siri Hustvedt, a fearless investigator and lucid storyteller, creates a mesmerizing picture." —Robert Birnbaum, The Morning News
"Much less an illness memoir than an inquisition into the science of the brain. Hustvedt calls on everyone from Freud to Japanese neuropsychiatrist K. Hitomi to dig up answers. Hustvedt’s inquiries are fascinating." —Jonathan Messinger, Time Out Chicago
"This book is so good that you’ll keep saying ‘just two more pages’ until you finally look up and realized you’ve gulped it all down in one sitting." —Word Bookstore (Brooklyn, NY)
"As a writer, Hustvedt is more sensitive than most to the experience of narrating her condition, also exploring the very act of narration, of storytelling, as critical not only to psychoanalysis but also to illness and human experience in general. Considering that her exploration is all about points of connection and points of separateness, she very carefully crafts her memoir to connect all these various strands in a way that will spark readers’ own thought processes, to consider how the way the body experiences the world might be only loosely related to the way the mind does so. The Shaking Woman or a History of My Nerves starts with a small, seemingly minor incident in one woman’s life, but quickly broadens into a wide-ranging, intellectually rigorous examination of what it means to be whole—and human." —BookReporter.com
"[A] fascinating tale of mind and brain and body… the author brings us into her world, her very head, and helps us to understand… Anyone who’s interested in what makes our minds and bodies work will be fascinated, as I certainly was, by this fine book." —Ann LaFarge, Hudson Valley News
"Hustvedt has written an immensely readable book. In The Shaking Woman, she dives into work done by neuroscientists, psychologists, psychoanalysts, philosophers, sociologists, poets and writers, and into her own experiences as a writing teacher of mentally disturbed patients, and as a patient herself in a psychiatric ward and in offices of doctors and therapists. A Ph.D. in literature, a researcher, a novelist, an essayist, a mother, a daughter, a wife: All the parts of herself play a role in her search. So does her pain, her uncertainty, her fear, her openness to ideas old and new and the remarkable capacity to take in and question what she finds in both research and experience. Biofeedback to Buddhism, she does it all. And in roughly 200 pages…. We are in her debt." —Jane Juska, San Francisco Chronicle
"There’s no end to the memoirs of illness out there, but this one is different. There’s a nakedness to it… This is a curious book. Curiouser and curiouser as Hustvedt reveals her symptoms… Something ghostly still walks in these pages. And you can see it in Hustvedt’s novels as well. Something beautiful and ghostly and unexplained." —Susan Salter Reynolds, Los Angeles Times
"Hustvedt, a deservedly acclaimed novelist, takes up a traumatic circumstance in her life and writes a cross between a memoir and a philosophical essay." —Robert Pincus, San Diego Union-Tribune
"Hustvedt makes a stout case that brain disorders must be viewed not just as scientific phenomena but as human narratives, and she advances some useful correctives about the limits of neurobiological research." —Polly Morrice, The New York Times Book Review
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THE SHAKING WOMAN OR A HISTORY OF MY NERVES
WHEN MY FATHER DIED, I was at home in Brooklyn, but only days before I had been sitting beside his bed in a nursing home in Northfield, Minnesota. Although he was weak in body, his mind remained sharp, and I remember that we talked and even laughed, though I can’t recall the content of our last conversation. I can, however, clearly see the room where he lived at the end of his life. My three sisters, my mother, and I had hung pictures on the wall and bought a pale green bedspread to make the room less stark. There was a vase of flowers on the windowsill. My father had emphysema, and we knew he would not last long. My sister Liv, who lives in Minnesota, was the only daughter with him on the final day. His lung had collapsed for the second time, and the doctor understood that he would not survive another intervention. While he was still conscious, but unable to speak, my mother called her three daughters in New York City, one by one, so we could talk to him on the telephone. I distinctly remember that I paused to think about what I should say to him. I had the curious thought that I should not utter something stupid at such a moment, that I should choose my words carefully. I wanted to say something memorable—an absurd thought, because my father’s memory would soon be snuffed out with the rest of him. But when my mother put the telephone to his ear, all I could do was choke out the words "I love you so much." Later, my mother told me that when he heard my voice, he smiled.
That night I dreamed that I was with him and he reached out for me, that I fell toward him for an embrace, and then, before he could put his arms around me, I woke up. My sister Liv called me the next morning to say that our father was dead. Immediately after that conversation, I stood up from the chair where I had been sitting, climbed the stairs to my study, and sat down to write his eulogy. My father had asked me to do it. Several weeks earlier, when I was sitting beside him in the nursing home, he had mentioned "three points" he wanted me to take down. He didn’t say, "I want you to include them in the text you will write for my funeral." He didn’t have to. It was understood. When the time came, I didn’t weep. I wrote. At the funeral I delivered my speech in a strong voice, without tears.
TWO AND A HALF YEARS LATER, I gave another talk in honor of my father. I was back in my hometown, in Minnesota, standing under a blue May sky on the St. Olaf College campus, just beyond the old building that housed the Norwegian Department, where my father had been a professor for almost forty years. The department had planted a memorial pine tree with a small plaque beneath it that read, LLOYD HUSTVEDT (1922–2004). While I’d been writing this second text, I’d had a strong sensation of hearing my father’s voice. He wrote excellent and often very funny speeches, and as I composed I imagined that I had caught some of his humor in my sentences. I even used the phrase "Were my father here today, he might have said . . ." Confident and armed with index cards, I looked out at the fifty or so friends and colleagues of my father’s who had gathered around the memorial Norway spruce, launched into my first sentence, and began to shudder violently from the neck down. My arms flapped. My knees knocked. I shook as if I were having a seizure. Weirdly, my voice wasn’t affected. It didn’t change at all. Astounded by what was happening to me and terrified that I would fall over, I managed to keep my balance and continue, despite the fact that the cards in my hands were flying back and forth in front of me. When the speech ended, the shaking stopped. I looked down at my legs. They had turned a deep red with a bluish cast.
My mother and sisters were startled by the mysterious bodily transformation that had taken place within me. They had seen me speak in public many times, sometimes in front of hundreds of people. Liv said she had wanted to go over and put her arms around me to hold me up. My mother said she had felt as if she were looking at an electrocution. It appeared that some unknown force had suddenly taken over my body and decided I needed a good, sustained jolting. Once before, during the summer of 1982, I’d felt as if some superior power picked me up and tossed me about as if I were a doll. In an art gallery in Paris, I suddenly felt my left arm jerk upward and slam me backward into the wall. The whole event lasted no more than a few seconds. Not long after that, I felt euphoric, filled with supernatural joy, and then came the violent migraine that lasted for almost a year, the year of Fiorinal, Inderal, cafergot, Elavil, Tofranil, and Mellaril, of a sleeping-drug cocktail I took in the doctor’s office in hopes that I would wake up headache-free. No such luck. Finally, that same neurologist sent me to the hospital and put me on the antipsychotic drug Thorazine. Those eight stuporous days in the neurology ward with my old but surprisingly agile roommate, a stroke victim, who every night was strapped to her bed with a restraint sweetly known as a Posey, and who every night defied the nurses by escaping her fetters and fleeing down the corridor, those strange drugged days, punctuated by visits from young men in white coats who held up pencils for me to identify, asked me the day and the year and the name of the president, pricked me with little needles—Can you feel this?—and the rare wave through the door from the Headache Czar himself, Dr. C., a man who mostly ignored me and seemed irritated that I didn’t cooperate and get well, have stayed with me as a time of the blackest of all black comedies. Nobody really knew what was wrong with me. My doctor gave it a name—vascular migraine syndrome—but why I had become a vomiting, miserable, flattened, frightened ENORMOUS headache, a Humpty Dumpty after his fall, no one could say.
My travels in the worlds of neurology, psychiatry, and psychoanalysis began well before my stint in Mount Sinai Medical Center. I have suffered from migraines since childhood and have long been curious about my own aching head, my dizziness, my divine lifting feelings, my sparklers and black holes, and my single visual hallucination of a little pink man and a pink ox on the floor of my bedroom. I had been reading about these mysteries for many years before I had my shaking fit that afternoon in Northfield. But my investigations intensified when I decided to write a novel in which I would have to impersonate a psychiatrist and psychoanalyst, a man I came to think of as my imaginary brother, Erik Davidsen. Brought up in Minnesota by parents very much like mine, he was the boy never born to the Hustvedt family. To be Erik, I threw myself into the convolutions of psychiatric diagnoses and the innumerable mental disorders that afflict human beings. I studied pharmacology and familiarized myself with the various classes of drugs. I bought a book with sample tests for the New York State psychiatric boards and practiced taking them. I read more psychoanalysis and countless memoirs of mental illness. I found myself fascinated by neuroscience, attended a monthly lecture on brain science at the New York Psychoanalytic Institute, and was invited to become a member of a discussion group devoted to a new field: neuropsychoanalysis.
In that group, neuroscientists, neurologists, psychiatrists, and psychoanalysts sought a common ground that might bring together the insights of analysis with the most recent brain research. I bought myself a rubber brain, familiarized myself with its many parts, listened intently, and read more. In fact, I read obsessively, as my husband has told me repeatedly. He has even suggested that my rapacious reading resembles an addiction. Then I signed up as a volunteer at the Payne Whitney Psychiatric Clinic and began teaching a writing class to the patients there every week. At the hospital, I found myself close to particular human beings who suffered from complex illnesses that sometimes bore little resemblance to the descriptions cataloged in the Diagnostic and Statistical Manual of Mental Disorders (usually referred to as the DSM). By the time I shook in front of my father’s tree, I had been steeped in the world of the brain/mind for years. What began with curiosity about the mysteries of my own nervous system had developed into an overriding passion. Intellectual curiosity about one’s own illness is certainly born of a desire for mastery. If I couldn’t cure myself, perhaps I could at least begin to understand myself.
EVERY SICKNESS HAS an alien quality, a feeling of invasion and loss of control that is evident in the language we use about it. No one says, "I am cancer" or even "I am cancerous," despite the fact that there is no intruding virus or bacteria; it’s the body’s own cells that have run amok. One has cancer. Neurological and psychiatric illnesses are different, however, because they often attack the very source of what one imagines is one’s self. "He’s an epileptic" doesn’t sound strange to us. In the psychiatric clinic, the patients often say, "Well, you see, I’m bipolar" or "I’m schizophrenic." The illness and the self are fully identified in these sentences. The shaking woman felt like me and not like me at the same time. From the chin up, I was my familiar self. From the neck down, I was a shuddering stranger. What ever had happened to me, what ever name would be assigned to my affliction, my strange seizure must have had an emotional component that was somehow connected to my father. The problem was that I hadn’t felt emotional. I had felt entirely calm and reasonable. Something seemed to have gone terribly wrong with me, but what exactly? I decided to go in search of the shaking woman.
PHYSICIANS HAVE BEEN PUZZLING over convulsions like mine for centuries. Many diseases can make you shudder, but it’s not always easy to separate one from the other. From Hippocrates onward, making a diagnosis has meant herding a cluster of symptoms under a single name. Epilepsy is the most famous of all the shaking illnesses. Had I been a patient of the Greek physician Galen, who ministered to the emperor Marcus Aurelius and whose copious writings influenced medical history for hundreds of years, he would have diagnosed me with a convulsive illness, but he would have ruled out epilepsy. For Galen, epilepsy not only caused convulsions of the entire body, it interrupted "leading functions"—awareness and speech.1 Although there were popular beliefs among the Greeks that gods and ghosts could make you shake, most physicians took a naturalist view of the phenomenon, and it wasn’t until the rise of Christianity that tremors and the supernatural were bound together with bewildering intimacy. Nature, God, and the devil could wrack your body, and medical experts struggled to distinguish among causes. How could you separate an act of nature from a divine intervention or a demonic possession? Saint Teresa of Avila’s paroxysmal agonies and blackouts, her visions and transports were mystical flights toward God, but the girls in Salem who writhed and shook were the victims of witches. In A Modest Inquiry into the Nature of Witchcraft, John Hale describes the fits of the tormented children and then pointedly adds that their extreme sufferings were "beyond the power of any epileptic fits or natural disease to effect."2 If my tremulous episode had occurred during the witch madness in Salem, the consequences might have been dire. Surely I would have looked like a woman possessed. But, more important, had I been steeped in the religious beliefs of the age, as I most likely would have been, the weird sensation that some external power had entered my body to cause the shudder probably would have been enough to convince me that I had indeed been hexed.
In New York City in 2006 no sane doctor would have sent me to an exorcist, and yet confusion about diagnosis is common. The frames for viewing convulsive illness may have changed, but understanding what had happened to me would not be a simple matter. I could go to a neurologist to see if I had come down with epilepsy, although my past experience in the ward at Mount Sinai Hospital had left me wary of the doctors in charge of investigating nervous systems. I knew that in order to be diagnosed with the disease, I needed to have had at least two seizures. I believed I had had one genuine seizure before my intractable migraine. The second one looked suspicious to me. Uncontrollable shaking can occur in some seizures. My shaking was on both sides of my body—and I had talked throughout the fit. How many people talk through a seizure? Also, I had had no aura, no warning that some neurological event was in the making, as I often do for migraine, and it had come and gone with the speech about my dead father. Because of my history, I knew that a careful neurologist would do an EEG, an electroencephalogram. I’d have to sit with gooey electrodes clamped onto my scalp for quite a while, and my guess is that the doctor would find nothing. Of course, many people suffer from seizures that are not detected by standard tests, so the physician would have to do more tests. Unless I kept shaking, a diagnosis might not be forthcoming. I could float in the limbo of an unknown affliction.
I had puzzled for some time over my shaking when a possible answer announced itself. It didn’t appear slowly but came all at once as an epiphany. I was sitting in my regular seat at the monthly neuroscience lecture, and I remembered a brief conversation I had had with a psychiatrist who had been sitting behind me at an earlier talk. I’d asked her where she worked and what she did, and she’d told me she was on the staff in a hospital, where she saw mostly "conversion patients." "The neurologists don’t know what to do with them," she’d said, "so they send them to me." That could be it! I thought. My fit had been hysterical. This ancient word has been mostly dropped from current medical discourse and replaced by conversion disorder, but lying beneath the newer term is the old one, haunting it like a ghost.
Nearly every time the word hysteria is used now in newspapers or magazines, the writer points out that the root comes from the Greek for "womb." Its origin as a purely female problem connected to reproductive organs serves to warn readers that the word itself reflects an ancient bias against women, but its history is far more complicated than misogyny. Galen believed that hysteria was an illness that beset unmarried and widowed women who were deprived of sexual intercourse but that it wasn’t madness, because it didn’t necessarily involve psychological impairments. Ancient doctors were well aware that epileptic fits and hysterical fits could look alike, and that it was essential to try to distinguish between the two. As it turns out, the confusion has never disappeared. The fifteenth-century physician Antonius Guainerius believed that vapors rising from the uterus caused hysteria and that hysteria could be distinguished from epilepsy because the hysterical person would remember everything that had happened during the fit.3 The great seventeenth-century English doctor Thomas Willis dispensed with the uterus as the offending organ and located both hysteria and epilepsy in the brain. But Willis’s thought didn’t rule the day. There were those who believed that the two were merely different forms of the same disease. The Swiss physician Samuel Auguste David Tissot (1728–1797), who has remained part of medical history mostly for his widely published treatise on the dangers of masturbation, maintained that the two illnesses were distinct, despite the fact that there were epilepsies that originated in the uterus.4 From ancient times through the eighteenth century, hysteria was regarded as a convulsive illness that originated somewhere in the body—in the uterus or the brain or a limb—and the people suffering from it weren’t considered insane. It is safe to say that if any one of the doctors above had witnessed my convulsive speech, he might have diagnosed me with hysteria. My higher functions weren’t interrupted; I remembered everything about my fit; and, of course, I was a woman with a potentially vaporous or disturbed uterus.
Excerpted from The Shaking Woman or a History of My Nerves by Siri Hustvedt.
Copyright 2009 by Siri Hustvedt.
Published in 2009 by A Frances Coady Book Henry Holt and Company.
All rights reserved. This work is protected under copyright laws and reproduction is strictly prohibited. Permission to reproduce the material in any manner or medium must be secured from the Publisher.
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