Then My Wings Had to be Cut Off

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1 Introductory Note, by Renate Fischer (2001) The following text is the shortened English version of an article that was first published in the quarterly journal Das Zeichen ( 1997) which specializes in deaf and sign language topics. I am particularly grateful to Stan Schuchman for providing the English translation done by Robert Harmon. Those paragraphs that focus on the problem of diagnosis of psychiatric diseases, have been deleted for the present English version in order to make the text easier to read. So, although the diagnosis problem is a central issue of eugenics, the present version focuses on the issue of the communicative situation of deaf people in one psychiatric asylum in Hamburg, Germany, in the first half of the twentieth century. Renate Fischer, Saskia Abel, Brigitte Borth, Gesine Drewes, and Ulrike Lüdeke (1997/2001): Then My Wings Had to be Cut Off Hearing-Impaired People in an Insane Asylum in Hamburg in the First Half of the 20 th Century a The Alsterdorf Asylum In 1803 Denmark gave the village of Alsterthorpe, founded in about 1200, to Hamburg in exchange for other communities. It was there in 1860 that Pastor Heinrich Sengelmann a Originally published as Renate Fischer, et al., mir mußten dann die Flügel abgeschnitten werden. Hörgeschädigte in einer Hamburger Heil- und Pflegeanstalt in der ersten Hälfte des 20. Jahrhunderts, Das Zeichen, 39 (1997):

2 relocated his vocational school for socially at risk youths. Over time, the school became an institution for the disabled and by the time of Sengelmann s death in 1899, its fame had spread beyond the region. At the beginning of the 20th century it was among the largest institutions for the feeble-minded and epileptics. By 1939 the number of patients peaked at 1,872 residents (cf. Jenner 1987, 129), some of whom were housed in dormitories of up to one hundred beds. Such large patient populations did not occur by chance: from 1936 on, the diagnosis moral feeble-mindedness appeared frequently on the Alsterdorf patient cards. This points to a politically motivated aspect of psychiatry at that time, which made it possible to control and confine in institutions many people described as unrestrained, unbridled, asocial, etc. (Wunder 1987b, 111). In 1931, Dr. Gerhard Kreyenberg, a specialist in National Socialist Health Affairs, who served as the chief physician at the Alsterdorf Asylum, coined the designation special hospital for all types of defective states of mind. (cf. Wunder 1988, 89). At the same time, an anonymous author (probably Pastor Lensch, the Alsterdorf head chaplain and director of the institution) boasted that The Asylum, having striven for 80 years to isolate all possible feeble-minded persons, has contributed substantially toward eliminating congenital illness from society, blocking it from propagation and thereby allowing it to wither away of its own accord. (Anon. 1931/32,4) The Alsterdorf Asylum had become a showpiece of the Third Reich. 2

3 Our Procedure In the summer of 1996 and January, 1997, we were able to consult the patients archives at the Alsterdorf Evangelical Foundation (new name of the Asylum), where we sifted through a few thousand patient cards. In these files, we found evidence of hearing-impaired patients in twenty eight cases. For these twenty eight persons, only fourteen medical files were still extant in the patient archives. In one case the full medical file was missing for a patient whose fate had been described by Wunder (1987c, 209ff.) on the basis of both medical file and patient card. For another hearing-impaired Alsterdorf female patient, our 29th subject, whom we knew about from Wunder (1987c, 221), all documentation was missing. 1 We discovered twenty eight subjects because a hearing impairment was recorded on the patient cards (under the entry diagnosis or illness progress report ); all were patients designated as deaf or deaf mute, or, in a few cases as hard-of-hearing. Where hearing impairment owing to old age was explicitly noted, we did not include the affected person. We make no claim of completeness in our investigation, in part because we must assume that hearing impairment was not always reliably and unconditionally recorded on patient cards. Our findings emerge from the fact that for every one of the twenty nine persons, in addition to deaf-(mute)ness or hearing impairment, the medical documents record additional mental, emotional, or physical disorders, diagnosed according to the understanding of the times. Some 38 percent were women and girls, the majority men and boys. Not all of them were from Hamburg. The data we included covers the years 1900 to Most of these hearing-impaired people were adults at the time of their arrival in Alsterdorf; in many cases they were committed multiple times, with brief interludes of release. Our article is a bit difficult to categorize. It is not a scientific study; nor a statistical evaluation of data; nor a report on the history of an institution; nor a history of the Alsterdorf Asylum with special focus on the hearing-impaired; nor a history of forced sterilization in Hamburg.2 So what is it? Perhaps one could say this article is an attempt at a subjective presentation of the fate of hearing-impaired people in the Alsterdorf Asylum during the Third Reich. The reading of the patients archives was decisive for each of us. The photo portraits of the patients and the 1 As it turned out later, the documentation had simply been misplaced. 2 There exist studies relating to Hamburg for some of the themes mentioned; we refer selectively to 3

4 information about their everyday lives and catastrophes moved us deeply. Projektgruppe (Hg.) (1998), Rothmaler (1986), Wunder et. al. (1987). 4

5 That is why we resolved to write this article. It is consciously subjective and attempts, with thematically grouped quotations from the Alsterdorf patients archives, to remember the inmates of the institutions in those days. We have recorded what most moved us regarding hearing-impaired patients. That does not mean that what we have noted is unique to the hearing-impaired people; hearing patients experienced similar painful situations. To pin down what is specific to the hearing-impaired experience in asylums would be a task for the historiographer of psychiatry. Central to such a task would be an examination of the consequences of failed communication. Studies in deaf history, especially of the recent past, are faced with the problem of protection of data. By that we mean not only the legal regulations that require that an individual s personal files may not be used until fifty years after her or his death. We also mean that within smaller social groups, like the deaf community, publication can lead to delicate situations even after half a century. Individuals and their relatives, who might still be alive, are often identifiable even then. Therefore, we decided to forego biographical sketches to a large extent and instead to group excerpts from documents next to each other in a fashion that would preserve anonymity. Of course, this presents a considerable limitation on what is publishable; furthermore, it makes a serious case study impossible. Because we have tried to prevent identification in such a sensitive area, we have also forgone quoting some original sources. These include, for example, the report book of one of the later patients in the Alsterdorf Asylum, going back to the beginning of the 20th century, when she was attending a school for the deaf. When we found a case in which the director of a school for the deaf identified a former student to the authorities for forced sterilization, we also found documentation of the ensuing administrative process. Although personal documents were seldom preserved, we found a savings deposit book. Diaries or private letters are scarce; correspondence is usually only preserved when it deals with such matters as permission to receive a visit, that is, matters touching the regulations of the institution. 5

6 Every single file contains at least one photo of the patient; in some cases several pictures chronicle the individual s development over the years. These file photos no doubt served not only to identify the patients, but most of the turn of the century photographs present bodily features in such a way that, according to the psychiatric practice of the time, an image spoke for itself and the pictures illustrated the diagnosis, such as feeble-minded, epileptic, mentally sound cripple. Perhaps it is such experiences at school which explain the behavior of a school-age youth, during a 1942 examination in the Alsterdorf Asylum: As soon as the patient comes into the examination room he begins to yell [and] cries during the examination. But strangely, [he] becomes quiet immediately as soon as anyone comes up to him with an instrument, e.g., measures the head with a compass or listens to him with a stethoscope. In keeping with our effort to protect data, we have not recorded in our documentation any of the photos from the medical files of hearing-impaired persons. 6

7 The Problem of Diagnosis There is an especially high risk of a mis-diagnosis in deaf patients when the medical personnel and care- takers have at their command no knowledge of the psychological and sociological aspects of the various forms of deafness and when, because of lack of skill in sign language, no communication with the patient can be established (Monteiro 1990,11). During the National Socialist era, the life activities of hearing-impaired people were curtailed, especially for those whose malady, according to the diagnoses of the time, included a mental or emotional disorder. Like the diagnosis moral feeble-mindedness, the label congenital feeble-mindedness was broadly interpreted and frequently applied: The term innate feeble-mindedness is to be understood as every degree of mental weakness which, in a medical sense, can be clearly diagnosed as abnormal that is from the cases of idiocy (a state which in girls, for example, can lead to impregnation [sic!]) to the wide range of imbecility up to debility. (Law 1934, 91) National Socialist psychiatric eugenics classified those persons affected by the Law for the Prevention of Offspring with Hereditary Diseased Progeny as follows: Of the approximately 400,000 congenitally diseased persons who come into question under the law for sterilization, an estimated 360,000, that is, about 90 percent are psychiatric cases. (Roemer 1934, 120) This kind of medical outlook influenced the descriptions of course of illness such as the following notations, recorded on Alsterdorf patients cards, for a four-year-old girl and a young hard-of-hearing woman, illustrate: Or: Learned to walk at two and a quarter years... can t speak... deaf-mute plays by herself....unclean day and night... has epileptic attacks... is very restless, unable to occupy herself with toys, pulls everything down... must often be restrained with a belt since she smears things with excrement... is fed soft foods and bread. Patient attends the school here, but is described as very restless and disobedient. Later her conduct improves and she takes pains with her school work.... At work she is very changeable, always quarreling with fellow-patients, feels slighted, but lies a great deal and is dishonest. In bodily care she is independent, but not very clean or orderly. 7

8 In Hamburg hearing-impaired people with an additional diagnosis of a mental disease were often housed in the Alsterdorf Asylum an institution which, according to Wunder (1988, 86), was involved in the destruction of the lives of those unworthy of living. Of the twenty nine hearing-impaired persons on whose fates we have information, apparently only six were able to leave institutional life. Their relatives took them home, where they probably stayed, though that is not clear in all cases. Most stayed in Alsterdorf or other institutions until their violent deaths. Here we present examples of diagnoses as they are found in the Alsterdorf patients archives: Deaf-muteness. Schizophrenic traits. Imbecility, agitation states Thyroid deficiency, deaf-muteness, idiocy Cong[enital] Syphilis with imbecility and hearing impairment Porencephaly with spasm attacks and severe agitation states. Deafmuteness Deaf-muteness. Probably feeble-mindedness Sometimes uncertainty appears in the diagnosis: the patient is no doubt feeble-minded is she also deaf-mute?; or the patient is no doubt deaf is she also feebleminded? The following excerpts from the Alsterdorf medical files or patients cards illustrate this indecision: Hearing can not be tested owing to idiocy. Patient herself has been deaf since childhood, but in addition is certainly feeble-minded. Since she was not educable, like the deaf-mute as a rule. Can hardly lip-read, etc..... Very little can be said concerning the degree of feeble-mindedness since communication was hardly possible. Patient was a very quiet, modest girl. She spoke so little that she was often labeled as deaf-mute. She had also been in a deaf-mute school. Because of his deaf-muteness, no definitive judgement could be made concerning his intelligence. In view of the life-threatening significance which diagnoses such as feeble-mindedness could have, it is striking how little effort the medical personnel in Alsterdorf made for 8

9 clarification. Some of the patients, prior to their admission to this insane asylum, attended deaf schools, in some cases for years. One school director implored the school administration to discharge a seven-year-old boy, after barely half a year of schooling. He should have been released from being required by law to go to school; he was said to be not mature enough for school... feeble-minded, perhaps... idiotic, and disposed to be asocial.... The deaf-mute school has always declined to be nothing more than a welfare establishment for children of this kind, whose educability is questionable from the outset, the school director continued and then suggested sending the boy to Alsterdorf. About thirty years earlier this same deaf school had acted quite differently. In one case, from a record book from before 1910, a woman s diagnosis in Alsterdorf read, Imbecility, deafmuteness (according to the medical file) or Deaf-muteness and moderate feeblemindedness of undetermined genesis (according to the patient card). Two years before her committal to Alsterdorf she had completed her schooling, which had taken many years, and had been confirmed by the church. Her final record which attested to grades of very good in general behavior, fairly good in history according to the Bible and satisfactory in several other courses, including natural history, reading, and composition. These are certainly not the results one would expect in view of the medical diagnosis, even if it is quite clear from about twenty semi-annual report cards that she had also had significant problems in school. What did the school for the deaf do at the beginning of the century so that the girl could attain confirmation? Did the school in question shelter more than it educated? What conditions led to her commitment two years later to an insane asylum? What was the role of the young woman s maladjustment to norms of social behavior, as mentioned in other Alsterdorf records, such as that of the seven-year-old boy? The deaf-mute girl is decidedly feeble-minded...and also strongly sensually inclined. Tends to wander aimlessly on the streets and thus is at risk. Diagnosis, as well as the description of behaviors for purposes of prognosis and charting the development of mental disease, is sometimes associated with attribution of traits, which today are considered prejudicial toward the deaf. For example, it was often said of hearing-impaired Alsterdorf patients that they were distrustful. In 1933, the facial expression of a patient who had been designated in 1909 as decidedly feeble-minded, is described as: Searching and 9

10 somewhat lurking, like most hard-of-hearing people at the same time, decidedly intelligent. In at least one case where we assume that the person in question was deaf; it was only due to rigorous probing by people outside the institution that he was finally permitted to leave. When he was a small child, it appears that imbecility was confirmed without question. Later the diagnosis was said to be deaf-muteness and general backwardness, and finally deafmuteness. These constantly changing diagnoses for this deaf boy and shifting prospects for survival can be detected in entries in his medical file, where there are cross-outs, erasures, and corrections. Yet the institution, where he was so clearly out of place, made no effort to release the youth. Only after eleven years, at the end of World War II, was he finally released. Remarks on Language and Communication Behavior Especially within the scope of anamnesis are to be found judgements concerning communication behavior and/or linguistic aptitudes; sometimes the entries also reveal a little information concerning everyday life in the institution. The following quotation relates to the behavior of a newly committed patient at his first examination in the Alsterdorf Asylum: A very agitated character. Balls his hand into a fist in an idiosyncratic way, with the index finger stretched out in a greeting to the head and at the same moment on the mouth, apparently to order himself to be silent. Gesticulates and utters all sorts of unarticulated sounds while sighing deeply and forcing out air. Makes faces and grimaces intensely... To judge from testimonies, the patients seem to have used signs and sign language for communication, 3 and additionally German (written and/or oral with lip-reading) and non-verbal means of communication. Break- downs of communication, however, seem to have occurred often: Deaf-mute, minimal understanding of speech, makes himself understood through sign language. 3 The German documents use, among others, the words Zeichen and Zeichensprache, which are translated here as sign(s) and sign language. It is unclear whether the writers used the words in the sense of gesturing or in the sense 10

11 He was deaf mute, but was able to make himself understood very well. He showed great interest in his surroundings and was keenly aware of his fellow-patients. He knew how to make their bad behavior seem clear to the attendant and was able to cover up his own pranks, and in this way showed quite a bit of cunning. A certain need to make himself important expressed itself through large gestural play. To make himself understood he uttered sounds, gesticulated with his hands or wrote out his wishes. Patient was able to read and write. Is able to speak individual words with great effort. In general makes himself well understood with signs. Can t speak, deaf-mute, plays quietly by himself. A female patient, nearly forty years old, who had spent almost twenty years in the Alsterdorf Asylum wrote this 1926 note. The text reads: of sign language of the deaf. 11

12 Dear Pastor Stritter: Sister Marie and Mimi is very [sly?]. Supper stay in the kitchen. Afternoon drink cake and coffee beans Marie bake the cake. Oven burns. Comments added by the institution staff state, The investigation showed that [the patient] was mistaken. Her statements do not correspond to actual facts. 12

13 The following are descriptions of the communication skills of one female patient in the asylum, reported over a period of many years. When she is reprimanded she begins to cry and rage. (1930) Is deaf mute but makes herself understood easily. (1931) Is friendly and good-natured in the ward, popular with her companions. (1934) Is deaf mute but makes herself easily understood through signs or writes things out. Very unpopular with fellow patients since she likes to gossip. Always wants to be noticed, gladly helps where necessary. (1936) She has a friendly and quiet character, and is willing to help....she is not very popular with her fellow patients since she meddles in everything. (1938) She observes everything and comprehends very quickly. If she notices something unjust among the girls, she reports it immediately even though she is deaf mute. (1943) Here the medical personnel and care- takers seem to have employed written and oral German and sometimes signs ( sign language? ) to communicate with the patients. Still, in a number of other instances communication failed tragically: At times she is friendly, quiet, and obedient, understands orders through signs. When she doesn t understand something, she gets very worked up, often suffers also from unrelated agitation states during which she shouts. She often had to be isolated. However, [patient] could not be approached at such a time, since he would run away from his work and raise his voice in displeasure in loud, incomprehensible swearing. In general, he sat quietly at his place and took no part in anything. Because of his deafness, communication with him was minimal. 13

14 The file of a boy who was seven-years-old at the time of his admittance to Alsterdorf carried the notation Language: none. At the age of nine, he was transported to Mainkofen and evaluated as follows: Patient was suspected of tearing his bedding, since it was found to be torn mornings. Even when he was then forcibly restrained, his bedding was still repeatedly found torn up. Close observation revealed that not the patient but his neighbor... was the wrongdoer. Obviously, the boy could not defend himself. Sometimes the stay in the asylum or the progressive psychological illness wore down any existing communication skills. In 1901, a report about a patient, at the time of his first admittance to another institution, indicated that his speech is easy to understand. He was released, but shortly afterward was forcibly recommitted, with the following description: At first resists commitment with all his might. Strikes out at all around him, has to be forcibly restrained... Swears at his father for having brought him back. But thirty years later, in the Alsterdorf Asylum, the same patient is depicted thus: Communication very difficult. Patient speaks to himself incomprehensibly and inarticulately. However, during examination understands all demands quite well through sign language... Even in writing only imperfect communication is possible, since the patient writes completely confused and unrelated nonsense, yet it is possible to recognize that lively, paranoid delusions persist. He comports himself quietly and reclusively with no relationship to people in his vicinity, and murmurs softly and unintelligibly to himself. He occupies himself with light housework and reads the newspaper a lot. A female patient had been repeatedly shunted between Alsterdorf and Langenhorn and, according to her records, had been diagnosed in 1939 with deaf-muteness after meningitis, with schizoid tendencies. In 1949, she was barely thirty years old and once again confined in Alsterdorf, where records describe her as follows: Likes to sit, armed with a sheet of paper and a pencil... writes down in a painstaking hand words and sentences as a practice exercise... understands written requests and gestures. Through our observation we can also differentiate her states of agitation. On the one hand, when the patient has difficulty in communication she goes into a state of urgent 14

15 anxiety which quickly increases to wild motor agitation. She begins to roar, strikes her fists and head relentlessly against the walls, runs around aimlessly knocking over everything in her way, but at the same time is never aggressive on the contrary, she makes an effort to seek contact, to caress the nurses and to cling to them. Obviously, we do not pretend to judge the causes of this striking communication behavior from a diagnostic perspective. However from the medical documents, the impression comes through forcefully that, although the diagnosticians do indeed understand the desolate communicative situation of the hearing-impaired, their lack of understanding and isolation, they still do not regard these as conditions which need improvement, and so no action is taken. In another case concerning an adolescent patient, we read: Said to have been hard-of-hearing as an 11-year-old boy. This deteriorated to deafness. Since then he has hardly left the house at all, under the best of circumstances, once a month.... When his mother used to go away, she is said to have left him locked up, which frequently left the patient in a bad mood, whereupon he smashed dishes and windowpanes. At times he would yell for days on end. A young man, admitted for the first time to a state hospital in 1930 and diagnosed at Alsterdorf with deaf-muteness... schizophrenic traits... imbecility, agitation states was reported to have suffered a tragic event preceding his commitment. To soothe his mental torment, the staff prescribed medication, and shut the patient away, when he was not working in the hospital workshop. For about two to three months he has experienced agitation, which has perhaps been intensified by the fact that his dog, to which he was very much attached, was run over by a car. He exhibits these attacks mainly by yelling and scolding loudly. These conditions, which in recent days have occurred almost daily and sometimes twice a day, have been reduced but not eliminated by medicine...recently he has been so worked up that his transfer to Alsterdorf is necessary. 15

16 A Biographical Sketch A deaf man, whom we will call Mr. X, was born in 1897 and for eight years attended a deaf school in northern Germany. Afterwards he learned a craft. Some years later it was determined that he had changed psychically and had become more distrustful. He spent twenty years in various asylums, and finally was transferred to the Alsterdorf Asylum with the diagnosis deaf-muteness, paranoia. From several asylums, before his arrival in Alsterdorf, he is said to have written letters, pages long to his relatives. Then he wrote: My dear parents! I will never cease with grateful devotion. Also herewith to submit kindly the condition to be continued Then my wings had to be cut off, since at that time Fiede had restricted me for that reason. However, he didn t let the wings hang down, but returned me to you again and because of that he still didn t do himself any damage through negligence... Shortly after his transfer to the Alsterdorf Asylum, the director of his former deaf school informed the authorities that Mr. X should be sterilized in accordance with the Law for the Prevention of Offspring with Hereditary Diseases. As far as we could determine from the documents, forced sterilization was postponed and probably not carried out. The genealogical data for Mr. X drawn up in Alsterdorf contradict the information given by the director of the school. First names of relatives, for example, are different, and as so often happens in documents of this kind, the data concerning the inheritability of genetic deafness are inconclusive. During his time in Alsterdorf, his parents, especially the mother, repeatedly asked to have their son come home for a visit. Mr. X s escapes from Alsterdorf are documented, as well as staff rejection or postponement of approval for the requested visits. Thus the mother inquired of the administrators, And then we would also like to ask whether the Director will allow him to travel back and forth alone. He knows exactly how. For eleven years he always traveled alone from [...]. 16

17 The institution replied that they would try letting him go alone. Later, after another escape by Mr. X, his mother once again sent a postcard to her son: Father and I thought now that you went away again you ought to [....?] come every 4 weeks on Saturday and then return on Sunday evening. Then you could go to the movies sometimes on Saturdays when it doesn t cost so much for transportation. Then you could come this Saturday afternoon the 25 th till Sunday evening the 26 th. That is, if the management gives permission. Yes dear [X] it s too bad that it has happened again and you left again right away [.... ] good-bye. Next a memorandum at the Alsterdorf Asylum ordered that a notice be sent to the relatives:...request that the parents keep in mind that they are not to give their boy any false hopes, which only upset him and makes it more difficult for him and for us to get along. 4 The notice also rejects the request for leave for pedagogical reasons, but offers one day s leave with an overnight stay for the boy if he did not escape again. We were not able to determine from the records whether it was a question of repressive or responsible action on the part of the Alsterdorf management. In Alsterdorf the following observation was made about the patient: Likes to busy himself with drawing. Walks around the grounds a lot but doesn t engage in conversation with other patients. Communicates through sign language.... Patient was unusually agitated in the writing room. He wanted with all his might to go on leave, although this was not under consideration. Patient could not to be placated or dissuaded from his idea. Had to be taken to the guard room. Wunder (1988, 101 fn 33) tells us that guard rooms were set up in Alsterdorf in 1931 to deal with and watch over especially unruly patients. Based on theories of clinically-directed psychiatry, these rooms served as intensive management stations. There, the most radical therapies were carried out on these patients, including deep x-ray irradiation, shock cures with insulin or Cardiozol, and protracted baths. 4 The boy is about 40 years old. In 1963 a female patient of many years, who had turned 72 meanwhile, is labeled by the nurse as an old Alsterdorf girl : Patient is a very neat, helpful girl. 17

18 18

19 Further observations from the Alsterdorf personnel include: Patient is deaf-mute, very distant and sensitive. When he wants to communicate with the attendant, he writes out his wishes. But he also tries to lip-read to the best of his ability and to speak a few words. Whenever he is agitated and he has reason enough if his fellow patients simply look at him it is very difficult to get along with him. He always carries his belongings with him in a fabric pouch which he sewed himself so that nothing can be pilfered from him. Sticks completely to himself. Now and then he draws little pictures. Or: Patient is very distrustful owing to his disorder [deafness]. In 1943, an order signed by Dr. Kreyenberg directed that the patient be transferred, with the typical explanation because of heavy damage to the asylum by air raids. But this notation in the file is then crossed out and the patient apparently remained in Alsterdorf for the duration of the war. Shortly after the end of World War II the state of his health deteriorated dramatically; and within two months, though barely fifty years old, he died as a result of tuberculosis. In July of 1945 a new identity card for the German Reich [sic] had recorded: Unchangeable distinguishing characteristic: deaf mute. 19

20 The Law for the Prevention of Offspring of Hereditary Diseases and the Alsterdorf Asylum The Alsterdorf Asylum played an active role in Nazi racial purity measures, including murder. They participated in the implementation of the Law for the Prevention of Offspring of Hereditary Diseases of July 14, 1933, which legitimized forced sterilization and forced abortion. Among the congenital disorders which the framers of the law intended to eliminate were above all, mental disabilities, but also included congenital deafness. The Law for the Prevention of Offspring of Hereditary Diseases was one of several laws governing health matters. 20

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