The most important lesson from 83,000 brain scans | Daniel Amen | TEDxOrangeCoast

The most important lesson from 83,000 brain scans | Daniel Amen | TEDxOrangeCoast


Translator: Ilze Garda
Reviewer: Denise RQ In this talk, I’m going to give you
the single most important lesson my colleagues and I have learned
from looking at 83,000 brain scans. But first, let me put
the lesson into context. I am in the middle of seven children. Growing up, my father called me a maverick which to him was not a good thing. (Laughter) In 1972, the army called my number, and I was trained as an infantry medic
where my love of medicine was born. But since I truly hated the idea
of being shot at or sleeping in the mud, I got myself retrained
as an X-ray technician and developed a passion
for medical imaging. As our professors used to say:
“How do you know, unless you look?” In 1979, when I was
a second-year medical student, someone in my family
became seriously suicidal, and I took her to see
a wonderful psychiatrist. Over time, I realized
if he helped her, which he did, it would not only save her life, but it would also help her children
and even her future grandchildren, as they would be shaped by someone
who is happier and more stable. I fell in love with psychiatry because I realized it had the potential
to change generations of people. In 1991, I went to my first lecture
on brain SPECT imaging. SPECT is a nuclear medicine study
that looks at the blood flow and activity, it looks at how your brain works. SPECT was presented
as a tool to help psychiatrists get more information
to help their patients. In that one lecture,
my two professional loves, medical imaging and psychiatry, came together, and quite honestly,
revolutionized my life. Over the next 22 years,
my colleagues and I would build the world’s largest database
of brain scans related to behavior on patients from 93 countries. SPECT basically tells us
three things about the brain: good activity, too little, or too much. Here’s a set of healthy SPECT scans. The image on the left shows
the outside surface of the brain, and a healthy scan shows full,
even, symmetrical activity. The color is not important,
it’s the shape that matters. In the image on the right,
red equals the areas of high activity, and in a healthy brain, they’re typically
in the back part of the brain. Here’s a healthy scan compared
to someone who had two strokes. You can see the holes of activity. Here’s what Alzheimer’s looks like, where the back half
of the brain is deteriorating. Did you know that Alzheimer’s disease
actually starts in the brain 30 to 50 years before
you have any symptoms? Here’s a scan
of a traumatic brain injury. Your brain is soft,
and your skull is really hard. Or drug abuse. The real reason not to use drugs –
they damage your brain. Obsessive–compulsive disorder where the front part of the brain
typically works too hard, so that people cannot
turn off their thoughts. An epilepsy where we frequently
see areas of increased activity. In 1992, I went to an all-day conference
on brain SPECT imaging, it was amazing and mirrored our own early experience
using SPECT in psychiatry. But at that same meeting,
researchers started to complain loudly that clinical psychiatrists like me
should not be doing scans, that they were only for their research. Being the maverick
and having clinical experience, I thought that was a really dumb idea. (Laughter) Without imaging, psychiatrists then and even now
make diagnosis like they did in 1840, when Abraham Lincoln was depressed, by talking to people and looking
for symptom clusters. Imaging was showing us
there was a better way. Did you know that psychiatrists
are the only medical specialists that virtually never look
at the organ they treat? Think about it! Cardiologists look, neurologists look,
orthopedic doctors look, virtually every other
medical specialties look – psychiatrists guess. Before imaging, I always felt like I was throwing
darts in the dark at my patients and had hurt some of them
which horrified me. There is a reason that most psychiatric medications
have black box warnings. Give them to the wrong person,
and you can precipitate a disaster. Early on, our imaging work
taught us many important lessons, such as illnesses, like ADHD,
anxiety, depression, and addictions, are not simple or single
disorders in the brain, they all have multiple types. For example, here are two patients who have been diagnosed
with major depression, that had virtually the same symptoms,
yet radically different brains. One had really low activity in the brain,
the other one had really high activity. How would you ever know what to do
for them, unless you actually looked? Treatment needs to be tailored to individual brains,
not clusters of symptoms. Our imaging work also taught us that mild traumatic brain injury
was a major cause of psychiatric illness that ruin people’s lives, and virtually no one knew about it
because they would see psychiatrists for things like temper problems,
anxiety, depression, and insomnia, and they would never look,
so they would never know. Here’s a scan of a 15-year-old boy who felt down a flight of stairs
at the age of three. Even though he was unconscious
for only a few minutes, there was nothing mild
about the enduring effect that injury had on this boy’s life. When I met him at the age of 15,
he had just been kicked out of his third residential
treatment program for violence. He needed a brain rehabilitation program, not just more medication
thrown at him in the dark, or behavioral therapy which,
if you think about it, is really cruel. To put him on a behavioral therapy program when behavior is really an expression
of the problem, it’s not the problem. Researchers have found
that undiagnosed brain injuries are a major cause of homelessness,
drug and alcohol abuse, depression, panic attacks, ADHD, and suicide. We are in for a pending disaster with the hundreds
and thousands of soldiers coming back from Iraq and Afganistan, and virtually no one is looking
at the function of their brain. As we continued our work with SPECT, the criticism grew louder,
but so did the lessons. Judges and defense attorneys sought
our help to understand criminal behavior. Today, we have scanned
over 500 convicted felons including 90 murderers. Our work taught us
that people who do bad things often have troubled brains. That was not a surprise. But what did surprise us was that many of these brains
could be rehabilitated. So here’s a radical idea. What if we evaluated
and treated troubled brains rather than simply warehousing them
in toxic, stressful environments? In my experience, we could save
tremendous amounts of money by making these people more functional, so when they left prison, they could work, support their families and pay taxes. Dostoyevsky once said:
“A society should be judged not by how well it treats
its outstanding citizens, but by how it treats its criminals.” Instead of just crime and punishment, we should be thinking
about crime evaluation and treatment. (Applause) So after 22 years and 83,000 scans, the single most important lesson
my colleagues and I have learned is that you can literally
change people’s brains. And when you do, you change their life. You are not stuck with the brain you have, you can make it better,
and we can prove it. My colleagues and I performed
the first and largest study on active and retired NFL players, showing high levels of damage
in these players at the time when the NFL said they didn’t know if playing football caused
long-term brain damage. The fact was they didn’t want to know. That was not a surprise. I think, if you get the most thoughtful
9-year-olds together, and you talk about the brain is soft,
about the consistency of soft butter, it’s housed in a really hard skull
that has many sharp, bony ridges, you know, 28 out of 30
nine-year-olds would go: “Probably a bad idea for your life.” (Laughter) But what really got us excited
was the second part of the study where we put players
on a brain-smart program and demonstrated
that 80% of them could improve in the areas of blood flow,
memory, and mood, that you are not stuck
with the brain you have, you can make it better
on a brain-smart program. How exciting is that? I am so excited. Reversing brain damage
is a very exciting new frontier, but the implications
are really much wider. Here is this scan
of a teenage girl who has ADHD, who was cutting herself, failing
in school, and fighting with her parents. When we improved her brain, she went from D’s and F’s to A’s and B’s, and was much more emotionally stable. Here is the scan of Nancy. Nancy had been diagnosed with dementia, and her doctor told her husband
that he should find a home for her because within a year,
she would not know his name. But on an intensive,
brain-rehabilitation program, Nancy’s brain was better,
as was her memory, and four years later,
Nancy still knows her husband’s name. Or my favorite story
to illustrate this point: Andrew, a 9-year-old boy who attacked
a little girl on the baseball field for no particular reason, and at the time,
was drawing pictures of himself hanging from a tree
and shooting other children. Andrew was Columbine, Aurora, and Sandy Hook waiting to happen. Most psychiatrists
would have medicated Andrew, as they did Eric Harris
and the other mass shooters before they committed their awful crimes, but SPECT imaging taught me
that I had to look at his brain and not throw darts in the dark at him
to understand what he needed. His SPECT scan showed
a cyst, the size of a golf ball, occupying the space
of his left temple lobe. No amount of medication or therapy
would have helped Andrew. When the cyst was removed, his behavior completely
went back to normal, and he became the sweet, loving boy
he always wanted to be. Now 18 years later,
Andrew, who is my nephew, owns his own home,
is employed and pays taxes. (Laughter) Because someone bothered
to look at his brain, he has been a better son, and will be a better husband,
father, and grandfather. When you have the privilege
of changing someone’s brain, you not only change his or her life but you have the opportunity
to change generations to come. I’m Dr. Daniel Amen. Thank you. (Applause)

100 Comments

  • sujata karki says:

    Its always great to listen to a learned man.
    Psyciatry should look to the physics and biology of the brain too, not just the emotions

  • VMuscle says:

    How true is this though?

  • sharon smit says:

    How many peoples lives could have been saved if we had more medical professionals, such as this man. Clearly, he is passionate about what he does, and yes, that counts.

  • Bonna Viola says:

    Another problem is insurance companies won’t cover proper care !!!

  • Shameemah Jahed says:

    Amazing information which makes so much sense. great doc!

  • Johny_97 says:

    It shocks me how prevalent mental health is but so little is done to genuinly solve it. The only thing being done is certain medication being made for companies to profit off of , and not solve the problem.

  • - sabelmousse - says:

    good psychiatry! not the bad cookoos nest type. and that is out there!

  • D Amber says:

    Are these GMO and organic?

  • Hanzon Vector says:

    πŸ€‘

  • Edward Joyce says:

    Wonderful talk! Does anyone know why psychiatrist's continue to refuse to look at the object their purport to diagnose? What philosophy or agenda is behind this refusal?

  • Holistic University of Brisbane (HUB) says:

    What does he have to say about the MK Programs and the history of eugenics in psychiatry and the USA?

  • Holistic University of Brisbane (HUB) says:

    Psychiatry is a system of character-assassination and poisoning with dopamine-blockers. The fad with expensive scans is a distraction.

  • Francisco Turrillo Dubois says:

    Bravo!

  • ThePnuttt says:

    Looks and sounds awesome.
    But can also make a case for a government Manchurian candidate with this change your brain stuff

  • Carlos Cruz says:

    I am a doctor. I think the potential for spect imaging is interesting, but his claims seem too good to be true as the speaker states he can do thinks like reverse Alzheimer’s through β€œan intensive brain rehabilitation program” while not discussing at all what such a program would entail, probably because no proven program exists. Unless he has figured out a program that he has kept hidden from the the rest medical community, this guy seems like a fraud.

  • Anxiety Mentor says:

    Anyone believing this hogwash is obviously very easily influenced.

  • Azi Jank says:

    fantastic work by Dr. Amen

  • Carlos Loff says:

    Regarding damage I get it but regarding activity areas I wonder if they do just 1 scan per person or several to get and average LOOK, cause during one single day I bet brain activity can change a lot on the same person so one scan will only LOOK at one particular mood of that person's brain just at the moment of the scan, witch can be fully missleading about the usual person state for the other 23,9h of the day – you can catch an momentaneous relaxed brain scan when the person is usually hyperactive and vice versa

  • Limowm says:

    Ask the observer..

  • Limowm says:

    PS Dorian is not going to track the way felt..
    a hurricane can do whatever it wants when it comes to atmospheric pressure on it
    It’s going to be in the gulf sooner or later.. than I

  • Brenton Edwards says:

    Psychiatrists treat don't an organ, they treat the mind

  • Christopher Whitener says:

    Too bad common sense didn’t show up In them scans

  • G M says:

    Thanks again Maverick!

  • LuqmanLSG says:

    Amen to that!

    (I’ll show myself out.)

  • Kaaren Timmerman says:

    I am very concerned that this video remains as a Ted Talk, since his use of brain scans has been universally discreditted. Mental health professionals with even a basic understanding of the current researach in brain science are aware of this. I believe he has probably bilked millions who see him on TV and sites like this. I fully support free speech, but doesn't an entity such as Ted talks have some obligation at least have a duty to alert viewers to these issues

  • Sarah Civgin says:

    I love him! That’s more aligned with social justice!

  • abomohamed elgazar says:

    Magnificent work . Thats how we should approach patients .

  • Elle Groover says:

    πŸ”₯πŸ”₯VERY IMPORTANT MESSAGE TO THIS DOTOR!! ===>>>. That was great Dr D!! You ought to send a copy of this talk to EVERY TREATMENT & REHAB CENTER across the nation!! And special attention to our west coast homeless people who suffer from addiction BUT PRIMARILY FOR THE MENTALLY CHALLENGED!!! Because when you fix the brain 🧠……the body WILL follow. Eventually. You are on to something Dr D!! I think this premise could work with DEPRESSION AS WELL. See what I mean Doc??! You’re on to something great for SO SO many people!! God Bless you!! πŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸŒˆπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ’œπŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ‘πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ’•πŸ™πŸ™πŸ™πŸ™πŸ™πŸ™πŸ™πŸ™πŸ™

  • YUE CAI says:

    Yep mate, fully aggressive. I my country people always say grumpy people are more likely have stomach disease; but I always tell them it’s stomach disease make people grumpy.

  • ni ko says:

    so what's the treatment?

  • Liette Barkley says:

    Just how long does a $700Β television last?

  • Ana Nazario says:

    Passion for what you do can make a big change in others …

  • Christine Still says:

    Familiar w/ APGAR scores at birth? Difficult birth, scores of 3 -2 – no heartbeat! Incubated w oxygen but no spontaneous breathing for 32 minutes. Difficult as child, prison since 18 (in & out)., he’s 47 now. HOW do I get a brain scan for him bc love & therapy have not worked ?

  • Lally P says:

    Psychiatry is an infantile and unreliable pseudo science. DO NOT TRUST THESE PEOPLE! I have spent a lifetime in illness that these quacks flounder in the darkness unable to treat.

  • Jaclyn Roth says:

    Incredible. We need more doctors like you.

  • J H says:

    Consume an antifungal diet to keep the brain healthy .

  • manjunavinsingh Ranveer says:

    Pls cover topics like OCD, schizophrenia n depression Dr.

  • Faham Parsa says:

    how to get this in foreign countries ?

  • ThinkingOutLoud says:

    2019 and I see no changes. Was this man’s work and message lost? Ignored? Or was it refuted or overcome by newer research?

  • Pascale Nahmias Bouquillard says:

    Spect scans are well known by psychiatrists but they are so expensive that patients can not afford them. Doctor Amen, could you help us ?

  • Jack Gorfien says:

    So, how is the brain able to be rehabilitated?

  • Daniel Pohl says:

    Great lecture. Thank you.
    There is also one important thing to consider, and that is effects of microwave radiation from wireless networks and devices on human brain. Truly, absolutely devastating and the coming 5G will make it a lot worse.

  • dillardstreet432 says:

    EXCELLENT!

  • Danny Sequeira says:

    Excelente video… Muchas gracias!

  • DINY NICHOLS says:

    What can be done about these brain conditions to help the person whose brain is affected?

  • Dan Car says:

    This is revolutionary.

  • Gary Shields says:

    C8 MCT oil, is absorbed mostly by the brain. It's better than drugs. You'll get memories back from things that happened fifty years ago like it just happened. You'll be a (Product Name=Brain Octaine Oil) junkie.😁
    Next, K2-D3 vitamin & Boron to decalcify the brain & Hemp Oil which contains all 22 amino acids & is transdermal(absorbed directly into your cells(brain). Trisodium phosphate & magnesium it. & πŸ’‘πŸ”†πŸ‘½

  • El Grande says:

    Snake oil salesman!

  • rebelamanda says:

    What a great, natural speaker. He could make a talk about toilet paper riveting. Seriously. Thank you, Sir

  • Deborah Carder says:

    Unfortunately, he only relates the physical changes of the brain but not the initial cause, other than a traumatic injury or tumor. There are other very significant damages to the brain such as Adverse Childhood Experiences (that girl who was mutilating herself), toxic exposures in food, mercury dental fillings, environmental molds and poisons. There are also the ungodly spiritual exposures and sinful behaviors that damage the brain.

  • Shadow Man says:

    This guy needs to head the professsional psychiatric community.

  • karroome says:

    Oh my god where was this vid before.
    Simply put, bad people are bad for a reason. Good people are good by nature

  • Richard Fleming says:

    how do I repair my brain at 50

  • Tracie O'Grady says:

    How do you change a brain?

  • Larry Hoyt says:

    The medical community has a real problem with the validity and need for these costly scans. I have seen this method back fire with one of my students.

  • R J says:

    Great information

    Thank you for this video and your dedication to the cause.πŸ‘πŸ»

  • TYR FREE says:

    I can understand that having a brain injury May cause behavioral issues. However that does not take into account of people who we're bought up in emotionally abusive homes. I don't think there's anything wrong with their brains. Emotional abuse or abuse of any kind takes its toll overtime. Now I don't know what a normal brain does with emotional abuse but from what I read the brain tends to hold on to traumatic experiences. It does this so that we can avoid the traumatic experience next time. It is a survival mechanism. The same mechanism can have the opposite effect because it never allows the person who is traumatized emotionally, to move on from their experience that happened to them years ago.

  • Travis of Bickley says:

    Since homelessness is currently in the Forefront of the news and its media Outlets this particular TED Talk would be significantly more effective if such people as Government entities and especially President Trump got to see this Daniel Amen on 83,000 brain scans presentation and make sure that these people who are in such things conditions is holding this homelessness or toxic conditions such as imprisonment or confinement to a mental institution without these brain scans and the understanding of the types of treatment that might be required based on the scan and not just the symptoms may be significantly more beneficial to this these populations.

  • Nafisa Dahodwala says:

    I want an uncle like him too!

  • Chad Craft says:

    So what can be done about it ???? That’s the most important question that was not answered. Who cares about a scan if there is no plausible solution offered ?
    Offering false hope does not help anyone.

  • Lisa Casella says:

    Amen!

  • CodeRevolution TV says:

    I just wrote a cool blog post on this subject, on my blog coderevolution(dot)ro: "The Most Important Guest Post Guidelines You Need to Know" – if you are interested in details on this subject, feel free to check it out!

  • Blue Is says:

    Nobel Prize material here! Congratulations Doctor

  • maximuscomfort says:

    Perfect example for an addition to biometric face ID cards.

  • Catherine Murphy says:

    Gosh this man speaks such practical truths?

  • nitramgnal says:

    No description of treatment.

  • RavishingTwinkle says:

    The brain scan of a sociopath and psychopath is different from that of neurotypical. Brain scans reveal fate.

  • Giulietta Ciambotti says:

    You are not stuck with the brain you have… we can change it. Amazing.

  • Shashank Singh says:

    psychiatry can change generations of people – true , very true sir

  • Alicia B-G says:

    This needs to be shared far and away!

  • Alison Dunn says:

    Something this simple could have so many lives from all the shootings in America. Wish people would realise that brain scans should be affordable and not be so money grabbing. Sad they have a price on a people’s lives.
    Brain scans should be compulsory at certain ages for everyone. We could save thousands of lives so easily.

  • Count Saint Germain says:

    Dr.Daniel ,
    you are proud about your work and I agree with that but why dont you say about the risks of your research when special services which serve the politicians governs use your discoveryes to dominate public mass ? Many social conflicts start from a button and also when the job its done well they finished them from the same place …
    Plus sir , our brains are not designed to pay taxes which make a batter life for parliaments people or gouvenants !

  • Count Saint Germain says:

    I forget to say about criminals behavoiours and genetic code that the real problem its there in the agresivity genes which aparently are much numerous than to the other peoples !
    And its wellknown that our brain structure its configurate at the first 9 nine month woomb life by our genetic heritage !
    In my oppinion a criminal its like a poissined snake ! He could change his skin but never his venom !

  • rupesh gupta says:

    Better not to play with Brain Because if we can convert a criminal to civilized person, we can convert civilized person to a criminal, and people will see violence and dead everywhere.

  • Irene Quinn Marco says:

    Preach it!!!! TRUTH!!! Help

  • Andrew Herbert says:

    Play this at 1.5x

  • Ashkan Kordmahaleh says:

    I love this talk; I’ve watched it multiple times and every time, I learn new fascinating facts about our brain complexity and potential.

  • Lisa Anne says:

    Wellbutrin caused seizures and subsequently a TBI, But I then started to paint 2015 And i have just joined a gallery and have begun to sell my work

  • v2snider1 says:

    80 thousand brain scans and his ego qualifies him to know the mind ??? Sorry it’s much more complex

  • Nicole Skinner says:

    Makes me so sad. My grandma gos to VA Phyc unit.She is a vet who is 94yrs Old. At the VA old & young mixed together in the phyc Ward …no geriatric specialty psychiatry going on there,or scan technology, their old computer system can't connect to other hospitals to get accurate data about their vets. The social worker called it a " time capsule"…How I wish the VA could do scans for vets! My friend's son who is a vet has had 3 of his vet friends commit suicide. Very sad.

  • Libia Garcia says:

    Espectacular

  • b weaver says:

    But HOW did they change it? Diet? Exercise? Operations??

  • KINGCOINS BANDANTIQS says:

    DANIEL PLEASE HELP ME GET A SMART BRAIN PROGRAM AND TREATMENT BECAUSE I MIGHT JUST CHANGE MY MIND ON OTHER NEGATIVE VIEWS OF THE MALPRACTICE AND THE MISUSE OF PSYCHADELUC DRUG TESTING ON PATIENTS WHO REALLY DID NOT NEED THEM JUST BECAUSE THEY WERE NOT LISTENED TO AND BELIEVED PLACES LUKE THE ONE I WAS FALSELY PLACED IN BY INDIVIDUALS TO 5150 FACILITIES JUST TO HAVE PHARMACEUTICAL TRIALS JAMMED AND FORCED DOWN THIER THROATS WHEN THEY REALLY DIS NOT KNOW THAT THEY WOULD BE ADDICTED TO THEM AND FROM ANY REACH OF TAKING THEM UNLESS THEY COMMITTED SUICIDAL AND DISLIKABLE ACTS UPON THMSELVES OR HARM TO THIER BODIES JUSTS TO BE SENT BACK TO THOSE PLACES …… i will only speak to you personally if you are for real and if you really want to change and save lives like i do. and i have tons of data for you . i love psychology and i wanted to be a psychiatrist myself but but never finished only you have a passion and only you can probably help me help you to help them and others like like me thank you daniel and god bless your new form of sight …..,,

  • Mike Becket says:

    Some of not most don't actually have a functioning brain. …..well we all knew that. ..

  • Alma Glad says:

    I love this talk!! Wow

  • Z WolF says:

    Fasting anyone?

  • Eduardo L says:

    I need a scan no more medication to Enrich big pharma

  • safety first in texas says:

    great opportunity for good,

    and bad

    depending on its use.

  • roman2011 says:

    Sounds like an infomercial – we offer a simple solution (that no other doctors have thought of) to your life threatening problems. Get a brain scan now and the second is for free.

  • Megan Kull says:

    Wow! That was a powerful speech. When was the last time my brain had a check-up? What might people see if they actually looked?

  • D4NC3Rable says:

    This man is SO passionate I love listening to someone talk like this about their area of expertise. And he's right.

  • Karen Antle says:

    What does the therapy involve? HOW do you treat brain injuries?

  • JJKORKY says:

    What an amazing story – an amazing kid

  • Manuel Serratos says:

    Some people have complained that it's been 6 years since this talk and not much or nothing has changed. I'd like to agree, but I think Mr Amen meant more than only scanning patients' brains.
    He kept making a strong case for some scanning-based treatment better than the usual drugs and therapy… and what I understood at the end is that such treatment is extracting brain tumors or other deformities, brain surgery.
    If many people still wanted to follow such procedure psychiatrists would be limited to referring patients to brain surgeons if therapies and drugs have failed. But, again, since some people here claim not much has changed it figures that most people decline to follow through with Dr Amen's ideas, not really surprising as great as they sound.

  • Col Price says:

    incredible, moving and we need corruption i.e big pharma, health insurance kicked out of the ballpark to enable us to develop this idea into the mainstream NOW.

  • AntiR0b0t says:

    Step 1: Get health insurance
    Step 2: Brain scan
    Step 3: Live a better life

    Talk about BRAIN FOOD, top 5 tedx talk to date. <3

  • CptObvious says:

    But how are you changing their brains ??????????????????????????????

  • Arian R1A says:

    ii see already as the military use this technique to manipulate people

  • All rounder Vahi says:

    Amazing .., πŸ‘πŸ‘πŸ‘πŸ»πŸ‘πŸ»

  • Alexis Tosta says:

    I would like to know how I can reach out to this man.

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