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Season 10 | Episode 4

Patient Zero

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The greatest mysteries have a shadowy figure at the center—someone who sets things in motion and holds the key to how the story unfolds. In epidemiology, this central character is known as Patient Zero—the case at the heart of an outbreak. This hour, Radiolab hunts for Patient Zeroes from all over the map.

We start with the story of perhaps the most iconic Patient Zero of all time: Typhoid Mary. Then, we dive into a molecular detective story to pinpoint the beginning of the AIDS, and we re-imagine the moment the virus that caused the global pandemic sprang to life. After that, we're left wondering if you can trace the spread of an idea the way you can trace the spread of a disease. In the end, we find ourselves faced with a choice between competing claims about the origin of the high five. And we come to a perfectly sensible, thoroughly disturbing conclusion about the nature of the universe ... all by way of the cowboy hat.

Guests:

Kathy Gregory, Beatrice Hahn, M.D., Greg Harrell-Edge, Jonnie Hughes, Judith Walzer Leavitt, Jon Mooallem, David Quammen, David Rosner, Nolan Smith, Nathan Wolfe and Carl Zimmer

The Most Horrible Seaside Vacation

In 1906, a rich family vacationing in Oyster Bay, NY started to get sick. Very sick. It turns out they'd come down with typhoid, a disease forever associated with one woman: Typhoid Mary. You think you know this story, and we thought we knew this story too. But as producer ...

Comments [9]

The Cell That Started a Pandemic

In the early 1980s, epidemiologists were racing to understand a mysterious disease that was killing young men in California. As we now know, that disease was AIDS. And it soon grew into one of the biggest global pandemics in human history. But back in 1984, no one knew what it ...

Comments [30]

Contagious Ideas

We're left wondering, what would happen if you were to treat a good idea like an infectious disease? Could you trace it back to one individual, and one flash of insight? Jon Mooallem tells us about his quest to track down the origin of the high five--a story that starts ...

Comments [5]

Comments [65]

Shane Hooley from North Carolina

So I really liked the show, but all in all it was for a homework assignment that I still have to complete. I didn't really like the last 20-30 minutes because it had nothing to do with anything pertaining to diseases and how they are transmitted. It felt like a waste of time and I felt like they were going to get back onto the topic so I had to listen to the entire thing. Now it's almost 10 o'clock and I have school tomorrow and I haven't even started the post-audio show assignment yet. *Sigh*

Dec. 11 2013 09:42 PM
clara from texas


I Am Mrs Clara, i live in texas (USA).
[READ MY STORY. ON HOW I GOT MY AIDS
CURED].
Truthfully, i was tested HIV + positive last
5years. I keep on managing the drugs i
usually purchase from the health care
agency to keep me healthy and strenghtful, i
tried all i can too make this disease leave me
alone, but unfortunately, it keep on eating
up my life, this is what i caused myself, for
allowing my fiance make sex to
me unsecurely without protection, although i
never knew he is HIV positive.
So last few 4days i came in contact with a
lively article on the internet on how this
Powerful Herb Healer get her well and
healed. So as a patient i knew this will took
my life 1 day, and i need to live with other
friends and relatives too. So i copied out the
Dr ojukwu the traditional healer's
email id:DR.OJUKWUTELLERSPELL@OUTLOOK.COM,
and i mailed him immediately, in a little while
he mail me back that i was welcome to his
temple home wereby all what i seek for are
granted. I was please at that time. And i
continue with him, he took some few details
from me and told me that he shall get back
to me as soon as he is through with my
work. I was very happy as heard that from
him. So Yesterday, as i was just coming from
my friends house, Dr ojukwu called
me to go for checkup in the hospital and see
his marvelous work that it is now HIV
negative, i was very glad to hear that from
him, so i quickly rush down to the nearest
hospital to found out, only to hear from my
hospital doctor called gregory havis that i
am now HIV NEGATIVE. I jump up at him
with the test note, he ask me how does it
happen and i recide to him all i went
through with Dr ojukwu . I am now glad, so i
am a gentle type of person that need to
share this testimonies to everyone who seek
for healings, because once you get calm and
quiet, so the disease get to finish your life
off. So i will advice you contact him today for
your healing at the above details:
Email ID:DR.OJUKWUTELLERSPELL@OUTLOOK.COM or on his mobile num:+2348112060269,sir you are the best.

Nov. 01 2013 06:37 PM
Drew

The segment on the sources of HIV was fascinating. I was a bit disappointed when Glenn Burke was referred to as "the gay guy." Apparently after all the research and interviews done about him, the hosts couldn't remember his name. Especially after explaining his tragic life after baseball, it sounded a bit demeaning.

Aug. 27 2013 09:15 PM
Mary from Tulsa

The HER and her colleagues thing really disappoints! I assume this was edited, so there's no excuse. In fact, your editing with layers and bits is so annoying I cannot listen to this show for more than a minute even when the topic interests me very much. Less would be more. Stop playing around, and strive to communicate.

Aug. 27 2013 01:35 PM
Germony from Milwaukee, WI

I love this one a lot. But it left me with a number of questions.
The origins of HIV if it traced back to mutating monkeys viruses. Why doesn't it seem to effect man that have sex with man more? Why not everyone equally?

Aug. 26 2013 01:32 AM
Chris

Does anyone know the name of the music that played during the monkey story toward the end of that segment at about 40 minutes in - it sounded like a really modern choral/orchestral piece based on How Great Thou Art, maybe?? Would LOVE to know who the artist is and what the piece was! PLEASE!!

Aug. 25 2013 04:01 PM
Jackie

LOVED this show. It was interesting, entertaining, and fascinating. But, why why why did you guys say HIV virus numerous times? Human immunodeficiency virus virus? Argh!

Aug. 25 2013 01:45 PM
hpm from Colorado

About the high fives: If I heard correctly, you said that Jean-Luc Godard's film "Breathless" came out in 1955. It was 1960.

Also, if the high five is really a folk custom, you will never find its origin. It's like trying to find who first told the story of "the hook" or the "hatchet Lady."

Sweet story, though.

Aug. 24 2013 05:18 PM
Linda from Park Rose Heights

Interesting show.

I also wanted to note that I worked with my friend Randy Shilts the last few years of his life. In "And the Band Played On," Randy did not claim that Gaetan Dugas was The Patient Zero, rather he was an example of how diseases spread, A patient zero. The misconception that Dugas was The man who brought AIDS to America was a marketing ploy to get someone to pay attention to Randy's book. When Band was first published, Randy's editor said that no one would review the book. Once St. Martin's marketing department spread The Patient Zero story, Band was reviewed, became a bestseller and, subsequently, has been recognized (on many lists) as one of the 100 most important books of the last half of the 20th Century.

And one case that has always intrigued me is that of Dr. Tom Dooley, the Navy hero and founder of Medico. Dooley died of a mysterious skin cancer in 1961 at the age of 34. He was a gay man who was dishonorably discharged from the Navy in 1956 due to his homosexuality. In the 1950s, Dooley visited Dr. Albert Schweitzer several times. Schweitzer was working in the area of Africa that has been identified as the place where the virus may have crossed over to the human population. According a friend of mine who was Dooley's boyhood friend, Medico pilot and former lover, Dooley also spent time in several US cities where those (later identified) mysterious cases emerged in the late 1950s and early 1960s. I'm not intimating that Dooley had AIDS or that his mysterious skin cancer was KS, his former lover and I just found his untimely death to be an intriguing medical mystery. Imagine what Dooley could have accomplished had he lived another 30 years.

Aug. 24 2013 04:23 PM

Jad, Jad, Jad ... a Mac-Genius is not a license to poop all over English grammar by using an object pronoun in place of a subject pronoun.

SHE and her colleagues and NOT HER and her colleagues performed tasks.

C'mon man you are too smart, too educated to dumb your lingo down to the hoi polloi in a lame attempt to sound ... ugh ... cool.

Aug. 24 2013 03:54 PM
Karl Heidemann from Sioux Falls, SD

While I enjoyed and appreciated the Radio Lab piece, I found it contained a great deal of speculation that was, for the purpose of the story, accepted as fact, and then built further upon. And its overall thesis remains the the core of the larger "status quo" explanation for HIV/AIDS.

Edward Hooper's "The River: A Journey to The Source Of HIV And AIDS" offers some fascinating insight into, and an entirely different perspective on this topic. In this meticulously researched tome, many of the presumptions of the Radio Lab piece (and the status quo explanation) are dissected and discounted, and more defensible hypotheses proffered.

I do not, necessarily, agree with Hooper's conclusions, but his work stands, at the very least, as a caution for us to not believe everything we hear (or read).

Aug. 24 2013 12:40 PM
Garrett from New York

This is a really incredible episode and also my first. I think there is a lot of good information here! I hope that all the research also considered the other theories on the origin of HIV; as the monkey spillover disease origin is a theory and has not been completely verified. The unlikelihood of the virus hybrid surviving and turning into HIV has given rise to other research suggesting that the disease is human made for the human body even though it is technically a "young" disease. If this information can be the basis of another episode, give it a look because it too is an incredible story.

Aug. 23 2013 02:36 PM
cpig from Oakland

The song at the end is by a band called "the Supersuckers" its off their album "Must've been High"
Fantastic stuff- check it out.

May. 28 2013 04:05 PM
Cameron Shelton from Kansas City

Does anyone know anything about the guitar riff / music which begins at 49:28 and can be heard most clearly from 50:12 to 50:17? Thanks.

Apr. 04 2013 12:47 AM
MagicBlackLady

Nice hypothesis about the origin of HIV... No one has mentioned the possibility of crossover into human populations via earlier, poorly prepared vaccines using many species of animal organs... has this been considered? And what would the liability implications be if... say a pharmaceutical company cut corners financially say in maintaining adequate refrigeration systems in developing country clinics... say in West and Central Africa and a new pandemic was a result... Just a thought.

Nov. 14 2012 12:06 PM
Martin from 94070

IT'S NOT HIV-Virus. It's just HIV (V=Virus)

Jun. 29 2012 03:12 PM
Martin from 94070

IT'S NOT HIV-Virus. It's just HIV (V=Virus)

Jun. 28 2012 08:46 PM
podiceps60 from Perth Austalia

but what is the guitar music at the end of this podcast Patient Zero?

Jun. 28 2012 06:12 AM
Daniel Halperin

Dear Radio Lab (and NO need to post this publicly, I'm just passing this on "FYI"): I think you have a fantastic show, and I enjoyed listening to the segment the other day on the viral history of HIV. Also, FYI much of the material seemed(eerily?) similar to our recently published book on the AIDS epidemic (Tinderbox; Penguin Press, 2012), and I wondered if perhaps that was just a coincidence? Anyway, no biggie, it was a good (and accurate) show... Thanks for airing it.... Sincerely, Daniel

Daniel Halperin, PhD
Adjunct Associate Professor
Gillings School of Global Public Health
University of North Carolina, Chapel Hill

Jun. 07 2012 11:56 AM
Dan Buchan

No no no....the "high five" originated in Mel Brooks' 1968 film "The Producers" -- watch the Springtime For HItler musical and you'll see it, 7 years before Rocky Horror.

May. 27 2012 03:12 PM
michael from Hermosa, SD

I'm in the midst of listening to the "high five" story, hoping you mention this 1975 source of the high five, the Rocky Horror Picture Show:

http://www.rockyhorror.com/

Perhaps this movie helped popularize it, and the baseball player, Glen Burk(?) saw the movie?

May. 26 2012 12:58 PM
Sloppy Boggins from Toronto

And on the "high five" the volleyball reference is somewhat inaccurate as they do a "high ten". It is done in good or bad situations and often is just acknowledgment of each other to refocus for the next play. Most commonly seen when players sub in.
The only reason I think the "high five" and "high ten" should be distinct is because the "low five" is as equally similar yet vastly predates the others.

I can't believe I'm posting about this. :)

Apr. 28 2012 05:22 PM
Sloppy Boggins from Toronto

This is exactly the reason I enjoy this program. You take something as complex as AIDS and make it easily accessible.
My own look into the spread of HIV had also led to chimps when people were looking at me like I was crazy for suggesting that. But the "how" was more specific and somewhat sinister. Forgive me as my memory for the specifics has faded but there were people making vaccines, I'm pretty sure for polio, from chimps. There eventually became debate on their methods as they had to kill the chimps to access the material necessary to produce the vaccine. Despite this debate they continued to produce this vaccine in the same method and 'could' be the source for human infection.

Apr. 28 2012 03:26 PM
Colas from Strasbourg, France

This is a very interesting show. It is very entertaining but not enough scientific or critic to my point of view.
It would have been very informativ to speak about the HIV in itself and the difficulty of recognizing it (microscopy, molecular biology etc), the difficulty about HIV testing, the controversy around the aids statistics, the difficulty of linking HIV to AIDS, the effects of new antiretroviral drugs etc...

http://www.youtube.com/watch?v=_p-ttLfkZHQ

Mar. 11 2012 06:56 PM
Rachel

Once again, fantastic work. I've listened to the AIDS story a dozen times now.

Dread Pirate Clinton from Montreal, if you're still looking for it, the network referred to in the AIDS story is in:

Auerbach D.M., Darrow, W.W., Jaffe, H.W, and J.W Curran (1984) Cluster of cases of the acquired Immune Deficiency Syndrome-patients linked by sexual contact, American Journal of Medicine, 76, 487-492.

Jan. 26 2012 01:15 PM
Kierie

Listening to the high five segment in "Patient Zero," I recalled biking late one night along 14th Avenue in Manhattan back in 2007. As I pedaled mid-block, a tall, jacketed man stepped out between parked cars to hail a cab. Without thinking, I rose out of the saddle and raised my arm to give his cab-hailing hand a high five. He shouted with delight. Thanks, Glenn Burke.

Jan. 21 2012 08:33 PM
BOB

can anyone give me a summary of this

Jan. 07 2012 04:36 PM

This story is soo COOL!!

Jan. 07 2012 04:22 AM
Landing7981 from Naples, FL

One of the best episodes I've heard. I recommended it to my family and they loved it as well. Keep up the great work!

Jan. 06 2012 05:32 PM
John from Indiana

Comparing Typhoid Mary's situation to the story of AIDS raises some disturbing questions about our "modern" way of dealing with pandemics. If simian aids was ever as fatal to chimps as HIV is to humans, it would have eventually wiped out all of the chimp population, except possibly for a few if they had some natural immunity, or were at least able to resist aids long enough to reproduce. Many of their offspring would have also had this resistance, some even stronger than their parents. In the course of evolution, their offspring would quickly come to dominate, while the others would die off (and the existence of these stronger individuals would be a hazard to the rest of the population, especially if they were only "healthy carriers", and not fully immune). Before modern medicine, that was the only way a species had to survive a pandemic of a fatal disease.

But when Typhoid Mary was found, we immediately quarantined her "for the safety of others". That means there was no way for her genes, which gave her natural resistance, to spread. Of course, today we'd study her genetics and biochemistry in the hopes of learning how to fight the disease, but it raises the disturbing issue that if that attempt failed, continuing to quarantine her would also mean giving up on a "last hope" option for keeping the human population alive.

Several years ago I read that a population of prostitutes somewhere in Africa had been found that seemed to have a stronger than normal resistance to HIV.

Dec. 10 2011 11:53 PM
Nate from Beaver Falls, NY

Is it just me, or are there the faint strains of the eerie screechy music from the shower scene in the movie Psycho at 35:53 where the Nathan Wolfe describes a chimp going after an organ of another chimp "that was a tasty morsel".

If so...kudos to you Radiolab......if not...score one for an over active imagination.

Dec. 09 2011 01:56 PM
AndrewD from Perth, Australia

This has to be one of my favourite episodes, alongside Parasites and Ooops. Oh, and all the others of course

Dec. 08 2011 02:13 AM
Nick from Detroit, MI

scratch that. 1960

Dec. 05 2011 11:16 PM
Nick from Detroit, MI

Breathless was 1959, not '55. Just FYI from a movie nerd.

Dec. 05 2011 11:12 PM
Beth Novey from Washington, DC

Perhaps chimps should get some credit for being the first high fivers?

Hand-clasp grooming!

http://www.nature.com/nature/journal/v437/n7055/box/nature04023_BX2.html

http://www.emory.edu/LIVING_LINKS/hcg.html

Dec. 05 2011 12:10 AM
Cici from Philadelphia, PA

best. episode. ever. period.

Dec. 02 2011 04:07 PM
Claudia from Chiang Mai, Thailand

Almost five years ago, I lost the love of my life to complications from AIDS. My husband passed away and every day since, I have lived with a great loss. Listening to the HIV story, there are so many "what ifs" running through my mind, and tears running down my cheeks. A truly emotionally wrenching story. Thank you.

Dec. 02 2011 07:42 AM

This was one of those episodes that reminded me why I fell in love with RadioLab in the first place. The AIDS story was downright phenomenal.

Dec. 01 2011 12:44 PM
Gabriel Ramos-Fernandez

Although I normally like your show, I have to say that this one was pretty disappointing. First, the way in which you introduce the patient zero idea, using a contagion network as a visual aid, is misleading. One thing is to have a highly connected individual (which in the case of sexual contacts, could simply be a very promiscuous person) and another is to trace the origins of the disease, which could be traced back to a not necessarily promiscuous person. Second, while searching for the origins of a disease is definitely interesting, I find the high five story pretty silly - I mean, this gesture is so simple that it could have been used anywhere, multiple times, not necessarily being "invented" by anyone.

Nov. 29 2011 03:36 PM
Kim Butler

Here is a related interesting and sordid tale. Really worth a read, especially for Radiolab listeners who have heard Patient Zero.
I would LOVE to hear RL do a closer look at this guy...
http://goo.gl/ZkMWk

Nov. 29 2011 01:46 PM
Tony

Rafael, the song is a variation of "Infinite Love" by Dustin Wong.

Nov. 28 2011 09:17 AM
Rafael from Jersey City

First: what is that song that comes in and out during minute 50 when Glenn Burke "invents" the high five?

Second: What a great episode! I'm always pleasantly surprised by episodes I click on out of strength of habit more than strength of interest. I thought the theme "Patient Zero" might be a bit heavier than I was in the mood for... but wow. Riveting. This is why tuning in has become a reflex.

Nov. 27 2011 02:31 AM
Jim from Lichfield, UK

slightly odd coincidence that if you use Roman numerals for the 5 in HI 5 its HIV. Tenuous I know, but a coincidence none the less!

Nov. 24 2011 07:18 AM
JonnyH from Seattle, WA

In the book "El Birdos" by Doug Feldman he puts forth the theory that Orlando Cepeda was patient zero for the High 5 back in the 1960's. Also in baseball! The book is about the 1967-1968 St. Louis Cardinals.

Nov. 23 2011 07:24 PM
Rick from Utah

It would be intriguing to hear about the patient zero of Chuck Norris jokes!

Nov. 23 2011 05:27 PM
Evan

Hail Mary Mallon = Aesop Rock + Rob Sonic. Makes sense now!

Nov. 22 2011 03:35 PM
super sovak from NY

I was surprised that "Deadly", the recent fictional revival of the Typhoid Mary character by author Julie Chibbaro was not mentioned.

Nov. 22 2011 01:51 PM
Matt from Fredericksburg, Virginia

If you enjoyed the segment about Gaetan Dugas, read more about Robert Rayford. Fascinating stuff! Well done Radiolab!

Nov. 22 2011 09:09 AM
Dan Frye

We all gonna act like that guy didn't know what Carbonite was?

Nov. 21 2011 03:04 PM
Tony

Robert from Bucharest, the song you are looking for is called Articulate Silences, by the band Stars of the Lid, from the album "And Their Refinement of the Decline". Highly recommended band. I wish Radiolab would give credit to the musicians who create the music they use.

Nov. 21 2011 09:37 AM
Susanna from Albuquerque, NM

As the child of an epidemiologist, I was familiar with Typhoid Mary's story from an early age--in fact, because I tended to harbor a strep throat (i.e., carry it but not get sick), my nickname was "T-Mary" (epidemiology humor).

I also learned from my father that fads spread in the same pattern as epidemics, and that both can be plotted on a bell-shaped curve.

Nov. 20 2011 11:52 PM
Peter from Mountain View, CA

In case anyone else wants to track it down, I found the high five from Breathless at 1:14:26 in the Google Video copy of Breathless at http://video.google.com/videoplay?docid=154265816642125228

Nov. 20 2011 09:41 PM
Robert from Bucharest, Romania

I came here looking for a one of the songs played during the podcast and I'm shocked to find there's no list of them.
I really want to identify the song that was played during the "High five" segment, when they all get teared up because the robotic arm works.
Can anyone please help? I know it's silly, but I would really appreciate any help.

Nov. 19 2011 09:35 PM
Christopher Murray from Ireland

To avoid disputes in a RadioLab episode decades hence, I would like to stake my claim here and now to being the originator of the heterodyne kiss.

Nov. 18 2011 04:09 PM

In regards to the Patient Zero Story and the spread of ideas - I guess you never heard of William S. Burroughs ideas as language as a virus ( or the Laurie Anderson Song derived from these ideas?)

Nov. 18 2011 02:39 PM
Gavia

This episode (one of my favorite recent episodes) reminded me of the book Bellwether, by Connie Willis - a great book about the "patient zeros" of fads. It's a fictional book, and though it has a lot of interesting facts about fads, so don't read it expecting a factual answer to the question of where fads come from. But Willis' fictional hypothesis about the origin of fads is very interesting...

Nov. 17 2011 05:24 PM
Jim Marks from Houston, TX

I would encourage you guys to follow-up on some of those closing remarks about Darwin and the impact that his "Origin of Species" had on the prevailing narrative about "creation".

The contemporary "culture war" between evolutionary science and creationist religion is something which actually manifests _after_ Darwin's theory takes hold. Prior to 19th Century advances in biology and cosmology, the prevailing religious understanding of the first three chapters of the Book of Genesis were far less literal than what we think of as the "traditional" understanding today. That "tradition" is actually about 200 years old, at the most, probably far less. Much more ancient views on these passages are far less literal and experience the "truth" being conveyed as being far less about history (or pre-history) and far more about _purpose_ and _causation_.

In much the same way that you've shown how hard it is to find Patient Zero once certain compelling (almost always apocryphal) narratives become conventional wisdom, in the same way it can be very difficult to recover truly traditional religious perspectives once certain compelling replacements set themselves up as "fundamental" and "mainstream".

Almost nothing of contemporary, Protestant Christianity as it is practiced in the USA is actually "traditional" if you look at the history of the church and yet these views have a dominance in our culture that makes it seem impossible to imagine anything else as normative.

There have _got to be_ some good stories you could unearth in this area and Darwin may in fact be a good place to start.

Nov. 17 2011 01:33 PM
Dread Pirate Clinton from Montreal

Great episode!

Does anyone have a link to the original CDC AIDS diagram tracking the sexual history of the 30 or so patients?

Nov. 17 2011 01:07 PM
Seanzie from Asheville

That HIV investigation was the most fascinating and chilling story, beyond Biblical. It's the combination of scientific engagement and symbolism--the most terrifying and evil scourge of nature is something that originated with the consummation of inter-primate consumption! Chimps are definitely the Cain of the family.

Peabody?

Nov. 17 2011 07:38 AM
Stefan Wrobel from Los Angeles

I'll start by saying I loved this episode especially but two things annoyed me:

1) Complete emotional pandering by throwing in the robotic arm story. Seriously, what did that have to do with the origins of the high five?

2) You said when you started the high five story that it had nothing to do with diseases, but AIDS came up probably as many times as in the previous story! LIES!

Nov. 16 2011 03:04 PM
J G Luz

Oh radiolab, who else could ever convey the alchemical in the biochemical--geniuses, all of you!

Nov. 16 2011 11:26 AM
J G Luz

Oh radiolab, who else could ever convey the alchemical in the biochemical--geniuses, all of you!

Nov. 16 2011 11:25 AM
Jouko from Helsinki, Finland

I stumbled on Radiolab some time ago (via Krulwich's blog), and now after listening a number of episodes it's fair to say I'm thoroughly hooked. Thank you guys for such a fascinating, inspiring show! I will surely spread the word up here..!

Nov. 16 2011 10:13 AM
Daniel from Berkeley, CA

Poetic indeed. The whole interplay between mindfulness and the environment, it's just beautiful.

As always, thanks for the journey. Hi five!

Nov. 16 2011 12:36 AM
Lee Lee from Taos, NM

On cowboy hats: On a trip to Tibet, I was impressed that some Tibetans were wearing "cowboy hats". I commented on this to a friend, who said that it was in fact a very traditional design worn by Mongolians. It made me wonder whether the design was brought to the west from the Asians who worked on the railroads. I like the conclusion that it was designed by the environment & interesting the parallels between the American West and the Asian highlands.

Nov. 15 2011 04:41 PM

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