Will there be enough earth for us all?

This elegant video short poses the question

vol. 1 issue 21


This week, docu-mental is moving to new digs, so it’s more chaotic than usual around here. We’ll be back to our twice-weekly schedule in September.

In the meantime, those american states of mind I talk about are on my own mind a lot lately, particularly as I increasingly see headlines indicating just how far the tentacles of nativism are able to reach these days, including into countries known for tolerance, such as Sweden.

To review, the five states of mind I have determined are the ones through which we filter all news and information, or have it filtered for us are:

  1. Us vs. them

  2. Fear of scarcity

  3. Projection

  4. Apathy

  5. Cognitive dissonance

One of the influences on my thinking about the interplay of these mindsets is an exquisite video released in 2016 by the American Museum of Natural History, depicting human population through time. This six and a half minute animated history of humanity’s existence mesmerized me the first time I viewed it, and I have watched it several times since.

Fundamentally, it is an animated graphic showing how it took 200,000 years for human population to reach one billion, and only 200 years to reach 7 billion. We are projected to reach 8.5 billion people on earth by 2030, leveling off at 11 billion by 2100.

When I first saw these elegant, if slightly eerie, graphics set to compelling music, it snapped into focus for me how not only our exponential procreation over millennia, but massive shifts in human migration due to wars, contagion, access to resources, and scarcity have all played out in relationship to the earth. Of course we are frightened at some level about there not being enough to sustain our existence. This has to impact — even subconsciously — how we think and thus, how we act. All five states of mind are relevant here, but particularly our fears of scarcity acted out in “us vs. them” constructs such as nativism, are easily understood watching this video.

The video is also a compelling escape from whatever you’re doing this minute, and offers a poetic vehicle to contemplate how the common denominator in our rising levels of mental anguish globally is us.

Here’s the video:

Looking forward to returning in September!


Saudi Arabia is still drinking our milkshake

The most popular docu-mental issues and podcasts so far

vol. 1, issue 20


Welcome to all our new subscribers, including our new premium level subscribers!

My name is Whitney Fishburn. I am a former full-time health sciences and policy journalist based in Washington, DC, and I appreciate your interest in this newsletter. It’s my goal to present you with useful tools for processing the news so you don’t become anxious and/or depressed. One way I do that is to look for pathways past partisanship pitfalls, and go instead into realms we all share as americans, little “a”.

If you’ve been forwarded this, consider becoming a free subscriber. If you already subscribe…you know this is a unique publication, and are looking forward to September when we add more exciting features.

Meanwhile, here’s a guide to some docu-mental issues and episodes you might have missed since we debuted six months ago.

Our most popular podcasts:

My Days and Nights with the Reagans
An interview with Reagan biographer and former TIME White House correspondent, Larry Barrett.

It's not him, it's us: narcissism in POTUS45 is beside the point
An interview with the sole surviving member of the American Psychiatric Association’s Ethics Committee that wrote the Goldwater “Rule” that calls for APA members to refrain from commenting on the mental status of public figures. (This is the one that earned me both the most hate and love mail.)

Our most popular commentaries:

Valuing silence: Why noise-free zones should matter to our legislators
“In the silence, there are things that you do not know exist until you put yourself in their path of not hearing them.”

From the Heart of the Civil War
“I just wish that I could fly the flag, pledge my allegiance, and love my country without it being co-opted by one and scorned by the other.”

Our most popular analyses:

The new economic paradigm:
How house concerts and independent publishing are at the leading edge of a parallel universe of trade

Why are surprise military missions on the rise in US cities?
DOD fears of dystopia are also up

Saudis drink our watery milkshake
Among our most popular items of all was this analysis of the impact of a Saudi-backed agricultural conglomerate’s purchase of water rights in drought-stricken California.

Here’s an update:

Saudi Arabia sucking up dwindling American water supplies

If you read the article I wrote back in April about how Almarai, a Saudi Arabia-backed agricultural firm, has been scooping up largely unrestricted water rights in drought-stricken California, this article in The Guardian might be of interest. It highlights that natural water supplies in that nation are expected to run dry within 150 years. Put another way, by its own admission, the kingdom is using four times more water than its natural underground aquifers can regenerate to support current levels of consumption.

Despite the kingdom has raised awareness over its water shortage plight, a plan to promote tourism on the Red Sea includes plans for 50 luxury hotels to be built. Projections are that once completed, water consumption by hotels along the coast will average about 56,000 cubic meters per day.

The incongruity will likely aggravate the situation for Saudis whose daily water consumption is double the rest of the world’s.

Desalination projects have been less than inspiring due to their environmental impact. Meanwhile, curbs on agricultural production do not mean Almarai uses less water…just less of their own water, and more of ours.

And our most popular Friday Funny:

Thanks for reading and for being a subscriber, free or premium!


The CVS/Aetna deal should be featured in our healthcare debates

The not-so-covert take-over of US healthcare should be top of mind for POTUS wannabes

vol. 1, issue 20


It occurred to me recently while I stood in line at my local CVS to purchase a box of syringes for new medication I must take through intramuscular administration as part of my recent autoimmune disease diagnosis, that my mistrust of CVS goes back to 2007 when it started issuing its electronic “Care Cards”. I was not pleased to know there was a database over which I had no control and which would be tracking indefinitely all my purchases. How cute, I know. Remember those days when we used to take privacy largely for granted?

At the time, I didn’t realize that the data tracking cards and the buying spree of vertically related companies was the thin edge of the wedge in CVS’s campaign to become the lords of American healthcare. This Seattle Times piece chronicles it nicely up to 2015. I have mapped the rest of its purchases for you in this article from back in June where I ask do you want Socialism or CVS.

Standing there annoyed because, through no fault of my own the purchase of said syringes had taken over a month to complete, I ruminated on that data capture.

I recalled a conversation I had last year while attending the Wall Street Journal’s Health Care Summit at the Four Seasons Hotel in Georgetown. As a trade journalist for Mergermarkets hoping to break scoops about the frenetic activity in healthcare, I was only this squinchy much higher than persona non grata among the likes of Aetna CEO Mark Bertolini and other C-suiters (many, if not all, of whom had body guards tracking their every move) and healthcare illuminati. That’s why I was alone as I munched on swanky crudites with exotic dips and sipping a San Pelligrino, praying to the Gods of Journalist Intel, when another loner asked if he could share my table.

Ask the universe for a break, and look what happens!

He looked like he’d had a hard day on his feet and would rather head back to where he was from in the upper Midwest so he could relax with a little ice fishing. Why was he here, I asked. Turns out, he managed some pretty hefty data processing contracts for all the major healthcare companies. Including — especially — the US government, particularly the Centers for Medicare and Medicaid Services (CMS).

Did the government have a chance of making our electronic health data actually synch properly (currently it does not) such that we would benefit as a nation from all the money being spent on it, much to the heartache of many a physician?

Uh. No.

Oh, shocker. But I bet CVS is ahead of the curve on that now that they look like they will have everything they need to own the doctors and the patients, I said.


The details of that conversation boil down to this: Medicare data. Boomers are where the bucks are, and if CVS can own the majority of that demographic’s spending habits on drugs, and know how to predict and even shape those habits, CVS will literally own the healthcare market and control trends.

“All along, it has been about the data,” my new friend told me. “They want to control as much of it as possible. The more they do, they more control they have. And they have a lot of data.”

For more on that, see the article I wrote in June and especially this one I wrote in the inagurual issue of docu-mental back in February. Meanwhile, because they’ve been investing in their healthcare IT infrastructure since the mid 2000’s, this is what they presented to investors back in June:

I am still looking for a good graph issued by CMS that shows they are capable of this and already implementing it. I believe, based on my conversations with him, that Health and Human Services Secretary Alex Azar dreams about it happening one day, if only on his watch. For now, I could only find enormous ZIP files of ponderous charts likes this one to explain how that dream of seamlessness between the patient experience, physician efforts, and data capture are to function:

Yeah, you’re not alone rolling your eyes there. Doctors are as thrilled with all this mumbo jumbo as you might suspect. As in, they hate it. Does it even work? It might except that your favorite president and legislators can’t walk in a steady healthcare policy line long enough to make anything meaningful happen.

Which brings me back to where I was, standing not at the cafe table in the posh Four Seasons but in the not posh (and not private at all) CVS, thinking that if the behemoth’s elegant and simple graph created for investors is true, I almost wouldn’t mind CVS managing my data and my healthcare experience. I like efficiency. The government is not efficient. Spoiler alert! Efficient, seamless government-run healthcare won’t happen in my lifetime or yours either.

So, why do I grouse?

Because for all its power over the healthcare system, CVS still escapes being featured in the tiresome healthcare debates we seem addicted to. Meanwhile, as legislators fixate on Medicare-for-all, CVS is steadily making in-roads to be the obvious choice for efficiently delivered healthcare, and the only ones really taking notice are Jeff Bezos, Jamie Dimon, and Warren Buffett with their own slowly rising healthcare empire.

I believe CVS should absolutely be a factor in our healthcare debates. The company has the power to change the playing field, and by not acknowledging that in any of their debates or stump speeches, political candidates are being disingenuous at best, displaying their ignorance at worst.

The difference between CVS and CMS is not their IT, it’s that shareholders have the power, not American citizens. They are profiting off of the purchase of our personal data, and yet are not subject to our desires for what they do with it. There is HIPAA to protect our privacy, but that is like a cheap first aid kit bandage on the way that CVS as a pharmacy benfits manager is using our data to shape the market by controlling what prescriptions doctors in their plans can prescribe, or once Aetna has fully merged with it, even determining which physicians we will see.

It’s all there. They are telling us this is what they are doing. These are publicly available slides, and if you’re Alex Azar or Bernie Sanders, aren’t you just about to cry when, taking these numbers at face value, you see how well CVS is already delivering healthcare?

Consider that together with Aetna, that is now plus this:

Which by the way, is boosted by Aetna already doing this:

Notice that they collect population health data. That means they can make granular connections between their population of customer who have type 2 diabetes, for example, and who is costing their insurance plans more money, and so start flagging them if they purchase too many Twinkies. Maybe CVS/Aetna will send these customers a friendly reminder that too much processed food and sugar is directly linked to diabetes. That’s good. Maybe CVS will start refusing to sell these consumers certain foods implicated in type-2 diabetes, or they will make it more expensive for them to purchase those items. Well, now we’re getting into some squishy territory, aren’t we? Profiling. Discrimination. What amounts to the controversial “sin taxing” of sugary drinks, cigarettes, and alcohol.

These hypotheticals might point to free market solutions to our vexing healthcare woes, and they might even be protective of our health and effective in the economy, but CVS and its shareholders are in control, not us. Doctors and other personnel are increasingly working for one employer (and it’s not the government, which everyone who abhors Medicare-for-all is so scared of), and the federal government is only tangentially involved in setting policies. I think it sounds terrific!


Except that I was standing there in the line to get the certain-sized syringes after a month of not having them for the injections I am meant to have weekly because the pharmacist at first didn’t have them because they aren’t typically stocked by CVS, or so he told me then, although no one from his staff, including himself, had bothered to call and tell me that ahead of time.

Nor did they call my specialist. There went one week. When the syringes were ordered, no one called me to say they were in, so they sent them back after a few days. There went two weeks. Then I was out of town. There went three weeks. Then they had to re-order them. Another week. And on it went. Eventually, they blamed me for not having given them my phone number. It took them four visits for them to tell me this. So much for effective data management.

In a market-driven economy, I would normally go elsewhere rather than put up with mediocre service, but since most of the independent pharmacies in the area have closed in the last few years since CVS has taken over the marketplace, it would have been more difficult to do.

This is the type of concern that has hung the deal up in court.

The reason why CVS as the bully on the block bothers me is because no one is watching it become so big it can control my data, but not necessarily serve my healthcare needs.

Doesn’t it sound like the big, bad government take-over of the healthcare system we’re being told will kill a fifth of our domestic economy by those vehemently opposed to Medicare-for-all?

Big is as big does. Government isn’t bad. Corporations aren’t bad. Too big is bad.

The reason CVS can do give me crap service is because they are watching me but no one apparently is watching them. What could possibly go wrong as they continue to grow, I wonder. The days of “too big to fail” come to mind, but I don’t want to ruin your supper.

I am not advocating for a federal single-payer system, not yet anyway. But if we’re going to discuss Medicare-for-all as part of our national healthcare debate as we run up to the next presidential election, then we need to also discuss how this kind of single-payer one-stop-shop is already happening and what it can already teach us about whether such a system would work, and if so, how.

Thanks for reading.

The new economic paradigm:

How house concerts and independent publishing are at the leading edge of a parallel universe of trade

vol. 1 issue 19


Recently, my husband and I attended a “house concert”. Our hosts established that their interest was in throwing a nice party for friends, and in our case, friends of friends, while supporting music they loved. Our only obligation as guests that night was to be respectful during the performance. Other than that, we were treated first to lovely food, wine, and convivial conversation in a bucolic setting, followed by an outdoor concert by a performer who was previously unknown to us.

On behalf of the performer, our hosts asked the audience to contribute to a collection as we each saw fit. They did this after the show was complete.

As we tucked our money into the collection, I considered that we were taking part in a novel economic model, one where consumers pay according to the value they assign to what they have already consumed, rather than paying first and hoping they get their money’s worth.

It is the refinement of a consumer-driven economy where caveat emptor is redefined as “buyer decide” rather than “buyer beware”.

The model has been profitable for Shannon Curtis, the performer that night. According to a popular book she wrote on how to succeed solely by performing in private homes, she grosses an average of $12,000 per month.

House concerts are exactly what the name implies: a concert held at someone’s home. Curtis is not the progenitor of this growing trend, although her book has established her as an authority in how to make it a career. Other itinerant performers have also created helpful literature, including this guide for potential hosts.

Curtis and husband-producer Jamie Hill embark from their home in Northern California each summer to travel an average of three months straight, traversing the continent and back again, performing up to 60 shows. Often, the venues are a back yard or other outdoor feature. Many concerts are held by the same hosts annually. There are variations on the model, but essential ingredients for success include unabashed self-promotion, skillful leverage of social media, meticulous scheduling, and a willingness to go pretty much wherever there is a demand for your sound and style.  

Curtis’s signature sound is more Laura Nyro meets Las Vegas than coffee house casual. After the host introduces her, she greets the group, shares a confessional story, performs a song to compliment it, repeating the cycle as she accompanies herself at an electronic keyboard with synthesizer, illuminated by atmospheric stage lighting. There is no back and forth with the audience during what amounts to an entire album’s worth of songs. It is not just a performance, but a show. She has memorized a script, there are cues for lighting and additional sound effects. The point is, she’s a professional.

Contrast this with another outdoor concert my husband and I attended recently at a nationally known venue. The tickets were not cheap, and they came with a hefty service fee. Parking was tedious, we were searched upon entry, and were searched again before being shown our seats which were about three feet from where we were told to guzzle down the rest of our bottle of picnic wine or dump it.

When the main act finally appeared on stage, we enjoyed hearing familiar songs played by two technically brilliant masters, yet both seemed disengaged, bored, and didn’t even bother to introduce the rest of the impressively talented band. Worse, the sound was not mixed properly and so much of the band’s output was distorted.

The more the former arrangement appeals to you, presumably, the more enthusiastic you will be about showing your appreciation when asked, and even to support the performers by purchasing merchandise from their pop-up store after the show.  In the latter arrangement, I was annoyed to have been taken for granted by the celebrity musicians – no matter how brilliant their talent – after having put considerable time, effort, and inconvenience into supporting them. I certainly had no interest in their merchandise.

Before the house concert, Curtis introduced herself to everyone present, thanked us all individually for being there, and developed a feel for the vibe she was playing to. She told me post-concert that 30 audience members is her ideal size, as it affords “the right intimacy”. At the celebrity tour gig, the band leaders didn’t bother to acknowledge that the weather was crap but there we all were anyway, all several thousand of us. Really, not even a hello. Because they disappointed me in this way, I doubt I will go see them live again, even if I continue to be a fan of their music.

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Curtis’s focus on creating intimacy helps ensure she makes a good living: if the 1,800 people who attend her shows (60 concerts x 30 audience members per show) each put $20 in the collection, that’s $36,000 after three months. Add to that the sales of merchandise, and it’s clear that unless Curtis has dreams of immense stardom, she needs no record label or distributor.

In truth, not all musicians or artists do have dreams of immense stardom. They just want to get paid to do what they love and are trained to do. All the better that they are able to interact with fans who appreciate their work and who pose no threat, physical or otherwise; the very nature of the private host model means guests are vetted before being allowed into the venue.

This intimate model does away with reliance on the entrenched corporate channels that limit an artist’s access to essential resources if they are to have a career: means of production, promotion, and distribution. In the direct-to-consumer scenario, the money that Curtis and others like her make is their own to invest in the resources that will continue to propel their careers.

It may seem like a lot to gross $12,000 per month, but their overhead certainly limits their margins. Curtis and musicians like her also must create financial cushions to pay the bills when they are using down time to write songs, produce new material, and just recuperate from the rigors of the road.

What they lose in the margins, however, they will make up for in autonomy. A powerful difference between house concerts and the traditional model of music sales is that self-employed performers like Curtis do not lug around an entire industry of middlemen who need justification for their salaries.

In the music industry, a lot of money and resources are spent keeping the structure in place, including on people whose job it is to convince you that you like and want to hear certain artists – even artists who have grown bored. The promotional team themselves them might not even care for the music they promote, but they do care about a paycheck. Meanwhile, Curtis’s truly consumer-driven model is nimble and authentic.

Another plus of the direct-to-consumer model is that audience members already have been qualified as potential buyers by the hosts. If this puts you off, consider the difference in psychology between this model and a multi-level marketing scheme where you recruit friends to be members of a salesforce, make them buy the products you sell, and hope they meet their sales targets because your own income depends upon it. To me, this sounds stressful, even tacky. With a house concert, friends need only be good guests. You’d likely expect that from them anyway.

This model is unlikely to replace corporate music, nor should it, at least not any time soon. Live music fans such as myself will continue to go to large venue concerts, even if we are choosy about them; not all big names are disrespectful to their audiences. Plus, much of the music industry is publicly traded, and is important to the economy in other ways. Yet, the direct-to-consumer model expands the marketplace for live music since the hosts, who do not typically take a cut of the earnings, make possible the low-cost delivery of the music. This leads to a greater supply of live music for an even greater number of fans who might not want to or can’t afford to spend money on tickets to live shows at established venues.

On the demand side, if a fan doesn’t get an invitation, then he or she is free to be host concerts themselves. Often, house concerts are co-hosted by groups of friends who pool their resources.

Naturally, as a journalist who chose to leave corporately owned media to publish independently, I am sympathetic to the house concert model. My product’s value is not determined by me but by members, nor are my costs determined by traditionally requisite overhead that an industry says I must carry if I am to succeed. But what I love best of all is that I am writing with service, not profit, top of mind. I cannot afford to be cynical and just assume that because I generate content, I should be rewarded with your time, attention, and financial support. And the revenues I generate are invested in expanding my ability to serve.

It occurred to me while driving home from the pleasant evening: House concert muscians and independent publishers are not rejecting our system of commerce, we’re not even modifying it. We’re existing along side of it, creating an entirely new system, one that is predicated on community. Fans of house concert musicians are not going to give up on bigger name musicians who might be supported by the old structures, but whose talent is what largely got them where they are. Neither would I ever expect my readers to abandon the New York Times for what I offer.

But, because the economic model house concert musicians and independent publishers such as myself are creating is not driven by policymakers, economists, or legislators, we are free to respond to our audiences organically, to nourish their needs while also meeting our own.

Isn’t that the real goal of a free market?

We arrived at the house concert as strangers that night. We came away members of an amicable group who’d been empowered to choose how we wanted to participate in the marketplace. No one was shortchanged, no one was harmed. In essence, the new economic vehicle is community.

docu-mental is member supported. Even if you are not a paid premium member, your willingness to become a regular free subscriber is important to our growth.

Currently, docu-mental: mapping the american states of mind is published twice weekly, but beginning later this month we will publish Monday through Friday.

If you’d like to learn more about this publication and the ethos behind it, please visit the about page.

docu-mental does these 5 things:

Inspires you to re-evaluate and clarify how you identify as “american” *
Gives you tools to predict how larger trends will affect you personally
Helps you expand your sense of agency when dealing with those trends
Demonstrates how empowerment results in less anxiety and depression 
Encourages you to apply this intellectual/emotional synthesis to all news media

Thank you for supporting docu-mental!

Happy Friday,


(photo credit: Blair Fishburn. Shannon Curtis and Jamie Hill at House Concert at Pleasant Hills Farm, Darnestown, Md.)

Media mega-merger puts docu-mental ahead of curve

Together, we are re-inventing news for the better

vol. 1 issue 18


Yesterday came the announcement that Gannett, publisher of USA Today as well as hundreds of local papers — including the Courier-Post in Cherry Hill, New Jersey where I had my first column — will merge with local and regional media company GateHouse Media, to create the nation’s largest newspaper chain. The Department of Justice is not expected to block the sale.

According to the Washington Post:

The $1.4 billion purchase of McLean-based Gannett by GateHouse Media, based in Pittsford, N.Y., will create a conglomerate that will own more than 250 daily newspapers and hundreds of weekly and community papers. The new company will retain the Gannett name and will have publications in 47 states, reaching more than 145 million unique visitors each month.

In this extraordinarily leveraged deal, GateHouse is backed by Apollo Global Management. The private equity fund also owns CareerBuilder.com, and as of this summer, is also the owner of the photo processing sites Shutterfly and Snapfish where so many of us store our images in the cloud.

Local newsrooms, millions of images, classified ads (which is where job listings used to appear in the analogue days) — aside from my being disturbed by the fact that these components sound to me like the elements of an organization intent on challenging Facebook by data mining us and then selling us back to ourselves as “news”, there is the fact the news is becoming increasingly centralized.

Also from the Washington Post:

…the efficiencies wrought by the merger may also result in publications that rely less on local reporters and more on USA Today-type stories produced or edited remotely and published in dozens of the company’s publications. Journalists across the country fretted over whether the deal would mean a wave of layoffs…

Andrew Pantazi, a reporter for the Florida Times-Union and president of the newspaper’s guild, said journalists in his newsroom were anxious about any cuts, particularly the elimination of editor roles. Pantazi said some newsrooms have lost editors because they were reorganized into hubs.

“We’re afraid of that big number: $300 million,” Pantazi said. “We’re afraid of what happens when you have fewer journalists working in the state of Florida.”

Regular readers know by now that one of the founding tenets of docu-mental is that too big is bad, regardless of whether it is a government or a corporate enterprise. It’s just too easy to avoid being responsible to the people who are supposedly being served when you can hide behind the bureaucracy that has stripped you of your authority.

To say nothing of the similarities of this to state run media in autocratic nations like China and Russia, I agree with this source in the WashPo article. She voices my fear that it will be stockholders and not local news consumers who will be in the ascendant:

Jane Hall, a professor of journalism and media studies at American University, said she worried about the viability of local newspapers whose parent companies respond to stockholders’ wishes, even at the risk letting competitive journalism slip by the wayside.

Plus, there is the inevitable slide in quality and accountability that comes with “too big”. Although it is true that the readers in the markets where these papers will still operate will appreciate having some kind of reporting, as we have seen time and again with large entities, the autonomy of people within the organization and the quality of the product they can offer will be diminished; corruption and apathy are difficult to contain. That is precisely what happened with Wells Fargo, for example.

By now, I hope that you have noticed and appreciate that docu-mental does not take an us versus them stance on current events. I don’t claim anyone has the moral high ground, even if I try to detect and uncover deceit and hypocrisy. Rather than focus on the latest outrage, I observe patterns.

The spirit and mission of docu-mental has been authentically mine since the first issue. I am here because I had a vision that if I could demonstrate how five particular states of mind have been used to manipulate us, we would see how our individual power has been eroded, including by corporate media, but how having an awareness of this phenomenon would also help restore our power.

I did not let myself get cut out of the either of the two news organizations where I last worked; I left. I researched the best way to become my own publisher, I honed my voice, and I continue to work on a shoestring to shape and refine this unique service.

Meanwhile, both media companies where I worked in the past five years have been bought, also with private equity money, all of it foreign. Foreign holding companies especially do not have local quality editorial and customer service as their primary goal; they are strictly seeking to make money, usually through margin squeezing. And, after the cuts, demoralization is usually insurmountable, and quality and customer service suffer.

I am accountable to my readers, but by the same token, you do not need to stick with me if you don’t like what I offer. That way my editorial independence is assured, and you are richly rewarded if you like what I am doing: you get the pleasure of knowing you made this possible, and you get the benefit of a service unlike any other that is always focused on customer service.

For more about what we’ve accomplished to date, and what docu-mental is all about, have a look at the updated “about” page.

I am excited by the opportunity to serve in this time of momentous change.

Thank you,

Washington, DC

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