gemelli with shrimp

Image: myrecipes.com

I love gemelli, especially during the warm months. This is the perfect meal to make after you spend the day on the beach. It’s light, delicious, and oh, so GOOD!

Ingredients:

  • 12 ounces gemelli or other short pasta
  • 3 tablespoons thinly sliced garlic (from 4 large cloves)
  • 2 cups low-sodium chicken broth
  • 2 tablespoons extra-virgin olive oil, plus more for drizzling
  • Coarse salt and freshly ground pepper
  • ¾ pound medium shrimp, peeled and deveined
  • 2 teaspoons finely grated lemon zest, plus 1 tablespoon fresh lemon juice
  • 8 ounces sugar snap peas, trimmed and cut on the diagonal into ¾-inch slices
  • ¾ cup crumbled feta (3 ounces)
  • 2 tablespoons finely chopped fresh dill, plus more, coarsely chopped, for serving
  1. Bring pasta, garlic, broth, 2 cups water, and oil to a boil in a large straight-sided skillet; season with salt and pepper. Cook, stirring frequently, 3 minutes less than instructed on pasta package.
  2. Add shrimp and 1 teaspoon lemon zest and cook, stirring occasionally, 1 ½ minutes.  Stir in peas, ½ cup feta, and dill and cook, stirring, until peas are bright green and crisp-tender and shrimp are opaque, about 1 minute.  Stir in lemon juice.  Serve, topped with remaining ¼ cup cheese, remaining 1 teaspoon zest, and coarsely chopped, dill, and drizzled with oil.

Let me know if you try this recipe. I’d love to hear your feedback.

 

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wig

Image: Pixgood.com

Shortly after my first round of chemo, I (correctly!) presumed that it was time to figure out how (the f-bomb!) to buy a chemo wig because I knew that being bald-bald-bald was inevitable. As you may recall, hair loss occurs because chemotherapy targets all rapidly dividing cells—healthy cells as well as cancer cells.

Hair follicles are the structures in the skin filled with tiny blood vessels that make hair. They are some of the fastest-growing cells in the body. When not in cancer treatment, hair follicles divide every 23 to 72 hours. But as the chemo does its work against rapidly dividing and growing cancer cells, it also destroys hair cells. Within a few weeks of starting chemo (in my case a little over 2 weeks), a person may lose some or all of the hair.

At this point, there really is no known, proven prevention for hair loss due to chemotherapy. Attempts have been made (and continue to be made) to reduce hair loss by using tight bands or ice caps. The tight bands didn’t really work, but there is a great deal of hope around a new type of ice cap that my friend’s sister used during her time in Cancerville. (Shining Moment).

In the meantime, (thanks to the request of a reader!) I thought I’d share my process for buying a wig:

  1. Figure out your budget. Wigs range in price anywhere from $50 – thousands! Some insurance companies cover the cost (in part or completely). If not, there are organizations that give them to patients for free (Shining Moment):

Please remember to ask your oncologist to write a script before purchasing a wig. My doctor wrote one for me that covered $250 for my wig, “Danielle!” (My wig came with the name, “Danielle”). Oh, and one more thing…Not all stores accept scripts. It can’t hurt to ask, though.

  1. Determine what type of hair you want. Generally, there are two types:
  • Synthetic Hair. This type of wig is made from strands that are created from polymers. Generally, synthetic wigs can hold a style through wear and shampoo. You must be careful, though because there are many types of synthetic wigs that can easily melt near heat sources (and you DON’T want to add that to your list of issues!). Kanekalon is a type of synthetic hair that can be styled with a curling iron.
  • Human Hair. These wigs are made from real human hair (or a mix of human and animal – yes, animal – hair) that has been donated or sold to wig makers. These types of wigs can be colored, permed, cut, styled, and blow-dried, just like your own hair.
  1. I highly recommend, if at all possible, to shop for your wig before chemotherapy begins. This will allow you some time to get used to the look of your wig and help you to feel more “normal” (go ahead and laugh at the word normal) while wearing it. You will also have more energy for the shopping process and your stylist will be able to get a true feel for your coloring and complexion. But here’s the thing: Don’t actually buy it or have it styled until your hair loss has started because it will definitely affect how it fits you.
  2. When it comes to color, my hairstylist recommended selecting a shade slightly lighter than my own for two reasons: 1) a person’s complexion during chemotherapy tends to be off (my skin often had a beauteous yellowish-green tone) and 2) the less variation between wig color and skin tone, the more flattering the wig will be.
  3. Determine your look. Do you want to look like your “old” self or try a whole new look. I have worn long hair for the past few years and decided to try something different in the form of a bob. I kept my same hair color and texture, but went for length. It was kind of fun, actually.  Here’s a funny story: the first night that I wore the wig, I went out to dinner with a girlfriend. Our waiter (whom I know!) said to me, “You look different. Did you get your hair cut?”  I burst out laughing and told him that “No, I grew a new style overnight.” I mean, really. What else was I going to say?
  4. In terms of upkeep (yes, there is upkeep!), plan to shampoo, condition and dry your wig using special wig products. Speaking of which, there are wig specific brushes as well. I was blown away by this industry! Geesh! Also inquire about whether or not it’s ok to use styling devices as you don’t want to have your hair melt. The general rule of thumb is that it’s best to ask your stylist what will be best for your wig.

One very, very, very important point: not all chemotherapy causes hair loss. So, before you shave your head and buy a wig, please talk with your oncologist about whether hair loss is anticipated. I knew from the get go, that hair loss for me was pretty much a sure thing!

I hope that this helps!  Do you have any tips or helpful hints that you would like to share?

 

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sky

Image: dreamatico.com

Recently, a friend suggested that I read the Stanford University Commencement Speech delivered by Steve Jobs on June 12, 2005.  I am one person among the millions who quite often thinks about him, possibly because my mother passed away from pancreatic cancer.

What an incredible Shining Moment gift this recommendation was!  I suggest that you get a nice cup of tea and settle in to read these words of wisdom… brilliance, actually. Please read on…

I am honored to be with you today at your commencement from one of the finest universities in the world. I never graduated from college. Truth be told, this is the closest I’ve ever gotten to a college graduation. Today I want to tell you three stories from my life. That’s it. No big deal. Just three stories.

The first story is about connecting the dots.

I dropped out of Reed College after the first 6 months, but then stayed around as a drop-in for another 18 months or so before I really quit. So why did I drop out?

It started before I was born. My biological mother was a young, unwed college graduate student, and she decided to put me up for adoption. She felt very strongly that I should be adopted by college graduates, so everything was all set for me to be adopted at birth by a lawyer and his wife. Except that when I popped out they decided at the last minute that they really wanted a girl. So my parents, who were on a waiting list, got a call in the middle of the night asking: “We have an unexpected baby boy; do you want him?” They said: “Of course.” My biological mother later found out that my mother had never graduated from college and that my father had never graduated from high school. She refused to sign the final adoption papers. She only relented a few months later when my parents promised that I would someday go to college.

And 17 years later I did go to college. But I naively chose a college that was almost as expensive as Stanford, and all of my working-class parents’ savings were being spent on my college tuition. After six months, I couldn’t see the value in it. I had no idea what I wanted to do with my life and no idea how college was going to help me figure it out. And here I was spending all of the money my parents had saved their entire life. So I decided to drop out and trust that it would all work out OK. It was pretty scary at the time, but looking back it was one of the best decisions I ever made. The minute I dropped out I could stop taking the required classes that didn’t interest me, and begin dropping in on the ones that looked interesting.

It wasn’t all romantic. I didn’t have a dorm room, so I slept on the floor in friends’ rooms, I returned coke bottles for the 5¢ deposits to buy food with, and I would walk the 7 miles across town every Sunday night to get one good meal a week at the Hare Krishna temple. I loved it. And much of what I stumbled into by following my curiosity and intuition turned out to be priceless later on. Let me give you one example:

Reed College at that time offered perhaps the best calligraphy instruction in the country. Throughout the campus every poster, every label on every drawer, was beautifully hand calligraphed. Because I had dropped out and didn’t have to take the normal classes, I decided to take a calligraphy class to learn how to do this. I learned about serif and san serif typefaces, about varying the amount of space between different letter combinations, about what makes great typography great. It was beautiful, historical, artistically subtle in a way that science can’t capture, and I found it fascinating.

None of this had even a hope of any practical application in my life. But ten years later, when we were designing the first Macintosh computer, it all came back to me. And we designed it all into the Mac. It was the first computer with beautiful typography. If I had never dropped in on that single course in college, the Mac would have never had multiple typefaces or proportionally spaced fonts. And since Windows just copied the Mac, it’s likely that no personal computer would have them. If I had never dropped out, I would have never dropped in on this calligraphy class, and personal computers might not have the wonderful typography that they do. Of course it was impossible to connect the dots looking forward when I was in college. But it was very, very clear looking backwards ten years later.

Again, you can’t connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.

My second story is about love and loss.

I was lucky — I found what I loved to do early in life. Woz and I started Apple in my parents’ garage when I was 20. We worked hard, and in 10 years Apple had grown from just the two of us in a garage into a $2 billion company with over 4000 employees. We had just released our finest creation — the Macintosh — a year earlier, and I had just turned 30. And then I got fired. How can you get fired from a company you started? Well, as Apple grew we hired someone who I thought was very talented to run the company with me, and for the first year or so things went well. But then our visions of the future began to diverge and eventually we had a falling out. When we did, our Board of Directors sided with him. So at 30 I was out. And very publicly out. What had been the focus of my entire adult life was gone, and it was devastating.

I really didn’t know what to do for a few months. I felt that I had let the previous generation of entrepreneurs down – that I had dropped the baton as it was being passed to me. I met with David Packard and Bob Noyce and tried to apologize for screwing up so badly. I was a very public failure, and I even thought about running away from the valley. But something slowly began to dawn on me — I still loved what I did. The turn of events at Apple had not changed that one bit. I had been rejected, but I was still in love. And so I decided to start over.

I didn’t see it then, but it turned out that getting fired from Apple was the best thing that could have ever happened to me. The heaviness of being successful was replaced by the lightness of being a beginner again, less sure about everything. It freed me to enter one of the most creative periods of my life.

During the next five years, I started a company named NeXT, another company named Pixar, and fell in love with an amazing woman who would become my wife. Pixar went on to create the worlds first computer animated feature film, Toy Story, and is now the most successful animation studio in the world. In a remarkable turn of events, Apple bought NeXT, I returned to Apple, and the technology we developed at NeXT is at the heart of Apple’s current renaissance. And Laurene and I have a wonderful family together.

I’m pretty sure none of this would have happened if I hadn’t been fired from Apple. It was awful tasting medicine, but I guess the patient needed it. Sometimes life hits you in the head with a brick. Don’t lose faith. I’m convinced that the only thing that kept me going was that I loved what I did. You’ve got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven’t found it yet, keep looking. Don’t settle. As with all matters of the heart, you’ll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don’t settle.

My third story is about death.

When I was 17, I read a quote that went something like: “If you live each day as if it was your last, someday you’ll most certainly be right.” It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: “If today were the last day of my life, would I want to do what I am about to do today?” And whenever the answer has been “No” for too many days in a row, I know I need to change something.

Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the morning, and it clearly showed a tumor on my pancreas. I didn’t even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor’s code for prepare to die. It means to try to tell your kids everything you thought you’d have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.

I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my pancreas and got a few cells from the tumor. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I’m fine now.

This was the closest I’ve been to facing death, and I hope it’s the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept:

No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life’s change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.

Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.

When I was young, there was an amazing publication called The Whole Earth Catalog, which was one of the bibles of my generation. It was created by a fellow named Stewart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch. This was in the late 1960’s, before personal computers and desktop publishing, so it was all made with typewriters, scissors, and polaroid cameras. It was sort of like Google in paperback form, 35 years before Google came along: it was idealistic, and overflowing with neat tools and great notions.

Stewart and his team put out several issues of The Whole Earth Catalog, and then when it had run its course, they put out a final issue. It was the mid-1970s, and I was your age. On the back cover of their final issue was a photograph of an early morning country road, the kind you might find yourself hitchhiking on if you were so adventurous. Beneath it were the words: “Stay Hungry. Stay Foolish.” It was their farewell message as they signed off. Stay Hungry. Stay Foolish. And I have always wished that for myself. And now, as you graduate to begin anew, I wish that for you.

Stay Hungry. Stay Foolish.

Thank you all very much.

 

 

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red blood test

Image: Yourbloodtest.com

Prior to every chemotherapy treatment and now every appointment with my oncologist, I have to get a blood test. Why, you ask?  Well, blood tests, sometimes called blood panels, are one of a physician’s most basic tools  to see a detailed analysis of any disease (e.g., cancer) markers, the nutrients and waste products in your blood as well as how certain organs (e.g., liver and kidneys) are functioning.

I’ve heard blood test results referred to as “alphabet soup.” Ha! Ha! Not too far off. It’s important, however, to understand your blood results (at least at the basic level). Knowing how to read a blood panel is an empowering Shining Moment – after all, the status of YOUR health is what is being evaluated.

The “Complete Blood Count” or CBC, is a test that you’re likely to see on your blood test results. The CBC measures the amount of three types of cells in your blood: red blood cells, white blood cells and platelets. Prior to each chemotherapy or radiation treatment cancer, the doctor will most likely ask for a CBC to determine if the body is strong enough to endure another treatment. A CBC may also be used to track the progress of treatments.

Here’s the thing: if your numbers are off a little bit, don’t be alarmed. What is considered a “normal” range may vary depending on the lab but general guidelines for what to look for include:

Red Blood Cells (RBC’s) also called erythrocytes carry oxygen from the lungs to the tissues. They are the most common type of blood cell.

  • A normal RBC range for men is: 4.5 to 6.2 million per microliter
  • A normal RBC range for women is: 4.2 to 5.4 million per microliter
  • Red blood cells contain hemoglobin (HgB), which makes blood bright red.  Hemoglobin has a HUGE job: it delivers oxygen from the lungs to the entire body; then it returns to the lungs with carbon dioxide, which we exhale. Healthy hemoglobin levels vary by gender.
  • A low RBC count, known as anemia, leads to low oxygen in the blood, which creates a loss of energy, strength and stamina. Some people may also feel weak and dizzy.

White Blood Cell (WBC) count also called a leukocyte count, measures the number of WBC’s in the blood. White blood cells fight disease by killing bacteria, combating allergic reactions, and destroying old and/or damaged cells.

  • A normal WBC range for men and women is 3,300 to 8.700 per microliter
  • A low WBC count equals susceptibility to infection as WBC’s attack invading bacteria, viruses, and other foreign material in the body
  • A reading of 1000 WBC’s is the lowest level safe from infection

Platelets are components of red blood cells that help stop bleeding by enabling blood to clot. A normal platelet range for men and women is 150,000 to 450,000 per microliter

  • A low platelet count can lead to bruising and bleeding
  • 100,000 is the lowest level at which blood can clot normally
  • 50,000 is the level associated with risk of spontaneous bleeding
  • 5,000 is the level at which bleeding can become life-threatening

Sometimes blood counts are too low to be able to handle certain treatment, e.g., chemotherapy. In certain circumstances, a physician may prescribe medications called growth factors to stimulate the growth of certain types of blood cells. Examples of growth factors include:

  • Procrit (chemical name: epoetin alfa), Epogen (chemical name: epoetin alfa), or Aranesp (chemical name: darbepoetin alfa) to increase red blood cell counts
  • Neumega (chemical name: oprelvekin) to increase platelet counts
  • Neupogen (chemical name: filgrastim) to boost white blood cell levels

Questions to ask your doctor about your blood tests:

  • Why do I need this test?
  • Can I eat or drink before the test?
  • How long does it take to receive the results?
  • Will I need additional tests? If so, what kind and when?
  • Would you please explain what the results say about my health?
  • If my blood counts are too low, can I still get treatment?

From the time I first started writing Why Buy a Wig – way back when – I have advocated for keeping a complete copy of your medical record. This is so important!  Including each and every test result – including blood tests – is a key component of your medical record.

 

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The secret of happiness is freedom. The secret of freedom is courage.

~ Unknown

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grilled avocado

Image: cincinletseat

Avocados fix EVERYTHING! They’re loaded with potassium, vitamins and fiber-so when you eat them, you feel full. (Yay)! When I go grocery shopping I always see people searching for the “perfect” avocado, but let me tell you, they’re just as good a little under-ripe, too. You can use them for grilling because they don’t turn into mush…just sayin’

Ingredients

  • ½ pound cooked shrimp, peeled and deveined (tails removed), chopped into ½ in. pieces
  • 1 Tbsp red wine vinegar
  • ¼ cup extra-virgin olive oil, plus more for the grill
  • 1 small shallot, thinly sliced
  • 1 Tbsp honey
  • 1 tsp sliced mint
  • Kosher salt and black pepper, to taste
  • 2 avocados, halved and pitted
  1. In a large bowl, toss the shrimp, vinegar, ¼ cup oil, shallot, honey, and mint.  Season with salt and pepper.
  2. Heat a grill pan or grill to medium-high and brush surface or grates with oil. Place each avocado half face-down on the grill and let steam in its shell for 4 to 5 minutes.  Transfer to a plate and top with shrimp salad.

Enjoy!

 

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We make a living by what we get, but we make a life by what we give.

~ Winston Churchill

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longdistance

Image: Whatwegandidnext.com

As if having a friend with cancer isn’t bad enough, right? Well, I’m sorry to be the bearer of bad news when I say that it can feel worse. How, you ask?  When you live a bagillion miles away and can’t be with the person you love to support him or her in person. I know. I’ve been in this situation both as a patient and a friend and I’m here to say that it is a rotten feeling!

Personally, I felt fearful and helpless when I was unable to be physically present for my girlfriends who were contending with everything from decision-making to the side effects of chemo. However, as I did throughout the ridiculousness of my treatment, I put on my thinking cap and asked myself: “What would I say to the friend of a patient?”

I realized that even if you live far away, you can be actively engaged in the physical, emotional, spiritual, financial or logistical support that goes into caregiving. Becoming engaged – well, as engaged as the person with cancer wants you to be – can be helpful to all involved.

Here are some examples of different types of support that a long-distance caregiver can provide:

  • Create a “To Do” list of your friend’s needs and divide the list into immediate needs and long term needs.
  • Gathering cancer treatment and post-treatment information through contacts, internet research and phone calls. The KEY to this is asking if your friend wants this information.  Not everyone (myself included!) wanted other people to do research; however, other people welcome it.  The key with gathering information is to make sure that you do it from legitimate, credible resources. My list of credible cancer resources includes www.breastcancer.org and www.lbbc.org. (Living Beyond Breast Cancer)
  • Create a list of important contacts and information for emergencies. Compiling and maintaining an up-to-date list of key phone numbers and email addresses is a humongous Shining Moment. Be sure to include: doctors, pharmacists, case managers, health insurance providers, employers, friend, neighbors, family members, etc.
  • Assist in making and organizing appointments. Oh my gosh, is this ever helpful! Using shared calendars (e.g., Google Calendars) is a helpful way to stay in sync from afar.
  • Facilitate logistical needs with local friends and neighbors. These include everything from transportation to cleaning to grocery shopping and food preparation.
  • Serve as the point person for communication. You could start a blog or use Caring Bridge to keep people apprised of your friend’s status.  The key is to make sure that your friend has editorial review. In other words, don’t write ANYTHING about your friend that s/he hasn’t approved!

The thing to be sure to keep in mind is that everyone’s experience with breast cancer or any type of cancer for that matter is different.  The experience is ongoing and often unpredictable. Being flexible and consistently present – even from afar – will be the Shining Moment that you can add to your friend’s experience.

Here are a few organizations that can also help:

  • Cancer Support Community: http://www.cancersupportcommunity.org
  • Caregiver Action Network (CAN): http://caregiveraction.org
  • Caring from a Distance: http://cfad.org

Do you have any suggestions for what worked (or didn’t) for you?  I’d love to hear from you!

 

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screening

Image: Provimaging.com

Recently, I was asked about reduced-fee or free resources for breast and cervical cancer screenings. It occurred to me that I knew about them but hadn’t yet posted the information. Whoopsie!

Regular check-ups (that include screening) are so very important!  The primary goal of screening is for early detection.  There are of course many varying (and polarizing!) views on screening.  I happen to believe in screening. Perhaps one day, I’ll lay out the arguments of the people who are pro-screening and against-screening.  But in the meantime, here are the resources that I know of!

CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides access to breast and cervical cancer screening services to under-served women in all 50 states, the District of Columbia, 5 U.S. territories, and 11 tribes. These services include clinical breast examinations, mammograms, pap tests, pelvic examinations, human papillomavirus (HPV) tests, diagnostic testing if results are abnormal, and referrals to treatment. To find a screening location near you, use the interactive map found on their website at www.cdc.gov/cancer/nbccedp/index.htm

The National Breast Cancer Foundation (NBCF) partners with medical facilities across the country to provide free mammograms and diagnostic breast care services to under-served women through the NBCF National Mammography Program. In addition, the NBCF National Mammography Program requires that medical facilities within their network have the capacity to continue treatment after an abnormal finding or diagnosis of breast cancer. For more information, check out their website atwww.nationalbreastcancer.org/national-mammography-program

Visit the Susan G. Komen Affiliates page find an affiliate group in your area. Each local group has its own website with important information, like a local breast health resource guide. The Susan G. Komen group funds breast cancer education, screening and treatment projects for those who need it most.

If you know of any other free or reduced-fee services for breast and cervical cancer screenings, please let me know in the “Comments” section or by emailing me and I will update the resource page accordingly.

 

 

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The time to relax is when you don’t have time for it.

~ Sydney J. Harris

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