Prayer in Emergent Healthcare Settings:

Forming and Casting a Vision for Involving Prayer in Patient Care

Rev. Kris Leland Snyder

PT814 – January Term 2014

Rev. Dr. Sharon L. Lewis

April 1, 2014

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Prayer in the intensive care unit can be an ellusive often departmentalized

endeavor in most public hospitals. Considering that this task is even challenged in non-

for-profit hospitals the question of prayer, who enables and empowers the family and

paitent in this task, and how to best ethical practice prayer in the emergent healthcare

situation brings much challenge to chaplains, heatlhcare workers, nurses, and parish

pastors.

Ideally the task of answering if prayer has a place and can advance a movement of

God either for health or mercy begins with addressing the spiritual concerns patients and

families present with. Patients and families can at times have niave experiences in prayer

further complicated by tinges of fundementalist theology which idealize the

conceptualization of a God who answers all prayers - at least in the way we would

expectantly hope.

Hospital chaplains stand in a place and time of guidance and present a climate of

correction. As we struggle to grasp God's will and ultimate plan be it for our medical

needs let alone spiritual needs chaplains assist to identify key areas of strength when

concerning faith, how to evoke and assist this faith to speak into the doubt and times of ill

health, and how to move the family forward with a sense of hope and empowerment

vocaized by their acceptance and believing in a God who hears and answers all prayer.

From a Judeo-Christian perspective the practice of prayer is well documented and

supported as a means to bring about the presence of God, the hope of an eventual

outcome, and the reality that God remains active in the lives of His chosen people. Given

the level of anxiety often present in emergent care situations prayer brings about a sense

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of calm, the affirmation that God is truly dwelling in the uncertainty of the situation, and

the availability mortal man has to call on a God revealed in the Holy Scriptures.

Protestant Christians value the access to prayer as articulated in the work, “The

Lutheran Difference”. “The devil wants to drive us away from God and His kingdom. In

the Sixth Petition of the Lord’s Prayer, we pray for God’s protection from temptation. In

the Seventh Petition, we acknowledge that God does protect and deliver us from evil.”

(Pfotenhauer 2010, 346) Through prayer and in particular the official prayers taught in

the catechism of the Lutheran Church we have direct access to God. Even in times of

grave trouble the comforting words of the Lord’s Prayer lead us to believe in God’s

divine and good will for us whatever the outcome may be.

Luther in his Large Catechism gives further instruction to pastors when educating

the laity of the church on prayer. “Besides this, we should be moved and drawn to

prayer. For in addition to this commandment and promise, God expects us and He

himself arranges the words and form of prayer for us.” (Pfotenhauer 2010, 352) To

advocate and assist in the prayerful conversation with God becomes the responsibility of

the parish pastor primarily but in such absence or in the emergent care need of the patient

the hospital chaplain or spiritual care worker becomes the voice of one walking alongside

of the sick and dying.

Reformed theologians have advocated and pressed clergy to be concerned about

the practice of prayer - a task entrusted to the church to the benefit of the faithful. “The

blessings entrusted to the church. Whom God has entrusted with His spiritual and

heavenly blessings, in order that they might ordinarily be imparted there, must not be

regarded as useless and unnecessary to seek. And God has entrusted them to the church –

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namely, the Word, the Sacraments, the Keys of the Kingdom of heaven, the power to

loose and bind – in order that these spiritual gifts may be imparted to [to man] there.”

(Calov 2012, 135) Many such tasks are given to the church such as the preaching of the

Word, the right administration of the sacraments, and additionally for the sake of this

examination, the proper instruction and application of prayer as a useful means to attain

communication with God.

Scripture points to the importance of prayer and its ability to transcend difficult

situations. “14 if my people, who are called by my name, will humble themselves and

pray and seek my face and turn from their wicked ways, then will I hear from heaven and

will forgive their sin and will heal their land. 15 Now my eyes will be open and my ears

attentive to the prayers offered in this place.” (2 Chronicles 7:14-15) As demonstrated

continually through the witness of the Hebrew scripture the connection between God’s

people and prayer cannot be denied. By its very nature prayer becomes an open channel

for God’s children to uplift concerns to a God who is ever present in the realities of

trouble.

In the Gospel of St. Matthew Jesus himself points to the importance of prayer

even to provide a format for uplifting our concerns. Our petitions, concerns,

lamentations, and words of praise are heard by a God – and answered according to His

divine purpose and will. 7 "Ask and it will be given to you; seek and you will find;

knock and the door will be opened to you. 8 For everyone who asks receives; he who

seeks finds; and to him who knocks, the door will be opened. (St. Matthew 7:7-8 NIV)

God is relational, approachable, and faithful in answering our petitions uplifted in prayer.

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However wise discernment would teach us that these prayers may not be answered in

ways we would expect or demand.

Later in the New Testament witness we hear from James the brother of Jesus. In

his letter we acknowledge the two fold nature of prayer and Christian service. Pastors,

chaplains, and Christians alike share in the task of uplifting the sick in prayer and

anointing them with the promises offered by God in the Holy Scriptures. “Is any one of

you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. 14 Is any

one of you sick? He should call the elders of the church to pray over him and anoint him

with oil in the name of the Lord. 15 And the prayer offered in faith will make the sick

person well; the Lord will raise him up. If he has sinned, he will be forgiven. 16

Therefore confess your sins to each other and pray for each other so that you may be

healed. The prayer of a righteous man is powerful and effective.” (James 5:13-16 NIV)

Prayer becomes a forward action of the church in its ministry to those in its care. Pastors

and leaders share in the task of training and sending out those who offer prayers with the

sick and the dying bringing the sacred to the bedside of those in emergent care situations

often found in the ICU (intensive care unit) or ER (Emergency Room).

Discovering and casting a vision for prayer in the care of those sick and dying in

emergent care situations becomes a shared task between the healthcare and faith

community. “The linkage between sin, sickness, suffering, and death forms a

background motif for Isaiah in the Servant song of chaps. 52-53…The modern age

greatly resists this linkage. Medical practitioners generally rely on the physiological

staples of drug therapy and surgery.” (Reichenbach 1998, 553) The goal and task of the

hospital chaplain is to engage the conversation between faith and healthcare.

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Additionally to consider the linkages between modern medicine and its limitations, the

necessity of faith in the human experience, and the ability of both disciplines to shape the

patient care experience.

What we gather from the Holy Scriptures is that “healing is at the very heart of

God”. (Lewis 2014) The continuous witness of God’s people through the Hebrew

scriptures and later into the New Testament proclaims a message of an active present God

who brings healing in many and various ways. God by nature sought to bring healing to

His people and continues to do so. The act of prayer and seeking after the heart of God

for this evidenced healing found in scripture continues the human narrative of creation,

redemption, and sanctification as brought forth in the Holy Scriptures.

Leanne Payne in her work, “The Healing Presence”, advocates for prayer as a

pivotal tool for change. “He it is who comes and heals. It is He who befriends the sinner,

releases the captive, and heals the lame in mind and body. (Payne 1995, 144) Prayer

calls forth the presence of an active agent in the lives of the faithful and leads the person

of faith forward with the expectation that God is active, is listening, and will be present

even if the situation, medical outcome, or future seems uncertain and forboding.

Payne later in work speaks of the practice of evoking and inviting God’s presence

as essential task of prayer ministry – and for the work of the hospital chaplain and pastor

the task is ever of importance in an emergent care situation. Prayer becomes the calm in

the midst of a great storm, the reminder that God is speaking into the unknown, and that

the faith that claims us as God’s children is a reality that can be clung to in uncertain

times. “The practice of the Presence, then, is simply the discipline of calling to mind the

truth that God is with us. When we consistently do this, the miracle of seeing by faith is

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given. We begin to see with the eyes of our hearts.” (Payne 1995, 279-280) Faith is

assured, the presence of God is renewed, and the outcome whether unexpected or advised

is easier to withstand given the presence of faith in the healthcare situation.

Chaplains and pastors, nurses and doctors along with other healthcare

professionals become vessels for the work of the almighty. Through active or passive

participation in prayer at the bedside God’s presence is evoked and the work of healing

begins. “We become ministers of God’s healing love and power, therefore, as we learn to

invoke the mighty Presence of our Lord, and as we learn to become the vessels through

which He ministers in our midst.” (Payne 1995, 441-443) Chaplains through their

practice advocate for active participation by medical professionals through prayer when

appropriate and requested by the patient with the patient leading the prayer, the presence

of supportive clergy or religious leaders, and the presence of family if desired in and

through the process of prayer.

Research indicates the importance of faith in the event of an emergent health

event. . “To the average person grappling with life-changing events, the issues become a

bit more straightforward. They may not be able to define religion, but they most likely

know it when they see it and know whether or not if helps them.” (Koenig 2008, 10)

Faith is a means by which patients find hope and cope with the challenges facing them

especially when it comes to emergent healthcare situations. “Healthcare providers need

to review and assess health from a religious/spiritual as well as mental/physical point of

view.” (Koenig 2008, 12) A multidisciplinary approach to healthcare solicits a response

that is attentive to the spiritual care needs of patients and how to engage, protect, and

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guide these resources as a means of providing healing for the patient. Prayer is such a

resource and chaplains along with others can advocate for its use in emergent situations.

The question of the usefulness and effective quality of prayer in emergent care

situations for patients and families becomes an area of concern for those administrating

healthcare objectives and the chaplain/pastor responding to the crisis event. “The

pastoral caregiver is called upon to be a calming presence…The focus turns to mediating

anxiety.” (Rydholm 2002) Chaplains who advance the spiritual care concerns of the

patient and family work to gain trust, build unconditional positive regard, and seek to

bring the sacred and holy into a tense and ever changing situation. “In the tempest of

impending loss, ‘knowing the care receiver’ is crucial. Knowing the family, their history,

coping strengths, emotional trigger points, etc. becomes the needed rudder for steering

through the murky waters of end-of-life-decision-making.” (Rydholm 2002) Building a

relationship that is additionally supported through a prayerful encounter enables the holy

and sacred to speak into a situation that often evokes emotions of loss, regret, fear, and

desperation.

Prayer is often welcomed in the care experience especially when encountering

families in crisis. “Similarly high rates of daily prayer, meditation, and religious study

underscore the importance of religion in coping with cancer.” (American Medical

Association 2009, 1140) Part of the task of spiritual care would be to cultivate a place of

safety for the patient and family. Prayer can accomplish this task well when it attends to

the faith practices of the patient, the cultural foundations that formulate the faith of the

patient, and involve hospital staff that are comfortable and open to such processes. In her

work “Trauma Healing” Carolyn Yoder articulates the practice of grounding people after

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a traumatic event or loss. “A sustaining faith or spiritual practice” can be grounding to a

person or family experiencing an emergent healthcare episode. (Yoder 2005, 51)

Evoking the name of God and inviting his presence into the experience of pain, loss,

regret, illness, and trauma continues the patient centered focus as long as it is sensitive to

the faith experience of that patient and or family.

Prayer further articulates the relationship between God the Creator and human

kind in that from the very beginning it was intended that we be in communion with God,

that God desired and persued a relationship with us, and that regardless of our sinful

condition God has sought and continues to provide a pathway for redemption – most

notably through Jesus Christ. Theologian Karl Barth addressed the complexity that

inheritly defines the relationship between God and man. “Man does not possess the

power to be as man in the same way as God has His power to be as God, nor does he

have the power over his vital functions as God has His power as Creator, Ruler, and

merciful deliverer of His creature.” (Barth 1998, 246) We may not have such means to

bring about our own salvation, have the ability to manipulate a cure and demand a certain

outcome – but through prayer we have the voice to uplift our heartfelt concerns, desires,

and cries to a God who is ever present in both the good and ill times of our lives.

Our source for life, health, and salvation provides all these things out of His

divine Fatherly goodness. “For health, like life in general, is not an eternal but a

temporal and therefore a limited possession. It is entrusted to man, but it does not belong

to him. It is to be affirmed and wiled by man as a gift from God, yet not in itself and

absolutely, but in the manner and compass in which he gives it.” (Barth 1998, 245) This

relational identity furthers the idea that prayer and conversation with God during times of

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crisis and especially in emergent care situations is of great importance for the person of

faith. Life and health as well as salvation are valued gifts endowed from the creator God

– the same God who desires to be in relationship with his creation. To bridge and build

this access is important as patients and families navigate the deep troublesome waters of

sudden illness, cardiac episodes, trauma, and in some cases emergent mental health

situations.

Much conversation has in recent years developed both academically and

theologically on the topic of prayer in the healthcare setting. “Health care chaplains have

the privilege of sharing deeply meaningful experiences with patients/residents on a daily

basis. Prayer and ritual open up opportunities to explore with patients/residents their

understanding of the Divine and their relationships with others.” (Jones 2013, 106) For

patients of faith the ability to evoke tradition, ritual, and meaning into a situation that is

challenging brings hope and new life into the conversation. Prayer and pastoral presence

together work to bring assurance, peace, and the promise that God is present even in

difficult moments when decisions have to be made and death is very present.

Another essential task of prayer involves the process of healing. Healing can

simply be moving from one defined health diagnosis to an eventual outcome. Prayer

involves using the language of faith to evoke possible change. Yet this change or

eventual outcome is to be determined not be us but rather by faith as articulated in the

book of Hebrews. “Communication makes possible the development of an identifiable

Christian group. The Bible provides the language through which communication takes

place in the church.” (Gerkin 1997, 122) The bible demonstrates a pattern of how we are

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to communicate to God be it through the prayers of Abraham, Moses, the prophets, Jesus,

and in the later apostles.

As Gerkin points out the goal or focus of pastoral care in the Christian community

is this, “creating and maintaining a climate of relationship within which all members of

the community are understood and cared for.” (Gerkin 1997, 126) In emergent situations

this is all the more important as persons of faith struggle to find meaning, hope, and

purpose in their suffering. Chaplains become a voice of calm able to communicate the

presence of the Divine in settings were people feel lost, vulnerable, and distant from the

peace that faith brings.

In Henri Nouwen’s classic work “The Wounded Healer” the vocation of pastoral

care provider is called into focus. “The Christian leader is called to help others affirm

this great news, and to make visible in daily events the fact that behind the dirty curtain

of our painful symptoms there is something great to be seen: the face of Him in whose

image we are shaped.” (Nouwen 1972, 44) Through the action of voicing prayer the

chaplain or spiritual care provider begins the conversation with God, the evoking of

emotion and expression to our thoughts, feelings, concerns, and petitions with hopeful

and expectant faith that God will answer according to his will and not ours as suggested

in the Lord’s Prayer.

Speaking specifically to the vocation of hospital chaplain we learn the advent of

prayerful conversations with the Divine become a duty task which cannot be overlooked.

“Chaplaincy is largely a ministry of encouragement and comfort. The chaplain ministers

mostly to the unchurched or those who, by virtue of their circumstances, are at least

temporally separated from their church body.” (Woodward 2011, 146) To encourage and

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comfort especially in times of spiritual and physical distress becomes the vocational

calling of the chaplain. Often time does not permit the patient’s pastor to be present or

other external variables prohibit this from happening. Yet it is then the hospital chaplain

that advocates, prays, and brings into perspective the hopeful real presence of a God who

is present in the very day of trouble.

In moments in which life hangs in the balance prayer should be encouraged by

both the chaplain and staff when deemed that this is part of the patient’s experience/life.

Karl Barth suggests that we should “expect more from God, to let grow within us that

which he will in face cause to grow. We should use all our power to accept what God is

constantly offer us, to wakefully and prayerfully follow what God does.” (Barth, Word

of God and Theology 2011, 435) Accepting what God offers and doing what He does

proclaims the power of his relational presence. God offers an enduring presence that is in

itself healing and liberating to those suffering do to illness and eventual death.

Practical application of prayer ministry in the hospital setting works in several

ways. Chaplains when on call come in to assist staff, families, and patients with critical

care events such as traumas, cardiac events, and terminal causes in which death is

imminent. Prayer functions to give space for the sacred, voicing overall concerns

experienced by those present, and it sets the table for the feast of mercy that God

provides through His abiding and loving presence.

Prayers can be formal or freely recited from the lips of those praying in there

overall format. “The Lutheran Book of Prayer” is a treasure often used in spiritual care

situations and by pastors alike. “Teach me to believe that your abiding presence will

uphold me hour to hour. Give me peaceful days and restful nights. Bless me with a

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refreshing sleep. Come to me with healing in your wings. Speak to my soul the

comforting promises of Your Word, and keep me steadfast in the faith until the end.

Bless this household, and keep all of us cheerful, hopeful, and content. I ask this of You

who has redeemed me with Your own blood. Amen.” (Lutheran Church Missouri Synod

2006, 230) Formal printed prayers have the time and place as do freely spoken prayers

offered by the chaplain, family, patient, healthcare staff, and or pastor present at the time

of the emergent event.

Prayer also works the ability for soul healing to occur in many ways. Often

patients may present with a physical aliment yet underlining that presenting issue may be

other more pressing psychosocial and spiritual issues that need prayer and the Word of

God. “Soul healing prayer is allowing Jesus, who is not hampered by time, to bring

healing to areas of our emotions. Jesus’ desire is to be the Lord of our past, as well as our

present and our future.” (Lewis, Healing Unhealed Hurts 2014) Because we are more

than physical beings the idea of addressing other hurts such as psychological, social,

emotional, and spiritual wounds at the time of the presenting medical crisis is ideal. The

chaplain acts as an agent of God to bring about the presence of God, the ability to speak

plainly to God about the hurts involved, and seek a prayerful guided method to find

resolution.

Healing can happen and be expected for those who wait on the Lord who renews

strength and walks with those who endure hardships, illness, and moments of uncertainty.

“Yet, we are now seeing a return of the direct experience of God’s healing power in such

striking ways that the living tradition of the church – what the Spirit is helping us to

experience and understand today – is leading us again to a more lively awareness of what

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Jesus did in his healing ministry. If we ourselves see miracles of healing, we no longer

have difficulty in visualizing the healings.” (MacNutt 2001, 136) God’s healing power

can be revealed through prayer as evidenced in the Word and through our experiences

with patients and families. Yet how we choose to define healing is critical in our

approach to soul care, applying the truths of scripture to the realities of a diagnosis, and

the giving space for God to reveal His divine will in the lives of His children.

As we strive to be patient focused in our care endeavors we must acknowledge the

importance of spiritual care, prayer, and the spiritual needs of those seeking care in our

hospitals. “Spiritual or compassionate care involves serving the whole person – the

physical, emotional, social, and spiritual. Such service is inherently a spiritual activity.”

(Puchalski 2001, 352) Because we seek to balance the needs of the patient and serve

them fully addressing spiritual care needs such as prayer, the presence of a chaplain or

their personal pastor, and the availability of sacramental supplies to assist them in finding

healing is important to note as we explore whole person care.

Prayer can additionally be seen as a means of coping for patients and families in

emergent care situations. “Spirituality may be a patient need and may be important in

patient coping.” (Puchalski 2001, 354) It is through prayer that people uplift, voice, and

express their concerns to God. In coping with a medical diagnosis or a traumatic event

chaplains and others in the care situation would be wise to discern the use of prayer and

the patients need to find this available to them.

Also evident in healthcare settings is the use of prayer to assist healthcare workers

in post traumatic event processing. The chaplain becomes a voice of guidance, comfort,

and calm to aid staff in processing a medical event which may prove difficult to deal with

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as a whole. Pastors and chaplains are able to name the event which has brought stress to

the medical team and speak to how God can and will bring peace into the moment. More

clinical processes such as Critical Event Stress Management Debriefing or CISM discuss

the importance of rituals for those directly working with victims of violence, mass

casility, and traumatic unexpected deaths. Staff should become a focus of care and

prayer as chaplain move to bring awareness of the sacred in moments of crisis.

Finally to consider prayer in a clinical setting is to also see the role of prayer in

the New Testament church. “All these with one accord were devoting themselves to

prayer, together with the women and Mary the mother of Jesus, and his brothers.” (Acts

1:14) The devotion to prayer asks us to do so in our daily vocations – to seek God in our

endeavors and know that He answers our prayers. For those in emergent situations

bringing prayer to the bedside links the sacred to the broken and chaotic experiences of

trauma, illness, and possible death. Healing comes not in expectant, demanded, or

probable ways but through the will and action of a God who is real, present, and

trustworthy.

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Works Cited

American Medical Association. "Religious Copiong and Use of Intensive Life-

Prolonging Care Near Death in Patients with Advanced Cancer." Journal of the American

Meidcal Association (AMA) 301, no. 11 (March 2009): 1140-1147.

"Sickness and Illusion." In On Moral Medicine, by Karl Barth, edited by Stephen and

Allen Verhey Lammers, 242-247. William B Eerdman's Publishing Co, 1998.

—. Word of God and Theology. Kindle Electronic Edition. Edited by Amy Marga.

Translated by Amy Marga. New York: T & T Clark International , 2011.

Calov, Abraham. In The Church and the Office of Ministry, by C. F. W. Walther, edited

by Matthew C. Harrison, 133-136. St. Louis, MO: Concordia Publishing House, 2012.

Gerkin, Charles. An Introduction to Pastoral Care. Nashville, TN: Abingdon Press, 1997.

Jones, Chaplain Gerald L. "Prayer and Ritual ." In Professional Spiritual and Pastoral

Care, edited by Rabbi Stephen B Roberts, 106-117. Woodstock, VE: Skylight Paths

Publishing, 2013.

Koenig, Harold and Kevin Adams. "Religion and Health: Collaboration among

healthcare disciples can shape future understanding of how persons cope through

religion." Healing Spirit (Association of Professional Chaplains), Fall 2008.

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Lewis, Rev. Dr. Sharon. "God Heals: Outline." Basic Healing Course. Nokomis, FL:

Amazing Love Healing Ministry, January 2014.

—. "Healing Unhealed Hurts." Amazing Love Basic Inner Healing Course . Nokomis,

FL, January 2014.

Lutheran Church Missouri Synod. Lutheran Book of Prayer. St Louis, MO: Concordia

Publishing House, 2006.

MacNutt, Francis. Healing. Kindle Electronic Edition. Notre Dame, IN: Ave Maria Press,

2001.

Nouwen, Henri. The Wounded Healer. New York: Image Books, 1972.

Payne, Leanne. The Healing Presence: Curing the Soul Through Union with Christ.

Kindle Edition. Baker Publishing House, 1995.

Pfotenhauer, Patra. "Daily Prayer." In The Lutheran Difference, edited by Edward

Engelbrecht, 329-354. St. Louis, MO: Concordia Publishing House, 2010.

Puchalski, Christina M. "The role of spirituality in health care." BUMC Proceedings.

Washington DC: The George Washington Institute for Spirituality and Health, 2001. 352-

358.

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Reichenbach, Bruce. "By His Stripes We Are Healed." Journal of the Evangelical

Theological Society 41, no. 4 (December 1998): 551-560.

Rydholm, Laura. "Exploring Peaceful Passageways to End of Life Transistion: A Work

in Progress." The Oates Journal (Wayes Oates Institute), 2002.

Woodward, Whit. Ministry of Presence: Biblical Insight on Christian Chaplaincy. Kindle

Electronic Edition. North Fort Meyers, FL: Faithful Life Publishers, 2011.

Yoder, Carolyn. The Little Book of Trauma Healing. Intercourse, PA: Good Books, 2005.

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