{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/ng4gm8300f/manifest","type":"Manifest","label":{"en":["Dr. Kristi Darnauer"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2021-02-16 (created)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Subject"]},"value":{"en":["Covid-19 (topical term)"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","Kansas","Sterling","Lyons","pandemic","anti-vaxxers"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/202/809/small/KristiDarnauer%282-16-21%29.mp4_1691000648.jpg?1691000648","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809","type":"Canvas","label":{"en":["Media File 1 of 1 - Kristi_Darnauer_(2-16-21).mp4"]},"duration":1756.2,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/202/809/small/KristiDarnauer%282-16-21%29.mp4_1691000648.jpg?1691000648","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/202/809/original/Kristi_Darnauer_%282-16-21%29.mp4?1691000647","type":"Video","format":"video/mp4","duration":1756.2,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809/transcript/47181","type":"AnnotationPage","label":{"en":["Transcript of Dr. Kristi Darnauer interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809/transcript/47181/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Kristi Darnauer, MD: Where are you from?\n\nMorgan Weiler: I'm from Olathe.\n\nKristi Darnauer, MD: Okay.\n\nMorgan Weiler: So, yeah. And where are you from originally?\n\nKristi Darnauer, MD: I grew up in Western Kansas. I graduated from high school in Oakley. So if you come to Colorado, you've driven right by it.\n\nMorgan Weiler: You've probably told that to so many people.\n\nKristi Darnauer, MD: Yes, I do. I always say it's on the way to better things. You know, you're going skiing or you're going to the mountains for something beautiful and there's nothing in Western Kansas to stop for. So just nice people. We always say that too.\n\nMorgan Weiler: That's awesome. Well, we can go ahead and get started. Like I said, in the email, this shouldn't take, but like 20 ish minutes, depending on how much you share and that's up to you. So, if you want to start by giving your full name.\n\nKristi Darnauer, MD: Sure. I'm Kristi Darnauer, and I'm a family practice physician in Sterling, Kansas, and Lyons, Kansas. We serve the whole County of Rice County.\n\nMorgan Weiler: Great. And then your present title, you mentioned. Do you serve any other roles in your community?\n\nKristi Darnauer, MD: Not currently, not officially. So in the last year, I've been a consultant for our school district as they make decisions for COVID. And I previously was the medical director at our health department. So I will probably share more about that as we talk.\n\nMorgan Weiler: Perfect. And then where did you attend medical school?\n\nKristi Darnauer, MD: I went to KU Medical School in Kansas city.\n\nMorgan Weiler: Awesome. And then where did you complete your residency?\n\nKristi Darnauer, MD: Research Family Practice residency in Kansas city, Missouri.\n\nMorgan Weiler: All right. And then can you speak a little bit about your current position and what you do on a daily basis?\n\nKristi Darnauer, MD: Sure. I am a family physician doing full scope healing medicine. So I work in the clinic and our hospital on call. We work weekends, covering the emergency room and I still deliver babies and do C-sections. So, that's my day to day.\n\nKristi Darnauer, MD: I technically work part time, so I'm home a little bit with my kids. I have three kids and they are as much work as my workdays most of the time, so.\n\nMorgan Weiler: I can imagine. And then can you tell me a little bit about the patient population you serve in Sterling?\n\nKristi Darnauer, MD: Yeah, we have a wide variety of ages. We, again, I deliver babies, so I have newborns in my practice and then I also take care of nursing home patients. So it's the full spectrum of age. And then from a socioeconomic standpoint, as many rural areas where we have a fairly impoverished population as well. Working class, some immigrant communities that we serve here in our county, as well.\n\nMorgan Weiler: All right. So we're going to talk next about COVID. So what unique challenges did you and your practice face with COVID-19?\n\nKristi Darnauer, MD: Sure. I think from a practice standpoint, one of the everywhere medicine, all of a sudden everything was dangerous. And so we pulled back from an in-person standpoint with our office visits. We started to do a lot of telemedicine fairly early on in the pandemic in order to still safely see our patients and connect with them and provide them medical care, get their prescriptions filled and those kinds of things.\n\nKristi Darnauer, MD: So we started doing that early on. We also started to rethink everything we did and every encounter we had with even our coworkers. So we were pretty early mask adopters here in our practice, from the very beginning. And even among each other, which that ended up being wise, because a lot of places got shut down early on when the whole work environment got exposed and infected and offices had to close.\n\nKristi Darnauer, MD: So that, from a work standpoint in our workplace, that definitely changed the way things looked for a while. But also because we're in a small community, there's only four doctors in our county serving about 10,000 people here in the county. And then we draw from outside of our county as well. But we were suddenly the local experts in COVID, as well. So my work became a lot of after hours work, where I was doing a lot of reading and grasping for anything out there to figure out how to lead our community in all things COVID related.\n\nKristi Darnauer, MD: And so that became my primary work, I feel like, especially as we were... A lot of people were scared initially to come into the doctor's office. So our clinic numbers dropped fairly significantly as everyone's did. And so a lot of my time was spent coordinating efforts locally and communicating with other physicians and really researching a lot.\n\nMorgan Weiler: Okay. So what barriers and obstacles did you face early on in the pandemic?\n\nKristi Darnauer, MD: I'm sorry, I was just reading to see what I wrote. I think early on there was just a whole lot of unknown. And so there was fear initially for all of us, like what did this mean? Were we going to get exposed? Was this going to be like this martyrdom of healthcare workers, because they were treating this incurable disease idea.\n\nKristi Darnauer, MD: So I think there was some personal challenges to that, just as, people talked about healthcare heroes. Early on, there was this sense that we were entering into a war zone as healthcare providers, but that doesn't come without a cost. We also are human beings with families and I have three small kids. And so there was just some personal fear early on, especially in the pandemic when things were really unknown. Everything was unknown.\n\nKristi Darnauer, MD: So that was a challenge personally. We're in a rural community. And so there's no shortage of political opinions, which is probably true anywhere, but all of a sudden the pandemic became very political and our community was very divided. And so I would say, if I look back on the last year, the greatest challenge we faced was the division on how this thing should be handled and who should really be in charge of that and which political party should be in charge of that.\n\nKristi Darnauer, MD: And so there were a lot of challenges with that, because as physicians in the community would make recommendations to say, our local government, it was met with resistance and it was met with anger at times, because of the political tension that had developed in the early days of the pandemic.\n\nMorgan Weiler: So how did you end up handling that? Did you just push through it or was there anything that ended up working in your favor to protect as many people as possible?\n\nKristi Darnauer, MD: Yeah, that's a good question. My role... I've been here in Sterling practicing in Rice County for 10 years, almost 11 now. And in that time period, I had been the medical director for our local health department. And that job was really, for the most part, a very sign the orders at the end of the gear, attend the annual meeting once a year. They called me maybe once a month with a question about some protocol or a vaccination error that had been made, and we had to document it and those kinds of things. It was a very hands-off role. I was just the medical director. I got paid $125 a month to be the name at the bottom of the protocols.\n\nKristi Darnauer, MD: So then, March 2020 rolls around, and all of sudden we're in this pandemic and the health department director was actually slated to retire in the summer of 2020. So we started scrambling trying to figure out how we could replace her. How we could do all the things that were all of a sudden required for the pandemic, and do it with someone new. And so, there's a lot of conversations that happened. And I went to our county commissioners with some of my recommendations for the position, and I was met with tons of resistance. They were very rude and disrespectful to me as I was trying to make recommendations that I felt were necessary. We really needed someone in that position who could lead our county through this next year and through the pandemic.\n\nKristi Darnauer, MD: And so, because of a lot of that drama, I ended up actually stepping down from the position, which was very difficult for me to do, because here I am a physician leader in my community, and I'm essentially walking away from a position of influence during a pandemic, which was really hard for me. Because I felt a loyalty to my patients and I felt a loyalty to my community, but at the same time, they weren't listening to any of my advice. And there was no respect there for my medical expertise.\n\nKristi Darnauer, MD: And so I had hoped that walking away would send a message that they needed to consider what I was saying and take it under advisement. None of the other doctors in our county were going to step into that role because of the way I was treated. And we thought that would send a message and it didn't. And they continued to make the decisions they wanted to make which were, most of the time, at odds with what we were recommending as the medical community.\n\nKristi Darnauer, MD: We were making recommendations that were pretty standard CDC recommendations and PDHC recommendations, which were mask mandates early on, limiting of large gatherings, just some of those basic things that were recommended early on. And again, because of the political divide that had happened, we're really just got a lot of pushback.\n\nKristi Darnauer, MD: So, I stepped away. And honestly, from a personal standpoint, it was probably the right thing to do. You find yourself in this toxic environment where you're just, you're giving advice and no one cares. And so at some point you say, okay, well, I guess I will stop giving advice and you can come to me if you change your mind.\n\nKristi Darnauer, MD: But I literally, my husband and I spent the day before the 4th of July, walking around our little town, handing out masks that we had bought in order to try to help protect our community. And some people were grateful, I think, and some people understood what we're trying to do. And it was our way of saying, even if there's not a mask mandate we should still do this for each other. We really care about each other. And this is one way we can show it. So some people perceived it, probably some of those masks are in the trash.\n\nMorgan Weiler: Hopefully a small percent.\n\nKristi Darnauer, MD: Right. Hopefully. Hopefully.\n\nMorgan Weiler: So you already mentioned this, but how did you manage the professional life and not personal life? Is there anything else you want to add to that?\n\nKristi Darnauer, MD: Well, I left social media. One of the most divisive places, I feel like, was social media during that intense time period. And Sterling is a town of 2000 people. So the people that I care for in my office are coaching my kids' baseball team and are teaching my kids at school and go to church with me. And we see each other at the grocery store, it's a very enmeshed world.\n\nKristi Darnauer, MD: And so in that world, things seemed fine. We're good at that. Smiling at each other and interacting cordially. But then in social media and on Facebook, it became very divisive. And there were things said to me, about me, about my colleagues, that were really awful. And so, leaving social media was a boundary that I set for myself to preserve my soul in the midst of it.\n\nKristi Darnauer, MD: I became fairly disillusioned about some of the people in my town. And I know that people say things that they wouldn't say to my face, but they can easily stay it behind a computer screen. And so I was able to step away from that and then continue to function in this role without bitterness and without frustration, or at least not as much of those things. Because it wasn't a constant onslaught of that negativity.\n\nKristi Darnauer, MD: So that helped and that helped me personally maintain that. And then a lot of self-care. The pandemic is such an interesting thing because as doctors, we're trained to take care of people when they're sick. And there's a part of me that just wanted to do that. Like, can't I just... Give me the COVID patients. At the end of the day I'll just take care of sick people because that's what I'm trained to do.\n\nKristi Darnauer, MD: And instead, we were thrust into this role where we were public health experts and we were advocating for these public health measures that was really uncomfortable. And then getting a whole lot of backlash about it.\n\nKristi Darnauer, MD: I tell people... I'm used to people not listening to my advice. Right. I tell them to quit smoking and they don't. I tell them to lose weight and they don't. I'm used to that, but I'm not used to them screaming obscenities back at me about it or questioning my motives in the whole thing. I'm not used to that. And that's where it got personal and that's where it got hard.\n\nKristi Darnauer, MD: And so, I feel like that was what made this pandemic unique, is that we weren't just healthcare heroes out there taking care of sick people, although we were that. I mean, I have taken care of my share of COVID patients this year, but that actually seems like the easy part compared to the community and social interactions that I had over the last year.\n\nMorgan Weiler: Has that gotten any better throughout the year, do you think?\n\nKristi Darnauer, MD: Yes it has. I do think it has. I think it was probably, for me, at least, at its peak in the summer months, which is crazy because we had... Our numbers really were low at that point. And maybe that was some of the pushback, right? The community felt like, Oh, it's not really here. It's somewhere else. But as rural providers, we recognize that anything happening in the city trickles down to us. Because if the hospitals are full in Wichita, I have nowhere to send my sick patients to.\n\nKristi Darnauer, MD: And so, we could see that as writing on the wall and that may not have been as appreciated by other people. But I think that was some of the pushback that we felt. And I do feel like things have gotten better. Of course, I'm not on social media to know what people are really saying, right. But I do get more of a sense of people saying, we understand where you were coming from. We may not have agreed with it, but I see more people wearing masks in my little grocery store. I see, maybe it's just a general resignation of, this is how it's going to be for a while. There's not as much fighting against kids wearing masks in schools was a really big deal for us.\n\nKristi Darnauer, MD: And something really important, as I was advising our school district, I said, we really have to make this happen. And we did. We have had kids in masks in our little school all year long and they've been in school all year long, so I think that speaks to that success. But there's a lot of pushback from parents about, they didn't want to send their kids to school in masks.\n\nKristi Darnauer, MD: And I feel like some of that has faded and people are recognizing that it was a necessary evil in order to get kids to stay in school. And they're able to participate in sports, which we weren't sure was going to happen as summer was rolling through. So some of those kinds of things. Again, I feel like it's almost this resignation like, okay, fine. A compromise has happened maybe against their will and maybe a little reluctantly, but it's happened. And I do feel less of that negativity.\n\nMorgan Weiler: Good. So, let's see. If you could start the past year over again and do things differently, what would you change?\n\nKristi Darnauer, MD: Oh my goodness. Yeah, maybe some emotional resilience for myself on a personal level. Like I said, the reading... I've done a ton of reading as everyone has, learning everything I can about COVID and learning how to treat it and learning how to care for the COVID patient. Again, was the easier part relatively speaking. And these are really sick patients. So it's crazy to think that, that was the easy part but, if there was some way that I could have prepared myself for that emotional onslaught.\n\nKristi Darnauer, MD: And it's hard to know. We, as a people, all of humanity, have been under a crazy amount of stress in the last year. So would there have been any way I could have been any more prepared? I don't know, but that would have been nice.\n\nMorgan Weiler: Yeah. More snow days or something.\n\nKristi Darnauer, MD: There you go. Yeah.\n\nMorgan Weiler: So who, other than you mentioned already some coworkers, who did you work closely with during the pandemic that really helped drive community safety and things like that?\n\nKristi Darnauer, MD: Yeah, so actually, I was asked early on to be a part of a group called The Kansas COVID Work group for Kids. It was started by pediatricians mostly, but there's some family docs in the group and some school psychologists, some school nurses, some community psychologists, and this group was formed probably June or... Probably June, with the idea of trying to evaluate back to school safety. What did that look like? What does COVID look like in kids? What's our actual risk here? Some of those pediatric related things.\n\nKristi Darnauer, MD: I've been on that group. We've met pretty much weekly since the summer, on Zoom, as all the meetings are, yes. And I have really been so grateful for that group. I feel like the comradery there, the, we're not alone in the trenches, feeling. The information sharing that happens there and the, this is what we're doing in our community, and let's take this and use this in another community.\n\nKristi Darnauer, MD: That kind of collaborative ness has been really helpful and life-giving in a way, because you're speaking with other people who are like-minded and who are talking about doing the same kinds of things and that's always affirming.\n\nKristi Darnauer, MD: So that has been good. I feel like I've been able to network with other physicians and other professionals outside of even just my colleagues, my partner, Dr. Stacy Dashiell, we work really closely together on all the things. And when the weather was nice, we were taking long, long, long, long walks talking through all the things COVID. Trying to sort out how to best lead in our community.\n\nKristi Darnauer, MD: So that has helped, having that kind of connection to... Because it really is, I can't imagine doing this alone and trying to do it without that kind of support.\n\nMorgan Weiler: Yeah. So what kind of changes brought by COVID-19 will be permanent?\n\nKristi Darnauer, MD: I think from a practice standpoint, a lot of the telemedicine will stay. And I think in lots of realms, some of this work from home will stay for people. Some of the Zoom meetings will stay for people. So I think some of those technology things that we've realized we don't actually have to be in person to do some of these kinds of things.\n\nKristi Darnauer, MD: It's freeing. It's so patient friendly. I've got moms with three young kids that are actually able to make it to an appointment because they otherwise would have to find childcare. I've got patients without transportation that have a smartphone, and so they're able to talk to me on their phone. And so some of these kinds of things I think are here to stay, and that's a really good thing.\n\nKristi Darnauer, MD: I don't know how I feel about what public health is going to look like going forward. I feel a little bit concerned about what sort of damage has been done in relation to public health advice. And then what it looks like on the receiving end for communities.\n\nKristi Darnauer, MD: There's this new tension that's been created about who's in charge. Who gets to make these decisions now, is it local government or is it local health departments? And so, I guess I don't know how I feel about that. Concerned, I guess, because I think there has been some loss of trust in the community that people maybe don't know exactly what to do with health advice.\n\nKristi Darnauer, MD: For some reason there's been doubt about even doctor's motives and the advice that we give. And I feel like that maybe distrust has always been brewing in different groups of people. Maybe in anti-vaxxers or people who prefer alternative medicine, those kinds of things have been brewing, but now it seems more widespread. It seems like more people are questioning medical advice, questioning doctor's motives.\n\nKristi Darnauer, MD: So I think that'll be something be undertaken in the future and addressed. How can we rebuild trust in people? How can they trust us again as leaders and how can we demonstrate that we're trustworthy. So I don't know. That's probably a negative. That's going to take some time to undo.\n\nMorgan Weiler: Ah. So we're actually going to talk about students in residents next, who have the big undertaking of that. But how do you see COVID-19 impacting the learning of students in residents that are in family medicine?\n\nKristi Darnauer, MD: Well, we have not had students for most of the pandemic, so we typically take students out here and love it. And we've maybe only had one since during the whole pandemic. So I think just the hands-on experience has, at least in this last year, definitely has been affected.\n\nKristi Darnauer, MD: Going forward, I think this will have been one of those moments in training that you look back on and think, man, I'm so glad I was in training for that so I can see all aspects of it. And I think it will be... I mean, it's an education. It's just a different kind of education, right. And maybe a little atypical compared to what the curriculum said you were supposed to learn this last year, right.\n\nKristi Darnauer, MD: So I think it's there. It's different. I don't necessarily... I feel like student and resident education is generally so well done that you're not going to miss anything. So this year was crazy, but you're still going to learn all the things that you need to learn. And you're still going to be prepared to go out there. And you're just going to have this other tool in your toolbox that you wouldn't have had, had there not been a pandemic.\n\nMorgan Weiler: Yeah. That's a great outlook to have on that. What is your sense of where family medicine is going in the future?\n\nKristi Darnauer, MD: Like I said before, I think family medicine doctors, at least out here where we're the only doctors, we ended up being public health experts. We ended up being community leaders in a way we hadn't been before. Some ended up being community targets in a way we hadn't been before, but we... Right, yes.\n\nKristi Darnauer, MD: But I think there's an opportunity to continue to be leaders in our communities throughout this, as we continue to rebuild that trust, like we talked about. I hope that we can continue that, because family medicine is, as we, those of us in family medicine know, the best specialty to be able to connect with patients, to make life style changes, to affect communities. And so family medicine is poised to be able to be the leaders in this kind of an environment. And I think we have been. I know, again, I'm biased because we're the only ones here.\n\nKristi Darnauer, MD: Family medicine has been doing the bulk of the work. And of course, we are so grateful for our ID colleagues and our ICU colleagues, but we're the boots on the ground who are attending the meetings and saying we need to get everyone vaccinated now, and this needs to be a priority. And how can we facilitate this to happen?\n\nKristi Darnauer, MD: So family medicine, as always, has as much of a seat at the table as they will take, because I think that opportunity is always going to be there and we're just poised to be able to do it well, if we're given the tools and I feel like our organizations have been helpful in empowering us and giving us tools that really have enabled us to do that this last year.\n\nMorgan Weiler: Yeah. Good. So any views on important issues in this specialty related to COVID-19 that we haven't addressed or that you'd like to share?\n\nKristi Darnauer, MD: I wrote a little note that said, burnout. Because I think [crosstalk]. Yeah, I think whenever you add anything else to people's plates, that is a risk. And so, on the same hand that I'm saying family medicine can do this, family medicine is really already maxed out in most of their communities and in the roles that they play there.\n\nKristi Darnauer, MD: So I think you just have to be aware of it as... And our specialty has done a good job. They've tried to make connections with physicians and increasing the awareness of this idea of burnout. I would guess that you can't meet a physician who's lived through this last year, who doesn't, hasn't experienced some form of burnout.\n\nKristi Darnauer, MD: And maybe every person, right? We've all been affected by this in such different ways. But I think that would be something going forward we'll continue to address, or need to address, so that we can continue to do this job and to do it well.\n\nMorgan Weiler: Yeah. Anything else you'd like to add?\n\nKristi Darnauer, MD: I don't think so. I think we covered most of my little notes of things that I thought we should mention.\n\nMorgan Weiler: Yeah, I'm going to go ahead and stop the recording.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102974/file/202809#t=0.0,1756.2"}]}]}]}