when left around devices he thought about this fact in deciding to close the prison term despite his very bad prior experience with the cars well where she was thought to be heading and where she did head and despite is used to get her were well over the sentence the prejudice that i am arguing about is the thought that she would be hospitalized in stable have stabilized and the effect that that thought had just as a judge can disagree with a guideline he or she can agree with a guideline and believe that the guideline is the only choice is a violation of the girl however and in this case there is no clear statement that the judge case it would have to be it would be error only if the need for rehabilitation was the dominant factor or the driving force for more an increase in sentence but not if it is simply one of the a mix of factors as judge lynch pointed out judge woodcock never mentioned the word rehabilitation in his sentencing analysis he did mention the need for the defendant to receive adequate medical care that is something the statute specifically required him to consider and it is different from the statutory language relating to rehabilitate the statute distinguishes the two of them the basic assumption as i understand the defendant's position is that the judge has a starting point something less than the guideline range of sixty three to seventy eight months but decided to increase the sentence to the minimum guideline based on the defendant's medical condition we see it as the absolute opposite that what the judge said was that considering eleven factors that he specifically enumerated that had nothing to do with rehabilitation and had only to do with the cr and the way the defendant committed that those eleven factors would lead the court unequivocally to impose the maximum guideline sentence but that out of consideration of her medical conditions that the judge decided to depart so when we see the records showing the exact opposite of what the defendant said the eleven factors on which the court relied are all set forth in the brief they have nothing to do with rehabilitation they have to do with the fact that this was a four hundred thirty thousand dollar fraud that was committed over a period of five years against twenty five victims some of whom were fellow patients at alcoholics anonymous and drug treatment programs that that event didn't stop until she was confronted she didn't admit it and she was confronted with undeniable evidence of those factors have nothing to do with taishan now if i may turn to what is the related question or two related question fusil to depart downward based on her physical condition and also the overall reasonableness of the sentence this court has repeatedly said that in reasonable analysis courts should give due deference  to the superior coin and they had to each of the sentencing judge and that is because that judge has a greater familiarity with the case and has a greater opportunity to see the participants firsthand there were certain things about this case that make that standard of review especially appropriate this is a case where the trial judge held seven pre sentence conferences over the course of eleven months to consider what was the appropriate sentence for this defendant her tremendous evidence about her medical needs can evidence and arguments about departures and variance that was one thing second in addition to all of the ordinary information that judges have this judge consider nine hundred pages of medical records about this defendant's condition some of which suggested that she was sabotaging her own condition to white going to prison furred the judge heard by video conference testimony the testimony of the clinical director of the federal bureau of prisons women's hospital at carswell in which that official outlined in detail the resources that are available and the kinds of treatments that would called treatments that would be given to this defendant particularly with respect to her which is apparently the driving force for most of her other medical conditions finally the court took fourteen pages of transcript to explain why even though this defendant had serious medical conditions that needed appropriate care that the minimum guidelines sentence of six to three months was appropriate now turning to the departure issue itself i cited twenty eight j letter of united states versus herman not all cases are identical but herman strikes the government is pretty close this is a case involving a woman who was now and was down to seventy five pounds but had a series of other medical conditions and challenge the refusal to depart downward for that reason this court no abuse of discretion if the court has other questions  which the court could have corrected by means of rule thirty five if anybody had brought it to the court's attention but it everybody overlooked it so it's not a really good but still i don't know whether that clerical error