Solve the following math problem efficiently and clearly:

- For simple problems (2 steps or fewer):
Provide a concise solution with minimal explanation.

- For complex problems (3 steps or more):
Use this step-by-step format:

## Step 1: [Concise description]
[Brief explanation and calculations]

## Step 2: [Concise description]
[Brief explanation and calculations]

...

Regardless of the approach, always conclude with:

Therefore, the final answer is: $oxed{answer}$. I hope it is correct.

Where [answer] is just the final number or expression that solves the problem.

Problem: Let $m$ be the largest real solution to the equation
\[\dfrac{3}{x-3} + \dfrac{5}{x-5} + \dfrac{17}{x-17} + \dfrac{19}{x-19} = x^2 - 11x - 4\]There are positive integers $a, b,$ and $c$ such that $m = a + \sqrt{b + \sqrt{c}}$. Find $a+b+c$.
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