Tag Archives: psych

Scrum 1/2

scrum

1 – rugby – the method of beginning play in which the forwards of each team crouch side by side with locked arms; play starts when the ball is thrown in between them and the two sides compete for possession

2 – a confused crowd of people pressed close together and trying to get something or speak to someone

3 – a brief and disorderly struggle or fight

The limitation of riots, moral questions aside, is that they cannot win and their participants know it. Hence, rioting is not revolutionary but reactionary because it invites defeat. It involves an emotional catharsis, but it must be followed by a sense of futility.

Martin Luther King, Jr.

The high intensity LED strobes on the rig are lighting up the dark concrete canyons of empty streets in my urban workplace as I get closer to the call location. Sirens and the occasional air horn reverberate from the buildings as I creep through intersections and accelerate down the open streets. I pass City Hall and point out the tent city that was resurrected after a somewhat violent clash between the city police and members of the Occupy movement.

My EMT partner is helping to cover shifts in this county and is far from his normal surroundings of rural EMS calls. John is a part time EMT in one of the rural counties that surrounds my mostly urban county. He picked up this shift to get some overtime,  and being new in the EMS community, he wanted to come here to get some “action.” He’s about to get more than he bargained for as we get closer to the call location.

I round the corner just two blocks from my destination when I’m met with a SWAT skirmish line slowly backing towards my flashing rig. Thirty officers in full riot gear – extra padding in the uniform, full helmets with gas masks on, and plastic shields – are holding off a mob of four hundred angry people in dark clothing. The occasional bottle is lobbed from the crowd and breaks on the asphalt near their feet. The officer in charge whirls around to face me and a single motion from his baton-wielding arm is enough to convince me that I need to find another route to my destination. No arguments from me – this is the last place I want to be right now!

I pick up the mic as I point the rig up a one-way downtown street with headlights coming at me in all lanes. “Medic-40, we’re re-routing, we got blocked by protesters at Main street.” Driving the wrong way, up a one-way street, I’m giving an update to dispatch while pulling my ballistic vest from my bag and trying not to have an accident while I dodge oncoming traffic. I don’t remember this lesson being in my Emergency Vehicle Operation Course!

“You green-eyed mutha’ fucka’! I’m gon’ whoop yo ass like on Jerry Springer!” She’s screaming insults at me and balling up her fist as I escort her to the rig.

“Okay, you can whoop my ass later, let me check you out first.” Placating the psychotic patient has become something of an acquired skill in this county.

She called 911 saying that she needed an ambulance and then hung up. My dispatcher was unable to get her on repeated call backs so they sent us and a fire crew to see what’s going on. Seeing all of that in the call notes of the MDT I requested a PD back-up before we even got on scene. It’s just safer to have the guys with guns on scene when you don’t know what you’re getting into.

“Don’t you take me to no county hospital! I know my rights. You have to take me to EPS!” I’m taking a blood pressure as she yells at me. Just as I thought – way too hypertensive – she’ll need medical clearance before going to EPS (emergency psych services). She’s not going to like this because I’m now obligated to take her to the county hospital.

“Okay, here’s the thing. I need to put these restraints on you because you’re threatening me.” She struggles a little but lets me put the substantial leather wrist restraints on her – thereby greatly decreasing the chance that she can follow through with her threats to whoop my ass.

The city PD officers must be a little busy because they’re taking an eternity to get here. The fire crew simply escorted the screaming woman to the back of my rig and told me she wants to go to EPS. Before I even had her situated on the gurney the fire engine was driving away. Thanks a lot, guys!

“Why aren’t you taking your Seroquel?”

“I don’t like the way it make me feel! It make me all sleepy! Fuck you! Take me to EPS you green-eyed mutha’ fucka’!” Classic; the crazy person doesn’t like feeling normal so they stop taking their anti-psychotic medication. I’m about to make you feel VERY sleepy!

I’m drawing up a sedative in a syringe as the officers finally arrive and walk up to the back of my rig to face my not-so-pleasant patient. “I hear you want a green sheet, what’s going on?”

My patient seals the deal with her next outburst. “Fuck you! I’ll put you on a green sheet you bald-ass mutha’ fucka’. Let me up! I gon’ whoop his ass too!”

“Good enough for me. I’ll be back in a minute.” The officer walks back to his car to write up a 5150 form – a 72-hour hold for psychiatric evaluation – as his partner stands by in case we need any help.

As my patient is distracted by slinging insults at the officer I inject a sedative into her arm. With a green sheet in hand I have a pleasant drive to the county hospital and get a chance to do my paperwork while my patient snores like a chainsaw on the gurney.

 


Gangsta Rap 2/3

Kevin and I are dumb-founded. It was actually a good rap, despite the disturbing subject matter, and Lil’G seems to have some talent. I’d much rather listen to him rhyme than watch him tear the place apart.

“Lil’G man, you got some talent, you write that when you’re in prison?” I’m honestly curious.

“Nah man, I gots too much to do when I’m in the joint.” He’s dismissive with a wave of his hand.

“Too much to do? What, you working out all the time? Gotta build up those guns?” Referring to his biceps. Yet a tickling on the back of my neck reminds me that we didn’t exactly search him before he got in the ambulance with chest pain a few minutes ago. I hope Kevin did the “EMS pat down” as he put the monitor leads on him.

“Nah, I don’t work out in the joint. I’m too busy keepin’ an eye on all those niggas. Don’t never know when some fool’s gonna come up and try to stick me. Gotta be ready for a smack down, you know?”

After what seemed like an eternity PD shows up. Fortunately they pulled up to the front of the rig and I’m able to brief them before Lil’G notices they are here. The officers walk around the back of the rig so Lil’G can see them and it’s obvious by his expression that he’s not surprised. He knew this was happening all along. He’s been in this situation before and knows the drill just about as well as we do.

After a quick conversation and some paperwork the green sheet is finished and we can start to transport to the Emergency Psychological Services (EPS). Lil’G will get a psych evaluation and maybe stay a day or two for observation. It all depends on how he answers the questions.

It’s Kevin’s tech so I’m up front driving to EPS while Kevin finishes off the paper work. It turns out that no restraints or sedatives were necessary as Lil’G seems to want to go to the EPS. I can only imagine the life he’s led up to this point and how it may actually be comforting for him to rest in a relatively safe institution for a few days.

Growing up in the hood he presumably had few positive role models. He must have been in harm’s way often and exposed to some traumatic events. Just as a soldier comes back from a war with PTSD, I can imagine that life in the hood can create the same effect. Then at a formative age he’s placed in prison with its strict routine and lack of freedom accompanied by the ever-present danger of prison violence. Past traumatic experiences have created at least as many mental/emotional scars as physical ones.

Yet even with these obstacles this man has made it to his forth decade of life, which is rare for people in his situation. He seems to focus his energy on his rhymes, which he presents in all modalities of communication, with a harmony of visual/kinesthetic/auditory artistry. A man with limited education and vocabulary is able to access his inner emotions and express his feelings, dark and violent as they may be, to others and himself.

Pulling into EPS I hear the disturbing rhymes from the back of the rig.

I chop your head off… let it roll in a buck-et.

I punch your eyes out… so I can skull fuck-it.

 

But I aint trippin’ nigga… I won’t beg.

I drink the blood… from a bull dog’s left leg.

 

I told you once nigga… I ain’t even trippin’.

You get found nigga… by three old men fishin’.

 

We can do some shit… I might bust your brain.

But on the tip of my shoes… I’m leavin’ doo-stains.


Gangsta Rap 1/3

gang·sta

1  :  black slang; a gang member

2  :  a type of rap music featuring aggressive misogynistic lyrics, often with reference to gang violence and urban street life

rap

1  :  to hit sharply and swiftly; strike

2  :  a criminal charge; a prison sentence

3  :  music; to talk using rhythm and rhyme, usually over a strong musical beat

4  :  to have a long informal conversation with friends

Violence is a part of America. I don’t want to single out rap music. Let’s be honest. America’s the most violent country in the history of the world, that’s just the way it is. We’re all affected by it. That’s one of the frailties of the human condition; people fear that which is not familiar.

Spike Lee

“Ya’ see, I didn’t really call you here because I was havin’ chest pain. It nothin’ like that at all. Ya see, I thinkin’ about killin’ myself.” As the fire engine accelerates away from us Kevin and I have a very different call on our hands than the one we thought it was going to be just a few seconds ago.

Getting called to the middle of the hood for chest pain is a common enough thing and we answer these calls on a daily basis. Today we happened to be just a few blocks away when the call information arrived on the Mobile Data Terminal (MDT). I turned the ambulance around and we were on scene in less than two minutes.

Sitting on a chair in front of an urban church outreach center was a man in his early forties. The pastor and church volunteers are comforting him as we walk up to see what’s going on. Holding his chest he tells us of the pain he’s feeling and how he wants to get checked out at the hospital. It’s an easy call and the assessment and treatment are so rote that we fall into auto pilot as we go through the motions.

Seeing the fire engine approaching from down the street I write the man’s name and birthday on my glove and hold my hand up high so the fire lieutenant can copy it down for his records without having to exit the engine. In seconds they are off to the next call and we are alone with the patient. Of course, that was before I knew the true nature of the call.

After our patient drops the bombshell on us, Kevin and I take a collective deep breath and one look between us confirms the sudden detour this call has taken. In our business suicidal ideation is taken very seriously. A person who is truly suicidal, who has ceased to care about their own life, may not care about other people’s lives. Therefore, we can be in danger when dealing with these people.

Our new patient, Lil’G, is quite a formidable man. He has scars on his face, one of which is consistent with a knife wound. He’s 240 pounds of compact, short, boxer’s build with huge upper body development. He’s seriously built like a smaller Mike Tyson. He jokes with Kevin because he had to pull out the fat person blood pressure cuff just to fit around his huge biceps. He does a muscle man flex and smiles showing me a gold tooth. I’m feeling very uneasy about this. I give Kevin a look that he understands. “I’ll be back in a second.”

“Hey, where you goin’?” He’s quick with predatory instincts, watching every movement – nothing escapes him.

“I just have to get the computer from the front.” It’s a half truth which I hope he doesn’t see through.

Walking up to the front of the rig I turn on the portable radio on my belt. Opening the front door I grab the computer and turn off the rig radio which can be heard from the patient area in the back. I stand in front of the engine compartment so I can keep an eye on Kevin through the windshield as I call in to dispatch on my portable.

“Medic-40 go ahead.” The radio crackles back to me.

“Medic-40, please send PD to our location, code-2, our chest pain call just turned into a 5150 with suicidal ideation. We’re code-4, for now.” The code-4 tells my dispatcher that we are not currently in danger. The ‘for now’ tells her that I don’t know how long that’s going to last.

I’m standing outside of the back doors as Kevin is doing further assessments on Lil’G. Kevin knows the drill: we have to stall as long as possible so PD can get here to write up the green sheet (5150). Without it we have fewer of the options we may well need in this case, like restraints and chemical sedation.

I’m watching Lil’G as Kevin continues with the 12-lead EKG. Lifting up his shirt I see the multiple GSW (gun shot wound) scars.

“Lil’G, how many times you been shot?” Anything to distract him and buy us some time.

“Yo, I been shot four times, stabbed two, and sliced up a couple. It’s hard man, growin’ up in the 70s.” He’s not referring to the decade – to him the 70s are the street numbers in his corner of the hood.

“You ever do time?” I’m thinking prison ripped could explain the boxer physique.

“Yeah, I did six year, fo’ bangin’. You know; sellin’ a little, had sum ho’s, and a little bit a shootn’.” He’s not talking about shooting up with heroin. “Yeah, I got a strike on me.” In this state it’s three strikes for felony convictions and you’re in prison for good.

Kevin’s still trying to stretch out the assessment as I’m typing on the computer. “You got any medical problems?”

“Yeah, I got PTSD, bipolar, paranoid schizophrenia, and depression, but I ain’t takin’ no meds for it.” FUCK ME!!! I’ve got a bipolar psych patient who’s off his meds, built like Tyson, and thinking about killing himself. I really need a raise.

Lil’G could shred both Kevin and I if he put his mind to it. Not to mention tear the ambulance apart. We’re walking a fine line here and we have to keep him on the good side of his bipolar disorder. I’ve watched manic bipolar patients cycle from happy to violent a dozen times in the course of a single transport. If this guy cycles on us we’re fucked.

Despite the lethal potential of Lil’G he’s actually pretty engaging. He has a fast wit and keen observation skills. He decides I look like the silver terminator from Judgment Day, in reference to my hair style and clean cut white boy appearance. Seeing as the terminator impersonated a cop through most of the movie I’m not sure I like the reference.

“Yo man, that’s your new name, I’m gonna call you T2.” He has a full bodied laugh with muscles rippling to the diaphragmatic contractions. Great, I have a street name.

And just like that Lil’G cycles on us. Yet not to a violent nature – quite the contrary. Right there in the back of the ambulance he starts rapping. With perfect tempo and surprisingly colorful depictions he tells us what’s on his mind in the only way he knows how.

I’m on the microphone… gotta do it quick.

But never give a care… I ain’t scared to hit a bitch.

Gotta hit her from the back… nigga back side.

I don’t give a fuck nigga… it’s time for a wild ride.

 

Call me Lil’G… when you see me.

I see niggas on the street… trying to be me.

I got these knuckles man… I make ‘em laugh man.

Never give a care… put ‘em in a bath man.

 

Gotta do it good… cuz you know what’s right.

I never give a care nigga… cuz I’m hell’a tight.

I come from 69ville… nigga eight-five.

Never give a care… boy I don’t duck and hide.

 

I’m born on the east side… I’m going east bound.

You a block head… whose name is Charlie Brown.



Suicidal Ideation 2/3

An officer meets us as we walk up to the apartment building. “She’s in that apartment. Watch your step as you go in, there’s blood all over the place. Looks like she bit her tongue. We’ll have a green sheet for you in a few.”

We were called here for a 5150 but it’s looking like there’s more going on than someone who voiced suicidal thoughts. Once an officer hears a person say they want to kill themself, they have to write up a Form 5150 – it’s on green paper so we just call it a green sheet. Basically the 5150 is a tool used by law enforcement to hold an unstable person for 72 hours during which time they are psychologically evaluated. More often than not they are not “suicidal” – they just said the wrong thing at the wrong time or PD has nothing else to hold them on so they get the person off the street using the 5150 because it’s less paperwork for them.

Walking into the apartment I see two more officers standing in front of a slim woman in her forties. She’s sitting on a chair in front of a closet with blood dripping down her chin –  enough to saturate her shirt. She has ligature marks around her neck which are consistent with the belt that is sitting next to her. Looking in the closet I see the closet rod is broken in the middle.

The officer lets me take it in before he gives me the update. “Hey guys, this is Sandy. She’s been going through some pretty rough times and she tried to kill herself today. She drank a bottle of wine and put a belt around her neck and tied it to the closet rod. She hung there for maybe ten seconds before the rod broke. When she hit the ground she bit her tongue pretty bad. The blood freaked her out so she called 911.”

As I kneel down to examine Sandy I see the bottle of wine on the side table – it’s a Mondavi Pino Noir; not the usual crappy two-buck-chuck that they sell in the local liquor stores. Sitting next to the bottle is a Riedel Vinum wine glass. Riedel is known for being shaped so that the wine lands on your palate just so, and you pay for the privilege – a single glass can cost $25 or more. Well, she gets points for taste even if she can’t calculate load bearing stability very well.

“Hi Sandy, I’m going to be taking you to the hospital to get you checked out. Can you open your mouth so I can see what’s going on?” Sandy nods her head and opens her mouth. Pulling out my flashlight I see that she’s nearly severed the end of her tongue – it’s being held on by less than a half inch, yet the bleeding has slowed to a small trickle. I pull out a sterile piece of gauze and tell Sandy to pinch her tongue with her fingers as we walk out to the ambulance.

Once in the rig I can assess Sandy a little better. She checks out fine aside from the tongue and a minor abrasion to the chin. My only real concern is if the attempted hanging caused any damage to the throat that could cause airway obstruction issues or if her tongue were to swell to the point that it blocked her airway. Admittedly these are big concerns, yet I don’t find anything that would make me light up the rig and drive fast.

Sandy’s not much for conversation – partially because she’s holding her tongue (literally) and the reality that if not for the closet rod breaking she would be dead right now. We start driving towards the trauma center – I don’t plan to trauma activate her but I want her in the trauma center where they are prepared – in case the swelling causes any issues over the next hour or so.

I dim the lights in the back and tap away on my laptop as we take a quiet drive to the ED. I’ve watched partners in the past who will talk to people on a 5150 to try and figure out where they went wrong and offer advice. I have mixed feelings about that as it’s not necessarily our function in the medical community. Although I’ve probably taken more psych classes than my peers I feel it’s my job to treat the physical condition and understand the mechanism that led to the injury – so as to give as much information to the nurses and doctors that will continue to care for the patient. I feel it’s inappropriate to play Paramedic Psychoanalyst.

I’ve transported more people on 5150s for voicing suicidal ideation than I can even count – one man was even placed on a hold for texting it. But this is a different presentation. Sandy wanted to end her life so desperately that she put together a plan and acted on it. The carpenter that installed the closet will never know that had he put a third closet rod support in the middle, as he should have, a woman would be dead right now.

Section 8

sec·tion

1 – one of several parts or pieces that fit with others to constitute a whole.

2 – a type of Federal assistance provided by the United States Department of Housing and Urban Development (HUD) dedicated to sponsoring subsidized housing for low-income families and individuals.

3 – category of discharge from the United States military for reason of being mentally unfit for service. The meaning of Section 8 became known in households worldwide as it was used often in the 1970s TV series M*A*S*H, in which the character Corporal Klinger was constantly seeking one.

As we’re responding to an address in the hood, lights and siren running in the background, my partner Brent and I are playing the prognostication game. It’s a way to alleviate the monotony of the day a little by trying to guess the actual nature of a call from the minimal information on the MDT (mobile data terminal), which is often inaccurate.

The prognostication game is a way of staying sharp. We take into account the time of day, socio-economic make-up of the neighborhood, whether it’s a house, apartment, or “corner of” call, and if the call was initiated by cell phone or land line. In our busy county each crew runs around 1000 calls a year so we start to see trends pretty fast.

The prognostication game is also a means for bragging rights between partners – we keep track over a period of time (a shift, or a week) and the loser buys the winner coffee. The only downfall to the game is you have to be willing to drop the pre-conceived assessment immediately when you get there and your actual assessment points in a different direction.
The dispatch notes on the MDT only tell us we’re responding to a 47 year-old female with shortness of breath. I nailed the last one with the 35 year old male having abdominal pain with a pre-arrival diagnosis of pancreatitis aggravated by alcohol consumption. This time, I’m going with the easy odds of an asthma exacerbation. Brent has about the same odds with the guess of a panic/anxiety attack.

We arrive on scene to see the BRT parked in the parking lot of a high density federally subsidized housing project. We call it Section-8 housing in reference to the portion of the U.S. Housing and Community Development Act of 1974 which provides a subsidy for low income families and individuals. The neighborhood is largely African American and the frequency of asthma in urban areas like this is quite high; that’s why I went with the easy odds this time.

As we walk into the ground-level apartment we see the patient sitting on the sofa with fire fighters doing an assessment. In unison my partner and I stop, mid-stride, and our jaws drop.

We stand there, dumbfounded, staring at the decor. One whole wall of the apartment is covered with NASCAR matchbox cars, still in their packages and perfectly aligned – tacked to the wall with edges touching. There must be 300 cars on the wall.

On the adjacent wall is an altar with a picture of Jesus flanked by pictures of Dale Earnhardt and Dale Earnhardt Jr. The holy trinity, really? All pictures are of equal size and displayed with equal prominence. Sitting on the altar are shoebox sized models of the number 8 car and the number 88 car aligned with their respective drivers. What, no car for Jesus?

In the kitchen are two cats, one sitting on the counter the other sitting on the ground. Both cats are fixated on a cage on the kitchen floor with four birds that nervously jump from perch to perch.

There’s an angry looking, heavy-set white woman, probably not related to the Hispanic looking patient, standing near a day bed that’s covered in cash. A four foot square tapestry hanging on the wall over the bed with a picture of a white tiger has the caption, “The Eye of the Tiger” under the image.

I’m starting to think my asthma guess is out because of the chaotic nature of the furnishings. There are some interesting contradictions in the décor which could speak to the mental stability of the occupant. I mean seriously, who puts a bird cage on the floor when you have cats? Which animal is being tormented more by the close proximity? And being a NASCAR fan is great, although I’ve never seen one in this neighborhood, but deifying the drivers??

Someone with a psych history is more likely to have an anxiety induced hyperventilation. Brent was probably right on this one…

The thing is, Paramedics are trained observers that profile. Maybe that’s not a politically correct thing to say these days but I believe it’s true. The city police won’t use the “P-word,” but the FBI likes it so much they made a division of people who specialize in it.  Paramedics often get only half the story on any given situation, we are often lied to by our patients, and many times the patients have no idea what’s going on. So we have to fill in the blanks. That’s why we play the prognostication game – to exercise our mental abilities to fill in the blanks.

If I’m going to a call in the hood and someone is passed out then I’m looking for signs of drug/alcohol use. If I’m going to a call in the affluent neighborhood and someone is passed out I’m looking in medicine cabinets to check for an overdose on prescription medication. It’s just a matter of prioritizing the rule-outs based on observations and high probability odds. Everything will get checked by the time I get to the hospital but I modify the order of rule-outs based on what I see and how the patient is presenting.

The fire medic has been waiting for me to take it all in; I suspect they had the same reaction that we did. Finally I have a look at my patient. She’s breathing very fast with shallow breaths. I see the cardiac monitor; she has a heart rate of 136 with a regular rhythm.
The fire medic tells me she thought she was having an asthma attack and used her inhaler, but she is still short of breath. I look at the O2 saturation on the monitor and it reads 100%. She’s getting plenty of oxygen to the blood so she should be fine. The fire medic watches as my gaze shifts, gives me a shrug and tells me her lung sounds are clear. I’ll recheck the lung sounds when I get her in the rig but right now I want to cut the fire crew loose as I’m not going to need any help on this call. They get run pretty hard in this neighborhood so I try to take over the call fast when it’s possible so they can try to get some down time before the next call goes out.

I introduce myself to Rita, my new patient, and tell her that I’ll be taking her to the hospital. As she’s getting her purse the LT asks her about the money. He’s going to lock up for her but wants to know what to do about the money laying on the day bed. Rita says to give it to the angry looking white woman telling us it belongs to her.

Once I get Rita into the rig I start over with the questioning and examination. I ask if there was any kind of emotional event that precipitated the asthma attack; she says no. I check her lung sounds and they are perfect – no bronchial constriction or wheezing. I have her on my End Tidal CO2 (ETCO2) detector so I can measure the CO2 in exhaled breaths and have a real time wave form on the monitor to see how she is breathing. It also gives me an accurate count of respirations per minute.

Rita is breathing at 44 times a minute with an ETCO2 of 16. Normal readings would be a respiratory rate of 16-20 and an ETCO2 of 35-45 so there is definitely something wrong here. When I ask she again denies any emotional stressors or history of anxiety or panic attacks or any drug use. Looking down at Rita’s hands I can see the carpopedal spasm beginning to cramp her fingers – basically, breathing too fast changes the metabolic balance in the body resulting in cramping fingers and feet.

I tell Brent we can start driving as I’ve done my rule-outs and decided what my treatments are going to be. I start an IV and inject Benadryl into the tubing to sedate her a bit. Benadryl is a drug that’s typically used for mild allergic reactions or seasonal allergies, but our medical director added it to our protocols for mild sedation, which is an off-label usage (i.e., drowsiness is a side-effect of Benadryl). It’s not going to put anyone completely out but it does help to calm people down. I think part of it is a placebo effect in that people see me draw up a medicine and inject it while I’m telling them it’s going to make them feel better.

I turn the lights down in the rig and sit at the edge of the bench quietly doing my paperwork on the laptop. In some cases my treatment for a panic attack patient is to ignore them. Maybe that sounds cold but I have my reasons and often it works. Many times a panic attack is to get attention or to get out of a situation. Well, Rita doesn’t seem to want any attention. She’s staring at the cabinet and not looking at or interacting with me. I’m thinking she wanted out of a situation. Having accomplished that I’m going to leave her to her thoughts while we take the fifteen minute drive to her favorite hospital.

As we’re pulling into the hospital I take a look at the monitor. Rita’s respiratory rate has dropped to 22 and the ETCO2 level has risen to 20. Both numbers are moving in the right direction and Rita has had her eyes closed for the whole trip. After getting her into a room and giving the report I sit down to finish my paperwork at one of the nurse’s desks.

A few minutes later, Rita’s nurse comes out and I catch her eye – I thought of something else. “You know, there’s one other thing.” I tell her, “There were $400 dollars all spread out on a day bed and an angry looking woman who may have been the building manager. I’m thinking it’s the middle of the month so if she was paying rent now it’s pretty late. And even Section-8 housing is more than $400. I bet that’s what caused the attack in the first place.”

The nurse’s eyebrows lift up and she goes back in to ask about the money. Three minutes later she comes out shaking her head up and down. “That was it.”

It looks like I’m buying coffee tomorrow morning as Brent is winning the prognostication game today…