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  1. #1
    Join Date
    Oct 2008

    DS w/Sally Karioth - I am very old....been @ FL state for 40 years...started for degree in nursing, then switched to theatre, then went and moved ....wanted a graduate nursing degree...we don't have a grad program but we are 1 faculty short....object to narrative about education....degree in Nurse, advance Nurse, theartre, doctorate in ed. psychology...masters foundation ed...second masters in family nurse practictioner....post grad work...advanced nurse practioner....cannot write RX for narcotics but can write RX in FL....doctorate in clinical counseling...if it needs that I will refer them out...many patients come from doctors who refer them to me...teaching learning excellence....how to be efficient teachers...I tech 5 different classes on grief/loss in FL....one of the students as you remember (object narartive) names of courses you started...Death/Individual and FAmily in the 1970's believe it was first grief course in thecournty...ethnic and individual in grief and trauma...grief and culture, death and loss in family....been teaching...certified traumatologist...following Oklahoma city bombing we bacame.....object-narrative....following fema going into places where traumatic episodes our job to interact to first responders....symptomology...full professorship @ FSU - see patients and their family...as long as I been @ tallahassee for 40 years...terminal disease, family loss & struggle to get back on feet and worry about other siblings...kids struggle with things @ home, loss of job, out of control....death and grief and trauma.....physicians refer ....I do workshops for firefighters (object- sustain) what do you charge for seeing patients? I don't charge anything....

    somewhere between $30K & $40K
    grief and loss - in late 60's and early 70's how we deal with death and dying talked with woman about her work...she did patients have proper diagnosis. (object -sustain) name of individual...Dr. E. Hoover ross? trained ...any seminars in grief and trauma? maybe 50 a year and 10 years 100 a year...hundreds to thousands probably...nurses, clergy, firefighters, dog trainers, police, people go into sites with a lot of angst involved, social work students....study grief and trauma and related issues - lifelong event - new reserach read 5-6 hours per week....time total teach/read/lecture/counsel approx number of hours over lifetime focused on this topic....work 20 hrs per work X 48 weeks per year .....thousands...
    death and dying book.....contributor to Chicken Soup books...did a piece Parents Magazine explain terror to children.....chicken soup books started 15-20 years ago...occassionally I was asked..when came out seen as a help for everyday folks...tell one our stories in book - people get better and manage things...little vignettes short stories that are biographical....Chicken Soup book name ...for Surviving Soul....authored chapters on Edit board for trauma ....I edit other books...(object)_ I have authored chapters that have to be edited.....I do more editing of others work....compassion and friends a international organization...group of parents lost child felt family support for them should be there....tallahassee...other parents to talk - some getting better or getting worse...parents of children died of suicide or crib death...(object-sustain) degree in trauma or crisis intervention...no there wasn't even a class in it..when Dr Ross said I would like to teach first even lecture in country....we have several classes Religion, Nursing, grief class, death & dying, how to deal w/trauma class, pretty typical now...involve w/set up some of the curriculum.....ask them to send us a syllabus to put a program together....Judges and Pharmacy and ....Object -sustain....testimony as expert in grief and or trauma in other states...one or two thousand times...everyone grieve same way? JA....object- DS expert in grief and trauma....like to Voir Dire...JA - ever published peer review journals research studies articles? compassion fatigue, compassion energy, end of life issues, how parents chose to dispose belongings...Gay women and their treatment in Hospice situation....Southeast Research Journal...after Katrina wrote a grant for online journals.....object....Southest Research Journal is peer reviewed...Parents Magazine....not a journal...book they wrote ...Parent Magazine...book is Peer Reviewed by Editor of Barnes and Noble...they are publishing is a publishing house....what I am asking for is serious peer reviewed reserach journals....object overrule...
    You know what I mean by Peer Reviewed....when that book was propsed they went around the world ...please submit an article they read it and published it....what I mean by peer reviewed...experts in the field....those experts in the field approved my work be included...I am an editor on trauma journal they send articles to us and we determined...other peer reviewed articles? tell me what they are...give me my CV and I will tel you what they are....DS hands over CV

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  2. #2
    Join Date
    Oct 2008

    FL dept of Health is peer reviewed? experts got those...don't know who the other experts are....Healing adjucts medical model...chapter managing grief and loss - book Pediatric Nurse Practioners - online journal...what is the journal...Dealing with Death...Monogram put out set of articles....North American Transplant....name of journal...how ofter published - quarterly....any others...(object- sidebar) JA holds finger up to witness to indicate wait 1 min and smiles....

    (This woman has not YET named a Peer Reviewed Journal that I have heard!)

    civil cases and criminal cases 6 and 6 and 1 maritime case....1 case that she didn't interview ...talked to sis (object to her admitted as expert...HHBP she will be admitted as expert in trauma and grief

    Journal of Traumatic Advance ...several journals of Charles Figley work @ LSU, look @ instruments a Doctoral student might use in grief in loss study, work with IRB board make sure research students do will be valid....
    do people suffer grief in same way....no if I were to poll a room...I work a lot with children and ...(Object - sidebar)
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  3. #3
    Join Date
    Oct 2008

    DS - I want to give a hypothetical ...a 22 y/o mother w/nearly 3 y/o child ....loving mother and that child dies unexpectedly....how would you expect her demeanor for grief and loss? object -.....approach sidebar

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  4. #4
    Join Date
    Oct 2008

    DS repeats her hypothetical w/amazing and lovin bond with her child...since everybody does it differently...certainly see mothers lose their children who were loving...they lay down in bed, don't wash sheets in bed...
    conversly seen mothers clean out the child room, give away toys away, don't even say anything....too painful to go thru memories...some people go to cemetary every day and others say too painful...
    surviver guilt...in younger people...grieve...I have never had a patient act the same as someone else....other people don't act that way (object- sustain
    Mom comes from a family who cope .....with stress and trauma by engaging in denial and non-communication...object...DS asks to go thru the list - Sidebar

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  5. #5
    Join Date
    Oct 2008

    add to hypothetical she is tiny in stature....pregnant father says it is athletic...Mother said sedentary, denied pregnancy until 8 months old....(missed alot)
    assume her Father makes statement that she might still be alive...brother felt left out efforts look for child remains - brother angry not involved with child ....since the obvious pregnancy...assume she was followed..but she was not followed...(object HHBP go ahead and finish) given all this what effect that can have on grief of loss of child....Dr. says that was very complex...give me alittle leadway...helping family with lots support and usually coping mechanisms...make journey come out on the other side...I don't believe we resolve grief but we get thru it....culture dont air our linen for others to see...response to traumatic incident I would imagine how other people ...silence of the famiy are don't talk, don't feel, don't share often leave other people difficult to understand....Object - HHBP -just a second Dr...sustained as to other people...(kc crying) in hypothetical situations we can see denial is a great helper ...story can be changed a little bit...in these situations described here ...I could see typical for there to be no discussion or discussion look unusual or abhorrent or difficult to understand...lets add to hypothetical. during 31 days young mother leaves home goes out to bar get tattoo beautiful life...that type behavior and grief reactions...more than what you described more important to look @ behavior of what everyone did in those in 31 days ...seems very like other young adults they are reluctant grievers ...often say nothing happened. do risky behavior, do very thing their friend died from, retail therapy = acquire enough things make this go away.....look mad and sad response issue to grief...look @ adults limited exposure to world and inappropriate type behavior and responses I see risk taking...look like having great time spending money don't have,,get into trouble....berevement overload...someone act out after loss won't have anyone near them....loss is such a fine line betwen our job and children (object- sustain) how long does this type of behavior last? this type of behavior appearing normal fine - no change....appearing fine (object - overrule) ...always think normal and healthy grief and trauma ....grief loss but think about trauma years later someone asks this person to tell the story the story would sound the same and the behavior will not change....stuck on trauma...I have patients kept original grief responses for years and years...drinking, self medicating , little nest. not alot of people around....affect different...affective hysteria = their response to grief when come from environment without any healthy mechanisms...I have seen people lose a child and make arrangements to go to work next day and children go back to University and become hot shot student or very bad student...or don't want to talk about that...denial is what you tell self (object- sustain X2) all I have

    JB up for Cross....
    very sad....3 emotions sad, happy and mad....interest in sex...research that shows when you dont have rewards to make you feel better that makes you feel better (object- overrule) promiscuity is difficult to define...some folks who were very close find themselves doing things hadn't done in first 40 years ....anything on continuum for sex from frigid to over sex....object-overrule....I have had patients find sex will help them during their grief and later find that really wasnt helpful...can you give me anything inconsistent with grief? I can for healthy grief! NO ...anything inconsistent with grief...any type ...if you are not allowing me to say healthy responses and unhealthy resopnses require intervention...no matter whatever I tell you or hypothetical counsel gave you abhorrent grief responses need intervention - anything could happen when someone has a grief....if it is something abhorrent it is consistent with grief...everything is consistent with grief...everything with grief falls somewhere laong lines of healthy grief to abhorrent ....a certain person is at that time grieving...can you look @ set of actions and not know whether grief or loss...I have a tool use grief and loss system...I could read results I could say tell me about this specific thing....when first contact about this case...email in end of May beginning of June ...are you aware trial started trial started on May 23...no I didn't know trial started....email asking if I ever did expert witnessing about grief...when you walked in that door what facts about this case have you been given? none...I said at the time I got the email...I didnt know the name...I wrote and said there are people in Tallahassee do that work...I looked up name and said oh yes this had happened some time go....didn't research...when you walked thru door today what did you know about this case (object-overrule) asked to come to talk about general research and general loss...this case seemed to be about a young girl who lost a daughter...ever worked with women who kill their children...yes worked with Smith case...people who suffer grief maybe not the same way others grieve...that was for the Susan Smith trial who killed her children (object -sidebar)

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  6. #6
    Join Date
    Oct 2008

    JA discuss denial ...doesn't mean lying...can lie to self...folks use denial a lot and faced with profound grief or loss they have magically thinking ...ie: someone who loses a father might tell themselves their father is in Europe...know they are not in Europe...

    hypothetical...22y/o mother child dies..within half day goes to boyfriend...doesn't tell anybody child die....noone...rents a movie - spends night engage in sex relations with boyfriend that nite..next day tells Mother she is in Tampa with child everyone knows she is in Orlando...few days her Mom asks when come back...tells Mother accident in Tampa...within afew days tells her Mother she somewhere else...then tells Mother she and child @ Universal....doesn't tell anyone else that...then few days later tells mother she and child are in Jax...everyone else she talks to knows she is in Orlando...I could go on and on...I would agree a mother in crisis...would figure out how to make things better...grief makes people do very different things...if that occured with this mother ...I would she would need significant help.....

    add element mother killed the child...deliberately killed the child (object- no evidence) I disagree with counsel....Sidebar!

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  7. #7
    Join Date
    Sep 2008
    Orange County

    Sally Karioth testimony (grief therapist)

    PART 1



    She has been at FSU for 40 years - went to University of Wisconsin for Nursing, then went back to FSU where her husband was and was offered a faculty job.

    OBJECTION - narrative -

    She then got 2 masters and a phD and did some post doctoral work.

    She was a diploma nurse, got a BS in nursing, one Masters in Nurse Practitioning, one in psychology, Post doctoral work in genetics.

    Can you treat patients without a doctor in the room? She can because it is clinical counseling. A great many of her patients come from doctors.

    She is a full professor at Florida State. She teaches five classes in grief and counseling


    She started with a class called Death Individual in a Family, then she teaches Ethnic Variations in Grief Loss and Trauma, Grief and Loss in English Culture...

    She has been teaching in grief issues for 40 years.

    She is a certified traumatologist.

    Following the Oklahoma City bombing...


    Traumatology is the helping arm of FEMA that goes where places that have had traumatic episodes and to interact with first responders in helping them to not develop passion fatigue.

    She has seen patients for 40 years for treatment of anything related to death and grief and big causes of trauma.

    Organizations who refer her patients? Physicians in town refer to her patients who they believe have grief related problems.


    She doesn't charge anything for seeing individuals. She thinks she has seen between 30-40,000.

    She trained under a lady from the University of Chicago area....

    OBJECTION - non-responsive - SUSTAINED

    She trained with Dr. Elizabeth Kubler Ross.

    She does 50 or so seminars. She has probably done hundreds to thousands in her career. She gives them to police, doctors, firefighters, EMTs, dog trainers, Social Workers...

    How many years have you studies grief and trauma related issues? That is a life long issue. She has spent about 38,000 hours.

    Coping with Death and Dying, If You Want to Know if you are Dying, Ask the Cleaning Lady and she has been a contributor to the series of Chicken Soup books, also an article for Parents Magazine on explaining terrorism to children..


    Chicken Soup books - a series of books to help people.

    OBJECTION - relevance - OVERRULED

    She is on the editorial board for one of the trauma jornals.


    OBJECTION to speaking objections - OVERRULED

    She has authored a half a dozen or more chapters.

    Compassionate Friends is a new international organization

    OBJECTION - non-responsive - SUSTAINED

    It is pretty typical to have a grief and trauma class in the normal college curriculum.

    Have Judges and pharmacies consulted with you?

    OBJECTION - relevance and bolstering - SUSTAINED

    She has given testimony one or two dozen times.

    Does everyone grieve the same way?


    Are you tendering the witness on grief and trauma? Yes.


    Peer reviewed publications? Half a dozen - on compassion fatigue, compassion energy, end of life issues for children, gay women with Aids. What are the peer reviewed journals - Southeast Research Journal - online journals. Also, Parents Magazine book which was peer reviewed by the editors of Barnes and Noble. Serious peer reviewed?

    OBJECTION to the use of "serious" - OVERRULED

    You know what I mean by peer reviewed? I do.

    She is also an editor...


    She requested her CV.

    Tell me the peer reviewed journals are in which you have published.

    Florida Department of Health...

    I just want the Journal please. Florida Department of Public Health.

    What is the name of the journal. She stated this is an on line journal which is peer reviewed.

    Pediatric Nursing Manual - she agreed this is a book. The group that peer reviews this is pediatric nurse practitioners

    What is the journal - Dealing with Death - it's a monogram

    What is the journal? Something to do with transplants.


    SIDEBAR #10 (4:10-4:12)

    You indicated you had testified as an expert (DCS - please sit down) approximately 12 times in both criminal and civil cases and 1 maritime case.

    On what issues did you testify? The amount of trauma suffered by the victims?

    OBJECTION - relevance - SUSTAINED

    Have you ever been qualified to testify or give an opinion on grief where you had never interviewed the person involved? Yes, one. It was both criminal and civil. It was a child sent to a boot camp who eventually died. The criminal case was first. The trauma was to the victim. She interviewed a sister and got reports.


    HHJBP: Witness will be accepted in the are of grief and trauma


    The Journal of Traumatic Events - she looks a lot at the instruments going to be used in other journals. She works with the IRB Board.

    Does everyone suffer grief the same way? No.

    What she finds is a plethora on how they handle terrible news. She works a lot of parents who have lost children.

    OBJECTION - relevance -

    SIDEBAR #11 (4:17-4:19)

    Hypothetical - 22 year old mother with a 3 year old daughter who she has had an amazing relationship with who loses that child - please describe the grief...

    OBJECTION - pursuant to Harrison v Bird....

    SIDEBAR # 12 (4:20-4:28)

    Asume a 22 year old mother of 2 1/2 year old child who has an amazing bond with the child and the child dies, what can you expect? Everybody does it differently. He has seen mothers who have lost children go face down in the bed and not be able to get up for months at a time. Conversely, she has seen mothers who clean out the room, give away the clothes and toys in the house and the child is not spoken of. In younger adults, they are reluctant grievers and have a tendancy to buy into the grief issue and tend to take risks.


    If the mother is in a car with the baby and there is an accident and the mother has been drinking, rather than stopping the drinking, they may continue to drink and do risky behavior.

    It is often unsettling for other people to see that.


    Add to hypothetical that the mother comes from a family that engages in denial..

    OBJECTION - facts not in evidence -

    SIDEBAR #13 (4:32-4:33)


    I'd like to add to the hypotheticaol. Assume the mother is tiny in stature and weight, assume she becomes pregnant and visible, assume the mother explains it a sedentary...


    Assume young girl's brother knew she was pregnant and told to stay out of it, assume the mother was a nurse and not taken for an OBGYN visit until she was 19, assume the mother was not told until the 11th hour and the family does not inquire as to the father is. Assume that the young girl's father is summoned to pick up a car to an area to which it has been moved and stated that there is a smell of decomp and does not contact police or contact her. Assume that a family member knows that the remains have been identified, still maintains that she might still be alive and that the brother is angry because he feels left out when the parents begin to go look for the child's remains and is not involved to the obvious pregnancy. Assume that the young girl's father tells LE that he was concerned about the daughter so he follows her and the E-pass indicates she was not followed...


    Given all those types of behaviours, can you tell me what that type of family behavior can have on the grief of the loss of a child?

    There are 2 groups of ways that people grieve - healthy folks who make the journey in a healthy way. Families where there is a conspiracy of silence - in those situations it is very likely that the response will often lead other people to...


    We can see that denial is a great helper. There may be no discussions or discussions that may be unusual or aberrant.

    Let's add that during the 31days the mother goes to the bar, goes shopping, gets a tattoo, rents movies, can you please describe the significance of that type of behavior.

    She stated it would be important to look at the behavior of what everyone did during those 31 days. This seems very like other young adults in that they are reluctant grievers. They will often say nothing has happened, demonstrate risky behavior, drink to much, drug too much, retail therapy, partying to the edge of hysteria. Young adults with limited exposure to the world and appropriate behaviors, she sees risk taking, repeating the things that happened to the person, looking like they are having a great time, spending money they don't have. It's called bereavement overload. Someone who has loss after loss decides they don't want anyone around them because everyone around them leaves.

    OBJECT - narrative - SUSTAINED

    How long can this type of behavior last? This type of behavior appearing normal, fine, no change?

    OBJECT - appearing normal is grief? - OVERRULED

    Normal and healthy distinction. Grief and trauma very different. He has seen patients who have kept original grief responses for years and years and years.

    Have you treated individuals who have lost a loved one who have appeared exactly the same to friends and family the day before and the day after the loss and continued to appear the same for years afterwards? Yes. She has seen people who lose a child, make arrangements, and then go to work the next day and the next day.

    Denial is a great tool as long as you can make yourself believe what you are saying.



    Is being very very happy consistent with grief? Yes. Very very mad? Yes.

    Is every behavior between happy and sad consistent with grief? Yes

    How about an interest in sex? There is research that shows that when you don't have words to make things better, sex makes things better. No interest in sex to over interest in sex is consistent with grief?


    So, any reaction to your sexual desire is consistent with grief?

    OBJECTION - no facts to support and exceeds scope - OVERRULED

    She has had patients who found sex helped with grief.

    Can you give me anything that is inconsistent with grief? If she can't say there are healthy grief responses and there are aberrant grief responses, then anything could happen when someone has a great grief. If it was something aberrant, that would be inconsistent with appropriate grief response.

    Can you, from a set of activities, that a person is grieving? She has a loss inventory that plots on a diagram and she may be able to tell a loss occurred.

    Did you attempt to apply that to this case? I don't know the facts of this case.

    First contact in this case -she got an email end of May or beginning of June.

    Are you aware the trial started 5/23? No, she didn't know there was a trial.

    She got an email asking if she ever did expert witnesses on grief.

    When she walked in the door today, she had been given no facts of this case.
    She did not know who ICA was, how old she was or.. She was living in England at the time.

    When she got the email, she responded and said there were other people in Tallahassee who also did this. She then looked up who this was. She did not do any research. She really thought it was a general inquiry.

    When she walked through the door today,


    She was being asked to come and talk about general research associated with grief and loss and how it might affect individuals and that this case seemed to be about a young girl who had lost a daughter.

    She has worked with women who murdered their children. She worked the Susan Smith trial. She testified about how people who have enormous amount of grief can get confused and think the people around them should not suffer as much as they do.


    SIDEBAR #14 (4:56-)

    Denial is one type of coping mechanism. Does denial mean literally lying? Well, lying to yourself. Folks who use denial a lot and are faced with a profound grief or loss, may very well develop magical thinking until they can get themselves believing something else happened.

    It would be unlikely for someone in denial that they are where their deceased loved on is?

    Hypothetically, the 22 year old mother's child dies, she doesn't tell anyone the child has died, immediately within half a day, goes to her boyfriends house, rents a movie, has sexual relations (while living with parents) she then sneaks into the house while they were gone, she then over the next 30 days tells different people different stories about where her child is. She tells her mother the child is with a fictional babysitter, tells her friends the child is with her mother, she then tells her mother she is in Tampa with the child. After a few days, she creates another fiction of a car accident in Tampa, and continues to tell people other than the mother that the baby is with the babysitter somewhere else. She then tells the mother that she is at Universal, then Jacksonville with a wealthy man who is a possible boyfriend.

    Would you agree that that type of conduct is not consistent with the type of denial that is seen in grieving mothers? He would agree this is a young woman in crisis who is unable to figure out how to make things better. She may call it grief because grief makes people do very unusual things. But as described, he would think this woman needs help. She called this more magical thinking - if I can keep all these balls in the air, maybe it won't be true what I think might have happened.

    Let's add that the mother deliberately killed the child..

    OBJECTION - no evidence of this

    SIDEBAR #15 (5:05-5:12)

  8. #8
    Join Date
    Oct 2008

    JA - w/Dr K...can compartmentalize if they commit a horrendous act of murder ..yes they can...what you are describing sounds more of a psychiatric condition...I would refer them out...
    one way to stay afloat they may create an enviornment to look @ their past life or what things are expected of them....people have amazing ability to rationalize and compartmentalize - you can convince yourself that something is best for everyone....even if it is not....you may not know...if you have been fortunate to grow up with positive.....magical thinking.....not delusions I mean magically thinking...had Mom who had a child died ....she called and said he had never been in the rain before alone....so we grabbed blankets and umbrellas and sat in the rain....she knew the child ws dead ....magical thinking....I have helped many mother get thru grief...agree that a mother who is bonded to her child is amazing! I don't think it ever breaks..no more questions
    witness excuse

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  9. #9
    Join Date
    Sep 2008
    Orange County

    Dr. Sally Karioth

    Part 2

    SIDEBAR #15 (5:05-5:12)




    Denial is a coping mechanism for things other than grief? Yes. It is common coping mechanism for guilt? It can be.


    OBJECTION - this witness has not been tendered in guilt - OVERRULED

    In fact, it is document in literature that many people use supression and denial as coping mechanism of guilt and shame? Yes. Those who feel they have not done the right thing or lived up to expectations. When that happens, those people put that event in a box and compartmentalize and they can go on as if it didn't happen?


    The only problem is, that often they didn't do the thing, but feel guilt and shame for another event.

    Secondary PTSD symptoms can be seen.

    Yes, you can compartmentalize an unspeakable act.


    That calls more under the purview of making a psychiatric diagnosis.

    If it doesn't involve grief, trauma and loss - it would be outside of her purview.

    Guilt can come from a truly horrible act or a relatively minor act? Yes.

    In an attempt to stay afloat, a person may create an environment that works for them because to look at their past life or think about how they have been raised, they may very well come up with an almost merry discussion.

    She agreed that people have a remarkable way to compartmentalize.

    If you are evolved and insightful enough to actually evaluate at that level, those people may very well know that it is not good for everyone.

    Magical thinking is not delusions. She gave an example of a woman whose child had died and called her when it was raining and said that he had never been in the rain before so she went there with a blanket an an umbrella and they sat outside. Intellectually the mother knew the child was dead.

    The bond between mother and child never breaks.

    Doctor is excused at 5:31

  10. #10
    Join Date
    Sep 2008
    Orange County
    Jury has left for the day

    Don't know if this qualifies as another sidebar - but, if so,

    SIDEBAR #16 (5:32-5:37)

    HHJBP: Your best estimate as to when the Defense will wrap their case up?

    JB: Tomorrow.

    The state needs to have some potential witnesses ready tomorrow afternoon
    to start rebuttal

    Charge conference Friday and tentatively, depending on when we wrap up Friday, and closings Saturday. That's just tentative. I know I promises to give you extra time to contemplate...

    If closing will not be Saturday, will they be Sunday or the 4th of July?

    I would have to consult with the Jury and I will leave it up to them if they want to come in here Sunday and hear closing arguments, they will. You know what that means, once they go out, they stay out til either they reach a verdict or not. If they listen Sunday, they will deliberate a short period of time and then brought back in Monday morning and sent out to deliberate. I wouldn't make any plans for Sunday or Monday.

    JA: View of fireworks is great up here.

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