S1: It's time for Midday Edition on KPBS. Today we're talking about navigating the challenges around reproductive health care. Here's to conversations that keep you informed , inspired , and make you think. A local woman says she was denied her prescription for misoprostol at a local pharmacy.
S2: Her lawyer had said that these national decisions and these other states laws kind of emboldened people to think that they know best about an individual patient's health care.
S1: Hear about the fallout from that and what your rights are. Then we'll take a look at how recent bans on women's reproductive health care are impacting men. That's ahead on Midday Edition. It's been just over two years since the Supreme Court overturned the historic Roe v Wade ruling , which guaranteed the constitutional right to abortion. California has since expanded its protections for reproductive health. But as more states adopt abortion bans and restrictions , we're seeing more uncertainty about what is allowed and what isn't. On today's show , we want to talk about the realities of reproductive health care in California and how the national landscape is spilling into the state. Last year , a San Diego woman , Angela Costales , was prescribed a pill to manage her miscarriage , but she says her usual pharmacy refused to fill it. Instead , she went to a different CVS where she finally got the medication she needed. Christine Wong covered the story. She's the health reporter for Calmatters. I spoke with her last week about Angela's experience. Here's that conversation. Give us some background.
S2: Um , she's in her 30s , and she and her husband had been trying to start their family for quite some time. They were very excited when she finally had a positive pregnancy test. Um , but unfortunately , about two months into her pregnancy , they went in for her first checkup and found that they had lost the pregnancy. And so , you know , in sort of in collaboration and under the advice of her doctor , they , you know , waited to see if anything would change. I think there was a little bit of possibility , she said , that she might have had twins , but they didn't know yet. Um , but eventually it became very clear that the pregnancy wasn't viable. And because her body wasn't , um , hadn't started the bleeding process already. Her doctor recommended that she go through with a procedure and also prescribed her medication to help manage sort of the after effects of miscarriage. Um , and that's where we kind of get into this issue of her , her local pharmacy at the CVS. Um , Angela says that they refused to give her the prescription. Mhm.
S3: Mhm.
S1:
S2: Basically , it causes the uterus to contract and sort of expel the contents.
S1:
S2: So some obstetricians that I talked to about this told me that there are essentially three options when you have an early pregnancy loss. Um , you can sort of wait and see if the body is able to successfully empty the uterus by itself. Sometimes it is , sometimes it isn't. You can also have a surgical intervention to empty the uterus , which is what Angela opted for. And then this pill option , um , is sometimes used in conjunction with those other two options , just to kind of finish the process and speed things along. Yeah.
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S2: They didn't make it super clear why they were refusing it. But she does allege that the pharmacist told her , you know , it doesn't matter if I have this pill , I'm not comfortable dispensing it to you. And then they also allege that the pharmacy , the employees of the pharmacy at the CVS were not helpful in getting her prescription transferred to another pharmacy or in finding another employee who would be able to fill.
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S2: I think we certainly hear of stories out of other states where this is probably a lot more common and where there are abortion bans , but essentially women who are told , like the doctors can't do anything for you , and if their body is not progressing with the miscarriage , they've had to wait until you know there there's risk of infection , there's risk of other complications. There's risks for I think there's also just a really big emotional toll that this takes upon somebody who's pregnant. Just knowing that the pregnancy is not moving forward , but they can't get any sort of medical help. Mhm.
S3: Mhm.
S1:
S2: However , individual employees California does have , um , sort of conscientious objector protections. And so individual employees , you know , doctors , nurses , pharmacists , people in the health care field are allowed to object to providing a certain type of care , most often that is related to abortion care. However , it is the institution. The health care institution , like the pharmacy , is legally required to then make additional accommodations for the patient to be able to get that care anyway. It just doesn't have to be that employee that.
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S2: And there was actually , um , a very recent Supreme Court ruling on a secondary abortion pill or pill that's used for both abortions and miscarriages , and where the Supreme Court justices said that federal law has provided very clear protections for conscientious objectors for a long time.
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S2: I mean , CVS itself , along with Walgreens , the other sort of major retail pharmacy , has gotten in trouble or come under scrutiny from federal regulators before over similar complaints from patients across the country. Um , the federal Department of Health and Human Services published basically an agreement between the companies. Um , after numerous although they don't define how many complaints , um , of medication denial from both women experiencing miscarriages and people with disabilities and CVS and Walgreens were supposed to come up with policies and procedures to prevent this sort of situation from happening. Yeah.
S3: Yeah. Well , so.
S1: The medication denial is clearly a violation of the law. And though there's not been a lawsuit filed in this case involving CVS. Last month , the National Women's Law Center did put out a public letter that issued several demands to CVS. What are they arguing here ? Yeah.
S2: So the National Women's Law Center is representing and helping Angela in this case. And when I spoke to them , you know , and spoke to Angela , it was really important for her that that she sort of spread a public message about women's rights and pregnant people's rights. And so that's why they didn't opt for a lawsuit immediately. They're kind of waiting to see whether CVS meets their demands. And what they want is for CVS to , um , improve and make public its policies and employee training , um , for these scenarios nationwide , not just at this particular CVS. It also wants CVS to post a notice saying that patients do have a right to obtain their medication , regardless of if an individual employee objects. And the last I've heard , there's they're still waiting for a response. Yeah.
S3: Yeah.
S1:
S2: They have not they have not closed that door. Okay.
S3: Okay.
S1: Well , you mentioned one Supreme Court ruling earlier regarding a secondary abortion pill. They also recently ruled on other cases related to abortion care , like the Emergency Medical Treatment and Active Labor Act. While they're not always applicable here in California , we're seeing the spillover effects of these rulings.
S2: And I think that some of that , you know , when I talk to people in the reproductive health field and advocates , I think a lot of that has to do with with fear and people sort of rushing before their options become illegal locally. Um , and in California , certainly when you talk to clinics that are sort of that border , other states that have , uh , banned or have severely limited abortion access. They do see an influx of people from those states. And so California is definitely seeing an uptick in its sort of just health care system of people seeking this kind of care. And then I think Angela Costello's experience also illustrates just sort of , you know , the attitude of people. I think her her lawyer had said that these national decisions and these other states laws kind of emboldened people to think that they know best about an individual patient's health care and what they should be getting when they actually have no idea what the situation is at hand. Yeah.
S3: Yeah.
S1:
S2: I think people are , by and large , quite shocked that something like this happened in California , and it's probably happening elsewhere in the state as well. And I've certainly also gotten responses from from other places and other people around the state saying that they've had very similar experiences.
S3: And for those.
S1:
S2: And I think that , you know , patrons also have a route to report things to the state as well , if they think that something is in violation of the law because patients have a right to get timely access to the medical care that they need. And that's something that you can report both to the state and to your insurer as well.
S1: I've been speaking with Kristin Hwang , health reporter with Calmatters. Kristin , thank you very much as always.
S2: Of course , it's great to be here.
S1: Coming up , how abortion bans in other states are impacting medical practice in California.
S4: The fear for providers and for patients extend well beyond state lines , even into California.
S1: Hear more when KPBS Midday Edition returns. Welcome back. You're listening to KPBS Midday Edition. I'm Jade Hindman. Roe v Wade was overturned just over two years ago , and today there continues to be uncertainty and fear surrounding reproductive rights. We just heard the story of Angela Costales , who was prescribed misoprostol to manage her miscarriage. Then her pharmacy denied her the medication. There are more stories like Angela's out there. And even with California reinforcing its own protections , laws in other states are still changing. Now we'll get a glimpse at what health care providers are seeing in the field , and we'll discuss how the national landscape could impact care in our state. I'm joined now by Theresa Chang. She's an assistant clinical professor of emergency medicine at UC San Francisco. She's also a civil liberties attorney. Doctor Chang , welcome. Hi.
S4: Hi. Thanks so much for having me.
S1: Glad to have you here. So you're both a doctor and a lawyer.
S4: We're seeing it certainly during this Scotus term. Um , given the overwhelming number of cases that directly impact how I practice on a day to day basis in my role as an emergency medicine doctor , But a lot of my work focuses around this intersection of health and human rights , because we have been seeing increasing social inequities impacting how many Americans can or cannot access quality healthcare.
S1: Given that , what kind of work do you do around reproductive health , both from a medical and a legal perspective. Yeah.
S4: Yeah. So , you know , my my advocacy and my research and work centers around how we can expand quality emergency health care to vulnerable populations. And , you know , I've never thought that in my years of practice , certainly that in the US , we would include pregnant people to this list. And in the last few years , we've really felt this tension come to a head , and it's just continuing to boil up and affect how people are accessing care.
S1: Well , listeners just heard the story about Angela Costello where CVS refused to fill her prescription. It speaks volumes and really speaks to people being emboldened to challenge abortion laws , even in California.
S4: Right. So there are broad abortion bans currently in effect in about 18 states , right ? So 14 states ban all abortions in four states ban abortions starting at some point during the first trimester of pregnancy. But this the fear for providers and for patients extend well beyond state lines , even into California. So as an academic , as a professor , I teach young medical students and trainees who are , you know , future physicians. And I hear the questions quite regularly from these young doctors in training , many of them born out of fear. Many of them are scared because they are afraid to leave practice from California , and oftentimes it's because they're fearful for their friends and families , from the state , from wherever they originated from , not in California. And so I know personally of many trainees who have thus afterwards have decided to stay in California because of broad abortion care access and gender affirming care access. And so I think a very important point to what you were asking is that , you know , these these laws stoke fear by creating so much uncertainty. And so physicians are scared to act. It doesn't help that these laws are constantly in flux , and it's very much limited in an environment where physicians typically don't have any understanding. Right ? You know , the judicial system , the the legal system , these are arenas that physicians who are experts in their own rights have no access or experience within , and so they are so scared of figuring out what they can or cannot do. And it changes all the time. Mhm.
S3: Mhm.
S1: Well I mean in this in the CVS case this was just a situation where , you know they didn't want to provide medication for miscarriage or abortion.
S4: Yeah I mean so people can definitely take advantage of this uncertainty as well. I think for the most part , I mean , at least the trainees that I've spoken with , providers are just so scared of being arrested and charged , losing their license , potential prison time. I mean , in Idaho , for instance , doctors have been facing several legal consequences because in in a large part , they have the affirmative defense , which means that. So let's say they are charged with abortion or providing abortion or even providing assistance to obtain abortion , that the provider would still face charges , still face a trial. And then during the trial , they have the burden to show that what they did was actually right. And so it's many layers of legal complexity and fear inducing red tape and processes. And so I think what we really need to emphasize , and what we haven't heard as much , though , are really the patient and provider day to day realities that are coming out of these states with abortion bans , right. The stories coming out of Idaho and other states that are , quite frankly , very catastrophic , right. People being forced to wait until the literal brink of death. Physicians forced to play some sort of a game of life or death chicken , you know , as their patients conditions deteriorate to death , patients losing kidneys , their abilities to have children , you know , they are saddled with a lifetime of medical complications because there's so much uncertainty around what is happening. And these Scotus decisions certainly don't help. Right.
S1: Right. And can you go ahead and draw the connection for those who don't know between not getting abortion care or just , you know , the medical care that one would need , say , in the event of a silent miscarriage or something. And these , you know , issues , these complications that you just spoke of.
S4: So abortion care , I cannot emphasize this enough. Abortion care is medical care. I think that this is this is like very much a very poignant. It's a very it's a very emotionally triggering point for me because as an emergency medicine physician , I work in a place that is quite literally the medical safety net for a very broken health care system right across the country. And we are the place of last resort for many of our patients. And I think there's a huge misunderstanding in the general public's eye on how critical these , you know , abortion medications and even just the ability to end pregnancies in certain situations. How critical it is to someone's to saving someone's life. You know , as someone who's privileged to understand both the legal and medical lenses and reading the decisions that have come out , um , in the years past where judges who have no expertise in medicine are making life or death decisions impacting hundreds and thousands of people is heartbreaking and , quite honestly , devastating to hear. You know , a judge misrepresenting what an ectopic pregnancy is , right , and saying that you can just transplant an ectopic pregnancy into the uterus , or saying that ivermectin is a treatment for Covid. I mean , these are just blatantly untrue , false things that I mean , we are seeing now judges and policy makers , politicians in the emergency department and in hospital settings that , quite frankly , they have no business being in these places.
S1: In your legal background , have you ever known politicians and judges to suddenly basically step in and try to step into the role of a doctor , to jump into a field that they just don't know much about.
S4: All the time. Yeah , all the time. We're seeing this all the time. That's why , you know , it's it's very it's very interesting I think , you know , and we can talk about the Scotus case overturning Chevron deference , which I think will exacerbate this exact problem. Right. So we are very purposefully and intentionally weakening the role of science and evidence in policymaking. And overall , the US has now encouraged a dissolution of expertise , medical expertise , public health expertise , environmental expertise. We've been seeing this trend for years. It was very much so expedited by the pandemic. You know , where judges , as I referenced earlier , were deciding Covid treatments instead of science and research. So , as I said , judges are now more than ever taking shape and taking a place in emergency rooms in the hospital where they have no expertise , it will hamstring policymaking in emergent situations in the future where we need to act quickly , you know , like climate change or another pandemic. But from a day to day perspective , this has already damaged many lives of Americans and providers across the country. Mhm.
S3: Mhm.
S1: Well , let's talk more about some of those Scotus rulings like when Idaho recently challenged the Emergency Medical Treatment and Active Labor Act , the court dismissed it. There's also the Chevron deference case that you mentioned.
S4: So an FDA versus Alliance for Hippocratic Medicine. The Supreme Court ruled that they didn't have the necessary legal standing to hear the case. So they weren't quite they weren't the right place to hear the case. Whereas in Idaho and versus us , um , the antler case , um , Scotus returned to the case back to the Ninth Circuit. And so both rulings essentially have the same practical effect. Right. So essentially they delayed the inevitable , leaving people around the country in limbo. So even now we hear of stories even in California. Right. So where , you know , where we just heard a medically indicated and necessary drug was withheld in Texas , a court ruling has left people in Texas without access to the same emergency care that was discussed in Idaho. And so , practically , because Scotus did not rule on the merits of these cases , patients and providers across the country are left confused and unsure of what to do next.
S1: And as we mentioned , California really expanded protections for abortion since the Dobbs decision.
S4: Um , and more recently , end of last year , Governor Newsom signed SB 345 into law , which essentially was a shield law that provides legal protections for health care practitioners in California who are providing or dispensing medications or other services for abortions , contraception , anything , anything related to pregnancy and childbirth. Um , and we also have the Unruh Act , which is our foundational civil rights statute that prohibits discrimination on basis of pregnancy or medical conditions related to pregnancy and childbirth. Um , but even still , we have national policies and laws that are in place that should be protecting patients across the country. It's just that now we're seeing so much of it being challenged in courts , right. So I'm taller. Even the Affordable Care Act has regulations in place that prohibit recipients of of , you know , federal financial assistance from discriminating on the basis of pregnancy and pregnancy related conditions.
S1:
S4: And since the Dobbs decision , more people than ever are traveling out of state , particularly if they're in one of those 18 states that ban abortion care , um , to obtain abortion care. And generally speaking , access in states that do provide abortion care has also improved , so it's more likely to be covered by Medicaid or insurance. It's more accessible through telehealth. And there are new shield laws like the one in California. There , there's a shield law in Maine and New York and Vermont. And so all of these really create an environment where people have more access to abortion care should they want or require it. What we really don't know is whether or not you know , if it's the case of fewer Americans wanting to have fewer children , or was it just a matter of cost and safety and accessibility all along ? Right. We really don't know at this point because the landscape of abortion access has changed so dramatically. But we can surmise , right. So there are worsening economic stressors with inflation. You know , the geopolitical climate has changed dramatically with multiple wars across the globe. And we've seen this shift to in what people are reassessing as their personal priorities. In other countries , like in Japan , where , you know , the fertility rate has declined significantly.
S1: I mean , I want to I want to move on and talk about the presidential debate , because in the most recent one , President Biden promised to restore Roe v Wade if re-elected. There's confusion over that , though , with the November election just around the corner.
S5:
S4: Regards to the future of reproductive health care and policy , it's in the current context of how we are already facing a crisis of care for pregnant people , right ? So our maternal outcomes and mortality rates have more than doubled in the last two decades. And , you know , the maternal mortality rate in America is the highest of any wealthy country , and it's three times deadlier for black women than white women. And so we can't forget what the current context is like for , for Americans , because this dramatically impacts how we hope the future to change and where we can hope to go. I am hopeful that these recent court decisions galvanize instead of demoralize the general public. I mean , we know where the next battles were take place. As I mentioned before , some of these Scotus decisions have simply kicked the can down the road , so to speak , and delayed an inevitable future battle. But we really can't afford political ennui with the upcoming presidential and local elections. And so I really hope that these Scotus decisions inspire pregnant people and reproductive care providers to become politically involved , to vote , to organize. You know , because at the end of the day , policy makers , politicians , judges , they do not know what the day to day realities for Americans are like. And we are the ones bearing witness to the abortion ban fallout on the ground.
S1: Earlier you you mentioned how not only these Scotus rulings , but just the condition of our world now sort of makes people reprioritize having children. How do you see this Dobbs decision impacting the American psyche around having children. Particularly for black women.
S6: Yeah , I mean , I think.
S4: The stakes are higher than ever , right ? Given the economic climate , the social , political climate , you know , what the criminal legal system looks like in , you know , taking into account maternal mortality rates. So not only has abortion , the numbers of people seeking abortions increased , but also people seeking sterilization. And I think that speaks to the overall fear of not just around what our reproductive rights and access are , but looking at a larger geopolitical socio economic trajectory of where America and really the world is headed to , right. I think there's quite a lot of fear among younger generations in looking ahead , not in just our country , but in other countries as well. Of , you know , do they have a prosperous future ahead of them ? Are they able to make truly independent , thoughtful decisions about their own bodies , about where they can choose to live , where they can afford to choose to live , and their children can afford to choose to live ? And so all of these issues are coming to a head and influencing how we are making decisions about our next steps.
S1: This is definitely something we will be talking about for a long time. I've been speaking with Doctor Theresa Chang. She's an assistant clinical professor of emergency medicine at UC San Francisco. She's also a civil liberties attorney. Doctor Chang , thank you so much for joining us today.
S4: Thank you so much for having me.
S1: Coming up. A recent study shows vasectomies are up , how views on family planning are changing.
S7:
S1: Welcome back to KPBS Midday Edition. I'm your host , Jade Hindman. Today on the show , we're talking about the Post-roe world and how the 2022 Dobbs decision reshaped reproductive health care and access to it. But it's also changing how some people approach family planning and whether or not to have more children or children at all. A recent UC San Diego study shows a 25% spike in men receiving vasectomies since that Dobbs decision , and what's interesting is that more patients are either childless or single. It's not just happening in San Diego. Urologist across the country have published similar studies. Of course , there's a whole psychology behind choosing to get a vasectomy , and norms around men's reproductive health care could be changing post-roe too. I'm joined now by Doctor Daniel Singla. He's a psychologist and director of the center for Men's Excellence here in San Diego. Dan , it's good to have you back on midday.
S7: Yeah , thanks for having me on , Jane.
S1: Well , okay , so I want to jump into it. This study out of UCSD. It looks at men , specifically childless younger men considering vasectomies. You actually work in reproductive psychology.
S8:
S7: And one of the facets of this that I think is important is to factor in a generational approach. Say so I'm 50 , say , for folks of my generation , there was much more of a tendency to kind of follow the developmental line of , you go to school , you get a job , yet you get married , you have kids and so forth , and you work your way into the golden years of grand parenthood. And plenty of folks still go that route. But I've absolutely experienced that. You know , call it folks under 30 these days are stopping to reevaluate that and and want to be more mindful about how do I want to move ahead and is having children part of the plan for me ? And some of what I've seen going into that question includes , given the state of the world today. Is it a selfish move for me to to have a child and or are there aspects of ways that I want to contribute honestly to the environment ? It's not the most common way of thinking about it , but if you really want to contribute to the environment , a very green move is you don't have a child , which is a typical way that folks will will oftentimes frame that question. But also living here in Southern California , the rise of the so-called dinks. Dual income. No kids and folks who are choosing to remain childless for a variety of reasons , not the least of which is financial , is certainly on the rise.
S1: Well , you know , people often think of abortion rights and reproductive justice as a women's issue , but that's not the case.
S7: And sure , I mean we could talk about there are , you know , micro surgical vasectomy reversal options that are available. But generally speaking , the the men that I'm talking with are not thinking of it as something that , that I might reverse down the line. And again , there are a variety of facets that go into the thinking. Usually when they're working with me , they're wanting to talk through , well , what are some of the implications if I were to do this , what what would this mean about my life ? You know how attractive I might be to other people that want to date me. Like if you go on apps like whatever what whatever the , you know , the cluster of apps is that are for online dating , there's the whole childless like not looking for children. And I've heard very clearly from folks , if you're under typical reproductive age , say that that that 30 and under 20 to 30 period , that that significantly limits their ability to get more dates. That's certainly one facet of it. Um , another of it has to do with more of a sense of I don't want to put my my reproductive choices necessarily on somebody else. I want to take responsibility for my own. Um , and some of these men will say pretty straight out , well , yeah , I don't want to have kids , but I don't want to use condoms all the time , because once I'm in a relationship and we're committed and we've gotten tested , then I would like to be able to safely and comfortably have sex without a condom , but without the anxiety that we might be headed towards having a kid or , you know , the IUD didn't work or maybe forgot to take , um , the pill or what have you. Hmm.
S3: Hmm.
S1:
S7: It has been much less the case that say , you know , a 20 year old who recognizes , you know what ? I'm just I'm not going the dad route. That doesn't that doesn't appeal to me , and it never will. And so the patients of mine that have gone that route have definitely experienced the need to explain themselves in ways that , you know , a father of 2.3 kids doesn't have to.
S1: And also , earlier you mentioned the rise in Dinks , which is an acronym for Dual Income No Kid Families.
S7: And the reasons why they they choose not to have kids. My experience has been that that can actually be a selling point or a point of connection on the front end when they're both of the same mind , when when both members and when we're talking about , you know , having kids in their a variety of different way , you know , you have dad couples that might choose to be Dinks and they don't want to adopt a kid or do surrogacy or whatever. So there are a lot of different constellations of relationships that then have a variety of different reasons why they choose to remain childless. There's. There's the green angle , there's the financial angle. And for many of them , you'll you'll hear guys say some version of look , my relationship with my partner is going really well , and I am really scared about the prospect of having a baby and and sharing ? My partner and I don't want to. I don't want to rock the boat so much. Mhm.
S3: Mhm.
S1: Well , in general , what mental health challenges can be linked to reproductive health for men ? Certainly.
S7: Uh , depression , anxiety , post-traumatic stress , so-called fatherlessness or what I think of as father hunger. So for a lot of these men that may have had absent or neglectful or even abusive fathers , they can in many cases internalize a sense that , well , the model I had was terrible. So that would make me a terrible father. And certainly if they have a trauma history that's engendered depression , anxiety , maybe insecure attachment or avoidant attachment styles , then the prospect of having that safety and the connection the that is very helpful when you're going to have children would be sort of a foreign concept to them and really make them think twice about even getting into close , committed relationships , let alone going the step of introducing a child or children.
S3: Yeah , well.
S1:
S7: It's to recognize that reproductive rights and preferences does not have one specific gender. The implications are different for people of different genders. However , that being said , it's funny. People ask a lot about , you know , or these aspects of men and fathers , are they evolutionarily derived ? Are they hardwired ? And and the answer most of the time is , yeah , it's some of that. But it's also a whole lot of training. But the fact is as as a species , we are evolved to procreate. Right ? We're not only evolved to do that , but that's absolutely deeply in there for us. And then therefore folks get really entrenched in their positions. I have to have children. I don't want to I can't , you know , it's devastating to me because I want to , but I can. So the advice to be supportive is don't start with a foregone conclusion that it has to happen or it can't happen. And then when you factor in the implications of changes in the law and the safety of deciding to move ahead or not lead with appreciative inquiry , right ? My my point is not don't have an opinion because have opinions about what you want to do reproductively. But start with hey let me get you from your perspective first before I start pushing mine on you and you tend to find more area of overlap.
S3: All right.
S1: I've been speaking with Doctor Daniel Beasley , psychologist and director of the center for Men's Excellence here in San Diego. Doctor Stingley , thank you so much.
S7: Thanks so much for having me on.
S1: We asked you all how the overturning of Roe v Wade two years ago affects you today. Some of you expressed you are against abortion and that the Dobbs decision has impacted you , while others said it felt dehumanizing. And some of you are concerned about what the decision means for bodily autonomy. Cindy Nelson from North Park worries about her family's access to reproductive health care.
S9: As a mother , I also fear for my daughters and two female grandchildren's reproductive rights.
S1: Leave a message or you can email us at midday at pbs.org. That's our show. If you missed anything , you can download KPBS Midday Edition on all podcast apps. Don't forget to watch KPBS Evening Edition tonight at five for in-depth reporting on San Diego issues. I'm Jade Hindman. Thanks for listening.
