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Nick Soapdish
Apr 27, 2008


https://twitter.com/chillhartman/status/1080509085844422660

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Nick Soapdish
Apr 27, 2008


https://twitter.com/DefenseBaron/status/1080542000217243650?s=19

Ha

Nick Soapdish
Apr 27, 2008


CRUSTY MINGE posted:

Play a lot of euchre as a kid too?

Side note: I wish more people knew/played euchre as it is streets ahead of spades for a card game to play

Nick Soapdish
Apr 27, 2008


Nostalgia4Infinity posted:

As I was finishing my degree, I had a Marine officer recruiter try to neg me into commissioning.

Did you tell him you've hosed more Marines than he had?

Nick Soapdish
Apr 27, 2008


Vasudus posted:

Determining force shaping needs at this point is basically sorcery. You couldn't pay me enough to work in it.

When I was over in Afghanistan sat in on the briefings for how to reach 8.4k force limit via TDY and other accounting wizardry. Then the election happened and none of it mattered. Cannot imagine how much that Army HR Major who's job it was to do that hated her life.

Nick Soapdish
Apr 27, 2008


https://twitter.com/arlenparsa/status/1080941652418674691?s=19

The only thing those four DHS guys could sing is the 18 words

Nick Soapdish
Apr 27, 2008


EBB posted:

I'll loving die before I give up on this country.

:same:

Much like that t-shirt "I am conflicted about my service", it took friends and family a bit to understand how I can be super critical about the country while still loving it

Nick Soapdish
Apr 27, 2008


We talked about this in my first semester of my MSW program, thank Reagan for shutting down mental health hospitals and then not having properly funded community mental health centers

https://www.cnn.com/2019/01/03/health/er-mental-health-patients-eprise/index.html

quote:

(CNN)A "huge and largely unreported problem" is happening in ERs across the nation, one expert says.
"The extent to which ERs are now flooded with patients with mental illness is unprecedented," said Dr. David R. Rubinow, chairman of the Department of Psychiatry at the School of Medicine at University of North Carolina, Chapel Hill.
And this overflow is "having a really destructive effect on health care delivery in general," he added. "There are ERs now that are repeatedly on diversion -- which means they can't see any more patients -- because there are so many patients with mental illness or behavioral problems that are populating the ER."
A 2017 government report found that the overall number of emergency department visits increased nearly 15% from 2006 to 2014, yet ER visits by patients with mental or substance use disorders increased about 44% in the same period.
This supports Rubinow's belief that ERs are a major provider of mental health care for a "very, very sizable percentage of patients" these days.
Dr. Catherine A. Marco, from her vantage point as an emergency physician professor at Wright State University in Dayton, Ohio, said, "we commonly see depression, anxiety, substance-related conditions and suicidal behavior."
Firsthand experience suggests to Dr. Mark Pearlmutter, an emergency physician in Boston, that the most common mental health problems in emergency rooms are dual diagnoses, such as "substance abuse and depression, for example." He's also seen cases combining acute psychosis, bipolar disorder, suicidality, aggression and (mal) adjustment disorders.
"We're the safety net," he said.
On the opposite coast, Dr. Renee Y. Hsia, an attending physician at Zuckerberg San Francisco General Hospital and Trauma Center, also finds that the most prevalent psychiatric diagnoses among adults in the ER are alcohol-related disorders, anxiety disorders and suicide or intentional self-harm. Based on her own research of "avoidable" ER visits, she found that two of the top three discharge diagnoses were alcohol abuse and depressive disorder.
"There are very real spillover effects from this phenomenon, which affects not only our ability to care for these patients with psychiatric needs but all patients seeking care in the ER," she said.
In addition to longer wait times for everyone, "spillover effects" include dissatisfied mental health patients and an assumption of potential violence in the ER, according to these doctors.
Sharon Marshall, 43, says her multiple experiences in the ER as a psychiatric patient were "very upsetting."
"They took your phone away, and you couldn't communicate with anybody else in the world," said Marshall, who has been diagnosed with schizophrenia. Being held in the ER for "hours and hours and hours," during which time "you couldn't get your questions answered," means "you have very little control over your circumstances" and "you're at their mercy," she said. "Anybody would be upset."
She believes that her family should have requested outpatient services with her psychiatrist instead of authorizing an emergency psychiatric evaluation that was not voluntary on her part. It was not an arrest; it was a psychiatric hold, she explains.
"If you just play the game and you're quiet and don't pose any problems to them, they'll let you go," she said. "If you questioned being held or resisted ... you'd likely go to a psychiatric facility. The process was so very arbitrary."
Later, a car wreck gave Marshall greater perspective on her experiences as a mental health patient. Arriving in the ER with an arm injury "was like a dream," said Marshall, who works as a certified peer specialist for the Georgia Mental Health Consumer Network, a nonprofit advocacy and education organization. "I was definitely taken seriously when I was in there for a car accident."
David Morris, a psychologist at UT Southwestern's O'Donnell Brain Institute in Dallas, said, "the ER is not a great place if you're a mental health patient; the cardiac patients get put in front of you, and you could end up being there for a really long time." Worse still, a mental health patient could be feeling extreme distress the whole time they wait.
"It's a real ineffective and inefficient place for them to get care," Morris said. "People who need to be seen for other maladies that might be life-threatening, it slows them down as well."
Why is it happening?
Hsia points to "a shortage of psychiatric inpatient beds" as a "key contributing factor" to overcrowded ERs across the nation.
"Between 1970 and 2006, state and county psychiatric inpatient facilities in the country cut capacity from about 400,000 beds to fewer than 50,000," Hsia said.
A 2012 Wake Forest University Health Sciences study also showed that psychiatric patients who are waiting in ERs remain there 3.2 times longer than nonpsychiatric patients. These longer stays mean that for every psychiatric patient idling in the ER, there are two other patients not being helped, according to the study authors. Patient "boarding" -- holding of a patient in an ER bed while waiting for an inpatient mental health bed -- occurs frequently, the study indicates.
"We've also seen shortages in outpatient mental health facilities and substance abuse treatment programs," Hsia said. Many psychiatric patients who would otherwise receive long-term care are going "relatively untreated" and so end up in ERs, she says. "Patients may come to the emergency department when they cannot find help elsewhere."
One such patient is Karen Taylor, 46, diagnosed with post-traumatic stress disorder and depression. Taylor, who has had suicidal thoughts, says she visited ERs in her home state of Georgia multiple times because she "didn't want [the symptoms] to get so bad that I would actually go so far as to try to attempt suicide."
She was insured and routinely seeing a therapist, and Taylor's various trips to the ER were made out of necessity, she says, because her therapist does not offer after-hours services.
Driven by thoughts of self-harm, she had originally taken herself to a psychiatric hospital, but it would not admit her without the ER referral, she explained in a pained voice.
Emergency departments do not welcome patients like her, says Taylor, who described the ER as "a bad place for a mental health patient."
"They strip away your dignity, your clothes, everything, and the doctor comes in and treats you like dirt because you're taking up a bed," Taylor said. "I was told several times that I was just physically wasting space and I wasn't really sick like the medical patients were.
"They put me in a room where I stayed for hours on end. I've stayed in the ER for up to three days prior to going to a psychiatric hospital."
UT Southwestern's Morris co-wrote a study that examined psychiatric readmissions at one of the largest public hospitals in the nation, Parkland Hospital in Dallas, with more than 1 million patient visits annually. Nearly three-quarters of mental health patients there were readmitted for the same problem, the study found.
"Most of the patients simply were not able to follow up with their care," said Morris, explaining that the reason for this might be patient confusion about how to access follow-up care or a problem with transportation.
"Organizing the community resources that are out there, they cannot do it themselves," Morris said. "They need the help of a more structured environment. But the more structured environments that used to be available are no longer available."
As Morris sees it, if someone had diabetes and ended up in the ER, it would be clear that something's wrong with their ability to handle their condition and care. "That's the issue," he said. "Why are these folks having to do that? Do they need additional management and additional help to maintain the continuity of care?"
Marco, a spokeswoman for the American College of Emergency Physicians, says psychiatrists, psychologists or other licensed therapists are often backlogged; this is why so many mental health patients show up in ERs.
Pearlmutter, the Boston emergency physician, agrees. The reason mental health patients end up in ERs, he says, is due to a lack of "resources within the community and the closure many years ago (20, 30 years ago) of state facilities and, frankly, the fact that mental health is underfunded." Overcrowded outpatient facilities and services mean "patients might call and not be able to be seen for two or three weeks," he added.
"And a lot of this transcends insurance," Pearlmutter said.
In certain regions, patients may call and ask to see a counselor, and the response is that they're not taking new patients, or they don't take insurance and only take cash. "And if they do take insurance, the patient's got to wait," he said. "If the patient's feeling like they're in a crisis, what options do they have? The only place to go is to the ER."
The ER may be the only place to go even for patients receiving routine care.
Dan Stephens, whose diagnosis is major depressive disorder with psychotic features, sees a therapist once a week and a doctor every three months. Still, on two occasions, suicidal thoughts drove him to the ER.
"I had zero wait time at the desk. They took me straight back to the mental health section" of the ER, says Stephens, a 39-year-old warehouse worker. Delays occurred as he waited for an evaluation, he says. "The first time, it took me four hours to speak to somebody, the second time about six or seven. They had given me something to calm down, so I had relaxed a little bit instead of being uptight and ready to do harm to myself."
Stephens believes that the ER was necessary given his condition. He accepts longer wait times because, as he understands it, multiple types of doctors are able to care for a patient with a broken bone, but only specialists can treat someone experiencing mental health problems.
Still, one aspect of his two ER experiences was "very humiliating," Stephens said: "The worst part is being escorted to the back by a police officer."
Leaving an ER can also be problematic for mental health patients, according to Stephens: "Usually, you leave in a cop car in handcuffs." A 2016 national survey found that handcuffs were one of the "available tools" used by security personnel in 96% of the hospitals surveyed.
Though he understands why security escorts and restraints might be necessary for some patients, he believes that these measures weren't needed in his case, and he resents their use.
"If I come in of my own volition and say 'Look, I need help,' they should just walk me back there without having to get a cop or security guard," says Stephens, who lives in a small town in Georgia. "People look at you funny, that's what happens."
When he was treated like a criminal, the whole process made him feel worse about himself, he says.
Pearlmutter suggests that doctors may automatically call in help to restrain a patient experiencing a mental health crisis. With overcrowding and more mental health patients, "there's an increase in violence in the emergency department -- absolutely," he said.
One solution to ERs crowded with mental health patients is to do a better job at integrating mental health into medical practice, Pearlmutter says. It's helpful that family medicine and primary care physicians are increasingly providing mental health care, he says, but "we still have a long way to go."
"Payors, by the way, play a role in this," Pearlmutter said. Health care is funded in a manner that promotes a "siloing" of mental health versus physical health. Insured patients, for example, have certain benefits provided for their physical health and separate benefits offered for mental health.
Marco said, "we need more resources, both inpatient and outpatient, for mental health and substance-related disorders. We should advocate for increased funding for treatment of these conditions."
Rubinow says he first wrote about ERs crowded with mental health patients years ago.
"At that time, it was a tsunami on the way," he said. "That tsunami has hit."

Nick Soapdish
Apr 27, 2008


SquirrelyPSU posted:

I've been going through my memories for the last couple of hours, and I remember some white bread when maybe we had a hamburger bar and some rolls, and those were almost always within a week of a port visit. Carbs we're almost exclusively rice and lovely noodles.

There is not a single instance that I can recall of the smell of fresh baked bread on the mess decks.

Thinking back to my hazy memories of big deck amphib days in early 10s, they did have a bakery space on the mess decks. Guess the carrier CSs were too busy running Starbucks or whatever other fancy stuff to bake such exotic things as bread or cookies.

Edit: MCs coming around to do a fluff piece about deployment :chiefsay: CS2, go do inventory on the reefer
https://twitter.com/flynavy/status/1081668026372546560

Nick Soapdish fucked around with this message at 03:28 on Jan 6, 2019

Nick Soapdish
Apr 27, 2008


It is real great that everyone on the right has these great tips and suggestions for what those on the left should do, just a bunch of really helpful people out there

Nick Soapdish
Apr 27, 2008


https://www.bloomberg.com/news/articles/2019-01-07/irs-will-pay-refunds-during-government-shutdown-official-says-jqmrs9w6

quote:

The Internal Revenue Service will issue refunds to taxpayers even if the U.S. government shutdown extends into the filing season, a decision that may reduce political pressure on Congress and President Donald Trump to reach a deal to re-open the federal government.
“Tax refunds will go out,” the acting director of the White House Office of Management and Budget, Russell Vought, told reporters at a briefing on Monday.

Wonder what bullshit reasoning they'll gin up to authorize that

Nick Soapdish
Apr 27, 2008


FrozenVent posted:

REMEMBER THE MAINE ALAMO SAILOR!

FTFY

Nick Soapdish
Apr 27, 2008


EBB posted:

Motherfucker how do you get gout in jail unless you're cleaning out the commissary all the time?

Haven't you seen those news stories that totally tell both sides that prisoners are living high on the hog eating steak. Steak, I tells ya.

Nick Soapdish
Apr 27, 2008


https://twitter.com/DanLamothe/status/1083100523925065728

Some helpful advice to the couple of Coasties we have here

Nick Soapdish
Apr 27, 2008


As always, the comment section is just real real dumb

https://www.usni.org/magazines/proceedings/2019-01/senseless-government-shutdown-harming-coast-guard-families

quote:

Today, with the government shutdown in its third week, it is beyond troubling that Coast Guard men and women are being unnecessarily subjected to financial hardship while enduring the operational, mission-related circumstances that are accepted as part of their compact with their country.

These are the Americans who flew over the rooftops of New Orleans during Hurricane Katrina, saving thousands from flooded homes. These are the men and women who were the first ashore in Haiti after the earthquake, rendering aid, treating wounds, and delivering children in unsanitary, primitive conditions. These are the heroes who mobilized to respond to the worst marine environmental disaster in the nation’s history. These are the selfless service men and women who provided medical support to other Department of Homeland Security agencies to screen incoming airline passengers during the Ebola crisis and today are supporting the Department on the southwest border. These are the people who stand search-and-rescue watch and patrol our coastal waters and the Arabian Gulf. And these are the Americans who have accompanied the remains of my friends and colleagues to their final resting place in Arlington Cemetery, rendering honors and exercising the manners of our profession.

I am the son of a Coast Guard Chief Petty Officer and brother of a Coast Guard spouse. Our family’s life has revolved around the service my parents revered. A part of the “Greatest Generation”, they emerged from the depression and World War II to raise a family that moved frequently and fearlessly. They were tough and resilient.

I will turn 70 shortly and have had 47 addresses in my life. And while my parents and later my wife and I treated each new transfer as an adventure, there were tests and challenges. In the early 1950s my father got a no-notice transfer from Mobile, Alabama to Ketchikan, Alaska after it became clear our family was not a good fit in the segregated South. My father left immediately but it took our family months to catch up. We arrived in Ketchikan from a nearby island that had an airport, making the final leg by Coast Guard small boat with our luggage. Despite these and other challenges my mother and father believed until the day they died that the Coast Guard was the best thing that ever happened to our family.

Even with the arduous move to Ketchikan, they believed Alaska was the best place we ever lived. Our family was close even though my father deployed extensively on a large buoy tender as far as the Bering Sea. It wasn’t always easy. Before modern pay systems, direct deposit and allotments, service members were often paid in cash while at sea where they had no access to banks or the ability to send money to dependents. Families had to carefully plan around deployments.

In those times my mother had her priorities—food and rent came first and you dealt with other needs as you could. That said, the single most searing memory of my childhood, even more than the experience in Mobile, was watching my mother cope with my father’s unanticipated extended absence and little cash. My brother, sister, and I had been given banks for Christmas by family friends. They came locked and could only be opened at the bank where our saved change was then deposited to our savings accounts. One day during my Dad’s extended absence, we found our mother in the kitchen crying with a hammer and screw driver trying to open the banks, so we would have milk money for our lunches we took to school. Not even that experience dampened her love for my father and the Coast Guard, but it is an experience I have never forgotten.

In the years that followed we faced other financial challenges. We had transfers during difficult housing markets, forcing decisions on whether to endure a long family separation, risk a short sale, or managing a rental across a continent. In each case we persevered. Pay systems gradually evolved from cash payments to checks, then to allotment checks to dependents, then to direct deposit and modern ATM and automated payment options. We now have on-line self-service for most pay actions. However, the starting point is getting paid.

Coast Guard men and women have always served a cause greater than themselves based on the service’s core values of honor, respect, and devotion to duty. Honor is the compact you make with yourself and how you will demonstrate your character by your behavior. Respect is the compact you make with those around you—your family, community, fellow service members, and citizens. Devotion to duty is the compact you make with your country when you agree to become a member of the Coast Guard’s “Long Blue Line.” You take an oath to support and defend the Constitution of the United States and subject yourself to the Uniform Code of Military Justice—a higher standard than that demanded of your fellow citizens, but willingly accepted.

I am often asked what was the hardest thing I ever had to do as Commandant of the Coast Guard. No answer comes a close second. It is handing the American flag to the survivor of one of our heroes or telling a family we were unable to save their loved one. Hard tasks, for sure, but ones we accept with gratitude that we are able to honor our shipmates and those we serve. That is our compact with ourselves, those around us, and our country.

The responsibility of the government to our citizens and those who serve the nation is equally clear and unambiguous. It begins with “We the people” and sets clear guidance … “establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare.” “We the people” means Americans, all Americans. It does not distinguish between political affiliation, race, gender, sexual orientation, income level, geographic home, employer, or any other means by which citizens are often categorized or minoritized in this country.

I never believed it would be necessary to remind the leaders of all branches of government of their constitutional responsibilities, but it appears they have subordinated the “general welfare” of their fellow citizens to parochial interests. While this political theater ensues, there are junior Coast Guard petty officers, with families, who are already compensated at levels below the national poverty level, who will not be paid during this government shutdown. There is no reasonable answer as to why these families have to endure this hardship in the absence of a national emergency. These leaders should ponder how they would tell a spouse at Arlington that his or her survivor benefits might be at risk—again, for no reason. I’m glad my mother and father are not alive to see it.

Admiral Allen gave an interview on this topic on 9 January 2019 on National Public Radio.

Admiral Allen served as the 23rd Commandant of the U.S. Coast Guard.

Nick Soapdish
Apr 27, 2008


Radical 90s Wizard posted:

Log is older than Wall :colbert:

Did someone say log!?

https://www.youtube.com/watch?v=2C7mNr5WMjA

Nick Soapdish
Apr 27, 2008


https://twitter.com/AOC/status/1083579511889973250

gently caress Joe Lieberman forever

Nick Soapdish
Apr 27, 2008


bird food bathtub posted:

Really funny how for two years nothing happened on the wall with a unified government, then the week the opposition party takes over suddenly we have a government shut down and a potential state of emergency.

Yup, really funny how that works.

Reeeeeeeeal funny.

Also now is the time to slash entitlements

Nick Soapdish
Apr 27, 2008


LingcodKilla posted:

My office fud is now saying federal contractors are bullshit.

Dude, federal contracts pay your paycheck.

*crickets*

Keep your government hands off my Medicare!!!!!!!!!!!!!!

Nick Soapdish
Apr 27, 2008



That was last night and got this response

https://twitter.com/ddale8/status/1084463782359957504

Nick Soapdish
Apr 27, 2008


Our big special boy is looking out at the snow and making great policy announcements

https://twitter.com/RealPressSecBot/status/1084584890681577472

https://twitter.com/RealPressSecBot/status/1084587403367481345

Nick Soapdish
Apr 27, 2008


facialimpediment posted:

Ok I've studied a lot about opinion polling, methodology, and the general scientific nature of polling.

I don't think I've ever seen anything like this poll result.

https://twitter.com/ThePlumLineGS/status/1084892554469015552?s=19

I don't see it as that surprising. If you went into that speech against the wall, your favorite President (me) and his good brains didn't make any argument for flipping. Likewise, if you wanted a wall it was a prowall rambling.

Nick Soapdish
Apr 27, 2008


https://twitter.com/amyfiscus/status/1085027414026215424

I thought talking to allied partners was tough post-election, I cannot imagine how it will be going forward.

Nick Soapdish
Apr 27, 2008


https://twitter.com/ComdtUSCG/status/1085246326944788482

Perfectly normal country

Nick Soapdish
Apr 27, 2008


psydude posted:

Really sucks for all of the boat guys, because it was one of the least Army jobs you could have. Warrants commanded all of the vessels and there were a lot of neat TDY assignments and deployments you could pick up as a reservist.

Was just reading an article in this month's Proceedings that was talking about Navy surface training and how the Army's training was aligned with international standards so their mariners left with credentials from their service

Nick Soapdish
Apr 27, 2008


A lot of people here don't know their red recce, gonna need y'all to stay after class for study hall

Nick Soapdish
Apr 27, 2008


Terrifying Effigies posted:

In the event that the partial shutdown remains the status quo, the biggest thing down the road that might force Trump and/or McConnell's hand is tax season - for as much as the GOP likes to bitch about taxes, a lot of their voters are going to be pissed when they don't get their tax rebate checks in the mail.

The only reason why Trump and McConnell are getting away with keeping the government closed so far is because the so-called 'important' bits - defense and entitlements - were fully funded earlier in the year. Even if we manage to get everything back open this year, I don't know why the Dems would allow piecemeal funding bills next year since Trump will just pick the ones he likes and hold the rest hostage for more poo poo.

Reports are that Treasury are ready to call back IRS employees as essential to be unpaid and start on tax returns

Nick Soapdish
Apr 27, 2008


psydude posted:

I don't think he can postpone her trip because Congress has its own appropriations, right?

When have such things as rules, laws, or separation of power mattered recently

Nick Soapdish
Apr 27, 2008


https://www.youtube.com/watch?v=dkXigRoaSK8

Stealing from CSPAM, but man if Dead Flag Blues doesn't fit everything perfectly

Nick Soapdish
Apr 27, 2008


Defenestrategy posted:

Id say that maybe college will fix the kid like it does with a lot of people, but seeing that from his mom makes me know the kid will just join a college republican club or something and do weirdo protests where he wears diapers or some such.

I often wonder with those TPUSA chuds and the diaper thing how no one stepped a few feet back and looked at it from a third party. "Hmm, yes, you really owned the libs by dressing up as babies. Capital idea!"

Nick Soapdish
Apr 27, 2008


facialimpediment posted:

These high-level committee assignments are Pelosi's payback to AOC for her early support. The insurrectionists got poo poo posts.

AOC knows social; AOC knows politics

Nick Soapdish
Apr 27, 2008


Richard Bong posted:

Vote dem in the elections but be vicious as gently caress in the primaries. Then after the elections are done with go back to rooting out the centrist turds.

:same:

Nick Soapdish
Apr 27, 2008


https://twitter.com/PeterAlexander/status/1088550753185222657

:yooge: Your favorite president (me) has just signed an executive order. The Democrat Party has been outlawed. Bombing of Cryin' Chuck and Nancy Pelosi, or Nancy as I call her, begins in ten minutes. God bless America!

Nick Soapdish
Apr 27, 2008


Ragaman posted:

Excellent, this frees up forces for the South American theater :agesilaus:

:hmmyes:

But, yeah, this is a good thing even if it is from this administration

Nick Soapdish
Apr 27, 2008


Columbia is a region in the Pacific Northwest
Colombia is a country in South America

I am pedantic on this as one of the junior intel Os we had would publically ridicule her Marine equivalent who could not spell the country name correctly when we were floating in the Caribbean. It was fun watching JO on JO

Nick Soapdish
Apr 27, 2008



Rude but not incorrect

Nick Soapdish
Apr 27, 2008


Nostalgia4Infinity posted:

Husbear is in Florida for work this week and is sending me snaps of the beach.

If it wasn't for my husband taking a job back here in the midwest, I never had plans to move back. Weather like tomorrow confirms why I should have stayed away. At least I get to bundle up professionally and go help individuals dealing with mental disorders tomorrow.

Nick Soapdish
Apr 27, 2008


And what did they get for rolling the hard six and succeeding, one of the richest fuckers in the world calling them a pedo for not entertaining his child coffin idea.

Nick Soapdish
Apr 27, 2008


mods changed my name posted:

well it's a good thing we have a govt committed to nato right now

:yooge: Angela Merkel was very mean to me, very mean. Probably the meanest a German leader has ever been to an American. She just doesn't want to pay her fair share into NATO, so so sad. What's the point of NATO anyway? What American jobs has it created? Angela, or Angie as I call her, have you seen my election map, won so many beautiful counties across the United States. Did you know my great-grandfather was from her, left this shithole for America and I don't blame him. MAGA!!!!

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Nick Soapdish
Apr 27, 2008


mods changed my name posted:

i loving hate you right now

Let no brain be unbroken

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