Direct damages are the money that plaintiffs will not get or will pay out as a consequence of their injuries. There are two classes of direct economic losses: those that have already matured as of the time of trial and those that will mature in the future. Although there may be disagreement over whether a past loss was proximately caused by the injury, the amount of these matured losses may be determined with reasonable certainty. Future losses are much more difficult to analyze. In addition to factors unique to each type of future loss, all financial prognostications are subject to the vagaries of the economy. Interest rates rise and fall, wages fluctuate, and, most important, future expenses such as medical care are difficult to estimate. Future losses also depend on projections of the plaintiff’s future behavior. Every plaintiff’s attorney will argue that the client would have had a meteoric rise in his or her chosen field. Every defense lawyer will argue that the plaintiff was on an inexorable slide to financial ruin. The truth usually lies between these extremes, giving the jury considerable latitude in arriving at an award. In medical malpractice litigation, direct damages usually consist of lost earnings, medical expenses, and rehabilitation and accommodation expenses.