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	<description>Disasters, Terrorism, Preparedness, Emerging Infections, Response, Mitigation</description>
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	<itunes:summary>Disasters, Terrorism, Preparedness, Emerging Infections, Response, Mitigation</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
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	<itunes:subtitle>Disasters, Terrorism, Preparedness, Emerging Infections, Response, Mitigation</itunes:subtitle>
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		<item>
		<title>Emergency Medicine: An Allegorical Fable</title>
		<link>http://projectdisaster.com/?p=13825</link>
		<comments>http://projectdisaster.com/?p=13825#comments</comments>
		<pubDate>Thu, 14 May 2009 14:54:34 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
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		<category><![CDATA[R U Kidding? / Strange news / bizarre]]></category>
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		<description><![CDATA[Once upon a time, there existed this beautiful, rainbow-festooned land called EM.  On the highways and byways of the magical, mystical land called EM, there traversed a sleek, silver coach powered by six Arabian stallions.  It was the The King’s Coach….The Royal Coach.   It was a wonder to behold especially in the moonlight as the [...]]]></description>
			<content:encoded><![CDATA[<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Once upon a time, there existed this beautiful, rainbow-festooned land called EM.<span style="mso-spacerun: yes;">  </span>On the highways and byways of the magical, mystical land called EM, there traversed a sleek, silver coach powered by six Arabian stallions.<span style="mso-spacerun: yes;">  </span>It was the The King’s Coach….The Royal Coach.<span style="mso-spacerun: yes;">  </span><span style="mso-spacerun: yes;"> </span>It was a wonder to behold especially in the moonlight as the lunar rays danced on the backs of the great steeds and made the coach’s ornaments glisten.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>The natives of EM loved the coach of their beloved King.<span style="mso-spacerun: yes;">  </span>They felt the coach was their own.<span style="mso-spacerun: yes;">  </span>It was so special to them that they bestowed on it an appellation:<span style="mso-spacerun: yes;">  </span>E.R.<span style="mso-spacerun: yes;">  </span>And E.R. was driven by only one person, a knight, the King’s favorite:<span style="mso-spacerun: yes;">  </span>Sir E.R. Doc.<span style="mso-spacerun: yes;">  </span>The driving skills of E.R. Doc were considerable.<span style="mso-spacerun: yes;">  </span>They were astounding.<span style="mso-spacerun: yes;">  </span>They were mesmerizing.<span style="mso-spacerun: yes;">  </span>They were accomplished with such aplomb.<span style="mso-spacerun: yes;">  </span>But it required years of training and driving before Sir E.R. Doc acquired that special armor of sapiential authority.<span style="mso-spacerun: yes;">  </span>Now, after all these years, whenever the good knight drove E.R., it looked so easy to the casual observer that it seemed anyone could drive E.R. with the same fluidity and dexterity as E.R. Doc.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>One day in this magical, mystical land called EM, members of the Court were directed by the King to visit a region in the kingdom called “Hopital L’icu.”<span style="mso-spacerun: yes;">  </span>They were Nurse-Man, The Minister of Ad, and The Sultan of Con.<span style="mso-spacerun: yes;">  </span>To most of The Court and to all of the natives, these three were in league with power, money, and the Devil.<span style="mso-spacerun: yes;">  </span>They were The Unholy Three.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“How will we get there, Your Highness?” asked Nurse-Man.<span style="mso-spacerun: yes;">  </span>The Nurse-Man knew no fear of God, King, nor man.<span style="mso-spacerun: yes;">  </span>However, The Sultan of Con and the Minister of Ad said nothing preferring to keep their eyes down and their noses scraping the floors of the Palace, yet always prepared to advance themselves in the favors of the King.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>As an answer to Nurse-Man’s query, His Highness waved his royal wand and from behind the alabaster screen came Sir E.R. Doc.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“We have asked Our beloved friend to take you in Our Coach.<span style="mso-spacerun: yes;">  </span>He will get you all there with alacrity and in safety.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The Unholy Three were not happy with this.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Your servant, m’Lord,” said Sir E.R. Doc as he gave the King a wink and escorted his new companions to the Coach.<span style="mso-spacerun: yes;">  </span>The King concealed a smile for he and his Knight were more than King and knight.<span style="mso-spacerun: yes;">  </span>They were true friends.<span style="mso-spacerun: yes;">  </span>Sir E.R. Doc, more than once, had salvaged His Majesty’s Honor and Arse on their many adventures and escapades.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Into the courtyard, the King’s good knight led the Unholy Three towards the coach.<span style="mso-spacerun: yes;">  </span>The Sultan of Con was still rubbing the dust of the palace floor from his nostrils, but when he saw the Coach and horses this close for the first time, he marveled at its beauty and obvious power.<span style="mso-spacerun: yes;">  </span>So, too, did the Minister of Ad.<span style="mso-spacerun: yes;">  </span>Despite their ignorance about most matters, many were the times they whispered in the Royal Auricular Appendage about adding more wheels to the Coach or re-painting it a gaudier color or exchanging the Arabian stallions for mustangs because they were cheaper.<span style="mso-spacerun: yes;">  </span>Religiously, The King brushed them from His Ear like a horse’s tail with flies and usually directed them to other activities that were more suited to their limited talents.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Nurse-Man, however, was a different matter.<span style="mso-spacerun: yes;">  </span>She was intimately connected to the Coach.<span style="mso-spacerun: yes;">  </span>Her sole purpose in life was to ensure that the Coach was always ready, well-oiled, and immaculate and the horses sleek, strong, and well-fed.<span style="mso-spacerun: yes;">  </span>While Sir E.R. Doc appreciated her talents and her devotion to the tasks that made his job easier, there never existed a collegial camaraderie between the two.<span style="mso-spacerun: yes;">  </span>Perhaps it was the mustache and codpiece Nurse-Man was always sporting in order to make herself seem more important. </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>In any case, once Sir Knight had the Unholy Three, comfortably and hospitably settled into the plush Royal-red cushions of the Coach, he patted the rumps of his steeds and with a flick of the reins, started driving down the road to Hopital L’icu. <span style="mso-spacerun: yes;"> </span>He always went down this same road because it was straight and wide and didn’t have the potholes and ravines common to alternate routes.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>As the Coach flew down the road, Nurse-Man, the Minister of Ad, and the Sultan of Con looked out their windows and began chattering to each other in conspiratorial tones.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Suddenly, the Unholy Three reached through the little window at the front of the Coach and grabbed Sir E.R. Doc by the arse, for he was seated higher than they were and therefore that was all they could grab on to.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Swiftly recovering, for that was another of the knight’s many gifts, he asked, “Is there something you wish of me, my colleagues?”<span style="mso-spacerun: yes;">  </span>There was barely-concealed sarcasm in his question, for he knew Evil when he saw it, but he always believed God and King and his Armor of Sapiential Authority would protect him.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“You’re taking the wrong road,” piped up the Sultan of Con.<span style="mso-spacerun: yes;">  </span>The volume of his voice was loud. Louder than anyone ever heard.<span style="mso-spacerun: yes;">  </span>That was chiefly because his head was up His Majesty’s arse most of the time.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The Minister of Ad directed, “Take the Noblesse Oblige Highway.<span style="mso-spacerun: yes;">  </span>I just increased the peons’ taxes to pay for it.<span style="mso-spacerun: yes;">  </span>It’s newer and better and we will make better time.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Sir E.R. Doc demurred.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Thank you for your wise input, but I must respectfully disagree.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>However, the Unholy Three in the back seat became, not only insistent, but demeaning.<span style="mso-spacerun: yes;">  </span>After all, the King was not there and the Knight’s back was to them &#8211;<span style="mso-spacerun: yes;">  </span>an easy target.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Don’t argue, good sir,” said Nurse-Man. “This is really my coach.<span style="mso-spacerun: yes;">  </span>I wash it.<span style="mso-spacerun: yes;">  </span>I care for it.<span style="mso-spacerun: yes;">  </span>I rub down the horses.<span style="mso-spacerun: yes;">  </span>You’re just being permitted to drive it.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“But…” </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Have no fear, Sir Knight,” chimed in the Sultan of Con.<span style="mso-spacerun: yes;">  </span>“In case you get into trouble, I am right here and I will rescue you.<span style="mso-spacerun: yes;">  </span>After all, I’m really the expert in all matters related to EM.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The Minister of Ad, even more forcibly than before, announced, “We will do whatever our majority decides, sir.<span style="mso-spacerun: yes;">  </span>I am the King in his place and I give the orders but only if it’s during certain hours and specific days of the week and when His Royal Highness isn’t around.<span style="mso-spacerun: yes;">  </span>We must always consider profit margins first.<span style="mso-spacerun: yes;">  </span>So, stress me no further.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Nevertheless, Sir E.R. Doc, with his Armor of Sapiential Authority, typically impervious to intimidation, sarcasm and snide remarks, diplomatically tried to explain his posture.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>“Good sirs, oh, excuse me…and Madame…, your mustache confused me,” began the knight, “your suggestion is excellent, but the route is so new that well-designed maps showing hazards and pitfalls have not been created yet.”<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>With that, Sir E.R. Doc turned around in his seat, closed and locked the little window near his arse and continued on his pre-determined route.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The Unholy Three were apoplectic in anger and hatred.<span style="mso-spacerun: yes;">  </span>The years of this knight’s insolence must come to an end.<span style="mso-spacerun: yes;">  </span>So, using the Nurse-Man’s head as a battering ram, they crashed in the little window by the knight’s arse and clawed and scratched and pulled at the Sir E.R. Doc.<span style="mso-spacerun: yes;">  </span>He, in turn, could do little.<span style="mso-spacerun: yes;">  </span>It required all his energies just to handle the stallions and keep the Coach on the road.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>With all this violent activity and the Nurse-Man’s head, the hole in the Coach widened enough that<span style="mso-spacerun: yes;">  </span>the Unholy Three were able to grab the reins, pull the preoccupied knight from the driver’s seat, and pummel him into unconsciousness.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The Minister of Ad tried to stop the Coach, but the stallions, sensing unsure hands at the reins, grew panicky and galloped faster than before.<span style="mso-spacerun: yes;">  </span>Meanwhile, Nurse-Man and the Sultan of Con tied-up and gagged the knight and shoved his limp body under the seat.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Here,” cried out the Minister of Ad, “You take these reins.<span style="mso-spacerun: yes;">  </span>The bloody horses are out of control.”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“No fear, I pray you,” admonished the Sultan of Con and he calmly took over the reins and negotiated himself through the hole and into the driver’s seat.<span style="mso-spacerun: yes;">  </span>The steeds galloped on relentlessly and he directed them onto the alternate highway.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>To the two left in the back of the Coach, life was now proceeding swimmingly.<span style="mso-spacerun: yes;">  </span>They finally had complete control of E.R.<span style="mso-spacerun: yes;">  </span>However, while they were celebrating with occasional kicks to the knight’s groin, they were oblivious to events outside of their Coach.<span style="mso-spacerun: yes;">  </span>Not so with the Sultan of Con.<span style="mso-spacerun: yes;">  </span>As he struggled to maintain some sort of control over the stallions, day yielded to dusk and the weather turned dank and dangerous.<span style="mso-spacerun: yes;">  </span>Rain began pelting E.R. and the road became slippery and the stallions’ hoofs grew unsure.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>“Uhhh…I could use a little assistance up here, if you please,” shouted the Sultan of Con.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The tuneful notes that were in the throats of Nurse-Man and the Minister of Ad quickly metamorphosed into a vise that mercilessly strangled air intake.<span style="mso-spacerun: yes;">  </span>As they competed with each other to control the reins, their eyes were witness to a cratered road with neither illumination nor guardrails.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The more The Unholy Three’s hands struggled with the reins, the harder it was to control E.R.<span style="mso-spacerun: yes;">  </span>Time after time, the Royal Coach edged out past the berm sending gravel down into the deep ravine that skirted the highway.<span style="mso-spacerun: yes;">  </span>Beads of perspiration dotted the brow of<span style="mso-spacerun: yes;">  </span>Nurse-Man.<span style="mso-spacerun: yes;">  </span>Malodorous smells exuded from the pantaloons of the Minister of Ad.<span style="mso-spacerun: yes;">  </span>Excuses slithered out of the two-faced mouth of the Sultan of Con:<span style="mso-spacerun: yes;">  </span>“Don’t look to me.<span style="mso-spacerun: yes;">  </span>I only consult…Don’t look to me.<span style="mso-spacerun: yes;">  </span>This is your job….Don’t look to me.<span style="mso-spacerun: yes;">  </span>I have other responsibilities…”</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>Then it happened.<span style="mso-spacerun: yes;">  </span>It was on the last stretch of road, by the longest curve, next to the deepest canyon, Lawsooth Canyon.<span style="mso-spacerun: yes;">  </span>Just as the Unholy Three caught sight of Hopital L’icu, the rain and the darkness took final control of E.R. and the sleek, silver Royal Coach with its six Arabian stallions plunged into the canyon.<span style="mso-spacerun: yes;">  </span>As for<span style="mso-spacerun: yes;">  </span>Nurse-Man, the Sultan of Con, and the Minister of Ad, they were able to jump clear just as E.R. took its final voyage with <span style="mso-spacerun: yes;"> </span>Sir E.R. Doc manacled inside its bowels.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>At the funeral, all the princes and gentry in the land of EM came to pay their respects to the much-loved Sir E.R. Doc.<span style="mso-spacerun: yes;">  </span>That also included Nurse-Man, the Minister of Ad, and Sultan of Con who expressed their collective grief with glycerin on their cheeks to simulate tears and flayed themselves with whips adorned with soft rubber spikes.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The King never attended the funeral.<span style="mso-spacerun: yes;">  </span>He was inconsolable to have lost his dear friend.<span style="mso-spacerun: yes;">  </span>He convened<span style="mso-spacerun: yes;">  </span>“A Royal Inquiry Into The Events That Resulted In The Death of Sir E.R. Doc and the Destruction of E.R.” <span style="mso-spacerun: yes;">  </span>Due to the conspiratorial machinations of the Unholy Three, the Royal Inquiry determined that the blame laid squarely on the head of Sir E.R. Doc.<span style="mso-spacerun: yes;">  </span>He chose the wrong road.<span style="mso-spacerun: yes;">  </span>He whipped the horses onward.<span style="mso-spacerun: yes;">  </span>He lost control of the Coach.<span style="mso-spacerun: yes;">  </span>And it was he who was at the reins when the accident happened.<span style="mso-spacerun: yes;">  </span>Of course, there were no signs of ties on his wrists or feet or of the Nurse-Man’s petticoat that was stuffed down his throat.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>With that official decision,<span style="mso-spacerun: yes;">  </span>the gentry, angered by the loss of their beloved E.R., <span style="mso-spacerun: yes;"> </span>rose up with pitchforks and scythes, exhumed the decaying corpse of Sir E.R. Doc from his marble mausoleum and placed his head on the largest pike the land of EM ever saw.<span style="mso-spacerun: yes;">  </span></strong></span></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>The King, realizing how the events were beyond his control, sighed, smiled, and gazed with greater appreciation upon the talents of Nurse-Man….as long as she shaved off her mustache.</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong></strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"><strong>And they all lived happily ever after&#8230;&#8230;</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"><span style="font-size: small; font-family: Times New Roman;"><strong> </strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"><span style="font-size: small; font-family: Times New Roman;"><strong>The End</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"> </p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"><span style="font-size: small; font-family: Times New Roman;"><strong>Copyright:  PP Rega, 4/26/09</strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"><span style="font-size: small; font-family: Times New Roman;"><strong></strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: left;"><span style="font-size: small; font-family: Times New Roman;"><strong></strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;" align="center"><span style="font-size: small; font-family: Times New Roman;"><strong></strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt; text-align: left;"><span style="font-size: small; font-family: Times New Roman;"><strong></strong></span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"> </span></p>
<p class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-size: small; font-family: Times New Roman;"> </span></p>
]]></content:encoded>
			<wfw:commentRss>http://projectdisaster.com/?feed=rss2&amp;p=13825</wfw:commentRss>
		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/allegory5-14-09.mp3" length="223" type="audio/mpeg" />
			<itunes:subtitle>Once upon a time, there existed this beautiful, rainbow-festooned land called EM.  On the highways and byways of the magical, mystical land called EM, there traversed a sleek, silver coach powered by six Arabian stallions</itunes:subtitle>
		<itunes:summary>Once upon a time, there existed this beautiful, rainbow-festooned land called EM.  On the highways and byways of the magical, mystical land called EM, there traversed a sleek, silver coach powered by six Arabian stallions.  It was the The King’s Coach….The Royal Coach.   It was a wonder to behold especially in the moonlight as the lunar rays danced on the backs of the great steeds and made the coach’s ornaments glisten.  
 
The natives of EM loved the coach of their beloved King.  They felt the coach was their own.  It was so special to them that they bestowed on it an appellation:  E.R.  And E.R. was driven by only one person, a knight, the King’s favorite:  Sir E.R. Doc.  The driving skills of E.R. Doc were considerable.  They were astounding.  They were mesmerizing.  They were accomplished with such aplomb.  But it required years of training and driving before Sir E.R. Doc acquired that special armor of sapiential authority.  Now, after all these years, whenever the good knight drove E.R., it looked so easy to the casual observer that it seemed anyone could drive E.R. with the same fluidity and dexterity as E.R. Doc.  
 
One day in this magical, mystical land called EM, members of the Court were directed by the King to visit a region in the kingdom called “Hopital L’icu.”  They were Nurse-Man, The Minister of Ad, and The Sultan of Con.  To most of The Court and to all of the natives, these three were in league with power, money, and the Devil.  They were The Unholy Three.
 
“How will we get there, Your Highness?” asked Nurse-Man.  The Nurse-Man knew no fear of God, King, nor man.  However, The Sultan of Con and the Minister of Ad said nothing preferring to keep their eyes down and their noses scraping the floors of the Palace, yet always prepared to advance themselves in the favors of the King.
 
As an answer to Nurse-Man’s query, His Highness waved his royal wand and from behind the alabaster screen came Sir E.R. Doc.
 
“We have asked Our beloved friend to take you in Our Coach.  He will get you all there with alacrity and in safety.”
 
The Unholy Three were not happy with this.
 
“Your servant, m’Lord,” said Sir E.R. Doc as he gave the King a wink and escorted his new companions to the Coach.  The King concealed a smile for he and his Knight were more than King and knight.  They were true friends.  Sir E.R. Doc, more than once, had salvaged His Majesty’s Honor and Arse on their many adventures and escapades.
 
Into the courtyard, the King’s good knight led the Unholy Three towards the coach.  The Sultan of Con was still rubbing the dust of the palace floor from his nostrils, but when he saw the Coach and horses this close for the first time, he marveled at its beauty and obvious power.  So, too, did the Minister of Ad.  Despite their ignorance about most matters, many were the times they whispered in the Royal Auricular Appendage about adding more wheels to the Coach or re-painting it a gaudier color or exchanging the Arabian stallions for mustangs because they were cheaper.  Religiously, The King brushed them from His Ear like a horse’s tail with flies and usually directed them to other activities that were more suited to their limited talents.
 
Nurse-Man, however, was a different matter.  She was intimately connected to the Coach.  Her sole purpose in life was to ensure that the Coach was always ready, well-oiled, and immaculate and the horses sleek, strong, and well-fed.  While Sir E.R. Doc appreciated her talents and her devotion to the tasks that made his job easier, there never existed a collegial camaraderie between the two.  Perhaps it was the mustache and codpiece Nurse-Man was always sporting in order to make herself seem more important. 
 
In any case, once Sir Knight had the Unholy Three, comfortably and hospitably settled into the plush Royal-red cushions of the Coach, he patted the rumps of his steeds and wit</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
	</item>
		<item>
		<title>Tornadoes wreak havoc in middle America</title>
		<link>http://projectdisaster.com/?p=14233</link>
		<comments>http://projectdisaster.com/?p=14233#comments</comments>
		<pubDate>Thu, 14 May 2009 12:27:37 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Tornadoes]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=14233</guid>
		<description><![CDATA[ A tornado brewing in Kirksville, MO yesterday.

]]></description>
			<content:encoded><![CDATA[<p><img class="alignnone" title="1" src="http://a.abcnews.com/images/US/abc_tornado_090513_mn.jpg" alt="" width="320" height="240" /> <strong>A tornado brewing in Kirksville, MO yesterday.</strong></p>
<p><strong></strong></p>
]]></content:encoded>
			<wfw:commentRss>http://projectdisaster.com/?feed=rss2&amp;p=14233</wfw:commentRss>
		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/tornadoes5-14-09.mp3" length="932075" type="audio/mpeg" />
			<itunes:subtitle> A tornado brewing in Kirksville, MO yesterday. - </itunes:subtitle>
		<itunes:summary> A tornado brewing in Kirksville, MO yesterday.

</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>58</itunes:duration>
	</item>
		<item>
		<title>WHO:  4/24 swine flu press release</title>
		<link>http://projectdisaster.com/?p=13794</link>
		<comments>http://projectdisaster.com/?p=13794#comments</comments>
		<pubDate>Sat, 25 Apr 2009 15:52:38 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Infectious Disease, Outbreak & Pandemic]]></category>
		<category><![CDATA[Influenza]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13794</guid>
		<description><![CDATA[This is from WHO, 4/24/09:  &#8220;&#8230;Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern&#8230;.&#8221;
WHO Link:  http://www.who.int/csr/don/2009_04_24/en/print.html
Influenza-like illness in the United States and Mexico
24 April 2009 &#8212; The United States Government [...]]]></description>
			<content:encoded><![CDATA[<p>This is from WHO, 4/24/09:  <strong>&#8220;&#8230;Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern&#8230;.&#8221;</strong></p>
<p>WHO Link:  <a href="http://www.who.int/csr/don/2009_04_24/en/print.html" onclick="javascript:urchinTracker ('/outbound/article/www.who.int');">http://www.who.int/csr/don/2009_04_24/en/print.html</a></p>
<div class="sthd1">Influenza-like illness in the United States and Mexico</div>
<p>24 April 2009 &#8212; <strong>The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported. </strong></p>
<p><strong>The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.</strong></p>
<p><strong>Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.</strong></p>
<p><strong>The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico. </strong></p>
<p><strong>Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.</strong></p>
<p><strong>The Swine Influenza A/H1N1 viruses characterized in this outbreak have not been previously detected in pigs or humans. The viruses so far characterized have been sensitive to oseltamivir, but resistant to both amantadine and rimantadine.</strong></p>
<p><strong>The World Health Organization has been in constant contact with the health authorities in the United States, Mexico and Canada in order to better understand the risk which these ILI events pose. WHO (and PAHO) is sending missions of experts to Mexico to work with health authorities there. It is helping its Member States to increase field epidemiology activities, laboratory diagnosis and clinical management. Moreover, WHO&#8217;s partners in the Global Alert and Response Network have been alerted and are ready to assist as requested by the Member States.</strong></p>
<p><strong>WHO acknowledges the United States and Mexico for their proactive reporting and their collaboration with WHO and will continue to work with Member States to further characterize the outbreak.</strong></p>
<p><strong></strong></p>
<p> </p>
<h3 class="sectionHead3">For more information, please contact:</h3>
<p> </p>
<p>Thomas Abraham<br />
Communications in English<br />
Mobile: +41 79 516 3136<br />
E-mail: <a href="mailto:abrahamt@who.int">abrahamt@who.int</a></p>
<p>Fadela Chaib<br />
Communications in English and French<br />
Mobile: +41 79 475 5556<br />
E-mail: <a href="mailto:chaibf@who.int">chaibf@who.int</a></p>
<p>Sari Setiogi<br />
Communications in English and Bahasa<br />
Mobile: +41 79 701 9467<br />
E-mail: <a href="mailto:setiogis@who.int">setiogis@who.int</a></p>
<p>Gregory Hartl<br />
Communications in English, French, German and Spanish<br />
Mobile: +41 79 203 6715<br />
E-mail: <a href="mailto:hartlg@who.int">hartlg@who.int</a></p>
<p>Aphaluck Bhatiasevi<br />
Communications in English, Thai and Hindi<br />
Mobile: +41 79 484 2979<br />
E-mail: <a href="mailto:bhatiaseviap@who.int@who.int">bhatiaseviap@who.int</a></p>
<p><!-- include footer--><!-- include ftr--></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/flu4-25-09.mp3" length="2979657" type="audio/mpeg" />
			<itunes:subtitle>This is from WHO, 4/24/09:  &quot;...Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high ...</itunes:subtitle>
		<itunes:summary>This is from WHO, 4/24/09:  &quot;...Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern....&quot;

WHO Link:  http://www.who.int/csr/don/2009_04_24/en/print.html
Influenza-like illness in the United States and Mexico
24 April 2009 -- The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported. 

The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.

Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.

The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico. 

Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.

The Swine Influenza A/H1N1 viruses characterized in this outbreak have not been previously detected in pigs or humans. The viruses so far characterized have been sensitive to oseltamivir, but resistant to both amantadine and rimantadine.

The World Health Organization has been in constant contact with the health authorities in the United States, Mexico and Canada in order to better understand the risk which these ILI events pose. WHO (and PAHO) is sending missions of experts to Mexico to work with health authorities there. It is helping its Member States to increase field epidemiology activities, laboratory diagnosis and clinical management. Moreover, WHO&#039;s partners in the Global Alert and Response Network have been alerted and are ready to assist as requested by the Member States.

WHO acknowledges the United States and Mexico for their proactive reporting and their collaboration with WHO and will continue to work with Member States to further characterize the outbreak.



 
For more information, please contact:
 

Thomas Abraham
Communications in English
Mobile: +41 79 516 3136
E-mail: abrahamt@who.int

Fadela Chaib
Communications in English and French
Mobile: +41 79 475 5556
E-mail: chaibf@who.int

Sari Setiogi
Communications in English and Bahasa
Mobile: +41 79 701 9467
E-mail: setiogis@who.int

Gregory Hartl
Communications in English, French, German and Spanish
Mobile: +41 79 203 6715
E-mail: hartlg@who.int

Aphaluck Bhatiasevi
Communications in English, Thai and Hindi
Mobile: +41 79 484 2979
E-mail: bhatiaseviap@who.int

</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>3:06</itunes:duration>
	</item>
		<item>
		<title>On this day in terror history&#8230;.</title>
		<link>http://projectdisaster.com/?p=13760</link>
		<comments>http://projectdisaster.com/?p=13760#comments</comments>
		<pubDate>Fri, 24 Apr 2009 14:47:32 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Disasters - Education, Lessons Learned & History]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13760</guid>
		<description><![CDATA[London, 4/24/93:  City of London bombed. (http://news.bbc.co.uk/onthisday/hi/dates/stories/april/24/newsid_2523000/2523345.stm)

]]></description>
			<content:encoded><![CDATA[<p>London, 4/24/93:  City of London bombed. (<a href="http://news.bbc.co.uk/onthisday/hi/dates/stories/april/24/newsid_2523000/2523345.stm" onclick="javascript:urchinTracker ('/outbound/article/news.bbc.co.uk');">http://news.bbc.co.uk/onthisday/hi/dates/stories/april/24/newsid_2523000/2523345.stm</a>)</p>
<p><img class="alignnone" title="1" src="http://news.bbc.co.uk/media/images/38523000/jpg/_38523649_bishopsgate238.jpg" alt="" width="238" height="178" /></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/bomb4-24-09.mp3" length="1427356" type="audio/mpeg" />
			<itunes:subtitle>London, 4/24/93:  City of London bombed. (http://news.bbc.co.uk/onthisday/hi/dates/stories/april/24/newsid_2523000/2523345.stm) - </itunes:subtitle>
		<itunes:summary>London, 4/24/93:  City of London bombed. (http://news.bbc.co.uk/onthisday/hi/dates/stories/april/24/newsid_2523000/2523345.stm)

</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>1:29</itunes:duration>
	</item>
		<item>
		<title>MMWR:  Malaria Surveillance &#8212; United States, 2007</title>
		<link>http://projectdisaster.com/?p=13659</link>
		<comments>http://projectdisaster.com/?p=13659#comments</comments>
		<pubDate>Sat, 18 Apr 2009 18:25:05 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[CDC]]></category>
		<category><![CDATA[Infectious Disease, Outbreak & Pandemic]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13659</guid>
		<description><![CDATA[Title:  Malaria Surveillance &#8212; United States, 2007
Link to the complete MMWR article:  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5802a1.htm?s_cid=ss5802a1_e
Source:  MMWR April 17, 2009 / 58(SS02);1-16
 

]]></description>
			<content:encoded><![CDATA[<p><strong>Title:  <span style="color: #0b3d91;">Malaria Surveillance &#8212; United States, 2007</span></strong></p>
<p>Link to the complete MMWR article:  <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5802a1.htm?s_cid=ss5802a1_e" onclick="javascript:urchinTracker ('/outbound/article/www.cdc.gov');">http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5802a1.htm?s_cid=ss5802a1_e</a></p>
<p><strong>Source:  MMWR <span style="font-size: x-small; color: #333333; font-family: Arial;">April 17, 2009 / 58(SS02);1-16</span></strong></p>
<p> </p>
<p><img class="alignnone" title="1" src="http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/s802a1f1.gif" alt="" width="641" height="421" /></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/malaria4-18-09.mp3" length="7110347" type="audio/mpeg" />
			<itunes:subtitle>Title:  Malaria Surveillance --- United States, 2007 - Link to the complete MMWR article:  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5802a1.htm?s_cid=ss5802a1_e - Source:  MMWR April 17, 2009 / 58(SS02);1-16 -   - </itunes:subtitle>
		<itunes:summary>Title:  Malaria Surveillance --- United States, 2007

Link to the complete MMWR article:  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5802a1.htm?s_cid=ss5802a1_e

Source:  MMWR April 17, 2009 / 58(SS02);1-16

 

</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>7:24</itunes:duration>
	</item>
		<item>
		<title>Detecting Ricin Quickly</title>
		<link>http://projectdisaster.com/?p=13616</link>
		<comments>http://projectdisaster.com/?p=13616#comments</comments>
		<pubDate>Thu, 16 Apr 2009 13:57:57 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Bioterrorism]]></category>
		<category><![CDATA[Research & Data Collection]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13616</guid>
		<description><![CDATA[Detecting Ricin: Sensitive Luminescent Assay for Ricin A-
Chain Ribosome Depurination Kinetics

Matthew B. Sturm and Vern L. Schramm*

Department of Biochemistry, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Avenue, Bronx, New York 10461
Anal. Chem., 2009, 81 (8), pp 2847–2853
DOI: 10.1021/ac8026433
Publication Date (Web): March 20, 2009
Copyright © 2009 American Chemical Society

ABSTRACT:  Ricin is a [...]]]></description>
			<content:encoded><![CDATA[<h1 class="articleTitle">Detecting Ricin: Sensitive Luminescent Assay for Ricin A-</h1>
<h1 class="articleTitle">Chain Ribosome Depurination Kinetics</h1>
<p><!--AccessDenialMessagePlaceholder--></p>
<p class="onPage">Matthew B. Sturm and Vern L. Schramm<a href="http://projectdisaster.com/wp-admin/#cor1"class="ref"  >*</a></p>
<div id="articleMeta">
<div class="affiliations">Department of Biochemistry, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Avenue, Bronx, New York 10461</div>
<div id="citation"><cite>Anal. Chem.</cite>, <span class="citation_year">2009</span>, <span class="citation_volume">81</span> (8), pp 2847–2853</div>
<div id="doi"><strong>DOI: </strong>10.1021/ac8026433</div>
<div id="pubDate">Publication Date (Web): March 20, 2009</div>
<div id="artCopyright">Copyright © 2009 American Chemical Society</div>
<div>
<p class="articleBody_abstractText">ABSTRACT:  <strong>Ricin is a family member of the lethal ribosome-inactivating proteins (RIP) found in plants. Ricin toxin A-chain (RTA) from castor beans catalyzes the hydrolytic depurination of a single base from a GAGA tetraloop of eukaryotic rRNA to release a single adenine from the sarcin-ricin loop (SRL). Protein synthesis is inhibited by loss of the elongation factor binding site resulting in cell death. We report a sensitive coupled assay for the measurement of adenine released from ribosomes or small stem-loop RNAs by RTA catalysis. Adenine phosphoribosyl transferase (APRTase) and pyruvate orthophosphate dikinase (PPDK) convert adenine to ATP for quantitation by firefly luciferase. The resulting AMP is cycled to ATP to give sustained luminescence proportional to adenine concentration. Subpicomole adenine quantitation permits the action of RTA on eukaryotic ribosomes to be followed in continuous, high-throughput assays. Facile analysis of RIP catalytic activity will have applications in plant toxin detection, inhibitor screens, mechanistic analysis of depurinating agents on oligonucleotides and intact ribosomes, and in cancer immunochemotherapy. Kinetic analysis of the catalytic action of RTA on rabbit reticulocyte 80S ribosomes establishes a catalytic efficiency of 2.6 × 10<sup>8</sup> M<sup>−1</sup> s<sup>−1</sup>, a diffusion limited reaction indicating catalytic perfection even with large reactants.</strong></p>
<p class="articleBody_abstractText"> </p>
</div>
</div>
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<enclosure url="http://projectdisaster.com/media/ricin4-16-09.mp3" length="2629407" type="audio/mpeg" />
			<itunes:subtitle>Detecting Ricin: Sensitive Luminescent Assay for Ricin A- Chain Ribosome Depurination Kinetics - Matthew B. Sturm and Vern L. Schramm* -  Department of Biochemistry, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Aven...</itunes:subtitle>
		<itunes:summary>Detecting Ricin: Sensitive Luminescent Assay for Ricin A-
Chain Ribosome Depurination Kinetics

Matthew B. Sturm and Vern L. Schramm*


Department of Biochemistry, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Avenue, Bronx, New York 10461
Anal. Chem., 2009, 81 (8), pp 2847–2853
DOI: 10.1021/ac8026433
Publication Date (Web): March 20, 2009
Copyright © 2009 American Chemical Society

ABSTRACT:  Ricin is a family member of the lethal ribosome-inactivating proteins (RIP) found in plants. Ricin toxin A-chain (RTA) from castor beans catalyzes the hydrolytic depurination of a single base from a GAGA tetraloop of eukaryotic rRNA to release a single adenine from the sarcin-ricin loop (SRL). Protein synthesis is inhibited by loss of the elongation factor binding site resulting in cell death. We report a sensitive coupled assay for the measurement of adenine released from ribosomes or small stem-loop RNAs by RTA catalysis. Adenine phosphoribosyl transferase (APRTase) and pyruvate orthophosphate dikinase (PPDK) convert adenine to ATP for quantitation by firefly luciferase. The resulting AMP is cycled to ATP to give sustained luminescence proportional to adenine concentration. Subpicomole adenine quantitation permits the action of RTA on eukaryotic ribosomes to be followed in continuous, high-throughput assays. Facile analysis of RIP catalytic activity will have applications in plant toxin detection, inhibitor screens, mechanistic analysis of depurinating agents on oligonucleotides and intact ribosomes, and in cancer immunochemotherapy. Kinetic analysis of the catalytic action of RTA on rabbit reticulocyte 80S ribosomes establishes a catalytic efficiency of 2.6 × 108 M−1 s−1, a diffusion limited reaction indicating catalytic perfection even with large reactants.
 


</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>2:44</itunes:duration>
	</item>
		<item>
		<title>Berlusconi gets praise for the L&#8217;Aquila crisis.  Imagine that!</title>
		<link>http://projectdisaster.com/?p=13461</link>
		<comments>http://projectdisaster.com/?p=13461#comments</comments>
		<pubDate>Thu, 09 Apr 2009 16:16:52 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Earthquake]]></category>
		<category><![CDATA[Earthquake Resilience]]></category>
		<category><![CDATA[podcast]]></category>

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		<description><![CDATA[Link:  http://edition.cnn.com/2009/WORLD/europe/04/09/italy.quake.berlusconi/index.html
            Silvio checking out one of the survivors.
]]></description>
			<content:encoded><![CDATA[<p>Link:  <a href="http://edition.cnn.com/2009/WORLD/europe/04/09/italy.quake.berlusconi/index.html" onclick="javascript:urchinTracker ('/outbound/article/edition.cnn.com');">http://edition.cnn.com/2009/WORLD/europe/04/09/italy.quake.berlusconi/index.html</a></p>
<p><img class="alignnone" title="1" src="http://i2.cdn.turner.com/cnn/2009/WORLD/europe/04/09/italy.quake.berlusconi/art.berlusconi.afp.gi.jpg" alt="" width="292" height="219" />          <strong>  Silvio checking out one of the survivors.</strong></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/italy4-9-09.mp3" length="2441743" type="audio/mpeg" />
			<itunes:subtitle>Link:  http://edition.cnn.com/2009/WORLD/europe/04/09/italy.quake.berlusconi/index.html -             Silvio checking out one of the survivors.</itunes:subtitle>
		<itunes:summary>Link:  http://edition.cnn.com/2009/WORLD/europe/04/09/italy.quake.berlusconi/index.html

            Silvio checking out one of the survivors.</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>2:33</itunes:duration>
	</item>
		<item>
		<title>Fare thee well, Bob Quick.</title>
		<link>http://projectdisaster.com/?p=13449</link>
		<comments>http://projectdisaster.com/?p=13449#comments</comments>
		<pubDate>Thu, 09 Apr 2009 13:03:01 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Law Enforcement]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13449</guid>
		<description><![CDATA[what about bob]]></description>
			<content:encoded><![CDATA[<p><strong>Intro:  Talk about schadenfreude!  I&#8217;m sure we can all empathize with Bob about making such a dumb-ass mistake.  A mistake we could all make anywhere anytime.</strong></p>
<p>Click on <a href="http://edition.cnn.com/2009/WORLD/europe/04/09/uk.terror.arrests/index.html"title="1"  onclick="javascript:urchinTracker ('/outbound/article/edition.cnn.com');"><strong>WHAT ABOUT BOB?</strong> </a> for the full CNN story.</p>
<div class="wp-caption alignnone" style="width: 238px"><img title="1" src="http://img.dailymail.co.uk/i/pix/2008/05_02/PCQuickDM0605_228x322.jpg" alt="Bob" width="228" height="322" /><p class="wp-caption-text">Bob</p></div>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/quick4-9-09.mp3" length="2252826" type="audio/mpeg" />
			<itunes:subtitle>what about bob</itunes:subtitle>
		<itunes:summary>Intro:  Talk about schadenfreude!  I&#039;m sure we can all empathize with Bob about making such a dumb-ass mistake.  A mistake we could all make anywhere anytime.

Click on WHAT ABOUT BOB?  for the full CNN story.
</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>2:21</itunes:duration>
	</item>
		<item>
		<title>Piracy Update</title>
		<link>http://projectdisaster.com/?p=13444</link>
		<comments>http://projectdisaster.com/?p=13444#comments</comments>
		<pubDate>Thu, 09 Apr 2009 12:33:23 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Piracy]]></category>
		<category><![CDATA[Pirateering]]></category>
		<category><![CDATA[podcast]]></category>

		<guid isPermaLink="false">http://projectdisaster.com/?p=13444</guid>
		<description><![CDATA[
 
Link:  http://www.usatoday.com/news/world/2009-04-09-somali-pirates-us-thursday_N.htm?csp=DailyBriefing
]]></description>
			<content:encoded><![CDATA[<p><img class="alignnone" title="1" src="http://media.maps.com/magellan/Images/SOMALI-W1.gif" alt="" width="509" height="685" /></p>
<p> </p>
<p>Link:  <a href="http://www.usatoday.com/news/world/2009-04-09-somali-pirates-us-thursday_N.htm?csp=DailyBriefing" onclick="javascript:urchinTracker ('/outbound/article/www.usatoday.com');">http://www.usatoday.com/news/world/2009-04-09-somali-pirates-us-thursday_N.htm?csp=DailyBriefing</a></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/pirate4-9-09.mp3" length="1744169" type="audio/mpeg" />
			<itunes:subtitle> -   - Link:  http://www.usatoday.com/news/world/2009-04-09-somali-pirates-us-thursday_N.htm?csp=DailyBriefing</itunes:subtitle>
		<itunes:summary>

 

Link:  http://www.usatoday.com/news/world/2009-04-09-somali-pirates-us-thursday_N.htm?csp=DailyBriefing</itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>1:49</itunes:duration>
	</item>
		<item>
		<title>I-95 disrupted in West Palm Beach due major accident</title>
		<link>http://projectdisaster.com/?p=13441</link>
		<comments>http://projectdisaster.com/?p=13441#comments</comments>
		<pubDate>Thu, 09 Apr 2009 12:17:28 +0000</pubDate>
		<dc:creator>Paul Rega, MD, FACEP</dc:creator>
				<category><![CDATA[Disasters - Transportation]]></category>
		<category><![CDATA[podcast]]></category>

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		<description><![CDATA[
]]></description>
			<content:encoded><![CDATA[<p><img class="aligncenter" title="1" src="http://www.fogcityjournal.com/images/photos/maze_std.jpg" alt="" width="500" height="333" /></p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
<enclosure url="http://projectdisaster.com/media/traffic4-9-09.mp3" length="616933" type="audio/mpeg" />
			<itunes:subtitle></itunes:subtitle>
		<itunes:summary></itunes:summary>
		<itunes:author>ProjectDisaster</itunes:author>
		<itunes:explicit>no</itunes:explicit>
		<itunes:duration>39</itunes:duration>
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