virals (which many, including the Cochrane
Review, have called into question after years
when resistance to them was very high).
We are to be on the lookout for pneumonia
Nothing fills a primary care doctor or
pediatrician with dread like the prospect
of offices filled with flu zombies and hospitals too full to admit them quickly and
coworkers fainting and then – the fateful
shiver, and you realize you, too, are doomed.
The fact that the CDC sees fit to warn us is
quite terrifying, since I do not recall that
they have ever done so with a virus that we
have met before.
I always ask people, “If you have to get out
of bed, do you burst into tears?” I call it the
Flat Sign, the inability to be vertical coupled
with that unmistakable look in the eyes that
comes from having been ambushed by billions of viral assassins.
The Spanish Flu genome was reconstructed by the CDC in 2005 and was an H1N1
apparently novel to humans in 1918. It
killed more people than the Black Death.
It killed 15 million in India alone, and between 50 and 100 million worldwide, by the
latest estimate. It was first reported in the
West out of a French headquarters camp in
1918. Canadian historian Mark Humphries
believes that it arrived from China when
96,000 Chinese laborers were imported to
work behind the French and British lines on
the Western Front, since an identical illness
was decimating the Chinese in November
It caused a cytokine storm, which we
understand as vascular collapse and sepsis.
Reading about it will make you reach for
the thermometer, I promise, should you
even cough once, and make you hug your
loved ones tighter to you.
As for me, I have declared war on viruses. It’s either them or us, and I vote us. I
could use a light saber or two, or a death
ray, or the One Ring that rules them all. If
you come across these, tell me first: we will
attack together. DIVE, we will say, DIVE,
DIVE, DIVE and then we will torpedo the
flu - we hope.
Note: Dr. Barry practices Internal Medicine
with Norton Community Medical Associates-Barret. She is a clinical associate professor at the University of Louisville School of
Medicine, Department of Medicine.
CYCLISTS’ SAFETY 2
Stanley A. Gall, MD
n increasing theme in medical care
is the emphasis on prevention of
disease or injury. We advise patients to receive vaccines to prevent infectious diseases and for cancer prevention,
to have regular mammograms, and have
the first colonoscopy at the age of 50. The
state mandates automobile seatbelts and
motorcycle helmets for beginning riders.
a. A bicycle may be operated on the
shoulder of a highway;
Kentucky statute (KRS 189.030 (1)) provides guidance for cyclists as follows:
7. In all ways bicycles are considered “vehicles” by the State of Kentucky and
subject to all rights and regulations of
other vehicles including:
1. A front light must be illuminated when
riding at night or when it is darker than
usual (heavy overcast or dark environment).
2. A red rear reflector or light on the
cyclist or bicycle must be functional whenever riding on a highway or
3. At night, when overcast, or in a dark
environment, a steady or flashing red
rear light is mandated.
4. Bicycles shall be operated the same as
motor vehicles except on the following:
b. If a bicycle lane is provided, it must be
used whenever feasible.
5. Not more than two bicycles may ride
side-by-side in a single highway lane.
an increasing number of cyclists wear dark
colored clothing, making themselves perfectly camouflaged to motorists. Most cyclists have forgotten about bicycle etiquette
and ride like they own the road (i.e. three
or more abreast).
b. Signaling with hands, lamps or
mechanical devices for at least 50
feet before the turn.
To address the prevention of unnecessary cyclists’ deaths, the cyclists must be
responsible for their own actions. Firstly,
the bicycle should be compliant with state
laws by having functioning white and red
lights on the front and rear of the bicycle.
Secondly, the cyclist is advised not to be
camouflaged, but to wear bright colored
clothing. Thirdly, the cyclist must remember the laws of physics of the automobile
versus the bicycle and adopt an attitude of
accommodation rather than confrontation
with the motorists.
I believe cycling is a great sport for fitness and enjoyment; however, the average
cyclist seems to have forgotten the physics of an automobile versus a bicycle. The
modern cyclists have also forgotten that
the background in Kentucky is green and
Note: Dr. Gall is a professor at the University
of Louisville School of Medicine, Department of Obstetrics, Gynecology and Women’s
Health, Division of Maternal-Fetal Medicine.
He practices with UofL Physicians-Maternal-Fetal Medicine.
6. A helmet must be worn if the cyclist is
under 18 years of age.
a. Stopping at all stop signs and red