The Henrietta Lacks Foundation awards first assistance grants to HeLa descendants

Yesterday, author Rebecca Skloot made the following announcement at her website:

Today, the Henrietta Lacks Foundation awarded its first ever grants thanks to donations from Rebecca Skloot, and many readers. The first awards cover full tuition and books for five descendants of Henrietta Lacks starting fall semester 2010, as well as an emergency grant for one of Henrietta Lacks’s sons. More information about the inaugural Henrietta Lacks Foundation grants coming soon. For more information on the foundation, or to make a donation, click here.

As some readers know, I have been a big fan of Skloot’s book, The Immortal Life of Henrietta Lacks, and I have been the beneficiary of the cervical carcinoma cell line established in 1951 from the Ms. Lacks’s tumor.

When Rebecca announced last year that she was to establish a foundation to funnel profits and donations to assist the Lacks family, one of her primary goals when embarking on this project more than ten years ago, she also asked me to serve on the board of the Foundation.

I’ll have more to say about this process when a formal press release is made. But for the time being, I consider myself incredibly fortunate to do my part to honor the memory of Henrietta Lacks and assist her descendants.

Yes, Weedhopper, you can have the “same” R01 for decades

A discussion ensued yesterday among several of my learned colleagues following this post by The Genomic Repairman. Therein, TGR noted that a senior person in their field had two grants in their 27th year and 26th year, respectively. In NIH grant parlance, one is called a R01 (and that’s R-zero-one, chief), an investigator-initiated grant that is the bread-and-butter type of support by which the mettle of most biomedical researchers is evaluated. The other is called a P01, or program project, a group of R01-sized projects with one or more core programs that support each other in what is intended to be synergy.

Some of my colleagues question the merits of the P01 program since some just appear to be a group of individual grants that really don’t function interdependently – I tend to think that good P01s do a great job (disclosure: our lab is part of a collaborative P01 subproject led by a great senior person in my field who is deeply committed to the development of junior scientists).

But back to TGR. In his self-admitted angry rant, he asked:

Seriously to have two grants that old, um has there never been a fucking priority shift? Ever? At some point wouldn’t the NIH cutoff funding for the grant as this dude has probably drug this shit down the road for way to long.

TGR gets clever-points from me simply for the dead, driftwood photo in Figure 1 with the caption: “The overfunded PI with grants almost as old as I am!”

Believe it or not, grants funded under the same project name for more than 30 years are quite common.  In fact, a search of the NIH RePORTER database (the successor to CRISP), reveals this 62-year-old project as the longest I could find. The grant number is 5R01GM000091-62.

NIH grant nomenclature

As an aside, you can dissect this seeming gibberish by noting that the first number denotes the stage of the grant: Most common are Types 1, 2, and 5. Type 1 grants are brand-new, type 2 grants are competing renewal applications that are submitted after the original grant period expires, type 5 grants (like this one) are in the years of a funded grant period where the grant is renewed annually without additional peer-review. Other commonly-used definitions are the type 3 which is the award when an administrative supplement is requested, for example, to fund minority scientists for new studies related to the main thrust of the grant, or the type 7 which denotes a grant that has moved with the principal investigator to a new institution. Less common types I don’t know much about are the type 4 which seems to be a flavor of type 3 grants where additional funds are awarded and the type 9 which is used to describe grants whose primary funding institute has changed.

The two letter code, GM in this case, denotes the primary funding institute, National Institute of General Medical Sciences (NIGMS). Many folks in my field have CA designations for the National Cancer Institute.  My alcohol research colleagues will often have grants from NIAAA denoted AA and substance abuse research colleagues will have DA to denote projects funded by the National Institute for Drug Abuse.

The following six numbers are simply the sequential numbers of the grant that are assigned to each application regardless of whether it is ultimately funded. Yes, this was the 91st grant submitted to the NIGMS.

And, back to this discussion, the 62 denotes the year of the grant. You’ll see some grants where the last two numbers are followed by an A1 or the now-defunct A2, denoting a revised or “amended” application, or a S1 for a type 3 grant supplement. There are other designations that I’m sure other folks will drop in the comments.  Anyway, you can tell a lot about a NIH grant from its number.

Led until 2007 by Duke biochemistry professor emeritus, K.V. Rajagopalan, the most recent version of the grant investigated an unusual molybdenum co-factor, molybdopterin, as the central prosthetic group for almost all molybdenum-containing enzymes. Molybdenum deficiency is an autosomal-recessive trait that cause seizures in infants and invariably leads to childhood death. There is no known treatment. The activity of sulfite oxidase, a Mo-containing enzyme, has been a diagnostic test for the disease used since 1983 and many of the sequelae of the disease seem to be a result of sulfite accumulation and toxicity in neurons. This round-up from the International Molybdenum Association details some of the work on the role of molybdenum in human biology.

Dr. Rajagopalan has been a prolific biochemist with 199 papers on PubMed. Two of his first four papers in 1958 and 1959 were in Nature, and his last two in 2008 and 2010 were in Biochemistry and Journal of the American Chemical Society. One of my learned colleagues mused as to whether Dr. Rajagopalan was the original principal investigator on the grant (since NIH RePORTER doesn’t have records that far back – only to 1987 or 1989 in most cases). However, the first grant would have been awarded in 1945, assuming that grant periods were still one-year in length in those days. Of course, NIGMS wasn’t established until 1962 and the NIH, which traces its history to 1887, wasn’t established in name until the Ransdell Act of 1930 when it was called the National Institute of Health (singular).

So, it is likely that this longstanding grant was originally awarded to another P.I. – perhaps Dr. Rajagopalan’s mentor – in another institute, or perhaps just plain old NIH itself. It’s rather common, even today, for a well-qualified trainee to be named as P.I. of a grant when one’s mentor passes on to The Great Study Section in the Sky. Getting that grant renewed, however, is as tough as getting a brand new grant.

Longtime grantees – Deadwood? Driftwood? Or Clue Stick?

TGR may also care to note that the convention in the old days was to have a very broad grant title with the grant competitively reviewed for renewal on newly designed experiments. Much effort is expended on the merits on long-time renewed grants with young(er) folks like TGR criticizing longtime grantees as “deadwood” while more seasoned investigators note that a renewal means not only proposing new ideas but also being more carefully reviewed for progress on the previous aims of the grant.

For example, one of the fathers of my field – and one of the most encouraging people I have ever met in cancer research – Joe Bertino, had a grant entitled, “Mechanism of Action of Folate Antagonists,” that expired in year 45 only six weeks ago. Bertino was, and is, still doing cutting edge work on a class of drugs represented by methotrexate, whose clinical use he launched with Bruce Chabner and others quite early in his career. Even with a couple of high level administrative positions at the Cancer Institute of New Jersey and the University of Medicine and Dentistry of New Jersey, Bertino led a project on microRNA regulation of dihydrofolate reductase (DHFR) that appeared recently in PLoS ONE. Bertino’s group showed that miR-24, a tumor-suppressor microRNA normally modulates DHFR activity (required for nucleotide biosynthesis and cell proliferation) but a polymorphism in the DHFR 3-UTR prevents miR-24 action leading to high level production of DHFR that contributes to neoplastic transformation. Melding novel concepts of carcinogenesis with a career of work on DHFR is an example of the kind of thing that longtime grant renewals support.

Grant renewals were the norm when I was coming up in the 1980s and my tenure decision in the 1990s was highly dependent on the renewal of my first R01 that came through a few months before the review committee met. I don’t have statistics handy but my anecdotal experience on NIH study sections over the last decade of so have led me to think that grants renewed more than twice are becoming less common.

So rather than view double-digit-year grants as evidence of driftwood or deadwood, I would argue to TGR that such grants are evidence of a long career of investigator productivity together with the sustained ability to compete at the top 10-15 percentile of scientists in the field. Does a grant with a -26 influence a reviewer’s perception, especially a first-time grant reviewer? Perhaps. But in both ways. Some reviewers, especially first-time reviewers, might feel that they might be missing something if the grant appears to be shite while others might simply dismiss the -26 before they even start reviewing as though the grant carries a “Kick Me” sign.

My personal opinion is that most grants with more than 20 years of support have clearly earned it. I can’t argue individual cases whose history I don’t know – especially those outside my field as the example of TGR seems to be. However, my dear weedhopper may care to consider some of these points in his angry rant.

Real deadwood would be faculty who occupy positions without any grant funding who also shirk teaching responsibilities, resist any change or innovation by junior faculty, hold forth with painful, droning, and meaningless diatribes at faculty meetings, and bitch to you about the tough old days (when grants were funded at the 35th or 40th percentile) when they had to synthesize phosphate buffer from the elements..uphill, both ways, in blinding snow and ice.

But, then again, young investigators are supposed to be full of piss and vinegar.

ADDENDUM: Colleagues who have also weighed in:

DrDrA – Blue Lab Coats

JUNIORPROF

“Rosie the Riveter” was a Black woman

I’m off for another all-day work event that will leave me without internet, not even on the iPhone, so I leave you with some cultural anthropology to muse over as you while away your Friday.

I read the Denver Post all the time online but I somehow missed last week’s photo gallery of rare color pictures taken in the US during the Depression and World War II:

These images, by photographers of the Farm Security Administration/Office of War Information, are some of the only color photographs taken of the effects of the Depression on America’s rural and small town populations. The photographs are the property of the Library of Congress and were included in a 2006 exhibit Bound for Glory: America in Color.

The color plates are absolutely breathtaking. The images bring a time alive that many of us only heard of through our grandparents or saw in detached black-and-white photographs. I was not fully prepared for how the color made me think differently about those times and have more empathy for those who lived through those hard times.

Two photographs are particularly noteworthy to me: #54 and #66.

The first shows a group of women railroad workers having lunch in 1943, a time when so many men were off to war that workforce necessity overruled the gender roles that permeated the post-war 1950s and beyond.

The second photo shows an African-American woman installing rivets into an airplane in a scene reminiscent of the motivational “We Can Do It!” war campaign of Rosie the Riveter. Rosie the Riveter was based on a Norman Rockwell painting I had the good fortune of seeing displayed one summer in Aspen, Colorado. Not well-appreciated about the original painting (which appeared on the May 29, 1943 cover of The Saturday Evening Post) is that the stout woman is shown eating her sandwich on a stool with her riveter while resting her foot on a copy of Hitler’s Mein Kampf.

The Wikipedia entry on this campaign is fascinating and, interestingly, features photo #66 as the first in the entry.

I’m not an anthropologist but I find these images striking because they represent a time when societal needs outweighed our feeble penchant for racial and gender discrimination.

Many thanks to Maggie Koerth-Baker at Boing Boing for making us aware of this photo gallery.

From Mind Hacks: Illegal drugs found in legal highs sold in the UK

I’ve been kind of tied up with work things this week so my apologies for lack of original content. But I just had to share this with you because it was so reminiscent of the herbal adulteration story I brought you just a few days ago.

Many times when I post something on drugs that affect the central nervous system, I’ll get a tweet from Dr Vaughan Bell at Mind Hacks pointing me to his coverage on the same topic a few weeks ago. This time, he shares with us a report where dietary supplements sold in England have been found to contain newly-illegal psychoactives and related compounds.

For example, before the ban, a legal pill sold as ‘Doves Original’ was advertised as containing a blend of amino acids and ketones but actually contained the psychedelic drugs mephedrone and butylone. Both were completely legal but were simply not mentioned by the manufacturers.

Interestingly, after the ban, it seems that several companies just changed their packaging without changing their ingredients.

Out of the six products tested, all advertised as being legal, five included recently banned substances – including mephedrone, 4-fluoromethcathinone and methylone – and the other contained dimethocaine, a legal but unmentioned local anaesthetic (presumably to emulate the nose-numbing effect of cocaine).

Drugmonkey, newly installed at Scientopia.org, has in his archives a nice series of posts on mephedrone for your further reading on these compounds.

Read Vaughan’s full post here.

Scientopia launches – let there be w00t!

I’m delighted to announcement the launch of a new blogger-run, blogger-sponsored science blogging collective: Scientopia.

A fantastic group of 30 bloggers at 23 blogs, split roughly between former ScienceBloggers and many of my favorite science bloggers, have joined together to form this new network. No advertisements (yet) and a beautiful, clean interface. The efforts put in by this group have been heroic to essentially get this project from idea to frontpage is about three weeks.  (I know many of the parties involved in doing the heavy lifting but I’m not sure how comfortable they are with being promoted widely – all the bloggers were instrumental in drafting the collective’s code.)

As usual, Bora Zivkovic has the complete rundown with blogger names and prior and current links.  Here is the blog roll for Scientopia for easy reference – but just go to scientopia.org for their frontpage.

Congratulations, my friends!

Congratulations to Anton Zuiker on 10 years of blogging!

Anton Zuiker, author of the mistersugar blog, posted Friday on the occasion of his 10th anniversary of blogging.

Here was my comment:

Congratulations, Anton! Your love for a good story and selfless innovative thinking about community infected me five years ago and I consider myself extremely enriched by having you in my real and online life.

This history is beautiful and heartfelt – I am certain that Frank the Beachcomber was and is proud of what you’ve done here and what you’ve become elsewhere. Not just Anton The Writer, but Anton the father, husband, friend, and community leader. Even if you simply launched ScienceOnline, your international impact would be something to be proud of for anyone’s lifetime.

Heartiest congratulations, my friend!

Anton wrote a lovely post detailing his path over the last ten years of an effort spurred by his wish to honor the lifelong writing and storytelling of his dying grandfather. Very much like his compatriot and co-founder of the science communications unconference now known as ScienceOnline, Anton had a vision that the online community can also be a vehicle to improving one’s local, IRL community.

Four months after I started blogging, I had the chance to meet Anton and Bora (and Ayse and Jackson Fox) at a BlogTogether meetup in Chapel Hill. A door had been opened to me that has brought these and other remarkable people into my life. I never blogged about it because it was at a time when I was fiercely protective of my identity and made no reference to my IRL existence. It’s been a gift to live in the same community with these fine folks.

And if you’re wondering about the origin of “mistersugar” and the pig avatar, go to Anton’s “About” page. “Mistersugar” is easy to figure out but I could never have guessed what was up with the pig.

Go on over and congratulate Anton on a decade of great things.

#IOweBora update: You people are amazing

I just wanted to send out a heartfelt “thank-you” to everyone who has, and continues, to donate to support The Blogfather, Bora Zivkovic, and his family.

As  you know, Bora left ScienceBlogs in the Pepsigate/sbfail “DiasBora” thereby giving up some income essential to his family for groceries and such.

Almost 100 of you lovely folks have come through with donations of whatever you can afford. But even more amazing is that some of you asked how you might support Bora on a continuous basis with monthly donations for his awesome blog content and others offered even more support after their July payday. Those recurrent donations started to come in last night.

I’ve tried to get personal thank-you e-mails to each and every one of you (but I may have missed a couple, so please let me know if I missed you). I’ve passed along to Bora most of the funds that have cleared my PayPal account – I’ll leave it to him to respond to you on- or offline.

In the meantime, go here if you wish to provide a few doubloons to the author of the best overview of the history and future science blogging networks.

The blogging community and readers never cease to amaze me with their generosity and genuine appreciation for what many of us do simply as a scientific outreach hobby.

I am deeply appreciative of how forcefully you have come out to help Bora and his family in a time of need.

Much love, Abel

URGENT FDA WARNING: Do not use Miracle Mineral Solution

This FDA warning just came across my newsfeed regarding “Miracle Mineral Solution” or “Miracle Mineral Supplement” – also abbreviated MMS. This is absolutely obscene.



FDA NEWS RELEASE

For Immediate Release: July 30, 2010
Media Inquiries: Elaine Gansz Bobo, 301-796-7567, elaine.bobo@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Warns Consumers of Serious Harm from Drinking Miracle Mineral Solution (MMS)
Product contains industrial strength bleach

The U.S. Food and Drug Administration is warning consumers not to take Miracle Mineral Solution, an oral liquid also known as “Miracle Mineral Supplement” or “MMS.”  The product, when used as directed, produces an industrial bleach that can cause serious harm to health.

The FDA has received several reports of health injuries from consumers using this product, including severe nausea, vomiting, and life-threatening low blood pressure from dehydration.

Consumers who have MMS should stop using it immediately and throw it away.

MMS is distributed on Internet sites and online auctions by multiple independent distributors. Although the products share the MMS name, the look of the labeling may vary.

The product instructs consumers to mix the 28 percent sodium chlorite solution with an acid such as citrus juice. This mixture produces chlorine dioxide, a potent bleach used for stripping textiles and industrial water treatment. High oral doses of this bleach, such as those recommended in the labeling, can cause nausea, vomiting, diarrhea, and symptoms of severe dehydration.

MMS claims to treat multiple unrelated diseases, including HIV, hepatitis, the H1N1 flu virus, common colds, acne, cancer, and other conditions. The FDA is not aware of any research that MMS is effective in treating any of these conditions. MMS also poses a significant health risk to consumers who may choose to use this product for self-treatment instead of seeking FDA-approved treatments for these conditions.

The FDA continues to investigate and may pursue civil or criminal enforcement actions as appropriate to protect the public from this potentially dangerous product.

The FDA advises consumers who have experienced any negative side effects from MMS to consult a health care professional as soon as possible and to discard the product. Consumers and health care professionals should report adverse events to the FDA’s MedWatch program at 800-FDA-1088 or online at www.fda.gov/medwatch/report.htm.


The product website is still live and it is full of the most unreal claims I’ve seen in any online marketing scheme:

This Breakthrough can save your life, or the life of a loved one.
Please read.

The answer to AIDS, hepatitis A,B and C, malaria, herpes, TB, most cancer and many more of mankind’s worse diseases has been found. Many diseases are now easily controlled. More that 75,000 disease victims have been included in the field tests in Africa. Scientific clinical trials have been conducted in a prison in the country of Malawi, East Africa.

Separate tests conducted by the Malawi government produced identical 99% cure results. Over 60% of the AIDS victims that were treated in Uganda were well in 3 days, with 98% well within one month. More than 90% of the malaria victims were well in 4 to 8 hours. Dozens of other diseases were successfully treated and can be controlled with this new mineral supplement. It also works with colds, flu, pneumonia, sore throats, warts, mouth sores, and even abscessed teeth (it’s the only thing that controls and cures abscessed teeth).

The inventor believes that this information is too important to the world that any one person or any group should have control. The free e-book download on this site gives complete details of this discovery. Please help make sure that it gets to the world free. There are many medical facts that have been suppressed and this invention must not be added to that list. The name of the e-book is The Miracle Mineral Supplement of the 21st Century. This book tells the story of the discovery, and how to make and use it. This book can save your life. Give it a try.

No. No. Don’t give it a try.

Instead:

The FDA advises consumers who have experienced any negative side effects from MMS to consult a health care professional as soon as possible and to discard the product. Consumers and health care professionals should report adverse events to the FDA’s MedWatch program at 800-FDA-1088 or online at www.fda.gov/medwatch/report.htm.

Support for Duke breast cancer colleagues post-Potti

I came home yesterday and looked at the mail with a shudder: the Summer 2010 issue of the biannual Duke Medicine DukeMed magazine greeted me with a cover on personal genomics in breast cancer.

Oh no.

As a twice-yearly publication, it was probably published weeks ago and was sitting in a warehouse ready for mailing. All this while when The Cancer Letter broke the story about credentials issues surrounding Dr. Anil Potti and raised awareness of widespread criticism in the field surrounding work from him and Dr. Joe Nevins on genomic signatures and drug sensitivity of patient tumors (our post with links to reports here).

Indeed, Potti and Nevins were still quoted therein (article text here, full issue 4 MB PDF here):

“Genomics will revolutionize cancer therapy,” says cancer researcher Anil Potti, MD. “It allows us to identify a fingerprint that’s unique to every individual patient’s tumor. If you can match that fingerprint with the drug that’s most likely to work for that patient, you can make cancer treatment more effective and less toxic. It brings us closer to a cure.”

Potti and Joseph Nevins, PhD, of the Duke Institute for Genome Sciences & Policy, have led the effort to look at gene expression profiles from large groups of tumor samples and compare those profiles with treatment outcomes, searching for patterns (or genomic signatures) that indicate the “personality types” of tumors — those that are likely to metastasize or not; those with good prognosis and poor prognosis; a tumor that is resistant to a drug or one that is sensitive to a drug.

But the vast majority of the article featured several other Duke oncology physician-scientists with quotes and profile photographs on other efforts there to personalize breast cancer treatment. Several of these folks are colleagues who I respect deeply and whose scientific ethics and clinical dedication are beyond question – all are tremendous physicians who’ve relieved the suffering of thousands of women with breast cancer (perhaps a couple tens of thousands – and a couple of hundred men with breast cancer as well.)  One I recognize as a heme/onc fellow I taught in an AACR laboratory workshop over 10 years ago.

Just as many of my esteemed colleagues in the pharmaceutical industry are tarred with sweeping generalizations following high-profile but individual cases of unforgivable impropriety, I fear that some of my valued Duke colleagues may be similarly viewed by the broad public.

I recognize that the pending internal and external investigation of the Potti case may reveal some collusion of institutional leadership and culture.

However, I wish to register my personal and professional support for my other Duke colleagues quoted in this issue of DukeMed.

If my mother had a recurrence of her breast cancer or could gain access to an experimental treatment in a clinical trial outside of those based on Potti’s science, I would still send her there in a heartbeat.

Disclosure: I was co-author with one of the named physician-scientists on a 2004 Journal of Clinical Oncology case report of a breast cancer patient who experienced a delayed-hypersensitivity reaction during chemotherapy following injection of a mistletoe extract by a naturopath. Another co-author was my spouse, a former Duke physician-scientist. Since 2001, I’ve also held an adjunct faculty appointment at Duke and am a member of their NCI comprehensive cancer center. I draw no salary or other compensation from these appointments.

Five favorite molecules

This post was meant to go up yesterday but I was distracted by the lengthy conversation I had with my wife, a physician-scientist, about this very topic.

Many of you who attended the ScienceOnline2010 conference here last January probably met Carmen Drahl, the Princeton-trained chemist who now writes for Chemical & Engineering News and their appropriately-named drug discovery blog, The Haystack, as well as their Newscripts feature.

For the latter, Dr. Drahl pointed us toward a recent “Crosstalks” paper in Chemistry & Biology by Thomas U. Mayer and Andreas Marx of the University of Konstanz (and her interview with the authors) who mused as follows from their abstract:

Which five molecules would you take to a remote island? If you imagine yourself as a castaway on an island you might pick water, glucose, penicillin, and ethanol in combination with aspirin. However, as a scientist, you may ask yourself which molecules impressed you most by their chemical or biological property, their impact on science, or the ingenuity and/or serendipity behind their discovery. Here, we present our personal short list comprising FK506, colchicine, imatinib, Quimi-Hib, and cidofovir. Obviously, our selection is highly subjective and, therefore, we apologize up front to our colleagues for not mentioning their favorite compounds.

The full paper (PDF) is freely available at the time of this post (thank you, Cell Press!) and the science historian in me is delighted by reading it. I’ll be giving this out to my pharmacology students on day one of the upcoming semester and charge them with selecting and justifying a molecule of their own.

But the authors pose two different questions – a) which molecules, drug or not, would you take as the sole occupant of a desert island, and b) which drugs most impress you with their chemistry, biology, or impact on science.

She’s now asking for people to fill out this survey of their own five molecules to take to a desert island (or drop comments on her blogpost).

We approached the question as “what five drugs would you take to a desert island if you were the sole occupant?”

My thought process was to think about what would be most likely to kill you if you were alone as an otherwise reasonably healthy mid-40s dude coming off a bout of pneumonia. Antibiotics and vaccines have arguably had the greatest impact on the leap in life expectancy observed during the 20th century. Vaccines wouldn’t be necessary if you were alone, but antibiotics would be crucial, especially if you fell and broke bones.

But what antibiotic? One probably wouldn’t be encountering highly drug-resistant bugs so would ampicillin be best? Would you want two antibiotics? Perhaps one antibacterial and one antifungal, the latter giving the humid, tropical climate.

For any sort of painful encounter, I’d want morphine. Yes, it’s best injected and I don’t think one would be stranded with syringes as well, but there are oral morphine formulations that have reasonable bioavailability. Perhaps it would be good enough mixed in with coconut milk. If not, I’d take Actiq fentanyl lollipops or hydromorphone.

A good, daily analgesic might help. Aspirin has a lot of advantages despite the evolution of other analgesics like ibuprofen and naproxen.

I’m not sure how my asthma would be on a desert island, but I’d rather not chance it so I’d definitely use up a slot with my rapid-acting beta2-agonist, albuterol.

And if you have a strong, penetrating family history of depression like me, I’d bring an antidepressant – probably escitalopram. Think that’s not necessary? If you can’t even get up and go fishing or build a shelter because you are so paralyzingly depressed, an antidepressant drug could be just as life-saving as a broad-spectrum antibiotic.

Ahh, but malaria – maybe I’ll keep the morphine but give up the naproxen and bring some chloroquine.

This is kind of tough, eh? Some of the choices depend on your own pre-existing conditions.

What five drugs would you bring if stranded on a deserted island?

Even if you comment here, please be sure to put your choices in Carmen’s survey here. She notes that she’ll post some of her results next week.