When Darwin was born, however, we only needed to live to the age of procreation. Now, the American Association or Retired Persons is a big lobby. An extravagant posttraumatic cytokine response, while innocuous to a roaming streetwise d'Artagnan from Detroit, can prove lethal to Jessie Helms. Again, multiple organ failure is partially due to the initial bacterial or ischemic hit, but in large part it is a result of the inducible systemic inflammatory conflagration perpetrated on the unsuspecting cell by evolutionarily helpful, but potentially uncivilized, proinflammatory genes. Molecular biologists deal with these guys in the library. Surgeons confront these marauders in hand-to-hand combat daily in our surgical intensive care units. It is incumbent on the clinically active, surgical cognoscenti to, as so aptly stated by former heavyweight boxing champion Joe Frazier, "know your enemy."