Suppose you get stopped in the hallway outside the ED by a colleague who “has a friend” who went to Las Vegas and, about a week later, developed genital ulcers. He wants your advice regarding what to tell his “friend” to do. What do you tell them?

Don’t look now, but that gentle lapping at your toes is the first hint of the “silver tsunami” coming soon to an emergency department near you. Of the 313 million people currently living in the United States, 12% are over the age of 65 years, and one million are over 100 years old. More sobering, as of January 1, 2011, the first baby boomers started to qualify for Medicare.