Ending the Nuclear Threat

Sixty five years ago this week, the cities of Hiroshima and Nagasaki were destroyed in a flash. Instantly the nuclear bombs that caused those flashes killed over 200 thousand people with scores of thousands more dying in the subsequent days and years resulting from those bombs. A flash that forever changed our world in ways we still struggle with today.

Today we live in a world with over 23,000 nuclear bombs wired to destroy life many times over. These weapons have the combined firepower of over 130,000 Hiroshimas. Their use either by accident, miscalculation or intention would result in the greatest public health threat to our communities, nation and world.

The threat is real. In fact, last month the city of Los Angeles held the largest disaster preparedness exercise in its history, simulating the detonation of a 10 kiloton device in L.A. This exercise involved more than 88 city or town jurisdictions and 200 special districts. In my own community 65 miles to the north, our hospitals were also involved in this drill with decontamination and triage centers set up.

Such an explosion would result in 130,000 blast-related injuries, 122,000 burn injuries, 66,000 blast and burn injuries, 49,000 severe burn injuries requiring extensive hospitalization and 23,000 injuries to the head, thorax, abdomen and extremities. These tremendous numbers would be impossible to care for in the already stressed medical facilities of L.A. County which has only 13 trauma care centers with 7,500 beds. In the entire U.S. there are only 1500 burn beds with 300 - 500 available on any given day.

Should such an event happen, as a physician, I would be expected to give care - yet there would be precious little I would be able to do to help. Even if every surviving emergency responder performed exactly as they were trained, the loss of life and human suffering, the effect on the environment and economy would be enormous and likely insurmountable.

The fact that such an event has not happened is not a result of complex deterrence systems. Such systems are known to fail - witness the recent BP oil spill with all it's fail safe measures. No, the fact that a nuclear explosion has not occurred is due more to sheer luck. How long are we willing to rely on luck to hold out?

Faced with the magnitude of the destructive power of these weapons it is easy to become paralyzed. The very existence of these weapons with massive global stockpiles is itself a symptom of fear. This misguided thinking has resulted in well intended though dangerous calls to spend billions of dollars to modernize our nuclear weapons stockpiles, and to build protective defense shields that would be easily overcome and would provide no defense against our greatest vulnerability--that of a nuclear device smuggled into our country. These calls further hamper our greatest efforts to eliminate these weapons.

Einstein said it best, "the unleashed power of the atom has changed everything save our thinking and thus we drift toward unparalleled catastrophe." We must change our thinking, reverse the drift.

Indeed, a nuclear explosion of any size represents the greatest public health threat. As physicians who deal with public health threats from TB, cholera, AIDS to polio and whooping cough, we know the only rational goal must be prevention. We must prevent what we cannot cure.

Fortunately, we are at a time of unprecedented opportunity to create a world free of nuclear weapons. Governments around the world are realizing the will of the people. The urgent need for action is now. We must make our voices heard. Do not assume that someone else will take care of things.

Next month the U.S. Senate Foreign Relations Committee is scheduled to vote on the New Strategic Arms Reduction Committee signed by the U.S. and Russia. Thereafter the entire Senate must ratify the treaty with 67 votes needed. In the months ahead the Comprehensive Test Ban Treaty will be considered which would globally ban all nuclear tests. At 65 years, it is time to mandatorily retire nuclear weapons. This is not a partisan issue, it is a survival issue.