OPINION
DOCTORS ' Lounge
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BACK UNDER THE DESK
Mary G . Barry , MD Louisville Medicine Editor editor @ glms . org
During the Cuban Missile Crisis , I was nine . But even before that ( the nuns said we were close to Fort Knox and so those warheads were forever aimed our way ) we had atomic bomb drills . Fire drills were more fun ; you got to rush outside , in an orderly line of course , and see which class was fastest . Bomb drills initially involved crawling under your desk , with arms cradling head . Then they decided the safer plan was for us to line the hallways , away from windows , sitting cross-legged with heads down on ankles ( the tornado drill was identical ). I had no faith even as a first grader that any maneuver would help .
But I did stockpile canned goods in the basement in case of attack . It felt like something as opposed to nothing . I did all the laundry for many years , so the basement was my domain . I placed milk jugs full of water in the corners and also a library book about Hiroshima , as a reference . Mother was appalled and my sisters scorn – they had a grittier world view .
Now , with nuclear threats rapidly escalating ( in fact I hope we are alive to read this ) we are all shivering in our shoes and praying for peace , and wondering if we actually want to survive an attack or not . The International Committee of the Red Cross in 2013 wrote about the medical effects of a nuclear attack , and they are the grimmest yet .
People within a few kilometers of the impact zone are vaporized . People not vaporized are blast victims , directly or buried by falling objects ; those not blasted to death can then be incinerated by the firestorms created . The firestorms consume all available oxygen , so even if not burned , you get asphyxiated . In Hiroshima , 13 square kilometers were totally destroyed .
The immediate radiation deaths come later : with ruination of the GI tract , one dies of diarrhea ; with ruination of the bone marrow , one dies of bleeding and infection within several weeks . The peak deaths come with the nadir of cell counts . Burn wounds kill up to months later . Lungs swell with pneumonitis and fill with infection . The central nervous system , if exposed to certain levels of radiation , fails within 48 hours . With a smaller dose , one suffers blindness , convulsions , heat stroke , respiratory failure , delirium .
In Hiroshima , 270 of its 300 doctors died or were injured , and 1,654 of 1,780 nurses , the same . But even if many more had lived , they had nothing to work with . They could not transfuse the bleeding or bind up the wounded or relieve the burned of their pain .
We can all recall the attacks of 9 / 11 and the devastation of the surrounding neighborhood . The toxic cloud of ash killed slowly , but has ruined the lungs of many a Ground Zero worker . If there were numerous bombs worldwide , numerous firestorms would result , causing the nuclear winter . In 1983 , the famous TTAPS paper ( authors Turpo , Toon , Ackerman , Pollack and Carl Sagan ) described the effects of multiple megatons of explosions . Within 1-2 weeks , sunlight ceases to penetrate the soot and ash clouds , and temperatures drop to -20 C . Vegetation dies , water supplies are poisoned , animal food sources die , typhoid and cholera run rampant . The TTAPS abstract concludes , “ When combined with the prompt destruction from nuclear blast , fires and fallout , and the later enhancement of solar ultraviolet radiation due to ozone depletion , the long-term exposure to cold , dark and radioactivity could pose a serious threat to human survivors and other species .”
This is why the latest must-have for the leisure classes is the customized bunker . Yacht designers are frantically drawing up plans for those both terrified and rich . Ironically , decommissioned nuclear silos go for top dollar . Bill Gates has built into his Norwegian bunker the largest cache of seeds
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