Throughout history, physicians and other health care workers have dealt with catastrophes, caring for the victims and often feeling helpless when a disaster is so great that many lives are instantly lost or are beyond saving. For decades, a group of physicians has been urging other clinicians, political leaders, and the public to imagine an event of apocalyptic proportions that could very possibly occur today. The cause would be nuclear war.
In the early 1960s, the newly formed Physicians for Social Responsibility (PSR) published a comprehensive analysis of a clearly defined thermonuclear attack on the United States, including its human and ecologic consequences in a given area, specifically metropolitan Boston and southern New England (Ervin FR et al. N Engl J Med. 1962;266:1127-1137). In the Boston area alone, the analysis estimated, the blast, heat, and radiation from a thermonuclear attack would kill 1.4 million people and injure another 1.25 million. Of the latter, 1 million would die because no effective health care intervention would be possible. The authors urged physicians to educate people about such health dangers and to work to prevent them, as they do in other areas of preventive medicine (Sidel VW et al. N Engl J Med. 1962;266:1137-1145).