Epistemology of a disaster: a physicians's lessons from the Bay Area's October 1989 quake - in Oakland

Whole Earth Review, Fall, 1990 by Mark Renneker

When it comes to disasters, however, a carry-over from childhood is not healthy. The big, bad wolf may blow your house down, and you may end up in Oz from a tornado, but somehow you'll survive. Even though we may hear about disasters in the news on a daily basis, we feel immune because they so rarely happen to us. It is from that mind-set, I believe, that most disaster plans are generated; accordingly, disaster plans - whether personal or governmental - consistently misapproximate what can actually happen.

What Do You Believe?

I believe the December 2, 1989, U.S. Geological Survey predictions: Another earthquake with magnitude comparable to the October 17 earthquake, but located closer to the population centers in the San Francisco Bay Area, is expected to occur - with a probability of 50 percent over the next 30 years." (Similar predictions are made for Southern California.)

The U.S. Geological Survey considers the following cities at significant risk for earthquakes: Boston, Rochester, Buffalo, Charleston, Memphis, St. Louis (the largest quake in U.S. history - 8.3 magnitude or greater was in Missouri, in the 1800s), Salt Lake City, Seattle, Anchorage, and Honolulu.

I'm preparing for the next quake (or a similar disaster) and trying to help others to realize that they need to do the same. But I'm not sure that enough people were awakened by this last quake to achieve even rudimentary preparedness. Will the necessary billions of dollars be spent to reinforce or rebuild at least the critical public structures to withstand even the largest quake - particularly the hospitals? Will money be spent to develop new technologies to make earthquake-proof buildings? Will all health professionals be trained in disaster medicine, so they will know better what to do. Will our society learn to take earthquakes as seriously as the Japanese, who have whole-city earthquake drills - every citizen included.

We seem to be where we were with the AIDS epidemic in the early 80s: only dimly aware of the magnitude of the crisis. It is obvious that it will take a major and enormously expensive effort to prepare for what is coming - the Great Quake.

Metalogue: What is a disaster? In terms of systems theory, a disaster is an event or a series of events that halts or severely reduces the output of a system. A disaster leads to system disintegration and dissolution, a stripping away of structure and of what one has learned or knows. Rebuilding after a disaster is a lengthy and painful process.

Epilogue

The quake has left me feeling as if, for a brief time, I was a part of the Holocaust - yet I survived. (And, similar to Holocaust survivors, I don't want to let people forget what happened. I've even thought it would have been a good idea to have left a crumpled part of the Cypress as a monument, so we would be less likely to forget.)

I've developed a deeper mistrust of the capabilities and responsiveness of governmental agencies (a mistrust which, as an inner-city family practitioner who sees homeless and HIV-infected individuals, was already quite high). I've come to see more clearly how the editorial policies (and fears) of the media direct their reporting and consequently distort information. And I've come to realize that this little perch of land we're on up here, San Francisco, is to be appreciated one day at a time.