Concluding thoughts on the new nature of disaster management

Virtually all our previous responses to environmental disaster involved protecting citizens from adverse effects and then resuscitating survivors after the fact [2]. Now, we have found that most of that paradigm has been rendered moot and radically new concepts have taken their place. As the authors for this manuscript point out, virtually all of our previous "disaster plans, including those in hospitals were woefully inadequate and failed miserably [3]. Unless we learn the present and future logistical problems of environmental disasters, we cannot effectively plan for them.Part of that process is deciding whether we are more interested in constructing or blaming. Americans are notorious for blaming public officials for inadequacies, real or imagined [4]. Public servants are a convenient target for blame when things go wrong. But if there is any blame, it is rarely unilateral. More to the point, assigning blame is by its nature anti-constructive and we need more construction, not more blame. Accordingly, Americans speculated on blame, fueled by the same media process that spawned tabloid news, but on a separate level, we maintained construction. We all pitched in and tried to make it better as well as we could, including money and time donated through multiple ad hoc relief agencies [5]. And we learned.Health care providers, rendered powerless by lack of facilitative technology and hardware, opened their imaginations and thought outside the box to make things work. If sick patients couldn't be extricated in traditional ways, more non-traditional routes mobilized them. Field expediency moved mountains previously thought immobile. Concepts that didn't work were quickly abandoned and other more effective modes were identified by rapid trial and error. When public officials failed, private citizens rallied [6].We learned that trauma isn't the major issue after the event. And so the traditional horde of do-gooders flooding into the area to help actually hindered, as it