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At 8:07 on Saturday morning, Hawaii residents woke up to an emergency alert on their cellphones:

“BALLISTIC MISSILE THREAT INBOUND TO HAWAII. SEEK IMMEDIATE SHELTER. THIS IS NOT A DRILL.”

Until a second message called it a false alarm 38 minutes later, the people of Hawaii contemplated the end — the end of their lives, of their families, of essentially everything they know and love.

I am originally from Hiroshima. The Hiroshima Peace Memorial Museum and Park was within walking distance from my grandfather’s house.

As a family physician, I cared for Marshall Islander survivors of nuclear testing. Disaster medicine is one of my academic interests.

The war of words between Donald Trump and Kim Jong Un brings the world perilously close to nuclear Armageddon. As North Korea tests nuclear devices and delivery systems, the U.S. conducts military exercises and draws up plans for pre-emptive strikes.

Existential Moment

As adversaries go on hair-trigger alert, the potential for a mistakenly launched nuclear exchange increases. The probability of nuclear war thus approaches the probabilities that during the Cuban Missile Crisis.

The standoffs at the Russian border and in Syria are other reasons why the Bulletin of Atomic Scientists have placed the minute hand of the Doomsday Clock to midnight.

Under these circumstances, the people of Hawaii had good reason to fear that the threat was real. Many surely had an existential moment.

We should all pause to contemplate how each of us lives each day.

Since on any given day the wind might pick up a roof tile from a Copenhagen building and drop it on one’s head, Kierkegaard suggested that we should live each day in a manner such that we would not regret sudden annihilation. We should all pause to contemplate how each of us lives each day.

A 100 kiloton would be expected to cause 156,000 fatalities and 139,000 injuries. Hawaii schools to shelter-in-place “[i]n the event of a nuclear attack.”  The air raid siren is now being tested monthly. Many argue for for Hawaii.

Nine of 18 flight tests, however, of the missile defense system have failed. Technical experts about the ability of the system to defend against missile attack.

More missiles will not save us. Escalating military threats serves to increase the risk of a nuclear holocaust. The only rational response is prevention.

As pediatrician Helen Caldicott taught us, we must “eradicate nuclear weapons because they are medically contraindicated.” Her observation is not simply that nuclear war will ruin your day. Rather, her insight is that it is our duty as health workers to work to prevent nuclear war.

As , the German physician, writer and politician Rudolph Virchow said:

We need to revive the social movement to oppose the manufacture of nuclear weapons. We must first call for taking the weapons off of hair-trigger alert. We learned this Saturday that it is easy to make mistakes. Hawaii’s an “employee pushed the wrong button.”

In this arena, pushing the wrong button has unacceptable consequences. My Kierkegaard moment this Saturday morning has convinced me that I am not doing enough to prevent nuclear war. I will work on correcting that.