New Normals

“There’s been an earthquake in Japan.”

March 11, 2011. I was the US Seventh Fleet Surgeon on board the flagship, USS Blue Ridge. We’d docked that morning in Singapore for a five-day port visit and diplomatic exchange with our friends in the Republic of Singapore Navy. After an afternoon staff meeting with our RSN counterparts, I had returned to my stateroom to change into running clothes for a long jaunt before the equatorial heat became prohibitive. That evening I would join friends and shipmates for dinner at one of Singapore’s many fine restaurants.

Then my first class hospital corpsman knocked on my door with the earthquake news.

I scoffed. “There are always earthquakes in Japan.” I laced up my running shoes.

“Not like this one, sir. Turn on your TV.”

As a senior officer, I had a television in my room. I turned it to the Armed Forces Network feed of CNN International. A major earthquake and tsunami had struck the eastern Japan coast, about 150 miles north of Tokyo, which was about fifty miles north of our home port of Yokosuka. As the first videos of widespread destruction appeared on the screen, I got the call from the 7th Fleet Chief of Staff. All hands were being recalled to the ship. Blue Ridge would get underway as soon as we took on disaster relief equipment and humanitarian supplies, to proceed at best speed toward Japan. Our mission: Command and control of a 24-ship US Navy flotilla sortied to support rescue and humanitarian assistance to our major ally in the western Pacific. Operation Tomodachi had begun. (In Japanese, tomodachi means friend.)

My fleeting regret at missing one of the best liberty ports in the world gave way to thoughts about what medical assistance the US Navy might provide, and where and when. We had the playbook. Done it often in the past, usually in the aftermath of typhoons and other natural disasters similar to this earthquake. “We’ve got this,” I thought.

Oh foolish mind to ever assume the easy course. As many a learned military strategist would say, “Never plan to fight the last war again.”

No sooner had Blue Ridge left Singapore in her wake than we got the game-changing news. The Fukushima Daiichi nuclear power plant had experienced a major meltdown. It was now spewing radiation in all directions, including Tokyo and the sea to where US ships were bound. Scrap that old playbook. Never before had the US Navy rendered disaster relief/humanitarian assistance in an environment of known radiological contamination.

“It is safe to do so, doc?” That would have been a good question, but I got more explicit direction: Figure out how to do this because we will not abandon our closest Pacific ally in their time of greatest need. So, with a barrage of questions I’d never considered, and an equal barrage of conflicting advice from authorities and experts throughout the world, we set about defining the “new normal,” going where no naval force had ever before gone.

As Blue Ridge made her transit from Singapore to the waters off Okinawa, Japan, we worked 20-hour days, sat through briefings and teleconferences too numerous to count, and produced reams of written plans—many of which we scrapped right away as new information, advice, demands, or requests flooded our small office. I was fortunate to augment my over-tasked staff of six with a couple of senior Navy medical planners and several reservists, including my reserve surgeon who not only provided a fresh medical mind, but could spell me to get a few more hours of rack time (sleep) every day. We received stellar support from our medical chain of command, the US Pacific Fleet Surgeon and the US Pacific Command Surgeon.

By the time it was needed, we had a good plan. The major element was the recognition that trace nuclear radiation hundreds of miles from the source was not a severe threat to our US ships and sailors (in contrast to the zero-tolerance policy on nuclear-powered warships where the leakage of a single isotope is a sign of containment breach). Armed with that knowledge, we worked with our US and Japanese partners to establish concentric rings around Fukushima. The central ring, or “hot zone” was considered unsafe for any human. Each outer ring in turn required more or less protective equipment and/or restrictions on entry and dwell times. Outside the rings, even with trace detectable radiation, the area was considered safe for judicious routine operations. All presonnel participating in these operations were equipped with radiation dosimeters.

It worked.

While I’m proud of what we did in Operation Tomodachi, the real success story is the strength, collegial spirit, and resilience of the Japanese people. As they had done before, they turned to, united against a common threat, put aside differences, rose to the gargantuan challenge, beat it, then restored their country and their lives. In record time.

Of the many memories I have of those 35 days locked down in Blue Ridge supporting our friends, I recall one in particular. Early on, I had placed a call to my counterpart in the Japanese Maritime Self-Defense Force; a physician with whom I’d previously collaborated and socialized. The hour was late, and we both suffered sleep-deprivation. We always spoke in English, but in mid-conversation he switched to Japanese. When I asked him to clarify, he continued to speak Japanese. Then I realized he was talking in his sleep. I hung up and reflected. While I had been working on four-hours of sleep a night, he had been awake for 72 consecutive hours.

A moment of clarity struck me. For all my intensity and commitment to my Japanese friends, I was doing my job that would someday end. My tomodachi battled to save his homeland.

That happened in the spring, nine years ago. Few in the world had ever heard of something called COVID.