Many times in Jacksonville's history have physicians and public health officials joined together to address a crisis. In 1854, when Savannah suffered terribly from yellow fever, members of the newly formed Duval County Medical Society used cannons, among other measures, to enforce the quarantine that kept away ships from that city. On May 25, 1883, the Society held an emergency meeting with the Jacksonville Board of Health to deal with a dreadful smallpox epidemic. It was agreed that there would be compulsory vaccination for all residents, and the DCMS physicians offered their services without charge. Within a month, the epidemic was over. In 1888, it was yellow fever; in 1901, it was the great fire that decimated hospitals, water systems, and doctors' offices alike.

It is remarkable to me that our nineteenth century colleagues could endure the emotional turmoil and scientific uncertainty of yellow fever when it reached Jacksonville in 1857. At that time, any doctor could recognize and recite the terrible clinical course of this disease but there were few scientific facts with which to prepare or protect. It would not be until 1881 that a doctor in Cuba would suggest that the disease is transmitted by mosquitoes, and nearly a century later that the virus would be isolated and a vaccine created. In 1857, the fear bred by such ignorance must have been dreadful: it is recorded that most citizens fled "except for a few physicians, a druggist, and clergymen".

Now we face the specters of nuclear, chemical and biological terrorism. Today's threats in the wake of the attacks of September 11 are in some manners similar to those faced by Jacksonville physicians in the nineteenth and eighteenth centuries. As in 1857, we know little about what might attack us, when, and how. We have been told of more than a dozen agents that could be employed by terrorists, most of which are totally new to the Jacksonville medical community. There may even be genetically modified biological agents or combinations of chemical agents which have never before been seen by mankind.

The role of today's physicians during a health crisis remains as it has been for the past 148 years of the Duval County Medical Society. We have not fled, panicked, or abandoned our commitments to our patients, our community or our profession. Instead, we have gathered across Jacksonville to learn, to discuss, and to prepare.

By late September, meetings had begun with DCMS officers, our Community Health and Disaster Preparedness Committee, and officials of the Duval County Health Department. We assisted local hospitals and the Health Department's Dr. John Montgomery to provide lectures on biological and chemical terrorism. In three weeks, more than 1000 physicians attended these lectures. We sent our members information by fax and by email. The Florida Medical Association website made available vast amounts of information and CME credit programs. The Florida Board of Medicine, chaired by DCMS member Dr. Gaston Acosta-Rua, granted that 1 one hour of CME credit on bioterrorism could be used in lieu one of the required programs on domestic violence or HIV.

This issue of Jacksonville Medicine is part of the second and longer phase of our preparations. Over the next few months we will be involved intensely in creating detailed disaster response plans so that we will be ready in the event of an attack. This is occurring at several venues. The DCMS Disaster Preparedness Committee was restructured for this crisis with Dr. Mike Bernhardt as the new Chairman. Similar committees have been activated with DCMS members in charge at most of Jacksonville's hospitals. New education programs are being formulated to share these programs with our doctors. Several of our members and Mr. Phil Gilbert, our Executive Vice President, have been appointed to the Governor's regional task force on terrorism preparation. DCMS is helping to write legislation, supported by Senator Steve Wise, which would provide hospitals, health departments and physicians with supplies that are needed urgently.

Jacksonville physicians are answering the call of President George W. Bush. We are remaining on the job, working hard, and demonstrating both strong resolve and leadership. This is our role as it has been for the past 148 years. I am proud to be among you.

November, 2001/ Jacksonville Medicine

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