My experiences in responding to disasters are quite varied. While there are several different definitions for disasters, it is important to remember that like emergencies, what is routine to me might very well be a disaster for you. From the simple emergency medical services run to averting the disaster with a response to a chemical spill, each experience brings with it lessons learned and hopefully people saved.

My biggest lesson learned, unfortunately, came during 9/11. It was here that I realized that the books and seminars were correct in that an unpracticed plan really doesn’t exist, and that like a quality safety program, without buy-in from the top management of an organization, no emergency plan can succeed. To exacerbate the situation, there has yet to be debriefing on the event to even begin to develop and understand the lessons learned from what many feel is not the last event of this type for our region.

A disaster response requires coordination be developed well in advance. While this is a nice thought, it fails to mention that not only does the coordination need to be established; it needs to be practiced regularly. And while disaster drills are good for the six o’clock news program, everyone goes into the event knowing it’s a “drill” and systems might not be taxed to the limit as they would in an unplanned event. A perfect example would be a tri-county drill held in southern Maryland a few years ago. The simulated event was a plane crash into an industrial area during a working day. While a nice idea, the set-up for the drill was flawed. All of the units that could potentially respond, including some over 50 miles away -- with limited access into the disaster area -- were all staged about 1500 feet from the “disaster site.” There was no real opportunity to see how the disaster progresses. No chance to see how counties with all volunteer emergency services could staff such an event on a weekday. It was a fine example of practicing a page from the book without ever testing to see if the writing on the page was based on flawed suppositions.

Here is where experiences in the emergency services field can help the apprentice emergency manager. In the field of pre-hospital emergency medicine, it is not uncommon for quality assurance managers to work with crews to critique and debrief calls. Crews often internally debrief after each run, working to correct mistakes and improve outcomes for the patients. The ability, however, to take this and translate it to all disasters is a skill that few possess.

While most can argue the point at were an event becomes a disaster, few can dismiss the fact that without coordination, real ongoing coordination, the potential for the disaster to overwhelm its participants grows exponentially. Preplanning events is good, but only if they can be practiced under as realistic conditions as possible. And finally, debriefing is a valuable tool, but only if there is a belief in top-level management (or top-level elected officials) that the planning, response and recovery to events is a necessary function of the organization.

All that being said, your experiences to a disaster will be based partly on your role, training, education, and experience. It will rely on your level of interaction with the major parties to the event, and your willingness to change your beliefs, preconceived notions, and if necessary that two hundred-page response plan you just developed to combat the next set of events.