Our duty is to go over the brink. (Managing Editor's Desk).

Four years ago, I was standing in the office of a past president of our association. I remember a number of items from our conversation. I vividly remember one item in particular.

With a look of seriousness that stunned me, he emphatically said, "Nelson, I'm scared.... I don't know what we would do if there were a terrorist attack in this community."

He went to some length to explain that he and his staff had by then already participated in a number of terrorist-response exercises and drills. Yet even with this training, there remained a gulf between what he knew and what he knew he would have to know to respond properly to an incident of that nature.

In an eerily similar experience, I had the feeling all over again that there was something missing when I, along with thousands of others, participated in the extraordinary Top Off exercise almost a year ago right here in Denver. As many NEHA members know, the U.S. Department of Justice conducted an intricate and mammoth simulation of a terrorist attack in May of 2000. Three American cities including Denver were the targets for the coordinated assault.

The number of people and agencies taking part in this event was unprecedented. Professionals from many fields, from law enforcement to emergency response to public health to personal health care, were involved. The simulation even required 24hour shifts; the orchestrators of the exercise made every effort to render the experience as real as they could.

Despite the seriousness of the event directors and the sincerity of the event participants, something was missing. As with my conversation with our past president, it was as if we were all taken to the brink... but left short of it.

There were too many jokes on the side, too many pooh-poohs at the possibility that the events being simulated ever could really occur. There was an academic feel to the whole thing as opposed to any real sense of fear, panic, or imagining the unimaginable.

Many responses were mechanical and by the book. What was missing (and maybe what was simply not possible) was the effort to move into a mindset that was likely to prevail during such an incident--a mindset that would have made the entire event feel more real. It was as if everyone was thinking that the unthinkable could never really happen. Thus our responses, actions, and analyses were carried out in the mindset of students rather than that of stressed husbands and wives who knew that back home were their suffering spouses and children.

I am writing this column on Sunday, September 16. It is now almost a week since the assault on the United States. The death toll, I'm hearing, is expected to total twice that of Pearl Harbor--the marker of the last century for how horrible a surprise attack can be.

With the audacious and wicked attack on our country, we have now gone over that brink. No more nudging up to it and then safely retreating. No more scoffing at the likelihood of such an unthinkable act ever occurring. We've gone over the brink, and like it or not, we now live with a new and fearsome reality Terrorism is as real as the air we breathe. Moreover, we have a role in responding to it.

I wish, for humanity's sake and for the sake of our profession, that the death and destruction our nation is now suffering constitute the worst that we shall ever have to live through. The cold and harsh reality however, is that there are yet other brinks in front of us that are both feasible and even more calamitous.

In particular, if terrorists are capable of committing an act so unthinkable as to hijack four occupied airplanes and crash them into buildings housing thousands of innocent civilians, is it any longer unthinkable that other suicidal zealots would be capable of releasing killer biological agents into our environment? And agents so lethal as to make the thousands of our dead countrymen and -women in New York and Washington look trivial in comparison? These are the brinks yet before us.

I consider myself to be a realist. Nonetheless, it terrifies me even to think the ultimate unthinkable--which would be a biological attack involving death counts soaring into the hundreds of thousands. Yet do we, as environmental health professionals, have any choice but to be open to the possibility of such an atrocity? I don't think so. We can no longer participate in training exercises divorced from the fear and the stress we must feel if we are to get everything out of them that is possible. Countless lives may depend on our preparedness. That means that, unlike in the past, there can be nothing missing from every form of training experience we can go through. We need to be 100 percent prepared and not a percentage point less.

How many times have we heard in the past several days about how much more this country could have and should have done to enhance airport security? We would never want it said of our great profession in the aftermath of some terrible disaster that we should have done more to prepare-either to prevent or to minimize the damage from something like a horrific biological attack on one of our communities.

I have argued in previous columns that we are an army of centurions, deployed throughout our nation and communities to intercept and combat mostly invisible agents that threaten the health of our communities. Whether the assault is coming from a foodborne-illness pathogen or a breakdown product of radioactive decay, there we are--analyzing, setting up defensive measures, going on the offensive, communicating with our people, and so on. Our army must now take on the very same role with regard to the scourge of terrorism in all of its unthinkable dimensions.

In the wake of the attack on our east coast and in light of what has been missing from many of the previous terroristresponse training exercises I'm aware of, it is my humble opinion that we need to do two things. First, we need to read every article we can on terrorism response; we need to attend every workshop we can; we need to learn from others, practice routines, and, in every way possible, become as expert and proficient in this area as many environmental health professionals are in such mainstay environmental health topics as food safety and protection.

Second, we have to take this threat to our very humanity as seriously as we can. Passion and seriousness need to substitute for skepticism. Extra effort needs to replace going through the motions. Investing one's heart in these exercises needs to be more important than following the abstract computations of one's brain. There is simply too much at stake.

The apt adage: "To be forewarned is to be forearmed for such a time as this" seems more than instructive. It is now our professional ethic and duty to be forearmed. We have been forewarned. This is nothing less than a call to arms for our army. We owe it to our loved ones, our communities, and our country--and ourselves--to respond at nothing less than 100 percent of our full capabilities. If we are properly prepared and emotionally equipped to respond to such previously unimaginable acts of war, we will save countless lives and by so doing demonstrate that these wanton acts can be beaten.

Note: NEHA is working hard to help every single member of this profession advance in this area. We have two separate grants whose purpose is to create educational products that will help prepare you to respond to a range of possible different kinds of terrorist attacks. We also have some publications on this topic and are frantically looking for more that could be of help to you. In the past, our Annual Educational Conference (AEC) has offered special tracks in counter-bioterrorism training. Our plan is to expand those tracks for our upcoming AEC in Minneapolis.

Finally, we are also trying to help environmental health professionals in the cities affected by the assault. NEHA members should know that our counterpart professional society in England, the Chartered Institute of Environmental Health, has donated $20,000 from the profits of its annual conference for NEHA to give, as best we see fit, to those in this profession affected by the terrorist attack.

We are truly on the front lines. NEHA will do everything it can to be of assistance to you as you cross the brinks in front of us.