The concept of disaster medicine has been in evolution for decades. Its requisite components were buried within disparate, often apparently unrelated disciplines and specialties. Today, we know these diverse disciplines must work seamlessly together and are essential for disaster preparedness, response, mitigation, and recovery. Events such as the tsunami in Indonesia, Hurricane Katrina in the United States, the cyclone in Myanmar, and the Novel H1N1 (2009) pandemic have served to reinforce our interdependence on one another and the globalness of our interconnected responsibilities. As we view the challenge of “all-hazard” preparedness, we are forced to recognize that our geopolitical borders are meaningless and sometimes a barrier to the public's health. In this new millennium, our nation and the globe must now reflect on contemporary threats that are truly international in scope, such as emerging infections, terrorism, weapons of mass destruction, and other disaster events.

From the late 1960s through today, I have had a unique vantage point to observe and contribute to our ever-expanding knowledge base in the fields of disaster and emergency management, as well as in public health and disaster medicine. As a medic, police first responder, registered nurse, physician, professor, trauma surgeon, and Surgeon General of the United States, I have been a witness and participant in this history.

As our knowledge base has exploded in depth and breadth, we have struggled with our own nomenclature and definition of terms. Such rapid growth has made achieving consensus on many complex issues extraordinarily difficult.