War double suicide     I am writing in reference to the article on page 2-A of the 11 April edition of the Southwest Times Record about nuclear attack on Titan missile silos. I am alarmed about the optimistic tone of this article. I suspect that some readers found encouragement from this article that a nuclear war might be winnable.     Nuclear war, even a limited one, would result in death and injury on a scale that has no precedent in all of human history. Medical disaster planning for nuclear war is meaningless. There is no possible effective medical response. Most hospitals would be destroyed, most medical personnel dead or injured, most supplies unavailable. Most survivors would die.     There is no effective civil defense. The blast, thermal and radiation effects would kill even those in shelters. Worldwide fallout would contaminate much of the globe for generations and severely damage all living things.     The atomic bomb dropped on Hiroshima was primitive by today's standards. The blast killed over 75,000 people and injured nearly 100,000 out of a population of 245,000. Ninety percent of the 76,000 buildings within the city limits were destroyed. Fewer than 30 of Hiroshima's 150 physicians were able to attend the victims. Of the 1,780 nurses, 1,654 were dead or too badly wounded to work.     In 1979, several U.S. government departments cooperated in preparing a study describing the effects of a nuclear attack on Detroit. A one megaton atomic weapon exploded in central Detroit would result in 70 square miles of property destruction, 250,000 fatalities, 500,000 injuries, plus damage from widespread fires. Of the 18,000 hospital beds in and around Detroit, no more than 5,000 would remain relatively undamaged. Only one percent of the injured could be accommodated and none of them could obtain the services required by a typical, severely burned patient in today's modern hospital.     Of course, a nuclear war would involve hundreds of bombs and the destruction from such is beyond imagination. Civilization in the U.S., U.S.S.R., and much of the rest of the world could be destroyed in an instant. If existing nuclear weapons were reduced in number by 90 percent, the story would be unchanged. The threat of annihilation would remain the same.     An objective examination of the medical situation following a nuclear war leads to but one conclusion: prevention is our only hope.     Regarding nuclear warfare, General Douglas MacArthur made this statement: "If you lose, you are annihilated. If you win, you stand only to lose. War contains the germs of double suicide." Michael S. Cole, M.D. 18 April 1982 Southwest Times Record

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