I was one of about 600 dermatologists sitting in a lecture hall during a meeting in Maui when our muted smartphones suddenly started howling in unison. A text message popped up stating, “BALLISTIC MISSILE THREAT INBOUND TO HAWAII. SEEK IMMEDIATE SHELTER. THIS IS NOT A DRILL.” We all assumed a nuclear weapon from North Korea was headed our way.

The lecture was interrupted. The confused and concerned attendees milled around. The immediate response was largely “this can’t be real.” Meanwhile, the text alarm went off again transmitting the same message. The hotel intercom repeated the message and warned us to get inside the ballroom.

We sat in stunned silence. Most people were texting good-bye messages to their children and loved ones. The hotel employees stood in a circle holding hands and praying. My wife had the good sense to move us against a wall so we would not be impaled by a falling chandelier. I turned off all my electronic devices in the hopes that they would still be usable after the explosion. I noted my heart rate was elevated.

Among the attendees was David Cohen, trained in disaster preparedness. He ran up to his room, filled his bathtub, and put his mattress against the glass window. Richard Winkelman went down to the beach where he could at least witness what was about to annihilate him. Dirk Elston speculated the missile’s target was Kauai, where nuclear weapons are siloed. My wife was confident that the missiles would be intercepted, similar to the way they are under the Israeli missile defense system, and shot down before they hit any target.

And so, we mostly waited. The 30 minutes of largely silent confusion gave me a unique opportunity for self-reflection. I realized that many of my issues are petty and that I am insignificant in the scheme of things. I have never felt so helpless in my life. My mind entered a sort of fugue state, and I looked back on my life and realized it had been a darn good ride. I thought about my teenage children. I realized I had many, many things to be grateful for. I felt a huge burden lift off my shoulders and felt like I was floating about an inch above the floor. As I stared into nothingness, I internally reprioritized objectives. I was ready to die.

Then, just as suddenly and unpredictably as it arrived, the alert was called off. The imminent attack was no more than the mistaken push of a button.

But the event remains a defining moment for me. All the small battles that make up a life and career will continue, but I can no longer take them as seriously, and I will now take more time to reflect. I think I will get closer to God. I will try to be a better man, a better father, and a better citizen. It changed me, I think for the better.

Dr. Coldiron is in private practice but maintains a clinical assistant professorship at the University of Cincinnati. He cares for patients, teaches medical students and residents, and has several active clinical research projects. Dr. Coldiron is the author of more than 80 scientific letters, papers, and several book chapters, and he speaks frequently on a variety of topics. He is a past president of the American Academy of Dermatology. Write to him at dermnews@frontlinemedcom.com.

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