A shadowy terror group smuggles a crude nuclear bomb into the United States, then detonates it right in the heart of Washington D.C., setting off a 15 kiloton explosion.

Eighty thousand Americans are killed instantly, including the president, vice president and most of the members of Congress, and more than a hundred thousand more are seriously wounded.

News outlets are soon broadcasting a message they’ve all received from a group claiming responsibility.

It says there are five more bombs hidden in five different cities across the America, and one bomb will be set off each week for the next five weeks unless all American troops based overseas are ordered to immediately return to the U.S. homeland.

The nation is thrown into chaos, as millions scramble to flee the cities, clogging roads and choking telecommunications systems.

The stock market crashes, before trading is halted altogether.

Martial law is declared, amid widespread looting and violence.

That was just one of the nightmare scenarios for a potential nuclear disaster that former U.S. Secretary of Defense William J. Perry vividly described as he delivered the Center for International Security and Cooperation’s annual Drell Lecture on Wednesday.

“My bottom line is that the likelihood of a nuclear catastrophe today is greater than it was during the Cold War,” Perry said.

Most people were “blissfully unaware” of the danger that simmering conflicts in geopolitical flash points around the globe – including Russia, China, North Korea, Iran and Pakistan – could easily turn nuclear, Perry told the Stanford audience.

A new nuclear arms race with Russia

Perry said he had tried to foster closer cooperation between the U.S. and Russia when he headed the Pentagon during the mid ‘90s and helped oversee the joint dismantling of four thousand nuclear weapons.

“When I left the Pentagon, I believed we were well on the way to ending forever that Cold War enmity, but that was not to be,” he said.

William J. Perry shares a video depicting the threat of nuclear terrorism with a Stanford audience.

Since then, relations between the West and Russia have soured badly, prompting Russia to modernize its nuclear arsenal and assume a more aggressive nuclear posture.

“They’re well advanced in rebuilding their Cold War nuclear arsenal, and it is Putin’s stated first priority,” Perry said.

“And they have dropped their former policy of no first use of nuclear weapons, and replaced it with a policy that says nuclear weapons will be their weapon of choice if they are threatened.”

While Perry said he believed Russian president Vladimir Putin did not want to engage in a military conflict with NATO forces, he said he was concerned about the possibility of Russia making a strategic miscalculation and stumbling into a conflict where they might resort to the use of tactical nuclear weapons.

“If they did that there’s no way of predicting or controlling the escalation that would follow thereafter,” Perry said.

Chinese economic problems increasing tensions

In Asia, a slowing Chinese economy could exacerbate domestic political tensions over issues such as wealth inequality and pollution, and encourage Chinese leaders to divert attention from problems at home by focusing on enemies abroad.

“China has had more than 10 percent growth now for almost three decades, but I think there’s trouble ahead,” Perry said.

“The time-proven safety valve for any government that’s in trouble is ultra-nationalism, which in the case of China translates into anti-Americanism and anti-Japanese.”

China has seen a major growth in military expenditures over the last decade, and it has used that investment to build a blue water navy and develop effective anti-ship missiles designed to drive the U.S. Navy hundreds of miles back from the Chinese coastline.

One potential flash point for a conflict between China and the U.S. are the artificial islands that China has been building in the disputed waters of the South China Sea.

“In a sense, China is regarding the South China Sea as a domestic lake, and we regard it and most other countries regard it as international waters, so their actions have been challenged by the U.S. Navy and will continue to be challenged,” Perry said.

North Korea’s growing nuclear threat

Meanwhile, China’s neighbor North Korea has continued to defy the international community and conducted another nuclear test in January.

“North Korea is today building a nuclear arsenal, and I would say clearly it’s of the highest priority in their government, and they have adopted outrageous rhetoric about how they might use those nuclear weapons,” Perry said.

William J. Perry delivers the Drell Lecture in an address entitled "A National Security Walk Around the World."

“These missiles today have only conventional warheads that are of no significant concern, but they are developing nuclear warheads,” Perry said.

“They already have developed a nuclear bomb, and the latest test, as well as tests to come, will be designed to perfect a bomb small enough and compact enough and durable enough to fit into a warhead. If they succeed in doing that, then the bluster will become a real threat.”

Perry said he hoped China and the United States could combine forces and adopt a “carrot and stick” diplomatic approach to force North Korea to abandon its nuclear weapons program – with the United States offering aid and international recognition, and China threatening to cut off supplies of food and aid.

He said he expected to see “more acting out” from the North Korean regime in the coming months, in the form of further nuclear and rocket tests.

Like it or not, the Iran deal is the only deal we’ll get

The landmark deal reached last year, where Iran agree to curtail its nuclear program in exchange for the lifting of economic sanctions, was a better resolution than Perry had expected to the negotiations, but it has met with significant resistance from groups he described as “strange bedfellows.”

“The opposition in Israel and the United States opposed the deal because they fear it will allow Iran to get a bomb,” Perry said.

“Whereas the opposition in Iran opposed the deal because they fear it will prevent Iran from getting a bomb. Both cannot be right.”

Many Republican presidential hopefuls have publicly stated on the campaign trail that they would withdraw from the deal if they got elected to the White House, but Perry said that would be a strategic mistake.

“The opposition in the United States has a simple formula – we should withdraw from the deal, we should reinstate sanctions, and we should renegotiate a better deal,” Perry said.

“Let me be as blunt as I can, this is a pure fantasy. There is not the remotest possibility that the sanction could be reapplied if the United States withdraws from this deal, because the day we withdraw from the deal, our allies are gone, the sanctions are gone, there will be no renegotiations without sanctions, so this deal, like it or not, is the only deal we will ever get.”

Another “Mumbai” attack could spark regional nuclear war

Nuclear rivals India and Pakistan have more than a hundred nuclear weapons on each side, as well as the missiles to deliver them, and a conventional military conflict between them could quickly escalate into a regional nuclear war, Perry said.

Another large-scale terror attack, like the coordinated assault in Mumbai that killed more than 163 people in 2008, could lead India to retaliate militarily against Pakistan (which India blames for encouraging the terror groups operating in Pakistani territory).

Perry said he was concerned that Pakistan would then use tactical nuclear weapons against invading Indian troops, and that India might then respond with a nuclear attack of its own on Pakistan.

“So this is the nightmare scenario of how a regional nuclear war could start,” Perry said.

“A nightmare that would involve literally tens of millions of deaths, along with the possibility of stimulating a nuclear winter that would cause widespread tragedies all over the planet.”

A ray of hope

Despite all the potential for nuclear disaster in the current geopolitical environment, Perry said he was still hopeful that nuclear catastrophe could be avoided.

"While much of my talk today has a doomsday ring to it, that truly is not who I am,” Perry said.

“I’m basically an optimist. When I see a cloud, I look for a ray to shine through that cloud.”

One important step toward reducing the nuclear threat would be improving relations between the U.S. and Russia, he said.

“My ray of sunshine, my hope, is I believe we can still reverse the slide in U.S. Russia relations, he said.

“We must begin that by restoring civil dialog. We must restore cooperation between the United States and Russia in areas where we have mutual interest…If we succeed in doing that, then we can work to stop and reverse the drift to a greater and greater dependence on nuclear weapons.”

Perry ended his speech by urging the audience to keep striving to rid the world of the threat of nuclear weapons.

“We must pursue our ideals in order to keep alive our hope – hope for a safer world for our children and for our grandchildren,” he said.

The world remains perilously close to a nuclear disaster or catastrophic climate change that could devastate humanity, according to Stanford experts and California Governor Jerry Brown, who were on hand to unveil the latest update to the Bulletin of Atomic Scientists’ “doomsday clock” on Tuesday.

The symbolic clock was created in 1947 when Albert Einstein and Robert Oppenheimer (the father of the U.S. nuclear program) founded the publication.

The closer the minute hand gets to midnight, the closer their Board of Science and Security predicts humankind is to destroying itself.

“I must say with utter dismay that it stays at three minutes to midnight,” said Rachel Bronson, the publication’s executive director and publisher, in a bi-coastal teleconference carried live from The National Press Club in Washington D.C. and the Stanford campus.

Despite some positive development over the past year, such as the Iran nuclear deal and the Paris climate accords, the doomsday clock is now the closest it’s been to midnight since the peak of Cold War hostilities in the mid 1980s.

Stanford experts, including former U.S. Secretary of Defense William J. Perry and former Secretary of State George P. Shultz, said they agreed with the dire assessment.

“The danger of a nuclear catastrophe today, in my judgment, is greater than it was during the Cold War…and yet our policies simply do not reflect those dangers,” said Perry, who is a faculty member at Stanford’s Center for International Security and Cooperation.

Perry said he was especially concerned that the U.S. and Russia were engaged in new arms race, with both countries working to rapidly modernize their nuclear arsenals.

“Whatever we need to do for deterrence, it does not require rebuilding what we did during the Cold War era,” he said.

Perry urged President Barack Obama not to give up on the goal of nuclear disarmament during his last year in office, and to push for a breakthrough deal to control fissile material at the upcoming Nuclear Summit in Washington D.C.

“These summit meetings have been quite significant, and if he can use this last summit meeting to establish international standards for fissile control, which fifty heads of state sign up to, that would be a real achievement,” Perry said.

Shultz said the U.S. needed to offer a new version of the bold plans and decisive actions that legendary American statesmen George Marshall and Dean Acheson pursued after World War II.

“We have to be engaged, because when we don’t give leadership, nobody does,” said Shultz, a distinguished fellow at the Hoover Institution.

The doomsday clock was initially designed to communicate the threat from nuclear weapons, but has since been expanded to include cyber and biosecurity and the dangers of unsustainable climate change.

California Governor Jerry Brown described climate change as a “daunting threat,” with many similarities to nuclear dangers.

“Climate change and nuclear accident or nuclear war or nuclear sabotage or nuclear terrorism, they’re tied together,” Brown said.

“Climate change is moving slowly, but tipping points are around the corner and you don’t know when you’ve reached one, and beyond a tipping point, we may not be able to come back.”

Brown said he was dismayed at the lack of political action to address climate change and nuclear threats.

“I’ve been around politics all my life, and I can see an obviously broken process, a democratic system that has turned more into spectacle than getting the job done,” Brown said.

“In order to have the political leaders deal with this, they have to first acknowledge it.”

When a high school student in the audience asked what he could personally do to tackle the threat of nuclear weapons, Perry said the most important step was to educate himself about the issues, so he could educate others.

“If you can get ten people interested in talking about this problem, and each of those ten can get ten people interested in talking about this problem, it builds up in a geometric progression,” Perry said.

“I think once the public understands the dangers, they will galvanize our Congress and our leaders into action.”

[[{"fid":"221894","view_mode":"crop_870xauto","fields":{"format":"crop_870xauto","field_file_image_description[und][0][value]":"Herbert Abrams","field_file_image_alt_text[und][0][value]":"Herbert Abrams","field_file_image_title_text[und][0][value]":"Herbert Abrams","field_credit[und][0][value]":"","field_caption[und][0][value]":"Herbert Abrams","field_related_image_aspect[und][0][value]":"","thumbnails":"crop_870xauto"},"type":"media","attributes":{"alt":"Herbert Abrams","title":"Herbert Abrams","width":"870","style":"width: 400px; height: 500px; float: right; margin-left: 15px","class":"media-element file-crop-870xauto"}}]]Renowned radiologist Herbert Leroy Abrams, who co-founded the Nobel Prize-winning organization International Physicians for the Prevention of Nuclear War, died Jan. 20 at his Palo Alto home. He was 95.

Abrams was a professor emeritus of radiology at Stanford University, a senior fellow at Stanford's Freeman Spogli Institute for International Studies, and an affiliated faculty member at the Center for International Security and Cooperation (CISAC).

Abrams' illustrious, multi-faceted career embraced what he called the "four dimensions of bio-medicine" – patient care, research, teaching and advocacy.

"For as long as I have known him, I could only describe Herb Abrams as a class act," said Sanjiv "Sam" Gambhir, professor and chair of radiology at Stanford. "It is upon the shoulders of giants such as Herb that we ourselves stand today at the cutting edge of radiology."

Former U.S. Secretary of Defense and CISAC colleague William J. Perry praised Abrams for his "wisdom and carefully chosen words" in his advocacy for better control of nuclear weapons.

"The forces maintaining nuclear weapons and creating the danger that we might use them are very powerful and very hard to stop, and Herb and the International Physicians for the Prevention of Nuclear War were an early voice of sanity in this field, " Perry said.

Visionary pioneer in radiology

Born in 1920 in New York to immigrant parents, Abrams declined to go into the family hardware business. He graduated from Cornell University in 1941 and earned his medical degree from Long Island College of Medicine in 1946.

According to his family, Abrams had planned to become a psychiatrist until he was captivated by radiological imaging, which provided the road map for virtually all surgical and many medical therapies.

Abrams, his wife, Marilyn, and daughter, Nancy, moved to the West Coast in 1948.  Their son, John, was born a year later. Abrams completed his residency in radiology at Stanford in 1952 and joined the faculty as an assistant professor in the department in 1954.

While Abrams rose to become director of diagnostic radiology at Stanford, he and Marilyn raised their children in the Bay Area during what his children say he often called "The Golden Years" – rich with deep friendships, youthful exuberance, guitar-playing, family adventures, and professional success.

Abrams was an internationally known authority on cardiovascular radiology and wrote more than 190 articles and seven books on cardiovascular disease and health policy.

For many years he served as editor-in-chief of Postgraduate Radiology, and he was founding editor-in-chief of the journal Cardiovascular and Interventional Radiology.

In 1961 he published Angiography, the first comprehensive volume on the subject, which now is in its fourth edition (edited by Stanley Baum) under the title Abrams' Angiography: Vascular and Interventional Radiology.

"Under his guidance, Stanford pioneered in the fields of coronary artery imaging and the diagnosis of adult and congenital heart diseases, as well as vascular diseases, such as renal artery narrowing as a cause of hypertension," said Lewis Wexler, professor emeritus of radiology at Stanford, who was a resident under Abrams.   

"For many years, I referred to him as 'Dr. Abrams,' even though he requested a less formal address," Wexler added.  "I think I waited until I was a full professor before I called him 'Herb.' His wife and a number of his old friends from San Francisco called him 'Hoppy,' an endearment that aptly describes his energy, excitement and ability to jump effortlessly from discussing radiology [to discussing] health policy, politics, religion, art and music."

The Boston years

In 1967, with their children pursuing their own paths, Abrams and his wife moved to Boston, where he became the Philip H. Cook Professor of Radiology at Harvard Medical School and radiologist-in-chief at Brigham and Women's Hospital and at the Dana Farber Cancer Center.  The intellectual environment of Boston invigorated him and he devoted himself to building a great radiology department, a new research institute, and an outstanding teaching center.  During their time in Boston he and Marilyn also began a long love affair with Martha's Vineyard, where they built a house in 1975.

Steven Seltzer, chair of the Department of Radiology at Brigham and Women's Hospital, who holds the Philip Cook professorship at Harvard Medical School, which Abrams previously held, remembers his longtime mentor as a visionary who helped broaden the scope of radiology as a discipline.

When Seltzer arrived at Brigham and Women's in 1976 to do his radiology residency in what was then a very small department, he recalled being "incredibly impressed with the professional growth opportunities and the values and quality of the program that Abrams was building." He added that radiology was "still growing up" at that time and that Abrams had a vision that began during his years at Stanford and developed during his years in Boston.

"He was a very determined man. I fully bought into that vision. I thought this is a good person to have as a mentor and a role model, because I also aspired to live in a world that had similar characteristics that Herb had dreamed of," Seltzer said.

As a mentor and teacher, Seltzer remembered, Abrams pursued and demanded excellence and sometimes exhibited impatience.  During the time that Seltzer held the post of chief resident in radiology at Brigham and Women's, the hospital scored one of the first CT scanners in the city. The device operated 18 hours a day, seven days a week, and was staffed by residents after hours and on weekends. This was in addition to the residents' regular on-call duties. When the residents balked, Seltzer approached his boss and questioned the fairness of the arrangement and suggested that the residents be compensated with a stipend. "He just looked at me and said, 'Steve, you're doing this. This is your responsibility, and you need to get the residents comfortable with it.'"

During their 40-year relationship, Seltzer got to know another side of Abrams, whose approach to being a grandfather and great-grandfather was far different from the "tough love" he doled out to his students.

Anti-nuclear advocacy

Toward the end of the Boston years, in the early eighties, Abrams developed a keen interest in the effects of ionizing radiation and nuclear weapons and the problems of accidental or inadvertent nuclear war, which led to the next phase of his career as an anti-nuclear activist.

"He leveraged his training in radiology to become one of the leading experts on the health effects of low-dose radiation," said David Relman, professor of medicine at Stanford and current co-director of CISAC.

"It's a problem that doesn't get as much attention as the catastrophic effects of a nuclear blast, but the long-term consequences of low-dose radiation was something that Herb … helped promote as a serious issue, worthy of attention and study," Relman added.

Abrams discussed the threats posed by radiation in a story published in the Spring 1986 issue of Stanford Medicine magazine. He said that, for physicians, nuclear weapons and nuclear war were "the central health issue of the 20th century."

"We need to educate not only our colleagues and our students, but our constituents – the patients  – and ultimately policymakers about the consequences of nuclear war," Abrams said in the article. "Medical students are seldom taught about the effects of radiation. It's important because there have been radiation disasters unrelated to nuclear weapons, and there will be more in the future."

He was founding vice president of International Physicians for the Prevention of Nuclear War (IPPNW), which won the Nobel Peace Prize in 1985, just five years after the organization was established. He also served for many years on the national board of directors and as national co-chair of Physicians for Social Responsibility (PSR), a U.S. affiliate of IPPNW.

"His contributions were huge," said Scott Sagan, Caroline S.G. Munro professor of political science at Stanford. Sagan added that under Abrams' leadership the IPPNW "did yeoman's work to try to educate the public and world leaders about the consequences of nuclear war at a time when many, including some in the Reagan administration, were minimizing the consequences of nuclear weapons use."

Abrams returned to Stanford in 1985 as a professor of radiology, but spent most of his time in research at CISAC, working to link various disciplines and philosophies in the political, international and academic arenas to create a better understanding of international security during the nuclear age.

Presidential disability

In the 1990s Abrams began to focus on presidential disability and its potential impact on decision-making.

In 1992 he published The President Has Been Shot: Disability, Confusion and the 25th Amendment, which brought together important issues at the intersection of medicine, politics and humanism.

"[H]is contributions to our intellectual life and to our knowledge of the presidency and so much more were significant and lasting," said CISAC co-founder John Lewis, who invited Abrams to join CISAC after he returned to Stanford.

Near the end of his long life, Abrams wrote about the effects of aging, not only on leaders but also on himself.

Sagan said Abrams "continued to make both scholarly and policy contributions" even toward the end of his long career.

"Herb lectured every year at Stanford on how the physical and psychological health of leaders influenced their decision-making about war and peace," Sagan said.

CISAC co-director Amy Zegart said Abrams "was vibrant to the end," attending seminars and "asking hard-hitting questions."

"He had an incredible mind and an incredible heart, and I think everybody saw both of those things in him, which is why he was such a bedrock of our community for such a long time," Zegart said.

A vibrant family life

Always at the core of Abrams' life was bringing together his family to travel, to ski, to play tennis, and to celebrate birthdays and holidays. 

On his 95^th birthday Abrams played four-generation tennis with his son, grandson, and great-grandson on Martha's Vineyard, where his family spent summers for 45 years. Until the last month of his life, he played doubles three times a week.

In addition to Marilyn, to whom he was married for 73 years, daughter Nancy (Richard Eilbert), of Lincoln, Mass. and son John (Christine) of West Tisbury, Mass. ,Abrams is survived by three grandchildren (Pinto and Sophie Abrams, and Natasha Eilbert) and three great-grandchildren (Kalib, Silas, and Axel Abrams).

Memorial donations in memory of Abrams may be made to Physicians for Social Responsibility 1111 14^th St. NW, Suite 700, Washington, DC, 20005, or by visiting that organization's website at www.PSR.org.

A service to celebrate his life will be held on the Stanford campus on March 19; details will be announced.

Why did Iran agree to send the bulk of its low-enriched uranium out of the country and remove the core of its Arak reactor? Those actions significantly lengthen the time it would take to build up a nuclear weapon program.

Siegfried Hecker, CISAC senior fellow and former Los Alamost National Laboratory director, shares his personal view in the Bulletin of Atomic Scientists: http://thebulletin.org/iran-nuclear-option-more-trouble-it-was-worth9064

Can the U.S. find the right balance between cooperation and containment, so it can realize the long-term benefits of the nuclear deal with Iran? CISAC visiting fellow Nicholas Burns, who helped to negotiate sanctions against Iran for the Bush administration a decade ago, offers his opinion in this piece for The New York Times.