Thursday’s shake was a reminder

And yet, I was wide awake, heart pounding, for nearly 15 minutes after.

My husband rolled over and went back to sleep. So did our dogs, snoring happily. Meanwhile, my nervous system had other plans.

As a physician and former trauma and burn surgeon, I have spent years watching the human stress response play out in real time. What happened to many of us last night has a name and a mechanism, and understanding it is itself a form of preparedness.

This is not a personal failing. This is the amygdala doing exactly what it was designed to do. When the ground moves beneath you, your brain triggers a threat response before your rational mind can catch up. cortisol and adrenaline surge. Your heart rate climbs. Your body is ready to act, even when there is nothing to act on. Even when you are the emergency manager who knows, professionally, that everything is OK.

What I have learned across my professional roles, first in medicine and now in emergency management, is that the same stress physiology shaping how a trauma patient responds in the first minutes after injury also shapes how a community responds in the first minutes after a disaster. The mechanisms are identical. So are the interventions.

If you felt that surge last night, this is for you.

The first thing I did was slow my breathing. Deliberately. Counting in, counting out. This is not a wellness cliché. Slow, controlled deep breathing directly activates the parasympathetic nervous system, lowering cortisol and bringing the prefrontal cortex, our decision-making center, back online. In the trauma bay, a patient who could regulate their breathing was a patient we could work with. The same is true for any of us sitting up in the dark at 1:41 in the morning, waiting for an aftershock that does not come. A few minutes of slow, deliberate breath is a physiological reset, and it is available to everyone.

Once I had settled, my mind turned to the question this earthquake asked of all of us: Are we actually ready?

San Mateo County sits in one of the most seismically active regions in the country. The San Andreas Fault runs through our county. According to USGS, magnitude 4 or higher earthquakes occur two to three times a year here. We are not asking whether the next significant earthquake will happen. We are preparing for when.

So here is what I thought through in the quiet after Thursday morning’s shake. Not as a checklist. As a conversation I want to have with our community.

Shoes by your bed. If an earthquake damages your home, the floor may be covered in broken glass or debris. Shoes already placed beside your bed mean you can protect yourself the moment you stand up. Even in a no-shoes household, this one matters.

Know your safest spot before you need it. Drop, Cover, and Hold On remains the standard. Get under a sturdy table or move to an interior wall away from windows and anything that could fall. Think through it now, for every room in your home. If it happens while you are in bed, look up. What is above you on the walls and shelves? Now is the time to secure it.

Have a go bag and a plan. Water, medications, documents and a phone charger can make an enormous difference if you need to leave quickly or utilities go down. Talk with your household about where you would meet and how you would communicate if a larger quake struck while family members were in different places.

Know where your information will come from. Sign up for SMC Alert at smcalert.info to receive official updates directly from our office. The USGS “Did You Feel It?” tool lets you contribute to the scientific record of how shaking was experienced across the region. Your report genuinely matters.

This morning’s earthquake caused no harm. The next one may not be so forgiving. Take five minutes today, not to worry, but to act on one of the steps above. That is what turns a sleepless night into something useful.

Dr. Shruti Dhapodkar is director, San Mateo County Emergency Management.