After the surging ocean waters spawned by Japan's magnitude 8.9 earthquake receded, the drowned were only the first victims to be counted. In the coming days, physicians and public health officials along Japan's hard-hit eastern coast can expect a second wave of tsunami victims with aspiration-related illnesses, trauma and crush wounds, as well as the threat of disease spread by contaminated water. As they tend to survivors, Japanese officials can look to the experience of health workers who ministered to victims after the massive tsunami that inundated Indian Ocean nations on Dec. 26, 2004.