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Georgia . “ It ’ s a very different environment . Docs are used to being in charge , and you can ’ t take that attitude . You ’ re just a small cog in a big wheel . At the end of the day , you don ’ t want to get anybody hurt . In times of stress , when the shit is hitting the fan , the last thing you want is to lose your cool . You always have to remind yourself , ‘ This is not my emergency .’”
Dr . O ’ Brien shared one account of his time as a SWAT team medic , a day that had a profound effect on his vision and respect for the men and women involved . He began , “ There was a guy who had held a woman hostage for days . He ’ d repeatedly raped her . He was heavily armed . She escaped and told the story , so SWAT was going to arrest him .
“ As they make entry into the house , I ’ m kneeling by the van at the corner of the property . I hear three bursts of automatic fire and then , ‘ Medic up !’ Holy crap . We ’ re on . I didn ’ t know what I was expecting to see . I go through the living room and get to a hallway . SWAT is still clearing the place . There ’ s a guy that ’ s deader than hell in the hallway . I was struck by a few things . First , I was very impressed with how quickly this guy had died .”
“ A little bit of background ,” Dr . O ’ Brien offered , “ This suspect was waiting for us . But he was in the act of cleaning his guns . We happened to hit him at that exact moment where the gun was disabled . If that gun had been together , it would have been a different story .”
“ But , I found myself impacted by the environment around me . I should have kept my focus on delivering care . I looked down the hallway , and had one of my most profound moments in SWAT ,” he said with a small crack in his voice . “ The rest of the house isn ’ t clear , and there ’ s a SWAT guy blocking the hall . His job is to take a bullet for me . There ’ s a guy here who had raised a gun to the officer , and they shot him . And yet you ’ ve got a SWAT guy standing there , willing to shield me from anything while I take care of someone who just tried to kill one of their officers . That ’ s amazing .”
Although Dr . O ’ Brien has worked in separate capacities with police , fire and EMS , the recent surge in active shooter scenarios is driving those three organizations into closer collaboration than ever before .
“ Fire has an untapped resource for those scenarios . All firefighters are EMTs . They aren ’ t often used in that capacity , but if crap happens and you ’ re all of a sudden looking at 30 or 40 casualties and the scene isn ’ t safe , how do you deal with that ?”
Dr . O ’ Brien explained that in the event of an active shooter , SWAT 30 LOUISVILLE MEDICINE
Grandaughter KyLee and daughter Kirsten
would hunt for the aggressor . After them would follow firefighters protected by armed law enforcement to identify and treat injuries and casualties . Once the scene is stabilized , the SWAT medic would help with the victims .
As a collaborator with each department , Dr . O ’ Brien helped to shape the plan that ’ s in place today and has presented this Louisville model internationally , advising other countries on steps of the process including how to incorporate firefighters into an active aggressor scenario .
That ’ s just one example of how in the last two decades , Dr . O ’ Brien ’ s work has expanded outwards from Louisville . For example , he served for many years as the state medical advisor , and had an opportunity to travel overseas helping other countries strengthen their emergency services .
In late 1999 , Turkey was struck by a devastating earthquake which resulted in thousands dead . Just a few months later , Dr . O ’ Brien and a team of physicians from across the country were on a plane bound for Turkey . The objective was to help design a comprehensive disaster plan so nothing that catastrophic would happen again without a planned medical response .
“ A very progressive group of Turkish physicians said one issue they had both during and after the earthquake was a lack of hospital disaster plans ,” he said . “ So we were invited to a university in Izmir , Turkey . There we presented our hospital emergency plan , and it was one of the great successes of my career .”
At the beginning of the week , Dr . O ’ Brien and the other Americans were explaining their plan to “ a room full of physicians who had just seen firsthand what chaos looks like . By the end of the week , they had developed and exercised a national hospital disaster plan . That became their national model and a publication . Being a part of that was powerful for me .”
The year 2008 was a transitional one for Dr . O ’ Brien . He stepped down as state medical advisor and had surgery to remove prostate cancer . For the first time since the 1970s , he wasn ’ t providing direct medical oversight anywhere . “ I thought , ‘ Wow , this is quiet .’ So I looked to what I had enjoyed in the past and asked how I could reignite that . I thought back to that Turkey visit from 2000 and wondered if I could explore international work through my EMS experience . Because if there ’ s one thing the US knows , it ’ s how to screw up EMS . We ’ ve made every mistake you can , so if I could short circuit some of those mistakes for others that would probably be very worthwhile .”
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