ride as part of a two-person physician/nurse team to the scene of
medical emergencies.
“It gave me a tremendous amount of responsibility early in my
residency. You take off from the hospital, and you’re going to some-
thing terrible, and you’re on your own,” he said. “So I get the call
for a helicopter run, and I’d pull out my general textbook before I
went to make sure I was knowledgeable on whatever the situation
was. It was a huge learning experience but very thrilling.”
Those helicopter runs would form the basis for his first job out
of residency, becoming the medical director of Stanford University
Hospital’s helicopter program in Palo Alto, California. Still, the city
of Louisville had made a big impression on Dr. O’Brien. In just two
years, a residency with unknown possibilities had led to a newfound
home away from home.
As a SWAT Medic
seconds,” he laughed.
Dr. O’Brien returned to responsibilities both old and new. He
remained a part of helicopter and ER rotations, but he was also being
groomed to take EMS obligations from Dr. Don Thomas. Those
obligations brought him into close contact with both Louisville and
Jefferson County EMS as well as the Louisville Fire Department.
“Dr. Thomas was a fire dog. He loved fire and got involved in
Louisville fire in the early 70s. He became a passionate believer in
CPR, a brand new concept, and taught it to the firefighters. Even-
tually, he wanted to pull EMS into the fire department, which is a
pretty common model.”
Dr. O’Brien was serving as Assistant EMS Director under Dr.
Thomas during this transition. He would later become director
upon Dr. Thomas’s retirement. Dr. O’Brien was also serving as fire
surgeon in which he accompanied firefighters to the scene and
coordinated medical care.
“EMS with fire seemed to be a good synergy, but the cultures
never blended,” he said. “We tried it, but there was too much friction.
EMS is now out of fire and is its own third service system. It’s been
a great relationship for 20 years now.”
Not only did he work with the EMS and Fire Departments, Dr.
O’Brien has long been one of a handful of doctors in Louisville and
Southern Indiana to work as a SWAT team medic. Dr. Bill Smock
was the first to look around the country and see that SWAT could be
supported with a medical component. Dr. O’Brien saw the position
being created and joined soon after. “This was in the mid-1990s,” he
recalled. “You have these guys operating in an environment where
if they don’t exercise good caution, it can be exceedingly dangerous.
And they were there without any provision for health care. That
didn’t make sense.”
Dr. O'Brien and his wife Kris in Ireland
“Louisville, much to my surprise, was a hell of a town. It was a
magical place to live in the 80s. I really enjoyed my residency, and
by the end, I was sad to leave.”
In fact, upon landing in Stanford, Dr. O’Brien’s belief in the
strength of Louisville’s health care programs was reinforced. “I
learned a lot in Stanford but one thing was just how good the emer-
gency medicine program was here. California thought they were
the best at everything, but it was highly bureaucratic and difficult
to effect change. I ran into a lot of walls trying to put my mark on
the system out there.”
After a year on the west coast, Dr. O’Brien was asked if he wanted
to be a faculty member at U of L. “I thought about it for about 10
To prepare, Dr. O’Brien completed SWAT team training, both in
Kentucky and at the Federal Law Enforcement Center in Glynco,
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