J. Patrick O’Neal, MD – Remembers Public Health’s Early Years

A very well-respected force in his field, Dr. Pat O'Neal has watched Emergency Preparedness move to the forefront of public health.

With a trembling voice, Dr. J. Patrick O’Neal, MD, Director of Health Protection for the Georgia Department of Public Health, struggles emotionally to find the words to describe the painful event that sparked this revelation. “Nearly 40 years later, it still gets to me,” he says.
Dr. O’Neal recounts his experience as a new doctor on Christmas Eve, when a father accidentally backed over his 2-year-old child, with his car. “When they brought the child to me, there was no sign of life. “But you don’t give up when it’s a child. We resuscitated him for three hours and finally stopped.”

Barely able to continue, he painfully describes having to tell the mother that her child was dead. “I can still hear her voice crying out, ‘Please don’t stop. Jesus wouldn’t take my baby at Christmas Eve!’”

Dr. O’Neal knew then that if there had been a system in place to have a surgeon readily available, they could have “gotten to” what he believes was a ruptured spleen, and the baby could have survived. He used that very traumatic experience to gain legislative support for funding of a trauma system in Georgia. “Every bad event is a catapult for potential opportunity,” he reiterates.

This philosophy is also his explanation for the perceived evolution of public health, specifically the emergency preparedness component. “The reality is that emergency preparedness is not new. We didn’t talk about it much, but it’s one of the core elements of what public health has to do,” he explains.

Dr. O’Neal served as the Medical Director for the Office of EMS/Trauma in the Georgia Division of Public Health first under the Department of Human Resources (DHR) and then later under the Department of Community Health (DCH). For 29 years prior, he practiced emergency medicine at DeKalb Medical Center in Decatur. In his final seven years at Dekalb Medical Center, he served as the Regional Medical Director for EMS throughout the Greater Atlanta area. A very well-respected force in his field, he has watched Emergency Preparedness move to the forefront of public health. Describing Public Health as primarily “invisible” prior to 2001, it was mainly viewed as a safety net for indigent health care and STDs. People saw it as only being available on Monday through Friday, during business hours,” he declares.

This stigma began when public health originated from the social work arena that responded largely to the indigent population. Only recently have people realized the many components of public health.

“Public health has always been a 24/7 operation. It was responsible for monitoring disease processes and intervening to mitigate the impact of diseases,” stated Dr. O’Neal. “Though it was unnoticed by many, it was still very essential.”

After the 9-11 and Anthrax attacks in 2001, perceptions changed. From these events, policy makers began to realize that public health needed to have a robust ability to respond. Congress decided to appropriate funds differently. What was once a $1 million Public Health Emergency Preparedness budget for the entire state was now $26 million for public health preparedness and the charge to rebuild the public health infrastructure in three years. In that three years however, it was discovered that terrorism would take on many forms. Congress realized that emergency preparedness was necessary but there was more of an emphasis on terrorism.

It was not until Hurricane Katrina however, that natural disasters were considered an essential component of emergency preparedness and response. Dr. O’Neal describes Hurricane Katrina as “a natural event so catastrophic that it shifted everything. The role of public health in responding to an event like Katrina made a tremendous emphasis everywhere,” he recalls. “It was the first time that the Natural Disaster Medical System (N.D.M.S.) was activated and a multitude of patients were flown in from Louisiana and surrounding areas. We realized how important it was to develop and maintain partnerships.”

Hurricanes Katrina and Rita seemed to be a caveat for another event that would call a need for partnerships, the Haiti Earthquake. Dr. O’Neal describes his personal reflections. “It hit me. It really is worth all of this. To see the response to individuals arriving by plane with such catastrophic injuries and diseases that I’d only read about; and to know that we had a system in place to offer treatment to those individuals, showed a fantastic evolution in the way of health care worldwide.”

Though pleased with the evolution of health care in general, Dr. O’Neal realizes that there is much more work to do. “In the next 10 years, I hope that the response component will be an ingrained part of public health education, training and practice, he describes.” “We haven’t seen the end of terrorism and there are so many emerging infections. Public Health will be challenged with having to respond to it all. But with each event, we become better prepared and equipped to respond to the next.”

-Story by Melva B. Robertson, M.A.P.W., Risk Communicator Emergency Preparedness and Response, Cobb & Douglas Public Health

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