A Long Way Home

James Brown, M.D., was once a seminary student and worked at a bank, but he found his true calling in emergency medicine

When James Brown was in high school, he didn’t think he wanted to become a doctor because of the uncertainty that came with the job. Oddly enough, he now practices emergency medicine, one of the most unpredictable specialties of them all. Brown is chair of the Department of Emergency Medicine at the Wright State University Boonshoft School of Medicine.

He graduated from an accelerated high school when he was just 15. For the next five years, he was in seminary studying to become a priest. After realizing that his passions lay elsewhere, Brown worked in a bank while attending paramedic school in Newport, Kentucky.He served as a paramedic with the Jefferson County Police Department for several years. Near Louisville, It was one of the few police departments that also offered paramedic services, and Brown says the lights on the ambulance they used were blue just like those of a police car. There were times that policemen driving it actually pulled people over. The drivers were flabbergasted, of course.Brown also got to make emergency flights in helicopters, back when doctors and nurses would commonly fly to accident scenes. He lived only a few blocks from the hospital, so he would often wake up to a phone call from the flight team.

As part of his duties, he worked the infield at Churchill Downs each year during the Kentucky Derby. The crowds got to about 70,000 annually. Despite the number of people, the injuries he saw were fairly predictable, except for a few.When the weather heated up at the Downs, folks would use knives to cut their jeans into shorts. Brown sometimes saw some serious lacerations. Then there were the people who drank too much.

“There are two big, cement flower pots on either side of the finish line. This guy did a backflip off one of the pots, and it didn’t work out well for him. He passed out on the way down and sort of flopped like a fish,” Brown said.

Brown eventually became one of the first civilian supervisors in the police department, but decided to pursue a career as a medical doctor because of his passion for emergency medicine. He had figured out that uncertainty was what inspired him after all.“It wasn’t a deliberate path. It was certainly a wandering path,” Brown said. “You know how in those comics, ‘The Family Circus,’ there’s a character named Billy who wanders around the yard when he doesn’t know what to do. Well, that’s me in medicine. It took me a while to find my way home.”

He tried to keep an open mind in choosing a specialty, but it was hopeless. Brown was meant for emergency medicine. At one point, he even expressed to his wife that he was worried he might not like emergency medicine from the doctor’s side.“I remember my wife laughing hysterically. She said, ‘That’s not going to happen.’ Everybody who knows me would laugh about it. They just knew that I was destined to do emergency medicine. That’s my personality,” Brown said.

Despite the course load at the University of Louisville School of Medicine, Brown worked as a flight paramedic all the way through medical school. After graduation, he completed his emergency medicine residency there.There were so many things that drew him to the specialty. He likes being one of the first to try and figure out what’s ailing a patient. And each day is truly unpredictable. “Most people want consistency, to know what the next day will be like. I never know and I like that. It’s unique to what we do,” Brown said.“The variety attracts me. We don’t see people with diagnoses. We see people with complaints,” Brown said. “Most other specialties rely on us to solve the diagnostic dilemma. It’s that unknown that appeals to me. And I like the challenge of having to make decisions at times with limited information.”

Brown also likes teaching, and his position at the Boonshoft School of Medicine is an excellent fit. When he was in seminary, he had a notion he might go into teaching. During his time at the University of Louisville, he found a similar penchant for academic medicine.“In many ways, my dream job became available. The opportunity was here,” said Brown, who came to Dayton, Ohio, when his wife,Judy Masset Brown, M.D., matched for her residency in pediatrics. “What I like about teaching emergency medicine is training people to make those quick decisions safely. We get the chance to give students and residents the chance to get a first crack at a patient — obviously not the critically ill ones. They think it’s fun, unless it’s their first day. Then it’s terrifying.”

As a clinical instructor, he enjoys preparing students for what they may face, and has been impressed with how well they handle unpredictable situations. And though he still practices emergency medicine, his focus is more on teaching than it used to be.

“I don’t do true overnights anymore, but I still work weekends and holidays. That’s what we do,” Brown said. “Emergency medicine has always been egalitarian. We all do it all. There’s no pecking order in emergency medicine.”

Brown’s advice to students considering the specialty is to be comfortable with uncertainty. He says they must be willing to see everything and do everything. “Emergency medicine is very much a team sport. Everybody participates and we spend a lot of time in proximity with each other,” Brown said.

When he’s not educating the next generation of emergency medicine doctors, Brown is fond of travel. He and his wife go to Italy often. They also like to visit Hawaii.Brown enjoys cooking, especially savory dishes. He does a lot of Italian cooking, but gets more into the country-French style, as he doesn’t favor fancy sauces. He is also an avid reader. “I’ve read the ‘Lord of the Rings’ series way too many times,” Brown said. “It started when I was required to read The Hobbit in high school. I’ve been a lifelong fan of Tolkien.”

— Daniel Kelly



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