Adapted from the keynote presentation at ACOFP ’23 by Col. (retired) Kevin O’Connor, DO, 16th Physician to the President 

I started out after residency in pretty rough conditions. I was in an old WWII barracks with no sinks and no air conditioning. There would be about 85 people there for sick call, 83 of whom were full of crap, but two of them had cancer or a heart attack. It did make for great training. I would get medical students from time to time, and I must have treated them right, because after a year or so, they invited me to teach full-time at the residency program.  

While I was at the residency program, I started getting a steady following for manipulation. I had a couple of commando guys from this little group called, “Delta Force” who liked it because it was immediate gratification. It didn’t involve meds. I would say, “I heal with violence,” which they liked. It sells itself, especially to special operators.  

You see, when I got into the military, I wanted to be a paratrooper. I got to Fort Bragg (now Fort Liberty), which was the Home of the Airborne and Special Operations Forces, but I had nothing to do with any of those things at the time. But I did the thing that a mentor taught me, “Express the interest.” I started hanging out one night at a “boxing smoker”, where a couple of paratroopers slug it out in a ring. I went up and introduced myself to the ring doctor. He was a family doctor, too. I had been to Airborne School as an ROTC cadet, but I asked for his advice on how to actually become a paratrooper – with the 82d Airborne Division! He said I should talk to the Division Surgeon—and it turned out he WAS the Division Surgeon.  

Human nature is that people want to help you, but how can I know how to help you until you tell me what you want to do? I expressed the interest. The next morning, I had orders as a PROFIS doc (a doctor who works with a unit that doesn’t normally have one until they deploy) to a battalion in the 82d. I walked right over to the battalion headquarters and introduced myself to the commander. That evening, I was jumping into the night sky with a thousand of my closest friends.  

Remember those commandos? I continued providing OMT to folks over at the uUnit, and one thing led to another—and I ended up being selected to be Deputy Surgeon, and eventually Command Surgeon at DELTA.  Then they hit the towers. Couldn’t have seen that coming—Command Surgeon of the only counter-terrorist unit in the Army, when the Global War on Terror kicked off—all because I healed with violence.  I did other things okay too, but that’s the only reason they ever met me. 

Manipulation opened the door to the White House, too. While I was at Ft. Carson as Chair of Family Medicine, I got a call from a doctor friend who was at the White House, and he said, “Hey, are you still doing that back stuff? I have someone I was hoping you could take a look at, and we’re going to be in Denver.”  

It turned out the patient he had in mind was President [George W.] Bush. He liked it, and the next time they were in Denver, they called again. After a few times, they said, “Hey, do you want to maybe compete to roll with us full-time?” Then I was at the White House, not as the physician to the President or Vice President (the President’s or VP’s PCM), but as one of the White House physicians, providing 24/7 coverage. I ended up being the first DO assigned to the White House full-time. My plan was to do that for three years and then hopefully go back to special ops. 

When the Obama/Biden administration came in, leadership in the White House Medical Unit (WHMU) assigned me to take care of the Vice President. A month or two in, the Vice President’s mom fell and broke her hip, and I was pretty involved in that.  Then we transitioned from that fairly naturally to end of life planning, which is bread and butter family medicine, and Vice President Biden asked me to stay. I stayed mostly out of personal loyalty. He was a guy who hadn’t had a boss in 36 years as a senator, and now, in his 60s, he had a boss, pretty much for the first time—a much younger guy (whom he was a mentor to). It was fascinating to me, just to observe the grace of it. So I agreed to finish the term–and then he went and got re-elected.  It ended up taking me 11.5 years to finish my 3-year tour at the White House.  

I remained Vice President Biden’s PCM when he retired from the White House, from my practice at GW Medical Faculty Associates.  One day, he told me he was thinking about running. I told him, “Lay down until the feeling goes away.” You see, President Biden never didn’t run because of ambition. I think he ran because he felt like he had to. Truthfully, I didn’t think he’d win, because he was too centrist. So, I wasn’t really worried about it until South Carolina. And then, of course, he ran the table, and then won the general election.  

I’ve been with President Biden for over 14 years now and we’ve been through a lot together. Early in the relationship, we were about to head to the train station. As you would imagine it’s not like the doc rides in the same car as the President or VP. For one thing, we should be able to respond to things. More fundamentally, we’re “the help,” and very okay with that.  But on this occasion, the VP told me to get in the car with him. When we got to our destination, he tapped me on the knee and told me to come on down to the Lake House once we got to Delaware and we could chat some more. I paused for a moment, and then explained that I had a very competent PA friend of mine waiting on the train and covering him for the weekend.  My daughters had a dance competition. The VP said, “Look, I know that you’re not on my staff, and I can’t tell you what to do.”  I responded, “Sir, you are correct, I am not on your staff—but I assure you, you can tell me what to do.” He said, “Well, If I ever look up and I see you, and I subsequently find out that there’s somewhere else you should have been—like a dance recital, a parent-teacher conference, or something like that—and you chose face time with me instead of that, I will think less of you as a man. You will have identified that we do not share common values.” I said, “I appreciate the sentiment.” At that point, the VP did seem a bit upset – he said: “Sentiment?! You think I’m a philosopher? I rode this train an hour and a half each way, every day, for 36 years. A child can remember something they want to share with you for 12 hours, and after that it’s gone, and you’ll never know what you missed. You have to hit that window, even if it’s just a kiss goodnight. Okay. I’ll see you Monday.” 

Regardless of policy, politics are just politics, and I don’t involve myself in that – but the one thing I can tell you about your president is that he’s never strayed from that philosophy, never once.  He is a committed family man, and makes sure that those around them don’t lose sight of what really matters. 

I have about 60 full-time folks on my team now, and 10 are doctors. Of those 10, 4 are DOs right now–and by personal intention–I do NOT participate in the selection process. 

We are all threads of a vast tapestry. Each of us has the potential to profoundly impact the life of another. The effect may be immediate or in a decade in a way we would never have imagined. ACOFP enjoys a well-deserved reputation for professionalism, fellowship, and patient-centered focus, and you look out for one another. We need to cherish and fortify that connection.  

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