Doctor’s Orders
Spirited Physician Jack O’Brien Prescribes a Point-Blank Approach for HIV Prevention
by Dann Dulin

Photo by Craig Macleod

Dr. Jack O’Brien was born on the same day as the Virgin Mary, 8th September. But the year was 18 BCE and Dr. O’Brien wasn’t born until 1989 CE. “We share nothing except the same day of birth,” wisecracks the medical doctor. The similarities stop there. Well…kind of.

If you regard the Virgin Mary as a humanitarian (her son certainly) then the parallel continues. Dr. O’Brien, an attending physician specializing in HIV, is also a researcher, and a bit of a trendsetter. While in residency he oftimes became a “social worker,” setting up patients with free care and housing. During this time he set up a PrEP Program at Jersey City’s Christ Hospital, and implemented initiatives for other medical students, including how to counsel their patients living with HIV. As president of the LGBTQ+ Medical Club while attending SUNY Binghamton, Jack organized HIV clinical training, and promoted and pioneered medical health for the gay community.

Within the past few years, the adoption and widespread use of PrEP, or pre-exposure prophylaxis, amongst those who are most at risk, is now aiding in another barrier against those who are negative with staying negative. I would like to proudly before all of you state that I am taking PrEP myself, and I firmly believe that it is the key to making the U.S.A. AIDS-free.

On World AIDS Day 2017, O’Brien was the Keynote Speaker in Jersey City, NJ, where he stridently proclaimed, “Together…condoms + PrEP work!”

On that day he continued: “Within the past few years, the adoption and widespread use of PrEP, or pre-exposure prophylaxis, amongst those who are most at risk, is now aiding in another barrier against those who are negative with staying negative. I would like to proudly before all of you state that I am taking PrEP myself, and I firmly believe that it is the key to making the U.S.A. AIDS-free.

“….Healthcare is a human right, and I am dedicated to treating everyone equally regardless of their socioeconomic status, gender identity, sexual orientation, race, or religion.… It is my goal as a primary care provider to ensure that these patients have proper prevention of diseases that are indeed preventable, which now includes HIV. However, the key to staying HIV and AIDS free is right here, right in my hands. Let’s make America AIDS free, one pill at a time.”

With that, Jack then stepped down from the podium and gleefully popped a PrEP pill in front of the whole crowd. The Jersey City assembly was a victory and he felt honored to be there, explaining to the audience that HIV is being squashed in their area, due in large part to their advocacy.

Board-certified in Family Medicine, Jack graduated in 2016 from New York Institute of Technology (NYIT, or commonly known as New York Tech), located in Old Westbury, Long Island, with a Doctor of Osteopath (DO) degree. This professional integrates his practice with a holistic approach, treating the person as a whole being——blending Eastern with Western philosophy, if you will.

Jack was raised in Onondaga County, New York in the wee town of Lafayette, a suburb of Syracuse. With a population of 4,000, it has one McDonald’s and one traffic light. “A po-dunk town,” he flippantly states then adds, “It was a shotgun-in-the-back-window with a Confederate flag on your pickup-truck kind of place.”

Though one might think he’s of Irish ancestry, Jack boasts that he’s an “American Mutt,” with strong Italian bloodlines. He is the first person in his family to enter the medical profession. Jack, who’s extremely close to his family and credits them for creating the successful person he’s become, came out to them at sixteen—and was fully supported. They straight away told him they loved him. But, mom and dad had one fear, Jack contracting the virus that causes AIDS.

In 2003, their reaction was not surprising, especially hailing from a rural area. “Any STI seemed quite foreign and intangible to them,” Jack points out. Even for himself, Jack only knew about HIV and AIDS in an abstract context from books, and he surely never encountered anyone else who was openly gay in his tiny habitat. It wasn’t until he was seventeen that condoms were even mentioned and that was spoken strictly in terms of pregnancy. Given those facts, his parents’ only knowledge of the epidemic was that if you’re gay, you die.

In his youth he was a Level 10 Junior Olympic Gymnast. (In 2011 when Jack moved to New York City, he began to coach recreational gymnastics full time, his students ranging in age from twelve months to fifty-five years.) From ages eleven to sixteen, a close family member sexually abused Jack. In summer 2019, before he moved out to the West Coast for a new position, he revealed this secret to his parents. He then learned that his dad was also sexually abused as a child.

Unfortunately, Jack’s first boyfriend was also abusive. Thanks to therapy, he’s worked through the pain and healed it into a strong sense of empathy for his patients going through similar horrors. “No one deserves this type of treatment, ever,” he exclaims. O’Brien has supported the global nonprofit Survive To Thrive, helping those who’ve suffered abuse, and, with his father, the McMahon Ryan Project that specifically provides aid to children who have survived abuse.

O’Brien’s attractiveness goes beyond his leading man looks. His bright, brimming personality and sharp humor is seductive, which towers over a childlike mischievousness that is adventure driven. Jack’s playful nature encompasses donning drag as “Cher Whoreowitz” for an office Halloween party, to purchasing an airline ticket to Puerto Vallarta two hours before boarding, to cooking bacon and eggs in the morning completely naked, but then regretting it the second a few splats of grease flies onto his body!

The guy possesses a morsel of wicked humor and is deliriously up for fun and frivolity, which certainly provides bedrock to a taxing physician’s schedule. When out for a rousing evening with friends, they may refer to him as “Porsche Authority,” a cool drag name he invented. Deriving joy from spontaneity, on a recent whim Jack braved the wild blue yonder and went skydiving. And yet another adventure he had his heart set on was riding in AIDS/LifeCycle, but COVID halted that ambition…for now. In a word, the doctor paints himself as, “Bold.”

Freshly transplanted to the West Coast in 2019, Jack filled a position at a medical team in Beverly Hills. During lockdowns, he stayed pretty much in his West Hollywood digs. Last year he was unable to see his Canadian beau due to COVID restrictions and somehow that has now faded into the background. He also was in an intense polyamorous relationship with a male couple in Los Angeles; however that too has subsided. Currently, Jack is in the monogamous throes with a serious boyfriend.

Being in isolation last year propelled him to start penning his memoir, My Mostly Horizontal Gay Life—a working title for now. Chapters include issues on sexuality, polyamory, domestic abuse (physical and emotional), and eating disorders. He hopes to deliver these hot-button issues in a witty timbre. There will also be a substantial section diving into his relationships that were wholly maintained around the “need to stay monogamous for fear of acquiring HIV.”

Another COVID offshoot is in the therapeutic and meditative realm. Jack made a 180-degree shift from his original linear plan and delineated trajectory into a more fluid journey. His motto nowadays, “‘I’m living as large as I can’ …as Big Ang [Mob Wives star] would say—of course according to CDC recommended guidelines—because I could drop dead tomorrow.” Jack is now living life with greater conviction.

It’s mid-evening and Jack appears on my computer screen dressed down in a chocolate brown Aeropostale hoodie, postured on a dark navy blue sofa with two tasseled pillows, one mustard colored and the other eggshell, planted directly behind him. My instant focus gravitates to the man’s radiant skin and his natural rosy cheeks that could have been brushed by Renoir himself. Jack sports close-cropped whiskers and ‘stache.

One swiftly learns by conversing with Jack that he’s totally transparent, his life an open book. Jack’s dedication to his own health and vibrancy is a superior indication of practicing what he preaches.

He has the down home charm of Marcus Welby, MD, the titular character of a classic sixties TV series, played by the incomparable Robert Young, and the stalwart take-charge attitude of Dr. Max Goodwin, played by the striking Ryan Eggold on the current medical series, New Amsterdam.

Dr. Jack has had a chock-full schedule today, but remains cheery, calm, collected, and at times, cheeky.

Jack as one of his alter egos, Cher Whoreowitz

Dann Dulin: I like your off-the-cuff manner, Jack, and I’m keen on your drag name, “Porsche Authority!” So you’ve donned female attire a few times, what does it do for you?
Jack O’Brien, DO: Drag is pure escapism. It allows you to access all of the things that you want to actually do without any of the emotional weight of it being attached to your “true” self. It’s fun, carefree, and helps you live how you truly want to live.

Oh I get it. When I did drag it always made me better understand women. I guess sort of the story arc of the film Tootsie, though I think a gay man has unquestionably one leg up more than a straight man like Dustin Hoffman when it comes to this. [He nods, his coffee-colored eyes locked into mine.] Jack, how did you first hear about the AIDS epidemic?
I think I was around ten when I first heard about it in sex ed class. They explained that HIV/AIDS was acquired through sharing needles, unprotected sex, and blood transfusions and that it could be prevented through condom use. However, they only talked about it in terms of heterosexual intercourse—penis into vagina—so I was very confused as to how this largely affected gay men since they never mentioned anal intercourse once. [He grimaces and then laments] I guess it was blasphemous to use those words!

At the turn of the century you were just coming of age. Hormones raging, horny as hell, as any typical teen! Even though the cocktails were around and HIV was no longer as deadly, it still was a dangerous virus. How did it all play out for you?
Unsurprisingly it was hard for me to really “kick back and fuck” with the constant fear of HIV. Even while in medical school, they made all these “cocktails” sound super toxic and completely untolerated. Looking back on the majority of my relationships, I had been so fiercely monogamous not for personal attachment reasons, but for the fear that I was going to get HIV.

I get your drift!
Prior to 2012 I was convinced that every new sexual encounter was an opportunity to contract HIV. [He clicks his tongue.] I also hated condoms, but to make sure you did not get HIV and also not use condoms was to only have sex with one person. I know…how boring. [Jack casts his inquisitive puppy-dog eyes to a side-glance, lifting his brows.]

Probably many peers of yours felt the same.
[With a moment’s contemplation, he swiftly moves forward, bolstering a hand under his neck, resting a finger on his full lips.] PrEP was not even on the horizon when I was fourteen in 2004. Back then everyone was a condom Nazi, including myself, unless I was in a relationship. As I had largely been in long-term relationships, I never used condoms and used this “monogamy” as a crutch to not use them. [He breaks.] In retrospect, this is idiotic, but again that underdeveloped teenage prefrontal cortex really will trick you into any situation that will get the dopamine flowing.

I feel so indebted to every patient above the age of sixty that I get to treat because they are the people who have allowed me to walk around in a wig and heels and not be assaulted. I just want to say “Thank you” to every patient that participated in the research studies we did at Pacific Oaks Medical Group (POMG) in the eighties and nineties to help establish the “cocktails” so that we now live in a day and age where being undetectable means you cannot pass the virus on to another person.

Ahh, those teen years, yikes. Tough. How old were you when you first got tested?
I first got tested when I was seventeen and a freshman in college. I marched my ass down to the free clinic in downtown Binghamton. I was terrified!
My family doctor in Syracuse knew I was gay, and never ever spoke to me about condom use or sex…ever. Some angry disgruntled and definitely undersexed sixty-five year old nurse judged me up and down for not using condoms with any of my boyfriends, and offered me a rapid HIV test, and a gonorrhea and chlamydia test just for my urine. They all came back negative.

What prompted the test?
I got tested because I didn’t trust my boyfriend at the time and all I remember feeling was fear waiting for the results. It was the most anxiety I had ever felt in my life. This is the same anxiety I felt every time I went to get tested, which again fueled my being super-monogamous even though I really did not want to be. Thank god for PrEP helping quash that anxiety now!

What kinds of patients does your practice consist of today?
I work every day with HIV-positive patients. Some of them were the very people who helped form ACT UP, or lived in New York City during the Stonewall riots. Every one of them has such an interesting story to tell. I feel so indebted to every patient above the age of sixty that I get to treat because they are the people who have allowed me to walk around in a wig and heels and not be assaulted. I just want to say “Thank you” to every patient that participated in the research studies we did at Pacific Oaks Medical Group (POMG) in the eighties and nineties to help establish the “cocktails” so that we now live in a day and age where being undetectable means you cannot pass the virus on to another person. What a wonderful time to be alive!

I only have one to two patients who have AIDS as it’s defined now and I have hundreds of patients on PrEP. Our practice [other team doctors] does a lot of outreach and education here in Los Angeles.

I know you are a great advocate of free healthcare for all.
There’s zero reason that anyone in the U.S.A. should not have free and ample access to HIV medications and treatment. I spent so much time in Residency setting up patients with access to free doctors and clinics and housing and I understand that there are hurdles in getting this type of help, but once you have it (Jack clears his throat) you are more than capable of never having the diagnosis of AIDS.

Case in point, the PrEP Program you established at Christ Hospital in Jersey City.
Christ Hospital has this amazing service called “Charity Care” where they offer hospital based insurance to those who do not have traditional insurance for whatever reason. Maybe they are here without proper documentation from another country, or do not make enough money to pay for traditional insurance or do not qualify for Medicaid. I somehow convinced the hospital administration to get Truvada covered under the hospital formulary for these patients. I made pamphlets and gave talks to the residents to teach them how to prescribe PrEP, and all of the appropriate follow up that needed to take place.

We held monthly lunch meetings to help educate the other medical students on gay issues; HIV, polyamory, drug use, terminology and gendering used in the gay community so that they could more adequately and less awkwardly treat future LGBTG+ patients.

Whoa. You grabbed the torch and forged. When you attended New York Tech in Old Westbury, New York, you were LGBTQ+ president. I want to hear more about the initiatives you implemented for other medical students about learning how to counsel those with HIV.
We held monthly lunch meetings to help educate the other medical students on gay issues; HIV, polyamory, drug use, terminology and gendering used in the gay community so that they could more adequately and less awkwardly treat future LGBTG+ patients. [He takes a steady inhale.] We even held a mock simulation where we had to deliver the news that a patient was HIV-positive and what the next steps would be in their treatment and the resources that would be at their disposal locally. It was really a great experience to be able to educate them about something that normally only gets two hours of teaching time. We did a good job!

You are undeniably “on it” rallying around others when needed. Where does that altruistic attitude derive, Jack?
From my parents and my grandmother. I know, super cheesy! Whenever we would be doing something remotely “nice” my grandmother would always say something along the lines of, “I wonder what the poor people are doing?”

Oh, Jack…. My sis and I were raised the same way. My dad would say the exact same phrase!
[He flashes a pleased-as-punch smile which turns promptly somber.] My grandmother grew up quite poor and worked her way to being middle class despite her husband dying when my mom was eleven. She had no degree or training, and did not even graduate from high school. [Jack takes a complete breath.] My parents were always very giving with family and friends, and I could clearly see that the more you gave, the more that came back to you.

Outstanding point. Many of us are too shy or proud to ask for help. Who do you deem a hero in the epidemic?
Anyone who provides humane and compassionate care for those who would normally not be considered “heroes.” I think anyone that is working to their ultimate capacity while still giving compassionate care is a hero. This goes for all of the grocery store employees, delivery people, taxi drivers, my front desk staff, and etcetera. It really takes a village to get through this shit!

Truly. Where will we land in ten years with the AIDS epidemic?
I think that the developed world will be doing much better, as we continue a strong decline of new HIV-positive patients and AIDS-related deaths over the past five years. I think that we will eventually have a cure, similar to how we have one for hepatitis C that will really be a game changer. However, unless we really apply funding and effort to combat HIV in Africa, we will probably not be much different than we are today.

How did you get into the comprehensive integrative aspect of medicine?
Some people seem to have this false notion that Osteopathic Physicians learn to practice Western medicine. We still practice largely, almost wholly, Eastern and Allopathic medicine. We heavily rely on the body’s innate ability to heal itself and focus more on primary care. We always stress the importance of the mind-body connection, and how physical limitations are often products of some other issue that needs to be fixed without medicine but with meaningful simple changes to diet, exercise, and mindfulness.

Fun on the beach with besties. Photo courtesy J. O’Brien

It’s wise to treat the “whole” person and not just the symptom!
I do often find that the majority of patients’ issues are at their core, a lack of personal responsibility and ownership over their lives. They want to “outsource” their problems like they outsource cleaning their apartments with a maid, or sending out their laundry to get washed and folded for them. I practice radical honesty with my patients, and do not sugarcoat what I see in them. I feel that this helps them face their problems, whatever they be, with the full truth.

I like your laser-sharp approach and your simpatico bedside manner, Jack.
[The physician contemplates, not sure if he’s heard me. His breezy tone becomes lower as he concludes] Ultimately, as a healer, I only exist to guide people to make better decisions, and those decisions are always their own. It’s just a matter of doing…exactly what they already know has to be done.


PATIENCE PATIENT
What movie could you watch over and over again?
This is going to sound depressing but the movie Wit with Emma Thompson.

What is the name of the first boy you kissed?
My best friend growing up was also my first boyfriend. Samora. I was a terrible kisser. He was terrific. We were eleven. We also lost our virginities to each other when we were fourteen.

Who was your teen celebrity crush?
Ricky Martin!

Masked fun at the beach. Photo courtesy J. O’Brien

What fun film have you streamed within the past few months?
I Care A Lot [with Rosamund Pike, Peter Dinklage, and Dianne Wiest]. Who doesn’t love evil lesbians and little people destroying each other? [He chuckles with delight.]

What keeps you in optimum shape and health?
Maintaining good sleep hygiene and a semi-healthy diet. Everything in moderation, but I would say getting good sleep is what really saves me the most.

What happens after we die?
It all ends and there is nothing. I find that very calming…because life is insane.
[He elaborates.] Our cells get broken down and turned into whatever is around it. I guess that’s a form of reincarnation….But not in the typical sense that most people talk about reincarnation. That energy is neither created nor destroyed but just regenerated into something else.

Finish this sentence. When depression comes I…
Prioritize myself. And am kind to myself for destructive behaviors. I also reach out to those around me for help with even basic things like cleaning up my apartment or making sure that I stay social.

Who has been your life “guru”?
The gay icon comedian, Margaret Cho has definitely taught me to be authentic to yourself and not succumb to the bullshit around you. It’s up to you to do things one hundred percent for yourself for fulfillment and happiness.

What pic is on your homepage mobile?
Me jumping out of a plane!

Name your first Broadway show.
Chicago.

What’s your favorite musical?
The Book of Mormon.

Name some of your favorite singers.
Beyoncé—hey fellow Virgo! [yells Jack then ticks off more faves] Whitney Houston, Mariah Carey, and Maria Callas.


Dann Dulin is a Senior Editor of A&U.