Trauma Surgeon and Police Officer, Dr. Martin Greenberg about performance under pressure.

Dr. Martin Greenberg shares his unique experiences bridging the fields of medicine and law enforcement. Key topics include the evolution of tactical medicine, stress management, effect of challenge or threat state on physiological responses, a unified theory of stress and training, decision-making under pressure, de-escalation techniques, the importance of automaticity, and modern training methodologies for police officers. Dr. Greenberg shows that the OODA loop contains all the modern stress and DM science and can be used as a basis to understand the officers’ relationship to their environments and their decision-making process under stress . Dr. Martin Greenberg is a retired hand and trauma orthopedic surgeon with over 40 years in medicine and 24 years in law enforcement. A former police officer, SWAT operator, tactical medic, and police Medical Director, he pioneered Tactical Emergency Medical Support (TEMS) in Illinois, where over half of SWAT teams now have embedded TEMS units. As an IMERT Executive Council member, Dr. Greenberg has taught extensively on emergency response and authored The Law Enforcement Medical Encyclopedia.

Topics and quotes from the podcast

Transition to Law Enforcement (“I had to become a police officer to further the cause of tactical medicine inside inner perimeters.”).

Motivation from Columbine Incident (“We were not handling these active shooter incidents correctly.”)

Introduction to Tactical Medicine (“Tactical medicine is now recognized as a medical specialty.”)

Challenges in Law Enforcement Medical Training (“Our law enforcement community was underappreciated and underpaid.”)

Stress and Performance (“Stress is outside forces affecting individuals.”)

Ventral and Dorsal Pathways (“The dorsal stream handles cognitive decisions, while the ventral stream processes emotions.”)

Sympathetic and Parasympathetic Nervous Systems

Quiet Eye Phenomenon (“Experts focus longer on important things, suppressing emotional responses.”)

Thinking right (“Cognitive thinking enables goal-oriented responses, while emotional thinking is reactive.”)

Unified Theory of Stress (“We wanted to correlate human physiological reactions to stress with decision-making.”)

OODA Loop Framework (“Observe, Orient, Decide, and Act guide rapid decision-making.”)

Training with High Fidelity Simulations (“High-fidelity training helps simulate real-life scenarios.”)

Cognitive and Emotional Thinking (“We can train to think cognitively instead of emotionally.”)

De-escalation Techniques (“Empathy and active listening are critical to de-escalation.”)

Police Officer Training Gaps (“Academy training often leaves officers underprepared.”)

Importance of Scenario Training (“Scenario training shortens the learning curve for novices.”)

Future of Law Enforcement Training (“We need to integrate modern psychological principles into training.”)

Quotes from the podcast

“Going safely through the door might be the door of a warrant service or a courtroom.”

“Stress, though often seen as negative, is the driver of natural selection.”

“The Quiet Eye is a critical element of expert performance.”

“By understanding stress physiology, we can optimize training and survival.”

“Scenario training at the speed of life improves retention by up to 50%.”

Extra

The Three Ecosystems of Force Science

Ecosystem 1: The Officer

“An officer’s mental and physical wellness directly affects their behavior.”

Ecosystem 2: The Environment

“Scene management includes barriers, cover, and discretionary time.”

Ecosystem 3: The Subject

“Understanding a subject’s thoughts and emotions is critical.”

Three Insights on Tactical Medicine

Combining Military and Civilian Techniques (“Military and civilian medicine now share knowledge.”)

Training Medics in Law Enforcement Tactics (“Medical providers must understand law enforcement to avoid liabilities.”)

Prioritizing the Golden Hour (“Embedded medical teams save lives during the critical golden hour.”)

The OODA Loop

Quotes on the OODA Loop:

“The OODA loop lets us frame decision-making in a rapidly changing environment.”

“It’s about constantly updating your schema to respond to new information.”

“Boyd’s OODA loop integrates cognitive processes with physiological reactions to stress.”

“Orientation is the most important phase—it shapes your observations and decisions.”

“The loop doesn’t stop—it’s continuous, with each action feeding back into the next observation.”

“It helps us explain how experts adjust to situations faster than novices.”

“Through training, we can hardwire expert schema into the OODA loop, shortening reaction time.”

“It’s not just about acting quickly but acting effectively under stress.”

“Boyd’s insights anticipated modern neuroanatomical findings about decision-making.”

“Using the OODA loop allows us to think tactically while managing the emotional responses of stress.”

About John Boyd

“John Boyd formulated the OODA loop, a theory that explains decision-making in dynamic environments.”

“Boyd was an Air Force Colonel known for his ability to maneuver in dogfights within 40 seconds.”

“He described the OODA loop as a learning system that adapts to rapidly changing conditions.”

“Boyd understood the importance of updating mental concepts or schemas in response to new information.”

“He even incorporated principles from physics, like Heisenberg’s uncertainty principle and Godel’s incompleteness theorem.”

“Boyd showed us that experts with adaptable schemas outmaneuver opponents stuck in rigid thinking.”

“His orientation step is foundational, shaping observations and decisions.”

“He emphasized that mental flexibility and constant reevaluation are key to surviving and thriving in ambiguity.”

“Boyd’s principles are still relevant, serving as the foundation for modern decision-making models in law enforcement.” “The OODA loop reflects the way we are neurologically hardwired to process and act on information”.

Balance Between Response and Ability

“The term responsibility is a play on words—it’s not just about duty, but about having the ability to respond effectively in dynamic, high-pressure situations.”

Call to Action

Integrate Tactical Medicine (“Embed trained medical teams in SWAT to enhance survival.”)

Adopt Scenario-Based Training (“High-fidelity training improves cognitive responses under stress.”)

Focus on De-escalation (“Empathy and preparation are keys to resolving conflicts.”)

Bridge Training Gaps (“Supplement academy training with real-world scenarios.”)

Understand Stress Physiology (“Knowledge of the sympathetic and parasympathetic systems enhances performance.”).

Video

Audio of the podcast

https://creators.spotify.com/pod/show/erikhein1970/episodes/Trauma-Surgeon-and-Police-Officer–Dr–Martin-Greenberg-about-performance-under-pressure-e2tnnod

Book

https://www.amazon.com/Law-Enforcement-Medical-Encyclopedia-Navigating/dp/B0CPR2RDG3

Article