Born in 1959 in Atlanta, Georgia, Fesmire grew up in Chattanooga, Tennessee and graduated high school Valedictorian from the Baylor School in 1978. He graduatedMagna Cume Laude from Harvard College in 1981. Fesmire graduated from Vanderbilt University School of Medicine in 1985 and completed a residency in Emergency Medicine at University Hospital in Jacksonville, Florida in 1988 where he received the Outstanding Resident Award.^[26] In 1992 Fesmire was elected as a Fellow of American College of Emergency Physicians.^[26] He practiced as an emergency physician at Chattanooga Memorial Hospital from 1988 until 1991 and had been practicing at Erlanger Baroness Hospital from 1991 until his death in 2014.

Fesmire received the Emergency Medicine Foundation's Young Investigator Award in 1996 for his work in developing a rapid protocol for the evaluation of chest pain patients.^[27] In 2006, he received the Ig Nobel Prize in Medicine for a 1988 case report detailing the use of digital rectal massage as a cure for persistent hiccups.^[28][29] In 2008, Dr Fesmire was named a Hero of Emergency Medicine by the American College of Emergency Physicians.^[1][27]

At the time of his death, Fesmire lived in Chattanooga with his wife and two sons. He was Medical Director of Chest Pain Center of Erlanger Medical Center.^[30] He was also Professor and Clinical Research Director of the Emergency Medicine Residency Program^[31] of the University of Tennessee College of Medicine^[30] and Chairman of the Clinical Policy Committee of the American College of Emergency Physicians.^[32]