2010 Keynote Address - SIUE Pinning Ceremony

by Todd Karpinski, ICHP President
June 14, 2010

Good morning everyone. Thank you so much for the opportunity to be part of the 2010 SIUE pinning ceremony. I always welcome an opportunity to come back to downstate Illinois where I spent three very enjoyable years working and developing long-lasting professional and personal relationships. As some of you know, I was the Director of Pharmacy at St. Elizabeth’s Hospital in Belleville, IL. During my tenure at St. E’s, I had the opportunity to precept IPPE students from the first pharmacy class at SIUE as well as provide some didactic lectures on the VERY popular management topics at the school. As fortune would have it, we have a former SIUE student, Michaela Doss, as one of our PGY1 residents at Froedtert Hospital this year. I must say she has done an excellent job during her residency year and is what I consider to be one of the top performers this year. I only wish we were able to keep her on as a clinical pharmacist; however, I know she will do great things down at OSF in Peoria.

The pinning ceremony today marks your transition as a student from didactic learning to experiential education. You will be given a pin that commemorates the occasion and reconfirms your commitment to our profession. You will experience many transitions and changes as you progress through the profession of pharmacy: a transition from student to resident; student to pharmacist; and transitions up, down or laterally throughout your career. Some of these changes and transitions will be very intentional and for the betterment of your career, while others may be unplanned, not voluntary, or come as a complete surprise to you.

I would like to take a moment to walk you through one such event that occurred during my most recent professional transition that has changed my life. This event was not planned and took me and my family by complete surprise – one of those ‘punch you in the stomach’ events that you never expect to happen to you.

While some of you in the audience today may not know me personally, you certainly recognize my last name and likely associate it with a much better looking Karpinski…or as the students typically refer to her as Dr. Karpinski, which I still find somewhat humorous every time I hear it from students. Julie (that’s Dr. Karpinski by the way, who is also my wife) and I had a very clear path with regard to our professional lives. We both set professional goals we wanted to strive for and had a good plan in place to how we wanted to achieve them. I, for one, had the goal of becoming a Director of Pharmacy at a prestigious academic hospital, leading a group of highly trained clinical pharmacists and technicians to help define and set best practice within our profession. For those who know me, this was a pretty lofty goal, however one that I was fairly dead set on achieving. Julie’s professional goal was to be part of a Drug Information Center within an academic setting, working with skilled faculty and helping to train the future generation of pharmacists.

About 16 months ago, my professional goal and dream came true. I was offered the Director of Pharmacy position at Froedtert Hospital. While many folks across the country have never heard of Froedtert and have no idea on how to spell, pronounce, or even find it, I can tell you it is one of the best academic hospitals in our region and has been awarded a Top 10 quality rank amongst all academic hospitals across the country. I was so excited to actually receive the offer to lead this wonderful department of pharmacists, technicians, residents, and students. This was exactly the change and transition I was looking for; in my eyes life couldn’t get any better than this.

Once I accepted the offer to move up to Milwaukee and take over the reins at Froedtert, we needed to find the right position for Julie. As fortune would have it, Concordia University was in the midst of starting a pharmacy school and had a need for an individual to help with curriculum development and to start a new Drug Information Center. Now I know there are more than a few in this room who weren’t very happy about me pulling a very well respected member of the SIUE team up to Milwaukee (sorry Mark); however, I was extremely pleased that Julie was able to find a position that would meet her professional goals and aspirations.

So everything seemed to be perfect. I had the position of my dreams, Julie had a great opportunity with Concordia, and outside of spending 6 months apart during the transition, everything seemed to be falling in place just as planned. What came next was a complete shock…I refer to it as life happening. One of those events that you never plan for, never expect that only happens to other people. I will never forget those couple of weeks in May 2009 that changed our lives.

While breastfeeding our son Eli, Julie noticed a lump in one of her breasts. Knowing that clogged ducts during breastfeeding can lead to harmless lumps, she didn’t think too much about it, but after two weeks, decided that a clogged milk duct would be gone by now, and she should get it checked. So she made an appointment with her nurse practitioner; the nurse practitioner assured us it was nothing, however she did send Julie over for a diagnostic mammography just to be sure. We have since learned that many nurse practitioners rule out lumps and never send patients over for a mammography screen; we will forever be grateful to Susan Massey for erring on the side of caution and recommending the screening.

Here is where things start to blur together for me. It was such a difficult period in which each time we received news or an update from the medical team providing care it was never good. This was so far from normal for us that we were uncertain how to handle it. Both Julie and I have lived extremely blessed lives where nothing seems to go wrong, we seem to be at the right place at the right time, and have never had to deal with any significant adversity. That was all beginning to change.

Following the mammography results, which weren’t good, but still inconclusive, Julie was sent for a biopsy. I hated being up in Milwaukee during this time; however, I knew she was in good hands (she was being evaluated at St. Elizabeth’s by physicians and staff I knew), and I was still convinced that this was all much ado about nothing and that the results would come back as a benign tumor. Following the biopsy, we were told the results would take 1-2 weeks. This didn’t seem acceptable to us as the Memorial Day holiday was just around the corner, which would delay things a bit more, so the surgeon made some calls to have the specimen rushed for freezing, slicing and evaluation. We learned the results would be back the Friday before the Memorial Day holiday.

Now Memorial Day is a big event for me; I have for the past several years been attending the Indy 500 with a group of friends. I figured this year would be no different. My ‘plan’ was to drive from Milwaukee to St. Louis to get the good news that it was a benign tumor, spend some time with the kids, and then head over to Indianapolis for the race weekend. I remember speaking with my friends and family during the 6 hour trip to Edwardsville assuring them that everything will work out, just as it always has. And then the call came – I looked up at my caller-ID in the car and saw it was Julie calling from her office. I was 15 minutes away from campus…almost there. As soon as I answered the phone and heard the silence on the other end, I knew. It was one of the worst moments of my life. There was nothing I could do or say that could change the diagnosis she received – it was in fact breast cancer. That was the punch in the stomach moment I will never forget. And the news kept getting worse. We accepted the diagnosis but convinced ourselves it would be an early stage, very treatable and curable. When the staging came back as IIb, it was another shock. Needless to say, the Indy race was off and another race began!

Once all of the news sank in we began to plan out Julie’s treatment course. Following surgery, we had our first bit of good news: only one tumor was found, and only one lymph node was involved. Although this didn’t change the staging, it was much better news than we expected and was our first win against this deadly disease. Julie then had to endure 24 weeks of therapy including a very tiring, nauseating 12-week course of adriamycin/cyclophosphamide followed by weekly Taxol for 12 more weeks. After this and a much needed vacation, she underwent reconstruction surgery and has just today completed a 6-week course of radiation. So after this 11 month ordeal, I am happy to report she is doing quite well and we expect a full recovery and cure.

You may be wondering why I decided to share such a personal story with you during the pinning ceremony. I have two reasons: the first is to give you an update on your former professor that has helped get you ready for your transition into rotations, and the second reason is because during this ordeal Julie demonstrated some qualities that each of you can learn from – qualities that can make this and future professional transitions a success. In fact, I think we can all learn a little bit from these qualities to help us prepare for the unexpected curve balls that life will throw at us and to help us be better individuals overall.

The first and most important qualities that Julie demonstrated are perseverance and commitment, especially in the face of adversity. During the trying ordeal never once did she deviate from her goal of beating the disease or feel like giving up when the treatments were difficult. You will need the same level of perseverance as you start on your rotations. This may come in many forms. It may be during a difficult rotation with a tough preceptor where you can’t seem to do anything right, or it might be on one of the rotations that doesn’t particularly interest you but that you do need to find value in. Nelson Mandela once said, “It always seems impossible until it is done.” It seemed impossible that we would get through 45 weeks of treatment, but now it’s done. You may get the feeling that a rotation or project is impossible, but trust me…if you persevere, you will get it done.

Throughout Julie’s course of therapy, Julie remained very committed not only to her job but also to the profession of pharmacy. I am not sure of the exact number of days she missed from her work either here at SIUE or at Concordia, but I do know the number is quite small, and the days missed were only at the direction of her physicians. She would go to work during the day then leave to receive her chemotherapy infusions or radiation treatment.

Not many of us can imagine how difficult it must be to maintain professional focus in the face of a cancer diagnosis while receiving toxic treatments to fight the disease. Some days I can’t concentrate if the Starbucks coffee is too strong or weak – nothing compared to developing a didactic curriculum with a toxic regimen of adriamycin and cyclophosphamide coursing through my veins. In addition, Julie maintained her commitments to ACCP, ICHP, and other professional organizations she has been involved with. It would have been easy for her to take some time away; no one would have blamed her. But instead, she maintained and fulfilled all professional commitments. WOW!

One other thing I should point out here is her support for my involvement. We received Julie’s diagnosis at about the same time that my organizational work was at its peak. I was three months away from being installed as the President of ICHP, had just been named to the Executive Committee for the Practice Managers section of ASHP, was appointed Vice-Chair of the UHC Financial Committee and had been asked to serve on several advisory boards. Never once did Julie ask me to “give something up” or to “take a break away from these groups”. She knows how important it is to be involved with these organizations to give back to our profession. So I want to give that message to you. As you move into your rotation year, eventually graduate from school and officially join the pharmacy profession, it is your obligation, as a professional, to give back. You can join a state or national pharmacy society. I tend to have bias for ASHP and ICHP; however, there are many more out there. Your contributions may be in the form of voluntary work at a free clinic or in lobbying our state and national legislators on the behalf of the profession. Whatever it is, just do it. I often hear from pharmacists that they are simply too busy and don’t have the time or the energy to give back to the profession. To this I say...well I guess I can’t say that here. When I hear this I give them the story of Julie – who during a long treatment cycle for cancer maintained a full time job, is in the midst of raising two young boys (and one older boy at times) and still was able to give more to further the profession of pharmacy.

The second quality is to always give your maximum effort in everything you do in both your professional and personal life. I challenge each of you to give more than 100% or more than you think you have during each of your rotation experiences. I promise you that if you give 110% to anything you do, including your time on rotation, you will get back 150% more than what you expect. Two months ago, Julie and I went on vacation to celebrate the end of a 24-week cycle of chemotherapy. We planned four days in San Francisco and another four days in Lake Tahoe. I had signed up for a half-marathon run as part of this trip through San Francisco’s Golden Gate Park – what better way to see the park and the Great Highway than a 13.1 mile run. Despite the fact that Julie had undergone a pretty tough regimen of chemo and had ran very little in the past several years, she decided that she wanted to push herself and run the race as well. So despite the fact that I wanted to set a personal record time at the race, I decided to run with Julie, primarily because I thought there was no way she was going to be able to handle this distance or the elevation changes in the race. And as usual, I was wrong. Not only did she finish the race, she averaged a very respectable 5.0 MPH pace. She gave all she could, plus more during the race, taking very few walking breaks. At the end when we crossed the line, I knew she had given the 110% to the race and based on the smile I saw on her face, I know she got back a lot more. I challenge each of you to give the 110% effort on your rotations. When your preceptor is staying late to educate a patient or attending a code or just wants to discuss a case, take the opportunity. When you get home from a long day on an ICU rotation, take 30 minutes to read the latest article on sepsis or sedation or whatever. Not only will you impress your preceptor, you will gain so much more useful knowledge that you can apply to your rotation. Whatever you do in life, give your 110%. In my opinion life is too short to do anything halfway, and if it is worth doing, you might as well give your all and then some.

The final quality, and something that I have truly gained a new sense of during this past year, is the empathy we express for others. Cornel West once said, “Empathy is not simply a matter of trying to imagine what others are going through, but having the will to muster enough courage to do something about it.” I have been so amazed at the outpouring of support for Julie and my family during this ordeal – from the letters and messages of support, to the surprise home-delivered dinners, to the flexibility that both SIUE and Concordia have given Julie. Amazing! As a pharmacy department leader, I am often faced with employees who are going through hard times. While I have always felt bad for their situation, I could never truly empathize with what they were going through. As previously mentioned, life always had seemed to work out for me. So, if there is one positive thing I can take from this experience, I now have the ability to hopefully see through the eyes of others as they are faced with difficult situations. During your rotations, you will have direct contact with patients who are dying or who may have just received a devastating diagnosis. These are the moments when you must be empathetic. Remember, even though you may have been present during 30 new diagnoses of cancer, it is likely the patient’s first. Remain empathetic. Or after a long day in a retail setting, remain empathetic to a struggling mother as she comes in 2 minutes after closing time to fill an antibiotic for her infant child. Maya Angelou once said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Remain empathetic.

I want to thank you for the opportunity to speak with you today. I hope some of the insights I have shared will help you in your transition from the classroom into the experiential phase of your academic career and then as you transition into the profession of pharmacy. I want to leave you with one more bit of advice. I recently read a book by Kevin Carroll titled Rules of the Red Rubber Ball: Find and Sustain Your Life’s Work. In the book Carroll channels his childhood passion for sports and plays into a universally appealing blueprint for life. The author questions why the same passion for our work and professional lives is not there as it was when we were kids playing games. So I challenge you to find your own red rubber ball in everything you do as it is the surest way to peace, happiness and prosperity.

Thank you.

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