2017 National Society of Genetic Counselors Presidential Address: Do Something that Scares You EDITORIAL 2017 National Society of Genetic Counselors Presidential Address: Do Something that Scares You Mary E. Freivogel1 Received: 2 November 2016 /Accepted: 9 November 2016 /Published online: 21 November 2016 # National Society of Genetic Counselors, Inc. 2016 2017 National Society of Genetic Counselors Presidential Address Do one thing every day that scares you. Think about it. Every day. Something that scares you. Wow! Really? That’s a lot of scary stuff. I know what you are thinking. I’m not sure that I really have time to fit all those scary things into my schedule which, given that I am a typical genetic counselor, is already chock full of doing my job, as well as the jobs of at least 2 other individuals, and volunteering to be the manager of my son’s soccer team and president of the PTO, and writing a manuscript, and a newsletter article, and serving as moderator of a sup- port group at our hospital, and going the extra mile to be supportive to people that I care about.… Maybe, just maybe, I could fit a scary thing in between 5:05 pm and 5:13 pm. Maybe. But it would be so much easier to play it safe. I’m comfortable that way. My goal for the next 30 min is to challenge you to WANT to be scared. Because we cannot be brave if we are not scared. Courage cannot exist without fear. So… I’ll say it again: Do one thing every day that scares you. I love this quote. Absolutely love it. I’m not sure why but it speaks to me. Especially lately. In my current position at Invision Sally Jobe (a large outpatient imaging organization in the Denver metro area), the last few years have been some- what of a whirlwind as I’ve been propelled from being a clinical genetic counselor to managing a team of about 20 individuals and overseeing the development and growth of our clinical service lines, which include things like MRI, CT, and musculoskeletal ultrasound. I was absent the day they taught us about those subjects in genetic counseling training so, needless to say, it’s been a significant learning curve for me. Although I am still closely involved with our Genetic Services team, who I treasure immensely, I am pulled in many directions and I’m called upon to do things I’ve never done before… things I never dreamed I would be doing but, at the same time, things I love to do because they challenge me. And scare me. And make my heart beat more quickly. And make me sweat a little. Yet, at the same time, make me feel like I’m growing in monumental ways. When I am tempted to shy away from a task, I remind myself that this is something that scares me. And I should do it. Because it will make me better. This quote is typically attributed to Eleanor Roosevelt but, funny enough, that’s not actually the case. I’d like to share a bit about the rich history of this phrase. The theme began in the nineteenth century when Ralph Waldo Emerson wrote the following in his essay entitled BHeroism^: Always do what you are afraid to do (p. 262). The concept was revisited again by Jane Addams, who was a social reformer in Chicago and received a Nobel Peace Prize in 1931. She referenced this quote in the late 1800’s and again in 1931 in BBoys’ Life^ magazine: Every day you are placed in some situation that definite- ly tests you… Almost every step of progress that you make will be in the face of difficulty and discourage- ment. But don’t let it beat you! Always do what you are afraid to do (p. 22). * Mary E. Freivogel mefreivogel@gmail.com 1 Invision Sally Jobe, 8200 E Belleview Ave, #200E, Greenwood Village, CO 80130, USA J Genet Counsel (2017) 26:1–5 DOI 10.1007/s10897-016-0048-5 http://crossmark.crossref.org/dialog/?doi=10.1007/s10897-016-0048-5&domain=pdf In 1960, Eleanor Roosevelt picked up on this topic. She wrote about it then and again in the 1980’s in her book called BYou Learn by Living: Eleven Keys for a More Fulfilling Life^: You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face… You must do the thing you think you cannot do (p. 25). Finally, an exact match for the quote appeared in 1997 and is attributed to Mary Schmich, a columnist for the Chicago Tribune who wrote an essay targeted at young students that mimicked a graduation speech. She said: Do one thing every day that scares you (p. 4C). Some of you might remember that this essay was adapted into a popular spoken-word song in the 1990’s titled BEverybody’s Free (To Wear Sunscreen)^ by the film director Baz Luhrmann… this quotation was included in the lyrics. Obviously, I wanted to share a story with you about a time that I did something that scared me. I feel like you expect me to tell you something related to my career or genetic counsel- ing or my work with NSGC. So I’m going a different direc- tion. Just to keep you all on your toes. I run. I run a lot. Not as much as I used to but I do enough to keep my sanity in check. Funny enough, my genetic counsel- ing career led me to discover my love of this incredible sport. When I began my work at Invision Sally Jobe, I discovered a pretty amazing organization called Bright Pink. I met wonder- ful, amazing, inspirational people. Some of these were young women with a BRCA gene mutation and two of them asked me to run the Chicago Marathon with them in 2012 to raise money for Bright Pink. I hadn’t ever run before but I figured it would be a cool thing to check off my bucket list. As I started training, I realized how much I loved running. I ran the Chicago Marathon in 3 h and 26 min and qualified for the Boston Marathon. I was in Boston on April 15th, 2013 and I thank my lucky stars each and every day that I crossed the finish line about an hour before the terrible events that oc- curred that day. I was preparing to celebrate when the news emerged. My cell phone began to buzz like crazy with loved ones asking if my husband and I were safe and sound. I decided to return to Boston in 2014 to run again. Fueled by some pretty crazy emotions, I was determined to work really hard and to see what I could do with the proper training. A good friend, who excels in ultramarathons, offered to coach me and talked me into training Bjust a bit more^ for Boston so that I could run a 50 K a couple of weeks afterwards. That’s about 31 miles. As many miles as Baskin Robbins has flavors. Yeah. You want to talk about something that scares you? That scared the hell out of me. So I trained harder than I’ve ever trained. And I returned to Boston. And I ran the marathon in 3 h and 21 min, which was a personal record. And two weeks later, I drove a little bit south of my house to Larkspur, Colorado and I ran 31 miles. And it was hard. And I wanted to quit. Thirty-one miles is a long way, no matter how you look at it. The course was a looped course, meaning I ran 4 laps of about 8 miles each. I thought this would make it easier but it was pretty horrible. Each time I rounded the loop, I ran right… past… my… car. With each lap, I was more and more tempted to give up and exit the course and go straight to the comfort of my Volkswagen Passat and drive home. I ran the first lap pretty quickly… so quickly that I passed the loop before my husband and kids arrived. But I did see them the second time around, which always warms my heart. I ate some potato chips and drank some Gatorade and got some hugs before they headed off to soccer games. After the 3rd lap, my brother was there cheering me on. I asked him BAre you going to stick around?^ He said BOf course! I wouldn’t miss seeing you finish.^ I died a little inside at that moment as I realized that, if he stayed, I really had to finish this thing. I couldn’t escape to the parking lot. As painful as it was, I had to be brave and get started on that 4th lap. I dug deep. Mentally. Physically. Spiritually. By that time, I knew the course pretty well, which honestly made things harder. There were no surprises. Nothing to distract me. I knew what was coming. I knew when I would be climbing hills and I dreaded them. I knew when I would be descending, which was wreaking hav- oc on my quads by that time. I knew that the shirtless guy in a kilt who had been running with me on and off during the entire race would continue to try to make conversation with me and I honestly wished he would spontaneously combust so I didn’t have to listen to him anymore. But I pushed through. And I finished. And I cried. Hard. And I hugged my brother and thanked him for being the primary reason I finished the race. And of all the medals I have, of which many are colorful and ornate and distinctive, my favorite is the medal from the Greenland 50 K, which is incredibly unassuming with its’ simple black ribbon and round shape. I finished in 4 h and 56 min, which was good enough for 4th place female overall out of a total of 47 women who were crazy enough to sign up for this daunting task. I was proud. Damn proud. I drank a cold Diet Pepsi and sat down to give my shaking legs a rest. It felt really good to finally get into my Volkswagen Passat that I had passed so many times that day. I headed to a craft beer festival with my friends for the afternoon and finally landed at a bar where I ate my weight in fried cheese… because that’s what you do after you run 31 miles! I finished 2014 by running both the Chicago and New York marathons in the fall, which were also about 2 weeks apart. It 2 Freivogel was a monumental year and one that I will never forget. Was it hard? Absolutely. Was I missing toenails? Yes! Half of them. Was I scared? Yes… countless times along the way. Was it worth it? Words cannot express how extremely Bworth it^ it was. By pushing myself, I realized that I could do things I never imagined I could do. I began to see my potential differ- ently than I had before. I raised my expectations of myself, not only with regards to running but in other parts of my life as well. I am reminded of this T.S. Eliot quote every time I put a bib into the book that holds one for each race that I’ve done (from the Preface to Harry Crosby, Transit of Venus in 1931): Only those who will risk going too far can possibly find out how far they can go (p. ix). I definitely risked going too far in 2014 but, to my surprise, I discovered that I had the potential to go further than I ever dreamed if I was willing to push myself. I can’t help but think that the courage that I found within myself in my running in 2014 played a key role in early 2015 when I was offered a 3rd nomination for the NSGC presidency. I struggled because, having been let down twice before that, I was tempted NOT to try again. As we all know, it’s difficult NOT to be chosen for some- thing you really want. And it’s easy to become compla- cent and say BWell… it just wasn’t meant to be.^ But in my heart and soul, I knew that this role was something I wanted and although I feared that 3rd rejection, I was more fearful of the possibility of wondering what would’ve hap- pened had I tried again. So I swallowed my pride and sum- moned my bravery and threw my name in the hat (again!) for the 3 year term as NSGC President. When Jen Hoskovec called me to tell me I was slated, I was ecstatic. And relieved. And grateful. And, funny enough, I was scared. This was something I had wanted for many years and I was so frightened that I wouldn’t be chosen. Yet now that I had been chosen, I was petrified. And, I won’t lie… standing up here at this moment? Still ridiculously terrifying. But, regardless of how scared I am, it’s humbling to be here today and as we celebrate the 35th anniversary of our AEC, I can’t help but reflect on and draw inspiration from the incred- ible leaders who have held the role of NSGC President in the past. Obviously, I have big shoes to fill and I have heartfelt gratitude to those who wore them before me. In order to prepare for this speech, I asked past Presidents to tell me about a time when they did something that scared them. I would like to share some of their stories in hopes that they will inspire you to be brave, as they did me. Angie Trepanier described a time when she was brave in the face of conflict and initiated an honest conversation about a problem in the workplace, knowing that she might be opening herself up to potential criticism. When the criticism came, Angie accepted responsibility for things she could’ve done better but objectively stated what she had done well. She was an advocate for herself while, at the same time, listening to other perspectives and reflecting on what she heard. Liz Kearney told me about a time when she wrote a funny poem as a farewell for a colleague at work. She read it with shaking hands and knees at the going away party, worried that people would think it was silly. To her surprise, everyone loved it. It provided inspiration and positively impacted her team. Liz reflected BAs we gain more skills and experience as professionals, it becomes harder and harder to truly challenge ourselves and easier to remain complacent. If we are commit- ted to life-long learning, we must more actively seek those opportunities to be scared.^ Jehannine Austin, who has been an amazing mentor to me over the past year, described her experience with creating her own job in a brand new discipline immediately upon graduating with her genetic counseling degree. She did this against all the advice that she received from people around her because it felt like the right thing to do and she wanted to be true to herself rather than living her life to meet other’s expectations. She describes this experience as Bterrifying but also necessary.^ During his NSGC presidency, Ed Kloza navigated genetic counselors through a very tumultuous time when ABGC was seeking recognition by the American Board of Medical Specialties, which would require it to divest itself of all non-doctoral members. All genetic counselors certified by the ABMG would have to be removed from membership. Ed told me: BThis needed to go to a vote of the ABMG membership, where counselors were the majority. We could have vetoed the move and remained with ABMG, a stance taken by many GC diplomates (and many doctoral level supporters), but I did not want genetic counselors to be accused of preventing the growth and recognition of medical genetics. That would be a tough burden to bear and would not bode well for our profes- sion and our relationship with MD geneticists. I strongly en- dorsed our split with the ABMG, knowing that if we were on our own there was the possibility that the profession would falter, but I felt confident that we had matured to the point that it was time to stand on our own two feet, that we were strong and healthy enough to survive, and even thrive, if we were self-reliant.^ Barb Biesecker feared taking on the NSGC presidency while pregnant with her first child and working a job that required long hours. However, she learned the power of delegation and came to appreciate the value of an effective team. These skills allowed her to advance in her career. BI learned that being scared can be a good thing as it suggests you are taking your work seriously, striving to do a good job and not settling.^ Do Something that Scares You 3 During her presidency, Deb Doyle led the controversial and polarized discussion around separating the NSGC AEC from the ASHG meetings. And when Brenda Finucane was President, she played a key role in a pivotal decision about pursuing a clinical doctorate as the terminal degree for genetic counselors. Ginny Corson was scared in the late 1990’s when she was the President of ABGC and took the lead on negotiating a new contract for the certification exam with the President of ABMG. She prepared well, with the help of the ABGC board members, but was anxious and intimidated. Kathy Schneider candidly shared her experience lobbying for genetic counseling licensure in DC on the morning of September 11th, 2001 and the subsequent terrifying evacua- tion of the building and her journey to get back to her family in Boston, which involved sharing a rental car with three strangers. She was impressed with the acts of kindness and compassion that took place and how resilient people can be in the face of adversity. In the same year, Karin Dent was called upon to present an abstract about Utah’s successful licensure bill at the ASHG meeting when a colleague was unable to attend the meeting. Public speaking was, and still is, one of Karin’s greatest fears but she secretly wanted to prove to herself that, even though she was only 3 years out of genetic counseling school, she could do this presentation, she could do it well, and she could be proud of her accomplishment. Wendy Uhlmann was courageous, along with Diane Baker and Jane Schuette, when they co-edited the very first book on genetic counseling, which would be used to train students internationally. Although this group had the background from their years of teaching and training GC students at the University of Michigan, they had never worked on a book before and had limited publications. They relied on a team of experts to write chapters and published 2 editions of this book, the second of which included Beverly Yashar as a co- editor. Steve Keiles, in classic form, denied ever being scared. Ever. Because he is bionic, as we all know. He shared that he has made many decisions in his career that were not Bslam dunks.^ He said BThere was always a safer option, but I never really felt scared. I focused on the positive of what could be and not on the fact the timing wasn’t perfect. If we waited for the right time, it likely would never come. I would rather try and fail than fail to try. Instead of focusing on what could go wrong, what if it all went right?^ This reminds me of an amazing woman named Alison Levine who was the keynote speaker at the most recent Smith Bucklin leaders’ forum. Alison led the first American all-female expedition up Mt. Everest and has also completed the Badventure grand slam,^ which means she has climbed the highest peak on each continent and skied to both the North and South Poles. In her book, BOn the Edge,^ she recounts a lesson she learned on the mountain that has also impacted countless other areas of her life: Fear is fine, but complacency will kill you (p.83). She expands: Don’t ever beat yourself up for feeling scared or intim- idated. Fear is a natural human emotion, and it’s a strong survival instinct that keeps us alert and aware of our surroundings. But fear doesn’t have to keep us from pursuing a challenge. The real danger often comes from failing to react to shifts in the world around us… com- placency can lead to extinction, threatening our liveli- hoods and our lives (p. 83). I don’t have to tell you that the landscape of genetics and genomics is changing at a rapid pace. The roles of genetic counselors are expanding and we are being stretched in direc- tions that we never imagined. We are faced with frightening issues that may challenge our core beliefs, like population- based screening for hereditary cancer, direct-to-consumer ge- netic testing, alternative models of service delivery, workforce concerns, conflict of interest issues, collaborative partnerships with non-genetics healthcare providers, and technology that may very well someday do part of our job. We cannot shy away from these topics; rather, we must jump in with both feet and embrace the chance to drive change in the way that we feel it should be driven. We are 100 % responsible and ac- countable for ensuring our relevance in the face of great changes in our field. We cannot be complacent. We must be nimble yet resilient. We must be united by our common values. We must look challenges in the eye and address them with confidence. And we must do all of this even when we are scared because if we don’t, we risk being left behind. If we face our fears and see them as an opportunity to be brave, our profession will go further than we ever imagined. What do I want to accomplish as President in 2017? I want to push NSGC members beyond their comfort zone. I want each and every genetic counselor to feel valued for the contri- butions they make. I want to be approachable and reasonable. The thoughtful Wendy Uhlmann sent me a beautiful quote by Winston Churchill that she saw while getting her flu shot, of all places: Courage is what it takes to stand up and speak. Courage is also what it takes to sit down and listen. I stand up and speak today and I will continue to do so when necessary to ensure the longevity of our phenomenal profession. Yet, when it’s time to listen, I promise to promptly take a seat and open my mind, my ears, and my heart to ensure 4 Freivogel that I understand the needs of NSGC’s members and our pro- fession in general. I hope that my remarks today have provided you with some inspiration and I ask you to continue the conversation into 2017 and beyond. Wherever your path leads, do not lose sight of the incredible strength that you have as an individual nor the infinite resiliency that we have collectively as a profession. Final thoughts: Be brave. The more you practice the better you get. Define courage for yourself. Your courage isn’t the same as someone else’s. Don’t compare yourself to others. Rather, stretch yourself in ways that are appropriate for you. Overcoming even a minor obstacle can be addictive and can drive you to explore new ways of being courageous. Start small. Dream big. Be your own kind of brave. And when you feel your heart beating quickly and your head starting to spin, that means something really incredible is about to happen. So take a deep breath, plant your feet firmly on the ground, look your challenge straight in the eye, and do something that scares you. Acknowledgement This presidential address was edited for publication. Do Something that Scares You 5 2017 National Society of Genetic Counselors Presidential Address: Do Something that Scares You 2017 National Society of Genetic Counselors Presidential Address