PH Specialist Story
Karen Fagan, MD
Meet Dr. Karen Fagan: An Innovator in the PH Field
Dr. Karen Fagan is an associate professor of medicine and pharmacology, chief of the division of pulmonary and critical care medicine, and director of the Pulmonary Hypertension Center at the University of South Alabama in Mobile, Ala. Dr. Fagan has been involved with PHA for the past 10 years, serving on PHA's Scientific Leadership Council (SLC) for the past six. She is presently the chair-elect of the SLC and a member of PH Clinicians and Researchers (PHCR). The following is an interview with Dr. Fagan.
What sparked your interest in PH?
As a first year fellow in pulmonary medicine, I was working with Dr. David Badesch. At the end of our usual workday, he asked if I wanted to go with him to see his PH patients. I was immediately fascinated, intrigued and inspired by the patients and their complex problems and treatment. Soon this became my favorite part of the day, and I was "hooked" on PH from that time forward.
What advances have you seen in the treatment of PH patients since you started practicing?
I started working in PH right as the first approved treatment (Flolan®) came online, so one of the obvious advances has been the new treatments that have become available. The tremendous growth in basic science focused on understanding the pathophysiology of PH has also been amazing. What I also see as a real advance is the education about PH that has and continues to be offered by PHA and other organizations.
What do you find to be the most encouraging advances currently taking place in the PH field?
The advances in understanding the science of PH and development of treatments for patients have occurred at an unprecedented pace. As someone who spends a good bit of time in a basic science lab, I am especially excited about the focus on understanding the links between changes in vessel structure to changes in both vascular and right ventricular function. This integrated approach has included involving bio-medical and mechanical engineers alongside biologists to study these complex systems. I am also encouraged by the innovative ideas focusing on reversing the complex arteriopathy that is the hallmark of PH. If we can keep up the pace of the past several decades, we will identify more effective treatments, and hopefully a cure in the near future.
Do any cases or patients really stand out to you?
Yes — all of them! I have always said that being a doctor is an honor because patients and their families invite you into their lives at some of the most vulnerable times. This is never more true than in PH. I am always inspired and amazed by my patients. I rejoice in the victories and grieve the unbearable losses. Both my professional and personal lives have been forever changed by my patients and the PH community.
There is one recent event that does stand out for me. At PHA's recent International Conference in Orlando, I brought my daughters (who do not have PH) along and enrolled them in the Kids' Room so I could attend the meeting. Before the meeting, we talked about PH and that some of the kids in the Kids' Room might not be able to do everything that they could but that, just like my daughters, they would want to make new friends and have a good time. My kids had a great time at the meeting! As I picked them up at the end of the first day, one of my daughters was so excited for me to meet her new PH friend. As we were heading up the elevator, she said, "Mom, you work in PH right? My friend has PH, and you need to work harder so she can feel better!" So true!
What are the most rewarding aspects of serving on PHA's SLC and what do you look forward to as the Chair-Elect?
There are so many rewards of working with PHA and the SLC that it is hard to identify just a few. One thing that I believe is that the SLC is at the forefront of the evolving PH field and has a great responsibility to advise the Board of Trustees on how the resources of PHA can be leveraged to advance the science and care of the PH patient to the fullest extent. The SLC has lots of interesting things on its agenda for the next several years that I am excited about including: developing new patient and healthcare professional educational resources; identifying new treatments and tools to assess patient clinical responses; funding innovative research from young investigators (hopefully "hooking" them on PH early in their careers); and promoting PH awareness and early diagnosis. I am honored that my peers have confidence that I can help move us toward achieving these lofty goals.
What is the most important piece of advice you give your PH patients?
The most important thing that any patient can have is knowledge, so I encourage my patients to seek out as much information about PH as they can. Shared information means that my patient and I can be the most effective partners in their care as possible. PHA is a great source of information and support for the patients and their caregivers, and I always recommend that my patients visit the website and call for information and support from PH peers. I usually write the PHA web address on the back of the business cards that I give to my patients on their initial visit. Maybe I should print it on the front the next time I need to order cards!
Do you have any advice for new PH practitioners?
The field of PH is expanding so rapidly and requires that all of us are diligent in learning as much as we can and keeping up with the expanding medical literature. There are lots of educational resources available from independent learning (like PHA Online University) to PHA's International Conference and meetings. Connecting with other experts in your region where you can exchange ideas and discuss difficult cases is also important (perhaps through opportunities like the PHA Preceptorship Program and joining PHCR). A career in PH is very rewarding but takes a lot of effort, too!