As a “macho farmer” in out-of-the-way Cable, Ohio, Sam Sowers simply could not understand how his boy aspired to be … a nurse.
“Nursing is a woman’s job,” he said, expressing a common sentiment for the time.
His wife, Janie, would not let that stand. “If our son wants to become a nurse, he’ll become a nurse,” she said with a determined stare, Sowers recalled. “It doesn’t matter if you’re a man or woman. What matters is whether you have the passion to care for people in need.”
As Sowers thinks back on a 35-year medical career that led him to become president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine in 2017, he can find no greater turning point.
“It was one of those moments when my mom connected with my passion,” he said. “And because of that, what she said and her support, anything was possible.”
Sowers, 58, occupies one of the most prestigious leadership positions in American medicine, and he still proudly refers to himself as a nurse. That juxtaposition would have been inconceivable when he entered the field in the early 1980s. But colleagues say the leadership style he learned in the trenches of cancer and HIV care could not be more timely given the essential role nurses are playing in the coronavirus pandemic.
When he interacts with those treating Covid-19 patients, he taps feelings he experienced as a young nurse confronting the terror and uncertainty around HIV/AIDS.
“People went to work every day feeling they were putting their lives at risk,” he said. “The same is true today. There is a toll.”
Nursing sharpened many of the skills — listening, collaboration, high-pressure decision-making, delivering criticism with empathy — that make Sowers a successful executive. In turn, his story helps young nurses glimpse the breadth of what they might achieve. He’s not the only nurse at the top of a major medical center; his friend Regina Cunningham is CEO at the Hospital of the University of Pennsylvania. But he remains unusual.
“I think it’s exceptionally meaningful and inspirational,” said Patricia Davidson, dean of the Johns Hopkins School of Nursing. “It really demonstrates the depth and breadth of our profession. … When nurses are portrayed in media, they’re not always portrayed doing the work they do. Have you ever seen a doctor show where the head of the whole operation is a nurse like Kevin Sowers? It’s about challenging stereotypes.”
Forget nursing or supervising a prestigious hospital system. Any form of college seemed far-fetched for Sowers during his youth on that Ohio farm, which lacked indoor plumbing in his early years. Life’s possibilities did not seem to extend much beyond the soy beans, corn, pigs and cattle in the back yard.
“I didn’t realize we were below the poverty level, because everyone around us was as well,” he recalled.
His grandmother, who’d played piano on silent films, taught him music, nurturing his promise on the keys and as a tenor vocalist. He planned to study piano and voice in college. But given his family’s inability to afford tuition, he needed to work. That led him to a pair of jobs at local nursing homes, one as a music therapist and one as an evening orderly, bathing and feeding residents.
“I wish I could say it was strategic,” he said, chuckling. “But if you’ve driven through where I lived, you know there’s not much there. And so these were the jobs that were available at that point in time.”
He found a calling that surpassed even his love for music. It makes sense to him now when he thinks back to his childhood, watching his mother, who had no formal medical training, care for her children after they’d been injured on the farm.
“It really connected tightly with what I was doing as an orderly,” he said. “I found great passion and felt like I was often getting back more than I was giving when I interacted with the people I cared for.”
He did not care that male nurses were uncommon. He switched to nursing school at Capital University in Columbus.
Sowers’ motivation only deepened when his grandfather was diagnosed with glioblastoma, an aggressive cancer affecting the brain and spinal cord. He watched with frustration as attending nurses and doctors failed to communicate clearly about the disease or to show empathy for the corresponding emotional torments. He learned what not to do.
“It felt as if my grandfather was just the glioblastoma in room four,” he remembered. “And I never wanted another family to have to feel that way.”
After graduating from Capital, Sowers pursued a master’s degree at Duke, where he’d ultimately spend 32 years as a nurse and ascendant administrator. He worked with cancer and HIV patients, those who seemed most in need of the intimate care his grandfather had not received.
Sowers did not enter nursing with visions of executive grandeur. In fact, his friend and mentor, Brenda Nevidjon, had to shove him into his first leadership role atop a new inpatient oncology unit at Duke University Hospital.
When Nevidjon asked him to open the unit, Sowers thanked her for believing in him but said she’d surely find another able candidate.
“He really loved the role he had, and he was superb at it,” she remembered. “But I said, ‘Look, it is a once-in-a-lifetime opportunity to take a unit that doesn’t exist and bring your values and your leadership into it. And you can do it.’ … The rest is history.”
He also recalled that she told him she needed him to do it, and if he said no, he was being “insubordinate.”
“She told me that in the life of an organization, there will be times that the organization needs you to do something that you may not want to do,” he said.
It’s a leadership tenet Sower has never forgotten. Those who’ve worked under him at Duke and Hopkins say he’s king of the “stretch” assignment, asking talented young people to take on tasks for which they don’t feel entirely prepared.
Once Nevidjon (now CEO of the Oncology Nursing Society) nudged him, he never looked back, climbing the ladder until he became CEO of Duke University Hospital in 2009.
“She saw something in me I did not see in myself,” he said. “And I think that’s a strong message … the value and importance of mentoring this generation and the next generation in the multitude of ways that nurses can play a role in changing lives. If it weren’t for Brenda, I wouldn’t be talking to you today. I’d still be a clinical nurse specialist.”
He recalled another lesson learned from a chaotic night on which he cared for the cancer-stricken wife of a longtime dean at the University of North Carolina. After hours of watching Sowers scramble from one end of the unit to the next, the dean quietly pulled him aside and said: “Young man, tonight, you did not lead.” In other words, he’d lost his decision-making compass amid the pace and chaos.
Sowers thinks of that criticism when confronted with crises and times of great change. Friends say he’s at his best in such moments, finding the right words of compassion but also asking difficult questions and delivering lucid criticism.
Carolyn Carpenter, who worked at Duke and now leads Sentara Healthcare in Virginia, pictures her old boss standing in front of a grieving audience after a 2017 helicopter crash killed four people, including two Duke nurses and a patient.
“One of his extraordinary skills is voicing the grief and the hope that people have at the same time during difficult moments,” she said. “Being able to put words to that in a way that people can understand their grief but live with hope. There are very few leaders who can do that in a way that’s so authentic.”
Nursing is a different profession than it was when Sowers’ father, now deceased, uttered those skeptical words four decades ago. About 12% of registered nurses are now men, up from 2.7% in the 1970s. Nurses play prominent roles not just in hospitals but in clinical research, law and policy think tanks.
These days, Sowers makes decisions that might not bear fruit for six months or even six years. He’s comfortable with that, yet his heart still resides at those bedsides where he provided care with his own hands.
“Every day I miss it,” he said. “Even though there were really hard days, and I remember those, I always went home feeling that I’d made a difference on that day in people’s lives.”
About Kevin Sowers
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