A Little Luck Never Hurts

Nursing’s first JHU Distinguished Professor

In a speech to celebrate her selection as a Johns Hopkins University Distinguished Professor, the first such honoree ever from the School of Nursing, Fannie Gaston-Johansson, PhD, RN, FAAN, thanked the dean, the University president, her colleagues, collaborators, students, and family. The brilliant international researcher then thanked dumb luck.

p12_Fannie_Gaston-Johansson“I was living in Sweden, studying for my PhD, and learning to speak Swedish,” she said. “My dissertation topic was ‘The Pain Experience,’ so I interviewed patients, but I kept using the wrong word when I spoke with them about pain. Some told me that they were not experiencing pain, but ‘ache’ or ‘hurt.’” It was a distinction the transplanted North Carolinian couldn’t yet fathom.

Her response was to create the Painometer, a plastic wand with tabs, diagrams, and sliding markers that helps patients wordlessly translate what kind of pain they’re feeling—and where.  It would change pain research forever, but it was only the beginning of her influence on nursing. And the Distinguished Professorship is most certainly not the end. Before her speech, Gaston-Johansson took a moment to reflect. “To be acknowledged, singled out as University Distinguished Professor at Johns Hopkins, that really means something,” she said.

“Dr. Gaston-Johansson has always led by example,” said Jacquelyn Campbell, PhD, RN, FAAN. “She could have spent these last few years resting on her considerable laurels, being content to leave her significant mark in addressing pain in patient care, in nursing science, in global healthcare, in interdisciplinary research education, and in increasing the diversity of our students, faculty, and staff. But she continues to lead us.”

In her talk, Gaston-Johansson proposed that “luck lies behind many successful strategies in life, rather than thinking through strategies, planning, or one’s talent.” Collaboration is there too, she said, remembering three Nobel-Prize laureates invited to the University of Gothenburg in Sweden while she was dean of nursing there. Theirs was a story of “outstanding collaborative networks and colleagues” and missed opportunities by those who refused to participate. “One of the laureates even commented that his mentor said to him that the work he was doing was going nowhere and would lead to nothing, and therefore his name did not need to be on the paper. This was a big mistake, big mistake.”

Fannie Gaston-Johansson’s Speech

“Thank you very much, Dean Hill, for that wonderful introduction! And thank all of you for coming to the reception. I would like to share with you how I first found out something was in the air, about an honor for me.

I was in the airport in Boston, and I realized that I had missed a call: The message said: “Here’s my number. Call me … maybe.”

I am thinking some handsome, strong male figure is calling, so I hit the button again and it says, “Missed call from Martha Hill.”

So I call Martha back, and she is in France, and she said, “Oh, hi Fannie. Congratulations!”

Not sure what she was talking about, I said “Thank You” hesitantly.

Dean Hill responded, “I am so proud of you, and what do you think about the award?”

So now I have to confess that I do not know what she is talking about.

And she says: “You have not received the letter? Well I won’t tell you what it is. I will wait until you receive the letter.”

Eventually I did receive the letter from President Daniels announcing that I have been appointed as University Distinguished Professor, which I consider a great honor!

Today, I would like to speak to you about being successful in an unpredictable world and the role of randomization, luck, collaboration. You will probably find some of my ideas challenging, to say the least … but bear with me as I try to give examples in my life where randomization and luck, and working in an environment that promotes networking and professional collaborations, have been untold stories of success for me.

First, let us talk about randomization and luck.

I propose that luck lies behind many successful strategies in life, rather than thinking through strategies, planning, or one’s talent. So I am proposing that success in life can be random, and far more random than we have come to believe, as stated by Frans Johansson, my nephew, in his new book The Click Moment. Success in an unpredictable world means that you will have to “stick your neck out and take a chance” and surround yourself with diverse people and situations that are different from your own experiences because this will stimulate new thoughts and bright ideas.

Take, for example, my life, where luck played a major role in the discovery of the Painometer, my signature innovation. I was living in Sweden, studying for my PhD, and learning to speak Swedish. My dissertation topic was “The Pain Experience,” so I interviewed patients about their pain, but I kept using the wrong word when I spoke with them about it. Some of the patients told me that they were not experiencing pain, but “ache” or “hurt” were more appropriate terms to describe their experiences.

After a while I became stressed with the constant correction of my Swedish and finally broke down and asked patients, “Is there a difference in Swedish between the words pain, ache, and hurt?” Almost 100 percent said yes, definitely. And when I asked 7-year-old children if there were differences between these words they also said yes and added that ache was what their grandmothers experienced in their joints. They could even say that ache was a dull feeling, and pain was sharp and intense. These findings were later replicated and verified in the U.S. in African Americans, Hispanics, Native Americans and Caucasians. This simple, inconvenient, random, lucky, unpredictable conversation with patients in Swedish (a language I could barely speak at the time) led to a milestone in shaping my career and the discovery and production of:

  • two patented Painometers, which are pain assessment tools developed for use in research studies and clinical practice;
  • 25 out of 84 data-based papers published in scientific journals about pain and the Painometer;
  • 19 large and small grants leading to millions of dollars of funding for my research;
  • Numerous local, national, and international presentations and many recognitions, honors, and awards.

The Painometer has been used in numerous research projects across the USA and Sweden. It has been produced and sold out in Sweden, so I need to produce more of the Swedish version of the tool. A market waiting to be tapped!

The Painometer is now being used in clinical practice in the USA. A group of 11 hospitals in Texas recently purchased 100 Painometers to teach their nurses how to use the tool. They are now inquiring about ordering 3,000 more Painometers for use in clinical practice (which I do not have in stock).

Little did I know at the time the value of the random-lucky and chance discussion with patients about the words pain, ache, and hurt that would lead me into studying linguistics, the language of pain, methodologies and psychometrics properties of instrumentation, and discovery and development of the Painometer.

Secondly, I want to focus on the importance of being successful by being part of an academic environment that promotes a network of professional collaborators.
I am talking about a free-thinking environment with freedom to collaborate with a variety of others from diverse backgrounds. The best scientists in the world are connected to outstanding collaborative networks and colleagues.

When I was serving as dean of nursing at the University of Gothenburg, Sweden, our university invited three of the Nobel laureates from Stockholm to Gothenburg for dinner. Some interesting facts about these Nobel Laureates:

They were all in their late 30s when they conducted the research that led to them receiving the Nobel Prize. All were now in their late 50s or early 60s.

Neither they nor their mentors had the faintest idea that the work that they did at that time would lead to a Nobel Prize, and they said jokingly, “and therefore my name was first on the article.”

One of the laureates even commented that his mentor said to him that the work he was doing was going nowhere and would lead to nothing, and therefore the mentor’s name did not need to be on the paper. This was a big mistake, BIG mistake.

But most importantly, their major mentors always provided a rich environment and connected them to collaborators within and outside their own university environment and discipline. Each of the Nobel laureates felt that the freedom to collaborate and network had been the most important aspect of their research careers that had led to them receiving the Nobel Prize.

Now this brings me back to the School of Nursing and Dean Hill, who is an outstanding role model, mentor, and collaborator. She has created a supportive environment at the School of Nursing that promotes faculty networking and collaboration at all levels, communities, national, and international universities, professional organizations, industries, health service organizations, and other entities throughout the world.

This also brings me to the School of Nursing MHIRT [Minority Health and Health Disparities International Research Training] Program, where I serve as PI. The MHIRT has been one of the longest-running funded international NIH grants at JHU that Dean Hill has participated in and supported for 13 years. The MHIRT Program is a collaborative endeavor to improve research experiences and collaborations abroad.

Dean Hill has created an environment where collaborative educational and research relationships are developed between the School of Nursing and School of Medicine, Bloomberg School of Public Health, and Arts and Sciences, WSSU, A&T, and Brown University. She is supportive of JHUSON faculty and students collaborating with foreign researchers in Sweden, South Africa, Australia, South Korea, China, Haiti, Uganda, and numerous other local, national, and international collaborations. Thank you, Dean Hill, for providing an environment where I could network and collaborate freely, spread my wings, and grow

.In closing, I would like to thank Dean Hill for recommending me, and President Daniels and the Board of Trustees for appointing me as Johns Hopkins University Distinguished Professor