Keep Looking Up: A Reflection on Our Path Forward

This year’s Hematology/Oncology Pharmacy Association (HOPA) 2025 Annual Conference in Portland, Oregon, offered us more than just the usual blend of science, strategy, and networking. I had the privilege of witnessing at this meeting the extraordinary work that goes into making our community feel cohesive, relevant, and inspired through my work on the HOPA Board of Directors. I had the joy of reconnecting with old friends and longtime colleagues—people I’ve worked alongside, learned from, and grown with over the years.

Equally meaningful was the chance to meet the next generation of oncology pharmacists—residents and early-career practitioners whose passion and vision were on full display. They bring an energy that is contagious, hopeful, and necessary. Their questions were insightful, their curiosity genuine, and their drive palpable. And let’s not forget the laughs, whether over coffee between sessions, during a group dinner, or just walking through the exhibit hall. This conference was full of joy. It reminded me that while the work we do is serious, it doesn’t always have to feel heavy. These moments of connection and levity are just as vital to sustaining us.

As pharmacists, we often find ourselves immersed in the micro-details of patient care, diving into protocol optimization and the latest clinical advancements. But every so often, something or someone comes along to lift our gaze, to remind us why we do what we do. Carolyn Taylor’s keynote at this year’s meeting was one of those moments for me.

A renowned photographer turned global health advocate, Taylor shared not only images but also stories—stories from the margins of care, from corners of the world where a cancer diagnosis is often a death sentence, not because of biology, but because of inequity. Through her organization Global Focus on Cancer, Taylor has dedicated herself to illuminating these disparities and advocating for scalable, sustainable solutions in cancer, especially in low- and middle-income countries.

Her words and images were beautiful and haunting. They challenged us to consider how our expertise in pharmacy can—and should—extend beyond our borders. How do we share knowledge meaningfully? How do we ensure the lifesaving therapies we manage and administer are not a luxury but a standard, no matter the zip code or country code?

One quote Taylor shared has stayed with me: “Are we offering care that truly helps—or simply doing what’s possible?” That question cuts to the heart of what we do. In our highly technical, high-pressure environments, it’s easy to become focused on regimens, guidelines, and the mechanics of care delivery. But if the outcome of that delivery is toxicity without benefit, then, as she reminded us, “that is not care.” Her keynote was a call to offer choice, dignity, and honest conversation, even in the hardest moments.

And perhaps most stirring of all, she reminded us: “You are not just the system—you are the system’s conscience.” That resonated deeply. As pharmacists, we aren’t merely gears in the machine—we are the steady voice asking whether the machine is serving the people it was built for.

One of the most memorable moments for me came outside the walls of the convention center. Early one morning, just as the Portland sky began to lighten, a few colleagues and I laced up our boots and headed out on the Marquam and Flicker Trail Loop for a quick hike. It was quiet, damp with dew, and full of that crisp, earthy scent you only get in the Pacific Northwest. As we climbed, our conversation flowed easily—some of it about work, some of it about life—but often we walked in silence, letting the rhythm of our steps and the rustle of trees fill the space.

It was one of those classic Oregon trails: steep in places, rocky in others, shaded by thick evergreens, and occasionally interrupted by breathtaking views that stopped us in our tracks. As we moved along the trail, I found myself continually switching my focus—watching my feet to avoid missteps on the uneven path, glancing behind to admire how far we’d climbed, and, most importantly, pausing to look ahead, to see where the trail was leading.

It struck me how much this mirrors life—and our work.

As clinicians, leaders, and caregivers, we often get absorbed in the granular details. We focus on the ground beneath our feet: documentation, drug interactions, staffing coverage, billing codes, and metrics. These are the roots and rocks of our path—absolutely necessary to navigate safely, but not the entire journey.

At other times, we glance back. We reflect on where we started, the progress we’ve made, and the milestones achieved. We celebrate how far our field has come: from cytotoxic chemotherapies to cell and gene therapies, from inpatient-centric models to robust outpatient networks, from pharmacists being considered support staff to essential providers and thought leaders. These backward glances matter. They ground us in history and hard work. But they are not enough.

What we must not forget—and what Taylor reminded us—is to look forward. To lift our eyes and ask: What’s next? Where are we going? Who’s being left behind?

Our collective hike in oncology pharmacy must include global vision. Although we have made tremendous strides in clinical advancements, those advancements remain inaccessible to large swaths of the world. Carolyn showed us women in Southeast Asia who travel hours for basic screening. She introduced us to families in sub-Saharan Africa navigating a cancer diagnosis without a single oncologist in their region. She highlighted the absence of infrastructure, medication, and education—needs that are solvable but not yet solved.

And here’s the uncomfortable truth: Even within our own communities, disparities persist. Geography, race, language, and income can all determine who gets treatment and how soon. The path forward demands that we look beyond our immediate surroundings.

As oncology pharmacists, we are uniquely positioned to help drive this progress. We are clinicians, yes—but we are also educators, innovators, researchers, policy advocates, and change makers. Each of us has a role to play.

The conference in Portland buzzed with examples of how we are already answering this call. From sessions on innovative research to presentations on the Big Idea, I was proud to see the energy in the room—curious, collaborative, and committed.

And while we explore these vast topics, we must also remember that the path ahead is not always linear. Just like a hike, our journey in oncology pharmacy includes switchbacks, detours, and moments where the climb feels steep. Progress is rarely immediate, and change never comes as fast as we want it to. But that’s OK. It’s not about racing to the end—it’s about remaining mindful on the trail ahead.

Looking down helps us stay grounded. Looking back helps us stay humble. But looking forward—looking up—keeps us inspired.

I encourage each of you to carry that spirit with you. What is one step you can take to lift someone else up? What is one thing you can do to make access easier, care safer, or your team stronger? What is one area where you can lift your eyes from the rocks and reimagine the landscape?

Maybe it is taking your expertise to a community clinic. Maybe it is advocating for policy change. Maybe it is reworking your practice model to incorporate patient voice more intentionally. Or maybe it is something smaller but just as powerful: mentoring a new practitioner, contributing to a publication, or showing up for your colleague who needs a little extra grace that day.

If Carolyn Taylor’s message taught us anything, it's this: Progress starts with people. Systems don’t change without human hearts behind them. And healing, whether in Kansas City or Kathmandu—requires more than medicine. It requires presence. It requires persistence. It requires vision.

To close, I return to that hiking trail on the Marquam and Flicker Trail Loop.

At one point during the hike, I looked back and I could see how every careful step—every pause, every push upward—had led us to that moment. And I realized something simple but profound: I had spent so much of that hike making sure I didn’t stumble that I almost forgot to take in the view.

Don’t forget to enjoy the view.

Don’t forget to honor how far you have come, even as you keep climbing.

And don’t forget to look up, because the summit may be just around the bend.

Here’s to more shared steps, hard climbs, and forward vision. Let’s keep walking together.

The views expressed in this article are the author's own and do not reflect the views of their employer.