MentorVIEW With Paul Pierpaoli,
Senior Vice President Of Pharmacy Practice at McKesson Medication Management

He has served as a member of the board of directors and past president for the American Society of Health System Pharmacists. Pierpaoli is also the recipient of hospital pharmacy's highest honor -- the Harvey A.K. Whitney Lecture Award.

"Take every opportunity to explore the unknown and, more importantly, to explore yourself because the most interesting journey anyone can take is a journey of self-discovery."

PNOW: At the ASHP annual meeting, you talked about mentoring and the work of John Gardner. What are your thoughts on Gardner's quote: "Excellence is doing ordinary things extraordinarily well."

PP: He's been an extraordinary thinker and a person who's greatly influenced contemporary philosophy as well as the political scene in America. He founded Common Cause, which is a very important citizens' advocacy group here in the United States. He was also Secretary of Health, Education and Welfare. That's when I first learned of his writings. I was practicing pharmacy at the National Institutes of Health when he was Secretary of H.E.W., which published a newsletter with fantastic editorials that he wrote. I have always recommended his writing, especially on excellence and self-renewal. He's added so much to the way we think as a society.

PNOW: Because you tend to move around to different opportunities would you say your career has exemplified "self renewal?"

PP: Very much so. I guess you could call me an itinerant. I have moved around quite a bit in my career. At my last count I have been a Director of Pharmacy in seven distinct settings and that does not include what I am doing now, which is a totally different venue than the traditional position of a director of pharmacy.

PNOW: What factors do you consider when deciding to make a career move?

PP: In my own mind, every move I've made has been calculated. I wasn't necessarily trying to climb to a higher rung on the ladder, but I came to the conclusion early in my life that most organizations have a finite amount of energy. If you are a middle manager or program manager like a director of pharmacy, you can only go so far before you begin to reach a point of diminishing returns - particularly in terms of the personal energy you are using to build programs. I am a person who likes to start new things. I am not a maintainer. I love to start from scratch. Goethe, the German philosopher, was quoted as saying: "Things are always best in their beginning." I really believe that. Some things do get better later on, but clearly there is a lot to be said for being able to build things. That's been my way of looking at things over the years as I have moved from one position to another.

PNOW: How have you benefited from your various career moves?

PP: My energy comes from building new things from scratch, seeing them grow and getting the rewards that come from that on a personal level. Every time I have moved I think I have learned a great deal about myself and my own limitations. I've brought with me the experience and the knowledge and wisdom that I have gained from a previous position. It's been very, very helpful to me professionally and socially. We've lived in a lot of different parts of the United States, especially during the formative ages of my children's growth. They learned a lot in the process too. They learned how to adjust and live in a new community, making new friends. Every time you do that, you get closer and closer to your true self. It's a journey of self-discovery.

PNOW: You recently became a grandfather for the first time. Tell us a little bit about how that feels.

PP: That's been wonderful! I have a 20-month-old grandson, Andrew Steven Pierpaoli. With the first grandchild, you tend to realize that perhaps you did not enjoy the things you should have with your own children's rearing and so you enjoy being a grandparent very much.

PNOW: What tips would you give to your son to be able to maintain his career commitment but still have that precious time with his children?

PP: I think I spent an inordinate amount of time devoted to my professional career. At times I may have done so to the exclusion of my family. No one can ever spend enough time with their family, and I may have fallen short in that regard. I think, to a certain extent, my children have already garnered some of that wisdom because they are conducting their lives a bit differently than I did. I would advise people to really make time for their family. Also, take time to care for yourself and your own personal development through hobbies and other activities that create some self-enjoyment and pleasure as well. There are times that I think I didn't enjoy life as well as I could have. I think part of that was my preoccupation with turning around the programs that I was directing and the obligations I felt I had to my profession.

PNOW: Throughout your many career moves, what were some of the biggest challenges you faced?

PP: With virtually all of my career moves, I think the biggest challenge was not having the luxury of moving my family with me because I didn't have the perk of a company or corporation buying my home and relocating me. I had to live alone and commute back to where our family was based, and it's very difficult to do that. But that's a testimonial to my children and wife. When you are alone and distanced from your family and you take over a new position of sizable responsibility, you tend to spend virtually all of your waking hours at work. It sets a bad pattern for when you are finally reunited and at a steady state again with your family. You tend to continue to carry those habits of working from early in the morning until late at night.

PNOW: Could you identify one or two things that pulled you through those tough times?

PP: If you're truly a professional, you become totally engrossed in what you are doing and that becomes an enormous distraction which in a way is a blessing because it allows you to focus completely on what you are doing. It works out quite well because when you're in that kind of a situation and are spending so much time and energy devoted to turning around an operation or program you get a jump start on things and see progress a lot sooner than you normally would. My own personal problem was that once my family did get on the scene and we were a unit again, I was still spending a lot of energy based on the model that I was using while I was separated from them, and that's not healthy. It creates an imbalance that I think can be dangerous not only to your mental health but to your family as well.

PNOW: Your parents were first-generation immigrants from Italy. Please tell us a bit about them.

PP: My father came to the United States in 1913, and my mother came in 1917 or 1918. I grew up in a bicultural world with parents who spoke another language and brought their customs, which I think are wonderful, from another country. Yet, I had to thrive in a different environment when I went to school. I look back now and am very grateful for that. It wasn't easy living in that bicultural world but it has helped me immensely in terms of coping with ambiguity and change.

PNOW: How did it feel to be the first child in your family to graduate from college?

PP: It was a great day for my parents, neither of whom had any formal education what-so-ever in Italy. They always emphasized the importance of education because it could lead to a better life. And they were right! In my case, in one generation, we have done very well, which I think says a lot for a country like the United States. I was very, very fortunate to have the parents that I had who supported my education and encouraged me. Moreover, I was very fortunate to go to a state-supported university for a very modest cost at the time. My parents were of exceedingly modest means. Going to a state-supported university enabled me to pay for my education without a lot of debt, which gave me a jump start on going to graduate school. I was also very fortunate to go to a world-class university like the University of Michigan. My preceptor, the late Dr. Donald Francke, who is one of the founders of ASHP and also the leading thinker of hospital practice in this century, was an inspiration in every sense of the word.

PNOW: I know you believe challenge is connected to self-renewal. How do you connect the two?

PP: Unquestionably, you run the risk of failure every time you start something new. If you are successful in overcoming the challenge, you build an inner strength and a level of self-confidence that allows you to meet the next challenge. I think it is the basis for self-actualization.

PNOW: Tell us about something you may have considered a significant failure and how you ended up getting around it.

PP: I would have to say my most significant failure -- and I have had a lot of them -- was my very first position as a director of pharmacy. I unfortunately created some very unrealistic expectations for myself and for what I thought had to be done. I really pushed myself to the limits. I believe I was 26 years old at the time. I perhaps gave the impression to the people who had the power in that organization that I was impatient and wouldn't tolerate others not supporting me 100 percent. I didn't do it consciously, but a crisis did evolve which ended up in a stand off. I essentially felt I had to leave the environment because I would be ineffectual if I couldn't go to that next level. I did leave the organization and looking back it was a terrible mistake. I learned tremendously from that experience and it's helped me be more patient and tolerant with ambiguity and with people who don't share my opinion. I was too hard on myself and took myself too seriously. But I was able to pick up the ball and run again thanks to some wonderful colleagues and friends.

PNOW: What pearl of wisdom can you pass along to other pharmacists?

PNOW: Take every opportunity to explore the unknown and, more importantly, to explore yourself because the most interesting journey anyone can take is a journey of self-discovery.

Favorite Quote: "Excellence is doing ordinary things extraordinarily well." John Gardner
Favorite Song: "All the Things You Are" Not for the lyrics per se, but for its melody which many jazz musicians creatively improvise their own "take" on!
Favorite Book: "Duty" by Bob Greene. "It's an excellent book about ordinary people making extraordinary sacrifices for their country."

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