CF Expert and Pulmonary Trailblazer Dr. Karen Hardy Retires

During her 46-year career, she helped thousands of patients while training the next generation of pulmonologists

When Karen Hardy, MD, graduated from medical school in 1979, she started her internship and found her calling for her next 46 years in medicine: caring for patients with cystic fibrosis (CF).

CF is a genetic disease that mainly affects the lungs and the digestive system, causing problems with breathing and digesting food. The lifespan of patients with CF improved dramatically as Dr. Hardy’s career progressed.

“CF was the reason I chose to go into pediatric pulmonology,” Dr. Hardy said. “During my internship year, most patients with CF were dying in their teens. I developed a close relationship with a patient who was 17 when I met her and 18 when she died. Her goal was to make it to 18, which was unusual for the time. It was a privilege to get to know her and her family and take care of her.”

After her internship, Dr. Hardy completed a fellowship at the Children’s Hospital of Philadelphia. During her fellowship, she observed more than 100 autopsies of the lungs of CF patients who had passed away. Nowadays, most fellows will never experience one of these autopsies, she said.

After her fellowship, Dr. Hardy was part of the first group of people to ever take pediatric pulmonary medicine board exams. She headed to the University of California, San Francisco, and spent time at several other Bay Area hospitals before becoming the pediatric pulmonary chief at UCSF Children’s Hospital Oakland. She spent 17 years there, developed a pediatric pulmonary fellowship program and trained many pulmonologists that have gone on to hospitals across the country. In 2015, she made the switch to Stanford Medicine Children’s Health, along with her colleagues Diana Chen, MD, Manisha Newaskar, MD, Rachna Wadia, MD, and Eric Zee, MD.

Dr. Hardy’s career paralleled a revolution in CF treatment with the rise of modulator therapy. Modular therapies work by correcting or enhancing the function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which is defective in people with CF.

“Modulators have really been a godsend for many patients,” Dr. Hardy said. “They’re not perfect, but they’ve brought about dramatic improvements in most of our patients. When the results of the clinical trials testing the first modulators came out, all of us oldsters were crying in this academic meeting because of how amazing it is.”

With modulators and other treatment advances, patients with CF can now go to college, pursue careers, and have families.

“When I started practicing medicine, there was no such thing as an adult CF center,” Dr. Hardy said. “Now we’re crossing that threshold where there are more adult patients with CF than pediatric patients. Now it’s more important than ever to help young patients learn about their disease and how to manage it independently one day.”

One of the many patients who have grown up under Dr. Hardy’s care is Audrey Ruha. Audrey’s parents first met with Dr. Hardy in 2008, after CF was diagnosed in utero.

“What we found in Dr. Hardy was a presence that steadied us almost immediately,” said Audrey’s dad, Bill Ruha. “She didn’t sugarcoat anything; she was honest, direct, and clear. It helped us feel grounded. It really felt like, ‘We’ve got a team that has our back.’”

Sixteen years later, Bill said Dr. Hardy still exudes the same calm presence.

“Dr. Hardy is part of our extended family at this point—a member of the family who also happens to be an extremely talented doctor,” he said. “Her guidance has kept Audrey healthy. Her steadiness has kept me sane. We have health, happiness, and hope because of her, and it’s made all the difference in our lives.”

Cultivating deep relationships with her patients has always been one of Dr. Hardy’s biggest specialties.

“I’ve always been impressed that she really takes time with her patients to discuss not just medical issues, but family or social issues that can affect the patient’s care,” said Dr. Diana Chen, a pediatric pulmonologist at Stanford Children’s who started working with Dr. Hardy during her fellowship. “She taught me to do that too. There’s a little part of Dr. Hardy in each of us at Stanford that will still care for patients in the same way she did.”

Dr. Rachna Wadia, a pediatric pulmonologist at Stanford Children’s who also worked with Dr. Hardy during her fellowship and for more than nine years since then, remembers her focus on treating the whole patient and how that extended to trainees and colleagues as well.

“The biggest thing I’ll always carry with me is that Dr. Hardy always looks at the patient as a whole, and the same is true for everyone she knows,” Dr. Wadia said. “She is truly knowledgeable about everything, and she loves to share and gain knowledge. She makes everyone around her better.”

Dr. Eric Zee, a pediatric pulmonologist at Stanford Children’s who has worked alongside Dr. Hardy for many years, said that the deep relationships Dr. Hardy developed with her patients were always rooted in honesty and trust.

“Very early in my career and consistently since then, Dr. Hardy has always preached, ‘Honesty is the best policy,’” he said. “I have always found that candor is almost always appreciated by families, especially during difficult times.”

Dr. Hardy said that getting to know her patients over the years was “an honor” and something that motivated her career in medicine.

“I’m really interested in each patient’s life beyond their diagnosis,” she said. “Of course, I’m trying to help them understand whatever their condition is, but I like to go beyond that and help them as a person. It’s been a privilege taking care of patients and knowing about their lives. I’ve been so lucky to be involved for all these years.”