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Courage, Connection, & Doing Hard Things

PINK SYNC 2026 Main Event · Summit Strong

October 24, 2026

Megan Johnson, MBA, MPH, BSN

President & CEO, Intermountain Spanish Fork Hospital

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Personal Foundation

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Where I Found My Why

Environmental Services

Health Unit Coordinator

PCT/LPN

Frontline Nursing - ER

Regional Education

President & CEO

I started in Environmental Services, cleaning rooms. I had no idea what I wanted to do with my life.

Then came one 12-hour shift where not a single person spoke to me. No greeting. No eye contact. I went home feeling invisible.

I decided no one should ever feel that way. That became my why.

Leadership rarely starts with a plan. It starts with showing up, doing the work in front of you, and being willing to grow into what comes next.

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Nurse Leader

Chief Nursing Officer

Unit Education

Unlike most of my peers, I did not dream of being a hospital president. I didn't even know I wanted to be a nurse. My career in healthcare started in Environmental Services, housekeeping, cleaning rooms and learning the rhythm of a hospital from the ground up.

I will never forget one shift. I was working alone on an unfamiliar unit. Twelve hours, and not a single person spoke to me. Not a hello. Not eye contact. I went home feeling like the work I did didn't matter. Like I was invisible.

I wasn't a leader. I wasn't a nurse yet. But that shift changed everything. I decided that no one should ever feel that way if I could help it. Not a patient, not a coworker, not the person cleaning the room. That decision became my why. And in HC your why is important on those hard days. I went on to become an ER nurse, where I learned that leadership is built on trust, on relationships, and on advocating for others. Every next step in my career was built on that same thing: seeing people, and building relationships

I didn't have a five-year plan. What I had was a willingness to show up, do the work in front of me, learn from my mistakes, and grow into what came next. Hold on to that idea. It matters later in the story.

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I Did (Almost) Everything Right

Nurse. Healthcare leader. I understood the system.

I screened on schedule, every single year.

My mammogram came back negative.

And yet… I had cancer.

A negative mammogram isn't always the end of the story. For some of us, it's only the beginning.

What the report actually said

Lifetime risk: 20.5% (20%+ is high risk)

Dense breast tissue noted

Breast MRI recommended

I had the recommendation. I waited nine months to act on it. Information is not the same as understanding.

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Nurses are amazing at caring for others, not so great at caring for ourselves.

In 2017 my mom was diagnosed with breast cancer, caught on a routine mammogram. Watching her go through it changed me. I became a fierce advocate. We launched Ladies Night Out at our hospital. I spoke on local TV. I reminded every woman I could: one in eight of us will be diagnosed. When I turned 40, I promised to be the example. I screened every year. And every year it came back negative, with dense tissue noted. And I exhaled.

In September 2024, my mammogram was negative again. But a new provider told me my lifetime risk score was 20.5 percent. Twenty percent or higher is considered high risk. She recommended a breast MRI. And here's the honest part. Nurses make the worst patients. I waited nine months. I had no lump, no pain, no symptoms. We were bringing the MRI software live at my own hospital, and I decided to wait for it. I was the first patient.

The MRI showed an irregular mass. It took me another month to get the ultrasound, because I didn’t want to drive the 20 minutes up the road to another hospital and so I kept rescheduling around meetings. Want to talk about priorities? It wasn't me. During the US the radiologist recommended a biopsy. I distinctly remember the 3 pops. Two to obtain the tissue, and one to place the marker, just in case. I remember the mammography techs being so kind as they helped me afterward, and I wonder now if their kindness came from knowing what I didn't. I walked out 99 percent sure it would be negative and unaware that this would be my last mammogram ever.

Three days later, July 3, 2025, I got the call. Maegan, this is Julianne, I’m not at work today but this is my cell phone, call me. Invasive lobular carcinoma, Grade 2, Est/progest +, HER2 - .. I was now one in eight. Lobular cancer is about 1 in 10 breast cancers, and it can be harder to see on a mammogram. I don’t even know if anything would have shown up 9 months prior. But, I understood the system better than most people. And I still almost missed it. If that can happen to me, it can happen to anyone. That's not meant to scare us. It's meant to remind us that we are our biggest advocates, for ourself and others. The important this is to NOT…stop…talking.

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One Year. Everything at Once.

Sept 2024 · Negative mammogram

20.5% risk · MRI advised

9 months later · MRI

July 3, 2025 · Diagnosis

Stage 1 · No chemo or radiation

Today · Still here, still leading

In the same season I was leading a hospital, I became a patient. Then a patient again. Then again.

Cancer. Surgery. A ruptured appendix. C. diff. All while raising two boys and showing up for my team.

Strength isn't doing it all alone. It's knowing when to hand some of it to someone else.

You don't have to carry everything to be strong. Sometimes the bravest thing a leader does is ask for help.

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Then · Ruptured appendix

Then · C. diff

6 weeks · Double mastectomy

Within 30 minutes of hearing the word cancer, the calls started. A nurse navigator. An oncologist. A breast surgeon. I hadn't even processed the word yet. Within six weeks I had a double mastectomy. I was pissed, this was my decision, I was in control. Clean margins. No lymph nodes. Stage 1, genetic testing negative. That meant no radiation and no chemo. I cried. I know how fortunate that is, and I don't take it lightly, especially in a room like this. I was back to work in 3 weeks because I thought I needed to. Because I thought the pain and discomfort were my new norm with the expanders and that I would get used to it.

And then, just when I thought I was on the other side, my body had more to say. Remember that nurse make horrible patients. I shuffled around for 3 days thinking I had the flu. Turned out I had a ruptured appendix. And then C. diff. I found myself back in the hospital, abd drain, mentally weak and frustrated. It would take 8 months of failed abx before the c-diff would be treated by literally poop in a pill. During that 8 months I became all too familiar with the gut health/mental health connection. Add the cancer diagnoses and ask my husband. I was a mental, emotional, and physical mess.

All of this while my boys still had games, while I was leading a hospital. While my team still needed a leader.

I'm used to being the one who holds everything together. Last year taught me that strength isn't doing it all alone. Sometimes the bravest thing a leader does is admit she can't, and hand some of it to someone else. I had to learn patience with my body, and I had to learn to say, "I need help." Neither came easy, or naturally.

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The Part No One Sees

Cancer doesn't only happen to your body

Fear shows up uninvited

The waiting. The scans. The what-ifs, even after treatment ends.

“Do I even get to call myself a survivor?”

No chemo, no radiation, and still I asked: why me? Every hard is hard.

Your body changes. So can your sense of self.

Grieving the old you is real, and it's allowed.

You don't have to carry it quietly

About 1 in 3 women with breast cancer face depression. Ask for help.

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There was a part in all this that no one saw, and because I didn’t expect it, I hid it. Because cancer doesn't only happen to your body. It happened to my mind, my identity, my relationships. Fear showed up uninvited. In the waiting room. In the middle of a meeting when your mind wanders. And it didn't end when the surgeries did. Fear of recurrence is real, and many of you know exactly what I mean.

Then there were the quieter questions. Because I didn't need chemo or radiation, I felt like I didn’t do the hard things. Because of this I found myself asking, "Do I even get to call myself a survivor?" I had a peer who was diagnosed 5 months before me who was doing the hard things – red devil chemo for the first round. I clung to her, showed up for her chemo appointments and sat with her. We talked about each milestone and what to expect. I felt almost guilty sitting with her. And I asked, "Why me?" Not in self-pity. More like: what am I supposed to do with this?

Here's what I've come to believe. Every hard is hard. You don't have to earn your place in this room by suffering the most. Your body changes after breast cancer, after any cancer. And so can your sense of who you are. It's okay to grieve the old you. That grief is real, and it is allowed.

The drains, crying during my first shower after surgery, sleeping in a sit to stand recliner to 9 months, cherishing the pillow that Rebecca gave me to sleep with and even more so after the appendix and abd drain.

Depression is real and not to be taken lightly. About one in three women with breast cancer experience depression. And we naturally don’t talk about it. So if you're struggling, you are not weak and you are not alone. As a nurse, I'll say it plainly: your mental health is just as important as your physical health and part of your recovery.

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What Got Me Through

...and what I'd tell any woman walking this path

Let People In

My team saw me scared, unfiltered, and raw. Letting them in didn't make me a weaker leader. It brought us closer than I ever imagined.

Ask for Help

Asking for help is a leadership skill, not a failure. My husband sat in every appointment. My colleagues held the hospital while I healed.

Be Patient With Yourself

Healing doesn't follow a meeting agenda or your kid's schedule. Rest is part of the work, not a break from it. Give your body the grace you'd give anyone else.

Choose Your Hard

Pushing back on a doctor is hard. Wishing you had is hard too. Every path has its hard. Choose yours on purpose, not by default.

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There were many things that got me through the hard, but I want to highlight these four.

Let people in. As a woman leader, I never want to show weakness. My instinct was to protect my team from my worry. But I couldn't. They saw me scared, unfiltered, and raw. And instead of making me a weaker leader, it brought us closer than I ever imagined. Let people see you be human.

Ask for help. I'll be honest, I'm better at giving help than receiving it. Most women in this room probably are. But asking for help is a skill, not a failure. All those relationships I spent years developing, showing up for others were paying off. I was humbled by the support and love.

Be patient with yourself. Healing does not follow a meeting agenda or your kid’s sports schedules. I wanted to bounce back on my timeline, and my body said no, more than once. Rest is part of the work. Give yourself the same grace you'd give anyone else that you care for.

And choose your hard. Communication is hard, not communicating is hard. Asking for help is hard, nbut not asking can be harder. Life will never be easy. It will always feel hard one way or another. But we can choose our hard. Every path in front of you has its own kind of hard. We don't get to skip the hard. We do get to choose which direction we take, and we can choose on purpose instead of by default.

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Your Influence Is Bigger Than You Think

Talk About It . . .

Asking when they had their last mammogram. Do they know their lifetime risk? Do they know where to find it on a mammogram report?

Your story, told honestly, can change what someone else does next. You may never know whose life you’ve touched. But she exists.

. . . Even With the Men

Most of my peers are men. Talking to them about my breasts was uncomfortable. Then I realized they were listening.

They went home and talked to their wives, mothers, and daughters about screening. You never know how far your story travels.

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After my diagnosis, I asked dozens of women, “Have you had your mammogram?” "Do you know your lifetime risk?“ “Do you know where to find it?” Almost none did. Some realized they were four months overdue for screening. Some, four years. You could see it land on their faces. That's why I'm asking you to talk about it, even with the men. Most of my peers are men. At first, talking to them about my boobs was, let's just say, uncomfortable. But after a few conversations I realized they were listening. And I pictured them going home and talking to their wives, their mothers, their daughters about screening.

That ripple matters. Your story, each and every one of you, told honestly, can change what someone else does next. You may never know whose life it touched. It may be one person or many. But she exists, even just from talking.

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Two Philosophies That Carried Me Through

Know Your Why

Knowing the deeper purpose behind your work, and your health, carries you when motivation runs out.

My why wasn't abstract. It was my husband and my boys. It was every person I lead, who deserves a CEO who practices what she preaches.

Grow Where You Are Planted

Bloom in the season you're in, even the hard ones. It builds the strength you'll need for what comes next.

I grew in Environmental Services, and I grew through cancer. Neither was the path I would have chosen. Both shaped who I am.

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Two philosophies carried me through the diagnosis, the surgeries, and the unknown. I have used these professionally and now persoannly.

First, know your why. My why has never been abstract. It's Brian and my boys. It's every nurse, technologist, and person I lead, who deserves a CEO who practices what she preaches. It’s the relationships, and today, it's you. I'm an introvert. This is not my superpower. But my why brought me here. What's yours? What brings you back on the difficult days? Because there will be difficult days.

Second, grow where you are planted. A friend of mine, a neonatologist, told me that years ago. I didn't skip Environmental Services to get to leadership faster. I grew there. Every room I cleaned taught me something no textbook could. Same with my personal breast cancer journey. Did I want to grow through breast cancer? No. Nobody chooses this season. But here we are, and I've grown in ways I never expected. You can too, even in the hard seasons. Especially in the hard seasons.

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Discover What Gives You Confidence

Because confidence isn’t given — it’s found

Let people see you earn it

Sue Robel, a leader I deeply admire, taught me that. She walked in knowing. Not because she had all the answers — but because she had decided she belonged in the room.

Find your ‘thing’ and protect it

Something that tells your brain: I am ready. A song, a mantra, a morning routine. For me, it’s shoes.

Confidence is not the absence of doubt

Most of us wait until we feel ready. The truth is, the doing comes before the feeling. You build confidence in motion.

The leader in me will not allow this presentation to end without giving you something positive and fun to consider. When the hard things surface, like presenting in front of hundreds of women, I have to find my confidence. Even very accomplished women struggle with this. In fact, most women have experienced imposter syndrome, that feeling that I’m one meeting away from everyone finding out “I have not idea what I’m doing”. I've felt it. I still feel it. I can’t wait for the confidence to arrive. I have to be ready and build it in motion. So how do you build confidence? In yourself, in your journey, during the hard things. For me it was finding something that anchored me before I walked into the room.

Sue Robel, who led Intermountain's Canyons Region before retiring, was a nurse and a woman I deeply admire. Sue loved shoes. And she understood that the right pair isn't about fashion. It's a signal to yourself. A ritual that says, I'm ready. I belong here. Bring it! For me, it became shoes too. On the days I walk into a hard conversation or a big room, I pay attention to what's on my feet. My team can tell what kind of day it is by my shoes. After my mastectomy, they continued on the tradition by finding me a pair of sequin slippers to wear around the house during recovery. I would look at my feet and smile, remembering they had confidence in me which gave me confidence in myself.

Find your thing. A song on the drive in. A phrase in the mirror. A pair of fabulous shoes. Find it, use it, protect it, pass it on.

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This Isn't Just a Cancer Story

It's a story about doing hard things. Asking for help. Letting people in. Advocating for yourself and lifting others as you go.

“Take care of her. She's doing important work.”

Your story matters, and someone out there needs to hear it.

You are stronger than you know. You are not alone.

The world needs you well.

I am alive today because people showed up. A provider who was honest with me. Teams in healthcare who treated me like I was their only patient. A husband who sat through every appointment. Friends who let me fall apart. Colleagues who held the hospital while I was healing. This isn't just a cancer story. It's a story about doing hard things. About asking for help. About letting people in. About advocating for myself and lifting others as I go.

Every one of you has a story like that. Maybe you're in the middle of it right now. Your story matters, and someone out there needs to hear it. So, keep talking about the hard things. With your friends. Your daughters. Your coworkers. And yes, talk about your boobs with the men in your life.

And please, take care of yourself. The woman in your chair. Mentally, emotionally, physically. She's doing important work. You are stronger than you know. You are never alone. And the world needs you well.

Thank you.