43 IAM HONORED to be the inaugural contributor to the Journal of Palliative Medicine series on palliative care pioneers. I look back at the path that I and many of my peers like Andy Billings, Jim Hallenbeck, Robert Arnold, Charles von Gunten, and other leaders have traveled, and I am both awed and humbled by how far we have come in such a short period of time. I was a rather typical, academically naive, junior faculty member when I started my career at the Medical College of Wisconsin (MCW) in 1986, directly from my fellowship in medical oncology. My area of interest was neuro-oncology, I was doing basic research on peritumoral brain edema with the goal of establishing a research and clinical care program in neuro-oncology. My journey toward palliative care started 2 months after I came to MCW, when I saw a flyer tacked to the bulletin board outside my research laboratory. An innocuous notice, tucked beside more insistent notices about research RFAs and apartments for rent. The flyer announced an upcoming organizational meeting for the Wisconsin Cancer Pain Initiative (WCPI). I read the notice and immediately thought back to my fellowship mentor who demonstrated that residents and oncology fellows, myself included, could not do even the most simple equianalgesic calculations using commonly available clinical resources. Reflecting on his leadership in cancer pain, I thought to myself, “I should probably see what this is all about, maybe I can be of some help to their efforts.” Two weeks later I went to Madison and listened to Dr. Jan Sternsward, head of the World Health Organization’s Cancer Control program, graphically describe the international problem of poorly treated pain, and the opportunity we had in Wisconsin to make a significant difference, not only for Wisconsin residents, but throughout the world. That single speech changed my career, as I realized that the need to improve pain management, a basic human need with implications for everyone, resonated more closely with my interests in patient care, than my more narrow focus of neuro-oncology. Furthermore, I was impressed by the commitment of the health professionals, patient advocates, and health policy experts who all shared a common vision and goal. Over the next 10 years I served as WCPI Director of Physician Education, developing regional