Karen M. Krajewski: Stepping Outside the Lines

As the science of genetics continues to evolve, the impact of genetic counselors is growing in settings where they were once considered unnecessary. Case in point - Karen Krajewski, a dedicated, outgoing, creative individual who has found her niche by developing her own position as a genetic counselor through the Department of Neurology at Wayne State University in Detroit, Michigan. By making connections and working hard, Karen is proving that genetic counseling services are not only beneficial, but are much needed by the neurology patients at Harper Hospital in Detroit. Her contributions over the past seven years have made her an essential and valuable component of the neurology team. She is a pioneer in demonstrating the improved care for patients and new opportunities for counselors in non-traditional settings.

A variety of influences have drawn Karen into her current counseling role. She first heard mention of the field of genetic counseling from a college professor at the University of Michigan. A few years later, her good friends had a baby with trisomy 18, who survived only 10 months. These friends obtained genetic counseling during this difficult period, and through them Karen learned more about the help genetic counselors provide. She also has an uncle with Down syndrome. All of these experiences contributed to Karen’s interest in the field, leading her to serve as a summer volunteer with genetic counselor Joan Conard at Children’s Hospital of Michigan in Detroit in 1994.

Karen received a bachelor of science in biology from the University of Michigan, where she was also a proud member of the marching band. Karen then attended Indiana University, where she graduated with a Master of Science in Medical Genetics in 1997. While in graduate school, she performed a summer clinical rotation at Children’s Hospital in Detroit. There she met Dr. Shy, Dr. Kamholz, and Dr. Garbern, as well as genetic counselor Anne Greb, who were all instrumental in helping her identify the need for a genetic counselor in the neurology clinic. After graduation, Karen set her sights on creating a position for herself by maintaining contact with these colleagues and just, as she says, “showing up in the clinic!”

Karen's work in the neurology clinic is distinct in some ways from traditional genetic counseling, and she appreciates the unique opportunities she has. “[The] setting is different than most counselors who see patients primarily through genetics," she says. “I have the opportunity to focus on management, having a longer relationship with patients so I can deal with pertinent issues related to their condition that may arise in the future.”
At the same time, though, her position presents additional challenges due to the serious health problems her clinic treats. “Many of our patients have a significant disability involving chronic problems.”

In addition to her regular clinical responsibilities, Karen has played an active role in coordinating the study for Charcot-Marie-Tooth (CMT) disease at Wayne State University, and providing genetic counseling for these patients. The goals of the CMT clinic are to “better define the natural history of all CMT, since it is so heterogeneous, and to serve as a baseline for future clinical trials.” Karen has been involved in this study since its implementation seven years ago, and she hopes to see the beginning of the first clinical trial for CMT type 1A within the next year.

Karen also plays an active role in raising funds for the clinic through grants and an annual golf outing. She calls the golf outing a “way to raise money for the clinic and awareness, and a way for patients to get involved and feel more active in forwarding progress on studying the disease.”

Aside from her clinical involvement, Karen is active in a number of professional societies. She is a member of the Neurogenetics Special Interest Group through NSGC, and a member of the Michigan Association of Genetic Counselors. She is also a member of the Neurogenetics and Neuromuscular Sections of the American Academy of Neurology, where she is one of the few genetic counselors educating neurologists on the role that genetics plays in a number of neurological conditions.

Karen is also passionate about student education. She serves as an assistant professor of neurology for Wayne State University, where she provides lectures for neurology residents and medical students about neurogenetic diseases and their management. Karen is also a supervisor for Wayne State’s genetic counseling students for clinical rotations in Neurogenetics, conducts lectures, and serves as a small-group teacher for a medical genetics course for first year medical students. Karen strongly encourages all her students to “look at different fields, and see how genetics fits in.”

Among all her other responsibilities, Karen still finds lots of time for her 2 year old son, Nathaniel, whom she adopted last year from Guatemala. In her free time, Karen shows her pride in the “blue and gold” of her alma mater, the University of Michigan.

As counselor and teacher, Karen is making great strides in improving awareness of genetic counseling and its applications in unique settings. Karen should serve as an inspiration to all of us to step outside the lines, and find areas where we, too, can make a difference beyond expectations.