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Karin and Bob Johnson have explored all 63 U.S. national parks together, from the icy reaches of Alaska to the tropical shores of Hawaii.

Proud graduates from the classes of 1974 and 1976, they’ve carried their connection to the university with them, bringing their plush USF mascot, Rocky, along on almost every adventure.

To celebrate their 50th wedding anniversary, the Johnsons were planning a special family trip to Yellowstone in June 2025. But five months before the trip, Karin’s health took a sudden and frightening turn.

“I went to bed early and started vomiting,” she said. “It wasn’t food — it was dark and alarming.”

Her husband Bob, a former special forces medic, knew immediately something was seriously wrong and took Karin to the emergency room.

“I had just enough medical knowledge to know that black coming out of your mouth means that blood is there somewhere,” he said.

Doctors determined she had a hiatal hernia, a condition occurring when part of the stomach pushes through an opening in the diaphragm. Unbeknownst to Karin, who had celebrated her granddaughter’s birthday just two days prior, her stomach had slowly migrated into her chest cavity.

As Karin's condition worsened, she was transferred to Tampa General Hospital, where she met Christopher DuCoin, MD, chief of the Division of Gastrointestinal Surgery at USF Health, chief of the Digestive Diseases Institute at Tampa General Hospital, and professor of surgery at the USF Health Morsani College of Medicine.

When Dr. DuCoin reviewed Karin’s imaging, he immediately recognized the severity of her condition. Not only had her stomach herniated into her chest, but it had begun to twist — a rare and life-threatening complication that can cut off blood supply to the organ.

“I remember looking at Karin’s images and thinking, ‘Oh, that’s a lot of her stomach in her chest, and it looks like it’s starting to rotate,’” Dr. DuCoin said.

Dr. DuCoin initially hoped to perform a minimally invasive robotic surgery. His team runs one of the highest-volume robotic centers for esophageal surgery in the country, and has trained dozens of physicians on the procedure.

But once Karin was in the operating room, it became clear that robotic surgery alone would not be enough. Dr. DuCoin discovered that Karin’s stomach had fully twisted, cutting off its own blood supply. Part of the organ had died. This critical scenario happens in only about five of the hundreds of hernia cases he treats each year.

Bob and the couple’s three daughters waited anxiously for news. When Dr. DuCoin emerged, he asked if he could speak with them somewhere more private.

“It was kind of hard to keep it together emotionally when he said that,” Bob said. “911±ŹÁÏÍű were scared to death.”

Dr. DuCoin explained that he could not complete the surgery robotically. He drew a simple diagram to show how Karin’s chest cavity, esophagus and stomach had shifted and cut off circulation. His team would immediately transition to open surgery to remove the damaged tissue, then stabilize Karin before bringing her back for a second operation 48 hours later to reconstruct her digestive system.

“This was truly a life-and-death scenario,” Dr. DuCoin said. “You have to be able to use all the tools in your toolbox.”

The approach worked, supported by a multidisciplinary team of surgeons, critical care physicians, intensive care unit staff, interventional specialists and others who worked together to optimize Karin’s condition between surgeries.

Karin spent nearly three weeks in the ICU. Every morning at 6:30 a.m., Dr. DuCoin led residents and fellows to her bedside for rounds. Karin, herself a retired Pasco County teacher who spent 36 years in education, noticed something remarkable about these rounds.

Dr. DuCoin’s teaching emphasized empathy as much as medical skills. He paused during rounds to help students understand the patient’s perspective, showing that compassion is an essential part of successful care.

“I was moved that he taught empathy and compassion as well as medicine,” Karin said. “He explained things in a way I could understand and made sure the students saw me as a person.”

When Karin finally returned home, she slowly rebuilt her strength, eyeing her long-awaited family trip as additional motivation on her road to recovery.

“My daughters thought we should maybe cancel the trip,” said Karin. “But I said to them, ‘No way, we are going to go.’”

Four months after the surgery, the whole Johnson family stood together in Yellowstone National Park, celebrating a half-century of marriage, a second chance to make memories and a successful journey back to health.