As her young son, Ethan, was battling non-Hodgkin lymphoma in late 2009 and early 2010, Karen Glenn often worked from his room at Vanderbilt's children's hospital.

At the time, Glenn was the chief financial officer at First United Bank and Trust in Madisonville, Ky., and the hospital in Nashville was more than 100 miles from her office. It would have been easier for her to take extended leave while then-5-year-old Ethan underwent six months of chemotherapy, but as a single mom to twin boys — one fighting cancer, the other with autism — Glenn did not consider that a realistic option.

"The way I looked at it was that my boys needed me to do this," Glenn said of her decision to keep working through Ethan's treatments. "This was our life, our livelihood. I had to make it work."

It was not the first time Glenn and her family had to manage through a major medical crisis. Ethan and his brother, Jack, were born three months prematurely and then spent nearly four months in the neonatal intensive care unit at Vanderbilt. Ethan emerged relatively healthy, but Jack suffered severe bleeding of the brain and damage to his trachea. He breathed through a tracheal tube for two and a half years, until he weighed enough to undergo surgery.

Today, the boys are in middle school and, as Glenn put it, "are as ornery as can be." Both are thriving, though the ordeal Jack went through as an infant significantly delayed his development.

Glenn is thriving too. Six months after her son completed his cancer treatments, she was promoted to president and chief executive of First United. In the ensuing years, she has substantially improved the bank's performance — it posted a record profit last year — and spearheaded its first acquisition. She also has become one of Madisonville's most visible business leaders. 

Still, Glenn was initially hesitant about accepting the position. At the time, she lived nearly an hour away from the bank's headquarters and the job required her to move to Madisonville. She wasn't sure she wanted to be so far away from the relatives and friends who had been her support system.

"I came very close to saying 'no' because of the fear of the unknown," she said. "It was going to change my life so much."

But an old friend whom Glenn spoke with the night before she had to announce her decision urged her to set aside her fears and embrace the opportunity she was being given. She went in to work the next day and accepted.

"Had I not talked to that person, I don't know what I would have done," Glenn said during an interview at the cover photo shoot for this issue of the Most Powerful Women in Banking and Finance. "Now here I am sitting in New York City among all these fabulous ladies who have accomplished far more than I ever have."

Perhaps, but few have overcome as much adversity as Glenn. The health challenges with her boys left her "dead-dog tired at the end of every day," but she persevered for the sake of her family.

"Not having a career has never been an option for me," she said.

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