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In my limited experiences as a medical student and in dealing with patients and their families, I’ve learnt more about the impacts that patient’s conditions can have on their loved ones. I've come to understand more about how a cancer diagnosis doesn't just affect the patient - it permeates the lives of those around them too.On my placements, I was fortunate to be able to sit down and chat with Molly*, wife and caregiver to her husband who was recently diagnosed with cancer, to share her personal experience and draw light to her perspective as a carer. A perspective that can sometimes be overlooked."It all happened so quickly I didn’t know what was happening," Molly shared, as our conversation began. She recalled how it her husband's condition started insidiously, with generalised symptoms that did not resolve. Eventually, he was referred to the hospital. During their stay, her husband went through a battery of tests, many of which went over their heads. She felt that she didn’t know what was happening, why it was happening and what the treating teams were considering to be the working diagnosis. At this point, Molly and her husband felt very confused and bewildered. Coupled with the new and unfamiliar hospital environment, they were very disconcerted with the whole process and began to worry that something was not quite right.After a few days of tests, examinations and deliberation, Molly received an answer. At the time, she had just finished a conversation with her husband about an activity they were planning for the next few weeks. However, as the consultation with the treating physician progressed, she and her husband were told that the investigations seemed to be pointing towards a certain direction. Apparently, the imaging studies depicted what looked like to be a considerably progressed cancer. Upon hearing this, Molly said that she literally screamed. This was "most traumatic experience of her life". The nature of this reveal, the timing, the lack of preparedness was all too much for her, and she says that she has been in a state of shock since.Molly confessed how the news shattered her. "I've been lost since then," she admitted. Her stoic husband, the man she had relied on for the majority of her life, was suddenly declining, and Molly found herself needing to step up for both their sakes. She felt that her life had been swept up, and that the bubble of her blissful marriage had been popped. Molly stated she felt the pressure to stay strong in front of her husband, who could see that she was being worn down by the situation. She commented on the irony of the situation, seeing as her husband was the one who had been diagnosed with cancer.Molly expressed some frustration with the somewhat 'shallow' offers for help. After conversations with many health professionals in a short period of time, she began to feel that many of the discussions around self-care were repetitive, and not very helpful. "Every time I talked to someone new, they would tell me to take care of myself. But I didn't know how." Molly said that instead of suggestions and recommendations, she wished the professionals she had talked to would instead provide an avenue for her to talk and express her emotions. She felt bottled up, and said that many of the things she felt, she couldn't share with her husband because of his critical condition.Over the next few weeks, Molly and her partner found some stability in the ongoing discussions with the oncology team. They learnt about the condition, likely prognosis, treatment options and where they could look to get support. By this point, Molly had reached out to close family members, friends and others including her GP, who referred her to a counsellor.When describing what worked for her and what advice she would give to others in her situation, she commented that "having a space to express your feelings is so important." She said the experience felt as if she was in “a vast field with no borders in sight. You feel lost, like you're treading water”. But as the days and weeks went by, and both she and her husband began to acclimatise to this new normal, she found some comfort in accepting the ambiguity. Her advice to others was to allow themselves to express their emotions, "there's no right or wrong way to feel."When asked what she would prefer and expect from healthcare professionals, she said she would have benefitted from a gentler approach. "When a healthcare professional engages in conversations such as a cancer diagnosis, they need to do it gently and carefully." She also stressed the importance of taking into account the patients' lack of medical knowledge in conversations, as she felt like she has had to learn a ‘whole new world’ of vocabulary to make sense of what is going on. Molly remarked that not knowing what was going on was one of the worst feelings, especially when she began to have a creeping suspicion that something was not quite right with her husband. She said that she wished the communication had been clearer from the start in order to prevent that, and to set appropriate expectations.

My ReflectionHearing Molly's story as a medical student was a unique experience. It forced me to think about life's impermanence and our physical fragility. As a 23-year-old about to graduate from university, many times I catch myself planning for what I’ll do when I enter the next chapter of my life.While it is a fairly reasonable and human thought, I have fallen victim to the mentality of ‘expecting’ that I will have more time, or that I will have a future that resembles the plans I dream of today. Contrasting this with the shattered life that Molly is now living, the irony of the situation is palpable.From Molly, I learnt the importance of family and sacrifice. In the face of fear and uncertainty, she was doing everything in her power to make her partner’s life better. Her very human trait of carrying on no matter what, to me, resembles something suspiciously close to true love. This was a powerful demonstration of our capacity for good in the face of what is otherwise unbearable.As a future healthcare professional going forward, this story will stay with me. This insight gives depth to the patients and families I will see in the future, and will help me to understand a fraction of what they might be experiencing. I will be much more aware of the significant impacts a life-altering diagnosis can have not only for the patient, but their family and carers.

Written: 4th August 2023
Author: Muhammad IbrahimReworded from a Master of Public Health Assignment

Dotpoint Summary

IntroductionThe Leadership of Muhammad (Peace be upon him - PBUH), by Professor John Adair is a complex insight into the leadership qualities of one of humankind’s most pivotal historical figures. In doing so, Adair paints a vivid portrait, incorporating social, cultural and historical contexts with the theological and philosophical elements that surround Muhammad (PBUH).Professor John Adair (born 1934) has published over 40 titles on leadership throughout a varied career that has taken him from Egypt as a member of the Scots Guard, to deckhand over the Iceland seas, to hospital orderly, senior military lecturer, leadership training advisor and the professor for leadership studies at Surrey University (1). He has many achievements, prizes and recognitions worldwide for his contributions to the field of leadership (1).The Leadership of Muhammad (PBUH) was published in 2010, marking his 34th publication. Available for approximately $30 AUD at the time of writing, the book is comprised of 144 pages, making it a very digestible read at a reasonable price. Adair aims to distil core concepts of Islamic canon with pre-existing Arab Bedouin culture into universal ideas of leadership that can be applied to the modern day. The aim of this review is to discuss the merits and flaws of the ideas expressed, as well as the methodology and evidence used to support them.

General featuresThis book is written as a western perspective on Islamic history, with a focus on leadership. As such, it is an accessible read for the wider audience. Adair divides his book into 8 chapters, not including the introduction, conclusion and appendix. Throughout his book, Adair uses a mixture of personal anecdote, scripture, leadership theory and hadeeth (systematically recorded accounts and narrations of Muhammad PBUH). Adair attempts to organically create his story using multiple sources and methods to instil upon the reader the global qualities of leadership, using the pristine example of Muhammad PBUH.The first chapter introduces the infancy, childhood and upbringing of the prophet (PBUH) while discussing particulars of Bedouin Arab culture. Using key historical conflicts, Adair surmises that leaders should be a reflection of the traits that are required and/or valued in their groups. He creates a simple deduction stating that all organisations are comprised of humans, and the best leaders reflect humanistic qualities such as “goodness, kindness, humaneness”, implying that leaders should aspire to adopt these values.Chapter two, titled ‘The Shepherd’, reflects the young adult life of Muhammad (PBUH). His work as a shepherd is highlighted, and compared to the prophet-shepherds of the past such as David, Moses and Jesus (Peace be upon Them). Quoting Psalms and referencing Homer, Adair clarifies that the shepherd represents the most significant metaphor for leader in the Abrahamic tradition. Adair notes the importance of the shepherd’s intricate attention to their flock, their adoption of shared group risk and the key role they play in providing group unity while managing subdivisions. Adair denotes the complementary nature of a leaders’ knowledge of individuals within their group, with the leadership they display from the front.He divides the task of shepherds (leaders) into three ‘circles’: 1) to achieve the common task, 2) to create unity and 3) to address individual needs of the group.This can be seen in a figure provided within the book below (figure 1):

CritiqueAdair weaves a strong narrative regarding his personal views on leadership, enmeshed with historical, sociopsychological and theological arguments. Ironically, he uses ‘premodern’ sources to mirror ideas in current modern leadership theory. Moving away from 19th and 20th century ideas of leadership, Adair imbues his book with concepts of ‘servant leadership’, positing leadership is largely learnt and not wholly inherent (2). His position largely reflects the postmodern transformational view on leadership, with leaders adopting humane values, empowering their group, inspiring their followers and fostering individual development to bring about increased group effectiveness (2-4). The contemporary focus on the notion of ‘authentic leadership’ reflects Adair’s own views in the book regarding the necessity for leaders to be transparent, ethical and strong communicators, and agree well with much of what he argues (4).Overall, Adair shies away from a prescriptive, singular theory for leadership. Rather he focuses on a contextualised ‘needs and outcomes’ or ‘skills-based approach’, where he identifies traits, processes and behaviours that facilitate both individual needs within groups, but also work to enhance overall outcomes. Many of these ideas are replicated in corporate and healthcare settings, and their facilitation can lead to improved staff turnover, growth, satisfaction, performance, commitment and efficiency (5).Negative criticisms of Adair’s book arise not from his ideas on leadership, but more so the methodology and resources he uses to arrive to them. Adair for the most part does not cite sources regarding the biography of Muhammad (PBUH), or the English translation he uses for Quranic verses. There is potential for Adair to quote ‘weak’ or ‘rejected’ aspects of the biography, including apocryphal events that are not accepted by wider Muslim scholarship. While this is not a scholarly text and Adair is not a Muslim scholar, it is important for biographical elements to be appropriately cited as part of academic due process, especially if they are being used to draw conclusions. Factual inaccuracies that arise from this put into doubt the veracity of Adair’s claims, even if the ideas hold true on their own.Another criticism is the lack of overall focus in the book. While this may be due to author intent, in order to provide context Adair loses specificity in his writing. In a book of 144 pages, nearly half the book does not focus on either leadership or Muhammad (PBUH). Greater focus would have yielded more direct information about the titled topic. As a result, the book reads more generally, with less of a focus on leadership theory than one might expect. There is also some ambiguity in how Adair may see many of his generalised ideas applied, but in the concise and non-prescriptive fashion of his book, that could be intentionally left to the reader’s interpretation.

ConclusionAdair crafts a commendable text in concise fashion that combines many aspects of Islamic and Arabian leadership, through the linchpin of the Prophet Muhammad (PBUH). For those interested in history, culture, theology alongside leadership, this book packs a useful amount of information for any leader, although Adair leaves the reader to their own devices in terms of its application.

Navigating a Career in The Early Stages: Insights from Dr. Sanil Rege

Written: 18th November 2023
Author: Muhammad Ibrahim*Adapted from an interview

Introduction

Navigating a career in a field such as medicine can be a difficult process. As someone who is at the start of my career, it is especially daunting facing the multitude of choices that can lead me down the variety of career pathways. Speaking with those who have already traversed these routes has been especially informative. A useful by-product of my medical rotations has been to give me access to established or establishing individuals, allowing me to learn about the steps they have taken. This has been a very insightful way to appreciate what might come next for myself.In light of this, I had the privilege of speaking with Dr. Sanil Rege, a seasoned psychiatrist with a rich background in both public and private practice, as well as in research, medical education, business and leadership.I wrote this short article in order to summarise, explore and share Dr Rege’s insights and advice, particularly for those interested in medicine, psychiatry, entrepreneurship, and lifelong learning.

Dr. Rege's Career Path and Philosophy

In his own words, Dr Rege’s journey wasn't a straight path.Having grown up in Dubai, completed medical school in Mumbai, worked in psychiatry in places ranging from the UK, New Zealand, Egypt and Australia, Dr. Sanil Rege has cultivated a truly global palette of experiences and skills.Once moving to Australia, he started out his career in the public sector until 2013, before making a transition to full-time private practice and education. Dr. Rege has also worked as a locum across Australia and held an academic role as an Associate Professor in Western Australia.After moving to Melbourne, he enrolled in an MBA programme at Melbourne Business School. He decided to cease his studies after completing six subjects in order to apply what he learnt through his own projects.Practicing what he preaches, his career reflects the complexity and variety that a career in medicine can provide. This reflects the idea that there's no set linear path in medicine; rather there are only opportunities, and it is simply a matter of choosing which ones you want to pursue. With regards to psychiatry in particular, Dr Rege is a strong believer that it is a field ripe with opportunities and growth for those willing to explore.

The Importance of Being Open to Opportunities

One of the key takeaways from our discussion was the importance of being open to opportunities.
Dr. Rege highlighted that he has noticed it is very common for those starting out in their careers to seek prescriptive advice. It can be very tempting to follow in the footsteps of a senior who seems to be in the position you would like to be in one day.However, Dr Rege believes it is crucial to understand that circumstances change. What worked for one person may not necessarily work for another. What might have been appropriate in 2010 may not work for someone in 2023. Instead, the goal should be to learn and grow, as there are no wasted opportunities. Dr. Rege's own career, which he describes as seemingly 'random' at times, is a testament to this philosophy, where he proposes a process oriented mindset to approaching challenges.This ties in with the importance of having multiple mentors and sources of knowledge. Dr Rege believes that relying on a single mentor can lead to a biased or limited perspective. By seeking advice from various sources, you can synthesise your own understanding and approach to your career. This is particularly important in a field as diverse and evolving as psychiatry.

The Role of Education and Skill Development

Throughout our discussion, it became very clear that Dr. Rege is a strong advocate and practitioner of ‘broad-based learning’. He emphasised the importance of acquiring a range of skills, both general and specific.While he initially focused on psychiatry, he later expanded his skill set to include business management, marketing, website building, video editing and so on. Nearly all of these skills fell outside of the range of what might be considered ‘typical’ for a medical practitioner, however almost all of them have been incorporated into his practice.These skills may not always seem directly relevant, but they often prove invaluable in unexpected ways. He believes that innovation usually arises from the overlaps between multiple areas of knowledge, and that as professionals we should endeavour to have broad bases of knowledge to draw from.This is something he put into practice when applying basics of medical marketing and business management to his own private practice.

Overcommitting

Dr Rege cautioned against a tendency for people to overcommit to opportunities, especially early in one's career. While it can be tempting and is driven by the desire to ‘do more’, doing 10 things at once usually means you end up doing nothing well. Rather, Dr Rege advocates for selective commitment to opportunities, alongside the necessity of aligning these opportunities with a core vision or passion. This alignment helps in making informed decisions that contribute positively to your career trajectory.A big part of this alignment requires an understanding of the ‘basic’ direction of where you want to go. For many, simply the desire to learn and expand their knowledge can be a very powerful way to align themselves with opportunities. Prioritising those experiences that maximise learning, exposure to new ideas and consolidate core principles is a useful and consistent way to make the most of your limited time.

Recommended Resources

Dr. Rege recommended several resources for those interested in broadening their horizons. These include the book "Good to Great" by James Collins and learning about the Japanese concept of Ikigai, which explores the intersection of passion, skill, and career. He also suggested "Poor Charlie’s Almanack" for multidisciplinary learning and "The Medici Effect," which discusses how innovations often occur at the intersections of different fields of knowledge.

My Thoughts

This conversation was very useful as someone starting out in my field. As an individual who worries often about making the ‘wrong’ move, it was nice to be told that most experiences tend to offer some benefit down the line. It also highlighted the importance of resisting the temptation to have a ‘one-track mind’ when it came to career focus.This advice aligned with that of other mentors, who have guided me to be open with regards to my speciality of interest. I have been told that it is important engage with every rotation I work in with keen interest, as the skills I learn will stay with me wherever I go. Dr Rege’s advice also ties into the notion that I should spend the first few years as a junior doctor exploring my interests and developing ‘core’ skills. Specifically, I have been cautioned against narrowing myself down one particular path too quickly.As someone who prefers certainty and planning out my steps well in advance, this advice can fly in the face of my natural instincts. However, I find that as I increasingly become committed to ‘not committing’, I open myself up to learning more wherever I am. Where once I would feel that a particular experience is ‘boring’ or ‘wasted’ since it does not align with what I see myself doing, now I might approach that same experience with the attitude of trying to glean something of lasting utility. This has been a useful and interesting change in approach, and it is reassuring to see that the advice I receive supports this.My discussion with Dr. Sanil Rege was a very interesting experience, offering useful advice for anyone interested in psychiatry, medicine or starting their career in a broader sense. His journey shows that while the path may not be straightforward, it is filled with opportunities for those willing to learn and adapt. Whether you're a student, a young professional, or someone considering a career change, these insights can serve as valuable guidance on your own career journey.