Liv Nixon speaks to Noreen Sajwani, Head of Consulting at Impatient Health, about her journey from being a young Muslim girl growing up in Atlanta, Georgia post 9/11, to being tricked by her sister into studying nurse anesthesia, and the mindset she has needed to adapt throughout her career journey...
Liv: Good morning, Noreen. How are you?
Noreen: Good morning. I’m doing well. How are you?
Liv: Very well, thank you. Very well. Welcome to the UK!
Noreen: Exactly. Welcome to the UK before I go to Lisbon to then come back and then go back to Bali. So yeah, welcome to all around the world really.
Liv: Thanks so much for making the time to do this interview with me. I really appreciate it. I’m looking forward to chatting to you. So let’s get into this. So Noreen, what I want to do today is really get to know a little bit about you and your journey to date. So to help us do that, can you please, in your words, give me an overview of your story to date, but go back right to the start, start with your days in education, if you don’t mind, because it’s fascinating. And there’s a lot to get into!
Noreen: For sure. No, super happy to. I guess I will go back to the day that I was born. We could go forever, a days back, but I was born and raised in Atlanta, Georgia. I grew up in the South in a post 9/11 world, which obviously was an interesting time to grow up as a young Muslim, an eight-year-old Muslim girl at the time, and I’m giving away my age. That was an interesting time to grow up in the South. And to be honest, I really enjoyed growing up just with my family. I’ve got an older sister and my parents, but my parents were classic immigrant parents. They came to America, worked in factories, had about $5, and were married to each other for about three months. And that was the world that I grew up in. That was what I knew. And I think a lot of people from my generation talk about the impact that 9/11 had on them. And as I said, being a young Muslim girl, I wasn’t really any different, but I always grew up with this, do I talk about my religion? Do I not talk about my religion? And it always sat with me.
So you have kind of that cultural side of me, and then you’ve got the kid of immigrant parents and “you must succeed, you must get educated, you must do all the things and find the right career path that leads you to being successful” as is the American dream. So my mom was always very open to letting me do whatever I wanted “in the medical field.” So there was always that little caveat! And my sister actually just by whim ended up going into nursing school. She became a nurse and now she’s a nurse practitioner. So she works as effectively a doctor in California. And because I had no idea what else I could do, I said, “Okay, fine. I’ll be a nurse as well, but I like math, so what do I do about that?” My sister was like, “Oh, a nurse anesthetist, you’ll become!”
So I applied to what was one of the best nurse anesthesia programs in the United States. By the way, nurse anesthesia is a master’s program. So I didn’t know what I was getting myself into when I did this and applied to university at Georgetown, where I went and got there the summer before I started. I went, “I don’t want to do nursing. I have to do a four-year nursing degree in order to be able to become a nurse anesthetist.” And my sister had basically swindled me into doing this in the attempts of being like, “Math, you love math…”
My school of nursing and health studies had four majors at the time. Nursing was one of them. Human science was another, which was more of a pre-med track. And then there were two others: international health and healthcare management and policy. So I thought, ‘Oh, I haven’t traveled much around, like international Health’s not really my drive.’ Therefore, I fell into healthcare management and policy, which was effectively the business of healthcare. And for someone who likes math, that actually worked out quite well. So I did that as my undergrad degree.
The other part of it was my kid-of-the-immigrant-being-successful part. However, I didn’t realize that Georgetown is actually a Catholic Jesuit institution. And I promise I didn’t know this the first week that I was at University Liv. As a young Muslim girl growing up in a post 9/11 world, I caught myself going to a Catholic Jesuit institution for the next four years. I had to take a step back and think, ‘What did I get myself into?’ This is just all sorts of everything that I just don’t understand!
Anyway, long story short, that actually got me really interested because Georgetown was a place where interfaith dialogue was so widely accepted. It was one of the central principles of the Jesuit tradition. What it meant was that I could actually very freely and openly bring together my interest in healthcare and the business of healthcare with how sociocultural factors or the ethics of medicine come into play. And that was really fascinating. I really started to look at healthcare ethics. We had a class on that, and there was one where I learned about big bad pharma, the most unethical of the healthcare industry as we would have said at that time.
Graduation came upon me and I thought, ‘Okay, what do I do now?’ And I wasn’t ready to let go of that ethics and healthcare sort of lens.
So I actually applied and got into a master’s program that allowed me to study Islamic studies for two years and then go off and study whatever I wanted in the humanities. So I actually moved to London after I graduated and did that two-year degree in Islamic studies, and then I actually went to the London School of Economics and did my master’s in International Health Policy.
And what I loved about that actually was the fact that I didn’t have to choose. I got to pursue both tracks and in a way be true to who I was as the immigrant kid that’s still doing medicine and in the healthcare field, but also someone who is conscious of who she is in the world. I can’t change the fact that I am a female, and I can’t change the fact that I grew up Muslim in a Muslim household, but what I can do is actually marry the two seemingly different concepts in a way that’s actually fascinating for people.
So I went on to learn about the halal pharmaceutical industry in Malaysia and the different ways that we look at pharmaceutical ethics. And that actually got me thinking, if you can’t beat ’em, you should really join ’em. I ended up working in pharma for a bit. I actually joined Pfizer’s market access team and had one of the most incredible bosses I’ve ever had in my lifetime. He taught me loads and he was really great about telling me that you can bring together seemingly different concepts.
I think that was a mantra and a theme that kept coming into my life. I kept being told initially in school or in other places that we have one subject and another subject, and the subjects don’t come together. And I always challenged that and I said, but why not? And it was mentors like my boss Rafe at Pfizer that really said, no, do what you want. Bring the two together. Or, in my master’s program, where it was, yeah, you learn both and you bring them both together. And actually, that’s where I started my journey in consulting later on, working in life sciences strategy.
Now, as the Head of Consulting at Impatient Health, it’s about, let’s bring together disciplines, let’s bring together ideas, let’s bring together parts of the industry that don’t work together normally or that never get the opportunity to cause ruckus together, as I would say, because that’s what makes it fun, that’s what makes it exciting, and that’s what makes it enjoyable as well. So I think that’s been a kind of trending path in my lifetime, if you will. And it really did start back in the early days of my mom saying, “You’ve got to do something in healthcare,” and me going, “But I’m also Muslim. What do I do about that?”
Liv: It’s so fascinating though, and it’s so true what you say about these two things that can sometimes seem completely unrelated. It’s fascinating to see what you can do when you do bring those together. I was listening to one of Steven Bartlett’s podcasts recently, and he was talking about skill stacking. Connecting two completely different things and bringing them together, and Steve Jobs went and did a typography course. All of these things, it’s that skill stacking that you can do that can complement something, and on the outset, you might think something’s completely unrelated. Tell me more. You’re growing up as a Muslim girl, like you say, in the era of post-9/11. It seems you were dealing with that conflict of almost feeling that you needed to hide being a Muslim but being proud of being a Muslim. At the same time, it’s learning about your culture at a time when there was so much anger around the world, particularly in parts of the states. Tell me a little bit more about that because that has obviously shaped so much of what you do now and who you are?
Noreen: Totally. I belong to a liberal Shia community called the Ismaili community. And growing up, it was all about the sort of, I guess, for an eight or a nine-year-old, knowing the term “esoteric faith”. That term might seem a bit odd, but that was really a lot of what we learned. I would go to religious classes on Saturdays, and we would learn about how to be a global citizen, how to interpret the faith in today’s context, and how to be an ambassador of our faith. Pluralism was a common term that we talked about. So actually, a lot of that ideology about how you become connected to a globalized world, how you start to see beyond just yourself and how you can contribute to a community was very much a part of my upbringing.
As you say, Islamophobia was quite prevalent in my teens, and I kept finding that one of the things I longed for was a community that I could contribute to and where I could share my way of thinking and my background and have it be accepted. And that was a challenge. Of course, I’m not saying it was all peaches and roses, but what I did learn was that you make your own community at the end of the day. For me, the communities that I belong to are, of course, the Ismaili community. I was born and raised in that community, and I still interact and engage with it. But also the pharma community, I find that I’m a person who likes to engage with folks that are trying to challenge and push the status quo within pharma.
More recently, I would say I identify with the global nomad community. There’s a whole world of expats that travel around and become digital nomads, and I feel at home when I’m with my fellow nomads. I will say that a lot of times growing up, I actually–I’ll tell you, Liv–when I was in high school, my two closest friends were a Mormon and a Hindu, and we would always joke, “Oh, the Mormon, the Hindu, and the Muslim walk into the cafeteria together” . Obviously, we weren’t going into bars at that time, but interfaith was a part of kind of the bread and butter of how I saw my community and my world. I was actually so grateful and felt really blessed and privileged when I went to university because not only was it one of the things where I could then say, “Oh, this is normal,” but it became so commonplace that it really, for me, brought this idea of the sociocultural impact that religion, culture, and society can have on everything else, whether that be healthcare, business, or education. And for me, that was pivotal in having that kind of click in my brain to go, “There is something behind this.” The fact that you’ve grown up in this type of society around these sorts of people based on who you are and how you’re the same or different really impacts the way that you’re going to do your finances. It’s going to impact how you receive healthcare services. It’s going to impact the ways in which you interpret art.
It seems silly; some people are like, “You’re actually talking crazy,” but I found that I could only actually have that when I became so different from my surroundings that I was almost forced to branch out and find these other communities that I could belong to.
Liv: So do you think that’s what drives you now in your work? Do you think it is finding that something and then building from it?
Noreen: Yeah, I think it’s a great question because a lot of times, when I first started off my journey in life sciences, I found it a bit stale. Can I say that? I don’t know if that’s even allowed, but I found it a bit stale and thought, good lord, why are things like this? Why is it just so blah? And I found that actually, the things that people weren’t saying in the corporate meetings or officially on email were the things that were driving the ways we sold products or the ways we sent marketing messages to patients and the way that medical affairs reviewed journals or articles. And I’m thinking, why haven’t we actually considered that?
So I really do believe that even today, that’s how I landed into innovation and design, because I think it was, I guess, the term for someone that’s just thinking a bit quirky, I’ll say maybe. But I think innovation in design is a huge buzzword, but I think actually, a lot of that comes into what we would call today service design or what we would call humanistic design or being future conscious.
At Impatient, we take a framework that looks at speculative design and future-focused ideology and brings it into pharma, and it’s revolutionary because people have never thought about pharma that way. But to me, it’s almost why wouldn’t you if no one’s thought about it? That’s why we should do it.
And so I do think that actually, a lot of the ethos of the way that I like to work as a person, but also, I’m grateful that Impatient kind of has that sort of vision as well, means that I have the liberty and the freedom to never be bored at work because I always get the chance to just wind people up or, as I say, cause a ruckus or do whatever so that we’re actually just, not even just pushing the envelope, but really getting quite zany and unconventional in pharma because maybe just maybe that will mean that we move the 1% or the 2% in terms of progress. But you can’t, what’s the phrase? You can’t see the forest for the trees if you’re in the thick of the woods or whatever it is, there you go. You’ve got to be outside of it to come back in and go, oh, there’s more to this than just what I’m seeing around me.
Liv: Yeah. When you spoke earlier, you mentioned the ethics of pharma and how pharma is seen as the big bad guy. Throughout your journey and to where you are today, how does it look to you? Has your opinion on that changed and if so, at what point did it change? Tell me about that.
Noreen: As I mentioned earlier, when I first took this class on the ethics of healthcare, we had a whole session on the ethics of pharma. I walked out of that class thinking that pharma was the big bad wolf. I said to myself, “I will never work for pharma. They are just awful. They are an institution that cannot and should not be changed. We should just topple them all over.” Then I ended up in this position working at Pfizer. When I was interviewing for the job, I asked my boss, “How do you deal with the fact that you work in an unethical industry?”
And he was a bit taken aback, but as I said, he was a good guy, and he took it. I was actually grateful for that experience because once I joined the organisation, I realised that there is a difference between pharma, the industry with a capital P, and people that work in pharma. Sometimes I think we associate organisations or corporations, and we assume that the people embody everything that the organisation does. Surely, yes, we follow the vision and the strategy of an organisation, but people have their own value systems and ethical compass, if you will. So, it really took me a second to challenge myself and say, “Okay, it’s not that the pharma industry is unethical because the people are unethical. It’s actually that some things that happen in pharma mean that we are not being as ethical as we could be. And so, how do we target that? Let’s get the people who actually create the value systems of our society and the ethics of our society to change that.”
One of the things that I’ve really focused on early on was bioethics. I’ve yet to see the fact that a bioethical framework would be commonplace in a pharma company. There are some that have them, and it’s fantastic to see that. But I really think that’s an area where, let’s admit it, AI technology and whatnot is going to take over. Have we even thought about the ethics of AI in pharma? I’m not sure ethics in AI is a bit surface-level where we’re having some conversations about that, but we’re definitely not talking about what happens when the digital health therapeutic has a glitch and gives the wrong dosage of medication to the patient. And then, what is the impact that has on patients, on society, on the industry, on this whole element of trust that we talk about with pharma?
So, it took me a second to take a step back and go, “Okay, there is pharma, the industry as it was. There’s pharma, the industry today. There’s pharma, the industry tomorrow. Those are actually three separate things. And you’ve got the people that work in pharma that have their own sort of ethics and values that influence, yes. But they’re actually separate, and the people you know are really trying to do good, or they wouldn’t be there.”
And then, I think there was this idea of, as I said, “if you can’t beat ’em, join them.” Like, how are you going to make pharma more ethical, quote unquote, if you don’t work in it to make that change? And I tried to do a lot of research and work into how we can start to bring in bioethical frameworks into things like genomic medicine and personalized medicine. These are all areas that are going to thrive, but is there a pharma company that’s really putting that front and center? I don’t know. Maybe it’s time that we start poking that bear a little bit. And I think that’s part of why I continue to be in pharma because I see that there’s a lot of work to do in that area. And hopefully, with my background and the things that I’ve learned and studied, those skills will be transferable. Maybe I can stack those skills one day, as you say, Liv. Let’s see.
Liv: So, talk to me more about these bioethical frameworks. Speak to me as if I’m really stupid and tell me what you mean by it and what a good framework looks like in your mind, if that’s possible at this stage.
Noreen: Yeah, it’s a very loaded question!
The concept of bioethics really started, and I did a bit of research and it must be between 50 and 70 years old. If you look up bioethics, you can see that there are four key elements of bioethics. There’s non-maleficence, which is the intent of not doing harm; there’s beneficence, which is the intent of doing good – these are two separate things actually. Then there’s autonomy, which is the ability to make decisions, and there’s justice, which is how to ensure that what you are doing is fair and equal on a societal level.
So those are four tenets, and there are more – there are seven principles of bioethics and all of that – but really those four key principles are the basis of how you do anything in medicine in an ethical way. And the one that I find the most fascinating of the four, where I think we have the most headway to make, is non-maleficence. Because we can all agree that not even just pharma, anybody in the healthcare industry has the intent to do good – beneficence is there, right? We have lots of access discussions and we’re really trying to be just and fair as a society in how we deliver and retrieve medications or services and things like that. And autonomy, I think, is very directly related to patient engagement or HCPs being able to take care of their practice or make decisions that are in the best interest of the people they serve.
So I think those three, there’s almost a place where those three tenets sit or fit within the existing value chain of pharma. The one that I don’t think gets a lot of traction is non-maleficence. It’s the one where you go, no, I’m not going to do bad on purpose. Because I think that often gets muddled into it, it’s not profitable, right? Or it doesn’t make economic sense. Or how can we justify this? What is the basis by which we’re making these value decisions? And so one of the other reasons why I studied health economics was because I wanted to see what is the basis by which we’re actually making these value decisions. And I mean primarily in most European countries, it comes down to numbers. Economic evidence is what we use today. And in very rare cases and in some countries, we’re making progress. But in very rare cases, do we look at the social impact or the impact on productivity or the cultural impact that that has on shaping people? Because quite frankly, you can’t justify that into money today. It doesn’t have a financial return in the short term.
And so I think that concept of non-maleficence, and there are other aspects of non-maleficence as well, but that’s really one where I think we need to, as an industry, start thinking about how we set the right frameworks to say not only are we going to intend to do good, but we are going to actively try not to do bad. And it’s important for us to be future-conscious. We don’t always have to say, “Okay, this is what’s going to happen to AI in the future, and so we have to accommodate that.” It might not be the right thing to do today, but let’s just be conscious of that future and take society into account. And also let’s look at what that means for the other parts of our society and our world today as well. If you ask me for an ethical framework per se on that, I don’t have the answer, but I am recruiting and hoping that maybe we can get some ethicists across disciplines on board to then tackle that question in the future.
Liv: When we get the answer to that question, we definitely need another episode because it fascinates this whole idea of what is the answer to that? Good God, we’re still learning so much. We are in the very baby step stages of AI. And where it leads, there is so much good it can do. But we have to get it right. So yeah, I find it utterly fascinating. Good luck with that recruitment! (Laughs)
Noreen: A couple of years back, I attended a talk and there was a robot ethicist present. Oh, and I was like, he’s the guy we’ve gotta recruit. There are some titles out there that are a bit rogue as they might say, but those are the guys that we need. So I’m intent on finding them. Maybe we tag “robot ethicist” in the post, let’s do that!
Liv: I want to chat to these people that you’re speaking to!
Noreen, we’ve talked a lot about your journey to date and it’s fairly obvious, as we touched on earlier, that post-9/11, you must have had all sorts of experiences with different biases in different situations. Now let’s start with being a Muslim girl in a Catholic university. Talk to me about some of your learnings at that time.
Noreen: Yeah, so I think one of the key things that I learned was that healthcare and culture/religion are universal concepts. For a time, as a Muslim, I was part of the Hindu Students Association and was on the board. It was a point of pride for me, and I enjoyed it thoroughly. I embraced that opportunity and was privileged that the association was very small at the time. I happened to be one of the people that would show up Sundays at five o’clock because it was a time for me to reflect, contemplate and think about the week ahead.
It meant that I had an opportunity to engage with a different religious tradition that still had the same sorts of ideas. It was the concept of reflection, meditation, mind-body-soul, mental wellbeing, physical wellbeing, and social wellbeing. There was an element of prayer, and then we would go out for dinner together. It allowed us to have all of those aspects of health and wellbeing encompassed in one.
The more that I engaged with different religious traditions, and I ended up going on to be the president of the Interfaith Student Association because I genuinely loved it so much, the more I realized that at the end of the day, we’re all just people. Whether it’s your religious background, cultural background, or social background, we’re all leading to the same North Star – a balance of mental wellbeing, physical wellbeing, emotional wellbeing, and social wellbeing.
What does this mean for the world of health? So, I think it was an eye-opening experience. I actually wrote my university admissions essay on this topic, having no idea that I was going into an institution where interreligious dialogue was a key tenet.
But growing up, I wouldn’t tell people that I was Muslim until I was about 18. I told everybody that my parents were from India. And if people really probed and asked, once you say you’re from India, they assume you’re Hindu in the South. But in case there was any doubt, I would just tell people I was Hindu. I did it because it was easier. It was easier to blend in and go, “Yep. I’m just like you. Don’t worry.” So I think it was really this idea of how are you going to take ownership and charge of who you are and how you fit into your surroundings. That’s why I actually wrote my admissions essay on it. It was just about how I met a Hindu girl and she invited me to a religious festival with them. And I figured out that she assumed that I was Hindu and not Muslim. And so I had this whole dilemma of whether or not to tell her who I really am. But I did tell her, and we ended up being friends, and that’s what got me into university.
But I think it was actually self-awareness of the fact that there were parts of my identity that I did have to hide. And we still do, right Liv? There are times when I just won’t tell people that I’m Muslim, especially in Muslim majority countries, because the fact that I’m not veiling or wearing clothes that are not completely covering is just blasphemous from a cultural perspective, but not from a religious perspective.And I think there’s a huge divide there. So there are parts of my identity that I still shy away from. It’s natural. We all do that. But I think what it really taught me was you’ve got to be able to take the situation that you’re in, assimilate as best as you can, but also take your identity when you’re ready, parts of your identity, as you are ready to embrace them.
I almost felt a lot of guilt for a while that I didn’t reveal that I was Muslim to people growing up, or that I would say that I was from India. My parents are both from Pakistan. My grandparents are from India, but my parents are both from Pakistan. And now I do find that it’s really important to say that. It’s really important to say my family is from Pakistan. I was born in America. And look, I’ll be completely honest, there are times when I’m in the UK where my accent doesn’t really hide it too well, but I try to avoid telling people I’m American, and they’ll say, “Oh, you’re Canadian,” and they’ll just go with it because it’s not necessarily a part of my identity that is embraced at all points in time. So I really found one of my key learnings was it’s okay to not have to be so open about everything at all times. And there’s also no guilt that you should carry for that because sometimes society isn’t ready for you to be embracing every part of your identity. At least in my case, that’s what it was. And so I really did have to figure out where the fine line is, where the balance is, and where people will be ready to accept me and how, and in what way.
Liv: That comes with a massive amount of maturity, and you can only have that level of confidence about who you are at a certain stage in your life. It’s very personal for everybody.
Noreen: Yeah. And look, I will admit, I usually don’t expect to talk too much about my religious identity in a conversation. Although it’s interesting for me and it differentiates me, it’s not something that I necessarily want people to look at me through the lens of, “Oh, she’s a Muslim girl.” That comes with a lot of preconceived notions. So I don’t necessarily say, “Hi, I’m Noreen, and I’m a Muslim woman.” It’s not the first thing that I like to say about myself. But growing up, I was taught that the two things you never talk about at the dinner table are politics and religion. Then I went to Washington, DC, the home of politics in America, and became the president of the Interfaith Students Association. I’m thinking, “My God, I’m just really left, right, and center, just crossing all of the boundaries, aren’t I?” But I think it’s important.
Liv: So you live in Bali now?
Noreen: I live in Bali, yes.
Liv: How did that happen?!
Noreen: Well, growing up, when I was about 16 years old, my mom had been sick all of my life since I was about eight years old. And when I was 16, she decided to go back to Pakistan to receive treatment. We had tried for years in the States to find treatments, but nothing had really worked. So she went back. It was a two-year treatment, and we were separated from her during that time. As I mentioned before, we were a super close-knit family, so it really took us in very different directions.
And because we had never really traveled much as a family, I’d never really seen much of the world. One of the things that I took from that experience was that home is wherever you make it, at least for me. So I went out of state for university, and I was blessed that we had an incredible study abroad program. I went and lived in Spain for about six months. When I moved to London, I then lived in Jordan for a few months, and I have lived in loads of places since. So I did a year in China, came back, have been in London for a bit, and through all of those experiences, I really found that actually being a nomad was my identity and a really important part of it.
It’s funny to say, Liv, like this is a classic case of nature versus nurture because my sister is the exact opposite. She will stay on her couch at her position as long as she absolutely can until she’s gotta go take care of her patients. And then she comes back to that position, and she always gets mad at me because she says, “Why do you always have to be traveling? Because then if I ever wanna see you, I’ve gotta travel, and I hate traveling.” Whereas I’m headed on a flight to Lisbon this afternoon. So it really is a classic case of nature versus nurture.
But I’ve really found that for me, being a nomad was an important part of who I am, and it keeps my curiosity alive. It keeps my search for navigating the world and its nuances alive, and so when I joined the company back in December, I became a digital nomad, if you will. I’m very blessed that because we’re a fully remote company, we have that opportunity. I spoke to Paul, our CEO, and I said, “Look, I absolutely love you. I love this company. I love what you’re doing, but I can’t live in London. I’m sorry I can’t live in the UK.” And he said, “I don’t care where you live and where you work as long as you get the work done.”
I spent the first three months with my sister in California and then moved to Bali two months ago. And then I’m going back for two more months. The plan is that from there, we will do Mauritius, Taipei, and Costa Rica. So, I’m really following the digital nomad community and trying it out for a year, seeing what works.
It’s funny because, oddly enough, I find that I am on a search for a home, for a place where I feel like I could live. Bali is a great place, but it’s not that place for me. But there are lots of lessons that you learn along the way. And actually, it helps me be better at my job. It helps me be better in my life. It helps me be grounded in who I am a little bit more.
I’ve had a blog for about 10 years now that I don’t actually actively publicise, but here we are! 19th and Nomad. There you go. It’s called 19th and Nomad, and I blog about my journey through the different countries that I’ve lived in, the idea of home, where I am, and how that affects my relationships and my family. What is home to me? There was even one that I wrote on there called “I Date Cities, Not People.”
My sister, as I said, lives in California. My parents live in Pakistan. And so, really, as a global family, which is what we’ve become, it’s important for me to have the ability to move around and still do my job but do it where I can also be close to my family if I need to be.
Liv: Yeah. So tell me a little bit about Bali. I did actually have my honeymoon in Bali, I loved it. I did actually love Bali. But tell me a bit about what it’s like living there.
Noreen: So it’s really interesting, Liv, because I find that, and I will say this after living in the UK for as long as I did, I was a bit jaded because I find that as an American, I tend to be quite open. And at least in London, people are a little bit more reserved.
Which makes sense. But I found that when I then moved to Bali, it was a whole new world. Every single person that you meet on the street says hello to you, whether they know you or not. There was a time when I learned how to ride a bike while I was in China last year. So I took advantage of now knowing how to ride a bike and I went through the countryside of Bali up in the north and from Ubud all the way down.
And we were just cycling along this path, and there was a line of kids. It was a Sunday, so the kids were off school. They were with their parents and grandparents just doing their own work, whether it be tending to the home, talking to friends, or buying fruit. They would see us biking and they would just actively wave and say hello. The kids were screaming hi, and they didn’t know us and we didn’t know them, and we were never going to see them again. But they were just so grateful that we were there as people.
I found that people were just so human, so kind, and so hospitable. And I actually asked one of my tour guides at one point, “Why are people so nice? I don’t want to take that as a bad thing. It’s amazing that people are so great, but help me understand why are people so nice?” He said, “We believe in karma. Indonesia is a country that is 97% Muslim, but Bali is 90% Hindu. And so you really have this mixing of Hindu, Buddhist, and shamanist cultures, and a mixing of religions to fit the Bali tradition.
The concept of being nice to a person and that coming back to you is not a fear or a belief that if you are not nice, you will burn in hell. It’s actually just that you should be nice to people because they are going to be nice to you. So why not?”
Why not give kindness with kindness? So, I find that’s one of the things that I’ve really loved about my time in Bali. The sun and the beach never hurt, I will say that. But the other thing is, the timing is all year round. Because it’s on the equator, you’re going from about 7:00 AM to 7:00 PM and people work from about seven to three which means that you’re getting up earlier to catch the sun. Yeah, it makes you a little bit more productive, I think. I’ve got the benefit of being eight hours ahead of London, so I do start work a little bit later at about 12 which is great because I can do a workout in the morning, meet, chat with a couple of people over breakfast, that sort of thing.
And I also find that generally, the other nomads there are a lot more relaxed. It’s just this life of hustle and bustle. In terms of traffic, it’s awful and there’s lots going on, but everyone is just happy with what they’ve got. We were able to speak to some folks in the countryside who work in rice fields like every single day, 12 to 14 hours a day, bending over backwards, literally to just be planting rice fields in the rice fields.
And when we spoke to some of them and said, “This is really laborious work,” they said, “Yeah, but we love it. We love it because this is our land and these are our people and this is our family. We enjoy it. We sing songs, we have fun. Yeah, sure, we don’t have a lot, but we have enough and we’re grateful for that.”
So I think it’s a little bit of, I think that’s some of the lessons that I learned. Sometimes it is just that less is more. You’re happy with what you have, you’re grateful for what you have, and how can you channel that to be kinder to yourself, to be kinder to others, and to be kind in the work that you do? I think sometimes we’re quite harsh with our work. We can say, “All this bloody email I’ve got to respond to and all this, I’ve got to finish this presentation in about two hours and then deliver it and I’ve got this project timeline to follow.” And if we treat work like it was a person, would we be kinder to it as well?
So I think some of those people will say, “Oh, you’ve become a hippie.” And maybe I have, but I think if it puts you in a better mindset, I’ll take it.
Liv: Absolutely, I’m with you 100 percent. So I’ve got a couple more questions for you. The first one, I want you to tell me a little bit about the story of when you joined Impatient Health because we chatted about this on our pre-interview chat, and it stuck with me, and I’ve pinched a phrase of yours quite a few times since about putting on your white man pants!
Noreen: Sure. Yeah. I was actually in China at the time working for my previous company, Accenture, in life sciences strategy. And I was in Shanghai, so it was actually in the height of the lockdown that we had last April. I was just scrolling through LinkedIn. I knew that I wanted to continue working in innovation and design and in life sciences, and I just couldn’t find a company that actually brought all of that together in a way where I could also help that company grow and that company could teach me different things. I was passively looking, and all of a sudden, I found this company called Impatient Health and this really weird guy named Paul Simms, who will probably laugh at me when he hears this. He’s the CEO, and he was writing some stuff about how it’s different and revolutionary and let’s be challengers of the pharma industry. And I thought, “Oh, this is a lot of what I’m thinking in my head, and no one’s really willing to be weird with me, but maybe he will.” So I listened in on a couple of things, and I thought, “Okay, let me maybe approach him.” I went back and forth, “Do I message him? Do I not message him?” Messaging the CEO of a company on LinkedIn is a bit of a risk. I messaged the CEO of Nike when I was very unhappy with my shoe delivery and didn’t get a reply back from him!
So I thought, “Oh gosh, will he even respond?” Who knows? And it was really at that point in time that I had to challenge myself and go, “Noreen, if you were not the brown Muslim that you are… put that out of your head. If you were a white man, what would he do?” A white man would just go in and message him, and that’s exactly what I did. I messaged him and said, “Hi Paul. I really like what you do. I think there’s some collaboration here. Let me know if you can spare a couple of minutes. Let’s have a chat.”
Anyway, we had a call, Paul didn’t actually respond to my LinkedIn message. Instead, I got an email from Tom, a random guy who is the CEO of our organisation. I thought “Well this is quite rude. He didn’t even have the decency to respond back to me and just pawned me off to some other guy!” (Laughing)
Tom was very adamant about speaking, and we ended up doing interviews with them. I really enjoyed the work they were doing and wanted to be a part of it. I got the final offer from them and decided to join. Later, I found out that Paul never even saw the message. It was Tom who snapped it out of his inbox.
So, I’ve forgiven Paul since. But there have been a lot of moments like that where I’ve resisted and said, “Oh, yes, I’m an extrovert, Liv. But at the end of the day, as a woman of colour, as an American living in the UK, you have to take a step back and ask yourself, ‘Am I going to be too much? Am I going to rub people the wrong way? Am I going to be bold enough?'” There’s a very fine line between being bold, being direct, and having someone appreciate that and someone going, “Oof, too much energy. Oof, that’s just a bit off-putting. Oof, gosh, she’s too assertive.”
Even when I got the opportunity to go to China with my previous company, I was speaking on a global panel at the time, and the head of the global life sciences industry reached out to me after the panel and said, “Noreen, you did some great work. That was fantastic.” I thought, “Ah, thanks, really nice.” But how do you respond to the CEO of the global life sciences industry of a company with 750,000 people? It’s one of those things where you’re like, “Thank you, kind sir.” Liv, if the king showed up at your house tomorrow and was just like, “Liv, can I have a cup of tea?” Of course, you would say yes, but how do you deal with that?! I was just like, “Thank you so much.” He messaged again and said, “You’re a very eloquent speaker.” And I thought, “Good God, I’m really unsure.”
Is it that I can take advantage of this opportunity and say, “I’d love to grab coffee with you?” Is it that I just put a thumbs up and go, “Thanks dude, moving on?” But, and that was really one of the other points in time where I had to go, “Noreen, what would a white man do? How would a white man respond to this?”
And I, a white man would’ve responded and said, “Thanks so much. Could we get a virtual coffee chat in?” And so I did it, sent that message, ended up speaking to a man who is now a mentor, a coach, and a very good friend, Stewart Henderson, still at Accenture, who gave me the opportunity to go to China to get this experience. Wow.
And so I think a lot of times when I speak to other young brown girls, South Asian women, they often say the same thing. “Oh, but no, I don’t want to be too much.” And often I say back to them, “Okay, cool. What about the white guy sitting next to you? Do you think he would’ve done that?” Probably. So what’s the difference between you and him? Oh, you just have all these reasons to not reach out because of who you are, because you’ve been told that you can’t, or you don’t want to rub people the wrong way.
I remember one time I got feedback that I was too assertive, and I had to take a step back and go, “Okay, is it that I’m too assertive, or that I’m just an outspoken woman?” Yeah. You never really know. And I think these conversations are the ones that so many women have in the workplace now.
I was actually talking to one of my dear friends and colleagues, Jeff, who’s the head of research at work, about some of these challenges and how I had the white man conversation with myself. And he said, “Noreen, I’m so sorry. I have not been as supportive as I could have been.”
And first of all, Jeff is the biggest hype man I’ve ever had at work. He is a fantastic guy, very self-aware. But I think it was this thing of, he said, “Noreen, what can I do to be better? Like, how can I actually uplift you in these conversations? Maybe what I’ll do is, when you’ve made a good point, I’ll make sure to say, ‘Ooh, Noreen, I really agree with that point. That’s a really good point.'”
And by the way, Jeff does all of this anyways. Yeah. But just the fact that he then took the extra second to say, “Ooh, I’m gonna do that,” and having that awareness and reflection, I think those are some of the tactical conversations that we actually need to have with people in the workplace.
Because we talk so much about how we want a voice, we want to see at the table, we want to be at the table, we want to create the table, all of that stuff.
But then, we also know that men are a part of the equation as well. They are at the centre. They’re the equal sign of the equation. Like, they’re the other half. So, how do we tactically make this work? Mate, how are we going to make this work? How are you going to add me to that conversation?
And you need to strategise, don’t you? You would do it with your girlfriends. You’d be like, “Okay, you bring this topic up and then I’ll bring this topic up, and then we’ll get this point across.” Why wouldn’t you do it with your guy friends or your guy colleagues at work? So, I think it was actually a beautiful moment where I got the opportunity to make, I felt, have more of an open conversation about that.
But definitely, I would say putting my white man pants on, as you’ve said, has gotten me further than I would’ve ever thought before. And I’m grateful for that mindset. So, if anybody else wants to think like that, I would say do it.
Liv: That is such good advice. I have borrowed it a few times since we first spoke, and I keep it with me. I do! So, do you mentor people now?
Noreen: Yeah, of course. Throughout my journey, I’ve had loads of people who have reached out either from my university alumni group or through my religious community, or just through some of the summer camps I run. So sometimes they’ll reach out through there and say, “I’m interested in healthcare, I’m interested in consulting, I’m interested in strategy, I’m interested in innovation and design,” or they’ll just say, “You’re another brown girl in the big, bad corporate world. Help me.” And I do have a few mentees, and I love it.
I think when I was actually interviewing for Impatient, Tom, our CEO asked me what my dream job was. And I realise in retrospect, Liv, you’re supposed to say a place where you can blah, blah, blah and give qualities. I just gave a straight-up job. I said, “I would love to be an executive coach for pharma C-Suite execs that have just gotten into their position.” Because I think there’s a lot to upskill, a lot to learn. I want to be able to empower them to have the executive presence but also to be empathetic leaders. I went on and on, and he was like, “Why the hell are you applying to this job?” But I think part of that is that I really do enjoy coaching and mentoring, especially for people that I can relate to. Because number one, there’s not a lot of us that have cut into this industry. But number two, it doesn’t hit at home as hard if it’s not someone that looks like you that says that. You could have a male that says, “Just get in there. Just say it. Just elbow your way in.” And if you have a conversation with a female, they’re like, “Okay, so this is how you gotta strategise.”
Getting into the conversation, getting in your words, it’s just a different tone. It’s a different approach, it’s a different mindset. And so, I find that I’ve had between five and ten mentees. Sometimes I’ll speak to them monthly, sometimes I’ll connect with them once or twice and then catch up with them six months later. Or I’ll think of them when a job opportunity comes up and help them out. But I really enjoy it. It’s something I absolutely love to do. Also, it’s a great way to learn about what I don’t know as well. I always say to my mentees, “You’re going to know a lot more stuff than I know, and you already know it. It’s just a matter of me asking you the right questions so that you can then shine.”
People used to ask me, “What is your passion?” And I would say, “My passion is actually to help other people find their passion.” And I still stick to that. I really enjoy it. So, I think it’s been a great experience, and I’m always happy to help people in the industry, as I think that’s how you move forward as well.
Liv: I think you should mentor men! I think at some point in their lives, more women should mentor men who are leaders and CEOs or whatever.
Noreen: And it’s interesting that you say that as well because I think there’s obviously a difference between a mentor and a coach. But there is this perception that, you know, not, I don’t wanna say it’s a perception, but I would say it’s less common for a woman to mentor a man versus a woman to coach a man. That’s true. And just that slight change in the way that you’re wording it, I think is again telling, right? Of how we perceive the roles that people play. And so yeah, I would love to, I’d absolutely love to mentor. Not even just white men. Any men, yeah. It would be quite good fun. I would learn more from them, interesting. But yeah, I’ve not been approached yet. Yeah, lots of call to actions on this podcast. Yes. We’re trying to get the robot bioethicist. We’re trying to get the white men on board. We’re trying to do a lot.
Liv: We are ticking boxes left and centre. I’m loving it. Okay, so we are running out of time and I’ve yet to ask you the killer question that I have to ask everybody. Have you seen the Sliding Doors movie?
Noreen: I haven’t actually. I’m so bad at movies that I’ve definitely not seen that one.
Liv: It’s so old, potentially before you were born. But essentially, the story goes Gwyneth Paltrow was getting on a train, and she missed that train. I think it’s two years since I saw it. She missed the train, ended up going home, and when she went home, she caught her husband cheating on her. She ended up living a life entirely different, and the whole movie plays out the life that she had caught the train and the life she would have had if she hadn’t caught the train. So it brings about the question of what is your pivotal moment? And do you ever wonder what your life would have looked like if you had not missed the train?
Noreen: It’s funny because my sister and I chat about this a lot actually. And it goes back to how I naturally always start any of my stories about travel, about home, about how I’ve ended up in the position that I’ve ended up in. When my mom got sick and moved back when I was 16 to Pakistan, that was really, as a child, a pivotal moment. But I think it actually opened a lot of doors for me in retrospect.
My sister and I talked; we actually just had this conversation last week about what would have happened if our mom wouldn’t have moved back, and we would have stayed in Atlanta in the South. She would have still been practicing nursing, and I would have gone to an in-state university and never had the opportunity to travel as much as I have now. I probably would have been married by now. It would have been a very different life. And nothing is wrong with that life, but I think, at the time, obviously, we were really upset that our mom had to move back and all the rest of it, and that she was ill.
In retrospect, things always happen for a reason, and it’s almost like instead of missing the train, I almost caught a train. Like I caught this train that took me around the world and opened my eyes to so much more that is out there. And that gave me genuinely the opportunity to not just talk about being a global citizen but genuinely be a global citizen.
So, I think that was the one moment where I was just thrown into it, and it was like, “you are on the train, you don’t know where you’re going. Let’s just see where you end up.” And there were amazing stops along the way. Each of the countries I’ve lived in, even just having had the opportunity to go to China and all the rest of it.
It’s funny because every time I end up going to another country, my parents always say to me, “where is that on the map?” They never know. But actually, through the fact that I end up going to these different places, my parents get the opportunity to learn so much more about these countries as well.
And I feel I’ve written about this in my blog post way back in the day, but I do travel for my parents. I travel for my parents who didn’t get the opportunity to do that, who don’t have the opportunity to do that now. Because learning more about the world and being a global citizen and contributing to that is what I find my purpose is in life a little bit.
Yeah, I’m grateful to my parents actually for that opportunity because it meant that I caught not the last train but one of the few trains that comes by to say, “literally the world is your oyster, and wherever you wanna go, next month, wherever you wanna go this afternoon, wherever you wanna travel to next week, you can do it. You can try, you can learn.
Liv: On that note, we’re going to leave it there because, my God, I can’t think of a better way to end it, especially knowing that you’re going to Lisbon later on today!
Noreen, thank you. I do feel like we’re wrapping it up even when I still have so many more questions for you, and we’ve allowed extra time, so there is so much I can talk to you about, but thank you for taking the time to come on the show. It’s been an absolute pleasure to hear about your thousands of experiences and your journey.
Noreen: Of course. Thank you for giving me the space to have this conversation and to share that with you. I’m really grateful.