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Personal Tragedy Sets Career Mission for Physician-Scientist

Five Questions with Nizar Bhulani on Loss, Service, and Saving Lives.

As a young man just out of medical school in Pakistan, Nizar Bhulani, MD, MPH, suffered the sudden and devastating loss of his mother to stage IV breast cancer. The experience rocked his life and career plans, setting him on a mission to change the way patients with cancer or other terminal diseases are cared for.

During his research training and fellowship, Bhulani designed and studied interventions to improve clinical outcomes and quality of life for cancer patients. Today, as a physician-scientist in clinical and translational research, he’s leading a pioneering 10-year global clinical trial to investigate a breast cancer preventative that has the potential to save millions of lives.

Bhulani is a senior scientist and investigator at the Dana Farber Cancer Institute and serves as an “ambassador” for Harvard Catalyst’s education program.

You received your medical degree from the prestigious Aga Khan University in Karachi, Pakistan, where you were born. How did your path take you to Harvard Medical School?

It was  fate. Honestly. While I was at the Aga Khan University, I was living my dream as a student at one of the best medical colleges not only in the region, but in the world, where I was exposed to high-quality education and clinical practice. While I was there, I came to Boston for a short research elective at the Massachusetts General Hospital and Harvard Medical School (HMS). I fell in love with Boston. Someone told me: “Once a Bostonian, always a Bostonian,” and I think that rang true.

After my graduation from Aga Khan in 2012, I was planning to come to HMS for another research program. At that time, the focus of my research was gastroenterology, not cancer. However, I suddenly lost my mother to stage-four breast cancer. She passed away within three months of being diagnosed.

“Losing [my mother] became my impetus to change how we deliver healthcare, how we care for patients with cancer or other terminal diseases. That is where my journey in public health began.”

As a result of this  experience, I  saw and understood healthcare delivery not just from a physician’s standpoint, but also from the perspectives of a patient and caregiver. It forced me to deeply contemplate the professional career ahead of me. Losing her became my impetus to change how we deliver healthcare, how we care for patients with cancer or other terminal diseases. That is where my journey in public health began.

I still can’t comprehend how something as grim as that could become my guiding beacon and source of contentment in life later on. The loss of a parent can never be measured. I used to feel guilty that I couldn’t do much to prolong my mother’s life.  I understood much later that there wasn’t much that I could have done. But I felt that even though I couldn’t save my mother, I certainly could do something to save somebody else’s. Channeling my grief toward helping alleviate someone else’s distress is what I want to do.

Now, as a research scientist in the Division of Cancer Genetics and Prevention at Dana Farber, my work is running clinical trials to reduce the risk of breast cancer in high-risk individuals. My life has come full circle.

How does this research advance translational science?

Clinical genetics is really at the heart of this work. Women who carry a BRCA1 mutation have a 50 to 7o percent chance of developing breast cancer. The only known way to reduce the risk in these individuals is a bilateral mastectomy, which is complete removal of both breasts. Such a surgery comes with its own physical and emotional challenges. No nonsurgical approach is currently available to reduce breast cancer risk for those with a BRCA1 mutation.

We are testing denosumab, an injectable, FDA-approved drug used to treat osteoporosis. We want to find out if denosumab, compared to placebo, can reduce the risk of breast cancer in women who carry a BRCA1 mutation. It is a global phase 3 study–a rarity in the cancer-prevention world–that is currently ongoing in seven countries, including more than 30 sites in the United States.

Participants receive either the drug or placebo twice a year for five years. After that, we will follow them for another five years to determine if they develop cancer or any other side effects. So, anybody who joins today will be part of this study for 10 years. At that point we can truly understand the impact of the research.

It takes time, but I think patience is a virtue, and a quality we need to have in research. I believe this work can provide important information to help us reduce the risk of breast cancer in future generations.

What does your role as an education ambassador for Harvard Catalyst mean to you?

It’s a great opportunity for me to share my time and knowledge with my colleagues. I always find value in sharing, be it my expertise, experience, or just my time to help support others on their professional journey.

I live my life by a few principles. I always feel the question is not: What I have achieved? The question is: What have I helped others to achieve? Being a part of the Harvard Catalyst program as an ambassador helps me answer that question. It helps me realize the notion of social consciousness that I try to live my life by.

“I always feel the question is not: What I have achieved? The question is: What have I helped others to achieve? Being a part of the Harvard Catalyst program as an ambassador helps me answer that question.”

I often think about the words of Princess Zahra Aga Khan, the daughter of His Highness the Aga Khan IV, the Imam of the Ismaili Muslims and a Harvard College graduate. She says that service is a means for each individual to actualize the ethics of inclusiveness, compassion, sharing, respect for life, and personal responsibility for sustaining a healthy social environment. His Highness the Aga Khan IV is himself a beacon of hope for volunteerism, work ethic, and everything else that I want to embody in my life. I believe generosity is fundamental to life, whether it’s material resources, time, thought, or knowledge. I try to live by these ethics, to help not just myself but my peers.

Princess Zahra has been a huge inspiration in my life, so much so that I named my daughter after her. My daughter’s full name is Zahra Nur, which means bright light. She is the bright light of my life and the one who motivates me to do good for the world that I’m going to eventually leave for her.

Which Harvard Catalyst courses or trainings have you taken, and how have those fit into your skill set and career advancement?

I’ve taken too many courses to remember the names of them all! They’ve kept me busy for three years.

My life revolves around three Es: Environment, education, and experience. I feel there has to be a combination of all three for me to set myself up for success. At HMS, I feel I’m in the right environment, surrounded by the right people.

I’m a lifelong learner. My education did not stop with medical school or acquiring my MPH. Harvard Catalyst enables me to continue to nourish this (education) aspect of my life. By taking these courses, I can refresh my knowledge, learn new skills, and implement them into my current work. That enriches my third E, my experience, and helps me contribute back to my community and to the environment I’m part of.

Any advice for young investigators who are looking to supplement their training?

Stay curious. Stay open. And always learn; be a lifelong learner. Keep an eye out for all these courses. More specifically, try to understand what you need to do to add value to your team. Is there a skill set that you feel is missing within your team? Do you have a skill set you haven’t used in a long time, or one you will be using shortly that you need to refresh? Choosing these specific courses within the Harvard Catalyst curriculum could actually become the “catalyst” for that change and help you excel in your career. Find the gaps and fill them using all the educational resources available at our Harvard Catalyst.

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