Rozina Lakhani Mbbs ‘93
Rozina Lakhani is a member of the Medical College Class of 1993. Rozina did her residency in psychiatry at the University of Illinois, Chicago, where she also earned a master’s degree in public health. She was a hospital and community psychiatrist in Washington State before founding Shifa Health, an integrative mind-care center whose psychiatrists, psychiatric nurse practitioners, psychologists, and counselors aid individuals with anxiety, depression, and other health challenges. Rozina is a member of the American Medical Association and the American Psychiatric Association.
Would you please tell me about your early life?
I grew up in a small colony in the Federal Area of Karachi. My parents were educated through the 10th grade, which was fairly unusual then. I attended the superb Sultan Mohamed Shah Aga Khan School in Karimabad. I was always a very good student, always first or second in my class, and so I was able to attend St. Joseph’s College for Women for 11th and 12th grades. I was also quite active in Ismaili community life: for instance, I taught religious classes. I never had a summer in which I did nothing; I would take all sorts of classes, on sewing, typing, computers, business management, and so on.
A career counselor told me I would make a really good engineer or accountant, but I wanted to be a doctor — and so naturally I wanted to be at the best medical school, AKU. I was not, however, accepted on my first attempt. I was accepted to Sindh Medical School, but disliked it. Fortunately, I was also admitted to AKU’s School of Nursing, and so I transferred. I enjoyed the first year in nursing and excelled. I would spend every day in the library, even after night duty, studying for the MCAT. I have very warm feelings toward that library!
As I reflect back, I see now that that year was monumental in my emotional growth. Before that year, I had not known failure. After that, I did a lot of journaling, both for self-discovery and for trying to understand why I had not been admitted to the Medical College.
I learned that the Westerner who had interviewed me had written that I was “shy” and lacked “leadership qualities.” On reflection, I realized what had happened: when I walked into the room, he thrust out his hand. In Pakistani culture, women usually don’t shake hands with a man, and so I took his hand lightly, weakly. That threw me, and for the rest of the interview I was simply not myself. He took that as a lack of self-confidence.
I was bitterly disappointed at the time, but now thank that man. I do not think I would have achieved all I have achieved had he not said that: I have been utterly determined to prove him wrong. And, to this day, I shake hands quite vigorously!
I was accepted to the Medical College on my second attempt. Because I had been rejected the first time, I really valued being at the College. The Medical College was both interesting and demanding; we had high-caliber teachers and an advanced curriculum (much more so than at Sindh). It was very rigorous — and very hard to get high grades: everyone, no matter how intelligent, got Bs and Cs in some of the subjects.
Our class had only 50 students, and we were together all the time. I particularly liked Community Health Sciences. Our class, which was only the 10th batch, was assigned to Baba Island. We focused on epidemiology at first, and then on hypertension; we also taught the islanders prevention measures. One of the first things we had to do was number the houses on the island!
I loved CHS. I also did electives with CHS in summer. I spent one summer in Baluchistan conducting maternal mortality surveys and teaching maternity sessions. I then had an externship in Bangladesh and Nepal, working with the United Nations in its rural health programs. I learned how the UN provides care to isolated communities. These communities were quite difficult to get to; once, a landslide blocked the road, and we had to walk four hours to get to a small community in a valley!
I believe that everything happens for a reason, and that the universe watches out for us in mysterious ways. While in Nepal, I really wanted to visit the capital, Kathmandu. I booked a seat on a plane, but, to my great disappointment, did not have enough money for the ticket. While at church with the UN Director the following Sunday, I learned that the plane had gone down, killing everyone on board.
How did you decide on your specialization?
As I went through medical school, I wanted to do almost everything. I like making people happy, and so I wanted to do eye surgery (people are so happy when they can see well again) and obstetrics (people are so happy when they have a healthy baby). The only thing I did not want to do was oncology: I could not bear seeing children suffer. At one point, I felt anxious and depressed; our psychology teacher, Dr. Farhat Moazam, aided me through Progressive Muscle Relaxation. That experience made me gravitate toward psychiatry.
Toward the end of my time at the Medical College, I got engaged to a wonderful man, Jalal. Over time, Jalal went from being an accountant to an electrical engineer to an artist. I followed him to the U.S. and was accepted to the residency program in public psychiatry at the University of Illinois at Chicago. There, I learned the great efficacy of a team approach to community health. We would bring homeless people to our clinic and treat their mental-health issues. At the time, insurance companies offered little coverage for mental-health treatment; I was so taken aback at that that I wrote a paper on mental-health parity: to my delight, the paper won the Best Resident Paper Award. Later, while earning my master’s degree in Public Health — also at the University of Illinois — I wrote a paper on the global burden of public health: that was the great influence of CHS!
Following my residency, I accepted a position in community mental health with a hospital in Washington State. The hospital served low-income people; here, too, we took a team approach: I would work with a case manager and others. I would be in the hospital each morning and in the clinic each evening. After five years, I took over a private psychiatric practice and transformed it into a group practice. That practice, Shifa Health, now has two offices with 10 or so providers and 10 or so support staff. I am now getting trained in collaborative care, in which a primary care physician is teamed with a psychiatric consultant and a behavior case manager. With such a team, one can advise 40 patients a day — a superb model.
A year or so after founding Shifa Health, I had a life-altering experience. I was under tremendous stress: my practice had been growing swiftly, we had moved to a larger office, and my five-year-old was quite ill. In the midst of all this, I had a horrific car accident in which I broke my right hand: the simplest things were now quite difficult. At that moment, I had an epiphany: I began to write in a journal with my left hand, expressing gratitude for the many good things in my life.
Even after this highly stressful period ended, I continued writing in my “gratitude journal” every day. I also began sharing what I had learned with others. I did so through my books Stress to Joy and The Stress to Joy Gratitude Journal. When COVID hit, I also began a weekly series of podcasts, “Happy and Healthy Mind with Dr. Rozina.” I invite experts onto my podcast to share tips for mental fitness — the influence of AKU’s teachings on prevention.
My next book will be Dodging Depression. There are five “lines of defense” against depression; in order, they are: healthy habits; stress management; psychotherapy; natural remedies; and, medications and other more advanced treatments.
In my 26 years of practice, I have learned that some causes of mental illness are simply not under our control, such as a genetic predisposition to depression. Many causes are, however, under our control, such as nutrition, sleep, exercise, social connectedness, and mindfulness. Although most of my own work is on medication management and advanced treatments, I also help people modify these causes to prevent or reduce their suffering.
In truth, there are different types of depression. We now know that some of the types are caused by inflammation. We also know that diet can help immensely with some types: we should eat serotonin-rich foods such as eggs, nuts, and salmon, as well as foods that are high in micronutrients such as spinach and dark-leaf vegetables. Without question, we should cut down on sugar and processed food. The standard American diet violates all of these principles! Also, alcohol disarranges our “sleep architecture” — and, again, not sleeping well tends to increase depression.
So much of a patient’s recovery from surgery is tied to good mental health. The cardiac departments of many hospitals, for instance, have a stress-management program — because we know that complications from surgery soar wherever mental health is poor.
You have made AKU the beneficiary of your life insurance policy (through the Aga Khan Foundation USA). Why have you done so? Why support your alma mater in this fashion?
I owe my career to AKU: the education I received at the University is the foundation of all else. Others — the donors who came before me — made my education possible: now that I can, I should make the education of others possible. My understanding is that His Highness and the Ismaili community have contributed over $2 billion to AKU: such a fortune they spent to create the University, to make everything — my life in the U.S., Shifa Health, the care I give my patients — possible! For that I am eternally grateful.
And why life insurance? The final gift, the “death benefit,” will be far greater than the premiums I paid. What is more, I received a charitable deduction for each premium payment I made: I made a gift once each year to AKF; I received a gift receipt for that gift; and, AKF used the gift to pay the premium. Such a clever way to fund a life insurance policy!
My future gift will create an endowed fund: that fund will exist as long as AKU exists, and it will grow over time, thus increasing the good it does. I can have the annual “payout” from the fund support whatever is most important to me — indeed, can have it support more than one thing.
I am so happy at the thought that my legacy gift will support teaching, learning, and research at AKU for hundreds upon hundreds of years — and that it will create so very many doctors. Such a gift to humanity that is!
A note on endowed funds
An endowed fund is invested in AKU’s general endowment, which is the investment portfolio of the University. The endowment — and so each of the endowed funds within it — pays out approximately five percent of its value each year, supporting everything the University does — teaching, research, financial aid, and on and on. Quite simply, the payout from the endowment is the lifeblood of AKU: the University could not function without it. The endowment — and the endowed funds within it — will exist as long as AKU exists.
An endowed fund, then, is like a “miniature endowment:” it, too, exists forever, and it, too, pays out five percent or so of its value each year. A donor can name an endowed fund after himself or herself, a family member, or anyone else he or she might wish to honour and memorialise. What is more, an endowed fund grows over time, with the endowment as a whole, thus increasing the good it does.
