Ashiyana Nariani, MD, MPH: 'There's no mold that I belong in apart from my own shoes'

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Welcome Dr. Nariani. Thank you so much for being part of our Women in Ophthalmology Healio vlog series on leadership. Can you share your leadership roles with us today?

Good morning, good afternoon, good evening to each and every one of you. Thank you so much for the opportunity to be with you today. It is truly an honor. My name is Ashiyana Nariani. I am the global clinical consultant for Himalayan Cataract Project Cure Blindness. I am based out of India and I work in Nepal and Sub-Saharan Africa, Ethiopia, Ghana, Tanzania, South Sudan and a few other countries. It is my privilege and honor to be able to take part in a number of AAO committees like the Global Health Education Committee and the [Inaudible] Network. And I do verily, verily believe that, when it comes to why we are here today with women in ophthalmology, is that the changes that need to take place for us to achieve the goal globally will emanate from the woman. And so, it is such a privilege and honor to be with Cynthia and Femida today. Thank you so much. Leadership, I verily believe is something that starts with change of yourself. So if I am not the leader, if I am not the human that I wish myself to be, then that's the first change that I need to do. Mahatma Gandhi says that you must be the change you wish to see in this world. And that is my only aspiration in the realm of leadership— that may I be myself, changing myself, and perfecting myself each day so that I can then move ahead on the path of curing blindness and working in that realm that we collectively, so much so with everyone in this room today, are so passionate for doing.

Ashiana, wow, your words are so wise and they resonate so much and so deeply. Thank you for those philosophical pearls that you've shared with us so far. So, I'm going to ask you our second question, which is I'm sure along the way, and you've achieved so much, you've run into or have encountered some hurdles, some difficulties in the leadership arena. How have you overcome them and what have been some of the challenges that you have experienced?

I feel like difficulties has become a part of who I am. It's almost like with every difficulty I have to say, well, what is it that I have to learn from? Because if I'm able to overcome that difficulty that's when I see the benefits or the rewards, if you will. One example was when I moved to India, I believe to my knowledge that I'm the first US doctor regardless of ophthalmology or otherwise, I'm the first doctor from the United States to move to India full-time. And just in that realm, there has been no precedent before me of someone who has gotten through. So when I ended up applying for my licensing, something as basic as that, you have to overcome the challenges such as corruption and bribes that are faced in this country. And I said, you know, I'm American Board of Ophthalmology certified. That's clearly on the list of equivalent institutions to be accepted into India. And I can either choose to go ahead and follow what others tell me, which is, oh, you know, slip a 20 under the table, or I can choose to do it in the way that I was taught which is to be very straightforward and not engage in bribes or corruption. And that's what I chose to do. In that realm, it took me about a year or so without a position in India without my licensure without being able to practice ophthalmology. And I said, whatever it takes, but I'm not going to do it in a way that would a year from now or 10 years from now make me look back and regret the choices that I made. A year later, one of the chief ministers of India reached out to his team and said, "Help her," after hearing my story. And it ended up becoming a news of the town that a US eye surgeon, US fully-trained eye surgeon, has come to India to serve the underserved. And they looked back at my files and I was told on behalf of India, we apologize for keeping you in this country without giving you just a basic license. So in the leadership arena, every day can be a challenge and in global ophthalmology, which is my passion, even more so because you don't know what's going to happen. And sometimes it's the common phrase, you know, one step forward, two steps back. And sometimes I find that it's five steps back or you're not even seeing any improvement. And sometimes you're frustrated by that. But at the end of the day, I always believe that it's about the intention. So if my intention is to do something for the greater good, then whatever the results are, I have to ask myself, "Am I doing the best I can in the truest way I can, in the purest way that I possibly can?" And if the answer is yes, then I move ahead on my journey. And if I don't find that I am being true to the principles that I hold before me, then I take a pause and I rethink it and I reroute.

Lovely, Wow. Thank you for sharing that journey. What an amazing challenge you had, Ashiana, and the journey you went through. But you stayed true to yourself instead of slipping somebody that bribe that unfortunately so many countries have that as a normal way of doing business.

Absolutely, absolutely. And here it was almost like, you know, if you're not going to do it then, then don't expect results. You know that that's just how it is. But in the United States, we were brought up that these things just, you shouldn't engage in them. And so, I think in a way it's such a blessing to be an American, you know, to bring in those principles. Because for us, I'm not saying it doesn't happen, I'm just saying that in America it's very, to me, in medicine and otherwise, it’s very much for the greater good, for the patient in need, right? We're choosing things that make sense. In India, I have to be very, very careful that I always remain true to the patients that I serve. And there's always going to be their voice in my head saying, "Well, what is best for me, What is best for me?” Because it is easy to slip, but you have to keep asking yourself, "Am I doing the right thing?" And if you are, then move ahead.

I love how you are so true to your ethics. And of course, you know, ethics drives our purpose and drives our work. And I love how you said that with each obstacle was the lesson, right? There's a lesson in every obstacle that I'm here to learn and here to share. I love that. So thank you for sharing that. Our last question for you, Dr. Nariani, is what is the advice for your 20-year younger self?

For me, I love that question. I find it very difficult to answer that question.

Because you're so young!

As are you, my friend, as are you. Years ago, 20 years ago, I think I speak on behalf of many ophthalmologists, right? It's so difficult to get into ophthalmology. So 20 years ago I was you know, in, for a lack of a better word, the rat race of saying, all right, we are type-A personalities and we are going to move from one level in life to the next, to the next, to the next. And what is it going to be that's going to take me to that next level, right? Focusing on yourself, not a competition to anyone else, but that rat race within your own mind of what will it take for me to get to the next level. And I think now looking back, I wouldn't change anything about my life because it has taught me what I needed to learn on my journey. But I would say that 20 years ago, if I had a chance to say one thing in the realm of leadership to my 20-year young self, though I do still look quite young, is that ultimately, just relax. Because you are not competing for, you're not competing first of all with others. And secondly, you are not going to achieve the goal any greater if you do continue to— So, there's two parts of this, right? There's drive, personal drive and then there's that looking out word at others. And I would say personal drive, Ashiana, 20 years younger, continue, continue full speed ahead. But looking out at others and competing with others and seeing that you have to either fit in the mold of someone else. That is something, if I have to redo what I did, it was that there's no mold that I belong in apart from my own shoes. And I'm not here to try to one up anyone else. I'm just trying to be better today than— more perfect today than I was yesterday. And I think that was a lesson that has hit me over the past 20 years.

Wonderful.

Wow. So nice to hear your advice, Ashiana. And it was a privilege and an honor to meet you in person when I was in India this summer. So, thank you again for taking the time to share your leadership pearls with us. It's been a pleasure having you and safe, be safe. I know you travel all the time, so be safe.

It has been such a privilege, Cynthia to meet you when you were in India. It was such a joy to spend time with you and I'm waiting for the next opportunity when we're going to get to be together and have masala chai together. I'm hoping that at AAO we'll spend some time together. Femida, thank you so much and lovely to meet you. David, thank you for your time and for organizing all of this, and to women in ophthalmology for doing the great work that you're doing because you're really making the mold in ophthalmology for us all to have a space to be able to affect change and to be in a space of comfort where we know that it is the women in ophthalmology that are going to make the difference.