Clinical haematologist and researcher, Associate Professor Nada Hamad is the Director of the Haematology Clinical Research Unit at St. Vincent’s Hospital in Sydney, President of Australia and New Zealand Transplant and Cellular Therapies, and the former Chair of the Bone Marrow Transplant and Cell Therapies Group at the Australasian Leukaemia and Lymphoma Group (ALLG).

A/Prof. Hamad is a leader and trailblazer in the field of haematology. When she spoke to the Leukaemia Foundation about her interests in clinical trials and CLL, she also shared details of why she became a medical professional and what’s important to her. 

Nada Hamad’s background 

From the time she was a five-year-old, when travelling with her family, A/Prof. Hamad “was always the person with a first aid kit… the crisis manager”. 

“I really enjoyed helping people and resolving problems for people, not just problem-solving as a puzzle,” she explains. 

“I’ve always known I wanted to be a doctor, it was something I had dreamed about from a very young age.”  

But first, she had “a short time” in forensics, and this cemented the reason she then chose to do medicine, and that was her love of dealing with people. 

“The decision to become a haematologist came a lot later. Surgery was something I had initially thought about and took very seriously until I did a stint in haematology as a junior doctor.  

“It immediately became very clear to me that haematologists were a special breed of doctor. They were very nice, they were kind, they were scientifically minded and curious, and the level of science and depth that went into the clinical practice of haematology was above and beyond what I saw in other disciplines. 

“They have to learn how to look under a microscope, to understand the mechanism of the disease at a molecular [very deep] level. Haematologists are both scientists and clinicians and they deal with the most difficult diseases a doctor can face from a psychosocial perspective. 

“That really was the trifecta for me.” 

Having a forensic background gave A/Prof. Hamad “a way of thinking that is probably a bit novel in medicine”. 

“In medicine we’re trained to think a particular way. You have a set of tools to extract information from patients, from the disease, with a set of diagnostic tools, and there’s an algorithm for coming up with the answer to ‘what’s wrong with the patient’ and then finding the right treatment for them.  

“That framework is tried and true. It has emerged over a long, long time and makes a lot of sense. 

“I have had the experience, or the opportunity, to learn a different, forensic framework, which is… if you don’t have a way to test your theory, you need to come up with one; whether it’s a crime scene, or a lab test, or legal strategy. 

“I’ve learned at a young age not to accept the limitations of what is on offer.” 

“Forensic science is and remains an emerging field. The science moves quickly, and you have to use what’s up your sleeve, despite the very strict limits of the law and science around what you can and can’t do. 

“How you arrive at your conclusion sometimes requires a lot of lateral thinking. For me, as a haematologist looking after patients, I do use that; I don’t just rely on my skillsets learnt in medical school or in physician training.   

“I have a little part of my brain that does things in a slightly different way, and when it comes to designing systems and designing studies, I probably rely a bit more on the logic and philosophy I learned in forensics.” 

A/Prof. Hamad, an intersectional feminist, said her interest in equity, diversity and inclusion and their roles in research “probably comes from my time in forensics, with a strong focus on justice and on making sure you address your blind spots”.  

“It’s about putting herself in the shoes of someone you may not necessarily be familiar with – a person who might have a disability (whether it’s a visible or invisible disability), the woman with carer responsibilities, the person with barriers such as access to healthcare, or literacy, or even obesity.  

“A lot of people who live in bigger bodies don’t even want to see doctors because they’re afraid of being fat shamed.  

“There are a lot of elements in medicine and in the conduct of clinical research that we don’t think about in that way, and I try to bring that to my work, especially around designing clinical trial protocols, and how we write patient information.

“Through that lens I always find something that would exclude people unnecessarily and without scientific justification, including things like lactation exclusion, pregnancy exclusion, contraception-related exclusion. These are things that clinical trials usually cut and paste into a protocol without really thinking through the implications for a variety of people with invisible constraints or issues.  

“I use the WHO public health approach to intersectionality* in understanding healthcare outcomes, and integrate that into my clinical research protocol design. 

“I haven’t seen anybody else do it yet and I am promoting it internationally. It has been very much welcomed because most of the time people don’t think about it.” 

How A/Prof. Hamad balances family life and career 

“The balance between family life and career is one that everybody has to deal with in their own way,” says A/Prof. Hamad, a mother of three. 

“My personal and professional lives are not at odds. My professional life is a big part of my identity and who I am as a woman, as a human being, as someone who lives in service of others, and it demonstrates a way of life that I want my children to be a part of and that I share with my kids. 

“I talk to them very explicitly about why I’m not home at a particular time, and I explain the patients that are waiting for me and what they need, or what research projects I’m doing, and why what I’m doing is so important, and what kind of impact that has on the world for them in the future. And so, they are with me on that journey, rather than feeling like they’re missing out. 

“For me, it’s about making sure my family is part of my professional life, that they know what it is I do and why. 

“And also, that everything I do really is worthy of my time. Everything I do has to be aligned with my own personal values and what I believe in, so it justifies that time away from my hobby, or the book that I wanted to read on the weekend.  

“And the support of my partner is much easier to get because he understands what I’m doing, the value it has for me professionally, but also for humanity and the community, and what that means for our kids, to watch me do that kind of work.” 

A/Prof. Hamad’s holy grail  

“What would make me die a happy woman right now is for us to progress in this space of equity, diversity and inclusion in clinical practice, in the way we treat patients, and in research,” shares A/Prof. Hamad. 

“There’s a lot left for us to do in that space. We have done such incredible work in the science, in the precision of medicine, in the genetics of medicine, in the diagnosing, and the treatment options, and the different drugs. But if we haven’t figured out how to run that last mile in the marathon, and make sure that the most people get access to all of that incredible science, then we fall short. 

“If I have a patient who’s living in a large body, who doesn’t want to come and see me and dies of something that was preventable, that hurts, that stings. Or if there’s somebody who is unable to understand a clinical trial protocol, so they don’t sign up to a trial that could have saved their life, that hurts.  

“I want to see more in this space, to make sure that the fruits of our scientific labours are realised for as many people as possible, with as positive an experience as possible for everybody, no matter where they come from or what their psychosocial circumstances are, because that’s when we’ve truly achieved the best that we can achieve in medicine.” 

* Intersectionality is the acknowledgement that everyone has their own unique experiences of discrimination and oppression (gender, race, class, sexual orientation, physical ability, etc.) and offers a framework that focuses on the ways these multiple axes of inequality intersect and compound at macro and micro levels to produce a broad range of unequal health outcomes.