Rameen Shakur: A doctor, scientist, entrepreneur and a son

What does a South Asian immigrant family, living in the West, expect their children to become when they grow up? You guessed it right: A doctor or an engineer.

In fact, this has become so much of a cliché that when South Asians now make forays into the entertainment industry or offbeat entrepreneurial ventures, the first question they get asked in an interview, usually by a white person, is 'how did you convince your parents to not become a doctor or an engineer?'

For Rameen Shakur, a second-generation British-Bangladeshi who moved to the United Kingdom during his childhood, there was no escaping that destiny. In fact, in school, when he got picked for the rugby team, his father told his headmaster that he would have to accompany Rameen during his matches so he did not get exposed to any head injuries because his parents were set on him becoming a doctor.

And so Rameen studied medicine at the University of Cambridge, and did his clinical residency at the University of Edinburgh and University of Oxford, on the way to becoming a cardiologist.

"By the time I was doing my A-Levels I had figured I wanted to study genetics. I tried to explain to my mother that medicine was after all a branch of science and I was far more interested in the functional aspects of healthcare than just following a default schema," said Rameen during a recent interview.

"But my mother was a Buet-educated Bangalee mother after all, and she pulled the ultimate Bangalee card – emotional blackmail," Rameen said with a chuckle.  "When your mother is old and unwell do you not want to be in charge of my healthcare or do you want to leave it in someone else's hand? She asked me. There was no arguing with that."

At 41, Rameen, currently the youngest Professor of Cardiovascular Medicine, Genomics and Biological Sciences in the United Kingdom, has clearly distinguished himself as a medical doctor, having served as a clinician at two of London's top cardiology hospitals - the Royal Brompton and St Bartholomew's Hospital, the oldest hospital in the UK.

But what is unusual about this second-generation Bangalee immigrant's career path is that he also managed to pursue his passion to become not just a distinguished scientist, but also a successful entrepreneur.

Rameen is one of the foremost researchers in precision medicine, looking at how genetics can be used to repurpose traditional medicines for targeted therapies and treatments, to address underlying issues in a person's health. He researched genome editing technologies at the Harvard Medical School, did his PhD in molecular biology from the University of Cambridge, and set up a lab at the Koch Institute of Integrative Research at the Massachusetts Institute of Technology; along the way, mentored by the founders of the Covid vaccine.

His research naturally drew him to technology and Artificial Intelligence, and in 2015 he discovered and patented a device named Cambridge Heartwear, which is the world's first wearable ECG with real-time artificial intelligence.

He turned it into a company and later ventured into a number of life science and biotech companies, as founder, board member and chairman. This year, Rameen Shakur was appointed chair of the Cambridge, UK Institute of Directors (IoD), a more than the 100-year-old institution of leading global CEOs and directors of companies. He is the youngest and the first Asian to achieve this honour.

The personal, communal and global

Professor Rameen sounds like a typical first-generation immigrant over-achiever, doesn't he? Well, his philosophy in life and how all of this came about will surprise you.

"It may be hard to believe, but I actually go with the flow. All of this happened serendipitously," said Rameen.

In fact, Rameen ended up in the field of genetics almost by chance. At Cambridge, all medical students in their third year have to take up a science-based project, and Rameen found himself at the Wellcome Trust Sanger Centre because – in his own words – 'if you win a scholarship they serve three-course lunch and dinner for free.'

The young food enthusiast at the time, however, did not fully grasp the significance of the decision he had just taken. In between hearty meals, Rameen discovered a number of important genes and ended up being a part of a team that finished sequencing the entire human genome. While working at the Centre, Rameen would go on to secure the Fujikawa Scholarship to study the role of genetics in heart transplant rejection, also at the University of Cambridge.

Rameen had essentially figured out a way to pursue his passion for science while training to be a doctor. He got a big break when he was the first Bangladeshi to receive the Winston Churchill Scholarship, through which he was sent to study heart disease at Harvard Medical School, the relationship between genetics and heart disease at the Mayo Clinic, United States, and did an internship at the World Health Organisation, working on how to prevent heart diseases globally, especially in the developing world.

In many ways, the three endeavours captured what Rameen cared about in life – the personal, communal and the global.

"What I discovered during the time was that I was good at what people call lateral thinking. Although I did not know the word at the time, I was basically a polymath and enjoyed putting all the dots together," said Rameen.

At the WHO, Rameen was tasked with figuring out how to promote antibiotic use among poor children in Mozambique, to prevent a deadly heart valve disease called rheumatic fever, and true to his lateral-thinking capabilities, he managed to take the Mozambique football team – who had just competed in the African Nations Cup – on their tour bus to travel around the country and encourage children to take the antibiotics.

As Rameen ventured into different endeavours, his mother, Yasmin Shakur, an architect by training who received an MBE from the Queen for her services to the community, grew increasingly impatient with her son's lateral movements.

"Are you never going to finish medical school? She asked me one day, exasperated. And so I signed up to an MD-PhD programme and promised her I would be done in six years," said Rameen.

A dark turn

In 2002, however, right before he would embark on his fully-funded PhD, Rameen was hit with the news that his mother had been diagnosed with a very aggressive form of breast cancer. The doctors gave her 14 months to live. His mother's prediction that he would have to become a doctor to look after her arrived a little too early. He gave up on joining the PhD programme and took over his mother's treatment management.

"First of all, I refused to accept the diagnosis that she only had 14 months left. Sure, I was simply a third-year medical student but I was also someone exposed to cutting-edge research in medical sciences and knew the doctors had provided an arbitrary number based on an estimation," recalled Rameen.

Rameen argued back and forth with his mother's doctors on the treatment protocol, based on his knowledge of what was happening on the research frontier. His mother, true to her promise, put full confidence in the science her son espoused, to embark on a series of experiments and novel therapies, often to the annoyance of her general doctor.

"She underwent a form of surgery which at the time was unthinkable. After the surgery, her cancer went into remission for five years," said Rameen.

In the end, instead of 14 months, Yasmin Shakur would survive 14 years, until her untimely demise in 2015 at the age of 60. She would go on to see her son achieve further landmarks, get married and have children. In fact, her cancer would return to her neck right after Rameen's first year of marriage. The early years of marriage became a tough journey for the new couple, as it was for Rameen's father and younger brother, who also became a doctor.

These 14 years, meanwhile, would not only end up making Rameen a formidable physician but would also have a lasting impact on his research and entrepreneurial interests.

"I realised that the advice the doctors gave was standard and general. But medical care is often haphazard and not personalised. No one patient is the same, yet we expect them to all subscribe to the same mantra. Patients are also individuals, with an individual body and medical history.

I realised that research on how individuals, based on their underlying genetics, responded to different therapies and medicines, is what I wanted to do, as a means to come up with the next generation of therapies and treatment options," said Rameen.

Rameen would eventually enrol on a PhD programme in Molecular Biology at the University of Cambridge. He would secure a Wellcome Trust Fellowship which would once again return him to the Sanger Centre. The Fellowship granted him around a million pounds to set up a lab to research the methodology to use genetics to treat heart patients. The lab would go on to achieve a number of breakthroughs, including using a means to make human heart cells from one's own urine.

"What we do at the lab is develop a methodology to understand the underlying genomics of a patient early on, so that we can have interventions to reverse the biological process. We look at what signals in the body are abnormal and devise interventions targeting those abnormalities. It is where science, technology, computer science and medical and drug discovery meet."

"We are essentially changing the way medicine is done, and it is about time that happened," he added.

After his mother's passing, Rameen would receive an offer to shift his lab to MIT and this time, there was nothing holding him back from settling in the US. But before his departure, sitting at home and playing with a few gadgets on an electronics board, he built the prototype for the Cambridge heartwear device, which uses Artificial Intelligence to predict the onset of expectant strokes and a myriad of cardiovascular diseases.

A Bangladeshi son  

Rameen was six years old when his parents – both BUET-trained architects – immigrated to the UK. He still fondly remembers his early childhood in Dhanmondi, taking long walks with his maternal grandfather (Chief Engineer Abdul Wazid) around Dhanmondi Lake, the sound of Azaan from Sobhanbag Mosque and his early schooling in what was then a very new South Breeze International School.  He embarrassingly admits he was a spoilt boy who spent most days playing football and avoiding sitting down with the home tutor.

"I had a privileged upbringing and as a young boy, I was sheltered from the harsh realities of human struggles. All that changed when we had to move to the UK. I was bullied at school for not knowing how to tie my shoe laces. I hated the cold and the food was to me blander than a bread roll. However, I soon made friends and that is when I felt more at home," he said.

Having spent five years at MIT, Professor Rameen recently returned to Cambridge and finds himself often thinking not just about the past, but also about the future. Like every other second-generation immigrant, he has to wrestle with questions: why did my parents leave the country? How different would my life have been if they didn't? Would I ever return? What can I do for the country from here?

And as he eases into his role as chair of Cambridge and Cambridgeshire IoD, he also finds himself thinking a lot about the academic and entrepreneurial environment in Bangladesh.

 "We have a distinct lack of infrastructure when it comes to science tech startups. The main problem in our ecosystem is that there are no incentives for STEM-focused academics and graduates," said Rameen.

"The highest aspiration for your average BUET or medical student is to get good grades in their undergraduate studies and leave the country for a better life. They want to get paid more, reach a role such as a consultant and consider this the highlight of their lives. All the while, their children have no concept of what Bangalee culture is, and just complain about it from abroad.

This does not help anyone and it often belittles the humble beginnings we all start from. Unfortunately, there are simply not enough reasons for someone with a good brain and even better academic skill sets to stick around in Bangladesh and that is what we have to change," he said. 

Rameen is now eager to explore how this state of affairs can change so that real careers can be made in Bangladesh, and people like himself have the incentive to support others and feel part of a greater community.

"We need robust, sustainable long-term corporate governance strategies to allow the founders of tomorrow to upscale and compete in a competitive global life science market. Why is it we don't have a centralised infrastructure for the commercialisation of science and tech-based industries that are emerging from universities? How do we support commercial growth as well as academic curiosity? All of this can help the country."

Frustrated as he may be with the state of affairs, patriotism beats strongly in this young doctor/scientist/entrepreneur's heart. As an advisor himself to the UK government on how to build innovation in science and technology, Rameen very well knows the competitive space that all countries have to compete in, not just to nurture but also to enhance the next generation of unicorns, in life science and tech companies.

"Bangladesh is not an ordinary country. It represents the aspirations and hopes of many for whom perseverance and striving for a greater good is the norm. We are more than service industries, we are innovators and change-makers who want to give back. From the foundations laid by our freedom fighters, intellectuals and general folk, we now see a revitalised, developing economic power.

Giving back to a society, where the term 'we' is a larger word than 'I', is the Bangladesh I represent and hope we can move forward together in," he concluded.