More Than Miles Separate Pakistan and Newfoundland

Amin Muhammad Gadit, M.D., a psychiatrist from Karachi, Pakistan, now lives and works in St. John's, Newfoundland.

Although St. John's is one of the cloudiest, snowiest, windiest, and wettest major cities in Canada—and a far cry from the mild winters and warm summers of Pakistan—he loves it in St. John's.

“In Pakistan there are lots of political upheavals and great economic disparities,” he explained in a soft-spoken voice during a recent interview. “Life is more secure and peaceful here, especially for people raising a family, which is the case for my wife, Najma, and myself.

Credit: Amin Gadit, M.D.

“My working environment at the Memorial University of Newfoundland, where I'm a professor of psychiatry, is very good. I have a lot of autonomy and don't work under stress. And I like St. John's because it reminds me of Ireland. The people are warm and friendly. In fact, most of the people in St. John's are of Irish stock.”

It all started when Gadit, as a youngster during the 1960s, watched the American television series “Dr. Kildare.” “Dr. Kildare was an inspiring character for me,” he recalled. “He served humanity and devoted his life to his profession. So I decided that I too wanted to become a physician.” Gadit earned his medical degree in Karachi in 1984.

He then decided that he wanted to become a psychiatrist because there were only a few for Pakistan's large population. “I thought I could work wonders if I were motivated and hardworking enough.”

He did his psychiatry residency in Ireland from 1988 to 1993 because “at that time, the United Kingdom and Ireland were popular places for medical students from Pakistan.” After he became a psychiatrist, he spent six months in the United Kingdom learning more about forensic psychiatry.

For the next decade, from 1994 to 2004, he worked in Pakistan—first as an assistant professor of psychiatry at a private medical university, then at another private medical university as an associate professor of psychiatry and later a professor of psychiatry, and finally as vice principal of the medical school.

Serendipity Entered

Then serendipity, in the form of APA's 2004 annual meeting, intervened. While attending the meeting, he happened to meet a psychiatrist from Fredericton, New Brunswick, Canada. “We became friendly; he saw my CV and suggested that I come work for him as a consultant psychiatrist in Fredericton. I told him that I did not want to leave Pakistan. He then suggested that I take a leave of absence and work for him for a while. I decided that that might be a good idea and especially an opportunity to learn something about the Canadian mental health care system.” So in September 2004, Gadit moved to New Brunswick, with the intention of staying a year or two and then returning to Pakistan.

But while he was working in New Brunswick, he applied for a position as a professor of psychiatry at Memorial University of Newfoundland in St. John's, and in February 2006 he moved to Newfoundland to assume that position.

In his experience, there are big differences between practicing psychiatry in Pakistan and practicing it in Newfoundland. For instance, because there are so few psychiatrists in Pakistan and such a huge number of patients, “there is no formal recordkeeping or paperwork. You just see the patient and diagnose and prescribe medication. There is virtually no time for counseling or psychotherapy.”

He described psychiatry practice in Newfoundland as a “beautiful combination” of how psychiatry is practiced in the United Kingdom and the United States. “In all of Canada, but especially in Newfoundland, we are flexible in diagnosis, which is typically British, but we do a thorough biological workup on each patient, which is typically American,” he said.

Practicing psychiatry in Newfoundland has its challenges, Gadit has found. “For instance, the mental health care system here has ample resources, but there is a lack of organization, a lack of vision,” he said. “We are not making the best of [our system]. Also, we don't have highly developed subspecialties here—we are short of people in forensic psychiatry, and addiction services are not well developed. And the integration of psychiatry into family health care is not what you would expect for a developed country.”

He Made the Right Choice

On the whole, he believes that he made the right choice by moving to Newfoundland. “I am pleased to be in a teaching and learning environment and at the same time to be in a position to do good for patients.”

In fact, he intends to stay in Newfoundland indefinitely, and one of his plans is to develop a transcultural psychiatry department at Memorial University. A surprising number of people from other cultures seek psychiatric treatment in St. John's, and they may express their symptoms of mental illness differently.

He is also working on a transcultural homicide project for the Canadian Department of Justice in Ottawa. The project concerns honor killing, in which a woman is killed by her spouse or family for her actual or perceived immoral behavior. Honor killings are carried out as a result of a cultural mindset, not because they are legally sanctioned in Muslim countries.

“There have [also] been several such cases in Canada, so the Department of Justice wants me to give them a position paper on the international magnitude of honor killings and their relevance to Canada,” Gadit said.

Gadit also has an interest in demonic possession, which he has studied extensively. Demonic possession is “a type of psychosis that has not yet been well defined,” he suspects. He is interested in conducting more research on the subject.

But wouldn't it be difficult for him to do so in St. John's? “No,” he replied. “You can find demonic possession in every culture, even here in St. John's. For instance, several general practitioners in St. John's referred patients to me who believed that they were possessed by devils.”