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At the intersection of medicine, psychedelics, and social impact stands Fayzan Rab, an MD Candidate at Emory University School of Medicine who brings a fascinating blend of experiences to his current role as a clinical researcher at the Emory Center for Psychedelics and Spirituality. His research explores crucial questions surrounding the emerging psychedelic therapy landscape, from understanding minority communities' perspectives to examining the broader public health and economic implications of these groundbreaking treatments. Before pursuing medicine, Fayzan carved out a distinctive path that included leading product development at tech giants Google and Mindstrong Health, followed by grassroots political organizing in the Bay Area. Today, alongside his research, he channels his leadership experience into executive coaching, helping entrepreneurs refine their communication skills and presence. When he is not exploring the frontiers of psychedelic medicine, Fayzan enjoys life in Atlanta with his fiancée Shua and their cat Bella, where you might find them hunting for fresh produce at their neighborhood farmer's market or hosting spirited game nights with friends. In this Genomic Press Interview, he shares his insights on the transformative potential of psychedelic therapy in modern healthcare.

Keywords: Psilocybin; FDA; economic demand; public health estimate; exclusion criteria

Part 1: Fayzan Rab – Life and Career

Could you give us a glimpse into your personal history, emphasizing the pivotal moments that first kindled your passion for science?

Both my parents are physicians and while we never explicitly debated the merits of the scientific method, it was baked into the DNA of my upbringing. A few classes in college that looked at epistemology and the history of science reinforced in me the value of science as a neutral arbiter in deciphering reality. In my first career as a product manager at Google, we used principles from science (breaking problems into first principles, validating results, seeing what was reproducible) to build technology products for users. By the time I started medical school, I had a blended philosophy around science. I wanted to use the scientific method to rigorously test and examine questions that were pertinent in the real world. I have been surrounded by mentors who have encouraged that inquiry in developing my relationship with science and using it as a powerful instrument to bring clarity to topics that I feel are important to answer.

Figure 1.Figure 1.Figure 1.
Figure 1.Fayzan Rab, MD Candidate, Emory University, USA.

Citation: Psychedelics 2024; 10.61373/pp024k.0046

We would like to know more about your career trajectory leading up to your current role. What defining moments channeled you toward this opportunity?

My interest in psychedelic science began during a series of mini-lectures at UCSF designed for the public. I was contemplating a career switch from Silicon Valley to medicine, and I was blown away by some of the clinical research on psychedelic therapies for hard-to-treat conditions like PTSD and depression. The statistics were compelling, but the transformative, qualitative accounts from participants captivated me.

Emory established a Center for Psychedelics and Spirituality during my third year of medical school, which provided a natural playground to explore some of the questions arising in the burgeoning psychedelic ecosystem. While many researchers focused on clinical trial outcomes, I saw an unmet need to explore questions around implementation—such as public health needs and real-world operating models. This realization led me to create a research team to address these critical issues.

Please share with us what initially piqued your interest in your favorite research or professional focus area.

So often, I would drive home at the end of a psychiatric clinical service and be saddened by the way the healthcare system treats some of the most vulnerable and mentally ill in our society. These are the patients that many general providers often feel some aversion to wanting to treat. The current treatments we have do not seem to reach the patients with the worst mental illness or provide a sustained impact that changes the trajectory of their outcomes.

It would be a fool's errand to say that psychedelic therapies alone would change that. Treating mental illness will require changes within clinical practice but also investments into social safety nets, re-employment opportunities, and affordable housing.

Psychedelic therapies are one of many ingredients that could make a significant difference. I am fortunate to see a whole new field of medicine emerge at this stage of my clinical training. Some of the questions we get to ask about psychedelics, such as reimbursement models, diversity and inclusion, and public health, provide entry points to re-examine many fundamental aspects of the way mental healthcare occurs in the United States.

What impact do you hope to achieve in your field by focusing on specific research topics?

Many questions are well-intentioned in academic research for mental illness: how do we incorporate more minorities, what would improve access to all groups of people, and how do we measure or make a dent in growing rates of mental illness in the United States? However, many existing healthcare systems are structured in a way that makes it hard—if not impossible—to change these inequities. My hope in psychedelic science is that we get to integrate those questions early on while psychedelic therapies are in their infancy. By addressing and planning for them now, I believe these therapies could reach and become more accessible to those generally excluded from treatment innovations.

Please tell us more about your current scholarly focal points within your chosen field of science?

My research within psychedelic science encompasses several interconnected areas of focus. I examine the public health and economic implications of psychedelic therapy approval, particularly regarding patient eligibility and broader health outcomes. Another crucial aspect of my work investigates how cultural and religious minorities, with a specific focus on Muslim communities, relate to and might benefit from psychedelic therapies – this research aims to create more inclusive therapeutic frameworks. I am also deeply interested in expanding the clinical applications of psychedelics beyond traditional mental health conditions. While current trials predominantly focus on treatment-resistant mental illnesses, I am exploring potential applications for diverse populations, such as cancer patients and those with postpartum conditions, as well as different therapeutic targets, including OCD and chronic pain.

What habits and values did you develop during your academic studies or subsequent postdoctoral experiences that you uphold within your research environment?

In leading my research group, I am guided by two fundamental principles that shape our approach. The first centers on maintaining a narrow focus while seeking broader applications – each research question we pursue must connect specific inquiries to larger implications within the field. A prime example is our study that estimated potential patient demand for psilocybin therapy in depression treatment. While we focused on determining eligible patient numbers, this research illuminated broader aspects of medical eligibility criteria, FDA approval processes, and public health outcomes.1 The second principle emphasizes valuing progress over the pursuit of perfection. Academic work can often stall when researchers become overly focused on achieving perfection. Instead, I encourage my team to view peer review not as a test demanding perfection but as a collaborative opportunity to refine and enhance our ideas. As demonstrated in our recent publication (Rab, Raison & Marseille, 2024, doi: 10.61373/pp024r.0025 – in this issue), this approach has enabled us to contribute meaningful insights to the field while maintaining scientific rigor.

At Genomic Press, we prioritize fostering research endeavors based solely on their inherent merit, uninfluenced by geography or the researchers' personal or demographic traits. Are there particular cultural facets within the scientific community that warrant transformative scrutiny, or is there a cause within science that deeply stirs your passions?

The scientific method holds immense potential to address society's most pressing challenges, yet science is often conducted in isolation from community providers. I would love to see more direct collaborations with organizations and providers to identify the most pertinent real-world questions. In one of my research areas—Muslims and psychedelics—the majority of hypotheses are developed in coordination with local providers. By grounding research questions in partnerships with on-the-ground organizations, we can ensure that the results and discoveries are relevant and meaningful to those in the field.

What do you most enjoy in your capacity as an academic or research rising star?

At a fundamental level, it is validating. Sometimes, venturing outside the comfort zone of the conventional questions being studied can feel risky. Already, many clinical peers raise eyebrows when I mention I am studying psychedelic therapies. In addition, most researchers in the psychedelic space are not diving into the questions I am studying; it can be a lot to be with at times. To have our publication accepted and then widely publicized can be affirming for that initial instinct that had me venture in this direction.

Outside professional confines, how do you prefer to allocate your leisure moments, or conversely, in what manner would you envision spending these moments given a choice?

I believe that leisure is an important part of any creative research process. Asking unconventional questions, getting inspired, and playing with ideas were all made possible because I created dedicated, uninterrupted leisure time. Leisure's non-utilitarian nature takes the pressure off for it all to feel useful and paradoxically makes the inquiries I ask feel more organic and natural.

For me, leisure consists of some structured stream-of-consciousness writing (check out the morning pages concept from The Artist Way), playing pickleball with friends in my local community, and spending quality time with my fiancée and cat.

Figure 2.Figure 2.Figure 2.
Figure 2.Fayzan Rab with his cat, Bella Donna.

Citation: Psychedelics 2024; 10.61373/pp024k.0046

Part 2: Fayzan Rab – Selected questions from the Proust Questionnaire

What is your idea of perfect happiness?2

Celebrating the moments in my life that are already joyful such as my morning walk, watching a movie with my fiancée, and relishing that I get to ask the questions and work on the problems I organically love to think about.

What is your greatest fear?

To live a life that is not authentic to who I am.

Which living person do you most admire?

Bernie Sanders. He is willing to be misunderstood to serve what he believes will benefit humanity.

What is your greatest extravagance?

I love a good spa day. One of my good friends and I will make it a habit to visit a local Korean spa for a whole evening.

What are you most proud of?

I met a great life partner and had the courage to propose to her.

What is your greatest regret?

Staying too long in a job where I felt like my manager was personally putting me down.

What is the quality you most admire in people?

Pioneers who are invested in bridging disparate worlds.

What is the trait you most dislike in people?

Self-righteousness.

What do you consider the most overrated virtue?

People who take much pride in saying they are busy. Busyness does not equate to progress or value.

What is your favorite occupation (or activity)?

I love coaching people who are facing personally meaningful challenges in their life.

Where would you most like to live?

A home that is based around a lot of wildlife and nature but still close enough to a large urban center.

What is your most treasured possession?

My grandfather's stethoscope.

When and where were you happiest? And why were so happy then?

The weekend I proposed to my fiancée: a total surprise to her. Our close friends and family came into town the following day and surprised us again with a full-blown celebration.

What is your current state of mind?

I am a bit sad about current events in the world, but I am also calm, present, and grateful for what's next.

What is your most marked characteristic?

Deep listening and not being afraid to take the conversation one level deeper.

Among your talents, which one(s) give(s) you a competitive edge?

My ability to distill multiple, diverse perspectives and synthesize them into a path forward.

What do you consider your greatest achievement?

Cultivating a close set of friendships and mentors whose relationships have not succumbed to the busyness of life.

If you could change one thing about yourself, what would it be?

I would have more faith during times of uncertainty in the path I am charting for myself.

What do you most value in your friends?

I am lucky to have an empowered and accomplished set of friends. However, none of them conflate their resumes for what is most important: relationships.

Who are your favorite writers?

John Steinbeck, Haruki Murakami, and Jhumpa Lahiri.

Who are your heroes of fiction?

I love the character Yusuke Urameshi from the 1990s Japanese anime Yu Yu Hakusho. He is a high school student who dies in a car crash only to be resurrected to fight invisible battles with spirits, demons, and villains. The show is surprisingly deep about redemption, remembering the day-to-day joys, and being willing to put everything on the line for something you believe in. I regularly watch clips from that show for inspiration when I encounter setbacks or uncertainty.

Who are your heroes in real life?

Dr. Tom Insel for his willingness to reinvent; Bernie Sanders for his commitment to serving the common person, and my grandfather for his ability to connect deeply with others and amazing storytelling abilities.

What aphorism or motto best encapsulates your life philosophy?

“Amor Fati.”3

Atlanta, Georgia, USA 4 December 2024

1Rab SF, Raison CL, Marseille E. An estimate of the number of people with clinical depression eligible for psilocybin-assisted therapy in the United States. Psychedelics. Published online September 13, 2024. doi: 10.61373/pp024r.0025 – in this issue.

2In the late nineteenth century, various questionnaires were a popular diversion designed to discover new things about old friends. What is now known as the 35-question Proust Questionnaire became famous after Marcel Proust's answers to these questions were found and published posthumously. Proust answered the questions twice, at ages 14 and 20. In 2003 Proust's handwritten answers were auctioned off for $130,000. Multiple other historical and contemporary figures have answered the Proust Questionnaire, including among others Karl Marx, Oscar Wilde, Arthur Conan Doyle, Fernando Pessoa, Stéphane Mallarmé, Paul Cézanne, Vladimir Nabokov, Kazuo Ishiguro, Catherine Deneuve, Sophia Loren, Gina Lollobrigida, Gloria Steinem, Pelé, Valentino, Yoko Ono, Elton John, Martin Scorsese, Pedro Almodóvar, Richard Branson, Jimmy Carter, David Chang, Spike Lee, Hugh Jackman, and Zendaya. The Proust Questionnaire is often used to interview celebrities: the idea is that by answering these questions, an individual will reveal his or her true nature. We have condensed the Proust Questionnaire by reducing the number of questions and slightly rewording some. These curated questions provide insights into the individual's inner world, ranging from notions of happiness and fear to aspirations and inspirations.

3“Amor Fati” is a Latin phrase meaning “love of fate” or “love of one's fate” that was particularly embraced and popularized by German philosopher Friedrich Nietzsche in the 19th century. However, the concept has earlier roots in Stoic philosophy, especially in the writings of Marcus Aurelius and Epictetus.

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Copyright: © Genomic Press, 2024. The “Genomic Press Interview” framework is protected under copyright. Individual responses are published under exclusive and permanent license to Genomic Press.