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What I've Learnt - Dr Nellie Torkamani · WHAT I'VE LEARNT

• 0:07
  SPEAKER_00: Well, as one of Victoria's top endocrinologists, Dr.
• 0:11
  SPEAKER_00: Nellie Torcomani, has spearheaded the transformation for many women with midlife challenges ranging from menopause, obesity to diabetes.
• 0:22
  SPEAKER_00: We explore how the new prescriptions and resources have been transformative and why women's health is slowly but surely becoming front and center.
• 0:33
  SPEAKER_00: We also explore the complexity and terror of her home country and why she is pleading for the West to take notice and take action as Iran suffers the terror of an insidious regime.
• 0:48
  SPEAKER_00: Her family, many of whom are still living there, have been drastically impacted.
• 0:54
  SPEAKER_00: Nellie's mother has been trapped in the country with a blackout on Wi-Fi making it almost impossible to communicate.
• 1:02
  SPEAKER_00: So we have a lot to unpack, and I look forward to chatting to the very inspiring but also informative Dr.
• 1:12
  SPEAKER_00: Nelly Torcomani.
• 1:13
  SPEAKER_00: So welcome Nellie to the What I've Learned podcast.
• 1:17
  SPEAKER_01: Thank you so much for having me.
• 1:19
  SPEAKER_01: This is very exciting.
• 1:20
  SPEAKER_00: Well, I'm excited too, because you, as I mentioned in my intro, have been quite transformative for me, but also I know for many people.
• 1:29
  SPEAKER_00: Women's health is is still having a moment, which is good, but it's got a long way to go.
• 1:34
  SPEAKER_00: And having not only a female doctor and specialist is has been quite transformative for me, but also I know for many women it's as if you have somebody who understands what you need.
• 1:46
  SPEAKER_00: Do you think this is now becoming much more seen than it was before?
• 1:52
  SPEAKER_00: Because often women's issues have been sidelined.
• 1:56
  SPEAKER_00: And being a female doctor, do you think that has helped you with your journey?
• 2:00
  SPEAKER_01: I agree.
• 2:01
  SPEAKER_01: Yes, I do think that it's been seen more, but we're coming from a place of zero uh sort of attraction to some traction.
• 2:08
  SPEAKER_01: So although it's a lot and it has changed a lot, but we had zero input before.
• 2:15
  SPEAKER_01: Just up to recently, there was no formal training for medical students during their training and also in the university and after they get their degree during their training in the hospitals about menopause.
• 2:28
  SPEAKER_01: So menopause was just a one line that women go through menopause on one day, done, adjusted, forget about it.
• 2:35
  SPEAKER_01: And that's that's extreme.
• 2:37
  SPEAKER_01: As an endocrinologist, training in Melbourne in the biggest tertiary hospitals, there is only one hospital that has proper training for endocrinologists about female hormones.
• 2:51
  SPEAKER_01: I can tell you, most hospitals have male hormone training happening.
• 2:55
  SPEAKER_00: Isn't that crazy?
• 2:56
  SPEAKER_00: This is ridiculous.
• 2:58
  SPEAKER_00: Ridiculous.
• 2:59
  SPEAKER_00: Yeah.
• 3:00
  SPEAKER_00: Well, it it comes from a sort of, I suppose, a patriarchy and a sense that often women, I mean, as we know, and I know my daughter's a doctor, and I know two of my girlfriends' daughters are doctors, and I know just how challenging it is to become a specialist like yourself, because you have probably a total of 14 years training just to get to where you are, you know.
• 3:20
  SPEAKER_00: And I I know that that is challenging because you also have children and you're trying to be a mother as well.
• 3:26
  SPEAKER_00: So basically, the system, the medical training system, as you referred to, makes it extremely difficult as a woman to get into the system, to stay in the system, and to juggle all of those elements.
• 3:39
  SPEAKER_00: So kudos to you, but we really need people like yourself, and so therefore, it's probably male-dominated just by virtue of the fact that it's so challenging if you are a woman.
• 3:51
  SPEAKER_00: So all of that feeds into why then we don't have some of these major women's issues front and center, which is what you're trying to do, and so are other women like yourself.
• 4:01
  SPEAKER_00: Would you agree with that reflection?
• 4:04
  SPEAKER_01: There's a few challenges for women getting into you know training and medicine and studying.
• 4:09
  SPEAKER_01: It's not about, you know, their ability to study medicine, no.
• 4:13
  SPEAKER_01: But when you look at a female, when they get into med school, you know, whether it's post-grad or undergrad and the menu years, they have to consider other factors as well, whether they are going to have a family down the track, uh, you know, what are their plans?
• 4:26
  SPEAKER_01: And this is not a factor that a man would consider.
• 4:29
  SPEAKER_01: And even after they have a family, you know, man would have a different responsibility towards the child.
• 4:34
  SPEAKER_01: So they would need to structure their training, their planning, and everything, even the night shifts around what they have to look at as their role as a female, in training, in studying, and also as part of a family.
• 4:47
  SPEAKER_01: Aside from that, then comes the medical sort of changes and a sort of discrimination that happens in any many medical specialties.
• 4:56
  SPEAKER_01: Physician training is much better and much more female-friendly, but we see a lot of issues with surgical trainings.
• 5:02
  SPEAKER_01: And you know, there has been a lot of movement towards making it more equitable and getting more females on board.
• 5:08
  SPEAKER_01: Because when you have someone who has gone through the same things as you, well, they will understand you better, and then they will make it more possible for you to go through, and then you'll get better care for patients.
• 5:18
  SPEAKER_01: This is evidence-based medicine that female physicians and surgeons provide better care to their patients because they are more empathic, they they take more time, they go through things more.
• 5:29
  SPEAKER_01: So they're and that's why females make less money because they take longer in their appointments and they see the more complex, more needy patients, as they call it, because they care.
• 5:42
  SPEAKER_00: It makes a lot of sense.
• 5:43
  SPEAKER_00: And just to clarify, are you saying that they make that they're better in terms of just attending to the female issues, or do you think female issues need longer time and more attention?
• 5:52
  SPEAKER_00: Or are you referring to both male and female patients?
• 5:55
  SPEAKER_00: In general.
• 5:56
  SPEAKER_01: In general, yes.
• 5:57
  SPEAKER_01: If you have a female doctor, it's more likely that you get better care regardless of your gender.
• 6:02
  SPEAKER_01: When you are seeing a female patient, well, if you know how painful a period can feel, you know, well, you will be more empathic towards your patient and you'll be more sort of understanding of what they're going through, rather than saying, oh, this is how it's supposed to be.
• 6:17
  SPEAKER_01: You know, your lived experiences make a difference.
• 6:21
  SPEAKER_00: So if you, for example, so coming back to the reference that you started with, which is so fascinating to me that there's only really one hospital that offers very, I suppose, efficient and focused training regarding menopause, which it's now being talked about on social media, and there's lots of books now, and there's a whole movement driven by women, often female doctors like yourself, but women in general who are like going screaming from the rooftops, like we have been marginalized at such a point that really the impact is also then so societal because you've got the struggling, let's say, woman dealing with menopause issues or obesity issues or hormonal issues, and that then it has this whole filter right through the family.
• 7:05
  SPEAKER_00: So this is a very important social issue, anyway.
• 7:08
  SPEAKER_01: Exactly.
• 7:09
  SPEAKER_01: You know, you get increased.
• 7:11
  SPEAKER_01: So the women have the highest rate of suicide between the ages of 40 to 45.
• 7:16
  SPEAKER_01: Why do you think that is?
• 7:17
  SPEAKER_01: That's exactly when perimenopause is happening.
• 7:20
  SPEAKER_01: I read an article somewhere which was very interesting to me.
• 7:22
  SPEAKER_01: They said they have simulated the hormonal changes that happen in a woman around going through perimenopause and what would happen to a man.
• 7:31
  SPEAKER_01: And it is very similar to having a complete mental breakdown and needing hospitalization for mental health.
• 7:37
  SPEAKER_01: Like that is the level a man will need that level.
• 7:40
  SPEAKER_01: The women women go through extreme changes, but they're supposed to be putting up with it because just until recently, we didn't have a terminology as perimenopause as a diagnosis, even.
• 7:53
  SPEAKER_01: You are stressed, you are midlife, and you've got small kids and you're a professional, so just take time off.
• 7:59
  SPEAKER_01: Yeah, well, that will help, of course.
• 8:02
  SPEAKER_01: But that is not the issue there, you know.
• 8:04
  SPEAKER_01: We have to look at the bigger picture.
• 8:06
  SPEAKER_01: But you know that what the problem is, there are a lot of doctors, both in the general practice setting and then in the sort of you know, more specific specialized settings as well, that are extremely caring.
• 8:17
  SPEAKER_01: They want to help, but the problem is they haven't had the training.
• 8:21
  SPEAKER_01: There is no proper course, like there is some, but there's no widespread training to tell them, okay, so how are you going to diagnose this situation called as perimenopause?
• 8:32
  SPEAKER_01: How are you making sure that you're not over-prescribing or under-prescribing the training space is the problem here?
• 8:40
  SPEAKER_00: Very so, really, what you're saying is they're ill-equipped and they don't have the tools, and therefore, while they come from a place of caring and want to help, it's limited in the way that they don't have those resources.
• 8:53
  SPEAKER_00: But interestingly enough, and you and I have talked about this, the change in the dialogue, once again driven by women, has been pushing for a whole range of things.
• 9:02
  SPEAKER_00: What are you seeing, not only in the menopause space, in the hormonal space?
• 9:05
  SPEAKER_00: And I know it's multifaceted, and of course, social media is quite overwhelming.
• 9:10
  SPEAKER_00: It's like an avalanche for the average person because you've got do this, take this, there's everything from peptides through to, you know, I mean, you name it as you know, it's really overwhelming.
• 9:21
  SPEAKER_00: And I think a lot of women, not just menopause, but hormonally and dealing with all of the issues that you and I've touched on.
• 9:28
  SPEAKER_00: How do you cut through the noise?
• 9:30
  SPEAKER_00: And are you finding that something that you're mastering?
• 9:33
  SPEAKER_00: And if so, how have you found the tools?
• 9:36
  SPEAKER_01: Yeah, so that's a very good topic.
• 9:38
  SPEAKER_01: The commercialization of women's health is extreme.
• 9:42
  SPEAKER_01: Like the nonsense that is out there, the money-making strategies are extreme.
• 9:49
  SPEAKER_01: And that's the problem here with most women's health.
• 9:52
  SPEAKER_01: And yes, females have different needs in different stages of life, depending on their hormones.
• 9:57
  SPEAKER_01: And then when you don't, when you're desperate and you can't find treatments, you will, you know, you will hang on to anything.
• 10:03
  SPEAKER_01: And that's why eventually, after many years of you know avoiding it, I started my own, you know, social media presence to give out that evidence-based information.
• 10:14
  SPEAKER_01: The problem with evidence-based information is well, we we do evidence-based medicine, we are that is what we want, and that's our goal started.
• 10:23
  SPEAKER_01: But when there's not enough research, what do you do?
• 10:26
  SPEAKER_01: There's no evidence to be based on it, but you have all these patients.
• 10:31
  SPEAKER_01: So then when you have a reputable doctor who has experience, then we can go by clinical experience to the level of what we call off-label at some cases, where there is some growing evidence or there is medical logic to it.
• 10:47
  SPEAKER_01: So, first thing, look at who's giving you advice.
• 10:50
  SPEAKER_01: What is their credentials?
• 10:52
  SPEAKER_01: Is this just so I don't know, an influencer who's just, you know, had, for example, hair loss and is explaining what they have experienced themselves and now they've suddenly become an experienced, uh an expert in that field, or this is someone who's done many, many years of research in the field, seeing patients build up that sort of an experience, and also has the medical ethics behind it.
• 11:18
  SPEAKER_01: It's always a problem if you are getting advice from someone who would have an intention, a financial intention behind it as well.
• 11:26
  SPEAKER_00: Totally agree with you.
• 11:27
  SPEAKER_00: I think the other thing that's also confusing on that front.
• 11:30
  SPEAKER_00: So, for example, let's take HRT, which is obviously, you know, a topic which is a lot of people talk about in midlife.
• 11:37
  SPEAKER_00: Some have been put on it and been told, well, you've got from 40 foot to 45 to be on it, maybe 50 if you're lucky, but then get off it.
• 11:44
  SPEAKER_00: You know, we've had this discussion.
• 11:45
  SPEAKER_00: Then there's a whole lot of discussion around now, all the new evidence suggests that it's not inverted, commas as cancer-causing or cancer high risk, etc., which everybody was terrified, like to go on it.
• 11:58
  SPEAKER_00: Now, obviously, I'm not asking you to give clinical advice in this context, but I think the point of this issue is the constant, ever-changing research or perspective, some driven by huge pharmaceutical companies, as we know, some driven by, you know, all of these.
• 12:14
  SPEAKER_00: So it is that in itself is confusing.
• 12:17
  SPEAKER_00: So coming back to your point is you need an expert, somebody who can cut through the noise and distill the evidence-based options.
• 12:25
  SPEAKER_00: What's your take on that particular issue?
• 12:28
  SPEAKER_01: I think individualized medicine is the take here.
• 12:32
  SPEAKER_01: We can't do a one-size-fits-all approach at all.
• 12:36
  SPEAKER_01: And we can't just say point black, this is okay, or point, you know, this is bad.
• 12:41
  SPEAKER_01: There's there's no such thing as black and white here.
• 12:44
  SPEAKER_01: We have to look at the person, assess them, make a proper decision, and give them the options.
• 12:50
  SPEAKER_01: And really giving the options and hearing out the patient is so important.
• 12:56
  SPEAKER_01: I have women with a history of breast cancer, which has been hormone positive, which sit in front of me and tell me that my quality of life is so horrible that I am happy to accept the increased risk of breast cancer and go back on hormone replacement, go on hormone replacement therapy.
• 13:14
  SPEAKER_01: I'm not saying that that's for everyone, but when you sit down as a team, myself, their oncologists, their breast surgeons, and the person as the center of this discussion, making that decision with informed, you know, risks and benefits.
• 13:28
  SPEAKER_01: That's a different thing rather than me just telling you, no, no, this is all wrong.
• 13:31
  SPEAKER_01: This doesn't cause breast cancer.
• 13:32
  SPEAKER_01: Here you go.
• 13:33
  SPEAKER_01: No, it is always so individualized and look at your provider.
• 13:39
  SPEAKER_01: You really, you know, you don't go to the same, you know, you if you go to a hairdresser and they don't give you what you need, you go and find another one.
• 13:47
  SPEAKER_01: It's the same thing.
• 13:49
  SPEAKER_01: If a hairdresser is not experienced in blonde hair, you won't go with them.
• 13:53
  SPEAKER_01: You know what I mean?
• 13:54
  SPEAKER_01: Definitely not me.
• 13:56
  SPEAKER_00: And you definitely won't no, that's a really good, yeah, that's a very good example.
• 14:02
  SPEAKER_00: And I think the other thing is one of the things that, and I certainly experienced this with you, is your professionalism, but also a sense of nurturing and camaraderie and empathy.
• 14:12
  SPEAKER_00: And I think that's so important, coming back to your original notion that it's very important that women do often this let they offer this level of care and connection.
• 14:23
  SPEAKER_00: I'm not saying men don't, because I have some wonderful male doctors in my life as well.
• 14:27
  SPEAKER_00: But I think that if we look at the trajectory, training, which you've mentioned, taking it through to the system, making sure that there is evidence-based, not only research, but medications and prescriptions and individualizing the treatment.
• 14:42
  SPEAKER_00: All of those things are very important.
• 14:44
  SPEAKER_00: Is there anything that you've seen new and exciting that you would like to share with our listeners in terms of what you see might be coming up ahead?
• 14:52
  SPEAKER_00: As we know there's so many things that could be really, really transformative, but are there some that stand out to you?
• 15:00
  SPEAKER_01: There's a few very exciting things happening.
• 15:03
  SPEAKER_01: So in the field of metabolic health, and we have many drugs that are labelled as weight loss drugs, which I really do not like that sort of a label.
• 15:13
  SPEAKER_01: These are transformative medications that will help with metabolic health and different situations as well.
• 15:19
  SPEAKER_01: There are many medications coming along, so by the end of the year, we will be getting tablets, which is a very big change from the injectables, so we will have which will help both our diabetes patients, our pre-diabetes patients, our patients in metabolic syndrome, and all of those things.
• 15:37
  SPEAKER_01: So that's very exciting.
• 15:38
  SPEAKER_01: And new hormones are coming along.
• 15:41
  SPEAKER_01: So we've got different types of incretin hormones that can be used, and the new generations are coming, so that's very exciting.
• 15:49
  SPEAKER_01: The other thing is we have very limited options when we are looking at sexual drive and libido in postmenopause or women, and while we use options such as testosterone and other things, there isn't much available, and a new medication has just been approved by the FDA, which we are for you know, for sexuality, hyposexuality disorder in women, postmenopause, which is extremely exciting.
• 16:15
  SPEAKER_01: We're waiting for that to be able to be introduced to the Australian market.
• 16:18
  SPEAKER_01: It has to go through TGA and all of that.
• 16:20
  SPEAKER_01: So that is very, very hopeful for our all of our patients who come and we do everything, and their life is not back to their normal level.
• 16:29
  SPEAKER_01: So it's a big part of the quality of life of our women as well.
• 16:32
  SPEAKER_00: Well, all of that sounds very exciting and very hopeful.
• 16:35
  SPEAKER_00: And I suppose we are privileged in that there is do you see the Australian medical system as being responsive to some of these, still conservative, I would say, but responsive to some of these new and exciting options?
• 16:48
  SPEAKER_01: Yeah, I think we are because we've got world leaders in the field based in Melbourne, which is amazing.
• 16:54
  SPEAKER_01: You know, Australia is one of the only countries that has female testosterone available.
• 16:58
  SPEAKER_01: Uh, you know, you can get it from any pharmacy rather than the needing in going it to get compounded and all of that.
• 17:04
  SPEAKER_01: So when you compare it, for example, to the US, we are way ahead in that sort of availability.
• 17:09
  SPEAKER_01: You know, we have multiple different types of hormone replacement therapy available, which there were shortages and there was problems, but it's it was amazing that last year there had, you know, the best types went on to the PBS, which they weren't.
• 17:22
  SPEAKER_01: So there was changes happening.
• 17:23
  SPEAKER_01: And this is a bit there was this was a very big factor, obstacle against a lot of our women being able to uh access bioidentical hormones.
• 17:31
  SPEAKER_01: And this is not just for women above the age of 50, women as young as the age of 35 might need this depending on their situation.
• 17:38
  SPEAKER_01: So we're looking at a very big range of women needing help.
• 17:42
  SPEAKER_01: So, yeah, so it's amazing.
• 17:44
  SPEAKER_01: And from a metabolic perspective, yes, Australia is ahead of many countries with the medications that we have available.
• 17:52
  SPEAKER_01: We the problem that we have is funding and availability of subsidized access for the most in need because these are very expensive medications in general, but there are changes happening.
• 18:02
  SPEAKER_01: We have had positive recommendations from the PBAC for a certain group of our patients with heart disease and you know dealing with excess weight and obesity.
• 18:11
  SPEAKER_01: So we'll start there and slowly, hopefully, when the data builds up and there's real world data and they see the economical benefits of providing care before end stage problems happen.
• 18:22
  SPEAKER_01: I'm sure that they would look at the benefits.
• 18:24
  SPEAKER_01: It's all about money at the end of the day.
• 18:25
  SPEAKER_00: Yeah, I know.
• 18:26
  SPEAKER_00: It's so fascinating to me that yes, it is all about money, but also it's about putting women at the top of the pile and saying, we need attention to this.
• 18:35
  SPEAKER_00: And as you say, I mean, I suppose the flow-on effect is so dramatic in the workplace, at home.
• 18:41
  SPEAKER_00: There are just so many ways in which this is just fundamental.
• 18:45
  SPEAKER_00: It's the axis upon which our community functions.
• 18:49
  SPEAKER_00: And so let's look after our women, which is what you're highlighting.
• 18:53
  SPEAKER_00: And I'm seeing a lot of women putting their hands up.
• 18:56
  SPEAKER_00: So that's good to know.
• 18:58
  SPEAKER_01: Women are the backbone of our society, you know, the happy life, happy, happy wife saying, I'll change it and I'll say happy life, happy woman.
• 19:06
  SPEAKER_01: And the female in the house, when they're happy, whether it's the mother or the sister or the wife or the girlfriend, doesn't matter.
• 19:14
  SPEAKER_01: They are when they are happy, there's more peace and there's a better structure, you know, they're the backbone of the society.
• 19:21
  SPEAKER_00: 100%.
• 19:22
  SPEAKER_00: I agree with you.
• 19:23
  SPEAKER_00: And I think on that note, I'd like to also reflect talking about, you know, we we have mentioned obviously your Persian heritage, and this is a segue into how we are very privileged here at the moment, although we have our challenges in Australia politically, which we know.
• 19:41
  SPEAKER_00: Your family, in fact, I was at your office not so long ago, and you were trying to get a call through to Iran.
• 19:47
  SPEAKER_00: I think your daughter was trying to get through to your mom, and it was very, very stressful and traumatic.
• 19:53
  SPEAKER_00: And I felt deeply and empathically for you and your family.
• 19:59
  SPEAKER_00: I think we're all seeing what's happening, although one would argue we can't really understand why it's not front and center of every single news site, let alone social media, which we are seeing some horrific things coming out of Iran.
• 20:12
  SPEAKER_00: Let's touch on that a little bit because I know you and I we we share an understanding of what it's like to have a community that is highly cultural, highly intellectual, highly focused on education, but highly traumatized by history.
• 20:29
  SPEAKER_01: So you know, yeah, it is very, I think we share a lot.
• 20:34
  SPEAKER_01: We share a lot.
• 20:35
  SPEAKER_01: It's interesting that we have very two different worlds to start with, and then how it all comes through.
• 20:40
  SPEAKER_01: So, yes, I am a Middle Eastern woman, and as I say, there is nothing stronger than a Middle Eastern woman.
• 20:47
  SPEAKER_01: So I'm from Iran, I was born in Iran, I was in Iran until the age of six when we came to Australia for four years with my dad, did his PhD at the University of New England in New South Wales.
• 21:00
  SPEAKER_01: So I was here for four years and then we went back, and then I came back at the age of 25.
• 21:05
  SPEAKER_01: So living under the Iranian regime is a whole experience by itself.
• 21:11
  SPEAKER_01: And I think it will be out of the whole context of our talk.
• 21:14
  SPEAKER_01: It would be so long.
• 21:15
  SPEAKER_01: It's a trauma, it's a lived experience trauma, especially for women.
• 21:20
  SPEAKER_01: But I'm not going to separate women and men here because the trauma is very mutual.
• 21:25
  SPEAKER_01: But you know, women get them all.
• 21:27
  SPEAKER_01: And the Iranian women uh people have been trying for 47 years to fight this situation that is happening, which is a regime that has been totalitarian, a fascist regime that has been killing, silencing, and prosecuting people for their basic human rights.
• 21:45
  SPEAKER_01: And when I talk about basic human rights, I'm talking about for you to choose what collar top you're wearing to go outside, for you to choose what you believe in, if you which God to believe in, or how what you eat.
• 22:00
  SPEAKER_01: In your house, if you're having a party, would you want what food to serve?
• 22:05
  SPEAKER_01: This is as simple as it is.
• 22:06
  SPEAKER_01: And yes, over the years there has been changes and there has been leniencies, and they have tried to, you know, there has been changes like the last time that I was I went to Iran, which was a year ago, ironically, I was walking on the streets without a headscarf on.
• 22:20
  SPEAKER_01: But that's not because the government was getting, you know, backing out.
• 22:23
  SPEAKER_01: It was because the people fought and it was so strong that they couldn't really police it anymore as much as they tried to do it.
• 22:32
  SPEAKER_01: So since 2009 till now, there have been many movements, and I can go through the politics, but I don't think it's you know it's needed.
• 22:40
  SPEAKER_01: The recent movement that happened was initially started because of the economical pressure that happened and the changes in the currency valuation towards the dollar, and that's because of the sanctions that have been applied because of the political decision making that the government uh decides.
• 22:57
  SPEAKER_01: And so everyone, you know, it started from the bazaars, which are the markets.
• 23:02
  SPEAKER_01: So usually these movements start from the bazaars and they close their shop, but then people came onto the street that this was not political anymore.
• 23:10
  SPEAKER_01: They were asking for a change in regime.
• 23:13
  SPEAKER_01: This is it, enough is enough, and they were chanting.
• 23:16
  SPEAKER_01: And the chantings were clear on the street.
• 23:19
  SPEAKER_01: We don't want this regime, and we want, and most of the chant was for the crown prince of Iran, Prince Reza Bahrabi, to come back.
• 23:27
  SPEAKER_01: And yes, there are multiple political pathways in the opposition as well.
• 23:31
  SPEAKER_01: But that was what the chance of the people on the streets was.
• 23:36
  SPEAKER_01: Suddenly, for two days, when people were on the streets, there was extreme attacks to people, and there are reports of more than 50,000 deaths, murders by the government that have happened, and aside from the casualties.
• 23:48
  SPEAKER_01: And what happened during this time is for a very long time, I actually lost track of it, I think it was two weeks.
• 23:54
  SPEAKER_01: We had zero, zero connection with our families.
• 23:58
  SPEAKER_01: The phones, the text messages, internet, everything.
• 24:02
  SPEAKER_01: Even Starlink was eventually because they were going home to home, weren't they?
• 24:07
  SPEAKER_00: And actually, the regime I've been reading about this going home to home, and if they saw a Wi-Fi connection, they would target that home and murder them and take those people.
• 24:20
  SPEAKER_01: So they would use uh, you know, external ways to stop their starling from working.
• 24:24
  SPEAKER_01: It was to the level that people were sending their loved ones messages to the international televisions, the South Iranian, and doing, you know, small prints underneath, like, Mom, I'm well because satellites were still working.
• 24:36
  SPEAKER_01: So people at some places they tried to take the satellite issues away as well.
• 24:40
  SPEAKER_01: That was the level.
• 24:41
  SPEAKER_01: So we didn't even know if our loved ones were alive.
• 24:43
  SPEAKER_01: And when the internet came back, which is not completely backing, then there is not a family in Iran that has not lost someone that they know.
• 24:52
  SPEAKER_01: The brutality is, and the thing that really hurts is that a lot of people in the international community actually question us and they say this is the Western propaganda, this is not real.
• 25:06
  SPEAKER_01: I get it, there is a lot of you know, a lot of issues with the West and the governments and all of that, but you cannot deny the pain that the Iranian people are going through just because you don't agree with this country or that country.
• 25:20
  SPEAKER_01: That is not how it should be.
• 25:23
  SPEAKER_00: 100%.
• 25:23
  SPEAKER_00: At the end of the day, it's about humanity, and it's like you and I have shared this.
• 25:28
  SPEAKER_00: It's about a shared humanity.
• 25:30
  SPEAKER_00: And if we lose that, then what are we?
• 25:33
  SPEAKER_00: And we, as my community, have experienced it.
• 25:37
  SPEAKER_00: The denial, this has not happened, all of that is historical.
• 25:40
  SPEAKER_00: It's very common for certain elements of, shall we say, uh, the silent majority to take that perspective without knowledge, without understanding.
• 25:50
  SPEAKER_00: I think the evidence on social media is so traumatic and so clear that it's it's I just don't see how they can even dispute that this is happening.
• 26:00
  SPEAKER_00: Clearly, it's happening.
• 26:01
  SPEAKER_00: I mean, what's fascinating to me, and it's this is this is often how it goes, but everything from the judiciary to the media to the police to absolutely every element of Iranian society has been infiltrated by the regime.
• 26:15
  SPEAKER_00: So therefore, there is actually it's hard for people to understand.
• 26:18
  SPEAKER_00: There is nowhere to turn but to stand in the streets and to actually protest, many of them young.
• 26:25
  SPEAKER_00: And you and I, well, you've sent me some photos which I will post after as part of this episode.
• 26:31
  SPEAKER_00: And we've all seen these beautiful, young, vibrant, intelligent Iranians, male and female.
• 26:37
  SPEAKER_00: I actually read today, I think there were 30 very high-profile athletes that were murdered.
• 26:44
  SPEAKER_00: Olympic potential like from basketballers to like I was reading, and I'm looking at these beautiful, talented, hardworking sports people, women and men who have just been murdered.
• 26:56
  SPEAKER_00: It's very hard in the West for them to, for people who have not experienced a regime like that.
• 27:01
  SPEAKER_00: I mean, in my community, and we have always, we've lived pretty much always with a sense of fear and a sense of security at our schools, security everywhere, because we have to, we've just lived with that.
• 27:13
  SPEAKER_00: In a sense, the Iranians have lived with a much more extreme version, clearly, but it's very hard if you haven't had any exposure to that.
• 27:21
  SPEAKER_00: It sounds like almost dystopian.
• 27:24
  SPEAKER_01: It doesn't sound like a sounds like a handmaid's tale, which is a handmaid's tale.
• 27:29
  SPEAKER_01: That is what Margaret Atwood wrote the handmaid's tale from.
• 27:33
  SPEAKER_01: Initially, when I started watching that series, I hadn't read the book and I didn't know that.
• 27:37
  SPEAKER_01: And I was telling my husband, this sounds like our experience.
• 27:41
  SPEAKER_01: And then I looked it up and said, Oh, she has actually said that she has written it of the Iranian Revolution, or the Islamic Revolution, if I could.
• 27:50
  SPEAKER_01: But that that would that is what it was.
• 27:52
  SPEAKER_01: So that is our lived experience, and that is exactly where we are saying that people started to say, oh no, it's not happening.
• 27:59
  SPEAKER_01: No, it's good, it's this and that.
• 28:01
  SPEAKER_01: But you can't because it's not just Iran and it's not just the Iranian people.
• 28:06
  SPEAKER_01: The geopolitical international impact of this is extreme.
• 28:11
  SPEAKER_01: It will knock on your door.
• 28:13
  SPEAKER_01: It is not that it's oh, they're just on the other side of the planet, I don't care.
• 28:18
  SPEAKER_00: No, it will knock on your door.
• 28:21
  SPEAKER_00: And one could argue it's already knocking on the door of Australia.
• 28:24
  SPEAKER_00: And I think that's what people don't realize.
• 28:27
  SPEAKER_00: And in the sort of the safety of, I mean, as you know, it's the indifference that is often the best weapon for the perpetrators because they rely on inaction and lasciviousness with the West, who who there are elements of the West that obviously would like to take a position and would like to take a stand, but as we know, we don't know what's going to happen with the US, if they're gonna step in, if they're not.
• 28:52
  SPEAKER_00: I mean, it's all just so it's like a blur, which is often the case.
• 28:57
  SPEAKER_00: But I do think your point is very valid.
• 28:59
  SPEAKER_00: If we don't think it's coming and that it's just over far away, first of all, an example is how many beautiful Iranian people and Persian people live in Australia and have built a beautiful life like yourself, like your family.
• 29:12
  SPEAKER_00: It's not dissimilar to the Jewish community who have fled uh, you know, war-torn Holocaust and traumatic experiences and found a better life.
• 29:22
  SPEAKER_00: And people who haven't had the traumatic experience find it very hard to process what it's like to rise up and out of the dirt and to find that strength and courage.
• 29:35
  SPEAKER_00: And we can only hope and pray.
• 29:38
  SPEAKER_00: Are you saying the internet's back on in Iran now, or is just it isn't part of limited, yeah, limited.
• 29:45
  SPEAKER_01: It it gets cut and disconnected at times, depending on what the talks are going through.
• 29:52
  SPEAKER_01: So there are negotiations apparently happening, which I don't know how you could negotiate with such a government, but anyway, that's happening.
• 29:59
  SPEAKER_01: So depending on what is happening, things get limited, and it you know depends on what you have access to.
• 30:04
  SPEAKER_01: Yeah, so internet is up and running at the moment, but depends on where you are, what sort of access you have, and that sort of thing.
• 30:12
  SPEAKER_00: So I hope that you've been in touch with your family and your mum in those moments because I know that's very important, understandably, to you.
• 30:20
  SPEAKER_00: And we are all hoping and praying that there will be some resolution and that there is a regime change and that there is some sort of Western action too.
• 30:30
  SPEAKER_00: I mean, I do have to just mention that I cannot understand why there's not protests in the street about what's happening, and I think that is surreal.
• 30:38
  SPEAKER_00: You know, we look at some of the protests that have happened over the weekend, which were very traumatic, not dismissing that there is trauma in other parts of the world, of course.
• 30:47
  SPEAKER_00: But where are the protests?
• 30:49
  SPEAKER_00: I'm talking the not the Iranians having to protest here.
• 30:53
  SPEAKER_01: The colleges.
• 30:54
  SPEAKER_01: The college, you know, where are the where are the activists?
• 30:59
  SPEAKER_01: Where are the active empathy?
• 31:01
  SPEAKER_01: Is interest interesting.
• 31:03
  SPEAKER_01: On the note of protests, tomorrow is the biggest Iranian protest that is going to happen on Valentine's Day in front of the Parliament House at uh five o'clock, five pm in Melbourne.
• 31:16
  SPEAKER_01: This is in line with international big protests calling for you know help.
• 31:22
  SPEAKER_01: And just to add this, and I want this for your non-Iranian uh sort of listeners who might say, Oh, but there is never a benefit in an external source such as the US interfering.
• 31:35
  SPEAKER_01: So, first of all, the Iran people are not naive.
• 31:38
  SPEAKER_01: We grow up with politics.
• 31:40
  SPEAKER_01: Our six-year-olds are more politically informed than most 20-year-olds in the Western society.
• 31:47
  SPEAKER_01: So we are not naive.
• 31:48
  SPEAKER_01: There have been years and years of trying for change and you know, reform, which has been met with brutal violence and killing.
• 31:59
  SPEAKER_01: So this is a last resort.
• 32:02
  SPEAKER_01: There's no other chance, there is no other way.
• 32:05
  SPEAKER_01: Iran will change into North Korea if there is no intervention.
• 32:10
  SPEAKER_01: And to remind people, there has been intervention of external countries, foreign countries in history that has resulted in democracy.
• 32:19
  SPEAKER_01: Nazi Germany, France, South Korea, all of these are you know examples of countries that needed external help.
• 32:27
  SPEAKER_01: You would not have told the people of Germany to sit and wait, you know, go through what Hitler was putting them through and just you know get onto the streets and march.
• 32:38
  SPEAKER_01: It is not possible.
• 32:39
  SPEAKER_01: So we are not naive.
• 32:41
  SPEAKER_01: We are not hoping for a miracle, and we know that there's always a price to everything, but it's not like our oil or resources are going to us at the moment.
• 32:51
  SPEAKER_00: Clearly, yes.
• 32:53
  SPEAKER_00: I mean, that's very, very powerful.
• 32:55
  SPEAKER_00: And I know you show great courage, and I hope that you are safe and your family are safe, and they should be.
• 33:02
  SPEAKER_00: And we really it's very important that you mention that tomorrow.
• 33:06
  SPEAKER_00: And hopefully there will be people, non-Iranian people, that will stand up because really, as we often say, you know, we always say, we're the canary in the coal mine.
• 33:18
  SPEAKER_00: People think, oh, it's just happening, you know, there's that saying, it's just happening to the Jews, oh, it's just happening to the Iranians, oh, it's just happening to the Afghan Afghan women who are now not allowed to read, walk, talk, sing, anything.
• 33:32
  SPEAKER_00: So I think as a community and as an act of humanity, we're all hoping and praying.
• 33:39
  SPEAKER_00: And thank you so much for joining us at the What I've Learned Podcast.
• 33:42
  SPEAKER_00: I've loved talking to you about both women's health and your family in Iran.
• 33:48
  SPEAKER_00: Thank you.
• 33:48
  SPEAKER_01: Thank you so much for having us, having me.
• 33:50
  SPEAKER_01: And I should say the Jewish community has been one of the biggest supporters of us.
• 33:55
  SPEAKER_01: On our protests, I see someone who's non-Iranian, they're almost always from the Jewish community who come and join us.
• 34:02
  SPEAKER_00: And the same for us.
• 34:03
  SPEAKER_00: We've had a lot of support from the Iranian community.
• 34:07
  SPEAKER_00: And united, we shall overcome the terror.
• 34:10
  SPEAKER_01: I'm sure.
• 34:11
  SPEAKER_01: I'm sure there will be a day that comes.
• 34:14
  SPEAKER_00: Thank you.
• 34:15
  SPEAKER_00: Thanks, Nelly.
• 34:16
  SPEAKER_00: Thank you, Deb.
• 34:17
  SPEAKER_00: Thanks.
• 34:18
  SPEAKER_00: Bye.
• 34:20
  SPEAKER_00: Well, thank you for joining us on the What I've Learned podcast.
• 34:23
  SPEAKER_00: I hope you enjoyed that interview because we are so privileged to have a wonderful platform where guests come up and share lessons learned, rivers crossed, mountains climbed.
• 34:34
  SPEAKER_00: We love our shared humanity, and we are so grateful to have such a beautiful community.
• 34:40
  SPEAKER_00: So remember to stay curious, kind, and connected.
• 34:44
  SPEAKER_00: And we'll see you next time at the What I Plant Podcast.