The Belief That Has Guided Every Decision I've Made
As a physician-scientist who has worked across three countries and at least a dozen different settings, from a mountain village in western Iran to a research lab at Yale, I've had time to notice what actually holds everything together. It's not a method. It's not a specialty area or a research focus. It's a belief, and I've carried it with me long enough now that I can name it clearly: you cannot separate a person's health from the conditions surrounding their life. The moment I treat those two things as distinct, I've already started making smaller decisions.
This sounds like a principle that belongs in a public health textbook. But for me, Elham Neisani Saman, it became real in 2003, during the Bam earthquake. I was doing patient intake, triage, phlebotomy, wound care: whatever the moment asked for. More than 20,000 people died in that disaster. Tens of thousands more were injured. In the middle of that, what stayed with me wasn't the volume of patients. It was how completely their physical condition was tied to everything else: their shelter, their families, their access to basic supplies, whether someone showed up for them at all. That experience changed what I think a doctor's job actually is.
A few years later, working as a Health Advocate at the Hope Center Charity for HIV and Nursing Care in Varamin, I kept seeing the same pattern. The residents I worked with needed clinical care, yes. But they also needed someone to talk through social stigma with their families. They needed group conversations that replaced fear with information. Handing someone a diagnosis and a prescription and calling it done wasn't enough. So I ran workshops. I sat with families. I learned that education, real education that gives people tools instead of just facts, does something a prescription alone can't.
This belief is why, when I finished my OB/GYN residency in Tehran, I chose to go to Naghan. It's a small mountain village in western Iran, and the position came with a modest stipend and housing. That was it. I went anyway, because I wanted to understand how healthcare systems function, or fail, in places that don't have the resources most training programs assume. Serving as a health systems and quality improvement adviser across three community hospitals there showed me how to build something sustainable under real constraints. I learned more about systems thinking in that one assignment than in years of institutional training.
The same thread runs through my research on endometriosis at Yale. The condition affects millions of women and remains chronically underdiagnosed, often because women's pain is dismissed rather than investigated. That's not just a clinical failure. It reflects a broader pattern of who gets believed, who gets studied, and whose symptoms get taken seriously. When I presented findings at the 2015 American Society for Reproductive Medicine annual meeting, the science mattered. But so did the reason the science was needed in the first place.
When I think about my work with the Integrated Refugee and Immigrant Services organization, or my role co-founding the Organization of Middle Eastern Girls and Women, the same belief shows up again. Healthcare access is never just about whether a clinic exists. It's about whether a person can find it, trust it, and use it without facing barriers that were never their fault. Advocacy and clinical work aren't separate tracks. For me, they've always been the same thing.
I apply this in small moments too. When a patient sits across from me who has been through recurrent pregnancy loss, or who is quietly struggling with postpartum depression behind a composed surface, the question I hold is not only "what is the diagnosis?" It's "what is this person actually carrying, and what does she need to feel genuinely understood?" That question changes how I listen. It changes what I ask. You can read more about how this shapes my overall approach on my about page.
I don't think this belief will shift as medicine evolves. If anything, I think the arrival of AI in diagnostics and risk assessment makes it more important, not less. Technology can do extraordinary things, but only if it's built on data that reflects real, diverse populations and guided by people who remember why it matters. The work I'm committed to going forward holds both of those things at once: the science and the human being at the center of it. That's the only version of this work that feels worth doing. You can follow where that leads here.