Over the next three months, Dr Sharad Paul will be stretched in many different directions. Fortunately, like the skin he specialises in, he is very elastic.
For roughly a third of that time, he will be at his medical practice in Blockhouse Bay. On Wednesdays, he will do the free skin cancer checks he’s carried out for the past 20 years; he estimates he’s seen more than 100,000 patients through the service he funds himself.
In a fortnight, he will be in Soho, New York, launching his latest book, The Genetics of Health. It’s the eighth book published under his name – including three novels and a book of poetry on the nature of melanoma. He’s been asked to squeeze in an appearance on the daily talk show of American TV chef Rachael Ray.
Through May and June, Paul will speak at literary festivals in London, Dublin and Lillehammer, Norway. He’ll also give medical lectures on skin cancer surgery, and his latest pioneering “golden spiral” surgical technique, at the Mayo Clinic in Minnesota, Oxford University in England, Vienna, Oslo and Copenhagen.
On Mondays when he is in New Zealand, he will visit low-decile schools around Auckland, reading to children and encouraging them into creative writing. He’s also building a mobile classroom – library by day, homework club by night, where parents and kids can share a meal and learn about healthy eating. Paul has even offered to cook.
He’s disappointed that he’s had to withdraw from the World Masters Games in Auckland next month, where he was entered to play table tennis. A wrist injury put paid to that.
This global itinerary – frenetic to mere mortals – is not highly unusual for Paul, a finalist for New Zealander of the Year in 2012 and shortlisted in 2015. “Nothing is hectic, if it’s fun,” he says. This is a man who swears he’s never experienced jet lag (“It’s an attitude thing – I start behaving as if I’m on New York time before I get on the plane”) and claims to have never lost a working day through illness in 30 years.
Paul, who turned 51 last week, chuckles at the thought that most people he’ll meet on his upcoming travels won’t have a clue what he does outside of the realm they encounter him in.
“Literary people don’t know that I’m a surgeon; they think I’m a full-time writer or an academic. Most of my patients don’t know that I write books,” he says.
At a pub in Dublin last year, after speaking at the esteemed Dalkey Book Festival, “eight people suddenly ran home when they discovered I was a doctor, and brought back family members with their rashes and skin complaints,” he laughs.
“My life doesn’t feel extraordinary, because I’m just me. It’s what I’ve always done. I guess some people just lack the courage to do all that I do.”
His thirst for learning led to his latest book, The Genetics of Health, to be released in the United States next month, and New Zealand in May. Paul looks at how environments shape our genes; how genes affect the body’s response to prescription drugs; and how we should eat according to our individual genetic codes for better health. “I see myself as both the message and the messenger,” he says.
Paul predicts that now genetic testing is readily available, we will be prescribed medicine tailored to our gene types in the not-too-distant future. Since 2007, the U.S. Food and Drug Administration has recommended genetic tests to predict a patient’s response to common blood thinner warfarin.
In conjunction with the book, Paul has developed a saliva test analysing DNA to determine how genes can influence stress levels, nutrient and mineral metabolism, and even sports preferences. “Athletes might use it to see if they have the power gene, or the endurance gene,” he says.
Paul also believes we have “sluggish genes” – research has shown mice with mutations of the SLC35D3 gene are lazier and put on more weight. “People with sluggish genes are more likely to cancel their gym membership,” he says. “But you can overcome it.”
Genetic variations play a major role in how people respond to different foods, Paul says. Some people metabolise coffee quicker than others, depending on which variant of the CYP1A2 gene they have. “Slow metabolisers of caffeine have a higher risk of heart attacks if they drink more than two cups of coffee per day; fast metabolizers actually have reduced risk of a heart attack if they have at least a cup of coffee a day,” Paul says.
Paul, who also lectures in surgery at the University of Auckland, even questions whether we have a genetic predisposition for certain careers. Born in England, to doctor parents who returned home to India as medical missionaries when Paul was five, he jokes that he didn’t stand a chance. He also has a stream of grandparents, uncles and aunts who were medical professionals. His daughter, Natasha, is in her third year of dentistry at the University of Otago.
Awarded the country’s highest medical honour, the NZ Medical Association Chair’s Award in 2012, Paul continues to make internationally-recognised breakthroughs in skin cancer treatment.
His new surgical technique – the “Golden Spiral Flap”, for closing large wounds on the scalp – evolved from his curiosity as to why human hair grows in whorls on our heads, while a monkey’s hair doesn’t. It’s an observation he made while performing surgeries on primates at Auckland Zoo and the Orangutan Foundation in Borneo.
“Spiral patterns in nature are all for rapid expansion, and human brains expand extraordinarily rapidly in the gestational period between 10 and 17 weeks. I then wondered if using that pattern was a better way to cut the skin,” he says. The spiral-shaped flap that Paul devised reduces tension on the wound and doesn’t require a skin graft. His research has been published in a Frontiers in Surgery journal.
Other accomplishments Paul has lined up this year include completing a PhD in skin lines at the University of Queensland (where he also teaches post-graduates), and releasing a range of skin serums and natural sunscreens tailored for different skin types. His fourth novel, Solomon Chinook Salmon – about salmon farming, autism and the First Nation people of Oregon – is also poised for publication. “It’s a bit metaphysical and philosophical, as all my writing is,” he says. He’d also like to have his first mobile school library up and running at Glen Taylor School in Glendowie.
Despite his many social entrepreneurial projects, Paul confesses he’s not a natural businessman. In the 2000s, he opened bookstore cafés in Auckland and Brisbane called Baci Lounge. Both are now closed.
The Auckland store – which began as 80 percent books, 20 percent food – was initially successful, winning an Auckland Top Shop award, and funding his school literacy programme. “However, as the decade progressed, people began reading less and eating more, and it ended up 80 percent café and 20 percent bookstore — as the local populace evolved into hobbits with fatter guts and skinnier brains,” Paul writes in his genetics book.
“I’ve accepted the fact I’m never going to be the world’s wealthiest doctor,” he says. “But that’s not what drives me. I would be embarrassed to drive a Porsche.” He gets around Auckland in a run-of-the-mill four-door Mitsubishi. “I’m a bad networker because I don’t view life as a series of transactions. But I’ve been a good risk-taker in terms of living my life on my own terms.”
He’s reluctant to give up his Blockhouse Bay clinic: “I genuinely love the people I treat. But I know there will be a day when I get up and say ‘Oh my God, do I have to go?’ to one of the things I do. Then I will quit whatever that is. But right now, I have an amazing life.”
Paul wonders if he is better recognised overseas than he is in New Zealand, his home of the past 25 years. Here, he is “just this guy working away in Blockhouse Bay.” Two years ago, he was invited to dinner at Keble College at Oxford University; when he arrived, he discovered the dinner was in his honour, “a celebration of my life”.
“Sometimes I feel when I give all these talks overseas, people here are missing out. I don’t know if New Zealand really values what I have to contribute,” he says. “I have a lot of pride in New Zealand; it’s my home. But I’d like to be utilised here more.”