Prof Regan Solomons, Shaping the Future of Paediatric Healthcare

What distinguishes a 21st-century paediatrician working in a resource-constrained setting from his predecessors? This is the question at the heart of Professor Regan Solomon’s leadership vision and one that he unassumingly answers with his own presence and way of being in the world.

A highly esteemed Paediatric Neurologist and the Executive Head of Paediatrics and Child Health at Tygerberg Hospital and Stellenbosch University, Professor Solomons is deeply committed to challenging the status quo and advancing equitable healthcare for the children of South Africa.

In this episode of Awakening Doctor, we delve into his early inspirations, reflect on the many personal and professional milestones that have defined his life path, and explore his perspective on the importance of role models and mentors for the next generation.

From his illustrious research career to the invisible ancestral thread that led him to specialise in TB meningitis and the transformative initiative he spearheaded to support students facing food insecurity, Professor Solomon’s story is testimony to what is possible when legacy and destiny intertwine with humanity and heart.

Join us for this inspiring narrative of a dedicated medical professional who is shaping the future of paediatric healthcare.

The Tygerberg Pantry Project assists students who experience food insecurity and/or a need for other basic items. Please help them to create a sustainable culture of sharing vital resources by making a donation:

Bank: Standard Bank
Account holder: Stellenbosch University
Reference: Pantry project KP R5232
Account number: 073006955

Alternatively, contact the chair, Shannon Swanepoel, at 24969028@sun.ac.za to find out more.

Chapters

• 0:00 Introduction
• 4:31 Personal and Professional Reflections
• 16:22 Navigating Mentorship and Career Paths
• 22:28 Paediatric Medicine in the 21st Century
• 30:25 Personal Journey Towards Professional Success
• 37:39 Career Challenges and Personal Reflections
• 47:00 The Tygerberg Pantry Project
• 57:04 Navigating Leadership and Career Paths
• 1:03:49 Personal Journey Towards Paediatric Research
• 1:17:39 Qualities Beyond Academic Qualifications
• 1:22:29 Closing

Transcript

Prof Regan Solomons: 0:00

It's hard to see children suffer. I don't know if there's any sort of way - if you say no, it doesn't touch me, then maybe you're in the wrong career. It's the one thing that I think should drive the vision of the department. Especially when there's preventable causes of suffering due to social determinants. We must be absolutely relentless in our research efforts to go and figure out those and figure out ways to prevent all these unnecessary presentations. I think it's the one thing that does drive researchers as well.

Prof Regan Solomons: 0:31

You were telling me about the kid with AIDS. When I got my PhD, one of the students, my fellow student, was a year below me at university. We had a child that passed away of TB meningitis and he said he can remember I was wiping the tears out of my eyes. I can't remember that well, but that and another story. It's a little bit serendipitous that I ended up becoming a TBM - or making TB meningitis the focus of my research.

Prof Regan Solomons: 0:58

Last year, I spent time just looking at my family genealogy because I decided this is nonsense. I cannot only know my grandparents' names. I'm going to make a concerted effort so that my kids know where they're from. My mom has a photo of when she was eight years old and her little sister was five, and she told me her name was Joan and she passed away early. She was in a wheelchair and I actually traced her death certificate and on the death certificate, the cause of death was TB meningitis. So it's a bit of a note that brings.. I mean it's absolutely serendipitous how

Prof Regan Solomons: 1:36

I ended up, obviously, with lots of mentors along the way, but choosing that disease that still affects so many children in our setting, still having that on their death certificate. I'm choosing that as a career, so I think that's going to still drive me. I mean there's so much things to do because we can't be in the same place 70 something years later and kids still have a preventable disease on their death certificate. I mean that cannot happen.

Dr Maria Christodoulou: 2:08

Welcome, I'm Dr Maria Christodoulou, and this is the Awakening Doctor podcast. A space where we discover the personal stories of those who work in the medical and health professions. Join me as I explore the hopes, the fears, the aspirations and the real-life challenges of those who carry the title, responsibility and privilege of being a doctor. Joining us today is Professor Regan Solomons, a distinguished pediatric neurologist and the Executive Head of Paediatrics and Child Health at Tygerberg Hospital and Stellenbosch University. Regan is a globally recognized clinician and researcher and an inspiring teacher and mentor to many. A man with a big, generous heart, who remains rooted in family, community and his humble beginnings in the Cape Flats of Southern Africa. A visionary leader who is deeply committed to social justice and who has dedicated his life to advancing and improving equitable health care for the children of South Africa. So welcome, Regan. It's lovely to have you with us here today.

Prof Regan Solomons: 3:13

Thank you, nice being here and nice seeing you again.

Dr Maria Christodoulou: 3:16

Yes, and welcome Amy. Thank you. Amy is the producer and editor of the Awakening Doctor podcast, so it's great to have you with us.

Prof Regan Solomons: 3:36

That's a loaded question. Let's start with Regan Solomons because I think there's a bit of a difference. So Regan Solomons is from Cape Town, born and bred in Cape Town.

Prof Regan Solomons: 3:49

I grew up in Mitchell's Plain, went to school in Athlone and Claremont and then moved to Kuilsriver where I completed my secondary school training. I mentioned those places first because that's where my roots are, and I'll also mention some additional roots. My mom comes from Genadendal, so I always mention that I spent lots of my holiday time in Genadendal because my mom is a teacher and was always studying and was doing courses during the school holidays. So that also forms a little bit of my background, because I think there's a long history in Genadendal that was imprinted on me from quite early on. Regan Solomon's also the family man. I am married to Gailyn, my beautiful wife. I have two beautiful kids, 12 and 9, Nicolas and Celine, and that is completely my outside-o f- work persona. I try not to bring the work persona home. It's a bit of a protective mechanism because the work persona is Prof Regan Solomons.

Prof Regan Solomons: 4:55

I think I've grown into the role of Prof Regan Solomons. I'm a full professor in child neurology at Stellenbosch University. Became an associate professor in 2016 and a full professor in 2021. And, as from the beginning of last year, I've been the Executive Head of Paediatrics and Child health at Tygerberg Hospital and the Faculty of Medicine and Health Sciences at Stellenbosch University. So that's the work persona and I think with that comes big responsibility. So my usual Regan Solomons, which is fairly laid back and I like quiet time. The Professor Regan Solomons role doesn't quite allow for that. You have to bring something else to the party, because you don't just speak for yourself. You speak for the children that is seen. I speak for my colleagues and I also speak for up- and- coming students and school students that are also hopefully going to follow this same journey that I did.

Dr Maria Christodoulou: 5:56

So you and I met at the beginning of last year when you were what, a month into your new leadership role?

Prof Regan Solomons: 6:02

Yes.

Dr Maria Christodoulou: 6:03

And we walked a little bit of a coaching journey together and I'm aware that stepping into this leadership position has been quite an interesting and challenging opportunity for you. What would you say, a year down the line, about what it is to be the executive head of paediatrics at Tygerberg Hospital?

Prof Regan Solomons: 6:21

It's a privilege. I think it's always been a privilege. I knew that. I think the responsibility is probably much bigger than I thought when I stepped into the role because you do cross disciplines. So you're involved in lots of discussions outside of paediatrics and also strategic discussions where you're part of things that can impact 10 years, 15, 20 years down the line. So that is, I think, part of the evolution of being the head. It's just a responsibility that I've kind of grown into or thrown into in the beginning of last year. But I think there's also lots of opportunities to really add your voice and make a difference.

Prof Regan Solomons: 7:06

It's a difficult role to adjust to because in your head you followed the academic and scholarly process and the thinking was, it's just a next step. But I think the impact that you do make and the circle of things that you can impact on and the people that you impact on is a lot wider than I think one thinks of w hen you enter the job. Y ou think it's just all academics, I'm going to see patients, I'm going to do this, that and that, but that clear five-year vision and mission, definitely, t here's some points that added on to that by the second year of the job.

Dr Maria Christodoulou: 7:43

Right. Is there anything that has surprised you about what it means to be in this job?

Prof Regan Solomons: 7:50

I'm quite a laid back guy and, as a colleague, always cracking a joke and would have a coffee, but I think the colleagues have also accepted the role. So you really get called on for your advice and planning and I suppose it's probably the experience that I could offer. But I've never thought of it in that way before. T hat there is a bit of respect, at least for the position, and even outside of paediatrics, people actually want to know what my thoughts are on things. What is my view on anything from healthcare to research to teaching. It's enlightening and also something that I've had to grow into.

Dr Maria Christodoulou: 8:30

Right, so we've dived into where you find yourself today, and part of the intention of this conversation is for us to tell your story, and so I'm wondering if we can go back a little bit and you tell me, where should we begin in terms of telling your story?

Prof Regan Solomons: 8:46

Could probably start when I joined UCT as a 17- year old first- year MBCh B student. I think we can start there. A lot thinner and a head full of black hair.

Dr Maria Christodoulou: 9:01

Okay, I wonder actually, as you talked about that, I'm remembering a story you shared, I think, on LinkedIn, about your grandmother who bought you a book about medicine when you were still at school.

Prof Regan Solomons: 9:13

You're right, I really should start at that point. I think it was quite poignant. T his book on the bookshelf. I t doesn't have a spine anymore. But if you look at the content of the book now, it's probably not worth reading for the type of medical knowledge that's in there. But when I was in standard nine - so that's grade 11 - in 1991, my grandmother told me that she saw this book and she actually took it on lay-by. So she paid it off over a few months and I got the book when one of her friends gave it to me at her funeral. We'd always spoken about, you know, I want to become a doctor one day. A ctually to both my grandmothers. And she took it upon herself that this is going to add to my education because it's a medical book and I think she wanted to do her bit. So I mean it does stay with me. It's not going anywhere.

Prof Regan Solomons: 10:11

I think it's probably part of the reason why I went to do medicine in the first place. And I think, if you go dig a little bit deeper, I didn't know my grandfathers. They passed away long before I was born. But both my grandmothers were widowed quite young and my parents grew up really under dire circumstances. Both my grandmothers were what you call live-in domestic workers, because my grandmother from Genadendal was a live-in domestic worker in Sea Point. I can't recall where my other grandmother was, but that's where it started, and they did that so that their sons and daughters could finish school and the eldest looks after the youngest. And on my mom's side there's a few success stories from my mom's generation, how they helped each other just to get through.

Dr Maria Christodoulou: 11:09

I remember reading the post that you shared, with the picture of that book that doesn't have a spine, and being really touched by the tribute that you made to both your grandmothers for the impact they had had on your life, and it felt to me like you had such a deep respect and acknowledgement of the contribution, but also the legacy and almost a sense of responsibility to continue that legacy.

Prof Regan Solomons: 11:34

At that time you don't quite realise you're trying to do well at school. But here we have two elderly ladies realising the potential and putting lots of effort and encouragement into - to at least getting me at least to enter the race. Because I think when you're 14 and 15 you, you don't quite think that deeply, but I think once you reflect now, I mean, there's so many people to say thank you for their journey. So I have to do what I do well. I have to add on to their..

Prof Regan Solomons: 12:03

It starts with my grandparents, but not to forget my parents as well. From your fourth year in medicine at UCT, you go to different hospitals and my father let me use his car so that I could go to Princess Alice, and Somerset Hospital, Victoria Hospital, and he rode a bicycle to work. N ot for any leisure reasons. So he was quite strict. D idn't have tertiary education, but he knew exactly what his sons were capable of and didn't accept anything below what he thought your best was. But usually, he was quite right with what he knew your best was. And my mom, who's still alive, who's still a major supporter.

Prof Regan Solomons: 12:45

I just have these really good recollections from my varsity years as well. And my other grandmother, she passed away in 2002, and I was already long done with medicine by then, and you know, always nice to get their faces like, " you went to study medicine and I always thought why is this? I mean, it's not such a big thing, I'm just doing what I'm supposed to do, but I think it's the journey that the previous generations went through when those options weren't available to them. I think it's what makes it now poignant for me to reflect on.

Dr Maria Christodoulou: 13:20

Absolutely. So why medicine? What made you decide that medical school was the right place for you?

Prof Regan Solomons: 13:29

Before my parents moved house I went to look at my old school books and somewhere in there is a standard two composition in very ugly handwriting saying that I want to be a doctor one day because I want to help people, wear a white coat, and wear a stethoscope around my neck. So those were my three reasons, but as far as I can remember, I've always wanted to be a doctor. I don't know. I think I've ended up in the right place. Sometimes following opportunities and not by choice, but I think I've ended up in the right place. I think the need to help people was a big driver for me.

Dr Maria Christodoulou: 14:09

Where did that driver come from? What made you realize that people needed help?

Prof Regan Solomons: 14:14

I can recall back to school just going to visit a GP for a cold or an ear infection.

Prof Regan Solomons: 14:21

I was in awe of this person wearing a white coat with the ability to make you feel better, and I think there's just something in there that resonated really early on.

Prof Regan Solomons: 14:34

Without thinking of where I am now and the type of improvements I want to bring, I think it really starts with just the feeling that you get when somebody says, thank you, I'm better. Or comes back to you and a kid brings you a drawing, or this mom, the end of last year, got my address from one of my friends and I had seen her son when he was 11 years old, still in primary school. I treated him in the ICU and I followed him up every six months until fairly recently and she went to buy me a watch to say thank you because it was his matric farewell and just to say thank you. A nd in my head, I just really was doing my job. I want to see this guy better and always asked how she is, how her husband, how the family is doing. Without consciously thinking that I made an impact on people. I'm just really glad and touched that somebody would come back to me after all these years and just say thank you for what you do.

Dr Maria Christodoulou: 15:36

That's lovely. What was your time at UCT like?

Prof Regan Solomons: 15:42

To be honest, I didn't enjoy it. It was before the time of gap years. I was a bit young. I had turned 17 the November before and off I went to UCT. I made some fantastic friends along the way, but I can remember registration day. I think growing up in the 80s and 90s, it was the first time I'd spoken to somebody white and somebody black in my life and I stood there with, actually, no words, nodding. The black guy that stood in front of me actually was my clinical partner throughout, made the toast at my wedding, but it was such an eye-opener then.

Prof Regan Solomons: 16:23

You grew up in this sheltered community because I think the spatial placement of people in apartheid, y ou grew up with people who looked like you and I didn't know at school that, you know, there's much of a life outside. I'm glad I went to UCT because, I mean, I've made some lifelong friends. On the other hand, at UCT there was still, I think, the type of support for students that didn't traditionally come from what we call now Model C schools - you were just left on your own. So, it's one of those things that people don't need to say, but you can feel when people really are not interested in your education, and we kind of stuck together as black doctors, trying to help each other to answer questions. And if I can recall, I don't think it was anything conscious from anybody in the class. I think it's just growing up at that time. Let's just say the horizons and the minds weren't broad enough at that time.

Dr Maria Christodoulou: 17:28

So a very polite way to say that people's privilege blinded them to some of the circumstances you were dealing with.

Prof Regan Solomons: 17:34

Yeah, people with privilege hang out with other people with privilege. So very few privileged friends from my undergraduate year and a hell of a lot after I finished my MBCHB degree, and I think it's probably how I developed as a person as well and became a lot more vocal in saying exactly what I would like. And, as you know, I always try to act and say things diplomatically, but I think I always get my message across. But on reflection, it was just, when I think of the three places that I've studied, UCT is the one that had some memory for me of great friends made, but no other special memories, to put it bluntly.

Prof Regan Solomons: 18:15

Right, what were the other two places that you studied?

Prof Regan Solomons: 18:19

I studied at Stellenbosch. I did my paediatrics training and my MMed, and my fellowship training, and then I did, my PhD was joint between Stellenbosch and Vrije Universiteit, Amsterdam. It was a different experience then, but I think by then I'd also matured and grown as a person. So I have only positive memories.

Dr Maria Christodoulou: 18:42

Why paediatrics?

Prof Regan Solomons: 18:51

Actually, as an undergraduate, I didn't like paediatrics at all. I think I rotated through times of the year when I spent every week having a different strain of gastro, so it wasn't the most pleasant experience. And I rotated through paediatrics as an intern and it was okay, but didn't hold any special significance.

Prof Regan Solomons: 19:11

And I think in my community service, which I did at Worcester Hospital, we had an amazing paediatrician, Dr. Ralph Diedericks, and I think just the way he interacted with people and his colleagues and the patients and his approach to life in general. I know of a good few people that became paediatricians because of him and I think he's a big reason that I became a paediatrician. When I went to work in the UK the year afterwards and when I came back, I still harboured ambitions of wanting to be anything but a paediatrician. A surgeon, an ENT, a radiologist and I went back to Worcester and the only posts that there were were in paediatrics, and I said, okay, and ended up doing my diploma and quite liking working with the kids, and I became a registrar the next year. Sometimes your discipline or specialty chooses you whether you like it or not, but, reflecting back, completely the right choice for my personality and I think probably just my journey then just led me towards paediatrics.

Dr Maria Christodoulou: 20:15

Amazing. We've spoken about this in one of the previous episodes, that it's so often the case that people resist a particular discipline and then a mentor of some sort, a role model of some sort, or circumstance. A s you say, other posts are not available, and then you take this post and it opens up a completely different direction than one you had imagined.

Prof Regan Solomons: 20:36

Yes, and I think the role modelling is so important and to implement because people look up to what you do. They want to do things like you, if you're perceived to do it well. A nd how you treat patients and how you treat families. So I mean, it did make an impact on me and I had some really great role models subsequently, and you do end up going to these colleagues for their advice and they do shape the career route that you take and there's definitely an opportunity to implement, or forcefully implement, role modelling. A nd I have had some conversations with some colleagues. A lmost like a mentorship pipeline where you can match mentees and mentors wanting to follow a certain journey within academics, because it's not something that's openly available once you are a postgraduate student. As an undergraduate, I think there's people, there's resources that are put into place, but really, mentorship to shape a career, there's definitely a place for that and definitely an opportunity to plough back.

Dr Maria Christodoulou: 21:41

So you've touched on two things that I know are very close to your heart. The one is mentoring and coaching others, and I feel like you're quite passionate about that, and I read something you'd written recently about the importance of the knowledge transfer, not just about the academics but also the experiences, particularly for students from underserved or underprivileged communities. H ow to avoid the pitfalls, how to succeed in a clinical or teaching or research career, how to define the next career steps or identify opportunities. I was going to say where does that come from for you, but I think I can make some assumptions about that. I'm curious about what it was like for you.

Prof Regan Solomons: 22:28

So when I started as a registrar i n paediatrics, Dr Ralph Diedericks, and somehow at Tygerberg, I ended up - I think my first rotation was in paediatric neurology and I hated the rotation. I didn't like it at all. I started at seven and left at seven and almost like a father figure consultant, Prof Johan Schoeman and his colleague Ronald van Toorn, they asked me at the end of that rotation, would I consider paediatric neurology as a career afterwards? And my answer was no, d efinitely, definitely not. And I spent another two rotations there and I think the way that they emphasized work- life balance, definitely made a big impact on me coming through the ranks and played a big role. My academic journey as a researcher and scientist, i t's definitely with lots of input from the two of them.

Prof Regan Solomons: 23:23

Ronald van Toorn is still around as one of the paediatric neurologists. We're good friends and I chat to Prof Johan Schoeman fairly regularly. At that time there was a little bit of a metamorphosis. After I worked in the UK, you come back with a much broader worldview and a lot more confident and assertive of yourself. M aybe without any academic background to this, but I did find it profound that here's two white, Afrikaans- speaking colleagues really providing a father figure and an academic figure. T hat was quite profound for me and I think with the Afrikaans community at Stellenbosch, what you see is what you get. I do like that.

Dr Maria Christodoulou: 24:04

I remember you telling me about your time in the UK and how surprised you were by some of the stereotyping and assumptions people were making about you as a doctor from South Africa. Tell us a bit about that.

Prof Regan Solomons: 24:17

That's definitely humorous. So first, when you are not a South African, an African doctor, you get treated a little bit differently. So people watch you to see what you do, double- check your scripts. But after a few months things settle and you then become part of the confidant circle when a new doctor starts and they're like, oh, we have to watch this doctor, they're from this country.

Prof Regan Solomons: 24:41

So it was quite hilarious and I think the first assumption that people made, they tried to place me in a country because South Africa doesn't stick, because if you're in the UK and if you're from South Africa, you have to look and speak a certain way. And I tried to explain to people, South Africa is a massive country. Cape Town is different to Durban, different to Johannesburg, different to Pretoria. And I got asked to translate for a patient. Went in and thought to myself, why would somebody that's Afrikaans not speak English? And when I got to the patient, it was a Mexican patient speaking Spanish. I had to go back and say I don't speak a word of Spanish. Oh, I thought you were from Mexico. Cape Town is a few thousand kilometres from Mexico, so i t was quite hilarious. But I think the United Kingdom, at least London, is such a hodgepodge and people from everywhere. I think the English are quite reserved and they are very suspicious of outsiders, but I think I'm lucky to say it seems as if it's metamorphosising to a very open society.

Dr Maria Christodoulou: 25:50

So you say that it's very humorous and you laugh as you tell the story. Was it always funny when you were working in that situation and people were making those assumptions?

Prof Regan Solomons: 26:00

No. An example was when I got asked to prescribe or give medications that was prescribed, and this was changed, and the doctor was a surgeon, so in the UK they're called Mister. I stood right across him and he spoke to me via the nurse and I answered directly to him, not knowing any difference, and I had to speak to the nurse who relayed the information to him. So I found that incredulous. I was a little bit angry at the time, but then you just think of the pounds that they paid you for your service, which did dull the anger a little bit. Thinking back now, it's not right and hopefully things have changed a bit there.

Dr Maria Christodoulou: 26:42

Well, I know that kind of addressing some of those concerns has been a theme of your leadership vision for this last year. How's that going?

Prof Regan Solomons: 26:52

We had our first transformation workshop this year. I think it went very well. I think with discussions last year, I set out very nicely what my vision of transformation is, which is a little bit broader. It doesn't just - the reflex, the thinking is always you're speaking about people's ethnicity and it's not. It's a transformation in thinking how you become a 21st-century paediatrician and how you interact with 21st- century patients and their families, and colleagues that come from South Africa and Africa and outside, and how you do research, and how we interact with each other as colleagues, and how we embrace new technologies in teaching. So it's broad, but in essence, it's how do you interact with people to get the best out of each other and the best for your patients? So first transformation workshop went well.

Prof Regan Solomons: 27:46

I think we were given opportunities just to speak a little bit about ourselves. It was short and it's going to be a regular theme. Every six months we're going to have, we're getting actually my previous HOD, Prof Mariana Kruger, and Prof Sharon Kling, are going to give a talk on the ethics of professionalism. So I want to get my vision of transformation across. How do you transform a 20th- century paediatrician to a 21st- century paediatrician in, basically, what is a global village? How do you hold your own in these times? And I mean, you have to do that, because if you go back to the patient, it's best for the patient and that's the bottom line.

Dr Maria Christodoulou: 28:28

What would you say are some of the biggest differences between the requirements of a 20th- century doctor and the requirements of a 21st- century doctor in South Africa?

Prof Regan Solomons: 28:38

Your worldview has to be much broader. As a 21st century pediatrician, I think you encounter people that you might not have worked with before, patients you've had with migration. We have lots of different patients in our setting and the world is a global village. We're doing research with lots of different collaborators from all over the world and since COVID, there's this spirit of technology that can help us. H ow to think a little bit differently and how to do things that we've done for the last few decades, how to do it a little bit better and think of ways to improve services for children. So I think that's the big difference. A 20th century paediatrician in South Africa, I think, because of circumstances at that time, I mean, you had your very closed worldview and this is what you did. The world is different now and we have to, at least on a research level, we have to compete.

Dr Maria Christodoulou: 29:33

Yeah. W hat would you describe as some of the major milestones or turning points in your career or in your life, rather than just career?

Prof Regan Solomons: 29:46

Turning points? That's a difficult question. I haven't thought of that one. I think in my third year as a registrar, before then I was a little bit, let's just say after hours life kept me busy quite a lot. M aybe a little bit frivolous and, I think, superficial. Not thinking deeply about the impact that you can make. And in my third year, after a night out, I broke my leg and had to lie in bed with a backslab for two weeks thinking about the world, which is a good way to let you think, and it does make you think of where you are and what you do and what is the impact that you would like to make.

Prof Regan Solomons: 30:25

After that, there was a bit of a mindset change. And then, I think, the other turning point, was when I met my wife in 2007. So before there, read between the lines, I liked the after- hours life, and here I met somebody. I was completely ready to settle down and just bring a different aspect to my career. And then when I fathered kids. I mean, that is obviously a quick fire way to just think differently about the world and what sort of legacy do you want to leave behind for your children. So that's besides the day-to-day stuff - n urturing and making sure that the children don't think of boundaries without having no boundaries, if you get what I mean. H ow to encourage them to be the best version of themselves.

Prof Regan Solomons: 31:08

And a last turning point, when I got the Desmond Tutu Vrije University scholarship to embark on my PhD studies. I think it was one of these decisions. Prof Johan Schoeman told me there's this opportunity. He thinks I must embark on this. It was about two years after I'd finished fellowship training and it wasn't actually a question. It was more of a - an instruction, a bit of a push. I said yes without thinking and it was ups and downs for the first two years and then things just clicked for me and it opened so many research doors and just thinking about being a doctor in an academic setting, because it's always patient first.

Prof Regan Solomons: 31:47

But you have to be a researcher. Y ou have to ask questions, you have to add to the body of research from your setting, and you have to be able to know how to teach well and you have to be a leader and an advocate for patients, because you can't just do the one. It's not a 9 to 5 job, clock in, clock out, see a few patients write up Panados. I mean, the impact is so much broader than that and I think having those different aspects also makes things a little bit fun as a doctor because you can become very despondent with things like austerity measures and those sort of things. But you think back, the job that you're in has so many facets that if one makes you despondent while you're thinking about strategies for that, there's some other exciting things to keep you busy. I like the multifaceted nature of being a doctor i n the academic setting. I t's actually quite a privilege.

Dr Maria Christodoulou: 32:39

I noticed that when you were describing all those different things that one is required to do, you said the phrase I have to, I have to, I have to. Was there ever a feeling of c hoice in this vision?

Prof Regan Solomons: 32:53

I don't think there is a choice.

Prof Regan Solomons: 32:54

I think it's a privilege. I think for a doctor of my background to have come through and become a Prof and being an Executive Head. I don't think there's many in Cape Town, but I think, being cognisant of where I come from and my journey, I think it's one of these things that I have to do. I have to plough back and I have to make sure that there's a lot of better Regans that come through the ranks, because we're going to need good people out there, because I think, when it comes to the country's finances, we're going to need innovative thinkers with climate things. We're going to need our visionaries out there and you need the role models that look like you. So it's a bit of a duty and I think in the last year and a few months, I've had a good few job offers. Surprising, because a while goes by and you're in your career but my answer to them is always I have a vision. I have to see it through for the time period that I've set. So it's just something that I think needs to be done.

Dr Maria Christodoulou: 33:58

Does that ever feel like a burden?

Prof Regan Solomons: 34:02

I think sometimes it is because it does obviously influence your decision making and you think of other opportunities that you could have had. Would your kids like to go to school in another country? Would I like my salary to be double? There's obviously things like that, but not that I'm not paid well, but the bottom line is it's a privilege to be in this position and there's a whole province of children and their health that needs to be looked after, and I think there's plans underway for that. That's going to bear fruit down the line. So I think those thoughts outweigh all of the others.

Dr Maria Christodoulou: 34:40

What did it take for someone with your background to reach the position that you're in today and have this role and responsibility? When you say it's a privilege for someone with my background to be the Executive Head of Paediatrics, what did it take, Regan?

Prof Regan Solomons: 34:58

There's obviously lots of people with my background, but that have things like 'black tax', where you have to look after your grandparents, your parents, your siblings, and it's a reality. This needs to be done. I think it's probably one of the reasons why we don't retain enough academic staff that look like me, and it does need a serious consideration. But I think it's taken a long journey to get to that point, even though some people say, Regan, you're quite young. I'm 48 now. My journey at Stellenbosch University started 20 years ago when I entered the registrar program and it's been highs and it's been lows. It's registrar time, fellow time, the time spent reading a PhD, trying to elevate your voice so that you're the voice that can speak on your experience. It takes lots of time and at least I can say there's a few people that look like me that are starting to come through the ranks. Not that all people have to look like me, it's just it's so much nicer and there's so much advantages to having a diverse leadership because you have different worldviews. It just means there's so many options to tackling problems if you have different points of view. to

Prof Regan Solomons: 36:10

What do you think it would have meant to you to ahead and see a professor Professor regan Regan

Prof Regan Solomons: 36:17

I had no such thoughts. When I was a registrar, m y only thoughts were, I'm going to finish. My best friend from school at that stage was a vet in Hong Kong and I was going to go to South-East Asia with him and we were going to backpack for three months. That was my only plan in life, and then the fellowship position came up and I thought no, it's a good opportunity, I have to take this. At that stage I really enjoyed paediatric neurology and just after that I met my wife. So I think there's a reason for everything and I think the journey basically sorted itself out from there.

Prof Regan Solomons: 37:00

At that stage still no thoughts of becoming a Prof, b ut I must say kudos to my previous head, Mariana Kruger, who really kept you on your toes and sometimes explained your journey for you, but she had a very clear vision. W ith clarity, told me what I needed to do and when to get to the next steps, and you totally need a person like that. So I think I knew exactly what I needed to put in. T he type of collaborations, the type of research and output that I had to do, because you have to tick those boxes. There's no transformation Profs. People become Profs because you fulfill the criteria, and it's the same journey for everybody and it's nice to know exactly what you need to do to get to that step.

Dr Maria Christodoulou: 37:39

Right, I remember you telling me that you were surprised when you got the position.

Prof Regan Solomons: 37:45

There were a few candidates I think that I thought more senior than me. So you go in with a little bit of trepidation and thought I'm going to just present myself and had to tell myself I have what it takes to do this job. I'm ready. I do tick all the boxes and it takes a long time to get there because sometimes if you're a little bit self-effacing, you know, am I good enough and you have a little bit of imposter syndrome, but you have to get over that fairly quickly. So I was very shocked when I got called on my birthday, incidentally, in the evening, to say you're the new Executive Head for Paediatrics starting the next year, and I think it's still lots of emotions from that day.

Dr Maria Christodoulou: 38:28

And a year into the role. I asked you this at the beginning, but how are you feeling about the role now?

Prof Regan Solomons: 38:34

The role's challenging. I think I'm surrounded by a fantastic team. They're passionate people. They will sometimes differ with you, but always for the children first and I'll have that team supporting me any day of the week. There's some senior colleagues with lots of experience. Everybody's really brilliant at what they do and some young, up-and-coming colleagues that I can see really is going to make a difference. So I think year-end I have absolutely no concerns there.

Prof Regan Solomons: 39:01

I think the broader concerns is the austerity measures that I think is facing the Department of Health as well as universities. It does place lots of strain on services and colleagues and I hope to get to a space where the visionaries can come to the fore, like in COVID, so that we can address. I mean it's always children and their health first. I nstead of having a conversation about this is the rands and cents that we have available. So let the visionaries do their job and come up with new ways of doing things. It's challenging, I must say. I think the amount of financial challenges is quite huge and is quite stressful. But on the flip side, I'm surrounded by a fantastic team and in the faculty my fellow executive heads are also fantastic human beings and we do make lots of collective decisions.

Dr Maria Christodoulou: 39:53

What is your vision for children's health in this country? What are you hoping we'll head towards?

Prof Regan Solomons: 40:02

I still haven't veered from my vision that I pitched when I interviewed for my job, which is world-class care for the children in our province. I think there's always a temptation with austerity measures to say we can only do what is available, but we have the expertise and will, and there's fantastic colleagues, so why should we not keep world-class care as the focal point for the children in our province? I still haven't veered from that.

Dr Maria Christodoulou: 40:33

I find myself wondering what it's like as a paediatrician to be a parent, because even as a doctor or as a GP, there were often times where I felt completely out of my depth as a parent. And I remember once and I haven't admitted this publicly before, but my daughter fell off the bed. It was one of those moments where they roll and they fall unexpectedly. Until then they haven't rolled yet and you don't expect them to move. And I phoned a hospital. I was a young GP then, I was doing locums in other people's practices. My baby was still quite small and I phoned anonymously a helpline and asked what were the signs that I needed to look out for. Even though I kind of knew, I just wanted to double check and I didn't want to admit to a friend or a colleague that knew me that I had let my baby fall off the bed. So I'm wondering not only as a doctor, but a paediatrician and a paediatric neurologist watching your children grow and develop?

Prof Regan Solomons: 41:25

No, if there's anything medical - So my brother-in-law is a paediatric pulmonologist in private. If there's questions, my wife goes to him. She tells me I don't give her good answers because I think sometimes, being a paediatrician in an academic setting, you really see the sickest of the sick children. So sometimes your answers for a little bit of a scratch and things are a little bit blunt. So I don't do that. I'll play the supportive role. Ice and a little bit of a hug and kiss, and anything serious my brother-in-law has to give advice. I think my wife will agree that's the best policy regarding our kids.

Dr Maria Christodoulou: 42:04

Did you find yourself monitoring their neurological milestones and looking for developmental delays?

Prof Regan Solomons: 42:14

I'd like to say no. I'd be lying through my teeth. So I know when they're supposed to sit and crawl and walk and say words. And a funny story is my son was, I think, a few weeks short of being 18 months and he wasn't walking yet. He was crawling and shuffling and rolling around and my mother-in-law told me you have to take this child to a doctor that sees these things. I had to tell her that would actually be me. But two days before 18 months he just got up, went to fetch his ball that was somewhere else, walked back and then just crawled for another two days and then after that it was fine. But in the back of your mind you try not to do any informal assessments. I don't think my wife would have liked that.

Dr Maria Christodoulou: 42:59

Yes, I can imagine. Sjoe. What would you say are some of the high points of your life?

Prof Regan Solomons: 43:08

I think the high points is getting married and fathering kids and being in the same room when they were born. I think those are definite high points. And then my graduation, especially my doctoral defense in Amsterdam, where I was privileged enough to have my family, my parents and my in-laws and my brother. In Amsterdam, if you defend, it's a very old process and you have 10 minutes to give a layman's talk and then you get asked questions by a panel of people and you go up onto the stage with what you call two paranymphs. So my brother was my paranymph and one of the colleagues from Amsterdam, and we were in full penguin suits with tails and a white undercoat and a white bowtie, all of us.

Prof Regan Solomons: 43:52

And this goes back to medieval times when the academics presented their research because if it didn't agree with the Catholic Church's findings it might end up in a fistfight. So that's where the paranymph comes from. So I did this and at the end of the questioning, it's exactly an hour, and at the end of an hour I think the beadle, in formal attire, will stamp the sceptre on the ground and say ' hora est'. T hat means time is up. T he examiners go deliberate and you're left outside the room and then they congratulate you afterwards. I'll never forget it. The pomp and the ceremony was quite nice and it was lovely having family there with me. A nd then also two younger brothers, seeing them also succeed in their careers and becoming dads and also seeing their whole career progression. Yeah, I think we're always there for each other and I'm very proud of them and my brother and sister-in-law as well, from my wife's side.

Dr Maria Christodoulou: 44:47

Lovely. What about low points?

Prof Regan Solomons: 44:52

Low points. I think my final paediatric exam and I tell this to the students. T hey don't believe me. S o I failed my final exams. Looking back, I don't think I knew what I was doing. I think I was too cocky and went to the exams maybe six months early. It was a low point. And I think it obviously changes your focus afterwards. It does take a while, because at that time the exams is everything. And now it's just a story that I use to encourage the registrars, because I think the academic maturity comes at different times for different people and I think just the weight of expectation also for me. Y ou have this thing that you think is the ultimate thing and sometimes it becomes so overwhelming that you totally and completely mess up. So that was definitely a low point. And then I think I'm still lucky to have my mom, but when my dad passed away because I think we were sort of quite close as a family and the whole family was there when he passed away, so that is an obvious low point. I t wasn't a good time.

Dr Maria Christodoulou: 45:56

I read somewhere that you were also the main sponsor for the Tygerberg Pantry Project. Tell us what that is and how you got involved.

Prof Regan Solomons: 46:08

2014, a few stories came out. Our dear students would faint on the ward rounds because they hadn't eaten, and these were final year medical students. And we had a student at that stage, Omega Okeke, and we started talking about it. So I have sponsored a lot, but I also involved Karin Baatjes, who is the Vice-D ean of Teaching and Learning and who also had really good links with the students, and the students really look up to her, and told her, Karin, h ow can we get this going? So it started with some personal donations from me and my wife and every month we used to go to Makro, buy food stuff and toiletries and things for about two years, until we had two amazing students that really took the pantry project by its horns and took it into the student consciousness. So, with lots of events and people knew what the pantry project was about. So lots of donations, cash and food stuff donations, and the problem hasn't gone away. N ot at all. I think w ith the bursary scheme that students have, sometimes it only pays out later in the year.

Prof Regan Solomons: 47:11

So the first few months are tough for the students and when I heard of this for the first time in 2014, I'm like how can this happen? This cannot happen. A nd I think it's grown from there. We have amazing students involved now. Prof Baatjes is still involved with myself and it's in the awareness of - people know who the pantry project is and each year it's just also amazing to see the student's growth and initiative that they take to help grow this. So ja, it's 10 years old now and took a bit of a dip during the time of Covid when students weren't on site, but it's now getting to a point where we're going to need support and we're going to need to strategise how to support students that are on the decentralised platform. But there's definitely people involved and people willing to help. So it just came from a need and a feeling to say I mean, no, it cannot happen. N ot in your sixth year, not on my watch.

Dr Maria Christodoulou: 48:03

How do you think it went unnoticed for so long, because I imagine 2014 wasn't the first time that we had students hungry on campus.

Prof Regan Solomons: 48:11

I think it's having a student faint on the ward round, because I don't think it's something that you would tell people about in your group and I think the student passing out on the ward round, I think that just crystallised that and then you actually start speaking to people and you get a sense of how extensive the problem is. So the lines are open, people know it's there and it's still an issue. We need to support our students. They're going to be the future doctors, they're going to be the future vision and we want to make sure that all of the things are in place so that these students have the best opportunity to get through their MBChB and go make a difference to the country and their families.

Dr Maria Christodoulou: 48:52

I'm just thinking that there might be people listening who don't know about the project and I'm happy to share the link for donations and things at the bottom of the podcast info, so I will do that. But maybe let's just explain to people what the pantry project actually does. So you donated food and toiletries and things like that, and now there's an established pantry where students can go.

Prof Regan Solomons: 49:10

There's outside students, they have societies and then all the different residences have pantries so students can go to the pantries and anonymously get some starches and things that they would need to eat. And regularly we also try and find out what the big needs are at the moment, because it does differ depending on the time of the year, and I think for March and April we just did vouchers from the student centre, just to make sure that students can get these vouchers anonymously, because it's not - I mean, I don't think you want to make people's identity known, but if you just go to the same place where all the other students go to eat, that's an option. I'd love for it to grow to a point where it's just there and we don't have to worry about donations and things. It's a never-ending project. I t's not a business. I t's not profitable. You have to dispense what we have because the reason the pantry project is there is to ensure there's no food and hygiene product insecurity for our undergraduate students.

Dr Maria Christodoulou: 50:09

Gosh Regan. I think it's an amazing project and I think, ja, I really just want to honour and appreciate you for getting involved and for not just being aware of the problem but actually doing something really practical. F or you and your wife to go shopping and buy food and buy toiletries and donate them to the students. It's quite something.

Prof Regan Solomons: 50:29

I had to get my wife involved. She's much more organised than I am. It was quite nice and you go around and obviously you have to go to places and get the best price and get some things, and I think it's just your social impact you do and y ou don't see it as a duty. Not even a paying back. I t's just, it's something that needs to be done.

Dr Maria Christodoulou: 50:54

I think that's testimony to who you are and your character.

Prof Regan Solomons: 50:57

I think I was just at the right time with the right student. But I don't think it's something that you can just ignore and say no to, because it's one of these things that just gnaw at you and this cannot be right. So I think it's become a doctor-led initiative to a student initiative. Just the types of students over the years. It's really fantastic to see them actually running this. R unning drives, and Karin Baatjes being the wise heads to give advice but sort of really getting the student body involved. I think that's also a leadership, mentorship role, but it's nice to see the growth.

Dr Maria Christodoulou: 51:32

In the same place where I read about your involvement in the Pantry Project, I read that you have a life quote that you live by, and I'm not sure you will know in this moment which quote that is, but it had something to do with dragons.

Prof Regan Solomons: 51:47

I can't actually remember the quote. You can read it to me. It's from a Rwandan author, but I just found it was absolutely profound. But you can read it back to me please.

Dr Maria Christodoulou: 51:59

So the quote goes, Did you know you could destroy dragons? Dragons are not actually real. They just roar to scare you from your goals. In fact, they are afraid of determined heroes. They take flight at their approach.

Prof Regan Solomons: 52:15

Somebody eloquently put down, I think, what you face and there's a little bit of the imposter syndrome built into there, and the dragons are just noise or just your own voice telling you no, you can't do this. And if you do ignore it, you're singular in your purpose and you know what needs to be done then you have to go out and do it.

Dr Maria Christodoulou: 52:37

What helps you to be a determined hero?

Prof Regan Solomons: 52:41

Having a supportive structure outside of work and having a soundboard at home, being able to tell Gailyn what's bothering me and I think it's so nice to have a non-medic, because we can speak to each other about each others careers and it's often about the people, but it's nice to have a soundboard and just having really humorous moments with my kids, because your journey is your journey at work and you have to have a purpose. But that work-life balance is so important. If you don't have a balance, I don't think you can be a balanced leader i f you miss the big picture. E very little jigsaw puzzle has to be in place and if one's missing the big picture is not complete.

Dr Maria Christodoulou: 53:20

So what are some of the dragons you've stared down?

Prof Regan Solomons: 53:24

Sometimes there's internal dragons and there's external dragons. So the internal dragons, am I doing this the right way? Am I really meant to be here? Why am I doing this? And you have to constantly stare them down. I am in the right place and at the right time. And then the external dragons is just establishing yourself as a specialist and academic and getting your voice heard. So I think in meetings, I think I tend to be reserved and I'm not going to shout, but I'm still going to say no, no, this is what I actually want to say and just have to say there's no - who're you going to be scared of? It's only yourself. A nd I think if there's something important to say, and it's a lot easier to do it if you're doing this on behalf of the kids and you're doing this on behalf of your colleagues especially, and obviously for yourself, but there's just certain things that you need to say and I think those dragons are in the early part of the journey, when sometimes you think, you know, maybe

Prof Regan Solomons: 54:21

I should have said this or the opportunity didn't present itself. I mean, that's absolutely nonsense. If there's something to say, you get to the person and it needs to be out there because there's a purpose in mind.

Dr Maria Christodoulou: 54:36

Anything we haven't talked about that you want to share.

Prof Regan Solomons: 54:41

Growing up as a kid. I'll never forget my dad. We were in Worcester and we went to - my dad parked and said myself and my brother can get ice creams, and we were, not so politely, asked, at the age of seven and four, to go to the back entrance where we could still get our ice cream, but this wasn't the entrance to be used. I do remember it, and another opportunity when I was, I think I was in high school already, where we were at, I think, one of these holiday resorts and went to a table and sat down and this elderly man of a certain prehistoric South African town came to sit there and told us to leave because he wants to sit there with his family. And I remember my dad sitting there, blunt, and adding a little bit of colourful words what would happen if he doesn't leave there.

Prof Regan Solomons: 55:35

So just things like that does make a difference. Why I do remember it? Because on the flip side, the bulk of encounters and people, absolutely fantastic people that you've met along the way, that really make those encounters nonsensical and you are thinking that cannot happen. I think we've moved on as a country. We're not in that space anymore. I'm not quite sure if everybody's moved on in their minds, but I think it's just one of these things that I will always remember and I'm so glad that my kids are never going to have to go through that sort of thing. It must have been so much worse for my parents and the previous generation.

Dr Maria Christodoulou: 56:12

Gosh sorry that happened to you, Regan. Those are horrible experiences.

Prof Regan Solomons: 56:17

When you're seven years old, you don't quite know what to make of it. You don't know how to react. Somewhere deep down you know that's wrong, but you just wanted your ice cream and so patently wrong and I'm so glad that we've moved on. Obviously, as a country, there's so many challenges, but we're really in a different space when it comes to interacting with people and worldview than we were. But obviously lots of work still to be done.

Prof Regan Solomons: 56:43

It's not like it's all a rosy picture, but I think it's a work in progress so that those sort of things don't happen. And those are just stories, I remember. I mean there's a lot worse for other people growing up where it's very blatant or some that are still very blatant, and that's wrong.

Dr Maria Christodoulou: 57:01

And I know that those experiences are not limited to your childhood. I think you've had some even in this last year of leadership, some of those much more subtle, much less easy to label prejudice.

Prof Regan Solomons: 57:18

I think you do encounter - when you get suggested to make certain decisions, you do realise, what's going on here? I mean, this is not right and it's really subtle things and it's not something that's overt. But at that stage you wonder, is it because I'm a black head of department? Is it because I'm a young head of department? What's going on here? I must say, looking back now, a year later, I think I'm in a different space. I think also a little bit more assertive, and I think it's also to realise those for what it is and it's a potential to undermine and, I think, just to be really fixed with your vision and not to sway with your vision, while still being approachable, and a listener and taking the team forward.

Dr Maria Christodoulou: 58:03

I imagine that it's also quite hard to have ticked all the academic boxes - fellowships and PhDs and research and publications and then to still have people measure you based on those other criteria. R ace and ethnicity, and age.

Prof Regan Solomons: 58:21

Something that shouldn't happen obviously. You tick these boxes and I must say it's one of the things that I often think of and in some respects, there's obviously still a legacy of apartheid. People think in a certain way and people think about themselves in a certain way, as to what your boundaries and what your ceilings are, and it shouldn't be. I think it's the work and the journey and the type of person you are, and also having ticked the boxes. Those are the things that should count and you should be measured by things that you said you were going to do and the things that maybe you promised and you didn't do. That's the measurement of leadership. It shouldn't be anything else.

Dr Maria Christodoulou: 59:01

A couple of times in telling your story, you've told me about moments where you thought you were going to do this, whether it was taking three months to go backpacking in Southeast Asia, or you weren't going to do paediatrics, or you weren't going to do - and yet the thing that was offered to you was not something you thought you wanted and you ended up doing it and it turned out to be the right thing.

Prof Regan Solomons: 59:30

I call it the career magnet. No, it's sometimes fate has - already your journey is set up. How you get there sometimes takes a different road and a bit of a different time. I think, looking back, in my career as a paediatric neurologist, I was completely in the right place. I like problem solving. I absolutely loved it, even though I didn't choose it right at the beginning. I was in the right place and sometimes experiences and mentors and patients you see, do impact your journey. But I feel you always end up in the place that you're supposed to be and I would have been a horrible surgeon or radiologist.

Dr Maria Christodoulou: 1:00:06

What makes you say that? Why would you have been a horrible surgeon?

Prof Regan Solomons: 1:00:09

No, I think I really like working with the kids and I like the process. I think if you end up in a place that maybe you thought was the career for you and ends up not being so, I don't think you'll quite be in your happy space. You have to be happy in your career. It mustn't be your hobby. It certainly must be something that you tell other people what you do with absolute joy. I think that's the point that you should get to.

Dr Maria Christodoulou: 1:00:36

So when I finished my internship I did a six-month rotation through paediatrics as a Medical Officer and it was a little bit of a baptism by fire because they threw me into what was then Ward J2, which was all the babies who were born under 2,000 grams, and I remember having to stick needles in their little feet and draw blood and it was just. It was really traumatic. At the slightest shift in temperature or whatever, they would get really sick and need surgeries. And then later, when I was working in the ward, it was at the time when we had quite a lot of HIV positive babies in the ward. I remember two patients in particular. One was a little girl whose parents came from a rural area and she'd been in the hospital for six or nine months and she had AIDS and no one was visiting her because the family didn't have the means to come to the hospital and everyone was scared to touch her. You know you had to put gloves on.

Dr Maria Christodoulou: 1:01:23

It was in the days before we fully understood HIV transmission and how to protect ourselves, and I remember holding this child and being the only person who would go in there and hug her. But it was more about me taking care of my own inability to deal with what she was going through, Like I was creating all sorts of stories about her suffering and some of them probably true, but just it was so hard for me to witness that suffering. And then later there was a child who was about 11 who was a diabetic and similar story, parents from rural area. She'd been in the wards, a newly diagnosed diabetic and took some time to regulate her diabetes and I ended up bringing her home with me for a weekend so that she could get out of the ward. How do you work with children who are suffering on a daily basis and or be responsible for taking care of large numbers of children as the head of a department? How do you stay positive and hopeful and optimistic?

Prof Regan Solomons: 1:02:21

I don't think there is a choice not to. It's hard.

Prof Regan Solomons: 1:02:31

In the beginng of my career I struggled because I mean you would lose children and go through all sorts of self-inflicted inquests as to what should have been done differently, and you bring those sorts of things home with you and I think especially with neurology it's really nice to share good news, but often you have to share bad news and I think the way I dealt with it is just trying to think, put myself in those parent's shoes, and they want all the information.

Prof Regan Solomons: 1:02:57

You cannot withhold and sometimes you have to be a little bit - not blunt, not rude but just give all the information and you need to repeat it a few times. But it's hard, it's not pleasant. I mean, these children, especially once I became a dad. I mean it does hit you. That's why I think the onus is on us. We must try and do the best as we can for the children. It's hard to see children suffer. I don't know if there's any sort of way. If you say no, it doesn't touch me, then maybe you're in the wrong career. It's the one thing that I think should drive the vision of the department. Especially when there's preventable causes of suffering due to social determinants, we must be absolutely relentless in our research efforts to go and figure out those, and figure out ways to prevent all these unnecessary presentations. I think it's the one thing that does drive researchers as well. You were telling me about the kid with AIDS.

Prof Regan Solomons: 1:03:51

When I got my PhD, one of the students, my fellow students, was a year below me at university. We had a child that passed away of TB meningitis and he said he can remember I was wiping the tears out of my eyes. I can't remember that well, but that and another story. It's a little bit of serendipitous that I ended up becoming a TBM, or making TB meningitis the focus of my research. Last year I spent time just looking at my family genealogy because I decided this is nonsense, I cannot only know my grandparents' names. I'm going to make a concerted effort so that my kids know where they're from.

Prof Regan Solomons: 1:04:29

My Mom has a photo of when she was eight years old and her little sister was five, and told me h er name was Joan and she passed away early. She was in a wheelchair. A nd I actually traced her death certificate and on the death certificate, her cause of death was TB meningitis. So ja, that it's a bit of a note that brings it. I mean it's absolutely serendipitous. How I ended up, obviously with lots of mentors along the way, but choosing that disease that still affects so many children in our setting, still having that on their death certificate, I'm choosing that as a career. S o I think that's going to still drive me. I mean there's so much things to do because we can't be in the same place 70-something years later and kids still have a preventable disease on their death certificate. I mean that cannot happen.

Dr Maria Christodoulou: 1:05:27

What a story. I often talk about how the lineage and the legacy of that lineage expresses itself through us, and that there's no coincidence that you choose TB meningitis as your field of study, c oming from that background. Maybe we should just honour Joan - what was her name? Her full name?

Prof Regan Solomons: 1:05:42

Joan, Elizabeth Africa. My mum was child number six. Joan was number seven out of 11 children and she's the only one that passed away during childhood. Still, obviously, my mum can definitely remember and it's a disease that's completely eradicated in resource-rich countries. It's a disease of poverty. I call it what it is, and we cannot still have that happening so ja, thanks for that memory of Joan.

Dr Maria Christodoulou: 1:06:11

What are the stats in South Africa? Do you know at the moment?

Prof Regan Solomons: 1:06:14

It's getting worse.

Prof Regan Solomons: 1:06:17

So at Tygerberg Hospital we still admit 40 to 60 children a year with TB meningitis. Just before Covid it went up to 100 and we have of the highest prevalence of TB in the world in the area surrounding Tygerberg, the Ravensmead area. But I mean our children with TB meningitis do come from across the province.

Prof Regan Solomons: 1:06:37

You say it's a disease that's completely eradicated in the global north. Call it what it is. It's a disease where people have no food and where the shelter is poor. That is what causes it and I think it's a focus point and it's being researched, all the multiple facets of it, because it's a horrible disease we shouldn't be seeing, but unfortunately I mean that's how I ended up with TB meningitis as a research career. Basically because of my two mentors, J ohan Schoeman and Ronald van Toorn, who had established a big footprint in TB meningitis research. B ut we had the patients that nobody saw in those numbers elsewhere in the world in children.

Prof Regan Solomons: 1:07:17

It also starts with what they call the social vaccine, which is food, together with obviously lots of other things.

Dr Maria Christodoulou: 1:07:28

I feel this overwhelming welling of emotion in my heart when I listen to you and I can feel almost the pain of the suffering of that situation and the things you are witnessing, and the incredible heart with which you hold it all and your deep commitment to being part of the solution and a lifetime, certainly a career, invested in making a difference in these communities that are underserved and under-resourced, and I almost feel this compulsion to say thank you. T hank you, Regan, thank you for the work that you do in the world.

Prof Regan Solomons: 1:08:02

I'm part of a team and there's - luckily, there's so many people like me out there trying to do their bit to make a difference. I think my specific role is coordinating that next generation of doctors that see patients and ask questions. Why is this h orrible things happening? And you go do research and you tell people what you find and you go and find a cure or a prevention for these diseases. If there's one thing that I do besides for putting the children and their health first, it's facilitating that next generation of visionaries and leaders to come through. There's fantastic people and fantastic people drawn to a and child health. Everybody wanting to make a difference, and sometimes we need a little bit of a mentor voice and an enabling voice, but we need an army of such people with the problems we're facing. But ja, you start one by one.

Dr Maria Christodoulou: 1:09:00

So, on that note, what advice would you have for a young person who's thinking about studying medicine?

Prof Regan Solomons: 1:09:08

My advice would be if you're going to embark on a career or planning to study, you must really want to do it. It's not a fashion statement. Don't think you're going to become a gazillionaire practicing medicine. Get those thoughts out of your head. You're here because you're bright and you want to make a difference for patients. And I would also tell them there's such fantastic career options. You can see patients, but you can become a teacher. You can study teaching of medical students, you can do research. There's admin, there's management. There's so many different facets of medicine, so there's really a place for every sort of personality. But you must have a passion for medicine if you want to embark on a career.

Dr Maria Christodoulou: 1:09:51

Anything you regret looking back?

Prof Regan Solomons: 1:09:56

No regrets, no regrets. I think obviously there's decisions along the way. There's good ones and sometimes you make bad decisions, but I think it's part of the journey where you meant to get to. As long as you don't make bad decisions purposefully, I think, on reflection, your decisions do evolve, sometimes a little bit more information, but no regrets. I think once you make a plan, you do have to go for it.

Dr Maria Christodoulou: 1:10:21

So what are you hoping is next for you? Not j ust as a Professor of Paediatrics, but as a man, what does the future hold?

Prof Regan Solomons: 1:10:32

First as my wife will say, there's always room for improvement as a husband. So I would start there. I mean, my children are still in prep school. A lso to see their journey and provide them all the support so that they can end up in their desired choice of study and career.

Prof Regan Solomons: 1:10:50

And I think as a man staying in the same community as I grew up in, having the opportunity to plough back as well, and see if we can get some fruit from some hard ground. And next step in my career journey, we'll see where it takes me. I think I've always thrown - I've experienced different facets of the Department of Health and the university and the broader paediatric structures in the country and research globally. So we'll see where the journey goes, but I'm always the one that - sometimes with regrets - always said yes for opportunities, but it's always learning opportunities and we'll see where the journey goes. No specific plans. My journey is that - at least the five-year vision and mission in paediatrics and it should really be longer than that.

Dr Maria Christodoulou: 1:11:43

Right. I imagine that career magnet may play a part in directing this next stage.

Prof Regan Solomons: 1:11:48

Ja, it does. Sometimes opportunities do open up. M aybe some aspects that you thought you never were going to. You didn't even think about it. But I think, if I can give advice to myself from outsiders, throw yourself in and be open to new opportunities and see what comes from it.

Dr Maria Christodoulou: 1:12:07

Beautiful. Thank you. A nything you'd like to ask, Amy?

Prof Regan Solomons: 1:12:15

I went for a TB meningitis congress to Vietnam. It was absolutely fantastic, and so in my second year of reg studies I went to visit my friend who, at that stage, was in Hong Kong, and we went to Thailand as well. Two young guys in Southeast Asia. I can't tell any stories, but I would love to go again. It's just a culture that's so totally different to ours, with amazing food. I think I'm a little bit too old for backpacking now, but the travel bug is still there and wanting to see new things. But I think at this stage it's to share it with my family. For three months with a backpack maybe not, maybe a little bit shorter and with a trolley case would be a little bit better.

Amy Kaye: 1:12:59

Older and wiser travelling. It's so interesting with these conversations because I never know who the guest is going to be and I like to come in completely blind. And then I start listening to your story and then there are all these random things that pop up and I'm like wait, and it's so strange. There's always these parallel lines, the connection between Worcester. My family's from Worcester. The dragon. D ragons are very important to me. Then, at one point, I swear to you I'm not making this up, I kept thinking about ice cream and then you started telling your ice cream story and I was like what is going on? And it's like the more you talk, the more I kind of - it just starts - something happens. It's quite phenomenal.

Amy Kaye: 1:13:41

And I just want to say thank you for the amazing work that you're doing. Thank you for all the families that you have helped heal, the children's lives that you have changed, the families - just telling that story about that child whose family you checked up in every six months and the mother brought you the watch. You're clearly having an incredible impact on people's lives and there are going to be so many people that are going to enjoy hearing a little bit about who you are and the essence of who you are, and I just want to say it really was phenomenal hearing your story today, and I'm very, very grateful that I was allowed to be part of this, so thank you.

Prof Regan Solomons: 1:14:16

I'm glad. Maria knows from the coaching sessions. I think, see where the conversation goes and flows, and I like the unstructured nature of the - and Maria's good. She always gets you to tell - you think you're on safe ground and we're just covering, and then "you have to say stuff that you know is deep, but has to be done.

Dr Maria Christodoulou: 1:14:38

Thank you for trusting me.

Prof Regan Solomons: 1:14:42

Ja no. All I can say is, at least for my brother-in-law and from Karin Baatjes, they've had fantastic experiences with you and I'm glad they followed my recommendation. I told them, i t's gonna be hard because she's going to make you ask those questions that you know are crap and you're going to have to answer them. So, don't go there expecting -really, i t's for a purpose, to get to a certain place. So thank you.

Dr Maria Christodoulou: 1:15:07

I never take it for granted that people trust me with their stories. It's always a privilege.

Dr Maria Christodoulou: 1:15:12

And sometimes I think people hear me use the word privilege a lot and they probably think I just say it, but I really - for me, the work that I do is a huge privilege, Having people like yourself in senior positions dealing with really important issues, t rust me to hold a space for you to think about what's going on and how to be more efficient or more effective or how to be more centred in what matters, is - I can't really describe what it means, and it was such a privilege to work with you, Regan, and to share your story today.

Dr Maria Christodoulou: 1:15:43

I think that I've said to you before one of the reasons and I say this almost every time, but one of the reasons I wanted to do this podcast was that in those private, confidential coaching spaces, I was getting to know my colleagues in ways that I felt the public never got to know people. And when one hears the words Professor Regan Solomons, Executive Head of Paediatrics at Stellenbosch University, it conjures up these images that often have very little to do with the reality of the man who's sitting there in that role, and I feel like your humility today, your huge, warm, generous heart, your commitment to matters of social justice. That's exactly what I want people to understand. Again, w e have this idea of academia, we have this idea of research and big pharma and public perceptions of what that's all about, and actually behind it are people like yourself with this enormous heart and this enormous commitment to making a difference in the world.

Prof Regan Solomons: 1:16:39

It's that Prof Regan Solomons. Even, s ometimes I don't know what that is, because it's just your role at work and whatever journey I think brings you towards that, which includes where you come from, and I'm glad that I can bring a little bit of this, hopefully something new, to the role and make a difference.

Dr Maria Christodoulou: 1:16:59

What are you taking away from today's conversation?

Prof Regan Solomons: 1:17:02

I'm actually thinking back to that first contact session that we had and I can see the growth from then to now. It's been 16 months in the role and there's definitely some growth and, I think, a lot more of a willingness. I think my vision is still as clear in my head but I think still hopefully answering things succinctly, things that should be answered, or having thought about these already and having a plan. I think that's what I'll take away. I think that first contact, you're a little bit apprehensive in the job. I can see there is a teeny, weeny little bit of growth from then to now, so I'll take that out of it.

Dr Maria Christodoulou: 1:17:39

Fantastic and I'm struck by how, so often, when people look at how you got to this place in your career, they're looking at the checkpoints academically. You did this, and then you did this, and then you did this, and it's always the thing that qualifies you to be the Head of Paediatrics is this academic journey. And actually, as I listen to you, I'm thinking the thing that qualifies you to be the Head of Paediatrics at Tygerberg is your heart, is your integrity, is your vision, is your leadership skills. T his generosity of spirit and this commitment - to use your words - to ploughing back.

Prof Regan Solomons: 1:18:17

That's the one thing you like - You have to have all these boxes ticked and your CV has to be perfect to apply for this job, but what really helps you once you're in the job is actually none of - not, none of it. It does get used to a certain point, but it's how you deal with people, and are you resilient and are you agile? Can you listen to people and can you speak and be firm at the right time? But it's always a singular purpose. You must know why you're in the job, and it's never for yourself. There's always a bigger purpose.

Dr Maria Christodoulou: 1:18:53

Well, and you said earlier that it's a privilege for someone from your background to be in this position, and I almost want to say that that's the legacy of internalised oppression, because I think that actually your legacy, that grandmother who worked as a domestic worker and bought a book on lay-by because she knew you wanted to go to medical school. That father who rode a bicycle to work every day so that you could have access to the car to drive to the settings where you needed to do your training. That aunt who died of TB meningitis. The upbringing in those underserved communities in South Africa. Your experiences as a coloured man. T hose are the things that make you the best person for this job now, Regan.

Prof Regan Solomons: 1:19:47

Those lived experiences and that worldview puts you in a very unique place to understand people's challenges and also the academic challenges. A ll those things, b ecause you tick those boxes. I come, hopefully, with a broad view of things and sometimes all those determinants outside of what you see. I do tend to think about those things a lot. I must just end off with a note. I went to - three weeks ago I spoke at my old high school.

Prof Regan Solomons: 1:20:10

So, a few of the matriculants, I think, that finished - it was seven years after me - they organised a career day and al so a motivation session to the matriculants, and I could only come for an hour because it was a Monday morning, and Monday morning in my job there's lots of things to do. But they asked me to give a 20-minute talk. The principal of the school is a lovely lady, a Mrs. Basson, and she said the overwhelming factors at the school is food insecurity. So when they do have study sessions all the matriculants are coming but they have to organise soup, bread and those things. So I had prepped in my mind a talk that I was going to give and then I thought I'll speak about something else and then I just ad-libbed.

Prof Regan Solomons: 1:20:53

All I saw in front of me were matriculants really ready to go make a difference for their families and sticking the course. And they were there. They were present despite all those other things, and it was just a wow moment for me just to try and motivate and show the matriculants from my old school that, yes, it can be done. And there were a whole panel with people that have made a success in different careers. Yes, this can be done. And we're from this school and we're from this community. But I didn't see single parent households or grandmother- led. All I saw was guys sitting there with a singular purpose. They're going to ace this year's matric exams and then they're going to enter and they're ready for their plan to make a difference. And that was quite encouraging.

Prof Regan Solomons: 1:21:44

I'm sure it was wonderful for them and inspiring for them to see and hear from you too. Yeah, myself and the other panelists, I think at that old school you tell them there was a professor and I'm not the only professor that came from the school. I know another professor in anthropology, but professors can come from the school, and sportsmen, and I think there's a radio DJ and there's no reason why you can't go into your chosen career with all those barriers that you face. I think things aren't going to go hunky-dory. I mean that's a given, but you have to stay the course. It was nice and I actually want to see how we can formalise this, climb back to the school, maybe strategise a little bit, how we can make this a little bit broader than just speaking at the career day. So, quite keen to do that. I've thought about it a little bit.

Dr Maria Christodoulou: 1:22:29

I have no doubt you will make a contribution, and probably quite a significant one, thank you. Thank you so much, Regan, for your time, for your presence, for who you are as a man in the world. Really, it's a privilege to know you.

Dr Maria Christodoulou: 1:22:44

I'm Dr Maria Christodoulou and you've been listening to the Awakening Doctor podcast. If you enjoyed this conversation, please share it with your friends, follow Awakening Doctor on Instagram, Facebook and Spotify and go to Apple Podcasts to subscribe, rate and give us a good review. Thank you so much for listening.