On Callings and Being Mission-Driven

It’s been dawning on me recently that finding a calling is not the same thing as living a fulfilling life.

Over the past few weeks, I’ve had conversations with:

• Mission-Driven Founders who are pursuing meaningful work but feel burnt out and isolated
• Executive Directors who are servant leaders but feel like they put themselves last for the sake of “empowering others”
• Doctors who are pursuing a calling and yet feel like every other part of their life is being crowded out to serve patients
• Coaches who are scheduled every hour (talking about “possibility” and “transformation”) while they themselves have created another 9-5

To some extent, this is normalized.?

The mantra I would hear in both Silicon Valley and medical school is “If you are going to pursue something as big as a calling, you’ve got to say goodbye to your friends, work through your weekends, and schedule time with your kids/spouse”.

But does it have to be that way?

I was intrigued recently by this article in the New England Journal of Medicine (the NEJM for you folk in medicine) by Lisa Rosenbaum titled: “On Calling — From Privileged Professionals to Cogs of Capitalism? ”

Her basic premise is that callings are often co-opted by the powers that be (VCs, hospitals etc) to drive mission-driven individuals to work harder, for less pay all in service of the mission.

And that this is a basic disguise of late-stage capitalism to extract more from individuals without acknowledging that those systems do not truly care about mission-driven outcomes and are more focused on generating greater revenue at a lower cost.

This is dark but not necessarily inaccurate.?

Healthcare, for example, has become more consolidated within larger hospital networks and more focused on metrics like RVUs (a proxy for how many patients you are seeing per unit of time). Physician burnout is at an all time high and by most macroeconomic analysis, the quality of health outcomes has decreased over time in the United States (also linked below).

So it doesn’t seem that pursuing a calling often amounts to either fulfillment individually or better outcomes systemically.

So what gives?

I’ve seen many critiques of the ways institutions need to change in order to fuel a healthier ecosystem. And while I agree with many of them, those views seem incomplete because they ignore what agency exists within individuals.

This could be critiqued as hyper-capitalistic to focus on what the individual needs to do. But to put all our focus and frustration towards systems (that have incentives to not change) seems to also operate in bad faith and defer any responsibility we as individuals have in creating the experience we are having.

When I entered medical school, I wanted to test the hypothesis: Could I operate in this institution while not subjecting myself to the overworking burnout culture that was pervasive everywhere I looked?

What I noticed over the last 4 years is that I have tendencies—even addictions—to overwork, people please, and avoid the feeling of boredom at all cost.?

I had to get support from my coach, small group, inspiring friends and colleagues to separate demanding requirements of my job from my own desire to feel productive (even when I wasn’t getting that much done :)

I started taking whole days away from work every week. I said no to commitments I felt lukewarm about to create space for me to discover what I was genuinely excited about. I made requests to others to create workable structures to create a better experience for both myself and patients. I made room for creative expression and unstructured time to just enjoy life and get connected to my inspiration.

What were the results of that support:

• Went through medical school and didn’t experience burnout
• Got more done—with better outcomes—in less time
• Scored higher than my peers on my medical boards
• Discovered a niche and was able to find leadership opportunities beyond my current clinical training
• Delivered a main-stage TED talk integrating different aspects of my identity

Early on, when I was testing this approach, I would hear sarcastic comments from peers saying something like “that must be so nice that you are taking a day off.”

I found that odd.?

There was nothing unique about my situation. I could, however, feel in their sarcasm (read: despair), however, an unwillingness to admit their own role in creating their exhaustion.?

Will those old habits go away on their own??

In my experience, no.?

Achieving some status (becoming an attending, selling your company, making X amount of money) will not magically make old habits go away.

What’s more likely is that the mindsets that got us to this place are unlikely to take us further. It requires support to transform, break through old habits, and experience the fulfillment that we thought pursuing our calling was going to provide for us.

My name is Fayzan Rab. I am a child of immigrants, executive coach, and future physician.

I help leaders live the highest and fullest expression of their purpose and enjoy it! If that’s you (or someone you know), let’s chat.