The following is an excerpt from my new memoir The Anatomy of a Calling. The Anatomy of a Calling is about finding and fulfilling your calling, using Joseph Campbell’s hero’s journey as a map for what happens in between the moment when you hear The Call to Adventure and when you finally bring the Holy Grail home to your people who need it. This excerpt describes a particularly painful part of my hero’s journey and demonstrates what happens when we start to veer out of alignment with the integrity of the soul.

I received the letter from my patient Fiona in my box at the office after a long night of delivering babies, when I had almost no reserve left. In her letter, Fiona explained that after she and her husband fought for the bazillionth time about the fact that they hadn’t had sex in over a year, he threatened to leave her if she didn’t go see a gynecologist to figure out what was wrong. Because my schedule was so packed, she waited two months to see me, praying I might have some magical solution that would save her marriage. I had taken care of her a few years back, and her recollection of me was that I was approachable, tender, funny, compassionate, and honest. She felt she could trust me.

In her letter, Fiona explained that on the morning of her appointment, she showered, trimmed her pubic hair, and spritzed on her favorite perfume. She donned her laciest lingerie and wore her favorite dress. When she arrived at my office, she stood in line behind four other people signing in at the front desk and took her seat with the other twenty women in the waiting room. She waited for over an hour, and long past her appointment time, my medical assistant finally put her in a room, where she was ordered to undress and left alone in a chilly room wearing nothing more than a paper gown for twenty minutes. By that time, feeling cold and uncomfortably vulnerable, she started to cry.

Apparently, as she described in her letter, I didn’t acknowledge the tears or even apologize for the wait when I finally came in. Fiona wrote that I looked tired. My hair was up in a ponytail, my eyes were puffy and weary, and I wasn’t wearing any makeup.  I wore my white coat over my wrinkled green surgical scrubs, stretched over my pregnant belly.

She wrote that I made small talk with her as I filled out some papers and got ready to perform her annual exam, but when I asked her if she was having any problems, Fiona hesitated. I stood with my back to her, not making eye contact. Because I was so distracted, she didn’t feel safe to share with me the uncomfortable story of her failing sex life. So she decided to keep her mouth shut. I performed her Pap smear, refilled her prescriptions, and left her alone in the room, kicking herself.

When Fiona got home, she took off her finest dress and put away her lacy lingerie. It took her months to get brave enough to make an appointment with another doctor, but she had found a good one, who didn’t accept managed care insurance plans and no longer practiced obstetrics, so the doctor had been able to spend a whole hour with her. Her doctor was helping her to improve her hormone balance and getting her off antidepressants, and she and her husband were in therapy together.

She wrote that she didn’t intend to judge me or shame me. She was raised to believe that you treat doctors with respect and don’t question their advice or their behavior. But she was so hurt by the encounter, so disappointed in my actions, that she felt like she wanted me to know, just in case it helped other patients. She wished me well and congratulated me on my pregnancy and expressed compassion for how busy she knew I was. She signed it, “I believe you’re still in there. Love, Fiona.”

I wept when I read Fiona’s letter. The worst part was that I didn’t even remember the encounter, and I couldn’t conjure up an image of her face. Fiona was just another faceless, nameless number on the medical assembly line of my practice.

What was happening to me? How had I let myself get so busy that I failed to notice that a patient of mine had been crying? I was called to medicine to be a healer. I was the “squirrel girl,” after all. But what kind of healer leaves a crying, naked woman with a health concern feeling the way Fiona did? When had I stopped caring?

When I called Fiona at home to apologize after reading her letter, she thanked me for the phone call. She told me not to worry or feel badly. I felt unspeakably ashamed.


When I was done with work, still stinging from Fiona’s letter and the grueling night shift I had just finished, I stopped by the grocery store. The only thing that was keeping me from my well-deserved bed was a pimply, teenage kid who couldn’t seem to get my groceries scanned. I stood there for what felt like an hour, spent, hungry, and disappointed in myself. The kid’s face was flushed and his brow was starting to sweat, and I could see him looking helplessly at the other clerks, who were all scanning and swiping with ease.

Then I heard myself say something I still can’t believe came out of me.

“If I did my job the way you did your job, there would be dead people everywhere.”

Really. I actually said that.

On my way home from the grocery store, a squirrel darted out in front of my car, and I felt my car thump over it. I thought about stopping, checking on the squirrel to see if there was any way I could save it. But I just kept driving, anesthetized and depleted, without even looking back in my rear view mirror.

I couldn’t sleep that night, in spite of my exhaustion. I kept tossing from side to side like a tuna, my back hurting, feeling my baby kick my ribs. I thought about my father’s cancer. I thought about letting down Fiona and being mean to that poor kid. And the squirrel. The squirrel. Something felt squashed in my chest, like a vice was clenching my heart.  Tears would have felt welcome. They would have reminded me I was still alive. But they never came. I felt an uprising of pain but like a shaken Coke bottle with the top still on, the pain had nowhere to go.

It was the first time I’ve ever thought about suicide.

Just when I started thinking about how I would prefer to die if I killed myself, my baby kicked me, and I remembered that if I killed myself, I’d be killing not just me, but my little girl.

Oh my God. I couldn’t even manage to kill myself.

I felt a tornado of fury funnel up in me. I looked around for something to break—a plate or a vase maybe. But just as I was spinning in circles, finding nothing, I heard a voice.

A gentle, loving whisper said, “Darling, they’re about to break you. You have to quit your job.”

The moments that followed bathed me with what I can only describe as a flood of unconditional love unlike anything I had ever experienced, a waterfall of grace rushing over me and through me, filling my heart and body and mind with hope and peace. I felt my whole nervous system relax. My mind became silent and I felt myself pop outside of my body until I was no longer Lissa; I was the burst-open consciousness witnessing Lissa in her pain with unbridled love, compassion, and tenderness. In that moment, the very idea that life could be painful felt almost absurd. Looking down on myself, I saw myself laughing out loud like a crazy person. Perhaps this is what it looked like to lose your mind, but if that’s what it felt like to become insane, I didn’t have any desire to return to the pain of sanity. I felt weightless, untethered, as if I could be everywhere at once and also nowhere at all, at home in the vast expanse of nothingness that felt, instead of empty, uncommonly full. The idea of suicide suddenly felt ludicrous.

I felt as if I was ballooning all the way out of my body, growing bigger than the bed my body was still lying on, expanding bigger than the bedroom, bigger than the house, bigger even than San Diego itself, as if I was exploding into the atmosphere and beyond, becoming starlight itself, pure weightless, timeless joy and aliveness, glancing back at the earth with unspeakable awe.

Wow. This is awesome . . .

But then, as quickly as I had popped into this ecstatic state of consciousness, I flipped out of it. Jolted back into my body, I felt accosted by another voice, a cruel, judging voice that said “What are you talking about? You can’t quit your job! You’re about to have a baby. You have a mortgage. Plus, you spent twelve years sacrificing everything so you could be a doctor. You’d be stupid and reckless if you left your job. And what would everybody think? Doctors don’t just quit their jobs, especially when they have medical school debt and responsibilities. Not to mention that your dying father would be so disappointed in you. Don’t be silly. You have a great job. You have a terrific husband. You live in a gorgeous house. You should suck it up and be grateful for what you have. Now go back to sleep and stop being an idiot.”

But the tender, nurturing voice was insistent. “You don’t have to do it now, sweetheart. But the time is coming for you to quit your job, so get ready. And don’t worry. Everything will be okay, and you will not be alone.”

The mean voice piped up, “Don’t listen to that nonsense!”

The loving voice said, “Your father is a fifty-nine year old doctor who will die in three months. That could be you.  If you found out you only had three months to live, would you be living the life you’re living?”

My answer was a resounding, “HELL, NO.”

But how could I quit my job? and I had promised to pay the bills for both of us. I’d have to sell my house. And how could I possibly afford the $120,000 malpractice tail I’d have to pay for the privilege of quitting my job? How would we afford a place in San Diego? We’d have to move. Quitting my job would require a total life overhaul. It was too much to even consider.

The gentle voice said,

You don’t have to do anything yet. Just make peace with the truth. @Lissarankin
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I could feel the warmth of that voice surrounding me like a hug. My pulse slowed down. My breathing deepened. I felt invisible arms holding me as I curled up in bed, and the next thing I remember, the sun was rising over San Diego Bay the next morning.


I didn’t feel the least bit heroic that night. I was still a hero mired in my victim story in the Ordinary World. But what I didn’t know at the time is that my hero’s journey began that night with the appearance of the loving, gentle voice speaking the truth I had been unwilling to admit to myself. I had no idea what I was being called to do. I thought medicine was my calling, but my gut instincts, the chronic sick feeling in my stomach, my health issues, Fiona’s letter—they all felt like signs from the Universe that something wasn’t right. I was being called to do something else, but when I picked up that jangling phone, the message wasn’t clear at all.

Maybe you’re still slogging through the Ordinary World like I was, reassuring yourself that things could be so much worse, and you should just feel grateful for what you have. You may still be blind to even the possibility that your life could be so much more. You may not even realize how you’ll one day look back at this time in your life and recognize how relatively dysfunctional, dull, and joy-deficient your Ordinary World was compared to how you’ll feel when you find the courage to say “Yes” to your hero’s journey.

But one day, when you reflect back, you’ll understand that it was all a necessary and natural part of the journey, just like it is for every hero. You’ll understand that it was all happening in perfect timing and you were exactly where you were supposed to be until the moment when you were ready to pick up the phone.

If you’ve heard a voice warning you that change is afoot, you probably can’t see what lies ahead yet, but you have a strong sense that there’s something more, and that the time for you to embark upon your new adventure is coming soon. This is the first step of your hero’s journey.



Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine and The Fear Cure, is a physician, speaker, founder of the Whole Health Medicine Institute, and spiritual seeker. Passionate about what makes people optimally healthy and what predisposes them to illness, she is on a mission to merge science and spirituality in a way that not only facilitates the health of the individual; it also heals the collective. As she became aware of how fear dominates modern culture and how such fear predisposes us not only to unhappiness but to disease, she began researching ways to befriend fear so we can let it heal and liberate us, opening us up to greater compassion, not just for others, but for ourselves. Lissa has starred in two PBS specials and also leads spirituality workshops, both online, as well as at retreat centers like Esalen, Kripalu, and Omega. When doing what she can to sprinkle pixie dust on a fear-based culture, Lissa loves to hike, ski, and dance. She lives in the San Francisco Bay area with her daughter. Read her blog and learn more at