Resilience for Visionaries: A Guide
a year worth reflecting on
This has been a meaningful year.
It's the year I've been able to put forward my vision for what medicine could be. Through my work with HeliosX, launching MedExpress Canada with an incredible team around the world. Through building the obesity program at PocketPills. Through finally launching my own practice, The Shift Clinic. Through cofounding WellSpoke Learning in Health with fellow integrative doctors. And through writing my first book. It’s a book that occupies the awkward space between markets and medicine, between commodity and care.
It has also required more resilience than any year in recent memory. There have been hits of the kind that would have knocked me sideways five years ago. Misunderstandings that cut. Moments where I wondered if what I'm building is too different to survive. People who couldn't see what I was pointing toward let me know it.
But this year, those hits didn't land the way they used to. I can see things more clearly now. And I want to share what I've learned about what resilience actually is and how to build it. I’ve learned through my own life, through the research, through years of working with patients who feel just as misunderstood as I sometimes do.
This is for the visionaries. The ones who see what others can't. The ones who may seem in left field, but are actually just ahead of the curve. If you've ever felt misunderstood for wanting something different, this is for you.
they can't see what you see
I spent two and a half years as a varsity rower. I started closer to the bow, learning to match my stroke to the rowers in front of me. Eventually, I moved to the stroke seat which is the position that sets the rhythm for everyone else. When you're in that seat, you can't see the finish line. You're facing backwards. The only way forward is to trust your training, trust your crew, and never stop pulling.
I remember my hands bleeding for weeks from friction against the oar. This happens to everyone at first. The blisters form, break, form again. After a few weeks, calluses replace them. Twenty years later, I still have mine.
That physical memory stays with me now, in a different kind of work. Building something new, whether it be a practice, a business, a vision for what medicine could be, means pulling toward a destination that may not exist outside of the mind’s eye.
Some people will row with you. Some would rather tread water than help move in an unknown direction, because they’re convinced that the world is flat.
And some will try to sink your boat.
Not because they hate you. Because while they aren't willing to risk the discomfort of the unknown, they also aren't interested in you realizing the rewards of your quest. Your success casts them as they are. Stuck.
You don't have to take them with you. You can offer. Just make sure you're wearing your life jacket.
vision alone is painful
Vision without resilience is potential unrealized. It hurts. You see the destination clearly but lack the capacity, skills, resources or team to bring it to life.
Vision plus resilience is the difference between idea and execution. You need both.
But resilience isn't what most people think it is.
It's not grit. It's not white-knuckling through difficulty. It is not a feeling. And it is not the same as having a high tolerance for friction, just for the sake of it.
In my clinical work, we talk about resilience and strategic optimism a lot. Patients who are trying to lose weight have a lot of experience with failure, and re-engineering their outlook or vision is what we do in The Shift Clinic. The research backs this up: a meta-analysis of over 9,000 people across eleven chronic conditions found a robust positive relationship between resilience and self-care efficacy [1]. Resilience functions as a psychological buffer, helping people maintain emotional well-being as they navigate metabolic complexity.
Resilience is a set of learned skills. And, boy, have I practiced! In rejected book proposals, rejected medical school applications, failed campaigns, turned away pitches, unrequited romances, and even by my own body that one time my placenta tried to off me during childbirth. Every rejection looked like a failure to someone watching. But inside, every rep mattered. I was building memory, understanding and skill. They were false starts for a race I’d later win.
The difference between a false start and a failure is what you do next.
the body and mind aren't separate.
I spend my days working with people navigating chronic conditions like obesity, metabolic dysfunction, the downstream effects of decades of living in bodies that modern medicine hasn't served well. What I see repeatedly is a vicious cycle: frustration and isolation from unsuccessful attempts lead to depression, which contributes to further weight gain through stress-induced appetite and reduced physical activity. Managing this cycle requires treating the psychological and physiological together.
The relationship between resilience and self-care is bidirectional. High resilience supports better self-management. But successful execution of self-care tasks also reinforces your sense of resilience. [2] Every small win builds the psychological capital that makes the next challenge more manageable. This is why I structure my clinical work around the smallest possible units of action called tactics rather than dramatic overhauls. The wins compound.
This year taught me the same thing about this two-way street. Since early 2023, I’ve been putting on my own oxygen mask first. It made the people who were benefiting from my suffocation very angry. I considered taking off the mask many times, but it turns out I enjoy breathing, and they’re going to be angry anyway.
water-treaders
Some people have decided to stay where they are. This is perfectly fine. Not everyone wants adventure.
But you need to understand something about people who've decided to tread water: they've drawn invisible borders around what is and is not possible, and they'll expect you to agree with them. They'll need you to stay where you are so you can make them look good, like a piece of decor or an ornament. But you’re built for motion, and tip when still.
When you go to leave the borders (and you will, you must, because you can see beyond them) they'll flip the hell out.
Expect it. But do not wear it.
I've encountered more water-treaders this year than I care to count. People who wanted to borrow my energy without supporting the direction I was heading. People who expected me to agree that certain things weren't possible, when I could see clearly that they were.
leading from the inside out
Self-leadership is the shift from "someone needs to tell me what to do" to "I direct my own thoughts and practices to achieve what matters to me." In the research, self-leadership strategies fall into three categories: behaviour-focused (self-observation, goal-setting, self-reward), natural reward (finding inherent enjoyment in the process), and constructive thought patterns (reframing, visualization, positive self-talk). [3] [4]
I use all three with my patients. But the one that brings about The Shift most reliably is the cognitive piece, the ability to reframe a "failure" as a learning opportunity rather than evidence of fundamental inadequacy. This prevents the emotional spiral that derails so many people. It builds what researchers call psychological capital: hope, efficacy, optimism, and resilience working together.
Self-leadership rooted in your own values and not in external "shoulds" or other people's expectations, keeps you moving when things get hard. I've watched patients make decisions from their deepest values, and from fear or obligation. The outcomes are night and day.
When you anchor commitments in who you actually are, you borrow energy from your core identity. When you anchor them in who you think you should be, you deplete yourself.
This year, I had to practice what I preach. Multiple times, I faced criticism that would have made me question everything in earlier years. What saved me was clarity about my values. I know why I'm building what I'm building. That knowing doesn't make criticism painless, but it makes it survivable.
building your crew
Your job isn't to convince everyone. It's to patiently share the vision with those who want to get in your boat.
It takes all sorts to build something new. The people willing to endure discomfort don't have perfect resumes or track records. If it seems they do, they haven't risked enough to grow.
Look for the calloused hands.
When you find someone who's also a visionary, raise them up. Try to see what they see. Help them become patient with their vision and develop the flexibility to proceed off-map. Create conditions for level-appropriate error without sabotage. Celebrate those mistakes. Your future leaders need to know they're meant to false-start.
you can't do this alone
Individual resilience matters. But there's a reason I build community into every level of my clinical work.
Community resilience is the sustained ability of a group to utilize collective resources — physical, behavioural, social — to withstand and recover from adversity. Research on neighbourhoods with high "collective efficacy" (social cohesion plus willingness to act for the common good) shows lower prevalence of obesity and depression. Strong social networks establish resources that encourage health-promoting behaviours and provide support that buffers psychological distress. [5]
The relationship between individual agency and community resilience is a continuous exchange.
Your choices that consider the wider community, like supporting others on similar journeys, showing up consistently, being honest about struggle, leverage your personal power for the collective good. And the community's resilience provides the grace and space to make hard choices when you'd rather not.
This is why I built The Shift the way I did. Not as a solo practitioner seeing patients in isolation, but as a community where people learn alongside others who understand what they're going through. Peer influence is powerful. When you see someone else navigate what you're navigating, it no longer feels impossible.
name the critic, call the coach
Everyone has two voices competing for airtime. There's the Critic, cataloging every false start as evidence of fundamental inadequacy, every setback as proof you shouldn't have tried. And there's the Coach, able to see past the immediate difficulty to the larger pattern.
A central skill of resilient self-leadership in The Shift Clinic’s curriculum is learning to name the critic and call the coach.
When your nervous system goes reactive, it gets flooded with adrenaline, you’re unable to think clearly, and you can't self-lead. The prefrontal cortex, the part of your brain that plans and decides and sees consequences, goes offline. You're in survival mode. Every setback looks catastrophic from there.
The Inner Coach lives in calm clarity, able to read internal data without being hijacked by it. Getting there isn't about pretending you're fine. It's about regulating your nervous system enough that you can actually think. Sometimes that means stepping away. Sometimes it means breathing techniques or movement, or conversation with a trusted person. Whatever your particular reset looks like, you need to know what it is and use it.
all is not sunk
It will feel like your false starts and side quests are sunk: sunk costs, sunk time, sunk momentum, never to be retrieved again.
Time and momentum don't actually disappear unless you're using them to tread water, where you learn nothing, burn inefficiently, and run out of fuel rapidly. Time and momentum, when you're using them to try, get converted to memory. To skill.
As you get closer to actually taking off, all those reps suddenly show up. In coordination. In ease. In motion, which you earned in the past with all those times you thought you failed but got back up again the next day.
I've got a resume some would call chaotic. Lots of zigging and zagging in the short term. But others would call it rapid prototyping for the future by someone who scopes fast, performs intensely, and moves on when she's run out of future somewhere.
Everything I built this year drew on skills I developed in projects that "failed." The clinical frameworks. The intellectual property. The software designs. The systems of support for patients. All of it came from things I left behind because they were not right for the future.
disruptive presence
I've been called a disruptive presence about a dozen times in my life. Which means it has been said about me hundreds more times than that. At 12, I didn't understand it. At 22, I internalized it as evidence that something was wrong with me. At 41, I see the pattern.
The label never comes from people I'm leading or from those leading me. It only ever comes from self-appointed holders of order and control, usually those lateral to me, often under the auspices of fairness or stability. The water-treaders. Those for whom it's very frustrating that my followership must be earned, not assumed, never ordered. About them, I have always wondered: Why demand obedience when you could earn loyalty?
If a visionary is part of your followership, it's because she chose to be. Be ready for her to move on one day, and let her go, knowing you were both better off for the experience. Do not try to tighten the reins. She will escape.
She disrupts, remember?
critique as elevation
Critique is where you find your next edge.
This is normal for visionaries but deeply unsettling for others. For people intent on staying put, critique feels like the earth slipping out from under them. For those like us, it’s a reason to learn to fly.
When critique comes from unexpected places or in new forms, let it lift you. It's always going to come. The friction is feedback. It means you're sparking something new.
who I owe
I owe more than I can say to the vision-shapers in my life.
My parents, who let me roam, both physically and mentally, younger than they probably liked. But as a result, I was safe to come home when it mattered, and I knew I could leave again when I was ready.
My early bosses and professors who provided cover for me to do my thing, whatever that was, because it seemed to be working and it was interesting.
My friends from high school, university and early career who celebrated my head in the clouds and asked me never to change.
My extended family, for being proof that most diamonds on earth are still unmined.
To our scrappy little Shift team: Sarah, Chantelle, Angela, Sean, Leanne and now Jensen. Thank you.
To the patients who have followed me from practice to practice while I figured this out. Your trust and confidence are essential fuel for the hardest days. Thank you for the benefit of the doubt.
for the misunderstood
If you're reading this and you feel misunderstood by your doctor, by your family, by systems that weren't designed for someone like you, I see you.
So many of my patients are visionaries, too. They see possibilities for their health that others dismiss. They've been told they're "non-compliant" when really they just refused to follow advice that didn't make sense. They've been labelled "difficult" when they were actually asking good questions. They carry the exhaustion of being ahead of the curve in a world that many still think is flat.
If you're ready to find people who see what you see, intelligent, accomplished people who are done with conventional approaches, The Shift Clinic was built for you. And if you want to try the approach before committing, The Weekender is a good place to start.
the horizon
The thing about horizons is that they keep expanding the farther you go.
This used to discourage me. Now I understand it as evidence I'm still moving. The fact that there's more to see means I haven't stopped looking.
I look back at where I started this year, the ideas that were just ideas, the relationships that hadn't formed yet, the programs that existed only in my head, and I've come way farther than I thought, even as the horizon out front spreads so vastly.
This year gave me clarity. About what I'm building, who I'm building it for, and who I am when things get hard. I'm most grateful for everyone still in the boat, the ones with calloused hands. The ones who can't see the finish line either, but keep pulling anyway.
Let’s never stop.
footnotes
[1] Jin Y, Bhattarai M, Kuo WC, Bratzke LC. Relationship between resilience and self-care in people with chronic conditions: A systematic review and meta-analysis. J Clin Nurs. 2023 May;32(9-10):2041-2055. doi: 10.1111/jocn.16258. Epub 2022 Feb 22. PMID: 35194870.
[2] Jin Y, Bhattarai M, Kuo WC, Bratzke LC. Relationship between resilience and self-care in people with chronic conditions: A systematic review and meta-analysis. J Clin Nurs. 2023 May;32(9-10):2041-2055. doi: 10.1111/jocn.16258. Epub 2022 Feb 22. PMID: 35194870.
[3] Maykrantz, Sherry A., Luke A. Langlinais, Jeffery D. Houghton, and Christopher P. Neck. 2021. "Self-Leadership and Psychological Capital as Key Cognitive Resources for Shaping Health-Protective Behaviors during the COVID-19 Pandemic" Administrative Sciences 11, no. 2: 41. https://doi.org/10.3390/admsci11020041
[4] Almeharish A, Bugis B. Evaluation of the Factors Influencing Self-leadership in the Saudi’s Healthcare Sector: A Systematic Review . Open Public Health J, 2023; 16: e187494452302222. http://dx.doi.org/10.2174/18749445-v16-230228-2023-18
[5] Butel J, Braun KL. The Role of Collective Efficacy in Reducing Health Disparities: A Systematic Review. Fam Community Health. 2019 Jan/Mar;42(1):8-19. doi: 10.1097/FCH.0000000000000206. PMID: 30431465; PMCID: PMC7012267.
