Every year, for the past five years, I have opened my annual letter from the American Board of Obstetricians & Gynecologists, reminding me that it’s time to recertify. In order to keep my board certification active, I have to pony up a boatload of money, read 100 journal articles, and take an all day open-book exam that proves that I’m up to date on all the important research of the year. Whenever this letter arrives, I invariably flash back to that fateful day in Dallas in 2001 when I, along with hundreds of other OB/GYNs from all over the country, submitted to being verbally grilled by grizzled senior physicians trying to make us all feel like idiots.

In order to qualify for this exam, I had to record all the details of every patient I saw in the hospital the prior year – every delivery, every surgery, every hospital admission – along with hundreds of patients I had seen in the office. During the oral exam, my examiners – there were three of them – could call upon me to spout off memorized blah blah about how you stage ovarian cancer or the mechanism of action of methotrexate or the chemical structure of any drug I had prescribed or the branches of any artery in the body. Half the questions they would ask would pertain to the hundreds-of-pages document I had compiled about all my patients. The other half could be made up sh*t about anything my examiners felt like asking me.

While staving off waves of nausea, I answered my questions. When the exam was completed, I promptly ran to the bathroom and vomited. When my husband asked me how I did, I burst into tears and told him I failed and would soon be applying for a job at Ann Taylor, a threat I had been making while I studied for my exam. He handed me a gift-wrapped box. It was a dress from Ann Taylor, with an application on top of it.

I cried some more.

It was the single most stressful event of my entire life, more so than losing my father, more so than giving birth by C-section, more so than getting divorced, more so than losing my dog.  When the letter arrived announcing that I had actually passed my oral board, I puked again.

A Big Decision

But this year, when the letter arrived yesterday, I opened it, examined it, and realized I don’t want to keep my OB/GYN board certification anymore.

Just writing that makes my hands shake. The Gremlins in my head are going ballistic. But my Inner Pilot Light is speaking up this year. Here’s how the conversation is going.

The Gremlin: Of course you have to keep your OB/GYN board certification. What if your career as an author/speaker/blogger goes completely bust? This business is so fickle, everyone could turn on you, and then how would you pay the bills? That certification is a good back up plan. You should keep it.

Inner Pilot Light: But Lissa, you’re never going to do a Pap smear again, and you know it. You sold your speculums. You sold you autoclave. Your white coat is gathering dust in the closet. You’re on the right career path now, full steam ahead, skyrocketing to your dreams. Don’t look back, darling.

The Gremlin: You don’t know that. Anything could happen. Never say never. If you let your certification go and then you come on hard times and decide to practice medicine again, you’ll have to go back to Dallas and take your oral boards again. Don’t be a fool. Pay the money. Take the yearly test. Do it just in case…

Inner Pilot Light: Just in case of what, Gremlin? Don’t listen, Lissa. “Just in case” is simply the voice of fear masquerading as protection.

The Gremlin:  But what will people think? It sounds so good to call yourself a “board-certified OB/GYN.” Don’t you want the status?

Inner Pilot Light: Now you’re just grasping, Gremlin. Lissa doesn’t need some status symbol to prove to herself that she’s valuable, right Lissa? She has me, and I tell her she’s valuable all the time…

The Gremlin: But you worked so hard for it! You paid so much money to earn it! You gave up fourteen years of your life to study for it!  You sacrificed your marriages, your health, your sanity, and your LIFE to earn that piece of paper, goddammit! Keep the freakin’ board certification, Lissa. I beg of you! Do it in case Oprah calls. Do it so you can say “board-certified” on your book covers. Make up some reason if you want but, for the love of God, don’t let your board certification go!

Inner Pilot Light: Now settle down, Gremlin. Plug your ears, Lissa. The Gremlin is just scared. And I’m not. Go ahead and let it go, sweetheart. You’re safe. All is on track. You don’t need that piece of paper anymore. Thank it. It got you far. Honor it. You worked hard for it. Kiss it, for all the lessons it offered you. Now burn it. It’s time to let go and move on. Remember, the caterpillar dissolves completely before becoming a butterfly…It’s time to fly, darling. Let it go. To be what you must, you must give up what you are.

Nobody Was Neutral

When I announced on Facebook and Twitter that I was thinking of letting my board certification lapse, there was a mass outcry of polarizing opinions. Some, including many of my oldest friends, were fully in the “What the f*ck are you thinking?” camp. Many of those people watched me suffer so hard to earn that board certification. Others cheered me on for being willing to release what no longer serves me. What surprised me most was how passionately people felt about this. I got emails from people begging me to go back to clinical practice. I got other emails telling me I was such an inspiration and they were finally going to let their [bar membership/ board certification/ licensure/ teaching certificate/ insert whatever you’re keeping up “just in case”] expire. Nobody seemed neutral, which was interesting to notice.

I’m Letting It Go

I’ve decided to listen to my Inner Pilot Light on this one. I know that if I let it go, I will never go back to practicing as an OB/GYN, because I will never again submit to collecting a year’s worth of cases and getting grilled by three examiners in Dallas again. But I am not willing to let my fear make my decisions anymore.

Gremlin, I hear you. I really do. I know you think you’re protecting me, but I’m safe. The bills are getting paid. I don’t want to practice medicine anymore. I love my career and have faith that I’m on the right path and my Inner Pilot Light won’t steer me wrong. I have faith that the Universe has a plan for me and it’s all being revealed in Divine timing. I have faith that I won’t ever have to go back to a job that sucked the life out of me just in order to put food on the table. I have faith…

What About You?

Are you clinging to something that no longer serves you because you’re afraid to let it go?  Or are you brave enough to release it when it’s time to move on? Tell us what you think.


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  1. pamela

    Lissa, you’re reading MY mind! This is the exact conversation I have been having with myself the past couple days. Thank you for putting it in words – and with some humor! Just knowing I’m not alone in this dialogue, and the sometimes wild emotional ride it provides, is a comfort. Thank you so much.
    Many Blessings to You.

  2. Dar

    The gremlin is right all along, and that inner pilot light hardly even gives one valid reason for dropping the certification. Keep the certification, because that “gremlin”, which actually seems to be a voice of reason, is absolutely right on all counts.

  3. Dawn


    My hat goes off to you! My heart reaches out to you…you are truly an inspiration. I love the last paragraph of this blog. I am in what I consider the “baby stages” of personal transformation and I am wondering if medicine is also for me. I am grateful for having experienced the journey. I may continue, but I may not. I too believe in a master plan and I am “waiting and listening” patiently for my instructions. I realized that while my decision to be a physician was as authentic as any other, the place from which it came may not have been from the most authentic part of me, i.e. what I call my soul. I don’t know. It was what I thought I should do to be in service to my Creator and thus to others. That’s fine – there’s nothing wrong with that. It’s where I was at the time. However, I am learning that I have been disconnected from soul for a long long time. I am learning to reconnect. If I find that soul leads me on to do more in my chosen field, I will continue. If not, I won’t. In the meantime, my purpose is to be present in every delightful “now” moment that I live and breathe and even in the not so delightful moments. I will be compassionate toward people be they my patient or not. I don’t have to be a physician to be compassionate. I do have to be a human being to express love. That’s all that matters. Strap on the wings and fly Lissa…set your spirit free. Honor your past, boards and all….argh! lol!



    • Nona Simons

      Dear Dawn and Lissa,

      I share the struggle to do work I love and be true to myself. It is very sad that the medical profession has deteriorated to the point where it “kills the soul” for a person to practice medicine. It is supposed to be a healing profession, and at its best, that is what medicine does. At its best, the doctor takes time to talk to the patient about what is going on and what the best solutions are, and while doing this treats the patient with respect and answers all questions. At the best, medicine treats every person who needs to be treated and patients don’t have to worry about paying the bill, what insurance coverage they have, will they be able to continue treatment, etc. So many times I have known doctors who have sincerely wanted to help people and practice good medicine and “the system” gets in the way. I used to be a medical transcriptionist. Part of me loved the work, the information, the idea of helping people. But over the years, things got worse and worse on the business end of things, to the point where it interfered with delivering good patient care. After I worked for doctors at a large State University, that was it. The politics was horrible and staff like me was often not uniformly treated with respect. I was subject to the whims of capricious employers. The stress was horrible. It finally caught up with me physically to the point where I could no longer do accurate clerical work. The solution for me was to go on Disability and work part-time for my husband and on odd typing jobs while developing my artistic skills. I am opening myself to a “Higher Power” to direct me in the direction I should go to be happy and of service to others at the same time. I learned that being happy in my work and life is the most important thing. If I am doing what I am supposed to be doing it will work out; so far, I am not where I want to be, but where I am is not bad, and I am glad not to be where I was. I still speak out for things like Universal Health Care coverage and support Causes that promote human rights. I am keeping my eyes and mind open and working on my spiritual outlook. Seminars like the ones Lissa offers are very helpful in providing guidance on the path I have chosen to follow. May both of you be blessed and happy in all your activities as you strive to serve your highest service. I also wish the same for myself!

  4. Elke

    Dear Lissa,

    your message also cam to me at the right time. Actually I hear this voice since quite some time and had kept holding on out of fear not realizing yet what it is that I like to do instead. That is what blocks me to let go. While I now feel, once I really let go of it, the new can enter my screen?! It will be revealed to me…thank you so much for sharing your message with us. Blessings from my soul.

  5. Rachel

    Dearest Lissa
    YES YES YES I hear you (she cried orgasmically) (LOL)

    Your inner pilot light is shining BRIGHTLY
    You are RIGHT to follow your light.
    WE ARE ALL part of a revolution in health care
    YOU are a supreme health practitioner.
    You USED TO BE an Ob/Gyn for years – you will never lose that.
    You now have all the next phase coming your way now that you are letting go of old shackles.

    I have done a similar thing in my life

  6. Keyra

    I have been living according to my “gremlin” for long, I can’t tell who I am or what I want anymore! I have listened to this “gremlin” for so long that I am always on the brink of a nervous breakdown, always drained mentally, physically, emotionally. I’m not my fun loving self anymore; I’ve lost myself, but I don’t know who I am. I am completely confused!! I have moments of clarity, but my “gremlin” always seems to win. I can relate to this post very much!

    • Nona Simons

      I worked full times at various jobs for 10 years, mostly at a State University Medical School (see post above this one). It was an unhealthy life style. I would commute 1 hour to work, and 1 hour to home after work, often in nasty traffic. I was in a stressful environment where people were not treated kindly. There was back stabbing, unfair demands placed on people, competitiveness. I am still friends with some of the people who were kind and willing to work with people in a helpful way. The others are people I never want to work with or see again. I needed health insurance, so I stayed in some pretty awful jobs for way too long. In fact, the stress made my health worse! I was losing my ability to laugh and enjoy life. I felt like the “powers that be” were killing off my spontaneous, happy, authentic self; and I believe that indeed that is what they were doing. I cried a lot, especially when I worked long hours, was not appreciated or listened to and would get in trouble for helping people that needed help because doing so was not in my job description. I ended up having that “nervous breakdown” and developed severe depression and had to go on medication to function because my brain was so damaged from the stress that it was severely deficient in serotonin and norepinephrine. Finally, after losing four jobs in a row, due to the depression impairing my concentration, I said “enough is enough.” I went on Disability and chilled out for a few years. Slowly I am building myself up by doing things I love to do, cultivating happiness, and being of service to others. I have read books etc. and taken internet workshops on life skills, being my authentic self, being more optimistic, developing spiritually. I am so glad I did this and am still doing this. I am glad to be out of the rat race. Even with the financial challenges that my husband and I are constantly dealing with (a real hassle that is sometimes scary), I am happier now than when I was “chained to a desk” in a job that did not suit me for 8+ hours a day! It was not worth it! I am now able to feel joy, true joy for the first time in years. Going out in nature, shopping, even simple things bring me joy. My artistic creativity is blossoming. Sometimes you just have to give up the old security to create a new security, one that is much more user friendly than dealing with the rat race of stressful jobs; long, crazy commutes; and soul killing activities. May you find peace, happiness, and your true calling. You deserve to be blessed in all things you do. My best wishes are with you.

  7. Pam

    This has to be the bravest, most honest post I have read in a very long time.

    I applaud your decision to stay true to you and acknowledge the path getting there.



  8. Andrea

    Thank you so much for sharing your conversation with your gremlin…my gremlin has been in control for so long…this gives me a little permission to consider what I might like now…even after all those years of training, all that money spent on my education…perhaps its ok to consider (just, consider) that maybe its not right for me right now or any more…ahhhh, a first exhale…thanks for your courage.

  9. Susan Viljoen

    Hi, Lissa!
    I applaud you for going towards the peace and the calm and the feeling good in stead of staying with the very seductive, but fear-based, reasoning that says you must go through hell over and over again just because you have been doing it for so many years.
    Brave girl!
    And generous girl, for sharing your insight into this with the world..

  10. Shari

    Dearest Lissa,
    Congratulations to you for hearing your Inner Pilot and your Gremlin. They are both trying to protect you. Poor Gremlin! She just fears the worst. I am living with one foot in medicine and one in my budding creative life and so happy that I have found a way to move ahead, rather than stay miserable. I love my patients. But they are not my life. And as much as I love helping them, they do not come home with me or hold me when I am suffering. My inner voice is helping me to stand strong and love the person I am becoming. The transition is scary sometimes, but mostly it is exhilarating. I am so proud of myself for taking a stand.

    Best wishes to you and your commitment to YOU!

  11. Millie Bee

    I think, whether we follow our Inner Pilot Lights or we follow our Gremlins, either way is fine. Because both are us, and we can trust them both. When we feel like they’re at odds, maybe it’s because we’re choosing sides? Which is fine; we can choose sides if we want to/need to. But personally I’ve found it helpful to at least realize that that’s what I’m doing. Helps me see which way is out. Hope that makes sense/is helpful to someone…

  12. Cija Black

    Thank you for being an inspiration. I hate to think of all the people that live their entire lives, slaves to their “gremlin”. What a said, half lived life that is.

    Follow your “inner light” and keep writing. What you are doing is so valuable for yourself and everyone you touch.

    Best Wishes

  13. Camille

    This post comes at a time when I need to hear someone else further ahead on their path to purpose admit that it is okay to be afraid of leaving a professional designation behind especially if you know it longer serves you. I have been contemplating this day for myself for some time. It makes me weary to continue doing what I like to term “riding two horses.” I am trying to continue working in a profession I am licensed and build a business to allow my inner pilot to burn brightly! That is why it feels like attempting to ride two horses but one of them is holding me back and the other is trying to move ahead at a faster pace. Thanks for the encouragement!

  14. Anne-Claire

    In the past few days I have been even more aware than usual of how, when I can be relaxed and open, just what I need shows up, and this evening it has happened again. Thank you for this affirmation and for your courage in letting go. What an inspiration!

  15. Coral Bentley

    I let go of something which had mattered to me a great deal. I was good at what I did, and I know quite honestly that there is no other environment in which I can excel the way I did there. My flightiness, my broad range of interests, my ability to improvise all came together when I did my work. However, the environment slowly shifted from one where everyone was supportive of each other, to one where the other departments barely held onto their tasks and depended strongly upon those in my department. The stress climbed steadily, until it was stronger than the pride I had in a job well done. I still miss it, but the days where it worked are long gone. I’ll just have to find a different outlet.

    Thinking about neutrality – it is so hard for people to speak up when others do their jobs perfectly, never mind adequately. The responses you had received were polarized, probably because it takes that much passion to sit down and say something. 🙂 I figure that you’ll do what you need to do, however that ends up being, and few things are completely unretrievable should you some day change your mind. It will work out somehow or other. 🙂

  16. Stephanie J.

    Omg! This is exactly what I want to do. I now longer want to be an EMT. My inner pilot has told me for so long but I’ve been holding on “just in case.” it’s never going to happen, I might have a job offer tomorrow and now I feel I have the strength to say goodbye! Thanks “Dr.” Lissa, I think you still should keep the MD title, you earned it!!

    • Sarah

      Listen to your heart. I didn’t & stayed on as a paramedic for another 10 miserable years. I was good. One of the best they said. I did it all–high performance, rural, hospital based, aeromedical & dispatch. I loved working with patients but the drain of paperwork, making patients fit protocols for the supervisors & so the company could get paid….the decreasing ability to advocate successfully for my patients…the tears driving to & from work every day…the stress of being away from my children. I wanted to be home. Hell, I wanted to be anywhere but there. I became bitter & still today–9 years later, I”m still scarred by 24 years in the business. I have no desire to ride a truck again. I ‘m on my way to my dream. It’s taken work & energy, but I don’t worry any more that I’ve not done enough–because it was never, ever enough…and I simply couldn’t live with that.

  17. Julie Bee

    Synchronicity is at play…This theme is playing out in my life as well. A job I am grateful to have had for the past 8 years is coming to an end, due to a contract change. It’s out of my hands, but I’m ready to let it go…Ready to embrace something new. I am surrounded by fear monkeys and their chatter distracts me from holding on to my center and focusing on change bringing new opportunities. It’s a challenging time to be a light bringer when so many are trying to put out your flame. I feel that I’ve completed something (this career path I’ve been on for 25 years) and it’s time to bless it and move on.

  18. Tina Siuagan

    “Just in case” is simply the voice of fear masquerading as protection. – I saw this from your facebook page but didn’t bother to react.

    Or maybe I was too scared to so, that time.

    Having read this account, I realized I’ve given so much in life just to fulfill other people’s wishes.

    I am a registered nurse by profession. However, I am not a practicing nurse at the moment. I am currently working as a freelance writer, health advocate, singer, and television host. Anyway… Back when I was in high school, during that period when I was choosing the course and university I’d like to enter, I was pretty sure I’d like to become a lawyer. I’ve always known that I have the capacity to become one. However, my parents won’t let me. They wanted me to become a nurse because they’ve heard so much about Filipino nurses chancing upon better lives abroad and thought a nursing degree would be my doorstep or ticket to success… They kind of “forced” me to enter something I didn’t want in the first place. Back then, I liked to shout in front of their faces that I don’t like to leave my country, even though most people think that mine’s a rotten hell. I love it so much that I want to become a lawyer in order to serve my fellow Filipino people.

    Now, I don’t regret being a nurse at all. I actually love the idea that I am able to care for others, despite the fact that we are being maltreated in the hands of our own country/system.

    I so feel for you Doctor Lissa. However, I understand Gremlin that such board certification could use some renewal in the coming years, but not for back up – BUT FOR SERVICE. Not everyone is given the capacity and opportunity to become a doctor, to save lives, to make people feel hopeful and better. May that be one of the good reasons for you to renew such license. As for me, despite the fact that I’d do anything to pursue my long and overdue life passion, I’m still keeping this RN certification I have in my hands. Because I’d love to retire as a NURSE and LAWYER in the future. And simply because I love the feeling of being of service for others.

    “Just in case” is never a sign of cowardice. It’s a sign of maturity and intelligence. You’re an extraordinary woman. You know what to do. 🙂

    I always make sure to weigh things equally as much as I could. This is not an attempt to actually offer a neutral answer. Lol. Anyway, you’re decision-making mayhem has already passed. And whatever happens, I wish you nothing but the best of wonderful things to come in your chosen path.

    I’m very fortunate to have stumbled upon your site. It’s as if I found a voice in you. More power to you!

  19. Hollie Flynn

    Dear Lissa!

    Yes! Always follow your heart…your Inner Pilot Light!

    Release the “shoulds” and the “logic”…

    You’re ahead of your time (at the perfect time!).

    “People ridiculed the Edisons, Einsteins and Madame Curies— until they were successful.
    -EDGE Keynote

    As a dreamer, you will be laughed at…Thank them! -Unknown.

    Keep Trusting YOU. The Gremlins are ego and conditioning. Your Inner Pilot Light is your soul and Divine Guidance.

    With gratitude & love!

  20. t

    Thank you for doing what you say. I have no role models where I am. But I have google and I have found so many people I want to be like who can really change. I thought I couldnt live without a man.I couldnt admit I didnt like sex I didnt like the guy. I was raised to just be a wife. With the gremlins there is no peace even if you listen and follow the gremlin. With inner pilot light you can forgive others. I didnt want to leave the guy because I spent so much time on the guy. I failed I admitted I failed but now gremlins dont hurt me. By losing everything you can gain peace. There is a reason. Even going to Walmart and the checkout lane closes before you check out and have to switch lanes. Maybe its because you were supposed to be delayed to avoid a car accident. You gain abundance by losing material items. I got my two small tattoos and a piercing grew my hair long and gained weight. I want to be me now. Not envious anymore because I have nothing and not desiring anything anyone has I have my peace I wont lose that. Good Job

  21. Lisa Avedon

    Dear Lissa,

    I know exactly what moved through your mind and heart when you made that decision.
    I was a corporate pilot and flight instructor, very active in aviation and I loved every moment of that life. I was among the few women who are pilots, and I worked long hours and flew anything I could, working hard to achieve my numerous licenses. Every FAA flight exam I went through gave me a sick feeling until I was completely through and passed.
    I gave up my corporate flying job to raise my kids. It had been a decision I knew was right, but I really missed flying. I kept my instructor certificates current until last year.
    Last year, when I received the notice that my instructor training was due, I put it aside and decided that I was no longer going to work to renew the licenses. I held 4 different instructor licenses: flight instructor, instrument instructor, multiengine instructor and ground instructor. My memories of my life within aviation are filled with gratitude and happiness. I knew it was time to let go.
    Thank you for your candor and openness.
    Lisa Avedon
    Love Repair 101

  22. Leigh

    As many others here have stated, this came to me at just the right time. I have been working, struggling, trying to release a relationship that no longer serves me or him, but not knowing why I couldn’t seem to let go. Your words inspired me, touched a part of me trying to surface, and helped me face a huge part of why I have held on so long. Thank you for sharing your story, your fears, and your strength!

    I think our hearts will always lead us down the “right” path, even if it’s only the right path for now. Our fears keep us holding on to where we are even if we really need to let go to get what we want.

  23. Hilary

    You are most courageous — Yaaaay! Thank you for sharing your light with me (and the rest of the world)!

  24. Laura

    Hi Lissa,

    Congratulations! Let it go, don’t let the gremlin win. You are doing new and better things with your life now. Why subject yourself to that kind of scrutiny again when you don’t have to. I wish I could let my gremlin go, I am just waiting for the right time myself, when my inner pilot light says so I will know. (Thank you so much for the daily messages).

  25. Susan

    Dear Lisa,
    Please stop reading my journal:))!!! It seems uncanny or perhaps just so darn universal this conflict within that ….change a few titles and levels of courage and you have just described my current struggles and pressing decisions to be made. Over the past 9 months or so I have watched the old dissolve ….doors slammed shut… and hints of inspiration which would require more self esteem than I can often drum up. Your message, your sharing offers such inspiration…. perhaps I too can find the courage to ‘let it go” and get on with “it” . Susan

  26. Lissa Rankin, MD

    Thank you all for your thoughts. And I’m so glad so many of you found this inspring.

    I spent this weekend at Chris Guillebeau’s World Domination Summit and had this conversation with many “noncomformists.” A few told me to recertify, just so nobody could dismiss my next book because I wasn’t board certified anymore. But most told me liberating stories about canceling their legal bar memberships and letting go of their own certifications.

    The way I see it, people can question my credibility, but I know I’m credible. And again, I’m not letting go of my medical license. I’ll see be a physician who can prescribe drugs and see patients. I just won’t be a board certified specialist anymore…

    And remember, there is no “right” or “wrong” way to handle this if you’re facing something similar. Last year, it was right for me to recertify. I wasn’t yet ready to let it go. This year, it’s time…

    With love

    • Dolores Dryden

      Thank you, Lissa. “When the student is ready, the teacher will appear.” I lost my husband of 50 years two years ago: suddenly. Blood clots to the lungs. He was not feeling good but did not go to the doctor. He died with-in an hour of collapsing. Having said that – it is now two years passed. I am one who has always believed in ‘moving on’ – cannot say it has not been difficult as one is conditioned to the live one lives for so many years. It really is about loving someone and never seeing them again and beginning a new life without them. Grieving is so awful. I literally “hate” it. Now the ‘gremlins’ do keep ‘talking’ and since reading this article which I receive in an email that I signed up to receive; I think I was ready to read it. Knowing deep down I am strong yet conditioned to the “way it was.” I am now more adept and ready to make changes. Thanks to your article. Must admit I am NOT ready for any relationship and no loner want to be ‘attached’ to a person; want to live a life for ME; knowing this is not selfish. I have six cats of whom I love. Thank you for this article and am holding onto it, too.

  27. Suzy Carroll

    Sharing from the heart, speaking our truth – our fears, struggles and gremlin talk finds me taking a deep breath and centering in the knowledge that we are all in this together, supporting each other, growing together, crying together and LETTING GO together.

    I applaud your courage (and felt butterfly’s reading your HOLY SHIT and YAHOO decision) and sincerely thank you for sharing so openly! You go girl! xo

  28. Daien

    I found this post to be especially beautiful, and along with many others, celebrate your decision to not renew your certification. Four years ago I made the same decision with my licensing, and am grateful for the inner wisdom that encouraged me to depart from a system that in it’s essence I find to be disempowering, and not conducive to true healing. I now have the freedom to follow my heart and intuition in order to connect with my clients in whatever way works best for us both. I also have the responsibility to remain deeply in my own integrity whilst encouraging and empowering my clients to do the same. Heady stuff, this, making the world a richer place to live. Well done.

  29. Julianne

    Brilliant Lissa…Congratulations with your decision.. I think the gremlin will realise that you are listening to the only ‘pilot’ you should be listening too…and it’s time for take off now. The gremlin will get on board too, but only as a passenger from now on, tell it to take it’s seat belt & belt up, then get ready to fly into a brilliant future..You are amazing.xxx

  30. Kim

    Wow I could really identify with this post today. I too have and still am struggling with this also. Its amazing how strong judgement is when we use it on ourselves, its just so paralyzing. I applaud your for listening to your heart and not that part I call the “judge.” You will always be supporting when you listen to your inner guidance system. Again bravo, and you go girl!!

  31. Dynamica

    Imagine a huge smile on my face. You put it there. You’re flying, Baby! and it’s not a solo flight.
    Imagine your angelic team flying with you. Imagine all your human connections flying with you.
    Swoosh, soar, glide, zoom, vroom, vroom….

  32. Shannon McFadden

    Hi Lissa

    From the moment I first heard your own description of you, what you have been through, what kind of person you are, and the path you have taken to now taking, I felt we are soul sisters. We are so much alike. I really appreciate the path you are blazing before me. It makes my journey that much easier. Only because of my own fears have I held myself back.

    I let my RN registration go, vowing I wouldn’t go back. Then the Universe dangled a carrot and I bit. Jumped through a whole bunch of hoops to get my registration back. Over the last year I worked one week with this lovely carrot and found the integrity didn’t match mine. I applied for 3 other positions, because, well I had my license, I may as well use it. My whole body protested each time, to the point of getting a migraine and I’m not the migraine type, only when I don’t listen to my body/intuition do I get one.

    I do need to work until my path takes off, and dreams come true, however I know that is very soon. So for now I choose to give up my license and work for Costco. It is stress free for me, I choose that, while I work on my path.

    Thank you for being brave and walking your path and shining your light.
    With love

    • Nanette

      Here’s to listening to your Inner Pilot Light.
      Shine on!

      P.S. I have a gremlin, too, I named “Fearsome Freddie” a few years ago. Like you, I embrace my dialogues with him, and fortunately, since I created that character, my dialogues with him are much more light-hearted.

  33. letubu

    My Dear Friend,

    You have indeed spoken a universal truth. The Uni-verse supports you and so do I. You will do great!

  34. Peter J

    Thanks Lissa for sharing your experience. I feel much better now. I have actually just done something very similar; will spare you the details! I read your articles with close attention and find them very helpful

  35. christine

    Thanks so much for sharing your thoughtsI had somthing tough to discide this week. I have worked as a caregiver for many years keeping Sr. in their homes rather than going to nursing homes. I also work at a nursery it is my passion I love plants and am so very happy when I am at work. Betty passed away last week and I came to realize I can not be a caregiver any more,I well be 65 this year and even though I will miss the $$ some things are more important and having some thing that I feel happy about look forward to is what I want. I am saving your post for when I get scared and the “what am I thinking I can not afford this I need to work more” shows up i can look to my inner pilot light and feel once again I am right.

  36. Jay Williams

    Lisa.. THANK YOU. That was soooo good. I needed to read that. A friend of mine posted your website on Facebook. There are a few things in my life that I need to get rid of but don’t know how. I am trusting God-the universe to help and guide me.

    I applause you in making the right decision for yourself. I know it was not an easy decision but one that you felt in your heart was the right decision and that’s all that matters.

  37. Laney (Naware/Aradia)

    Sail on Lissa my dear, sail on! You know you’re going in the right direction when you’re passionate about, when it lights your fire. And you know how I know that? I learned it from you! Not from what you’e said, just in watching you grow and blossom, watching your transformation – even if from afar.

    I feel your Gremlin, because my own is saying some of the same things. I’ve held a nursing assistant certification for 10 years, for no reason other than “just in case”. I don’t like the work, it drains me, and as it turns out I can’t even keep a job in the position full time but for so long before I just can’t take it anymore. But for all those signs, the switching of jobs, having to take breaks, being tired, developing insomnia, and even depression I’ve stayed with it – “just because”. Right now I’m having my own dialogue. I had the fortune to know what I wanted to do when I was little, but I got discouraged by outer voices telling me I couldn’t make money doing it. Now I’m doing it “on the side” while I cling to the illusion of security that piece of paper gives, as well as the pain it causes me.

  38. Greta

    I also applaud you.

    On I much smaller scale, I decided not to go down the licensing path as a counselor due to the sharp contrast I felt between the way counseling jobs (and dance/movement therapy– I have my M.A. in both) made me feel (stressed out, burned out) and the reason I went into the field in the first place (to inspire joy, peace, and harmony). My truth was that it was not worth it to work in toxic “therapeutic” environments to get my licensure even though I’d spent so much money on my degree. So while I try to build my own path as a dance therapist/helper/healing artist, I work part time in an unrelated field, and also freelance using skills from my previous career. I often question that I’m moving forward but every day I try to do something to create my own path— independent of credentials. I fully support and understand the accreditation process, I just had to honor that it wasn’t for me, and trust that I’ll find my own way to help and inspire people.

  39. Lucien Harbuck

    Thank You Lissa for this very timely post! I too have suffered the perils of board examination and even subsequently came to administer them. My only hope is that I didn’t stoop to asking candidates inane, off-the-wall questions as an examiner!?! As one of those who suspects that within five years or so, the only profession still practiced in the USA will be, “Shelter and feed myself and my family without getting killed or killing unnecessarily!” Additionally, I do wish You would get the flock out of the Bay Area soon or you probably will go down with the steel and the rocks. But that’s purely your decision, Shucks!, You can write and post from anywhere! Thanks for Your Sophisticated (but not Overly So) Reflections.

  40. Don Ketterhagen

    Few open themselves as completely as you. I have been there, too. Thanks for sharing. Few things happen for no purpose and today I actually had time to read my tweets and came across yours. Yours filled a need and provided the push that I needed to continue my journey and not take the bad advice to go back into medicine.
    I grandfathered into my ACOG certification so never had to recert. But just the thought of obtaining my license again gives me similar and familiar waves of nausea. Thanks, but no thanks to those who would divert me from my purpose in life.

  41. Lissa Rankin, MD

    Dear Don,
    So glad to hear this post showed up for you right when it was supposed to. Welcome!

    And to the rest of you, thank you so much for sharing your own stories.
    With love

  42. Lauren

    I am a social worker by profession and it is slowly killing me but I cling to it as we have two young children and enough debt to drown us. I would so love to quit today. I have a long commute to work and deal with unbelievably stressful situations. I have been through a number of jobs thinking if only I find the right working environement, this will be enough. However, after 7 long years, I have come to the conclusion that my job will kill me emotionally , if not physically, if I do not have the courage to make a change

  43. Valerie

    Change is really nerve-wracking. I always feel it in my stomach.

    Why is it that our brains and our guts/hearts are so very polar from each other?

    I have let people and things “go” many times in this life.

    I’m pondering letting someone go at this point. I keep resisting, because of our connection. Yet, the situation is taking a toll on me.

    I am working with my therapist, with meditation, and with my own self to make sure the decision I make is good for me.

    Your decision was tough, but you FELT it was right.

    I am looking toward my feelings to guide me with this decision.

    Thank you for standing in your truth, to allow me to find mine by your example.

  44. Mary

    One of my yoga teacher mentors ends each of her classes with this phrase: “With Great Respect and Love, I Follow My Heart, My Inner Teacher.”

    I applaud you for your journey through what you shared was a very difficult decision and for following your heart, your inner teacher.


  45. Susie

    I read the most beautiful saying today for the reason we carry tension in our shoulders. It’s because we have allowed our wings to be bound in order to conform. I am glad there are people like you with the courage to fly, and uplift and teach us to fly also. You are on the path to help the most people, you are a gift, thank you.

  46. Jennifer

    WOW! How brave you are! I have watched my children, who are now almost adults, grow up in daycare and I have missed sports practices, concerts, just missed being a mom, and all of those magical times… so that I could also have a board certification… that little piece of F*&%$%#@ paper that is somehow supposed to make all those sacrifices worth it. I have worked myself sick. Still in a job that is sucking my soul dry every day. I know what needs to happen too… and I know that it is fear that is stopping me from making that leap! What an inspiring post. Thank you for sharing. It sure helps with the encouragement that I need to trust what my heart and soul already know. You have no idea what your words have meant to me about this subject. My heart has been aching so much over this very thing. THANK YOU, THANK YOU, THANK YOU!

  47. Joanna Branson

    Lissa, GO GIRL!!
    I refused to renew my K-12 teaching credential 5 years ago with no back-up plan and have NEVER regretted it, even though ALL of the gremlins in my life (including my parents who want the best for me, but don’t understand that the security of a thankless job in an environment of violence was killing my soul. “Security” just isn’t enough…) I have since discovered that I can teach at community colleges for fewer hours, with smaller non-violent classes, for almost the same money- and no “credential” required!
    Listen to that beautiful pilot light (whose POV you have mastered! I can “hear” it so clearly when I read your email messages. Thank you!) and NEVER look back! The gremlins DO shut up after a while… unless they’re your parents, in which case, they just start whispering…

  48. Lissa Rankin, MD

    Oh Jennifer, my heart goes out to you.

    Listen to that voice of your Inner Pilot Light. You can trust it. I promise. You don’t have to suffer any longer…

    Much love

  49. Erica

    Three frogs are sitting on a log. One frog decides to jump. How many frogs are left on the log? Three…the one frog merely made a decision. He didn’t jump. I finally jumped. Yesterday, I followed through with my decision to let go of a relationship that was no longer serving my Higher Self. I’d known for well over a year that it was unhealthy, but that Gremlin can be so eloquent and fear had me in a choke hold. My main intention at the moment I spoke the words that closed that two-year chapter was to be free. I wanted to be free from toxicity and negativity. I was dying to Self with each arrow from her BPD bow and dishonoring Self each time I reconsidered, recanted or hit rewind on my desire to leave. Yesterday, I finally signed my Emancipation Proclamation in INK, and although it might still be wet, the Gremlin has been silenced and I can breathe again!

  50. Savannah

    Loved this post ! Listening to your truest self is one of my biggest passions and it is utterly inspiring to read your process….gremlin vs IPL……so many can relate to that type of conversation….well I know I can 🙂

    I am cheering you on from the sidelines here and I salute you for being a courageous truth seeker and an awe-inspiring human being 😀


  51. Michelle Medina

    I think you’re being amazing as usual Lissa!!
    As for me. . . I can feel fear rising again, that fear of letting go that is so overwhelming it’d push me back into bed and keep me grasping at a trash can if I let it! It’s amazing to me how much fear can really take control of someone and “run” their life!

  52. Sofia

    Oh, Lissa,
    Somehow you always seem to say/discuss something that resonates so deeply with exactly where I am in my life. I just last month made a decision to resign from the practice of law by not sending in my bi~annual dues and signing the line that says “retired from the practice of law”. It took me a long time to get there as the certification and dues should have been in a year ago, February 2011. The Gremlins had my ear for all that time, but finally I was able to come to the decision that it was no longer something I wanted to do. Being a lawyer no longer served me or NOURISHED me (besides, I haven’t practice for more than 8 years already). I haven’t told my family of lawyers and judges, yet, but I know that will come with time, as well.
    I also wanted to update you on my Violin camp. It was this past week, which is why I am replying to this post a few days later. It was the most AMAZING & Healing experience for me. Playing the violin with others as I had done as a child FILLED me to the brim with gratitude. I was able to conquer some of my fear of making mistakes and not thinking I was good enough. I was even invited to join two orchestras this coming fall. That will be another terrifying act, but I think I will take it on, it can only serve me and NOURISH me and create more healing. Thanks for your INSPIRATION and WISDOM.
    With so much Love & Gratitude,

  53. Lissa Rankin, MD

    Oh Sofia, I’m SO HAPPY FOR YOU! Yeah!!!! Squeee!!! Cartwheels all around!

    So proud of you for going to violin camp and remembering your joy. May you continue to be brave and find peace in your courage.

    With love and appreciation for you,

  54. Kirstie

    Thank you for sharing in such detail with such a cool dramatic scene between your Gremlin and your Pilot Light. I too feel my Gremlin clinging to the ‘stable’ options for feeding myself. I am still in the precarious position of living mostly in my over-draft each month and barely making minimum payments on bills, not to mention feeding myself! I work a part time teaching job (used to be full time and then I stepped back to make room for my passion); yet my passion is still not taking off enough for me to be financially stable. I oscillate between feeling/thinking that I may have to leap into the void anyway with no cash of a safety net, or that the time just isn’t right yet.
    When does one know to leap?
    I don’t have wealthy parents/family to help me out, nor a significant other to support me. But everyday the sense of tension between my Gremlin and my Pilot Light grows.
    Your story gives me hope, and a bit more ability to tap into my patience.
    Thank you for sharing!

  55. Cherish

    “I am not willing to let my fear make my decisions anymore.” This is the nut of it, right here. We’re taught by parents, teachers, cultures, etc., to do exactly that. Live in fear. All of the “yeah, buts” and the “what ifs”.
    Bravo, Lissa, for not allowing it to rule you, even as you gentle it down 🙂

  56. Teresa Diaz

    Dear Lissa
    I am an OB/Gyn who practiced as an attending Physician for 8 years!! I live in the Bay Area. I stopped one year ago because I injured my back. I wanted to stop anyway because I was interested in proactive and preventative health care. I didn’t have the guts to stop work initially. What a trap… a mental jail! How would I pay my bills and my lifestyle etc etc. was what stopped me. I took the oral boards 3 times and failed all three times. I had a fabulous colleague in the same boat… failed 3 times. She recently passed her fourth try. I thank god I hurt my back and had to stop for a year to reflect how toxic traditional medicine is and to reflect on how continuing this path would be my short cut to an early grave. Thank god for getting sick July of 2012, because in September of 2012 I found Orgasmic Meditation. The same thing that you call Pilot Light we call orgasm. Anyway… like you, it has been difficult to decide to give up the years of torturous training and create what I know in my soul I the loving nurturing way to practice healing. When someone heard my story they pointed me to you. They said I remind them of you! So I looked you up and am reading your book Mind Over Medicine – so fabulous. We are destined to meet … I can feel it. Thank you for all that you do. Your faith in your inner truth is impactful and inspiring.

    Teresa Diaz, MD

    • s012seh123

      Theresa I empathize with you. I too just realized I failed my boards for the third time!!!I want to blow to my confidence.I love my job I take good care of my patients and it angers me that a border six examiners can determine if I’m good enough to be a part of the board

    • s012seh123

      Teresa I failed my boards recently. It was my 3rd time!! Can’t really believe it. I am baffled by this exam. Knew every question– at least I thought I did. I’m a pretty thorough doc, decent surgeon and love my patients and career. Don’t know why I need 6 examiners who hardly knows me, to pass or fail me based on stupid Questions. I Have 4 kids 11-4 yrs, great hubby who’s in Grad school and never here.
      Is my career over??
      You mentioned you had a partner who took and passed exam On 4th attempt. Will you forward this message to her?
      I would like her advice.
      I’m really desperate.

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