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  • Amina Aitsi-Selmi

This is heaven on earth - cardboard boxes, self-betrayal and career purpose

It’s a long one.

Last week, I gave a talk for a group of bright and inspired surgeons at Oxford University on invitation from a great friend. The topic I was asked to present on was how to keep surgery on the global health agenda.

I wasn’t sure about it, as my commitment is to coaching and I haven’t been doing much public health in the conventional sense but I was excited to try and bring the two together for the group.

One thing that bothered me was that I wasn’t introduced under my current role as an independent professional and Transformational Coach and Consultant but under my old public health titles, which reminded me that I was back in a system of acquired accolades and status...

When I had finished explaining what it had taken me to achieve the things I did in my career, I felt that the group was somewhat deflated…

I was curious as to whether I had missed the mark…

Initially, I went into rescuer mode trying to encourage them and make them feel it was possible – an old habit of overcompensation to instil enthusiasm and a sense of possibility where I think it’s missing…

But I know that overcompensating when people are not excited is not the best way to serve them.

In fact it’s a fatal error in coaching: you cannot want something more than the person you’re coaching/helping. They have to be enthusiastic. They have to be hungry. Because they have to go out and take action.

So I stepped back and probed into what was going on underneath the surface.

Then it came out:

“There’s no time to do this”.

Here it was…the spectre of doubt. Now we were getting to the real stuff.

All the strategy, information and solutions in the world won’t help you if you carry this belief.


I hear it often (I don’t have time) when discussing change. We live in a culture of being “busy” - a striking difference with my culture of origin where doing nothing is much more culturally acceptable…

So many opportunities are available to us in this day and age; it’s hard to know where to start resulting in analysis-paralysis. Throw in a bit of imposter syndrome and you can easily find yourself trying to do everything just to make sure you’re not missing anything without actually doing the things you really want.

So I shared the one thing I know about time management and that makes the biggest difference to my clients:

There’s no such thing as time management, it’s only choice management.

See this previous video on time management the wiser way.

From a more sinister perspective, the system isn’t necessarily supportive of your making authentic choices.

What these bright young surgeons are trying to do defies the current imperatives of a health system starting to crack at the seams from overwhelming demand. In an inward-looking Brexit and Trump climate, convincing taxpayers that their money is well spent on providing surgery in Africa or India and letting doctors go and operate there rather than in their own countries might not get you much support…

This can create an inner-conflict when you realise that your skills are not used where they are needed the most. For big picture thinking, global citizens this can be quite an uncomfortable experience. Your heart is telling you one thing but your head is telling you another.

You want to help people on the other side of the world where the need is greatest but you have your bills to pay, your career to maintain and your organisation wants you to do less meaningful but more voter friendly stuff even if it could be handled more efficiently in other ways…

I was shocked once to be told to slow down and be less efficient as I was embarrassing other people…


The system I worked in was starting to feel too small for what I had to offer. Something had to give…

Until I saw the implications of this clearly and made some tough decisions, things felt difficult and confusing.

What I eventually learned over the years is that in the end, it’s not about me. Or about the system. It’s about fit and the courage to take risks. If I really wanted to make a difference in the life a person on the other side of the world, I needed to be willing to take some real risks. If I want to make a difference in the life of a woman who is struggling to survive on a meagre income to feed her children and goes to heart-breaking lengths when one of them falls ill to get them whatever care might be available, I’m going to have to display at least the same amount of courage as she has, to truly meet her where she is. It’s just a law: let’s call it the law of proportional courage.

I can’t prioritise my cosy western lifestyle and hope to make a real difference. Otherwise, I’m just perpetuating the bigger injustice under the guise of volunteering and charity.

Unless I’m prepared to crack my heart open and feel the pain, fear and uncertainty of the people I say I want to help, my efforts are just cosmetic, patronising, if not counterproductive; a drop of water in a blazing fire.


Every time I’ve ended up doing something outside the box that felt fulfilling and real (and paid me), I had to be ready to give everything up first.

It’s as though life was saying: You really want this? You really want to be of help? OK, show me.

I had to get over the fear of losing my status and cosy life.

One evening during a period of career turmoil a few years ago, I decided I would just go for it: I’d rather do what my heart wanted to do (global health) from a cardboard box than not do it. I felt crystal clear. Immediately, a sense of peace overcame me and I heard my inner-voice say: this is the kingdom of heaven on Earth. You have entered…

I’m not saying that you have to go and live in a cardboard box (up until now I haven’t, although if I did, it wouldn’t even be the worst thing for me), it’s that you have to be willing to, in the name of something bigger.

Photo: The new office?

A couple of months after that moment of clarity, I was offered a substantive six month post as a NHS Consultant in International Public Health (I only know two other people with this title in the NHS) without interview. It was all above board and within the rules and a great springboard had I chosen to continue on that path.


Yes, the higher up the ladder of status, accolades and income you go and the more entrenched you get into a nice western, middle-class lifestyle, the higher the perceived risk of following your heart.

So how do you know when to take a risk and how big a risk to take?..

The answer: you just know.

You just know.

Then ignoring that inner-knowing starts to feel like a self-betrayal.

You know you’re on your right path when you’re not betraying yourself every day.

You’re not experiencing the symptoms of self-betrayal every day.

What are they?

The chronic low-grade anxiety – poor sleep, palpitations, racing thoughts and a general sense of unease. If you allow it to continue, you start to forget your inner-knowing entirely, the possibility that was within reach recedes and then you have to start numbing yourself… Your self-loathing may increase and you’ll swing between blaming yourself and blaming others, feeling that life is miserable and empty and that it’s just the way things are.

Eventually, you’re left with a pervasive, inexplicable feeling that something is off. Everything seems repetitive and dull which may then lead to depression. Your spirit has given up. Or rather you have given up on your spirit.

My job when people approach me about coaching is to prevent that from happening or help them correct it before it gets too deep.


A great way, to know if you’re true to your inner-knowing or betraying it is to give yourself space and time to clear the fog and noise of daily life.

Be wiling to be radically honest with yourself and feel uncomfortable if you have to in order to face the truth. Meditation, journaling and spending time with people, places, nature, music and books that inspire you will also help.

I ask all my clients to have a coaching journal and personal development practice for this purpose.

Last week, after a deep dive with a new client who said he had lost his confidence and wasn’t sure about his career path, he sent me a few lines from an Islamic spiritual teacher:

“You presume you are a small entity but within you is enfolded the entire universe […]

What you seek is within you if only you reflect.”

Have a good week,


It’s tomorrow! The Leaders Circle at Harley will start at 6.30pm where you’ll be learning and practicing powerful communication tools that can change everything in a conversation including presentations, negotiation and conflict resolution. You can still register here.

n.b. Having shared some of the material on communication last week on the online version of the Leaders Circle, I have a feeling the in-person version is going to be even better. Feedback included: “Absolutely brilliant” which is always nice to know!

Here’s a slide one of the communication tools we used.

Email me if you have any questions

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