The Well
Capacity accounting, feedback as dominance behavior, and why protecting your bandwidth is the most mission-critical decision you make.
At some point in building Diosa Ara, I sat down and did the accounting.
Not the financial accounting — I had been doing that obsessively since day one. eThe other accounting. The one nobody teaches you in medical school or business school or the endless founder development programs that tell you to build resilience and manage your energy and maintain your vision. The accounting of what I actually had available to spend, what was actually being drawn from it, and whether the math was sustainable.
It was not.
This essay is about what I did with that information. But first I want to be precise about what kind of accounting I am describing, because there is a version of this conversation that collapses immediately into self-care advice, and that is not what this is. Self-care advice locates the problem inside the individual and offers individual remedies. [1,2] What I am describing is a structural analysis that happens to require radical honesty about a person — specifically, about me. The difference matters. One produces a spa day. The other produces a company that can actually survive.
The Accounting
Capacity is not a feeling. It is a resource.
This seems obvious until you watch what most founders actually do, which is treat capacity like it is infinite and blame themselves when it runs out. They wake up depleted and decide they need more discipline. They miss a deadline and decide they need better systems. They snap at someone important and decide they need better emotional regulation. All of these diagnoses locate the problem in the management of capacity rather than in the fundamental question of how much capacity actually exists, where it is actually going, and what the ledger actually shows.
I am a Black woman building a company in emergency obstetrical care. I described in the previous essay what the research shows about the physiological and cognitive costs of that position — the emotional tax, the authority gap, the weathering that accumulates in the body regardless of income or status or how well everything appears to be going. [3,4] Those are not background conditions that a strong enough mindset overrides. They are withdrawals from the same account the company is drawing on. The question is not whether they count. The question is whether I was going to count them.
The honest accounting looked like this. The mission draws from the well. The clinical work draws from the well. Fundraising draws from the well. Team management draws from the well. Stakeholder relationships draw from the well. Public presence — the speaking, the writing, the being visible in every room where Diosa Ara needs to be represented — draws from the well. So does the tax described in the last essay: the vigilance, the emotional labor, the management of how I am being read in every room before I have said a single word about what I built. So does the physical reality of operating in a body that is weathering, whether I acknowledge it or not.
All of that is going in one direction. The question is what goes the other direction. And the honest answer, for most of the early years, was not enough.
That is not a character indictment. It is arithmetic. And once I was willing to do the arithmetic, the decisions that followed were not difficult. They were just honest.
Self-Knowledge Is Not Navel-Gazing
I want to name the resistance to this kind of accounting, because it is real and it comes from a legitimate place.
There is a version of the founder story — the version that gets told in profiles and on stages and in the books — that treats self-knowledge as a soft competency. The work is the work. The vision is the vision. The market, the technology, the team, the traction — those are the real variables. What you need to understand about yourself is secondary to what you need to understand about the problem.
I believed this for longer than I should have. I was trained in medicine, which rewards the suppression of personal information in service of the patient. I was trained in research, which rewards the removal of the observer from the data. I had internalized a framework in which attending to my own experience was a distraction from the actual job.
What I know now is that this is exactly wrong. Not as a matter of personal development, but as a matter of engineering.
The company is a system. Every system has a rate-limiting step — the constraint that determines the system’s actual throughput regardless of how optimized every other component is. [5] In the early stages of Diosa Ara, I was the rate-limiting step. Not my technology. Not my team. Not my market access. Me. My attention, my judgment, my presence, my capacity to think clearly and decide well and show up at full power for the people and moments that required it.
Which means that the most important variable in the company’s performance was not the one most people were analyzing. And the least analyzed variable was the one I had the most information about — myself — and was systematically refusing to use.
Self-knowledge, in this framing, is not introspection for its own sake. It is input data for the most important system in the company. Refusing to collect it is not discipline. It is a gap in the engineering.
What Feedback Actually Is
In the previous essay I described the social dynamics of unsolicited feedback — how it functions as a dominance claim rather than a developmental gift, how the double bind makes style adjustments structurally impossible, how the threshold for offering feedback on a woman’s leadership is dramatically lower than for men.
I want to add something to that here, because the relationship between external feedback and self-knowledge is one of the places founders get most consistently confused.
Feedback is information. Like all information, its value depends on the source, the context, and what it is actually measuring.
Most feedback from the field — from investors, from stakeholders, from colleagues, from casual observers of your leadership — is measuring one of two things: either your actual effectiveness (useful), or the distance between how you lead and how the observer is comfortable being led (not useful, and often actively misleading). The difficulty is that most feedback does not announce which category it falls into. It presents itself as objective assessment regardless of what it is actually tracking.
The way to distinguish between them is to have a stable, honest, continuously updated model of yourself that you can use as a reference point. Not a fixed self-image you defend at all costs — that is fragility dressed as confidence. A dynamic model. One that incorporates real data, updates when warranted, distinguishes between signal and noise, and is not destabilized by every piece of commentary that arrives.
Building that model is the work of self-knowledge. And you cannot build it if you are not willing to look at the places where the accounting is unflattering.
I have made decisions that didn’t serve the company. I have held positions too long because releasing them felt like losing. I have spent energy on the wrong things and withheld it from the right things for reasons that, when I was honest with myself, were about fear rather than strategy. I have been wrong about people. I have misjudged situations. I have, on more than one occasion, chosen what felt like momentum over what was actually sustainable.
None of those admissions make me a worse founder. They make me a better one. Because a leader who cannot accurately assess her own errors cannot accurately assess anything else. The same mechanism that produces self-honesty produces clarity about teams, about markets, about what is actually happening versus what you need it to be happening. They are not different faculties. They are the same faculty applied in different directions.
Emotional Intelligence Is Not One-Directional
The leadership literature has been discussing emotional intelligence for three decades, primarily in the direction of outward: read the room, understand what others are feeling, manage relationships, respond to the emotional reality of the people around you. [6,7]
This is real and it matters. But there is an equally important inward direction that receives far less attention: accurately reading your own emotional state, distinguishing genuine signal from noise, knowing when you are operating from clarity versus reactivity, and having enough interior honesty to notice when something that feels like principle is actually wounded pride.
These are not separable skills. A leader who is calibrated outward but uncalibrated inward is operating with a systematic bias in her most consequential instrument. She may be excellent at reading others while being blind to how her own unexamined state is coloring every read. She may mistake her fear for her values, her exhaustion for her limits, her depletion for her boundaries.
The inward direction requires something uncomfortable: sustained attention to the data you would rather not look at. The place where the accounting is unflattering. The pattern that shows up across contexts and therefore cannot be blamed on any individual context. The response that is too consistent to be explained by the trigger.
I have found this to be the hardest work of building Diosa Ara. Not the clinical problem — I was trained for the clinical problem. Not the business problem — I have been learning the business problem in real time and finding it tractable. The hardest work is maintaining the kind of interior clarity that lets me know, in the moment of decision, whether I am operating from my actual best judgment or from something unexamined.
And the work is never done. The well refills and empties again. The tax accumulates and must be acknowledged. The accounting must be revisited. Not as a crisis management protocol, but as a regular practice — the way a physician monitors vitals not because the patient is in distress but because the pattern over time tells you what no single data point can.
The One Non-Negotiable
Here is the thing I eventually said plainly to myself, and that I will say plainly now:
The company only exists as long as I can show up.
This is not a statement about irreplaceability or ego or the myth of the indispensable founder. It is a statement about the current reality of Diosa Ara at this stage of its development. The relationships that enable this work are relationships with me. The credibility that opens rooms is my credibility. The judgment that holds the clinical and strategic vision together is my judgment. The particular combination of MD, emergency medicine training, Black woman founder, and the specific anger at the system that comes from having seen it fail people I love — that is not transferable.
At some future stage, the company will be larger than any individual and will have systems, teams, and institutional knowledge that can survive the departure of any one person including me. That is a goal worth building toward. But we are not there yet. And pretending we are there yet — treating my own capacity as a cost to be minimized rather than a resource to be stewarded — is not sacrifice. It is a category error. It is the founder who runs the car engine until the car stops rather than putting fuel in it on the way.
The mission is to eliminate preventable maternal death. That mission requires Diosa Ara to exist. Diosa Ara requires me to be capable of running it. Therefore: my capacity is not separate from the mission. It is a precondition of the mission.
That reframe changed what felt like self-indulgence into what it actually is: operational necessity. The decision to protect the well is not a departure from the work. It is how the work continues.
The Decision
The accounting showed me what was coming in and what was going out. The decision that followed was not complicated once I was willing to see it clearly.
Some things that were drawing from the well were drawing for legitimate reasons and at sustainable rates. Those I kept.
Some things that were drawing from the well were drawing at rates disproportionate to their return — to the company, to the mission, to any version of the accounting that made sense. Those I either renegotiated or ended.
Some things that were drawing from the well were doing so not because they served the work but because I was afraid of what would happen if I said no to them. Those were the hardest to release, because the fear that held them in place was real. But fear is also a withdrawal. And it compounds.
Some things I had not been counting at all — the tax described in the previous essay, the accumulated weight of building in a body that the institution was not designed to support — I began to count. Not to make myself a victim of them. To make them legible in the ledger, so they could be factored into real decisions rather than silently draining an account I kept wondering why was running low.
This is what I mean by capacity accounting. Not a formula. Not a productivity system. A willingness to look at what is actually there, what is actually leaving, and what the math actually shows — and then make decisions from that reality rather than from the story about how much you should be able to do.
The well is not infinite. That is not a failure. It is the condition of being a person doing work that matters.
The question is what you are willing to do with that information.
References
Dean W, Talbot SG. Physicians aren’t “burning out.” They’re suffering from moral injury. STAT News, July 26, 2018. Available at: https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/.
Talbot SG, Dean W. Physicians aren’t burning out. They’re suffering from moral injury. BMJ Opinion, August 2019. Available at: https://www.bmj.com/content/bmj-opinion.
Woods-Giscombé CL. Superwoman Schema: African American Women’s Views on Stress, Strength, and Health. Qualitative Health Research, 2010;20(5):668–683. DOI: 10.1177/1049732310361892.
James SA. John Henryism and the health of Black Americans. Cultural Diversity and Mental Health, 1994;1(3):163–182. DOI: 10.1037/1099-9809.1.3.163.
Goldratt EM, Cox J. The Goal: A Process of Ongoing Improvement. North River Press, 1984. ISBN: 978-0884271956.
Goleman D. Emotional Intelligence: Why It Can Matter More Than IQ. Bantam Books, 1995. ISBN: 978-0553375060.
Goleman D, Boyatzis R, McKee A. Primal Leadership: Unleashing the Power of Emotional Intelligence. Harvard Business Review Press, 2002. ISBN: 978-1591391845.
This essay is the fourth piece in a series. Each piece that follows takes one argument made here and builds it out fully.
What It Costs - On Power, Structural Racism, and the Real Price of Building While Black and Female in Medicine
The Gunman in the Room — the system, the power asymmetry, and why this is engineering logic applied to a medical crisis, not ideology.
The Tax — what the research actually calls what you have been carrying, and why precision about the cost changes what you can do about it.
The Well — capacity accounting, feedback as dominance behavior, and why protecting your bandwidth is the most mission-critical decision you make. [You are here]
The Conversion — where Diosa Ara came from, what productive resilience actually is, and why the spiral is not the enemy.
Why I Can Say This — radical transparency as competitive strategy, the legibility gap, and what becomes possible when you stop protecting a position you were never going to be protected in.
If this landed with, the next one will too.
Dr. Yamicia Connor, MD, PhD, MPH
Founder & CEO, Diosa Ara | Creator & Editor-in-Chief, The Labora Collective
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