The Conversion
Where Diosa Ara came from, what productive resilience actually is, and why the spiral is not the enemy.
People ask me how I got here.
They mean it as a compliment, usually. The subtext is: you built something real out of something hard, and that is remarkable, and I want to understand the mechanism so I can hold onto it or apply it or at least recognize it when it appears in someone I know.
I understand the question and I appreciate the spirit of it. But the honest answer is not the one that makes for a good origin story arc — the one where the wound becomes the calling, where the adversity generates the insight, where the path was always pointing here even when it didn’t look like it. Those stories are satisfying because they are tidy. They locate the meaning in the destination and make the painful parts feel purposeful in retrospect.
The honest answer is messier. The path looked like a spiral. And for a long time I didn’t understand that a spiral is not the same as going in circles.
🌀 What the Spiral Looked Like
I entered medicine because I believed in its possibilities. I stayed in medicine long enough to understand its failures with a specificity that only comes from being inside them. I watched the system process patients who looked like me with a logic I could not reconcile with the oath that was supposed to govern it. I watched women receive diagnoses late, receive pain management inadequately, receive the presumption of exaggeration in place of the presumption of competence. I watched the institution protect itself against accountability with the same efficiency it deployed to protect its patients.
I did not leave medicine because it failed. I left — or rather, I moved — because I understood the failure well enough to see that the solution was not going to come from inside the institution’s own logic.
The institution will optimize for the institution. That is not a moral accusation. It is an organizational reality. If you want a different outcome, you build a different structure.
But between understanding that clearly and building Diosa Ara, there was a period that does not read as progress in any conventional sense. There were attempts that did not work. There were partnerships that dissolved. There were funding conversations that ended without funding. There were months where the clarity I had about the problem felt inversely proportional to my ability to move anything forward. There were people I trusted who turned out to be investing in their own vision of what I should be building rather than in what I was actually building. There were decisions I made from exhaustion that I would not have made from strength.
The spiral.
And here is what I learned about spirals: they are not going in circles. They only look that way from the outside, and from inside them, when you are too close to see the pattern. A circle returns to exactly the same point. A spiral returns to a similar point at a different altitude. Each pass covers similar terrain — similar obstacles, similar temptations, similar failures of nerve or judgment or timing — but from a position of different knowledge. You are not repeating. You are revising. This pattern is consistent with Kolb’s experiential learning cycle, where experience, reflection, conceptualization, and experimentation form an iterative learning process. [1]
The difference is not metaphorical. It is functional. And it was only by accepting the spiral for what it was — not a detour from the path, but the path itself — that I could use what it was giving me rather than spending my energy on the mistake of trying to get out of it faster.
🔩 What Productive Resilience Is Not
The cultural story about resilience has a problem.
It treats resilience as a trait — something you either have or you’re developing, something that is essentially fixed about a person or can be built through exposure to adversity. The story is: hard things happen, you survive them, the survival strengthens you, you emerge more resilient. Repeat. The adversity is the input. The resilience is the output. The mechanism is essentially passive: what doesn’t kill you makes you stronger, if you have the right character to receive it that way.
This is not what happened to me, and I don’t think it’s an accurate model for anyone whose resilience is actually functional rather than performed.
What I built — what I am still building — is not the capacity to endure more. It is the capacity to convert. To take the specific content of what went wrong — not just the fact of difficulty but the actual texture of it, the precise mechanism by which something failed, the exact place where my judgment was wrong or my understanding was incomplete — and extract from it something that changes the next attempt. Not in a vague “I learned from this” way. In a specific, technical, applicable way. The failure left a data point. What does the data point actually say?
That conversion is not automatic. It requires stopping. It requires the kind of honest assessment described in the previous essay — looking at what actually happened rather than what you need to have happened. It requires distinguishing between the lesson and the rationalization, which are often disguised as each other. And it requires a relationship with difficulty that is different from endurance. Not harder. Differently oriented.
The post-traumatic growth literature is instructive here. Researchers Richard Tedeschi and Lawrence Calhoun identified five domains in which genuine growth follows trauma: new possibilities, relating to others, personal strength, spiritual change, and appreciation of life. [2] What their research also shows is that growth is not the automatic result of difficulty. It is the result of what they call “deliberate rumination” — active, purposeful cognitive processing of the traumatic experience, as opposed to intrusive rumination, which is the involuntary re-experiencing that produces PTSD rather than growth. [3] The difference between the two is not the severity of the experience. It is what you do with your attention in its aftermath.
Productive resilience, in this framing, is not a trait. It is a practice. It requires deliberate attention directed at specific content. It produces specific outputs. And it can be trained — not by increasing your tolerance for pain, but by improving your ability to extract information from it.
🎓 The MD and the PhD
People sometimes ask me why both. The MD and the PhD. Two training programs that together constitute the longest possible formal education, the one that demands the most, the one that most people would not choose to undertake simultaneously if they had full information about what it would cost.
The question behind the question is usually: was it worth it? Or sometimes: did you know what you were getting into?
The honest answer to both is no, and also: it doesn’t matter.
What the MD gave me was clinical fluency. The ability to be in a room where a woman is hemorrhaging and understand exactly what is happening, exactly what the options are, exactly what the protocol calls for and where the protocol is failing. It gave me the language of the institution I was trying to change — which matters, because you cannot argue with a system in a language it doesn’t recognize. And it gave me the particular kind of credibility that comes from having been trained to stake your name on a diagnosis. Medicine teaches you to be accountable for your assessments in a way that produces a specific relationship with uncertainty: you learn to say what you believe is true based on available evidence, knowing you may be wrong, accepting the consequences either way.
What the PhD gave me was something different: the discipline of following data to conclusions regardless of whether the conclusions are convenient. Research training at its best is the systematic dismantling of your own wishful thinking. You form a hypothesis. You design the test. You follow the result. If the result doesn’t confirm the hypothesis, the hypothesis revises — not the result. That discipline, practiced for years across contexts that have nothing to do with the specific question you are eventually trying to answer, produces a particular quality of thinking: the willingness to let the data be more authoritative than the theory.
Together, those two trainings produced the exact equipment Diosa Ara required. Not because I planned it that way. Because the spiral brought me through both, and by the time I was building, I understood why I had needed both. That is what I mean by the spiral returning at a different altitude. I could not have seen the use of the PhD from inside the PhD. I could not have understood what the MD would require of me until the requirements appeared. But each pass of the spiral added something that the next pass would need.
This is not a story about everything happening for a reason. It is a story about what becomes available when you stop demanding that the path be straight.
🔥 The Specific Anger
I want to say something about anger, because it has been essential to this work and it is rarely described honestly in founder narratives.
There is a version of the origin story in which the founder is motivated by love — for the problem, for the people affected by it, for the vision of what is possible. That is true for me. I carry genuine love for the women this work is built to protect. That love is real and it sustains something important.
But the engine is not love. The engine is anger.
Specifically: the anger that comes from understanding something fully and watching it continue anyway. I understand exactly why Black women die in childbirth at the rates they do. I have read the studies. I have been in the rooms. I have watched the mechanism operate in real time with full knowledge of what I was watching. The anger I carry is not the anger of ignorance — the frustration of not knowing what is wrong. It is the anger of precision. The anger of someone who knows exactly what is happening, exactly why it is happening, and exactly what it would take to change it, watching the institution continue to choose the version that produces preventable death. [4]
That anger is not a liability. It is fuel. And it is clean fuel, because it is not personal in the wrong direction — it is not the anger of someone who was wronged and wants redress. It is the anger of someone who sees a solvable problem being left unsolved for reasons that do not survive scrutiny, and who has decided to be the person who solves it.
The distinction matters. Personal anger wants to be heard. Mission anger wants to build. Personal anger dissipates when acknowledged. Mission anger compounds when ignored. Personal anger turns inward when it meets resistance. Mission anger converts resistance into information and keeps moving. [5]
I have both kinds. What I have learned — through the spiral, through the accounting in the previous essay, through all of it — is how to distinguish between them in real time, and how to run on the right one.
🏗️ What Diosa Ara Actually Is
Diosa Ara is not the company I thought I was building when I started.
The company I thought I was building was a clinical intervention — a specific protocol, a specific deployment model, a specific response to a specific failure in the system. That is still true. The clinical work is real and it is the center.
But what I understand now that I did not understand at the beginning is that Diosa Ara is also an argument. An argument made in the form of a company. The argument is: the power asymmetry in the clinical encounter is a solvable problem. Deploying coordinated institutional authority — clinical, legal, operational — at the moment of crisis is not a workaround. It is the actual solution. And building that infrastructure, proving that it works, demonstrating that the outcomes change when the power dynamic changes — that is the evidence the field needs to understand what it is actually facing.
I did not arrive at that understanding in a straight line. I arrived at it through the spiral. Through attempts that failed and showed me exactly why they failed. Through partnerships that taught me what I was and was not willing to compromise. Through a funding process that required me to explain this work to people who did not share my premises, which forced me to sharpen the premises until they were irrefutable. Through the double bind of being taken less seriously than the work deserved while simultaneously being told the work was remarkable.
The spiral was the education. The education produced the company. The company is the argument.
And the argument is not finished. It is the subject of the next essay.
References:
Kolb DA. Experiential Learning: Experience as the Source of Learning and Development. Prentice Hall, 1984. ISBN: 978-0132952613.
Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 1996;9(3):455–471. DOI: 10.1002/jts.2490090305.
Tedeschi RG, Calhoun LG. Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 2004;15(1):1–18. DOI: 10.1207/s15327965pli1501_01.
Lerner JS, Tiedens LZ. Portrait of the angry decision maker: How appraisal tendencies shape anger’s influence on cognition. Journal of Behavioral Decision Making, 2006;19(2):115–137. DOI: 10.1002/bdm.515.
Thomas SP. Transforming Nurses’ Stress and Anger: Steps Toward Healing. 3rd ed. Springer Publishing, 2009.
This essay is the fifth 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.
The Conversion — where Diosa Ara came from, what productive resilience actually is, and why the spiral is not the enemy. [You are here]
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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