(Illustration by Luca Di Bartolomeo)
Leadership is a renewable resource—but only if approached with a spirit of self-renewal. That often requires individuals to detach from the work they are most attached to, to see their work objectively, to question their own tactics, to be open to change, and to embrace opportunities that require them to reinvent themselves.
Throughout my 35-year career as an optometrist turned social entrepreneur, I have practiced continual self-renewal in pursuit of a world where equitable access to eyeglasses is universal, especially for the poorest and most remote communities. The process of self-renewal can be unsettling and feel risky, but it is essential to persevere as a leader over decades and ensure you’re having the largest possible impact. John O’Donohue’s words in his poem For A New Beginning capture the essence of self-renewal. It starts with deep introspection and listening to your internal dialogue. Next an inkling emerges that signals your path might need to change in order to drive maximum impact, this is often an “inconvenient truth” given that it unsettles the status quo. “Then the delight, when your courage kindled, / And out you stepped onto new ground, / Your eyes young again with energy and dream, / A path of plenitude opening before you.”
Throughout pivotal moments of self-renewal in my life, including the founding and scaling of organizations like VisionSpring and the EYElliance, I have re-worked and re-assessed where and how I could contribute and what gave me the greatest sense of purpose at that particular time. A central lesson that emerged is that I could renew myself and my work by asking, over and over, in different ways: What is my highest, best use?
For those at critical junctures on your leadership journey, here are seven questions to help clarify your highest and best use:
Question 1: What is the animating purpose in my life?
When I was 23, I experienced a transcendent moment. Standing atop a peak in the Brooks Range of Northern Alaska, my ego dissolved—a known phenomenon among climbers—and I felt like I simultaneously became nothing and everything. At that moment, I decided the focal point of my life would be to live for something greater than myself.
What that meant in real life, I hadn’t a clue.
I had happened upon the question of my own purpose incidentally. If everyone asked themselves about their purpose with intention, though, many more people might be able to find a clear personal mission and dedicate their life to impact work.
Fast forward six months. I was in the Yucatan Peninsula, in Mexico, with Volunteer Optometric Services to Humanity (VOSH) to provide vision services to the underserved. I found myself face-to-face with a blind 7-year-old boy. I placed a powerful pair of eyeglasses on his nose. In an instant, they cured his blindness. He saw perfectly. It was a moment that changed both of our lives: I gave him his vision and he gave me mine. I realized that if I could mass replicate that experience my life would stand for something greater than myself. That moment implanted a fire in my belly that has yet to be extinguished.
More than 1 billion people around the world are dealing with visual impairment or blindness but don't have access to eyeglasses. It is the largest disability in the world. When you choose to work for positive and lasting change in an area of need so big, it will require effort that is consistent and strategic over your lifetime. The work must enliven your heart, because your heart is the motor for long-term sustained action.
Question 2: What is the best way to make the impact I’m seeking?
A pivotal experience two years later led me to question the impact model of my work.
Our VOSH team arrived in Quibdo, Colombia with 5,000 pairs of donated eyeglasses and hundreds of pounds of pharmaceuticals. There, I met a 42-year-old “blind” Indigenous Chocó woman. Again, a pair of eyeglasses solved her problem. After the miracle moment of sight restoration, she canoed back home. When she arrived, she was ostracized for looking “so funny.” A few days later, she reappeared requesting a different pair. Unfortunately, the only eyeglasses we had that matched her highly unusual prescription were the pair of 1950’s cat-eye glasses with rhinestones we had given her. She shocked us when she chose to leave the glasses behind. I remember thinking, “We must be doing something wrong if a patient chose blindness over sight.”
Going into this trip, my fourth, I had already been feeling uneasy. The organization that gave me my life’s work utilized tactics I started to question. How were we empowering local communities to take care of themselves? Did it make sense to provide used, donated eyeglasses? These doubts rushed to the surface as I saw the Choco woman canoeing back home without her glasses. We neglected her dignity, her ability to choose a pair of eyeglasses that were culturally appropriate and aspirational.
I began interrogating other approaches: If we charged for the glasses, could we tap into the powerful feedback mechanism of the market? If our products and services were valuable, and priced appropriately, would people spend their hard-earned money on sight?
Striving to refine your impact model is an ongoing process. Key insights, particularly those drawn from direct contact with your stakeholders, might expose deficiencies in your approach. In my case, paying attention to my nagging doubts and taking the desires and needs of that Choco woman seriously helped me call the question and shift my approach.
Question 3: What can I learn from others or existing approaches?
In search of a better way forward, I spent the next 5-6 years working on multiple sight-related public health projects.
I discovered the Aravind Eye Hospital, the world’s largest eye hospital and renowned social business in Madurai, India, where I spent six months teaching and learning about “compassionate capitalism” from Dr. Venkataswamy (Dr. V) and his amazing team. The core concept that business practices and principles could be harnessed to solve social problems stuck with me, and I witnessed how Dr. V held these seemingly opposing forces in harmony to tackle cataract blindness.
Then, I spent five years as the Director of the River Blindness Program at Helen Keller International (HKI), an international NGO dedicated to the prevention of blindness across the globe. I loved the work. It taught me how to partner with communities to deliver an essential drug to people who “lived at the end of the road.” Through my work with HKI, I was nominated to the Technical Consultative Committee (TCC) for the African Program for Onchocerciasis (River-blindness) Control which was a massive public-private partnership and collaborated with all of the biggest players in the sector: WHO, the World Bank, national governments, NGOs, pharmaceutical companies like Merck, and more.
Compassionate capitalism and public-private partnerships held the key to jumpstarting our impact. Instead of trying to reinvent the wheel, I took this time to learn from others who had acquired hard-earned wisdom that could inform my work.
Question 4: Are we intervening at the right level?
As a leader, I’ve found that my own leadership cycle spins, over and over again, from a burning passion to a sense of burnout and lost direction. At one of these low points, I began to ask myself if our strategy needed to be refocused toward higher-level policy changes.
Upon reflection, I realized that my discontent stemmed from the overwhelming feeling that there must be a better way to tackle health problems across Africa. Even though our work was focused on river blindness, it was impossible to ignore the raging AIDS pandemic, and the resurgence of malaria and tuberculosis. Ninety percent of the people on the TCC were doctors. I remember thinking, “If doctors keep talking to doctors, we aren’t going to get anywhere.” We needed to put health issues on the agendas of presidents and finance ministers—the people who held real power and purse strings. I couldn’t sleep that night; the fire in my belly was roaring. I paced the room, emerging the next day with a semblance of what would drive the next chapter in my life.
A few months later, I found myself in Council on Foreign Relations President Leslie Gelb’s office. I pitched him that global health issues needed to be prioritized because they would increasingly insinuate themselves onto the agendas of the US foreign policy establishment. He listened intently and replied, “Prove it.” I said, “Hire me and I’ll prove it.” He did. I was the first Health Fellow at the Council on Foreign Relations (CFR).
It was another remarkable time for self-renewal. Rubbing shoulders with the foreign policy elite, mastering a new language, and learning how power worked. I spent the next five years making the case that health is important to U.S. foreign policy. We published a white paper defining why health matters through the narrow self-interest, enlightened self-interest, and leadership lenses and articulating concrete policy recommendations that could be acted upon.
Question 5: How can I integrate everything I’ve learned into a new approach?
Despite making progress, starting a real dialogue, and winning champions like Ambassador Richard Holbrooke to the effort, I once again sensed the fire in my belly and my leadership energy running low.
I was itching to get back to the ground, but this time armed with the policy skills honed at CFR. I felt confident that I could integrate 15 years of lessons to start a new organization to address the massive market failure for eyeglasses across the world.
By this point, I knew I wanted my work to have a direct impact on health and prosperity. A conversation I had with a farmer in the Sanaga River Valley in Central Cameroon flooded back. She told me, “Our single greatest need is opportunity. We want to be self-reliant, and if we have opportunity we can meet our other critical needs, like better education and health care for our children.”
It was then I realized that vision is opportunity. It enables us to learn and work. Most people earn their livelihoods with their eyes and hands, and sometime after the age of 40, everyone loses their ability to see up close. Many of my patients in Latin America and India lost jobs due to failing eyesight. In the countless villages I visited, there was also an epidemic of unemployment or under-employment, particularly among women.
Then it hit me: What if local women were trained to start small businesses to sell simple reading glasses to their neighbors? If it worked, we could create and sustain livelihoods through the gift of sight. Again, I paced for days, my energy renewed once more, as I thought about bringing this concept to reality.
Question 6: Am I the best leader for the next chapter?
For the next ten years, I felt like I had limitless energy. With a small team, I built the social enterprise VisionSpring. Our mission is to ensure access to affordable eyewear, everywhere. I was in a state of flow. I slept five hours a night but didn’t feel tired. As the number of people served reached into the millions, awards came in, donors increased their support, and more established professionals joined our team and board.
After creating and scaling the organization, I felt the usual drained feeling return. It wasn’t for a lack of passion for the work, or the promise of the organization. To overcome it this time, I had to ask myself the hardest question yet: “Am I the right leader for VisionSpring’s second decade? Do my skills match the organization’s needs right now?”
In asking the question, I already knew the answer. But how do you detach from something that defines you? I found that to truly self-renew, I had to listen closely to my most authentic inner voice, even when it was telling me something I didn’t want to hear. I was starting to feel pulled toward a more systems-level approach to solving the problem of uncorrected vision. Only there could my most unique contribution be realized, I believed.
Question 7: What can I offer now that I couldn’t before?
Over the next several years, I slowly gave up the day-to-day reins at VisionSpring, which today thrives under the capable leadership of Ella Gudwin. VisionSpring is on the cusp of serving our 10 millionth customer and recently received a $15 million grant from Mackenzie Scott which will turbocharge our impact.
As I pulled back from VisionSpring, I pushed into co-founding EYElliance with Liz Smith. As a system orchestrator, EYElliance is exclusively focused on driving global and national scale strategies to bring glasses and their enormous benefits to the one billion people who need them. EYElliance once again renewed my sense of deep purpose by enabling me to bring all the skills, networks, and self-knowledge I have developed to tackle the challenge that first confronted me 35 years ago.
We all want to build our lives with intention, deliberately and consciously, so that how we live our life aligns with what matters to us the most. In the salient words of John Gardner, “Exploration of the full range of one’s own potentialities is not something that the self-renewing individual leaves to the chances of life. It is something to be pursued systematically, or at least avidly, to the end of our days.” The truth is, though, that while we may hunger for meaning and impact, and while that hunger may be genuine, unless we think consciously about how to make it happen, unless we approach building a life of meaning and impact like a job, we remain far more likely to look back with regret upon all we wished we’d done. Although the role of luck, fate, and circumstance should not be underestimated, I believe the better option is to put ourselves, as much as possible, in a position to call the shots and stomp out those regrets before they have a chance to multiply.
* * *
FOR A NEW BEGINNING by John O'Donohue
In out-of-the-way places of the heart,
Where your thoughts never think to wander,
This beginning has been quietly forming,
Waiting until you were ready to emerge.
For a long time it has watched your desire,
Feeling the emptiness growing inside you,
Noticing how you willed yourself on,
Still unable to leave what you have outgrown.
It watched you play with the seduction of safety
And the gray promises that sameness whispered,
Heard the waves of turmoil rise and relent,
Wondered would you always live like this.
Then the delight, when your courage kindled,
And out you stepped onto new ground,
Your eyes young again with energy and dream,
A path of plenitude opening before you.
Though your destination is not yet clear
You can trust the promise of this opening;
Unfurl yourself into the grace of beginning
That is at one with your life’s desire.
Awaken your spirit to adventure;
Hold nothing back, learn to find ease in risk;
Soon you will be home in a new rhythm,
For your soul senses the world that awaits you.
Poem used by permission. From the book, To Bless the Space Between Us, by John O'Donohue. Penguin Random House, 2008. www.johnodonohue.com
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Read more stories by Jordan Kassalow.