I built something from nothing. I trained the team, created the workflows, shaped the culture. I was thinking about walking away. Why does it feel like betrayal?
There's a particular kind of guilt that comes from leaving something you didn't just work at, but something you built.
It's different from quitting a job someone else created. When you leave that, you're stepping out of someone else's vision. But when you leave something you built from nothing? You're walking away from a piece of yourself.
And somewhere in your head, a voice whispers: "After everything you put into this?"
Building Something From Nothing
I came out of fellowship a trained allergist. What I wasn't trained in was how to run a clinic, much less how to set one up. I was lucky to have a colleague who was up for the challenge and energized me to take it on with her.
Together we built an allergy clinic from the ground up. We ordered supplies, considered workflow, learned the inner workings of being a cog in the wheel of a major academic center.
It was not easy at all. Tough doesn't begin to cover it. I didn't realize it at the time. I had just come out of training, and that was tough. This was just a different kind of tough. So I took the blows, surprises, twists and turns as part of the process and didn't think much of it. Now, looking back, I realize how green I really was.
The Strange Place of Not Knowing What You Don't Know
That concept of the competence ladder resonates with me deeply when I recall that part of my career. I knew what I knew, but I also didn't even know what I didn't know. That combination of knowledge and ignorance is a very strange place to be. You don't even realize you were there until you know enough to recognize it later, in retrospect.
Looking back, I can see myself in those early days. Confident in my clinical training, completely unaware of how much I didn't understand about operations, politics, personnel management. I thought the hard part was diagnosing patients. I had no idea.
The Tug-of-War
So when I decided that after six years of building, running, refining my clinic, training staff, building relationships, it was time to move onto the next phase in my career, there was a weight, a heaviness to the transition.
Yet at the same time there was something pulling me forward. It made that weight feel more like a tether from the other direction than something weighing me down. It was like being at the center of a tug-of-war rope. Knowing that eventually one side will win, but not until you are pulled forward, backward, forward, and backward.
Why Builder's Guilt Is Different
When you have put so much of yourself into something, it becomes a part of you, and you a part of it. You are inexorably intertwined.
Naturally, leaving that part of my life created some guilt. Although I was part of a major academic center, I had created my place in it, built something from the foundation. It was different from just being employed somewhere that someone else built. This made the transition that much more difficult.
I had patients, colleagues, family, and friends wanting to hear more about my plans. I didn't know what to tell them. I didn't yet know what I was getting myself into. On the flip side, they definitely knew what they wanted to tell me. I had colleagues who didn't understand, patients who felt left in limbo, and other patients who were truly excited for me. They knew this was the right move for me before I did.
Those patients, the ones who saw something in me I couldn't yet see in myself, I think about them often. They gave me permission before I could give it to myself.
Reframing the Narrative
It is important to recognize that when we build something, it doesn't mean we owe the rest of our lives or career to it.
There is a sunk cost of time and energy we put into the things we give our lives and careers to. We don't get that back in the same form we put into it. But we do walk away with experiences and experience that help us do better with our next adventure than we would have otherwise. Hard work is not lost even when we change course. It just makes the journey forward a little easier.
The thing you built can outlive your involvement in it. That's not abandonment. That's success. You created something that doesn't need you anymore.
What you learned building it? That's yours to keep. That's yours to use elsewhere.
The processes and protocols we created still exist. The staff I trained went on to train others. My fingerprints are still there, even though I'm not.
That's not betrayal. That's legacy.
Questions for Reflection
For those of you in a position of change, thinking of moving onto something different or leaving something you built behind you:
- What would you tell a friend in your position?
- Is staying serving the thing you built, or just avoiding the guilt of leaving?
- What becomes possible if you let yourself move on?
If you're feeling that tug-of-war, pulled between what you've built and what's calling you forward, that's exactly the work I do as a career transition coach. Book a free discovery call if you'd like a thinking partner to help you find clarity.
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