There appear to be multiple experiences in adulthood that may initiate psychological growth. "Healing" marriages, psychotherapy, religious conversions, dealing with adversity, and meditation are some examples. A calling itself may also be an experience that initiates or reflects psychological growth. Interview studies—such as my evaluation interviews with the 88 candidates—can be seen as qualitative re search and a necessary beginning that may yield hypotheses to be tested by more rigorous quantitative studies.
In this essay, however, I wish to use another source of data about callings—my personal experience of a calling to medicine and, later, to psychiatry. Understanding such personal experiences may also lead to useful hypotheses about the psychology of callings. The specific nature of my experience is not what I believe to be generalizable; rather, it is that the callings occurred in a particular developmental context, involved the resolution of conflict, and were aided by support from an important other.
It was during adolescence that I began to feel the strong inner impulse to become a doctor. The impulse was actually more like a conviction of what I wanted my life to involve. It was as if I had come upon an important self-observation, and it was an exciting and positive experience. As I began to let people know my decision, the feedback was almost always positive. The one important exception was my father—a powerful, charismatic man who had achieved much with just a high school education. And he had other plans for me.
A major turning point in my father's young adult life was a World War I commission that led to a decorated battle career and brought about the social acceptance he had not found as a poor farm boy. The worst experience of his life was being discharged after that war—much against his wishes—because only West Point graduates were retained. It came, then, as no surprise that he wanted me to go to West Point to fulfill his dream.
I was ambivalent; I wanted to please him but was not at all sure that a military career was right for me. He obtained an appointment for me, but I flunked the then-rigorous visual examination. My calling to medicine thus occurred during the familiar adolescent developmental challenge of establishing an identity, one that was centered on my wishes rather than on pleasing a powerful parent. Put in a different way, I needed a calling to resolve an underlying conflict with my father and to fortify my emerging autonomy.
Support for my calling came mostly from my mother. She idealized doctors and was thrilled with my choice. I believe her feelings of approval were genuine but probably also influenced by her use of indirect oppositionalism with her powerful spouse.
My sense of calling to psychiatry had some similarities. It began when I was an intern at the Brigham in Boston. I did well, and my professors outlined the steps leading to a possible academic career there. At the time, I was a young adult, husband, and father-to-be, so my ultimate career decision needed to be made. Many of my house-staff colleagues planned academic careers, but when asked which field they wished to pursue, they re sponded with what seemed like narrow interests. One mentioned amino acids, another the pancreas.
In contrast, I found myself in creasingly interested in patients' stories—what are now called illness narratives. Psychiatrists were assigned to each of the medical wards and were freely avail able to discuss such matters, as well as one's responses to patients and their stories. Although I did not experience a calling to psychiatry then (that took several years), I did become aware of the conflict between my basic interests and where I thought academic internal medicine was going.