the healthy doctor

Every day I wake up and feel like a failure. Today I decided that has to stop.

I’ve somehow only just realized that these beliefs about myself are, in the balance of things, really not helpful. That’s an understatement, to be fair. It’s a bit of a revelation to me because (a) for a long time, I wasn’t even aware of these internal beliefs, and (b) when I became aware of them, I simply thought they were normal, there to be helpful, and an accurate description of the situation.

This sense of being a failure and not being “good enough” has been pervasive through many parts of my life, and I’ve been a “high functioning achievement addict” since I was in kindergarten. But it’s also brought a degree of anxiety, distress, and at times paralysis. It’s compounded by the fact that my role as a researcher is incredibly competitive, with the most coveted grant schemes having almost a 90% failure rate. My role as a medical doctor is fraught with fear – what if I make a deadly mistake? Failures in medicine don’t just affect our self esteem – they affect others’ lives. And so I’ve created, in my achievement addiction, the perfect storm of how to feel like a failure at all things.

I’m slowly climbing out of this hole I’ve dug for myself for the last 40 odd years, and I’m writing this in case anyone out there can relate, whether or not you’re a clinician or academic or struggling with another part of your life that sends you mistaken messages that you are a failure and not worthwhile.

I’ve gradually changed my strategy to be solution-oriented instead of wallowing in my own misery, and here are some of my ways out.

1. Look after myself first. I nurture my physical wellbeing as much as possible with regular exercise, a whole food diet, and enough rest and sleep. Without these foundations, it’s just too hard.
2. Self-compassion. I have written a lot about this and it’s really the building block of how I begin to carve a different future for myself. I hope it will help you too.
3. Challenging limiting beliefs. I’m currently doing a well-validated e-mental health course called MoodGym. Challenging beliefs is one of the strategies to combat negative thoughts. For example, what is the evidence that I am a failure? I have behind me a string of achievements and more. I have spent some time looking at the evidence that I am not a failure.
4. Adopting a growth mindset. This one is really helpful. With any “failure” or setback, I look for what I can learn from it. Every setback is seen as an opportunity to grow. I’m starting to end the day with a list of what I’ve learned that day instead of what I’ve ticked off. It’s a work in progress and you can read more about Carol Dweck’s Growth Mindset here.
5. Practising mindfulness. Mindfulness encompasses not just paying attention on purpose from moment to moment. A crucial component of mindfulness is I accept that it’s uncomfortable to not achieve my goals. That’s ok. I can sit and live with the sense of discomfort, even locate it within my body (tight throat, tight chest, neck tension). I use the Smiling Mind app at night, and snatch moments during the day to tune in to how I’m feeling, bring my attention back to this world, and sit with any discomfort I’m feeling.
6. Humour. Sometimes life just gets all too serious with all this achieving. I love to laugh each day and a good laugh certainly helps put things into perspective all of a sudden. Here’s some humour for you that I think many of you can relate to – Michael McIntyre knew about the coronavirus! I laughed at this one until tears ran down my face.
7. Resetting my own internal expectations. This one is something I’ve just started to work on. All my life I’ve based my self-worth on external recognition of achievements. Praise and recognition from others, grateful comments from patients, awards, exam results, acceptance letters from journals. If I don’t have these external reminders that I’m not a failure, I find it difficult to believe in myself. I’m working on creating my own internal expectations for myself – based on my effort, what I’ve learned, and how I’ve grown, rather than if I won a grant or an award. Watch this space.
8. Recognising my right to being worthwhile, outside of any achievements. The drive to do things that make an impact is certainly beneficial to others – I’ve cared for hundreds, if not thousands of patients; influenced practice with my research; and most importantly, served as a role model for many. But what if I had done none of these things? Is my worth as a human being only tied to what I do? I am changing this narrative because it can’t be true. Everyone is worthwhile – each and every one of us, regardless of what we do. Everyone has the right to a happy and fulfilled life. I matter – simply because I am human.
9. Focussing on doing my best. I can’t do any more than what I can do, and I should be proud of the fact that I’m doing my best at all times.
10. Just stepping away from it all. Taking regular breaks from my professional life helps immensely. Stepping away from the computer on Friday evenings always seems hard at first because I’m stuck in a dopamine-inducing habit of checking emails and trying to tick things off my to-do list. By that time it’s been five long days of very hard work and hard work is my dopamine hit – if I am working hard, I feel like I am a good person. But once I shut down the laptop and enter a different world of relaxing while watching a movie, playing board games, sleeping in, spending sunny days at the beach, and even gardening, I feel like the restrictive yoke of my achievements and my sense of failure disappear, and I can focus on just being Over the years I’ve been able to claw back my weekends, for the most part, and they are now a very tightly guarded precious resource of mine that I will fight for tooth and nail.

My life has been an endless and at times very exhausting series of level jumping. Each new achievement introduces me to an even narrower field where it’s harder and harder to be outstanding and where even amazing achievements are seen with the lens of “not good enough”. What was good enough for the previous level (eg being a PhD candidate) is not good enough for an Early Career Researcher, and so on. With each passing year, I’m required to be even better than before. I’m hopeful that with the strategies above I’m able to stay focused on the right things (effort, lifelong learning, self-compassion, internal expectations) rather than chasing the endless validation of my worth as a human being.
I matter. So do you. So do all of us.

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