My biggest challenge was during my Internal Medicine residency. It didn’t come naturally to me. To diagnose based only
on physical exam, lab values, imaging… it felt like there was so much of true “healing” that we weren’t addressing. I often felt we were causing more harm than good, or just offering a temporary
quick fix. It all deeply went against my grain, but I tried to hang in there because I knew it was part of my path. At an annual evaluation, my program directors gave me the score of
“marginal”, and I felt the most devastating shame of my life. Even with everything I was giving of myself, my energy, my time, my heart... to have it not be enough, I was just broken. And right
after hearing that, I had to go do a 30 hour shift in the ICU, completely terrified of my inadequacy. I remember I would often sit in the shower, hoping somehow the fear and shame would wash
away. I'd curl up in a ball, trying to disappear, but I could never get small enough. Another haven was my car. I would break down in the solitude all the time. In one dark moment, I imagined it
would feel better to just let the car drive off the road and smash into a tree. I just couldn't believe I was even thinking that. It made me realize how shame is one of the most profoundly
destructive emotions we can carry.