It’s been almost two years since returned to medicine after a three-year hiatus from practice.  I recently finished the longest week of work I have had since starting this job.  I had a family emergency and a conference all converge around the same week, and ended up cramming two makeup days into an already full schedule.  It was long.  It was incredibly tiring.  I was very glad when I finally got into my car on Friday evening to drive home.

And yet, it wasn’t a bad week.  It actually wasn’t even an okay week.

It was a really, really good week.  Yes, I was exhausted and completely ready for dinner out with a glass of wine.  But I was just tired from working hard at an unbelievably rewarding job.

I’ve had plenty of time to think about what makes my current situation so different from my old job.  At first I thought it was people liking me, but I realized that plenty of people liked me at my old workplace, and I was a miserable wreck.  I thought it might be that now I am respected, but no, I had plenty of respect where I was too.

Then I realized: It’s the “v” word.

The reason that everything continues to be unicorns farting rainbows at my current job is that, after all this time, I am finally valued.

I think it’s extremely easy to confuse being valued with other ideals, such as being liked or respected.  They certainly share certain attributes, and we all feel good when we experience any of them.

In her book Lean In, Sheryl Sandberg (the current COO of Facebook) discusses a phenomenon called “the tiara syndrome.”  Admittedly, it involves some gender stereotyping, which Sheryl very gracefully addresses in her book.  Basically, women in general tend to function similarly regarding work.  We roll up our sleeves, put our heads down, and do really, really good work.  And we do some more good work.  We don’t promote ourselves, we don’t draw attention to all the great things we are doing, we just work.  Because if the work is good enough, and we do enough of it, someone will eventually notice what an amazing, wonderful job we are doing, and come plop a tiara on our heads to thank us for our efforts.

I was 100% a tiara syndrome devotee.  And let’s be honest, half of getting through a clinical residency is sheer force of will.  We train for years to roll up our sleeves and put our heads down and work.  And when one of our attendings tells us we did a good job, it’s like winning the lottery.

The problem is that the model for getting through residency is nothing close to the model for having a fulfilling and successful career for the rest of your life.

In my old job, I was a total tiara girl.  Was I liked?  Absolutely.  People loved me.  Was my work respected?  Definitely.  The residents gave me teaching awards, students would come back for repeat elective with me, colleagues would brag about me to other colleagues.

Was I valued?  No.  No sir, I most certainly was not.

Because here’s the thing about being valued.  It’s easy to confuse being valued with being liked.  We get the warm fuzzies with both being liked and valued.  They can look deceptively similar at first glance.  But here’s the catch: You can be extremely well liked by your colleagues and still have important promises made to you that are broken, be assigned a terrible salary that doesn’t acknowledge your work, be made to feel like no matter what you do it’s never enough, and be stuck in a situation with no support and no real way to succeed.  You can be the belle of the ball and work can still completely suck.

As hard as it was for me to admit, the reality is that it is simply not enough to pat me on the head and tell me I’m doing an exceptional job, and throw me peanuts to survive on.

But salary is the tip of the iceberg.  Ironically it’s the small things for me that really add up in terms of my feeling valued.  When I pass my chairman talking to someone in the hall, it is 100% guaranteed that he will stop me and say, “Oh Dr. St. Claire, have you met so-and-so-chairman from blah-blah-department yet?”  And then will go on to talk up my work ad nauseam to this poor trapped soul about how special my clinic is and all the innovative things we are doing.  His elevator speech has actually gotten quite good.

Or when my coworkers refer a child to me and tell me how relieved they are that I am here, and can help with complex care coordination that they just aren’t set up to handle as surgeons.

Or when my colleagues from the community ask me to chair a resource collaboration committee to try to best serve our patients and families.  And then when we have the meeting at 3pm on a Monday, my clinic coordinator naturally assumes I will want it catered, because how on earth am I supposed to host a successful committee meeting without feeding the participants?

I could go on and on with these little encounters that individually might seem trivial.  But when every single day at work is full of these kinds of interactions, you start to feel rather glowy and lovely inside.  Do I have hard days?  Of course.  Do I encounter challenging situations that frustrate me when I can’t do more?  Absolutely.  But working in an environment where I am not only liked and respected, but valued, makes me finally understand what Confucius was talking about when he said, “Choose a job you love, and you will never have to work a day in your life.”

I get it now.  For me, I just had to find a job that loves me back too.

Lumi St. Claire is a physician who blogs at My White Coat Is On Fire.