The dusty gym is a blur in my peripheral vision as I grip the high bar tightly and swing downwards from a handstand. I slightly pike at my hips to avoid hitting the low bar behind me before recruiting my abdominal muscles to tap my legs through a transitional arch position and complete the circle around the bar. Just before I return to vertical, my hand slips. I feel the bar leave my sweaty palm and scrape up my wrist and forearm as I plummet headfirst, careening through the stale air towards the ground below. I instinctually tuck my head inwards and twist my core sideways in midair, making the most of the split-second I have to orient myself so that I land on my shoulder instead of directly on my neck, the rest of my body crumpling on top of me.

“Oof, nice fall. Are you OK?” My coach asks from the chalk bin beside the bars. When my breath finally returns, I nod slowly.

“All right then. You’d better get back up there and try again so you don’t get scared of it,” she orders. I turn my head and roll my shoulders a few more times to make sure nothing is wrong, and with my body still shaking with fear and adrenaline, I walk back up to the bar, take a deep breath, and reach upwards to grasp it.

***

As a young gymnast, I found myself in this position countless times: waiting at the base of the uneven bars or standing at the edge of the balance beam after a terrifying fall, with my body aching from impact with the ground and my mind stupefied with self-doubt as my coaches forced me to get up and repeat the trick immediately.  They held the philosophy that after falling on a gymnastics skill, the single most important thing to do was to prevent fear from setting in and stoppings us from moving forward. This belief shaped their golden rule: after a fall, no matter how frightening or dangerous, we always had to get right back up and perform the skill again … before we got scared.

***

At the end of this past summer, prior to returning to the Georgetown University School of Medicine for my second year of medical school, terror and trepidation tyrannized my emotions. It took every ounce of my energy to block out the anxiety the previous year of school had generated within me. The memory of the indescribable stress, loneliness, homesickness, sleep deprivation, isolation, pressure, boredom, and confusion weighed heavily on my heart and mind, tripping my pulse into a frenzy and drawing sweat into my palms with every reminder of my academic commitments. Even more than that, my unshakable doubts about becoming a physician in general—doubts from which I had blissfully escaped during the joyful summer months—were roaring back through my psyche’s weakening floodgates.

In my medical journey thus far, I have been repeatedly told that such misgivings among young doctors mainly stem from feelings of inadequacy. Mentors encourage young medical students to ward-off imposter syndrome and silence the voices telling us that we aren’t intelligent, dedicated, or tough enough to be doctors. These words do little to assuage the qualms that dominate my outlook on my medical journey, as my fears seem to be the opposite. I do not necessarily ask myself, “What if I am not the person I need to be in order to succeed as a physician?” but rather, “What if medical school and becoming a physician prevents me from being the person I am?” What if I cannot manage it all—being someone who starts my day by running miles on empty streets while racing the rising morning sun; who prides myself in being a loyal and reliable daughter, sister, niece, and friend; or who avidly follows every major global news event so I can keep abreast of the world I want so desperately to help—all while still being a doctor? What if these things that are so central to my identity are too much for me to give up? What if I don’t really want this?

Still unable to formulate answers to these existential questions, I spent the last days of summer outlining ways to maintain my training regimen as a competitive distance runner during clinical rotations and residency, fretting about how I would attend my best friend’s wedding if it fell during a particularly demanding rotation, and pre-emptively grieving the precious time with family that I would inevitably lose to 80-hour workweeks. I looked for escape routes: frantically checking Georgetown’s deadline for tuition refunds and noting application requirements for other graduate schools that might take me down another career path. Essentially, I became my own personal fearmonger-imprisoning myself in chains of inescapable dread of losing control over my life, and more importantly, losing my identity. I envisioned myself being so wrapped up in the innumerable and demanding tasks required by medical training that I would lose time for leisure, time to engage with the people and world around me, and even time to simply be myself as my identity would not only fail to thrive, but cease to exist.

Of course, I didn’t tell a single person about any of this. In the gym, everyone understood why it was so terrifying to get back up retry a skill after dramatic and dangerous falls. My teammates, parents, friends, and even coaches, could easily relate to the fear of pushing through physical pain or failing at the skill once again—falling and injuring oneself in a humiliating show of inadequacy. In medical school, however, my fears are less concrete, and I don’t know that other people share or understand them, leaving me to toil in self-constructed isolation.

***

I feel my chalk-covered palms clasp around the wooden bar, as I swing my legs upwards and pull myself around it so that my hips rest on its edge. I fidget with my fingers and close my eyes, trying to block out the world around me. With the dust in the gym settling in the still air, I visualize the motion of driving my heels upwards to bring my body into a handstand and complete the uneven bars skill I have done a hundred times.

Suddenly, I find myself taking one final breath before I open my eyes and step through the door to the lecture hall, still biting the inside of my lip to keep it from quivering. I tread slowly towards my seat and tell myself that it doesn’t matter that I am not ready for this second year to begin. In fact, it is actually good that school is starting today, because maybe, if I can grit my teeth, put my head down, and push through all my doubts, I will finish medical school and finally become a doctor … before I get scared.

Sarah Heins is a medical student.

Image credit: Shutterstock.com