I think that from time to time, everyone has had the feeling that they weren’t doing their best. Maybe something we did wasn’t the right thing at the time. Perhaps we should have thought about it longer or acted sooner. We often second-guess the decisions we make, whether they involve matters of love, career, finances, child-rearing, or even where to meet the in-laws for dinner.

While I can do that in real life, I can’t do that as an emergency physician. While most of my daily work decisions have nothing to do with life and death choices (more like which antibiotic to give the cigarette-smoking patient with teeth ruined by meth, who has yet another dental infection), sometimes they do.

Sometimes I have to decide whether to administer a specific medication immediately or perform a necessary procedure urgently. Sometimes I have to consider two patients who arrive at the same time and determine which one to prioritize over the other. Sometimes I have to contemplate stopping what I’m doing and letting nature take its course, despite the cries and pleas from a family member trying to understand what has happened to their loved one.

That’s where knowledge and maybe just a little bit of attitude come into play. I trained as a surgical resident for a while. After being a lowly intern during the first year, at some point in the second year, you are allowed to open and close for the attending physician. There’s a certain headiness that comes with being called into the operating theater, scrubbing in, having someone dress you in gloves and a gown, and then having your every wish met as the tech hands you the instruments with which to perform the surgery.

You are in charge of the room. As you gain experience and learn from the attending, you develop your skills. You know what you’re doing, which helps when things start to go wrong. You draw from that experience and correct the mistakes.

I think that attitude helps when making those tough decisions. Or maybe it’s not attitude but confidence: knowing what you’re doing and feeling good about the decisions you make. And sometimes, when that little bit of doubt creeps in, I think about a great white shark meme I had hung up above my workstation: “You aren’t a disappointment. You are super great, and if people get down on you for not being perfect all the time, then bite their faces off. You are super great, and faces are high in protein. Super great.”

I mentally smile inside and continue on because that’s what’s expected of me: to be the person holding it together and making the decisions while others look to me for calm leadership. I take that experience and attitude and get the job done. Super great.

Veronica Bonales is an emergency physician.