In 2016, I sat on a hospital bed in Utah, having flown from North Carolina for specialized medical treatment as my life was slowly slipping away from starvation.

During this time, I was in the Air Force and an oral and maxillofacial surgery resident completing the medical school portion of my training, which I loved. On paper, I had made it. I was finally living the dream I had crafted for myself—so why did I feel so unworthy?

Unworthiness is a common experience—many of us are filled with self-criticism, feelings of not-enoughness, and a sense that we don’t deserve to be where we are. We may think that soon, we will be “found out” and shamed into recoil—seeking safety by moving out of sight from those who may judge us and discover our “truth.” To prevent a catastrophic event from occurring (such as being exposed as a “fraud”—so our brain tells us), we may self-sabotage and pull back to reduce our visibility. We may people-please and morph ourselves into who we think others need us to be to receive approval and acceptance. As we abandon parts of ourselves, it reinforces within our minds that who we truly are is not enough and exacerbates our sense of unworthiness and non-belonging.

This has been my experience, at least—how about you?

For me, my sense of unworthiness and fear of judgment by others translated into making myself smaller and smaller—aiming to reduce myself to oblivion. I threw myself into work and gained doses of self-value from accomplishments, but those moments of satisfaction were fleeting in comparison to the deeply held belief that I wasn’t enough.

Eventually, the pain of not enoughness turned into an unworthiness of nourishment, and if I were to eat, I needed to earn food—a belief that fueled my compulsive relationship with exercise. In our diet-culture-obsessed society, my behaviors were reinforced by the praise I received for being “disciplined” in my obsessively restrictive diet and exercise routine. I craved the praise, but I knew that the perceived “discipline” that helped to numb the pain of unworthiness was slowly killing me.

As I faced the repercussions of believing I was unworthy and the actions that numbed the pain, my mind, body, and spirit suffered. Exhausted, I considered throwing in the towel and had difficulty quieting the voice that wanted instant relief from the psych-ache.

After months of deliberating under the guidance of a team of health care professionals, I surrendered to accepting that I needed help. I flew across the country, and I was admitted for specialty medical care that I thought would save my life.

However, my hope for relief would soon be squashed. The specialty treatment center was not equipped to manage the medical complications of prolonged malnourishment, despite being a dedicated eating disorder treatment center—that problem is a talk for another day.

I was transferred to another hospital and left alone—states away from anyone I knew. As I sat on the hospital bed, unsure if I would make it and unsure if I cared, it became clear to me that all the years I spent chasing achievements and being who I thought others needed me to be were not the keys to contentment. If I died, it was apparent to me that most of the material belongings I had acquired would be a burden for my family to sort through, not an asset. And all of the time spent hating myself for not being perfect? What a waste.

What I could see so clearly, then, were all of the things I gave up in pursuit of a false sense of worthiness derived from achievements and societal approval, including time with loved ones, adventures in nature, genuine community, serving humanity in alignment with my values, and developing my spiritual beliefs. Oof—it was a gut punch as I acknowledged that the things I gave up in pursuit of meeting the demands of societal expectations and pressures were what mattered most to me.

This revelation could have been a catalytic event that spurred instant change, but it did not. The hospital transferred me back to the eating disorder treatment center with the recommendation that my heart needed proper nourishment, and the center confirmed that they wouldn’t be able to keep me with my heart rate as it was. Thus, I flew home, shoved down my feelings, and threw myself back into what I knew—work.

“Surprise”—this did not contribute to improved wellbeing.

It would take a few more close calls with death in 2017 and 2021 for me to surrender to a new way of living—rejecting the belief that our worth is tied to our achievements and rejecting the perception that our value is based on our willingness to sacrifice ourselves for our careers.

Walking the fine line with death also taught me who showed up for me and who cared about me holistically in my time of need, which helped me to see where my attention to gain the approval of those who did not was misguided.

Walking the fine line with death taught me that working harder wasn’t going to bring me more peace, happiness, or fulfillment. It wasn’t going to bring me closer to feeling worthy enough, and it wasn’t going to make me mentally tougher.

You know what did? Self-compassion.

Throwing away what I thought was true about worthiness opened up space to learn new ways of thinking. I dove into the work of Dr. Kristin Neff and found that cultivating tender self-compassion provided healing for all the years I abandoned myself. Developing fierce self-compassion equipped me with the tools to advocate for myself now and in the future. Self-compassion helped me to see that I was worthy of a fulfilling life true to myself all along.

I was worthy all along.

These lessons came at high risk and high cost. We shouldn’t have to walk the fine lines of death to learn them—it may provide little time to make changes if we survive. Thus, I offer my journey to you in hopes you may apply the lessons to your own life without feeling you need to learn them the hard way—you’ve worked hard enough.

And in case you were wondering—no one asked me for my CV, board scores, number of social media followers, how long I could hold my bladder, or marathon times on my (near) deathbed. None of it mattered. None of it.

Remember that.

Jillian Rigert is an oral medicine specialist and radiation oncology research fellow.