Up until a few years ago, I was living my life entirely in fear. In my earliest years, I remember lying awake at night judging if the creak I heard was significant enough to mean someone was breaking in. I was scared of basements, scared of strangers, worried if my parents would come home safely—the usual collection of childhood fears. During adolescent years, the fears of my approval-seeking self focused on achieving good grades and being liked by my peers. Even the anger I expressed towards my parents on occasion was a form of fear: I was fearing missing out on an experience with friends or fearing embarrassment around something related to our family.

Fast forward to being a new attending, and the same song kept playing, though this time, it was louder than ever before. I was relentlessly living in fear of being an inadequate doctor and missing an important diagnosis. When a specialist would call to discuss a mutual patient, my heart raced as I anticipated hearing that I had made a mistake. When I would be notified that one of my patients was in the emergency room, my instinct was to assume it was an omission on my part that landed them there. There was also a sense of unease in disappointing others. I feared disappointing patients if I did not offer to squeeze them into my already full schedule, I feared disappointing staff if I spoke up about my expectations around their performance, and on the song went…

As I entered motherhood, a new flavor of fear appeared: guilt. Guilty for wanting to sleep instead of play with my new baby, guilty for leaving him at day care for too long, guilty for feeling frustrated—endless guilt, endless fear that I was not being a good mother.

These fearful thought patterns were the fuel for a state of burnout at work and at home for me—a state partly created by my difficulty in upholding boundaries. I was too afraid to disappoint anyone, and the price I was paying was exclusively disappointing myself.

Courage came to me in the form of accepting help from a physician coach. I started learning how to untangle my thoughts and feelings from my identity, and that I existed on a level higher than the person reacting to the situation. I started noticing how many senseless fears I was carrying—fear of pain, fear of the unknown. In avoiding my fears, I was limiting the vibrancy in life. I was keeping myself small, my life small, by always taking the safe route.

My dear colleagues, we will always have that fearful, critical voice in our head trying to protect us. But many times, it may also cage us and keep us from achieving our full potential. Or perhaps from reaching for our heart’s desires. We need our fear to survive, but we need our courage to live. And so, the true work becomes recognizing where our fears limit us and taking the step to act beyond them. As Mary Oliver wrote: “Tell me, what is it you plan to do with your one wild and precious life?”

Sonja Grigg is an internal medicine physician.