I had matched into one of my top pick residencies, and I was living out my “dream life.” I was a very proud active-duty military member, and I was an oral and maxillofacial surgery resident. I loved where I lived, and my co-residents were amazing. The program fit my personality, and I was surrounded by extremely supportive attendings with few exceptions. I had gotten exactly what I had hoped for and more, yet rather than feel content, I became actively suicidal. Fast forward three years, and I would ultimately be discharged from the military after seeking mental health treatment, which prompted me to resign from surgery halfway through my six-year residency. I have been trying to make sense of what happened ever since, and I recognized that the patterns that were contributing to my suicidality were trapping me in a cycle which has taken several years to escape.

The dangerous trap of tying worth to achievements

One of my first attempts at escaping the suicidality was to bury myself in work. After being discharged from the military, I transferred from oral and maxillofacial surgery (OMFS) into oral medicine residency. I did not give myself time to pause, ground, and recover, a decision that contributed to my psychache as I continued to be chronically exhausted and overextended. I thought working harder could get me back to where I needed to be and finally feeling worthy. I was very wrong.

At the same time, the shame of being discharged from the military and quitting surgery fueled the unworthiness fire within, and I numbed myself by restricting my food intake and running compulsively, the exact solutions that sabotaged my military and surgery careers. Despite knowing the harms, I had a difficult time stopping as I did not feel worthy of food (or life) after “letting down” the military and my surgery residency (my own perceptions). I believed that if I ate, I needed to earn it through exercise. Though it was an attempted solution to reduce my own suffering, anorexia nervosa exacerbated the suicidal thoughts.

Throughout that time period, doctors who feared I may die from starvation cared about my life more than I did. I was more afraid of facing the guilt and shame of being a quitter than dying. Dying became an almost welcomed alternative to my mental anguish and exhaustion from the never-ending cycle of working harder and harder to prove my worth and constantly feeling that I was coming up short.

Escaping the cycle of shame and perfectionism

I did not see as clearly, then, what I know now: Tying our worth to our achievements is a very risky trap. When I believed that my worth was dependent on my achievements, I pursued the hardest career I could think of using my dentistry degree and aimed to perform perfectly. The gap between where I envisioned I needed to be to feel worthy (i.e., perfect) and where I perceived I was (i.e., always less than perfect) sustained the shame voice that constantly told me that I was “never enough.”

Being a shame-bound perfectionist and attaching my worth to my achievements were two of many factors that collided together and increased my risk for suicide. What I have learned during recovery is that the “never enough” voices tend to become engrained during developmental years and by systems that emphasize outcomes and reward perfect scores rather than embracing the imperfection of being human with love and compassion. Chasing perfection to reduce the shame actually maintains it in a vicious and never-ending cycle.

The turning point for me came when I intentionally stopped, faced the shame, and shared my experiences with others who offered compassion and non-judgment, proving for myself that shame thrives in isolation and heals in connection with others. Unburdened from toxic shame, I jumped off the merry-go-round attempts to feel worthy of life through more achievements. I spent time developing self-compassion and cultivating a sense of intrinsic worthiness. Self-compassion has helped me to stop tolerating shame-based approaches to learning, as I no longer believe that I deserve to be treated poorly and accept that learning requires a sense of safety. Detaching my worth from my achievements has been helping me to reduce how much I chase external validation and has helped me to turn inward and connect with my spiritual beliefs to identify how I am meant to contribute to the world. These changes have brought me more peace, contentment, and fulfillment, which I perceive are the feeling states that many of us really want in life while being misguided by societal pressures that lead us astray.

Lessons from facing mortality

As I reflect back on the journey, I recall how catastrophic it felt to change careers. I did not want to show my face after leaving surgery, and I was buried in shame and guilt for being deemed “unfit” for military duty and a quitter. However, I have pivoted several times since then without it being such a shock to my sense of self as I have learned to identify more with my values and less with who I think I need to be to prove myself to others. Nearly dying a few times has helped to open my eyes to what matters to me in the end, though I believe there are safer ways to learn the lessons (hence sharing them, here!).

When I reflect on what I learned while sitting in a hospital bed with a heart rate in the 20s due to anorexia and thinking that I may die, I recall a profound awareness that my achievements could not save me. The material items that I owned felt more like burdens than comforts as I imagined someone else getting rid of them when I am gone. As I sat there alone, I saw that the things that I gave up in an attempt to become who I thought I needed to be to feel worthy were actually what mattered: time with loved ones, health, and inner peace, to name a few.

Contemplating death can change us if we allow it, though I admittedly did not make drastic changes right away after being told I may die at any moment from complications of anorexia. It has taken several years to release myself from the grips of faulty narratives that were destroying me and embrace a new way of living. Today, I aim to live a simple life in alignment with my values. I maximize what matters to me while minimizing the noise of societal pressures that often lead us astray. While the journey has been dark and painful at times, I am grateful for facing death as I believe it taught me how to live more fully.

A message of hope for medical professionals

In hopes that you may also live fully, I leave you with these questions:

1. What would you like to take away from this article and apply to your own life?
2. If today is your last day on Earth, what would you regret?
3. What step will you take, today, to reduce regrets on your deathbed?

For those who are feeling burdened by shame and/or are feeling suicidal, I hope my story helps you to believe that the pain will not last forever, though I understand that may be difficult to see when feeling trapped and exhausted. I hope my story helps you to believe that there are ways out that can lead to better roads ahead for you. Please seek support from loving humans who may provide compassion and nonjudgment (the type of connection that heals shame) and know that nothing in your career is more important than your life. Nothing. You are worthy of living a fulfilling life, and I do not need your curriculum vitae (CV) to know that.

Jillian Rigert is a physician coach and a marriage and family therapy graduate student.