Practicing Medicine Through Self-Doubt

Many years ago, I had to miss school one morning because of a piano examination. I still remember the waiting room with no windows. There I was, sitting by myself. It was quiet. Too quiet. My heart was beating faster than usual. It was as if there was an amplifier for my heart sounds. I questioned if I was ready for the exam. I wondered if I would make major mistakes in the piano pieces or the aural session. At one point, the thought of not going into the examination room crossed my mind. Those fifteen minutes of waiting time felt like an eternity. Then I told myself that I prepared as best as I could. I will do my best. I walked into the examination room and greeted the examiner. I told myself I could do it. And I did. I made it through.

In medicine, it is common to experience doubt as physicians. In many situations, there is no absolute right or wrong answer. You may question if you are making the best recommendation for your patient. You may question if you have researched enough on a topic. You may start to question yourself if you are a good doctor.

Whatever it is, doubt can surface at any time. It is sneaky because it never disappears completely. Doubt revisits when you are faced with something new. Doubt knocks at your door when there is something you find challenging. Doubt is the feeling of uncertainty. In other words, as long as we are human beings, we are going to experience doubt from time to time. The question is, how to handle doubt so that we are not paralyzed by it.

Acknowledge doubt exists no matter how confident you think you are. You are constantly facing something new, and anything can trigger the uncertainty you have about yourself. Accept it when you are having doubts. What are you thinking that is causing you to feel that doubt? Ask yourself this question without judgment. You want to know what you are thinking and how that is affecting your feelings.

Accept that, in many situations, we are never going to be 100% ready and that is okay. If you wait until you are completely ready, you are probably not moving forward. When you have doubts about something, allow your brain to come up with what you are certain about. Look at your past experiences, especially in similar situations. Look at the time when you had doubts and you did it anyway. When you allow yourself to do things while acknowledging your doubts, you will continue to make progress and get closer to your goal.

Ask yourself, if you proceed with your decision, if you take action – what is the worst that can happen? You are doing your best. You are using your best judgment based on the medical knowledge you have. You make the decision to treat the patient with this drug for her cancer. The sooner you make the recommendation, the sooner the patient can get started. If you are questioning and doubting yourself, wondering if it is the right call, then the patient will still be waiting for some kind of intervention. Or the patient may decide to go with a second opinion. The worst that can happen, in this example, is that the treatment may not work or the patient may have significant adverse effects. Then we stop the treatment.

What is something positive that can happen? Of course, feel free to ask yourself what the best thing that can happen. If the potential benefits outweigh the risks, even though we do not know for sure if our decision or action will work, give yourself the confidence to take the next step. You may gain a lot more than you think.

Ask for help. When in doubt, talk to someone. Another set of eyes may see the situation at a different angle which is more helpful for you. It may be something you have never thought of. The other person may also serve as someone who challenges your thoughts and beliefs. Surround yourself with people who believe in you, who support you. It does not hurt to have someone next to you who has confidence in you, especially when you are doubting yourself.

Self-doubt is always part of our lives, be it at work or at home. Doubt may be louder at times. Acknowledge and accept its existence. Be kind to yourself when doubt arises. Find out why you feel doubtful, without judgment. Give yourself a boost of confidence by looking into your past, looking at what you accomplished. Ask yourself if you make that decision, if you make that move, what is there to lose? What is there to gain? Talk to your support group, someone who knows you and someone who supports you. Doubt is part of life. We can move forward beyond doubt when we can coexist with it while allowing some confidence in ourselves.