Around the halfway mark of my second year of residency, I was asked to apply to be a neurocritical care fellow. Instead of being thrilled about it, I became nervous. Was this what I really wanted to do? Maybe this would give me some more time to grow into the doctor that I felt I should be. Maybe three years of residency wasn’t enough. I had long discussions with my program director and my residency mentors. I even spoke to other EM docs across the country that had done neurocritical care fellowship and were now working in the field. Even after all of my field research, I wasn’t thrilled about pursuing a fellowship. Despite my doubts, I decided to go for it anyway. At a time where I was looking for an answer to “what’s next?”, this seemed to be the right door to go through. It would be great to be the first emergency medicine trained neurocritical care fellow at my program. I had already been the first EM resident in the Neuro ICU. I enjoyed my time immensely. I could learn more about neurology and critical care, two big interests.
So I applied for and accepted a position as a neurocritical care fellow. My program director, friends, and family were thrilled. Me? Not so much. I told everyone to keep it a secret and I refused to discuss it with anyone. I blatantly lied to people that asked me about my fellowship. I had no explanation as to why I was being so secretive. I just was.
As I finished out the second year and began my final year of residency, I became more unsettled about my decision. I began to work through the emotions that my tough cases at the beginning of the second year brought me. I started to feel a little bit more confident in myself and my clinical skills and acumen. I also started to get excited about my post-residency life. I had personal trips planned, new business opportunities I was considering and other adventures I was looking forward to. But the weight of fellowship started to rest heavily on my shoulders.
The fellowship opportunity came to me like an open door when I wasn’t sure what life decision I should make. I felt like the opportunity was there for me to take it. And as a part of the first class of emergency medicine residents from my program, my pursuing this fellowship would strengthen the bond between the neurology and emergency medicine programs. If I backed out of it, there would be a lot of people that would be disappointed.
Despite my hesitations, I began filling out paperwork for credentialing, sprucing up my CV, having meetings with my future co-fellows and attendings. All the while, I didn’t tell my program leadership my inner struggle. Instead, my co-resident, who was also my closest friend in the program, listened to me agonize over my decision for months. There were so many days where I went back and forth between going through with fellowship and turning it down. Crying, stressing, worrying. I didn’t want to disappoint anyone. But I knew if I actually went through with fellowship, I wouldn’t be happy. I was already unhappy.
One day, about a month before I graduated from residency, I just got fed up with being sad, stressed and unhappy. I had been whining about the same thing for what seemed like forever, and I was tired of hearing myself complain. I was either going to do the fellowship or I wasn’t. I finally said no to fear of disappointment and failure. I pushed back on the notion that I wasn’t good enough as a doctor with the incredible training I had received in my program. I stopped feeding into the insecurities I felt about disappointing others. I realized that every morning I would wake up, and would have to look at myself in the mirror. I need to be proud of the decisions that I make. If I said no to fellowship, would I be harmed? No. Would people be disappointed? Sure. But by saying no, I would get back my happiness, energy, and enthusiasm. That meant more to me than someone else’s disappointment.
I called up my fellowship director and told him that I would not be accepting the fellowship position. Needless to say, he was shocked. My announcement came out of the clear blue sky. As soon as I uttered the words, “I won’t be pursuing fellowship”, I immediately felt a burden lifted off of me. As women physicians, often times we are so relentless in our pursuit to help others that we continuously put ourselves and our true desires last. After months of agonizing and worrying about disappointing others, I finally followed through on choosing myself. I danced around my apartment, cried happy tears and sang. I finally made the right decision for me.
Dr. Kimberly Brown is an emergency physician and public health professional in Memphis, Tennessee. She has a passion for sharing health information with her generation and peers. Her clinical interests include neurologic emergencies, critical care, sepsis and education. Her website is https://www.drkimberlybrownmd.com/