“What do you think, Doc?”
Mr. G gazed expectantly at me from his bed. My palms started sweating and my tongue felt like sandpaper. I fiddled with my hospital badge as I furtively glanced around the room, searching in vain for my senior resident, who was working elsewhere. I resisted the urge to excuse myself and frantically scour the medical literature on my phone. “I am not the doctor,” I thought to myself. “I am just the medical student…if only for a little while longer.”
It was January, and I was in the middle of my final rotation of medical school—a sub-internship, more commonly referred to as a “Sub-I,” which aims to prepare soon-to-be medical interns (first-year residents) by challenging them to provide patient care as independently as possible. I have always been able to efficiently take charge of a situation, maintain composure under pressure, and lead with confidence and grace. However, with graduation and Match Day (the fateful occasion during which residency placements are announced) looming on the horizon, I suddenly felt unsure of myself. I was transitioning from a student to a doctor—a milestone for which I had been preparing since childhood. Residents and attending physicians trusted me to make independent decisions and supervise students in the earlier stages of training. Loved ones sought my advice for various ailments and sent pictures of recent injuries for my unofficial “diagnosis.” As a fourth-year medical student, I was expected to start thinking and acting like a doctor, because I would soon be one. Soon, the implications of my decisions would extend beyond test scores, into the realm of life and death. This epiphany hit me with the biting force of a chilly winter gale—the kind that makes you gasp for air and rub your stinging, watery eyes. I was suddenly plagued with misgivings: “I have no idea what I am doing. What if I make a terrible mistake? I have forgotten everything that I have learned, and I’m not even sure that I learned anything properly, in the first place. Am I good enough? I feel like a fraud.”
“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure…We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented and fabulous?’”
~Marianne Williamson, from A Return to Love: Reflections on the Principles of “A Course in Miracles”
Imposter Syndrome is a pervasive phenomenon. At one time or another, we all struggle with self-doubt in our personal and professional lives. It is human nature to second-guess our abilities, compare ourselves to those around us, cling to complacency, resist change, and doubt our accomplishments. If left unchecked, Imposter Syndrome can cripple our emotional well-being and ultimate success. How, then, do we “get out of our own heads”?
For me, singing is the most effective weapon against self-antagonizing ruminations. I literally drown out my doubts with an extensive, eclectic music collection. I release stress by belting an odd combination of show tunes, arias, and ABBA songs in the shower. In rehearsals, I pour my soul into the notes on the page—and into the ears of patient choristers, who kindly listen when I vent. Ultimately, I draw upon the core tenets of singing—guiding principles on which many Atlanta Master Chorale choristers rely:
1) It is not about you.
We sing in order to tell a story, foster human connections, and bring beauty, light, and hope to a demoralized, destructive, and discordant world. We do not sing for standing ovations, accolades, and personal recognition; those are simply the perks of outstanding, inspiring performances. Singing is a form of service, and the singer is merely the vehicle through which the story is told.
2) Find a happy medium between self-doubt and hubris.
Singing requires the ability to act—to “fake it till you make it.” Underlying insecurities add unnecessary bodily tension, rendering the singer’s instrument ineffective. Feigning confidence coaxes the body to relax, allowing singers to showcase their innate talents and technical training. Singing also requires the humility to seek and accept feedback from the director, accompanying musicians, fellow singers, and even the audience. The singer then incorporates this feedback into real-time adjustments in tone, pitch, diction, dynamics, tempo, and body language, thereby creating a richer performance.
3) Don’t let the big picture overwhelm you.
Keep the overall musical scheme in mind, but approach the piece note-by-note, measure-by-measure, and phrase-by-phrase. The downbeat of a concert is not the time to agonize over the audience’s reaction, or the tricky, chromatic section on page 10 of the score. Self-doubt derails the performance, but focusing on smaller tasks helps the singer surmount musical challenges.
4) You are never alone.
A choir’s success lies in each singer’s ability to lead effectively while uplifting the group, for “as we let our own light shine, we unconsciously give other people permission to do the same.” It is the blend of individually beautiful voices, guided by the director and supported by the underlying music, that makes a choir truly extraordinary. Singers approach the music from their own vocal perspectives, but ultimately collaborate to create a unified sound. If one singer momentarily falters, the choir carries that person forward until he or she regains footing. Even soloists do not perform alone; all singers glean strength, inspiration, and support from their directors, audience members, and accompanying musicians.
Like singing, medicine is ultimately about service, advocacy, compassion, and human connections; it has little to do with personal achievements. Providers are not omnipotent, and the best doctors possess the humility to ask for help and the ability to respond to feedback in real time. Fretting over the trajectory of one’s career is unproductive; it is better to focus on daily tasks—executing them with intentional confidence, and viewing them as learning opportunities. No one works in isolation. From the attending physician, to the employee who mops the hospital floor, everyone collaborates as an interdisciplinary team. When we blend our unique “voices” together, we are better-equipped to serve our patients and shine a healing light onto a dark, broken system.
It is now mid-April, and I continue to exist in a period of growth, upheaval, and transition. Match Day is now a beautiful and relatively distant memory, and my classmates and I are preparing for the start of our respective residency programs. I will graduate in May, move to a new city, and begin my emergency medicine residency in June. I specifically chose this field because I wanted to work “in the trenches” of the medical system, and although I do not truly know how the current pandemic will affect my first year of residency, I hope that I can rise to the challenge of serving patients during this difficult time. Even in the best circumstances, intern year is a grueling year for everyone, because the stakes are higher, the hours are longer, and our tasks are more complicated. If we succumb to self-doubt, we will be crushed by the weight of our newfound responsibility. Instead, we must each find ways to shift the focus from our own perceived inadequacies onto providing excellent, compassionate patient care—drawing upon our training and collaborating with more experienced members of the healthcare team.
Whenever I grapple with insecurities at the bedside, I will think of music, for even after I acquire a new title and embark on a new career, I will still be the same person that I am today—a singer. For me, the secret to combatting Imposter Syndrome lies in finding ways to keep “singing,” even when the glittering stage is replaced by a sterile hospital room.
Therefore, in moments when I feel unsure of myself during residency, I will go back to that day in January, when music ultimately gave me the courage to turn back to Mr. G, take a deep breath, and say, “Here’s what I’m thinking…”
-Written by Naomi Newton, Soprano in Atlanta Master Chorale
 Williamson, Marianne. A Return to Love: Reflections on the Principles of “A Course in Miracles.” HarperCollins, 1992.