It’s only in hindsight that we can see how we came to face such a large pile of crap. But unfortunately, hindsight isn’t very helpful when we’re facing the crap. I can tell you that I’ve used hindsight to bludgeon myself more times than I can count.

Hindsight can be helpful to us when we want to come up with strategies for preventing the same crappy situation from occurring again. But when we use it to beat ourselves up, it’s like being mad at yourself for not being superman. That’s just silly!

We can only make the best decisions we can with the information that is available to us in that moment. It’s easy to look back, after we have more information, and tell ourselves how dumb we were. Sometimes our priorities were not quite aligned, and we chose one priority over the other and it led to a painful outcome. 

But when we can learn from what happens without beating ourselves up, that’s where the value lies in hindsight. Why all this talk about hindsight today?

Two nights ago I found myself in a pickle. (A poo pickle, if you will.) And when I woke up in the morning, the pickle was still there to deal with. The options available to me were not very appealing– in fact they freaking sucked. 

When I first found myself in this pickle, my first reaction was to say to myself, “I’m such a sucker! How could I be so naive?!” I quickly moved into self pity, “Why is this happening to me? Why do I have to be the one to deal with this right now?!” Eventually I found my way into acceptance. 

The shit had already hit the fan, and it was time to deal with the aftermath. That’s why I think in these moments, when we are left with the shit no one else wants to deal with, we are best served by our courage. It is through courage, not shame, that we can make the best decisions for ourselves in those challenging times.

You have to put hindsight, blame, and shame aside when you are in problem solving mode. Whatever it was has already happened. Beating yourself up will only serve to increase your panic and zap your critical thinking skills.

Courage helps us see which path is the best path forward amidst the chaos. Through courage, we can take action despite our fear. It is only after we have settled the matter at hand that we can gently bring hindsight into the picture to study the event that unfolded.

So what can you do to face your steaming pile of crap (or pickle, or whatever else you want to call it)? 

Start by taking a deep breath (maybe near a nice candle or slap on some Vicks vapo rub to avoid the stench). Come back to your values and ask yourself, “What do I think is best at this moment? What can I do that aligns most with my values?”

Sit with those thoughts for a bit, not the thoughts about what other people will think or how it is the most awful thing in the world to happen to you. Remind yourself that every single person on this planet makes mistakes. Remember that you’re not the first person to find yourself in this pickle.  

Let the emotions that come up flow through you without attaching a meaning or story to them. Feel the emotions come and go, remember your values, and breathe. A solution will come to you, even though you may still feel uncertain and afraid. Courage will help you to act anyway. 

After the dust has settled, then take a peek at hindsight. That is the time to see what nuggets of wisdom you can get out of the crap pile you just conquered. Happy shoveling! 

The first talk I heard this morning was with Viola Davis, powerhouse actress and badass human being. Viola talked about the difference between ‘being real’ and being transparent.  Being real is trendy and avante garde, like openly rocking your $15 shoes.

But being transparent is about being vulnerable to express what’s really true for you. It’s about admitting when you’re struggling, embracing your weirdness, and setting aside the mask you wear to make other people comfortable.

Interestingly enough, the third talk I attended echoed those same themes about showing up in the world as yourself. Jay Schwedelson put on a talk called “How it Started & How It’s Going: How Failure & Pivoting Can Create Massive Opportunity”. He talked about his failures over his career and coming to realize that he only needed to be stellar at one thing rather than lots of things. 

Jay humbly poked fun at himself, with his less-than-impressive powerpoint slides that had personal photos of him. He talked like a normal human being rather than a fancy corporate person, and it was a breath of fresh air. 

In day nine of my journaling experience, I mentioned the more I embrace just being myself and not patrolling my interactions with others, magical things start happening and I meet the right people. Jay echoed the same thought, saying that when he stopped censoring himself and trying to be perfect, the number of people that walked into his life exploded. 

And then they featured freaking DR. JANE GOODALL. My god, what an icon. Talk about a total badass of a woman who, at 88 years old, continues to spread the word about hope, sustainability, and loving on our planet. 

My biggest takeaway from her talk is that there is still hope. And when we get so mired down in being hopeless, we put ourselves in tiny little miserable boxes that don’t serve us. But when we have hope that we can make a difference, and act on the little pieces that we know we can do, our life changes.

I’m tired of feeling anxious and afraid everytime I pull up the news section on my phone. I’m tired of my family members and I talking about how the world is going to hell in a handbasket. That doesn’t serve me and it certainly doesn’t help change things. 

I don’t want to live in the land of overwhelm anymore. I’d rather live in the present, have hope about what good things I can experience today and how I can help spread that goodness to others. That sounds way more enjoyable and within the shit I can actually control.

So what am I going to do? I’m going to surround myself with the stuff that brings me hope and actually makes me feel like doing something. Books, movies, songs, people, stickers…

Hit me up if you want to join me on this journey towards more hope!

Growing up in a family where intelligence is king, I tend to wear my intellect and big fancy words like a suit of armor to hide my insecurities. If you don’t feel good enough, just try to look smart enough! Right?

Ha! Here’s the problem I’ve run into with this. My goal is to have really great relationships with people. Relationships where I feel safe to be myself and to share my hopes, dreams, and silliness.  

But when I hide my vulnerability behind big fancy words and academic stuff, I find that it creates a barrier between me and the people I would otherwise enjoy meeting and getting to know. I love to learn, and that will always be a priority of mine, but that doesn’t mean I have to parade around my vocabulary.

For people that don’t speak or write that way, it can be intimidating. It shuts down some amazing conversations I could have had. So every day I’m working to step out from behind the smarty pants persona and just be me. 

It’s funny, because in medical school and the surgery world, you want to look impressive. Fake it til you make it. It’s seen as a sign of weakness to admit that you don’t know something or speak like a normal human being. 

I learned to put my accomplishments first and pretend to be confident, even if I wasn’t. All praise the research studies you’ve published! 

But that’s not who I want to be. I want to be someone who can talk with people without them having to scratch their head or silently nod without knowing what the hell I’m saying. That’s a one-sided conversation where nobody really wins. 

It’s a bit scary to show up and just be yourself, but I’m finding that as I do it, I find more people I actually enjoy talking with. Yesterday when I was at Starbucks, I met a couple from Boise, ID whose daughter graduated from medical school and is in internal medicine residency in Ohio. 

For the first time, I was casually honest with these strangers about my PTSD from surgery residency and how I was just working on figuring out life. I didn’t make fun of myself, I didn’t try to make myself look better than I was. I just shared my truth with them.

And we had a great conversation! They thought it was great that I am working on spreading the knowledge I have about emotional health and learning to love yourself. The wife got a kick out of me buying a bus, and told me I should finish it, even if it takes me five more years. 

We grow up in a society that tells us to be afraid of being ourselves. Most of the advertising world is about making you feel like you’re not enough and then trying to sell you something to fill that void. But it’s a bunch of bullshit. 

There’s enough space for everybody. It doesn’t matter what kink you’re into, what you like to nerd out about, or what flavor of mental illness you struggle with– there’s room for everyone. The more you embrace who you are and show up in the world without hiding, you will find the people you enjoy being around. 

Just be you, boo. The rest will fall into place. I believe that now, even though I will probably forget it at least 100 times in the next month. But that’s ok too.

Antidepressants don’t work well for everyone, but when they do work, they’re a godsend. Especially when you combine them with therapy and making changes to your thoughts and actions. Healing happens when we allow ourselves to rest, surround ourselves with low-stress, nonjudgy people, and take the time to listen to what we really need. 

We have to get out of the overwhelm before we can start healing. For those of us that judge ourselves for “being lazy”, this part can be the hardest. We want to go go go, but that’s not what our bodies and minds need when we are overwhelmed. You have to just STOP.

One of the things that sucks about PTSD is that it will creep into your day when you’re least expecting it. Yesterday my brain made the connection between the word Park and one of my former attendings. Suddenly I was back in that program. 

Once the triggers start, they tend to keep pulling other memories and feelings. But I’ve been learning not to judge myself for it. When those moments happen, I take a deep breath and remind myself that I’m not in that hospital anymore. 

I remind myself that I never have to go back to medicine or work at another hospital if I don’t want to. Then I take stock of the good things in my life and think about how far I’ve come already. I try to ground myself in the present moment. 

It’s getting easier. The more I keep gently coming back to the traumatic memories and untangling the connections with my childhood, the more I heal. One little baby step at a time.

Going back to the creativity bit, I want to share one of the thoughts I had yesterday. I know I’m kind of all over the place today, but who cares?

What if shame (along with guilt, embarrassment, and humiliation) is something we learn rather than being born with it? I’m no Brene Brown (the master of shame research), but hear me out.

When we look at little kids, they experience a whole bunch of emotions: anger, fear, sadness, joy, envy. But what about shame? I don’t think so. 

I think shame is something we learn. It’s something we’re socialized to experience. Shame is used to control people: from kids to adults.

There is a difference between learning there are consequences for our actions and learning to be ashamed of our actions (and even thoughts!) Shame keeps us in our place and prevents us from being too much or from asking too many questions. 

So who benefits from shame? Systems and people in power with authority. They benefit from people being weighed down by shame. 

Because when we decide to let shame go, what might happen? We might be more creative and innovative. We might demand better. 

And all of that leads to disruption of the status quo. Which is bad for those who want to keep the status quo humming along at its mediocre level. They benefit from keeping the rest of us small. 

I invite you to do a thought experiment. How does your shame help you? Can you think of any one good reason it benefits you? 

And then I’d like you to ask yourself, what would you do if you weren’t ashamed of anything? Who would you be? How would your life be different?

I’m really interested in what you think about shame and what your answers are to those questions. Leave a comment and let’s talk about it!

Did you want to see me broken?

Bowed head and lowered eyes?

Shoulders falling down like teardrops,

Weakened by my soulful cries?

Does my haughtiness offend you?

Don’t you take it awful hard

’Cause I laugh like I’ve got gold mines

Diggin’ in my own backyard.

You may shoot me with your words,

You may cut me with your eyes,

You may kill me with your hatefulness,

But still, like air, I’ll rise.

I want to dive deeper into the thought of how we hold ourselves back. Perfectionism in particular, has been the bane of my existence. And I know I’m not alone in that.

Those of us who struggle with perfectionism once saw it as something to be celebrated. Sometimes we wear it like a badge of honor, as if it is responsible for our accomplishments and superior work ethic. But that couldn’t be farther from the truth. 

Perfectionism is a soul sucking, creativity killing, joy smashing piece of shit. 

It causes you to constantly compare yourself to an ideal you can never meet. Nothing is bloody perfect, and yet those of us that struggle with perfectionism will exhaust ourselves with needing the product of our efforts to be “just right.” 

We wait until the timing is just right, enough people agree with our ideas, or the stars are in precise alignment. But what good does that do us? Not a damn thing. 

Perfectionism is an excuse to let our fear sit in the driver seat of our life. It prevents us from taking chances and being brave enough to really live. We think it will save us from being embarrassed, judged, or criticized.

But it doesn’t. Those things will happen no matter how hard we work, how closely we pay attention to details, or how precise our craft is. 

Judgment from others really doesn’t have anything to do with us. It has much more to do with the person doing the judging. When we claim responsibility for how other people feel about us, we keep ourselves small and afraid. 

Ok, so how do we go about breaking free of perfectionism? You’re not going to like it, and I know I don’t. You get ready to fail.

To combat perfectionism, you stop when something is “good enough.” You turn in your half-assed attempt. You try something even though you know you are going to suck at it.

You fail, again and again, until you realize that failing isn’t as scary as it’s cracked up to be. The world doesn’t end. People may make fun of you for a while, but then they move on to more exciting (or mundane) things in their lives.

Overcoming perfectionism is realizing that people don’t pay as much attention to what you’re doing as you think they do. They are too busy with their own insecurities and busy lives. 

This is why I’m writing and posting these journal entries publicly. To push myself to confront my perfectionism head on. Nobody is really going to care that much about what I have to say.

Some people might be marginally offended by my swearing, or majorly offended by a stance I take. But so what? I have a right to show up imperfectly and take up space, just as much as anyone else on this planet.

Hi, I’m Dr. Jessica Simpkins and I quit residency with $200K in student loans. I’m unemployed, have little money in my bank account, live with my parents, benefit from Medicaid, and struggle with PTSD. 

These facts don’t even begin to capture all of who I am. They are only part of my journey.

Go ahead and judge me. Be my guest. There’s nothing you could say to me that I haven’t already said to myself. 

I’m not hiding behind the mask of perfectionism anymore. You’d better bet I’m going to keep falling on my ass as I move forward, but I will keep getting up. I will keep learning from each and every failure. 

And every time I am reminded that I am enough without needing to do or be something more than who I am, I will only get stronger. Resilience is the antidote to perfectionism.

I could see the space in my mind’s eye. The art studio was partitioned from the coffee shop with a glass wall. Patrons in the shop could have a glimpse of the ongoing classes while the students on the other side would have a sound buffer from the busy happenings of the coffee shop. 

I could see all kinds of people coming into the coffee shop to gather. A group of bird-watching enthusiasts got together weekly to share stories and photos. Two mothers caught up over coffee while their kids stayed occupied at the kids’ table. College students studied for their exams while professionals worked from their laptops.

There would be open mic nights and other events held on evenings and weekends. The studio space could be used for a variety of classes. It was a place for all people to feel welcome and safe. A place to exchange ideas and foster community.

This dream kept me going through my year in general surgery residency. It probably says something that what got me through that year was dreaming of this community coffee house rather than being excited about becoming a surgeon.

During my year in surgery, I actually started a website with plans to grow my community coffee house online first. I looked into drop-shipping coffee and reached out to one of my favorite coffee houses in Sioux Falls, SD ask about a partnership. They said yes!

The funny thing is that the coffee bag design is what stopped me. At that point, the trauma of my year in general surgery was taking over, my confidence took a dive, and I began to question my ability to do things. 

The more my trauma response started to kick in, the deeper into survival mode I went. Like I mentioned in day one of my journaling experience, it took me down so low to the point of not wanting to be alive anymore. And although I’ve since quit residency and had a few glimmers of directions I could take in my life, my confidence is still shot to hell.  

When you endure trauma and watch other people in your life endure the same trauma, it can feel like all of the light and hope has been sucked out of the space you live in. It fucks with your brain and robs you of your self-trust. 

How can I trust myself when I led myself down that path for so long and let myself be abused? Ah, here we have another narrative. The narrative that says that I am solely responsible for the bad things that happen to me. That it must be my fault. 

I am afraid to be angry at other people when they harm me, because I grew up feeling unsafe around anger. If you’re angry, things will be taken from you, perhaps even love. Anger makes people say unforgivable things that leave permanent scars, right? 

That’s what I used to think. But I recognize now (at least on an intellectual level) that anger is totally appropriate and a valid expression of our experience. It’s how we express that anger that can be healthy or harmful. 

So as messed up as this may be, I have a hard time being angry with the surgery program for treating me and my colleagues the way they did. It was easier for me to feel like I had done something wrong than to see how bad up their mistreatment was. 

That’s also why I’ve had a hard time recognizing how much my PTSD has actually affected me. I blamed myself for my lack of motivation or my reluctance to get a new job, rather than recognizing these are residual effects of my PTSD. 

I’m not advocating that we blame everyone else for our trauma or that we adopt the role of a victim. But what I am saying is that we also shouldn’t blame ourselves for the shit that happens in our lives. 

Blame is not helpful. It keeps us stuck. We can try to look at our trauma with curiosity rather than judgment in order to understand how it is affecting us and to look at ways that may help us move through it.

I can be angry at what has happened to me, I can even be angry at people for what they have done to me, but to live in that space of blame keeps me from healing. It doesn’t turn back the clock and prevent me from experiencing the trauma I went through. 

As frustrating as it is to not be able to be back into my state of optimism about the future, I recognize now that I have to focus on healing first. My dream community coffee house will still be waiting for me. And whatever dreams come to life in the future will be all the more beautiful for my resilience and the deeper connection to myself that I’ve built.

As someone who values authenticity, I want to share my stories with all of their bumps and scars, not just my highlight reel. 

The last two years have had me on a crazy journey. In 2021, I hit rock bottom. Since then I have started to rebuild myself from the ground up.

I was on this trajectory to become a general surgeon. I’d graduated from medical school with my MD in 2020 and started my intern year in general surgery. I was so freaking excited until I had all of that excitement and enthusiasm beaten out of me. 

What I didn’t fully realize is that I had grown up feeling like I had to be an efficient, achievement-driven machine, to sacrifice my own wants and needs for the sake of others, and to avoid making mistakes at all cost. I unconsciously feared punishment, rejection, and the threat of having love withdrawn from me. 

This led me to mask in public, have different personas I would pull out in different settings,  and to squash the parts of me I thought other people didn’t want to see, hear, or know. 

With that programming in my back pocket, I started residency at a place that abuses their residents. Nothing you did was ever good enough and it was always your fault. 

You worked more than 80 hours this week? That’s because you’re not efficient, not because you had too much work on your plate. You didn’t know something? Well clearly you didn’t study or prepare enough. 

You think that patient is having a problem that we aren’t adequately addressing? You’re wrong. Your supervisors always know better than you. 

After routinely getting yelled at or sworn at just for asking questions, my curiosity became a liability. Questioning anything became dangerous and grounds for punishment. 

My fear of making mistakes shot through the roof. I had patients’ lives on my hands and little support from anyone. Not to mention we saw some of the most horrible things happen to human bodies.

I now know what “human roadkill” looks like. One man who was very dead was brought in by EMS after he had been run over by a semi-truck at high speed. I’ll save you the gory details, but it was surreal to see a human body be that completely broken.

There were so many more people I helped care for that had been shot, stabbed, burned, or had their limbs ripped off in motor vehicle crashes. That year I had the responsibility of having to do a “death exam” and pronounce three different women as dead. 

The first woman I pronounced as dead was younger than me. A photo of her four-year old daughter was taped to the wall across from her bed. It was brutal.

There were never any debriefs, never time to process the horrific things you saw. I didn’t have a PCP or dentist for that entire year, let alone a therapist.  

It felt like I lived off adrenaline during those twelve months. I was on edge all the time, waiting for the floor to fall out. One day I had a panic attack at the start of my shift in the emergency room when I learned my co-intern was put on remediation. 

Even though I had decided in October that I was going to leave the program, I felt like I had to protect myself at all costs. Internally I was screaming at the top of my lungs, but externally I had a huge smile plastered on my face. 

Masking all the time was exhausting. I lied about why I was leaving, and pretended like everything was fine. But watching my colleagues be punished day in and day out for just being trainees was heartbreaking. I felt so f*cking helpless.

When I moved across the country to start my second year as a psychiatry resident, the PTSD started. I saw my former colleagues everywhere in the faces of hospital employees in blue scrubs and scrub caps.

Every Tuesday I was on edge for the lectures, fearing I would be called out and ridiculed for not knowing the right answers to questions. I worked my ass off to be as efficient as possible, especially since I hadn’t studied psychiatry for the last two years.

After the excitement of my first month, the depression started to creep in. That same hopelessness was triggered a few times when I was required to perform care plans I feared were not in the best interest of the patient. With each moral injury, I felt like a piece of me died.

Every day was a challenge to just get out of bed in the morning. I dreaded going to work and began pulling away from my new colleagues. I’d make excuses not to attend social gatherings. 

Gradually thoughts of not wanting to be alive kept popping into my head. For a while, caring for my dog was the only reason I kept living. If I hadn’t adopted my dog when I did, I don’t think I’d be here today.

That’s when I knew I had hit rock bottom and needed to get some help. So I reached out to my program director and asked her if I could take some time off to focus on my mental health. I was very honest with her about what was going on, and she encouraged me to attend a partial hospital program.

I was terrified to be on the other side. To be a provider on the same side as the patients I’d been treating. But my desperation to feel better pushed me to accept the help being offered to me. 

If you’re struggling with depression or thoughts of not wanting to be alive, please reach out to someone who can support you. Call 988, the national Suicide and Crisis Lifeline. You can also see a list of mental health resources put together by the American Foundation for Suicide Prevention.

At some point I learned to just be quiet, to do my best to tiptoe around my family when they were on edge, and to try not to rock the boat. I learned to bring my parents things they would be proud of rather than problems for them to solve. It took me until I was in high school to squash my anger, but by the time I was in college I rarely got angry. 

Anger in particular seemed like a dangerous emotion to me. It caused people to say horrible things that cut like tiny pieces of glass and stuck with you forever. Anger made me feel unsafe and out of control.

This warped into me being an upbeat, enthusiastic people pleaser. No was not in my vocabulary, unless I said it to myself. I took on more and more, always trying to be someone my parents would be proud of.

But I was never proud of myself. No matter what award I had won or accomplishment I had achieved. It was never enough for me. 

My senior year of college, I took a literature class that exposed me to one book that changed my life. Bird by Bird, written by Anne Lamott. Lamott was funny and irreverent. I was shocked by her raw, blunt expression of her life and all of its dysfunction.

This book was a gateway for me into more irreverent, funny books about unapologetically owning our experience and taking responsibility for our lives. At some point, in one of the many books I read, I learned the lesson that we alone are responsible for our own emotions. 

Sadly I can’t presently remember which book really cemented this idea for me.

One day I was waiting at a drive-thru coffee kiosk for them to take my order. There was only one vehicle in front of me and they’d already driven around to the window. I waited and waited and waited. No one took my order. 

I even backed up and pulled forward again to make sure they knew I was there. Someone said, “We’ll be with you shortly.” They never took my order…

Angrily, I drove forward to leave. At just that moment someone said, “What can I get for you today?” I left in a huff without any delicious coffee and thought to myself, “God! They made me so angry!!”

Immediately after this thought popped into my head I burst out laughing. They couldn’t make me angry! I chose to get angry in the face of this situation, but nobody made me angry.

Blaming other people for how we feel prevents us from taking responsibility for our lives. It actually robs us of our own power. How we feel is up to us. 

This also means that we have no control over how other people feel about us. You’ve probably heard the quote by Paulo Coelho: “What other people think about you is none of your business!” It’s a tough pill to swallow sometimes, but it’s true.

When you grow up in an environment where you can’t express your emotions without fear of making things worse, it makes sense you might learn to distance yourself from your emotions and also feel responsible for other people’s emotions. But the truth is that you are not responsible for anyone’s emotions except for your own. 

And none of your emotions are bad! Anger isn’t bad, grief isn’t bad, envy isn’t bad, lust isn’t bad. They are all normal human emotions that all of us experience in our lifetimes.

What’s important is that we are responsible for what we do with these emotions. The words that come out of your mouth or the actions that you take when you are angry are your responsibility. You cannot blame those behaviors on anyone else but yourself. 

It’s taken me 29 years to learn this, but I am not responsible for my mother’s sadness, nor am I responsible for my father’s anger. I’m not responsible for disappointing my family or anyone else. Those emotions are theirs to own, and my emotions are mine. 

What I am still learning is that I am responsible for my own happiness. It’s up to me to experience more joy, gratitude, curiosity, and wonder. It’s my responsibility to treat myself with greater kindness and compassion. No one can do that for me.