I was glad I brought my water bottle with me. I sipped every few seconds, swishing the water around before allowing it to pass down my scratchy throat. My mouth felt like I held cotton balls in it the entire sleepless night before. I was up anxiously pulling together a lunchtime lecture for the residents, interns, and medical students working in the hospital. All week long, I had put off preparing for this talk. I was way too busy attending to the voices stored in my head. “You’re not good enough for UCSF,” from a chief of nephrology.

“Oh, you’re giving the talk?” from doctors years my junior. Their eyes disbelieving. Their skin like that “flesh” crayon in my childhood Crayola box that never lost its sculpted manufacturer’s point or paper wrapping.

“You’re so stupid.” This one all mine.

I could see the negative evaluations of attendings, written when I was a fellow. Six years ago. They were my colleagues now. I imagined their evaluations continued as whispers between them.

Over and over again like a heartbroken teenager hitting the replay button to hear that sad love long once more because it speaks to her heart so. The words sent waves of paralyzing anxiety from my brain, down my throat, to the pit of my stomach, leaking out onto my skin.

All in anticipation of preparing a talk about how to manage patients with chronic kidney disease. Really? I mean, managing chronic kidney disease is what I do. I was so disgusted with myself. Yet, still, the cotton ball mouth.

I intended for the talk to be interactive. I presented the case of one of my real patients. I asked them questions along the way.

What is important to consider here?

What would you do next?

Not 15 minutes in, I realized they knew very little of what I was talking about. Yet, I was up all night worried about looking stupid.

And then it happened. A medical student asked, “Could you tell us what the mechanism for that is?” It is always a medical student wanting to know exactly how, on a molecular level, something works.

Instead of me responding with something like, “I don’t know, it just does and in my clinical practice that is what matters to me. How about you look up the mechanism and let the group know,” I felt a flash of anxiety rush through me. My recording proven right. I was stupid. I was rattled.

I left that talk feeling like I could have done better, that I could have handled it better. If only I could get out of my own way, see myself clearly, and cut myself some slack when slack is due.

Just a few days later, I shared this with a group of black and brown women physicians at the Amos Medical Faculty Development Program annual meeting. Like me, they were all early in their careers trying to solve some of the problems in this world through research. The program had provided each of us with the salary and project support allowing us to do so. Like me, they had similar experiences of feeling belittled, demeaned, taken for granted, and being mistaken for the nurse, the student, even the janitor.

Nevertheless, many shared how they chose to see their situations. What voices they heard.

“I remind myself on a daily basis that I am a bad ass bitch,” said one. Never mind the not knowing everything; I am continually learning, she said.

Another shared that she doesn’t give a damn about the one (and there is always one) who doesn’t think that they can learn anything from her; she focused on the rest with open minds and good questions. She went on to recount a story of how she negotiated exactly what she needed and then some at her institution. “And, yes, I am a bad ass bitch,” she paused to insert midway through.

I thought about all the diplomas on my office that no one in my family knew how to guide me to get. I thought about all the standardized tests I’ve passed to get to this point, including the Internal Medicine boards. Twice. And the Nephrology boards. I thought about the several competitive research grants I’ve been awarded. And the invitations to speak at the national meeting for the largest organization focused on kidney health.

Damn, I realized, I am a bad ass bitch too. I smiled as this new message took hold of me, daring me to allow what someone else says or what someone might be saying or how someone else looks at me make me ever doubt my badassbitchness again.