When people ask me what A Little Life by Hanya Yanagihara is about, I have trouble describing it beyond the story of a young man named Jude with a horrific past and his relationships with the people he meets in college. The heart of the story lies not in the plot but in the connections that Jude makes with his friends, professors, and colleagues. Jude has a traumatic childhood that gradually reveals itself throughout the book, some of it so heartbreaking that I had to skim through certain sections. What really stuck out to me, though, as a medical student, was the feeling of inadequacy.
Jude’s abusive past leads him to fundamentally believe he is undeserving of love. He struggles to understand why his classmates want to be his friends and why his teachers find him brilliant. His disbelief continues for the rest of his life, through his time in law school and a master’s program, through abusive and healthy intimate relationships, until he eventually kills himself. Jude was beloved and celebrated by so many different people. He was adopted by one of his favorite law school professors and became a highly successful attorney, but none of this love or success was enough to convince Jude that he was worthy.
His fundamental conviction that he is an innately bad human is most clearly illustrated through his relationships. When Jude’s best friend from college, Willem, eventually confesses his love for Jude, Jude responds by saying he had never considered the prospect because he never believed he could be good enough to deserve the love of a wholesome human. He spends his whole life feeling that he is irreparably and that the people and success that surround him would disappear if the dark truth were illuminated.
I have been fortunate in my life to never experience any abuse close to what Jude endured, but I do understand his feeling of being innately inadequate. Throughout high school and college, I felt that my successes were flukes. I anxiously awaited for the moment when people realized I was not as smart or talented as I had tricked them into believing. I prepared to let everyone in my life down, because I knew the truth — that I was not special nor particularly intelligent. Each step in my life, whether it was taking my SAT or applying to medical school, felt like a new opportunity for people to finally find out how disappointing I truly was. I felt like an imposter.
And I know that I am not alone. A study of 1,380 medical students revealed imposter syndrome to be present in 49.4 percent of female students and 23.7 percent of male students. As a woman in medicine, this rings especially true. During medical school, we had some sessions where we talked about imposter syndrome. Other classmates opened up about their own experiences with it. I can easily read about Jude or hear my fellow students express their self-doubts and feel devastated that they cannot see their true worth through their skewed belief in their own abilities. When it comes to myself, however, I continue to struggle with accepting that I am smart enough to belong here.
As future doctors, we have a duty to our patients to give them the best care possible. We took the Hippocratic oath at our white coat ceremony and professed to offer help and to do no harm. This duty is at odds with my self-doubt. I have to question my fundamental belief in my own self-worth (or lack thereof) to know that I can become a doctor who treats patients as well as they deserve. I have to push past the false image that Jude and I and many others face to accept the knowledge that I am capable. But I know that this, like any change that forces you to reframe your understanding of yourself, will take time.
Claire Brown is a medical student.
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