Who’s That Girl? Impostor Syndrome at #SMACCGold

Picture courtesy of @mendyourhead - https://twitter.com/mendyourhead/status/328977580013277184/photo/1

Picture courtesy of @mendyourhead

I want to let you into a secret. I’m an impostor.

 

OK, that’s not quite true. I’m a 34-year-old (shock!) Emergency Medicine trainee with a penchant for karaoke and a passion for education, but I’m really not anybody special. I play the piano (badly) and can struggle through a basic conversation in French or German (even more badly), I have never achieved honours at university or prizes in my post-grad exams and my list of published articles in respected journals is… well, lacking.

 

So when I found myself sitting onstage, sweaty-palmed and tachycardic, waiting to talk to a packed roomful of people about paediatric EM at SMACC Gold one thought was overriding – “what am I doing here?!”

 

It wasn’t the first time that fortnight either. I headed to SMACC off the back of an incredible opportunity not only to teach EM trainees in Fiji but also to watch and learn from teaching sessions by my talented and passionate colleagues Nick & Iain – an opportunity which is infrequently afforded in the midst of ED service pressures. There is a lot you can learn from others’ teaching styles and their honest critique of yours. So there I was, having an amazing experience in Fiji and then in Broadbeach. Why on earth did I deserve that?

Breakfast in Fiji - tea and pancakes on the balcony

Breakfast in Fiji – tea and pancakes on the balcony

 

A potential answer is, I didn’t… But it’s the human tendency to obsessively analyse this perception that can be crippling. I promise you that what follows is not intended to be a self-pity party but my reflection on what makes SMACC so different from other conferences.

 

The impostor syndrome is well documented and is a little different from the occasional feeling that we are incredibly lucky to find ourselves where we are. This paper, published in 1978, described women who – despite having high achievement or academic excellence – maintain a belief that they are not intelligent and in fact that they have “fooled anyone who thinks otherwise”. The impostor syndrome does occur in men albeit to a lesser frequency and intensity; the great Joe Lex says, in his inspirational talk An Old Dog Learning New Tricks:

 

There’s been a dreadful mistake. They’re going to find out that I’m not really competent, I’m not really qualified to do this job. I will confess – I still feel this way about once a week.

 

Joe’s 45 Years on the Frontline talk now also includes the following quote I shared with him at SMACC2013 after I was struck by how his admission resonated with me:

 

 

We can feel like impostors regularly in our clinical practice, but as Joe says it tends to be in a low-level, infrequent way. To constantly feel like an impostor would be paralysing and we would struggle to treat our patients effectively.

Pretending not to be totally terrified

Pretending not to be totally terrified

 

But am I really an impostor? Having been  invited to speak at an International Conference somewhere along the line someone must think I’m good at something. And to be fair if you’ve met me in person you probably realise I don’t come across as lacking confidence – and I don’t have a problem with public speaking; I have an A-Level in Theatre Studies, am very much at home with a karaoke microphone and spoke at the CEM conference in 2013 on the role of social media in medical education with only about an hour’s worth of butterflies-in-the-stomach beforehand. But SMACC was different, and I know I was not alone in feeling an unprecedented weight of expectation. I know that at least four other speakers experienced similar feelings of performance anxiety although I won’t name them without their permission. The Game Face is an important mask we all need to wear at times.

 

At SMACC, the pressure to deliver an incredible talk was intense and I had felt it continuously for at least two weeks. It was also unspoken, and intrinsic in origin. There was no-one following me around, whispering in my ear that my talk had better be pretty bloody good, but I was unable to escape from that mindset. I’ve spent a lot of time since the conference trying to work out what made this talk – 20 minutes, in a concurrent session (so not even on the main stage) – such a huge deal for me.

SMACC Gold grilled my corn in many ways

SMACC Gold totally grilled my corn

 

I know that I hold in high esteem the quality of education delivered at SMACC (and I have an investment in preserving its quality). But more importantly, it’s about the people who attend SMACC; these are people who really, genuinely care about delivering the best in Emergency Medicine, Critical Care, Prehospital Care and Rural General Practice – many devote hours every week to generating FOAM blogs, podcasts and teaching resources – and because of this they are people whose opinions I really care about. They simply feel like family and I have a crazy urge to make them proud of me.

 

Where SMACC2013 was a little male-dominated and (in my opinion, not unfairly) criticised in places for feeling cliquey, SMACCGold was undoubtedly full of love. The unsolicited (and perfectly made to my exacting specification) cup of tea handed to me by Cliff Reid as I left the stage after my talk told me I shouldn’t have worried so much – I could be appreciated for my passion and contribution as much as the clinical and academic content of my talk. And even at the second meeting of the Fabulous Females of FOAM (not just for women – open to anyone feeling like an impostor, regardless of gender) the air was different – the meeting was never about man-hating but this time there was a palpable atmosphere of mutual encouragement, openness and appreciation.

I firmly believe that Impostor Syndrome is the reason the FFF needs to exist, and why women remain under-represented in the FOAM world. SMACC is filled with the great and the good; is the case really that none of us feels great or good enough to be counted among them but we’re too scared/proud/worried that we might be right to admit it openly?

 

If you saw me at SMACC you might have noticed I spent a lot of time in Amy Cuddy’s famous Power Pose – do watch her incredible TEDtalk on overcoming Impostor Syndrome if you have time. I practiced a great deal of self-talk and it did help. On the final concurrent of the final day of SMACC I stood up and talked for twenty minutes about Paediatric Emergencies. I can barely remember a single thing I said.

 

The wonderful, visionary, and incredibly hard-working Roger Harris

The wonderful, visionary, and incredibly hard-working Roger Harris

At heart, SMACC is just another conference – but it’s not just another conference. SMACC made me feel like an impostor, but it also made that completely ok. It wasn’t a hostile hotbed of arguments and determination to show speakers up but a meeting of friends and family and an incarnation of our daily struggles against disease, deprivation and death. And when we fight the good fight together we come to value the part we each play and learn that we are much stronger together than we can ever be on our own – and we find ourselves resolving to be the very best that we can be, impostors or not. So bring on SMACC US – I’ll be there, perfecting my power pose.

 

In heartfelt gratitude, to everyone who attended and tweeted about SMACC Gold; you made it what it was – thank you.

 

Comments

  1. says

    Know EXACTLY what you felt Nat – and your hug at the beginning of the conference cemented that feelign of “FOAMites catching up with old mates”

    Weingart’s call to arms from smacc2013 was resonating in my ears “Together, we ARE critical care” – from diverse backgrounds, across traditional boundaries. Powerful messages like those form Tamara Hills…experts like Levitan and colleagues…a bit of banter but mostly a thirst for sharing and knowledge

    I hope you will speak at smaccUS – or if not, rest assured of a job well done – and hand on to someone else

    It gets easier, eh?

    • says

      Hi Nat and Tim from Thailand :-)

      Fabulous post as always.

      Like you I found the lead up to SSMACC terrifying. I don’t think I slept through for 6/52 beforehand and seem to have gained the kgs Vic Brazil said she lost on twitter! So I’m very happy to be outed as one of your colleagues who shares imposter syndrome almost daily. The idea that someone, at some point is going to tap me on the shoulder and say….

      ‘Good effort, you gave it your best, but you just weren’t up to it’

      It rings true and is shared across all clinicians. Even those operating at national levels in some of the organisations affiliated to us say the same so you are in great company.

      And

      You are in great company.

      Vb

      S

  2. Casey says

    Yep
    Feel that syndrome!
    I get it at work everyday!
    I imagine one day some official will wander into my ED and nab me as a sheep farmer posing as a GP posing as an Emergency physician

    Yet at SMACC GOLD , I felt right at home. Sitting down to dinner with Weingart, Levitan and rob Rogers as if it were Sunday lunch – odd but relaxed

    Love the vibe Roger Harris & co managed to create
    Cool
    Casey

  3. Luke Regan says

    Lovely post and very generous with your observations both of yourself and others.

    My standard summary for folks back home of SMACCGold has been ‘the constant and certain feeling of being surrounded by 1200 people who know more, care more and do more than I likely ever will’….and that feeling being a profoundly reassuring and comforting one.

    I share your imposter paranoia (who doesn’t occasionally check their own GMC online just to make sure no one’s cottoned on yet??) but am powerfully reassured by the SMACC illuminati that the same fear is one of the things that has driven these inspirational folks to such high achievement. If fear of discovery makes us re-hash a talk six times until it’s actually good and rehearse it until we aren’t speaking like a manic-phasing cokefiend with a full bladder…how harmful a motivator can it really be?

  4. says

    Nat –

    I am so sorry to miss you and fellow impostors in Australia.

    I obviously feel your pain. The difference is that I am impostoring a LOT longer than you and am still getting away with it, although semi-retired. There are many days when I read something by aomeone else and feel that I have never had an original thought in my life. I have cobbled together a reputation as “wise teacher” on the works of others

    Read http://www.ncbi.nlm.nih.gov/pmc/articles/PMC300793/ to get you through the day / week / career, and recognize a few quotes that I have found useful.

    Muir Grey: “If you don’t doubt what you are doing at least once a week, you are probably doing the wrong thing.”

    Rudyard Kipling (“Do you like Kipling?” “I don’t know … I’ve never kippled.”)
    If you can dream—and not make dreams your master,
    If you can think—and not make thoughts your aim;
    If you can meet with Triumph and Disaster
    And treat those two impostors just the same

    And never forget the wisdom of T H White: “You may grow old and trembling in your anatomies, you may lie awake at night listening to the disorder of your veins, you may miss your only love, you may see the world about you devastated by evil lunatics, or know your honour trampled in the sewers of baser minds. There is only one thing for it then—to learn. Learn why the world wags and what wags it. This is the only thing which the mind can never exhaust, never alienate, never be tortured by, never fear or distrust, and never dream of regretting.”

    And never forget that you are not alone: http://www.theonion.com/articles/report-today-the-day-they-find-out-youre-a-fraud,35133/

    • Natalie May says

      Hi Joe,

      Thanks for your wisdom – I love the fact you can be so wise about not feeling wise!
      I especially like the T H White quote – very much in the spirit of FOAM.

      You were missed at SMACC – hope we can catch up soon

      Nat

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