The last time I was overcome with acute anxiety was prior to delivering a commencement speech at my medical school graduation. We were all donned in our black robes and squinting into the summer sun, waiting for the ceremony to begin.

I was pacing.

“I feel like I’m going to throw up,” I announced to my friends. “I really don’t want to throw up, but I’m really worried that I’m going to get up on that stage and throw up instead of give my speech.”

“Stop it,” they commanded. “You’re not going to throw up. You’re going to do great.”

A close friend of mine rolled her eyes at me and snapped, “Suck it up. You’ll do fine.”

They were right.

The last time I was overcome with more chronic anxiety was prior to beginning my internship. I fidgeted and futzed with all of my newly acquired accoutrements of a doctor: white coat, pager, stethoscope, scrubs, and various peripheral brains—

—since I was intensely aware that my own internal brain was insufficient! I wasn’t a doctor; I was a fraud!

One of two things occur when I feel anxious: I either become unnaturally still or unusually restless.

I recently sat for mock oral boards (unlike most—if not all—of the other medical specialties, psychiatry board certification features an oral exam that, amongst other things, consists of conducting a thirty-minute interview with an actual patient while an examiner watches. For the second thirty minutes, the examiner pimps the examinee!). Though it was a “mock” exam, I was nonetheless anxious and, similar to the stance I have adopted when interviewing for academic positions, I became unnaturally still. Petrified, maybe.

“Yeah… I noticed that you weren’t saying much… or even moving much,” a colleague commented. She was twirling a lock of dark hair again and again around her finger while we waited for the exam to begin. I couldn’t even bring myself to stop watching her play with that ringlet.

So, I’m feeling anxious again. I spent the evening working on my fellowship applications and I think they’re just about done—except for the really random things I need to photocopy to prove that I am not a fraud (…). Even now, I cannot sit still—how many times have I stopped typing this entry to pick at an eyelash or scratch my head or inhale deeply due to all the signals and noise in my mind?

• Send yourself a copy of your updated CV and personal statement.
• What if I’m forgetting something?
• Don’t forget to order an official transcript.
• What if my application gets lost in the mail?
• Remember to make copies of your applications.
• What if I don’t get accepted anywhere?

And on and on and on.

I don’t feel like I am going to throw up, but I also don’t feel like I’m going to have an easy time falling asleep tonight. I’ll feel much better once I release these paper birds to the postal service.

(Part of the ongoing Relationship Series.)