My whole life, my family looked at me as some sort of model of perfection with high levels of academic and professional success. I’m about to start a combined MD/PhD program, but it’s horrible to think that I’m going to be somebody’s doctor despite being so fucked up.

I worked so hard and cared so much, but that doesn’t mean I don’t get drunk whenever I’m alone, smoke way too much, and treat myself like garbage. All of my peers have such sound moral frameworks while I have nothing. I’m becoming a sex and drug addict and am on a path to the upper echelon of society where I simply will not belong. Nobody in my community will sink to these levels of degeneracy. I feel worthless and beyond saving. All I have is this brain and body and I’ve been poisoning myself for years. I worry what will happen as a physician.

If it sounds like I’m a privileged, narcissistic asshole, it’s because I am. And I hate myself for it. I don’t know how my career-having 30 year old self will look back on these years. College brought out the worst in myself. Classmates know me for who I am. My family doesn’t. I couldn’t imagine what they’d think of me if they knew.