This writer is laboring under a definition of herself that needs to be updated from the limitations of her childhood. I mean, she's a DOCTOR how inadequate can she be? First, she would benefit from work with a counselor to define and explore the aspects of her personality and character that make her unique that are more subltle and substantial than the pretty and smart continuum. She is obviously much more talented than she is giving herself credit for. Your own measure should be within yourself and not by comparison to others.

Also, the fact that her sister is following in her footsteps implies that her sister may have her own insecurities. Some families send children out into the world with a faulty self-identity. One that does not match their true worth. These women should talk about their childhoods and discover the ways their parents defined them. I would put money on the possibility that neither sister feels good about herself.

Also, this writer should suggest that while they could both be doctors, it might be healthier for both of them if their fields were somewhat different. These sisters might, through honesty, be able to support each other's growth and development of a strong sense of self.

The whole letter is strange. A doctor is going to write Prudie about her ongoing mental health issues rather than finding a good therapist? At least she didn't ask Prudie's help with mending a broken leg. And I totally agree with you regarding the little sister also having some insecurities. If she's always been more talented like big sister claims, why is she looking to change careers at just the time her current career should be starting to take off?

Prudie missed the boat in the sentence "Instead, tell her you've been taken aback by how her choice has revived what you thought were long-vanished feelings of rivalry and inadequacy, and you wanted to be able to talk to her about your painful childhoods."

Good luck. In my dysfunctional family with lots of similarities, when I've approached my brothers and sisters with the phrase, "I'd like to talk with you about our childhood," the answer is always "Why? What's the point? It's in the past and needs to stay there." When I mention we have behavior patterns that are hurting our relationships with each other, same answer. I've been in therapy (a lot and with good results), and now I have a short visits with my siblings when it's mutually convenient. Fortunately we live in different parts of the country and the visits are not frequent; emails and phone calls suffice, always about superficial topics.

I have built a good life for myself and built a "family" of my choosing, people who are mutually supportive and interesting to know. The doctor should do the same. And, yes, doctors do write to Prudie rather than finding a good therapist. They're no different from the rest of us.

Someone on another thread asked why everyone is assuming that the secretary is female, essentially accusing us of sexism because of it. How do we know the doctor is female? We assume so, since the siblings participated in the same activities. However, there are many activities in which both genders may participate. This would help explain why he is so sensitive about his little sister always showing him up!

dont want to hear while in the doctors office

10 - "mom always liked my other sister better, you know"

9 - "does this stethescope make me look smarter?"

8 - "i haven' been sued for malpractice yet, but with my depressed worldview i consider it an unavoidable eventuality"

7 - "you have 6 months to live.  i'd give you longer, but my sister gave someone 8 months yesterday, and we're in some sort of weird life-long competition"

6 - "your problems are all in your head.  unlike mine, which are unfortunately real"

5 - "my mom said i wasn't smart and caring enough to be a doctor.  i guess i showed her, eh?"

4 - "my favorite tv show is "house" . . . that guy just sums up my attitude toward this profession"

3 - "no i'm not gay.  i'm just obsessed with her.  she's my sister, anyway"

2 - "in the interest of full disclosure, i have to tell you that i just bought a house where the previous owner was murdered.  oh  . . . and i preside at lethal injection executions, to make sure the guy is really dead, too.   the whole death thing fascinates me"

1 - "stop whining.  i'm trying to get my OWN medication adjusted, too.  you're not the only sick person in this city, you know"

4 - "my favorite tv show is "house" . . . that guy just sums up my attitude toward this profession"

Ha ha!! Love that one!

--and it sounds like this is one.

Some previous posters were suprised that the LW chose to write Prudie instead of seeking counselling--while counselling is definitely a better option, I can't say that I'm shocked in the least. Doctors are notorious for not getting this sort of help--that's why they have a higher rate of substance abuse, divorce, and suicide compared to other professions. Right or wrong, most doctors see going to a therapist as an admission of weakness, a sign that they can't handle their work, and they worry about what their colleagues or patients might think. In some ways, sending an anonymous letter to Prudie is "safer".

This LW in particular sounds pretty ambivalent about her profession as it is. I got the impression that one of the driving factors behind her decision to become a doctor was the urge to prove her mother wrong--You don't think I'm so dumb, now, do you, Ma--I'm an f***in' doctor! Plenty of bright people are able to make it into medical school on that pretense--the problem is "proving Mom wrong" might not be much motivation if you're stuck in a field that don't enjoy, dealing with the day-to-day stresses of actually treating patients.

As was mentioned earlier, the LW also seems to have forgotten that a lot can happen on the way to becoming a doctor. Little sis might be saying she's going to do the same specialty as big sis, but chances are she hasn't even had a chance to see all the other possibilities that are available. Tons of medical students start out saying that they're going to do X, but end up going into Y after graduation. This seems like a bit of premature freaking out.

Long story short, I hope Dr. LW decides to look into counselling. It doesn't have to be a lifelong thing, and there's no shame in it. It also would probably help a lot.