Fear of those responsibilities was one of the things that kept me from being premed during college. Ultimately, I came in through a back door (from a PhD program to an MD/PhD program to finishing the MD) and figured out along the way that ultimately I trusted myself more than the other doctors to take good care of my patients. I still worry sometimes … the likelihood is high that one of my patients will commit suicide at some point in my future, which could mean a lawsuit etc., and everything I prescribe has risks. My strategy is to be brutally honest with my patients about what we know and what we don’t, and to involve them very much in the planning and decision-making process. Ultimately, if you treat people the way you would want to be treated, you are going to be practicing good medicine, and that’s the best we can do. With that, I actully usually sleep pretty well. Every once in awhile when one of my patients is actively very sick (suicidial, psychotic, whatever) and not yet hospitalized, it gets tough. I have a peer supervision group that meets monthly and a very good friend who is also a woman psychiatrist with a similar style, so when I’m nervous I talk to people. And my husband is my best support. SO that’s how I manage. It’s hard sometimes. As for my kids? I pray!