My trudge down a long and winding Fateful Detour began on the Monday after Thanksgiving, 2011. My employer, a medical school to whom I had devoted a quarter of a century, showed me the door. There was no farewell luncheon with commemorative gifts of appreciation. In fact, the security guard who escorted me to my car seemed downright grumpy.

The next morning, I surrendered to insomnia two hours before dawn and tiptoed down the arthritic staircase of our ninety-year-old Tudor. I worried that the creaking steps would wake our girls, but they slept on, blissfully unaware that our comfy life had imploded because their mom was batshit crazy.

Step by step, squeak by squeak, I descended. Whatever would I do with myself when I reached bottom? I knew how to work. I didn’t know how to not work. I didn’t realize it, but I would be hitting a bottom other than the one at the base of the stairs.

Hitting bottom is not a moment or an event but a prolonged and painful process. Others in recovery who had crawled out of similar, self-created abysses promised that I would survive, as would my family. They claimed that hitting bottom would transform my life for the better, but only if I was willing to slap my Ego into submission.

I wasn’t sure what they meant. I wasn’t a braggart or a power-hungry narcissist. I was an introvert, a people-pleaser. For God’s sake, I was nice. My new, painfully honest friends suggested that I was actually a clandestine egomaniac with an inferiority complex who needed to admit that massive volumes of my precious opinions and beliefs had been wrong.

What? You mean, just because my brain generates a thought doesn’t make it true? I was skeptical, but I was desperate enough to consider the possibility.

Battling my Ego remains a never-ending civil war. I’ve won some victories, but I’ve also suffered spectacular defeats. Thankfully, I haven’t let myself give up the fight. I’ve been grappling with my Ego over starting this blog for years. Whenever I made the slightest progress, my sneering Ego awoke and reminded me that there was nothing I could write that hadn’t been written before, and written better.

I’m an approval addict and a validation junkie, but writing and art offer no objective measures of success. I might fail—no, I will fail because it’s impossible to produce a creative work that everyone likes. To think that I might not please everyone triggers heart palpitations and sweaty palms, although it’s difficult to distinguish a panic attack from menopause.

I wasn’t one of those kids who knew they wanted to be a doctor since preschool. I didn’t consider medicine until halfway through my junior year of college. I had applied to college as an art major, but then I chickened out, calling it quits even before I bubble-wrapped my albums and HiFi gear and moved to campus. I wasn’t good enough. My art would never hang in the Louvre, and my writing wouldn’t end up on the New York Times bestseller list. Why bother?

Besides having a teensy problem with perfectionism, I wanted clear-cut goals and objectives. Tell me what to do, and I’ll do it. Give me a grading scale so I can discern whether or not I’ve succeeded. In the end, performing spinal taps on premature newborns scared me less than exposing my creativity to judgment.

Hitting bottom was the Fateful Detour that eventually brought me here, to the words on this page. After dragging my feet for months and months, I’ve finally accepted that I can’t wait to act until I’m not scared. No matter how many more therapy sessions I sit through, I’ll never be fearless.

The calendar pages keep flipping. On that morning in 2011 when I tiptoed down the stairs trying not to wake my girls, they were ten and thirteen years old. Next month, the youngest graduates from high school. I’m running out of excuses, running out of other people to take care of. There is only one obstacle standing between me and my dream, and that’s the woman in the mirror.

Today is the day that I defy fear. I’ll wipe my sweaty palms, ignore my palpitating heart and hope that I’m not mistaking a heart attack for courage.

Tell me stories about your own Fateful Detours. Have you ever forced yourself to do something that scared the bejeesus out of you?