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There are certain stories that stay with us.
Sometimes it is a book from childhood. Sometimes it is one line that keeps returning to us over the years, showing up in our decisions, our relationships, and the quiet moments when life asks us to tell the truth.
For me, one of those lines comes from The Velveteen Rabbit:
“Real isn’t how you are made. It’s a thing that happens to you.”
I have thought about that line for decades because I think it tells the truth. Becoming real is not about image. It is not about finally becoming polished enough, confident enough, successful enough, or impressive enough. It is not something we perform.
It is something that happens to us through life.
Through being loved. Through being worn down a little. Through loss, fear, tenderness, mistakes, and the moments when we cannot quite keep the mask in place anymore.
That is how becoming real began for me.
The First Day, I Felt Like an Imposter
In August of 1988, I arrived for the first day of my clinical internship at Henry Ford Hospital in Detroit. It was the internship I had wanted badly. It was my first choice, my stretch goal, the kind of opportunity I was not entirely sure I could get.
And then I got it.
Which, of course, is when the panic began.
I was the youngest in my cohort by several years. I felt inexperienced, unprepared, and very aware that no one from my graduate program had ever been accepted there before. I had left my husband and my familiar life in Ohio for this opportunity, and as I looked out the window of my room that morning, all I could think was: They made a mistake.
I dressed carefully, trying to look the part. I remember the olive-colored dress, the gray low heels, the white lab coat, the pocket DSM-III manual, the laminated medical abbreviation card, and the name embroidered on my coat: Dr. Lori Stevic-Rust.
On the outside, I looked professional.
On the inside, nothing matched.
That is often the cruelest part of imposter feelings. It is not that you have not worked hard. It is not that you are careless or unqualified. It is that the outside role arrives before the inside has caught up to believing it.
Room Three
That morning, my supervisor took me to the intensive care unit. My job was to evaluate a patient for depression and competency related to a decision to end treatment, which would ultimately end his life.
The patient was in room three.
There was a red sign on the door for universal precautions. I put on the shoe covers, gown, gloves, and mask. By then, my fear had become bigger than my training.
When we entered the room, I saw Nelson.
He was a young man dying of AIDS.
This was 1988, and the fear and stigma around AIDS were everywhere. It was in the culture, in the language, in the distance people kept, and in the way many patients were treated. AIDS was still being talked about by many as if it were a moral failing instead of a devastating illness.
Nelson was only a few years older than I was, but he looked much older. He was thin and frail, struggling to breathe, with dark purple sarcoma lesions on his arms. As I moved closer, I saw him trying to hide his arms under the sheets.
There were no flowers in the room. No balloons. No cards.
Just a bed, machines, and a small nightstand.
On that nightstand was a framed picture of two young men smiling, with trees and bicycles in the background. Nelson saw me looking and said:
“Yes, that used to be me.”
That sentence stopped me.
Because in that moment, he was not room three. He was not a diagnosis. He was not a referral question. He was a young man with a life, a history, a body that had changed, and a loneliness that filled the room.
When Professionalism Becomes a Mask
I tried to do what I thought a young psychologist was supposed to do. I tried to be composed, serious, clinical, and strong.
But I was overwhelmed.
I could feel my own fear. I could feel Nelson’s shame. I could feel the cultural shame laid on him by a world that had treated gay men with cruelty and distance. I could feel the absence of family. I could feel the weight of being watched by my supervisor, wondering if I was doing it right.
And then I started to cry.
I left the room and stood in the hallway feeling like I had failed at the very thing I was there to become.
I thought being a psychologist meant I had to be strong in a certain way. I thought emotion would make me look weak. I thought compassion, if it showed too much, would make me seem less serious, less scientific, less capable.
But standing in that hallway, I realized something.
I was so afraid of being an imposter that I was about to become one.
I could go back into that room and perform the version of a psychologist I thought I was supposed to be. Or I could go back in as myself.
What Nelson Taught Me
When I returned to the room, I stopped trying to do it perfectly.
I pulled up a chair and listened.
Not in the distant, polished way I thought professionalism required, but as one human being sitting with another human being in one of the most painful moments of his life. I let him talk. I let him cry. I shared some of my own fear. I stopped trying so hard to look like a psychologist and simply became present.
When I stood to leave, Nelson thanked me.
He said, “Thank you for being a real doctor.”
And then he added:
“You know, for not faking it.”
That stayed with me.
It has stayed with me for decades because Nelson named exactly what I was struggling with. I was so focused on becoming the psychologist I thought I was expected to be that I almost lost the very thing that mattered most: myself.
I could be professional and still be human. I could be competent and still be tender. I could be a psychologist and still pull up a chair.
Nelson died three days later.
But he changed me.
He taught me that people do not need the perfect version of us. They need the real one.
The Question Underneath All of This
That is what this episode is really about.
Who are you when you stop performing?
Who are you when you stop trying so hard to get it right, look right, hold it together, and become whoever you think you are supposed to be?
Where do you go quiet when something true is there? Where do you smile when you are actually hurting? Where do you keep performing strength when you are exhausted? Where do you keep shaping yourself around everyone else?
You do not have to answer all of that at once.
Just notice.
Because maybe becoming real does not begin with changing everything.
Maybe it begins with telling yourself the truth.
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Listen to the Episode
Listen on: Apple Podcasts | Spotify | YouTube
In this episode of Becoming Real with Dr. Lori, I share the story of Nelson, a young man I met during my first clinical internship, and the moment that changed how I understood authenticity, professionalism, imposter feelings, and what it really means to be present with another person.
