I was cleaning out my desk last week and found the crumpled letter of paper where I did my first fear-setting exercise (it’s a little too personal to post here). It was from 2020, right before I posted my first YouTube video.
Yes, you read that right. I was so terrified of posting a video that I needed to do a formal exercise to talk myself into it. (And people wonder why it took me 25 years to start…)
That’s when I discovered Tim Ferriss’s fear-setting exercise—a tool that has since helped me make every major life decision that I was deathly afraid of, from leaving medicine to posting YouTube Videos to controversial job decisions. I highly recommend checking out Tim’s full article and exercise here—it’s way more comprehensive than what I’m about to share.
But let me take you back to that first video because it was ridiculous how scared I was. tldr; no one cares (really).
Here’s what changed everything for me:
- Step 1: Define your nightmare in excruciating detail
- Step 2: Figure out how you’d recover if it all went to hell
- Step 3: Compare that to the cost of doing nothing
Let me show you exactly how this works.
Step 1: Define Your Nightmare in Excruciating Detail
When I was contemplating that first YouTube video, I spent weeks imagining the worst possible outcomes. My medical school classmates finding it and creating a WhatsApp group just to roast me. Patients googling “Dr. Zach Highley” and finding me pretending to do CPR on a stuffed animal. My professors thinking I wasn’t “serious” about medicine.
But here’s what actually happened when I forced myself to write it all down: My “nightmare” was maybe a 2 out of 10 on the life-destruction scale. Mildly embarrassing? Perhaps. Career-ending? Not even close.
The science backs this up. Researchers at Penn State found that 91.4% of our worries never actually happen, and the 9% that do are far less catastrophic than we imagine. Our brains are wired for what psychologists call “catastrophic thinking”—we literally evolved to imagine saber-toothed tigers around every corner. (Though to be fair, a mean YouTube comment can feel like a saber-toothed tiger at 2 AM. Don’t get me started on Reddit forums…)
Step 2: Figure Out How You’d Recover
This is where the magic happens. Once you’ve defined your nightmare, you realize how not-that-bad recovery would be.
My YouTube disaster recovery plan was laughably simple:
- Delete the video
- Never speak of it again
- Continue being a regular medical student
- Maybe change my name and move to Canada (okay, that was overkill)
When I later used this same exercise for leaving medicine, the recovery plan was more complex but equally doable—simply returning to residency at a different location or specialty, a couple job offers I had, locum work, tutoring, or using 25% of my savings to “figure it out” for a year. Really, the worst that would happen, wasn’t that bad at all.
Research shows that stress management interventions significantly reduce cortisol levels, especially when people engage in planning and writing exercises. It’s like your brain goes “Oh wait, we’re not actually going to die? Cool, let’s think clearly then.” (and guess what, most of the time (trust me), you aren’t going to die. It’s that damn evolutionary biology kicking in.)
Step 3: Compare That to the Cost of Doing Nothing
This is the part that gets me every time.
I remember sitting in the hospital, watching other residents grind through another 12-hour shift. Everyone looked dead inside. One senior resident was literally crying and locked herself in an office (this was the third time… that week.)
But some residents and clinicians in the hospital seemed… different. Energized. They were energized by every medical knowledge discussion, every patient encounter, and even with every (seeming) mistake! They also, 100% of the time, had a happy life outside of medicine. I knew, however, that the actions inside of the hospital weren’t energizing me, they were draining me.
If I did nothing, I’d become a zombie. 3 AM on night shift, collapsed in a hospital hallway (this actually happened), wondering if this was all there was to life.
Research shows that regrets of inaction are more intense over the long term, while regrets of action fade more quickly. We’re wired to feel worse about chances not taken than mistakes we made.
The Bottom Line
That crumpled fear-setting paper led to my first video, which led to 500k subscribers, which led to leaving medicine, which led to… well, a life I couldn’t have imagined from medical school.
I’ve used this exercise for every big decision since. Including one recently that I’m both excited and terrified about—but that’s a story for another newsletter.
Action item: What’s that thing you’ve been putting off because you’re terrified? This week, grab a piece of paper (or that Midori pad I’m obsessed with linked below) and actually write out:
- Your absolute worst-case scenario
- How you’d recover
- What happens if you do nothing
I promise you, the monster in your closet is probably just a pile of laundry. Or in my case, a “publish” button.