Originally published in ANM’s Through My Lens LinkedIn newsletter on July 16, 2026. Republished here with the original author attribution.
Original LinkedIn edition: Read the source article on LinkedIn.
For much of my life, I believed I had failed.
From the outside, my story looked like one of achievement. I attended medical school, completed six years of training and came from a family that valued education, hard work and ambition. Yet beneath those visible successes was a reality I could not explain. I struggled with things that seemed to come naturally to other people. I carried anxiety that lived not only in my mind but in my body, and I spent years wondering why I could never seem to reach the finish line everyone else appeared to cross so effortlessly.
It would take close to four decades for me to find the language that made sense of those experiences.
Receiving a diagnosis as an adult did not change who I was. It changed how I understood my life. Experiences I had interpreted as personal failings began to form a different picture: one of a neurodivergent woman trying to navigate a world that had never recognised what she needed.
Understanding that reality also forced me to revisit my childhood, my family and the expectations that shaped me.
I grew up in a family of four children as the only girl among three brothers. Being the only daughter had its perks. Both my parents doted on me. My father was a teacher and a brilliant man who believed deeply in education. He encouraged all of us to become the best versions of ourselves, and I believe each of us carried a piece of that expectation into adulthood.
In many African families, achievement is rarely viewed as an individual accomplishment. Success belongs to the family. It reflects the sacrifices of parents, the hopes of relatives and the promise of future generations. Becoming a doctor was not simply a career aspiration. It represented intelligence, discipline, security and the fulfilment of a collective dream.
Within that environment, I learned early that achievement mattered.
Having three brothers, two older and one younger, meant that responsibility, comparison and being looked up to were woven into my upbringing. I adored my brothers. They were bright, ambitious and hardworking. Yet somewhere within that family dynamic, I began quietly measuring myself against the people I loved most.
My older brothers were role models, and they lived up to that position. When I thought about my younger brother, however, I often felt that I had let him down. I believed he could not look up to me in the same way because I had failed to fulfil what I saw as “the dream”: becoming a doctor.
That belief became even more painful when he followed the same path and became a successful doctor himself.
I entered medical school and completed six years of training. On paper, I was the embodiment of success: intelligent, resilient and destined for a respected profession.
But the outside view did not tell the whole story.
Understanding who I am helped me make sense of experiences that had confused and discouraged me for decades. It gave me a framework for struggles I had long interpreted as personal failings and the confidence to speak openly about a life I had never fully understood.
For most of my life, I struggled to find my place in the world. I always felt as though I was missing something, something everyone else seemed to possess that allowed them to navigate life more easily than I could. Again and again, I felt like a failure.
What nobody could see was that I was not failing because I lacked ability.
I was struggling because ability alone was never enough to meet the demands being placed on my nervous system.
When Achievement Becomes a Mask
The idea of the “high-achieving autistic person” can be deeply misleading.
When someone performs well academically, gains admission to a demanding course or demonstrates exceptional intellectual ability, people often assume that person is thriving in every area of life. Achievement becomes proof that they are coping.
For many autistic women, particularly those diagnosed later in life, the opposite can be true.
Achievement may hide as much as it reveals.
You learn to observe and imitate. You rehearse conversations before they happen. You prepare excessively because preparation feels safer than uncertainty. You push through exhaustion because stopping feels like letting everyone down.
What others call determination may partly be fear.
What looks like independence may be the absence of support.
What appears to be success may be consuming every ounce of energy you have.
I completed six years of medical school but never practised medicine for a single day.
A few months before graduation, the reality of the life ahead began to overwhelm me. It was not the science that frightened me. It was the relentless human demands of the profession: the constant social interaction, the unpredictability, the expectation that I would effortlessly embody the ideal bedside manner.
I stopped seeing graduation as a triumph and began seeing it as the doorway to a life I did not believe I could sustain.
My nervous system shut down.
This was not a failure of motivation. It was not a lack of discipline. By that point, I had already proved how hard I could work. I had survived years of intense study in a learning environment where every module seemed to include oral examinations.
What few people knew was that those examinations came at a cost.
Before most exams, I experienced severe anxiety. Stress showed up physically long before I understood it psychologically. My stomach cramped. I developed urgent diarrhoea. I spent mornings moving repeatedly between my room and the bathroom while trying to prepare.
At the time, I thought I simply suffered from glossophobia: a fear of public speaking.
Now I understand that my body was communicating distress in the only way it could.
Even today, before a presentation, training session or important meeting, I may feel echoes of that same physiological response.
For years, I interpreted those reactions as weakness.
Now I recognise them as signs of strain.
The Weight of Comparison
Not practising medicine affected more than my career.
It altered the way I saw myself within my family.
My brothers appeared to be thriving. They seemed capable of achieving whatever they set their minds to. Looking at their accomplishments, I saw not their success but my own perceived shortcomings reflected at me.
The comparison did not come from them.
Much of it lived inside me.
I had absorbed a particular idea of success and used my brothers’ lives as evidence of how far I had fallen short of it.
Family conversations often drifted towards academic subjects, professional achievements and intellectual debates. Gradually, I began contributing less and less. Eventually, I found myself withdrawing altogether.
I convinced myself that I had nothing meaningful to add.
It was not because I lacked intelligence.
It was because years of abandoned plans, overwhelming transitions and unmet expectations had eroded my confidence.
Sibling comparison is not always expressed through rivalry or criticism. Sometimes it is far quieter.
Sometimes it is the pain of loving and admiring your siblings while using their lives as a measure of your own worth.
It is feeling proud of them and ashamed of yourself at the same time.
My diagnosis forced me to reconsider those assumptions.
My brothers and I may have shared the same home, but we were not necessarily moving through the world in the same way. The environments that energised or challenged them affected me differently.
Equality of opportunity did not mean equality of experience.
That distinction changed everything.
Discovering My Spiky Profile
One of the concepts that helped me understand myself was the idea of a spiky profile.
For years, I believed that intelligence and competence should look consistent across all areas of life. If I could succeed academically, surely I should be able to organise myself, manage transitions, maintain routines and tolerate demanding social environments.
My life repeatedly contradicted that assumption.
A spiky profile describes the uneven distribution of strengths and challenges often seen in autistic people. Rather than demonstrating similar levels of ability across different domains, a person may have exceptional strengths in some areas while struggling significantly in others.
They may possess outstanding memory while finding organisation difficult.
They may excel academically yet struggle with executive functioning.
They may think deeply and creatively yet find everyday social demands exhausting.
The result is not a flat profile but one characterised by sharp peaks and valleys.
Understanding this concept was liberating.
It helped me see that the different parts of my life were not contradictory. I could be capable and struggling. Intelligent and overwhelmed. Successful in one environment and unable to function in another.
I was not broken.
I had simply spent years trying to fit myself into a model of ability that did not reflect how my mind worked.
The Details My Mind Refuses to Miss
One of the ways my neurodivergence reveals itself is through the details I notice and remember.
Number plates are a perfect example.
As I walk down a street, I automatically read them. I compare them with one another, identify the years in which vehicles were registered and often connect them to particular periods in my life.
I do this almost unconsciously.
It is calming and grounding.
Over time, I realised that I could often tell who was at work simply by looking at the cars parked outside.
A few years ago, I was waiting with a cousin when she phoned another relative to give directions. Without thinking, I interrupted and described the make, colour and registration number of the vehicle we were in.
It was the first time I had ever seen that car.
The information had simply lodged itself in my memory.
I still remember my cousin’s surprise.
This is not the stereotypical neurodivergent talent often portrayed in popular culture. I am not an artist, and I do not possess extraordinary mathematical abilities; in fact, I flunked maths in high school.
But I do notice details.
I see patterns.
I absorb and retain information that others may never consciously register.
For much of my life, I dismissed these traits because they did not fit my inherited definition of success.
They could not erase my feelings about medicine.
They could not prove my worth.
So I failed to see them as strengths.
Today, I understand them differently.
Redefining Achievement
Late diagnosis has allowed me to return to my younger self with compassion rather than criticism. If I could meet that young girl/woman, I would tell her not to minimise herself.
I can now see the young woman who completed six years of medical school while carrying immense anxiety. I can recognise the courage it took to repeatedly walk into oral examinations while her body was signalling danger.
I can understand why the prospect of practising medicine eventually became overwhelming.
She was not lazy.
She was not weak.
She was no less capable than her brothers.
She was autistic and did not know it.
She was trying to meet expectations without the understanding, accommodations or language she needed.
Recognising that truth does not require me to reject my family or my upbringing.
My parents wanted the best for their children. Their hopes were rooted in love, sacrifice and a desire for security and opportunity.
But love does not always protect us from pressure.
Sometimes expectations born from love still leave little room for difference.
Today, I am learning that achievement cannot be measured solely by whether I became the doctor I trained to be.
Achievement can also be found in surviving environments that overwhelmed me.
In rebuilding a life after plans changed.
In learning how my mind works.
In replacing shame with understanding.
For years, I viewed my differences as evidence that something was wrong with me.
Now I see something else.
I see a mind that notices what others overlook.
A mind that remembers details others forget.
A mind capable of intense focus, deep curiosity and original ways of thinking.
I also see a nervous system that struggles with demands many people consider ordinary.
Both realities are true.
Neither cancels out the other.
Perhaps the greatest change of all is that I no longer use my brothers’ achievements as evidence against myself.
Their paths do not diminish mine.
My path does not make me a disappointment.
For decades, I believed my story was about becoming a doctor and failing.
Now I understand that it was about understanding myself.
The diagnosis did not change who I am.
It simply gave a name to the person who had been there all along.
For many years, I searched for an explanation that would help me understand why life seemed harder for me than it appeared to be for everyone else.
What I found was not an excuse, a limitation or a label that reduced me.
I found a language that allowed me to see myself clearly for the first time.
I hope that by telling this story, other women, especially those from cultures where achievement is prized, and difference is often misunderstood, might recognise something of themselves in it.
We are not the failed versions of who we were meant to be.
We are people whose strengths and challenges do not always fit conventional expectations.
Sometimes the most important achievement is not becoming the person others imagined for us. It is finally understanding, accepting and valuing the person we have been all along.
