A nearly perfect mother and her nearly perfect daughter came into the clinic. The child was 5 and was getting ready for kindergarten. Her drawing of a person was nearly perfect, and the physical exam of her was nearly perfect. Afterward, the mother and the doctor commiserated because they both knew what it was like to be only nearly perfect.

Never being good enough may not be a recognized medical disease, but it afflicts many. It is achieving something accompanied by the feeling of accomplishing nothing. It is being king of the hill while in an emotional valley. It is having a neat, clean, well-accessorized home — but feeling like a dump. It is having friends but being lonely; it is being smart enough only to believe you are not very smart. It is a gnawing, constantly comparing discontent of never being or doing enough.

There are people we all know who probably are perfect. They are beautiful and extremely handsome. They all sing in tune and play a musical instrument. They are polite to their elders and nice to their peers. They dress well and have summer part-time jobs that pay better than steady employment for some fathers of four. They are smart but not snooty, or they wouldn't be perfect. They volunteer at the homeless shelter and are regulars at the gym and agile on the court. They attend only the finest schools. They are politically involved and recycle all their trash, not just the pop cans. Most importantly, we also know we are not them.

The pathology of the nearly perfect is not being Barbie and Ken, tall, thin and beautiful; it is not recognizing their own goodness or what they do, regardless of their stature, weight or looks. They dismiss all the obvious evidence that they are OK. They are blind to their personal worth. They walk around black and blue on the inside from beating up on themselves.