I don’t think of myself as someone who is easily angered. In my capacity as a mental health provider, I have been called every name in the book, spat at and nearly assaulted. Although these experiences are never pleasant, I can intellectualize away my feelings about patients’ hostile behavior: this is just a part of their illness. While I have certainly felt frustrated after a long night on call, I would not describe myself as feeling genuinely angry toward these patients.

I don’t think I knew what real anger was until our daughter arrived.

Considering that infants and toddlers scream despite having been fed, changed, walked around, bounced, hugged and kissed, I am amazed by how rarely parents talk about just how furious our young ones can make us. I think about it frequently — during the day. At night, I am too consumed by that anger. I am busy wildly contemplating global child poverty, or marveling at our daughter’s fortune to have been born into a family that desperately loves her and wants to provide her with everything. I hear myself thinking: “How dare she treat us this way? Does she know how lucky she is?”

Those angry thoughts flood my mind when her cry suddenly cuts through the quiet of our all-too-short nights. The English translation of that cry is, “Tomorrow your 12-hour workday will be a groggy-eyed waking nightmare.” As her cry shifts into a throaty scream, I have sensed a slowly growing animus bloom inside me. I have felt my lungs fill with air in preparation to yell back at her. To make her feel as terrible as I do.

As I slowly let that air out in a quiet exhalation, I am reminded how hardwired feelings like desperation, hopelessness and anger are frighteningly difficult to keep at bay. Nothing breeds desperation like hopelessness. And nothing fuels anger like desperation.

Perhaps surprisingly, I believe that this anger is directed much less at our daughter than at myself. In these 4 a.m. confrontations I experience feelings of aggression in direct proportion to my perception of personal failure at the most important job of my life. In those moments I feel as if my love is not enough or that if I were stronger or smarter, she would not be crying. Unlike the easier compartmentalization of my patients’ hostility, I find it much harder to compartmentalize my daughter’s behavior as being simply a function of her stage of development.

Although I am trained to manage my emotions in the context of a doctor-patient relationship, the degree of parental closeness I have with my daughter renders me unable to use my background in any meaningful way. In these tense situations, she is like a boxer who constantly clutches her opponent so tightly during a bout that both fighters are immobilized. She holds me so close that keeping her behavior in context is far more difficult than with my patients. Even the most loving parent can be consumed by that sense of helpless rage, and in the middle of yet another sleepless night, I can’t temper my anger with words about my daughter.

Instead, again perhaps surprisingly, I keep my focus on me.

Before I step into my daughter’s room in the middle of the night during a maddening crying jag, I remind myself that I come first. I love myself first. I realize that these statements are anathema in a world that screams, “Your child comes first!” However, if I can’t love myself in spite of my constant sense that I am failing her, then I can’t really love her either. It’s like being on an airplane. In the event of an emergency landing, we are asked to secure our own mask before assisting others. If I tried to secure her mask first, I might not last long enough to do much of anything on her behalf anyway.