Washington (CNN) Army Surgeon General Nadja West is a model of confidence with her combat boots, impeccable military posture and three stars adorning her uniform.

Yet walking through the Pentagon courtyard, I had to pick my jaw up from the ground when she revealed that confidence was one of the main issues she struggled with as she rose through the Army ranks.

The first female African-American three-star general in US Army history, the highest-ranking woman ever to graduate from West Point, a wife and mother of two -- West's accolades add up to a badass woman by anyone's standard. Yet, like so many of us, she has struggled to believe in herself. Her story shows that even the toughest and most powerful women in Washington have overcome not just external barriers but internal ones.

"My parents always said of course you can do anything you want, but I never did," West told me candidly. "I would always have confidence issues: 'I don't think I can do that.'"

In our hourlong conversation, West, 56, was honest about how she was riddled with self-doubt as she began her career -- especially in her decision to pursue medical school. She says it was a random elevator encounter with a West Point alumnus that pushed her to get over her fears.

"He asked me about what I was interested (in), and I said, 'Well, I was interested in going to medical school, but I don't think I'll be able to get in.' And he's like, 'What's wrong with you? You know, why do you think that?'"

'A chance at life'

West's willingness speak honestly about her insecurities shows she has finally gained that elusive confidence -- a journey that began with a supportive adoptive family.

"I went from an orphan with an uncertain future to be able to be leading an incredible organization of men and women in Army medicine. It's very humbling," she said.

West was adopted at age 2 by a military family in the Washington, DC, area with 11 other adopted children. She frames the difficult circumstances of her early childhood with gratitude.

"My mom decided that she couldn't take care of me or didn't want to take care of me," West said. "I'm just very thankful that she decided to give me a chance at life because you could have had other options."

West's adoptive mother was from Hot Springs, Arkansas, and was the granddaughter of slaves.

"She remembered talking to her grandmother and shared stories," West said. West's mother decided on adoption when she wasn't able to have children of her own because of scar tissue from a ruptured appendix that she couldn't afford to have removed.

Her adoptive father joined the Army in 1939, when it was still segregated.

"He stayed with it for 33 years because he believed in it, in our nation, and believed in the changes that were occurring in the military well before society," West said.

"He and his buddy caught a train ride out to Fort Huachuca, Arizona, which is where they did the basic training for Colored Troops and colored soldiers that they were called at the time," she said.

West told me the white officers, who were doing the training, thought of the assignment as a "punishment tour," but her father said that changed when they actually got there.

"That was not a desirable assignment," she said. "But he said that he could see that ... once you get to know a person and you get to see your soldiers, they're just like anyone else."

Inspired by family and 'Star Trek'

West compares her father's experience of integration in the military to women's push for full equality in the military.

"You know, the same thing with women," she said. "Was it perfect? No. Did it take time to get, you know, improvements? Absolutely. But look where we are today. Women graduating from Ranger School -- I mean, it gives me goosebumps when I say it now."

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Ten of her family's 12 adopted children went on to serve in the military, and as the youngest, West says she was inspired from an early age by her father and her older siblings. West told me that one of her earliest memories is of being in elementary school in Washington when her brother Peter came to her kindergarten class with his uniform on.

"I was so proud because I wanted to show my classmates my brother that's in the Army," she recalled, still beaming.

West had another -- more celestial -- inspiration: 'Star Trek.'

"I thought Mr. Spock was really cool. I wanted to be the science officer, and I really wanted to be a Vulcan one day," West said, laughing and demonstrating an exemplary two-handed Vulcan salute -- "live long and prosper."

Growing up in the 1960s, the show also gave West an early example of a woman in uniform.

"It was like no big deal to see women on the bridge of a military organization," she said.

The Starship Enterprise wasn't available, but West Point was. West applied to the US Military Academy at the encouragement of her brother; she was accepted into the third class that allowed women, in 1978.

CNN cameras accompanied West as she returned to West Point's campus for her 35th reunion. Standing in her uniform, looking out over the Hudson River, she still had awe in her voice as she reflected on her place in the academy's long history.

"I'm actually part of the long gray line that includes people like Grant and Eisenhower and McArthur, Patton, and all those names that I used to read about."

Now a three-star general, West is greeted like a celebrity on campus by old classmates and new cadets. I asked her what it is like to be the woman everybody wants to see, and she said it is "still stunning" to her.

"If you told me when I was a plebe at West Point that you're going to be a three-star general, I would have laughed you out of the room because I just didn't see it. I couldn't see it in myself."

Being one of the pioneering women at the institution was not without challenges. West says her class began with 126 women but only 62 graduated. When she arrived, there was just one all-male class left, but she said for some, the goal was to "run all the women out before they graduated." West came close to dropping out herself.

West described an encounter in which a fellow cadet got nose to nose with her and, using her maiden name, said, "Grammar, you will not be here when I graduate." He was trying to intimidate her, but she says it had the opposite effect.

"I thought OK, if I have to ..." she paused, searching for the right word, "I'm going to stay." West went on, "That was that was a motivator for me because I said, 'I can't not make it now because I don't want to prove him right.'"

I asked her if this cadet made her cry, and she said he did.

"That's what the upper-class women would tell us -- 'whatever you do, don't cry.' And it's like, you know, I cry at cartoons."

'Don't take yourself out of the race'

West went on to graduate from West Point and then medical school at The George Washington University. She then went back to the Army as a medical officer and served in the first Gulf War. In the field, need melted away any potential discrimination based on race or gender.

As a captain in Operations Desert Shield and Desert Storm, her commander put faith in her abilities over the fact that she was a woman.

"He asked, 'Doc, can you fix broke soldiers.' And I said, 'Yes, sir, I can.' And he says, 'Glad to have you aboard. Glad to have you with us.' And so he didn't ask me where I went to medical school and ask what my grades were. He looked me in the eye and asked me if I could do that. And in my heart of hearts, I would do the darndest I could to live up to that."

West recounted a funny linguistic tic that came from being a military doctor in the field -- because there were no other women, the soldiers had simply to say "ma'am" and everyone would know who they needed.

"There was only one ma'am, so when they would see me on the post: 'Hey ma'am!" And they said, 'Where's ma'am?'" she recounted, laughing.

But the politics of rising up through the military ranks as an African-American woman were not always smooth. One friend of West's told her directly that she was only getting promoted because of her race and gender.

"He goes, 'Well, you realize that, you know, the only reason that you got promoted is because you're an African-American female. That's why I showed him my -- we have this officer record brief. I was the distinguished undergraduate in my class of flight surgeon course. The top graduate."

West says they are still friends today and that she was actually grateful to this person for being honest. He gave her the chance to prove her credentials when others might have just talked behind her back.

These challenges, which West has had to face head-on -- even through tears -- have made it especially important to her to encourage others, including her own daughter and her son, who is now following in his mother's footsteps as a plebe at West Point.

Photos: Photos: Women during World War I Photos: Photos: Women during World War I Women during World War I – Female army recruits from the United Kingdom are seen during drills in May 1917. World War I broke down barriers between military and civilian life. With the men away in battle, women took on an extraordinary role in support of the war, whether it was on the front lines or at home in factories and farms. Hide Caption 1 of 20 Photos: Photos: Women during World War I Women during World War I – Loretta Perfectus Walsh enlisted in the United States Naval Reserve in March 1917, becoming the first active-duty woman in the Navy and the first U.S. military woman who wasn't a nurse. Hide Caption 2 of 20 Photos: Photos: Women during World War I Women during World War I – Women work at the Gray & Davis Co. ordnance factory in Cambridge, Massachusetts. Munitions workers faced harsh working conditions that were sometimes lethal, such as in the Barnbow National Factory explosion that killed 35 near Leeds, England. Hide Caption 3 of 20 Photos: Photos: Women during World War I Women during World War I – A woman works as a porter at the Marylebone station in London. British propaganda posters declaring soldiers' dependence on female munitions workers gave women a sense that their labor contributions would be important -- and acknowledged. But this was not always the case. Hide Caption 4 of 20 Photos: Photos: Women during World War I Women during World War I – A Russian women's regiment from Petrograd (now St. Petersburg) relaxes in front of its tents. Women across the globe would serve directly on the battlefields, with many serving as nurses, ambulance drivers and cooks. Hide Caption 5 of 20 Photos: Photos: Women during World War I Women during World War I – Maria Bochkareva, nicknamed Yashka, was a Russian soldier who in 1917 created the 1st Russian Women's Battalion of Death -- an all-female combat unit. Hide Caption 6 of 20 Photos: Photos: Women during World War I Women during World War I – "Hello Girls" at work. The U.S. Army trained more than 400 female telephone operators to serve in France and England for the Army Signal Corps. These women were bilingual, speaking French and English. Hide Caption 7 of 20 Photos: Photos: Women during World War I Women during World War I – Grace Banker receives a Distinguished Medal of Service for her role as chief operator in the U.S. Army Signal Corps. She worked at a post close to the front lines in France. Hide Caption 8 of 20 Photos: Photos: Women during World War I Women during World War I – Female firefighters put a fire escape into position in the United Kingdom. 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Hide Caption 17 of 20 Photos: Photos: Women during World War I Women during World War I – Dorothy Lawrence disguised herself as a man in order to become an English soldier in World War I. Hide Caption 18 of 20 Photos: Photos: Women during World War I Women during World War I – A female munitions worker welds at an armaments factory. Hide Caption 19 of 20 Photos: Photos: Women during World War I Women during World War I – A British Army lieutenant sits in a garden with his wife and three children while on leave during the war. In Great Britain and the United States, women confronted wartime shortages of food, fuel and housing as they struggled to maintain homes and families while they also worked outside the home. Hide Caption 20 of 20

"You know the old saying that, you know, your mom wears combat boots used to be like a slur. It's like, 'Oh, she does. And they're pretty cool,'" she says her son jokes about his mother.

Self-doubt is a phenomenon that I have heard over and over from other women, even those as accomplished and barrier-breaking as West. It's genuine -- not self-deprecating. Admitting it publicly is generous in spirit -- and very female. It makes women like West more relatable role models.

West is keenly aware of that, which is why she now makes it her mission to pass along the advice she got during her own fateful elevator ride.

She makes an effort to stop to talk to younger people, even for a few minutes, because her own experience tells her that a short encounter has the potential to change the trajectory of their lives.

"One of the things that I tell people is just believe that you can, and then don't sell yourself short or don't take yourself out of the race before you even start running. And I almost did."