For the longest time, I believed that if I gave myself fully, 24/7, to work, to my son, to my marriage, to my friends, then eventually, everything would fall into place. That maybe, just maybe, I would finally be able to answer every message, refill every prescription, kiss every scraped knee, and fix all the things.

But what I’ve come to understand is that we, especially women, though not exclusively, often set ourselves up for failure.

In medicine, there’s a culture, spoken or not, that perpetuates the belief that this career is your life. That there can’t truly be anything else. And there’s an unspoken judgment, especially from older generations or colleagues who’ve internalized that belief. A quiet dismissal of anyone who dares to strive for work-life balance.

Recently, I overheard two providers talking. They were criticizing someone for missing work. One of them said, “Unless I’m on my deathbed, I wouldn’t miss work.” And I thought, “What does that say about the culture we’ve created?” How can we possibly offer our patients optimal care if we’re not even taking care of ourselves?

And then there’s the way society reveres women most when we disappear into our roles.

• The self-sacrificing mother.
• The tireless physician who stays until 10 p.m.
• The one who says yes, yes, and yes, until there’s nothing left to give.

We are praised for our martyrdom. Rewarded for erasing ourselves.

Even with the lost prescriptions, the forgotten appointments, the emotional labor, we’re expected to be accommodating, calm, small, agreeable. It’s not always said aloud, but it’s always felt.

And for years, I tried to fit that mold. I tried so hard to be “perfect.” But the truth is, perfection was never enough. There were always more messages, more demands, more expectations. And inevitably, despite all the effort, I would disappoint someone: my patients, my family, even myself.

So I began to wonder: Is there another paradigm?

Could I try something else, just for me?

What I discovered is that many of us live in these relentless cycles of overwork, followed by escapism. Sometimes it looks like a trip to Europe (no comment), sometimes it’s 20 candles we don’t need. We try to create micro-escapes to feel something, anything, because it gives us a sense of control.

But what I realized is this. The chaos? The lack of control? It was something I had co-created.

I kept telling myself stories like: if I just stay up one more hour and clear the inbox… If I give my toddler endless, unconditional support (which, spoiler alert, is backfiring a bit right now),… If I just do it all, I’ll find balance.

But the longer I live, the more I see: Balance is this thing we chase, but rarely catch.

• Maybe it’s not about balance at all.
• Maybe it’s about radical self-acceptance.
• Maybe it’s about authenticity.

We live in a world that celebrates perfectionism and filters, where even being real makes people uncomfortable. You say, “I’m tired,” and it’s awkward. People don’t really want honesty; they want smoothness. They want to ask, “How are you?” and hear “Good!” so they can move on with their day.

We pretend we have deep relationships, but the moment you offer true intimacy, it becomes too much. Because if I show up fully awake, it forces others to wake up too. And most people would rather stay asleep, numbed by screens or productivity or noise.

But the one we lie to most often is ourselves.

So here’s the truth: None of us have a formula. We’re all figuring it out. Pretending, performing, hustling. But what if we stop pretending, at least to ourselves?

• What if we say, “I’m exhausted today.”
• What if we let our four-year-olds hear “no,” and understand that mommy can’t always say yes?
• What if we say no to social plans that don’t feel right?
• What if we stopped betraying our own energy for the sake of being perceived as kind or good or accommodating?

Unless it’s a 100 percent yes, have the courage to say no.

Honor your own truth, even if no one else sees it.

That doesn’t mean everything will work out. There are no guarantees. But the more honest we are with ourselves, the more authentically we can show up. And maybe, just maybe, that gives others permission to do the same.

In the end, we’re all just trying. Trying to be good. Trying to be enough. Trying to be loved.

But maybe it starts with giving ourselves the sovereignty, grace, humility, love, support, and the patience we so freely offer others.

Preyasha Tuladhar is a family physician.