I don’t know when things started taking the wrong turn.

There are moments when words refuse to come, when they arrive after the moment they are needed, or sometimes do not arrive at all. It is not that I lack thoughts. I have them. Too many, sometimes. But when they are demanded in a precise moment, when someone expects an explanation, a response, a justification, my mind becomes strangely distant from my own words. What remains is silence, a silence that can easily be misunderstood.

From the outside, silence can look like avoidance. Hesitation can look like uncertainty. A delayed explanation can look like dishonesty. The world prefers things that are clear and measurable, actions that match words, words that match expectations. But the inner world does not always move that way. Thoughts do not always arrive in complete sentences. Intentions do not always translate perfectly into expression. And when translation fails, people begin to fill the empty spaces themselves.

Maybe that is where my question begins: Am I a liar, or am I simply someone who was never able to explain myself in time?

When I was an intern, I never questioned my ability to handle things. I believed every task that came my way was my responsibility. If something needed to be done, I did it. I stayed late, followed up, asked questions, and carried the pressure because I thought that was what being a good doctor meant. Back then, I was called a “smart intern.” I knew how to work hard. What I did not know was how different everything would feel when I became a senior.

Somewhere between becoming a senior and trying to become a leader, I started wondering when I became the person who could do everything wrong. I thought being a senior meant passing down what I had learned. I thought my responsibility was to guide juniors, make sure things were completed, and step in whenever help was needed. I believed that if I supported them enough, if I communicated enough, if I tried hard enough, things would naturally fall into place.

But I slowly realized that being a senior is not simply about knowing more or doing less. It is about carrying responsibility differently. A senior becomes a bridge between two worlds. You are expected to understand the struggles of those below you while also meeting the expectations of those above you. You carry instructions, decisions, concerns, and sometimes even mistakes that are not entirely yours. You stand in the middle, close enough to be blamed, but often far enough away to have limited control.

I was still trying. I was still putting in effort. But somehow, situations began to feel different. Small mistakes became bigger issues. Things I never expected became lessons I never asked for.

An intern once asked me which cases needed the most attention. It was not directly my responsibility, but I wanted to help. I tried to guide him because I remembered what it felt like to be new and unsure. Later, when one case was missed during presentation, the response was: “The senior told me to do this, so I did what I was told.” The help I intended became responsibility placed back on me.

Another time, a patient was scheduled for surgery the next day. I spoke with the operating surgeon, clarified what needed to be prepared, and informed the nurses, interns, and the team responsible for the night shift. I believed everything was communicated clearly. But somehow, there was a misunderstanding. The patient was not prepared. The situation became serious, and once again, it felt as though everything came back to me, as if all the effort, all the communication, all the preparation disappeared the moment something went wrong.

I accept my own mistakes. One time, I wrote “scalp” instead of “scapular” lipoma in a diagnosis. It was my error. I understand why it mattered, and I learned from it. But some moments are harder to accept, moments when you are blamed for things you could not fully control. Like being told you failed to inform someone about a case when they already knew about it but chose not to see the patient.

Those moments create a strange conflict inside, because intention and perception begin to separate. I know what I meant. Others only know what they saw. And between those two things exists a space where misunderstandings grow.

I do not often ask for help. Not because I believe I can handle everything alone, but because dependence carries an invisible weight. Every exchange seems to create an expectation, that what is given must eventually be returned, balanced, or accounted for. Connection is valuable, but sometimes the cost of being misunderstood feels heavier than the comfort of being supported.

So I learned to stand slightly apart. Even around people who mean well, I sometimes remain at the edge of interpretation, speaking enough to participate, but not enough to be fully understood. There are people whose presence makes this harder, not always because of what they do, but because of the history of previous misunderstandings. With them, every explanation feels like exposure. Every attempt to clarify feels like giving someone more material to interpret. So withdrawal becomes easier. Not because there is nothing to say, but because saying more does not always guarantee being understood.

Yet silence has consequences. What is not said does not disappear. It gets interpreted. And often, people complete the unfinished story themselves. Avoidance becomes a pattern. Hesitation becomes a personality. A moment of difficulty becomes a permanent identity. Someone who does not explain becomes someone who hides.

And that is the part I struggle with, because I am learning that being responsible for everything and being responsible for everyone are not the same thing. As an intern, your value is measured by how much you can personally do. As a senior, your value is measured by whether you can create a system where things continue to happen even when you are not physically doing everything yourself.

That transition is uncomfortable. You lose the comfort of saying, “I handled it myself.” Now you have to trust people. You have to communicate. You have to delegate. You have to accept that even after doing everything you can, things may still go wrong.

I am also learning that juniors are not extensions of me. They will not work exactly the way I did. They will make different mistakes, learn differently, and develop their own methods. My responsibility is not to create another version of myself. It is to help them become better doctors in their own way. I try to guide them, support them, and share what I have learned. I try to prevent problems before they happen because some mistakes cannot be undone once they occur. But even after all this, things can still go wrong.

Maybe being a senior was never supposed to be easy. Maybe leadership was never about becoming someone who never fails. Maybe it is about becoming someone who learns, communicates better, accepts responsibility, and helps others grow.

So I return to the question: Am I a liar?

I do not know. Maybe honesty is not only found in words spoken clearly and immediately. Maybe it also exists in intention, in effort, in the things someone tries to do even when they fail to communicate them perfectly. But I also know that truth cannot exist only inside one person. It must travel through language, and language is imperfect. What reaches others is often not the full truth, but a version shaped by interpretation.

Perhaps that is the hardest part of growing. Realizing that you can remain truthful in your intentions and still be misunderstood in your actions. That you can care deeply and still appear distant. That you can try your best and still become the person others question.

I miss being the intern who only had to work hard. Now I am learning to become the senior who has to make a team work together. And maybe that is what growth really is: not becoming someone who is never misunderstood, but becoming someone who continues to show up, even when the distance between what is lived and what is seen feels impossible to cross.

Rupa Bhandari is a general surgery resident in Nepal.