Advice from a Caterpillar: Reflections on
Change, Uncertainty and Identity
How might
we navigate uncertainty in medical practice?
As
physicians, we are constantly dealing with change and the uncertainty that
comes with it. But we never seem to have the time to reflect on how we change
as we try to navigate the uncertainty of medical practice.
We invite
you to read this short essay by our member @Ricardo Ricci. Through a fictional
conversation between Alice and the Caterpillar, we are invited to explore the
foundations of uncertainty and the evolving nature of identity.
Advice from a Caterpillar: Reflections on
Change, Uncertainty and Identity
Mr
Caterpillar, a few days ago you asked me, "Who are you?" with your
arrogant tone. Your existential question took me by surprise, as I was feeling
insecure about myself at the moment. I was having issues with my height and had
no control over my body, which made my situation rather unstable.
I had been
going through a rough time and suffering all sorts of weird symptoms after
drinking an unknown brevage; I went from being your height, Mr Caterpillar,
about twelve centimetres, to growing tall above the treetops in a matter of
seconds. Apparently, the instability of the body is necessarily followed by the
instability of the mind. As you may already know, mind and body cannot be
separated.
In this
blurry, delusional situation, you dare to ask “Who am I?”
I knew who
I was when I woke up that morning, but given the circumstances, I just wasn't
sure anymore. Such was the transience and instability of my states. You
remember, right?
Now that I
am back at home, I am not sure whether I should laugh or feel angry about your
nonsense. But I have convinced myself that it was not an illusion.
Mr
Caterpillar, you provided me with the opportunity to face unresolved issues --
issues that I was not aware of in my certain and immutable sense of reality, a
reality that I now realize is rather unpredictable.
Although, I
wouldn’t say you are in the best position to preach about permanence and
stability; caterpillars are not immutable beings, after all. When we met, you
were a larva and soon you will become a butterfly. How confident do you feel
about your identity? I wonder if you can call yourself a caterpillar while
being a larva? Would you still be you when coloured wings grow on your back and
you become butterfly? Can we even speak of a permanent identity?
Mr
Caterpillar, much water has flowed under the bridge of identity as we discuss
this existential matters. We used to think our development was only determined
genes. But scientists discovered that it's not that simple. It turns out that
our environment affects how genetic information is expressed. Did you know
that? And it's not only the physical environment...the social environment also
seems to play a role. I'm just amazed by the fact that social interactions can
shape our identity.
Thus, my
dear Mr Caterpillar, I am not the same
now as I was before I met you, and likewise the same happens to you. The
process may be even faster than your much expected metamorphosis. By the way
... can you feel your cells changing at this very moment? I don’t, but even if
I don´t turn into a butterfly, I know that I´m changing as quickly as you are.
Old cells in my body are dying and new ones are born, and so on and so forth.
The same happens to the human brain. Our neurons are constantly changing and
making new connections. What is considered useful is nourished and what is
considered obsolete is trimmed or modified. Connections between neurons hold
our memory in the form of partially stable chemical complexes. That is the
so-called long-term memory, the one that allows me to react when the Mad Hatter
or The Queen of Hearts calls: Alice!
Now, my
dear Mr Caterpillar: Can you see how fragile is the biological foundation of
identity? Transience, insubstantiality, and subtlety are its characteristics.
Our sense of self lives in the realm of the improbable, as does life itself.
Yours, mine, the planet´s even.
I can´t
believe you had the nerves to ask who am I?
I am Alice,
the incredibly weak and fleeting Alice.
I am Alice,
the one who, from that very unstable reality common to all humanity, aspires to
conquer the stars.
I am Alice,
the one who meddles into subatomic particles with the hope of understanding
what happened before the Big Bang.
I am Alice,
the one who with very limited resources aspires to bring some order to this
world of nonsense where it is considered totally normal to see the smile of a
cat after the cat is gone.
My dear Mr
Caterpillar, now I will leave, hoping that tomorrow, when you become a
butterfly, you will recognize me. And please don't forget to spread your wings
when we cross paths so that I can recognize you.
Written by
Ricardo T. Ricci
Translated
by Mariana Dittborn
Publicado en: https://www.ars-medica.org/
