Advice from a Caterpillar: Reflections on Change, Uncertainty and Identity

 

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/