This article was inspired by Andy Andrew’s book — The Butterfly Effect.
This book changed the way that I saw my interactions and actions each day because, everything you do, matters!
What if I told you that there is a young man who started medical school this year because he was inspired by me?
Yes, it blew me away the first time I heard this too!
I was both humbled and surprised to know that my actions had had an impact on this young man’s life and trajectory.
His mother told me that her son was starting medical and had decided to become a doctor because he was inspired by me as he watched our Palliative Care team care for his grandmother at the end of her life.
And I remember his grandmother clearly — Vivian. She had a wicked sense of humour that was mixed with kindness and a warmth that comes only comes from having lived a full life. But I also remembered Vivian because she had suffered significantly as her cancer progressed and her resultant pain gradually debilitated her.
And throughout the course of our therapeutic relationship which spanned nearly two years, I got to know Vivian, her twin sister and her family well. We held several family meetings to discuss Vivian’s treatment options because of all the twists and setbacks that she experienced.
Vivian stood out to me because she always managed to smile when she saw me and consistently rated her pain as a 4/10 despite what her family said and her use of pain medication! She was a worry but altogether lovely. I grieved when she died.
But more specifically I remember Vivian because she challenged our whole team with the complexity of her disease. It was never straightforward with her. And the elation of a pain regime that worked was always short-lived, as Vivian experienced yet another complication or less than ideal outcome as her cancer progressed. It was tough. But we never gave up.
And in all of this, whilst I don’t recall meeting this your legend but the one thing that I do remember about Vivian’s family was that she was deeply loved and always accompanied by a family member to every clinic visit, hospice stay and home visit that we made.
Inspiration in the face of challenge
Earlier this year, about eighteen months after Vivian died, her daughter saw me at the hospital and pulled me aside. She thanked me and our team again as we reflected on her mother’s life. But she then mentioned something that made me choke up.
She said that I had inspired her son Ryan to become a doctor. He was 15 years old at the time and he was inspired by the way that I had looked after his grandmother and was thoroughly impacted by everything that we tried to help fix her pain. He now wanted to become a pain specialist to help other people with their pain too!
I bit my lip as I felt the tears starting to well in my eyes because my mind flashed back to Vivian’s last weeks. I pictured them clearly and was reminded again of the desperation that I felt as we searched for answers to her distress.
See, we had exhausted all our available resources at both a local and tertiary level to help Vivian. And despite all the clever nurses and doctors involved across disciplines, nothing seemed to appease her pain. It was challenging and the emptiness that I personally felt from having nothing more to give was particularly jarring.
What do you say to patient who is clearly distressed and to their family, that there is nothing more that you can do?
In my eyes, her last days were less than ideal. I even entertained the thought that I had failed her.
But then, as I listened to her daughter recount the beautiful memories that they made in those weeks before she died, I was struck. To her family, everything had been done to make Vivian comfortable and they were grateful. And to Vivian, according to her daughter, she was at peace and her physical pain was somewhat muted by the meaning and joy she experienced before she died.
It thus genuinely surprised me that Ryan was inspired by what could be seen as a sombre moment of medical defeat and in my eyes a less than ideal representation of my medical expertise.
And yet there it was, in a moment of seeming defeat, something beautiful was born. Something precious was seen in my vulnerability.
In my weakness, he saw strength.
When our hands were tied, he found inspiration.
In watching me care for his beloved grandmother, Ryan was inspired to become a doctor.
His mother then said that Ryan hadn’t shown a great deal of interest in school before his grandmother became ill. But something happened within him as he watched us care for his grandmother that motivated him to take action. He saw his future self in me and the others he met and now wanted to do everything he could to become a doctor, to help others with their pain and their suffering.
My actions inspired him.
And this year, he started his own medical journey!
But this isn’t the most wonderful part of the story.
The most beautiful part of this story is about the butterfly effect of inspiration.
We don’t know when and we don’t know how, but our actions can inspire others and produce a ripple effect that can potentially impact many more!
The butterfly effect
The butterfly effect is not a myth but rather a metaphor for a proven law of physics.
The butterfly effect says that small changes, such as the imperceptible flap of a butterfly’s wings can produce a ripple effect of magnitudes much greater than when it started. That is, one small and gentle change or action can have a large effect and consequence.
The Butterfly effect was first described by Dr Edward Lorenz, a Professor of Meteorology at the Massachusetts Institute of Technology. His question was, “Does the flap of a butterfly’s wings in Brazil set off a tornado in Texas?”.
https://thehealthygp.wordpress.com/media/284c58704892109fc463e427e692320dBrilliant explanation of Chaos theory and Dr Lorenz’s work on the Butterfly Effect
His resulting theory suggested that the small changes in the atmosphere such as the flap of a butterfly’s wings, which through interconnected events, could lead to conditions conducive to producing a tornado!
He published his theory in 1963 and after enduring nearly 30 years of heavy criticism, Lorenz’s theory was proved correct!
His theory was finally described as “The Law of Sensitive Dependence Upon Initial Conditions” — in which a small change in the state of a non-linear system can result in a large difference in a later state.
The butterfly effect as it is now popularly known as the mathematical description of how small changes can produce large consequences. And for us, the important aspect of the Butterfly effect is that it can function with any first movements of any type of matter in our world — including people!
See this is what happened in Ryan’s story. My actions and concern for his Grandmother’s well-being had a profound impact on Ryan’s life. The little things that we did to help Vivian had a huge impact on her grandson’s next steps.
That is why every single move and action that we take, no matter how small, matters.
What we say and how we say it.
Our actions or our inaction.
Our presence and our absence.
All of these have an effect and ripple through our lives, touching those around us and having different magnitudes of influence and inspiration.
Your inspired action, born in vulnerability or challenge can go on to impact people that you may never meet and may go on to impact thousands, and possibly millions!
“Sometimes when I consider what tremendous consequences come from little things. I am tempted to think there are no little things.”
The butterfly effect of inspiration — My story
As I reflected on Ryan’s story, I smiled. This is because I realised that my medical adventure had also been inspired by a number of key people with whom my life had intersected. Their actions and moves rippled through their lives and touched me. Their seemingly small contributions had a huge impact on my my life.
See, at the age of 21, I had gotten my life back on track and I was focused on getting into medical school. Thinking about this now, I didn’t have a deep appreciation for what it meant to be a doctor, I only wanted to get into medical school. But my heart and motivation were changed from simply studying medicine to becoming a doctor when my mum was involved in a near-fatal car accident.
I remember the day clearly. We arrived in a panic at Fremantle Emergency Department. That afternoon we’d heard there’d been a serious car accident near my mum’s school and as we waited for her to arrive home, we received a phone call that confirmed our greatest fear. Mum was in the hospital. With my eyes burning from my salty tears and Kylie firmly holding my hand, I remember the person who changed my heart and motives. The on-duty Emergency Physician. He was kind and calm amidst the chaos around him. He could see that I was shaking and scared and intuitively held both my shoulders and met my eyes. “Your mum is going to be okay”. His words were what I needed at that moment. He connected with me and help appease my fear and worry.
I thought about this interaction for months after. I wanted to be like this doctor. Calm in the face of distress. Competent and kind. And most of all, able to make a connection when it mattered most. And from that day forth, my mindset changed from getting into medicine to becoming a doctor. It was no longer an academic pursuit, but rather a calling from my heart.
This encounter changed my life because when I spoke about it at my University of Sydney Medical School Interview a few months later, the emotion in my voice and the strength of my heart’s conviction, I’m sure, made all the difference to securing me a place in medical school.
Who would I have become had I not encountered and been inspired by this doctor? I’m not sure, but my brief interaction with him impacted my life and changed my heart’s calling and motivation. I saw my future doctor self in him.
However, the butterfly effect of inspiration in my life didn’t being there.
I was first inspired to become a doctor by my uncle Dr Gabriel Peirrera, the only doctor in my family. I admired him and was inspired by his confidence and by his casual but brilliant manner. He took an interest in me and was the first person to encourage me to become a doctor. The ripples of his influence as brief as they were (because he lived in Malaysia) made the biggest difference, especially during my tumultuous year 12 experience.
But the person whose actions have rippled and have had the greatest impact on my life and medical career is my mentor, Professor Kirsten Auret. Her brilliance in difficulty, thoroughness and kindness and constant curiosity has had a deep effect on me. Her actions, the butterfly effect of these I am sure have inspired countless others too.
And in her story, I see the butterfly effect of inspiration working too. Professor Auret’s medical life course was profoundly changed when a good friend of hers from university was diagnosed and died of a brain tumour. What inspired her was the small but thoughtful actions of the Palliative Care Physicians and nurses who cared for her friend in the last weeks and months of her life. The meaning and comfort that they helped bring to those seemingly dire moments, realigned Professor Auret’s course toward Palliative Medicine. And as result, her inspiring clinical life changed my course, and my actions helped to change Ryan’s course too!
This is the butterfly effect of inspiration.
Every single thing that you do matters!
More than that, your life matters.
The Butterfly effect of inspiration
The butterfly effect of inspiration is how the true joy we bring to our work and lives, inspires and encourages others.
True joy is seen in our contribution, in a broad and pioneering vision and in being able to embrace uncertainty and discomfort. These are marks of inspiring work.
When I cared for Vivian I was doing what I loved. I had left general practice a year earlier to follow the call of my heart toward Palliative Care. And in everything that I did, I modelled my clinical behaviour and standards of care on what my mentor Professor Auret had taught and inspired me to do.
It is stunning to me that despite all the setbacks that we encountered in treating Vivian, to Ryan, I was a shining star of what a good doctor looked like. Inspirational and memorable. The epitome of the doctor who had inspired me 18 years earlier — in control, humble and kind, intelligent and competent and most of all special!
It is certain that the people who will go on to change the lives of those around them and contribute significantly to mankind were all at one time inspired by someone with whom their lives intersected.
This is the butterfly effect of inspiration — how one move can impact hundreds, thousands, if not millions of lives.
As I reflect on this, I am excited because,
What will Ryan go on to do?
Who will he inspire through the joy of being a doctor?
Will this person change the course of medicine, nursing or another field?
The questions and ripples of inspiration continue!
One small move produces a powerful ripple that will impact significant numbers of people.
“There are generations yet unborn whose very lives will be shifted and shaped by the moves you make and the actions you take today. And tomorrow. And the next day. And the next” —
What Ryan’s story tells me is that we do not have any control over the moments that will go on to inspire others. They may be messy and probably not pretty, but these moments are certainly when we are pushed to the edge of our abilities.
I know that my most inspired moments as a husband and dad have been when I’ve messed up but shown love in impossible situations. And my most inspired moments as a doctor have always been when it’s challenging, difficult with no clear path forward.
These are the moments that inspire others and live on as memories.
Inspiring action always begins outside our comfort, where we rise to the challenge, doing what we love.
Who will you inspire with your joy?
What impact do your actions today have on the generations to come?
Be inspired. Your life matters. All life matters!
Remember to live intentionally. Love relentlessly. And most of all, enjoy your health!
Dr. Jonathan Ramachenderan