Lessons from the Butterfly


“We delight in the beauty of the butterfly, but rarely admit the changes it has gone through to achieve that beauty.”
–Maya Angelou

Growth and transformation can be messy. Ask any caterpillar on its way to becoming a butterfly. After eating voraciously to prepare itself, it secretes a long stream of liquid from glands just below its mouth. This liquid stiffens to become a silk-like thread attaching the caterpillar’s hind end to a twig or leaf. Then it spins the thread around its body to form a covering which hardens into a shell-like cocoon or chrysalis.

Now things get murky.

We’ve all heard that inside the cocoon, the caterpillar changes into a pupa. But did you know that the process involves actually digesting itself from the inside out? I didn’t.

As the caterpillar’s body liquefies, some of the old tissues are salvaged to fuel the makings of a new form – created from “imaginal” (undifferentiated) cells within the caterpillar’s body. So by deploying digestive juices, the caterpillar-pupa recycles its old larval body into food for building a new one.

Once the butterfly-to-be is ready to emerge, it releases a fluid which softens its shell. The butterfly pushes on the shell walls until they break open; this pushing develops wing strength. Once out, the creature needs to pump still another fluid from its thorax into its wings so they can open; they also need to dry. But then off it flies — a completely new being!
This is far from the “presto-chango” story I learned in grade school. Who could imagine “imaginal” cells, or that all these holy fluids lie within the lowly caterpillar-pupa-butterfly?

Physicians go through their own transformations, sometimes through joyful events but also through suffering. And sometimes our holy fluids are tears.

Getting accepted to medical school, for instance, is a high point for many physicians -– but it’s often accompanied by geographic moving, leaving behind one’s previous community and supportive relationships. Then there are events like meeting our first dead body in anatomy lab, taking our first medical history and physical on a live patient, or being called “doctor” when we don’t yet feel like one.

Transitions and high water marks continue throughout physician lives: selecting residencies, graduating, often moving again, and perhaps being cut from a training program. A patient has a bad outcome or even dies; somebody sues. Parents get sick and die; we get sick, depressed, or addicted to drugs; we get married; have babies; we select our first post-residency job and it absorbs us completely. We get divorced. Maybe we have a change of heart about our chosen specialty. Possibly we experience a paradigm shift about medicine itself. Or, our practice goes bankrupt. Life can be a cascade of light and darkness.

All these potential events (and many more) can provide substrate for alchemy within us. Crises can become transformation points rather than only points of suffering; the effort we expend getting through them can parallel the butterfly’s struggle for release and freedom.

The trouble is that while we’re in transition, we often can’t see the process for what it is. As Dr. Rachel Remen has said, “A transformation in consciousness affects a kind of double vision in people. They see more than one reality at the same time, which gives a depth to both their experience and to their response to the experience.” But until we come all the way through transition’s doorway, we may only feel cross-eyed – or worse. We’re between no longer and not yet.

We can feel disoriented, adrift, and isolated during such liminal periods in our lives — or even completely liquefied, like a pupa-in-process. And yet, there can be solace within the lost-ness, as David Wagoner writes in his poem, “Lost”:

Stand still. The trees ahead and the bushes beside you
Are not lost. Wherever you are is called Here,
And you must treat it as a powerful stranger,
Must ask permission to know it and be known.
The forest breathes. Listen. It answers . . . .
Stand still. The forest knows
Where you are. You must let it find you.

It is useful to think about, write down or share our own transformation points with others: times in our lives that changed us, and how we grew. These stories can provide sustenance for someone else coming along the same path, either now or later. They can serve as trail markers or cairns along the way. Finding them, we’re no longer so lost.