In 1972, MIT meteorologist Edward Lorenz posed the question: “Does the Flap of a Butterfly’s Wings in Brazil Set off a Tornado in Texas?” In chaos theory, this question came to be known as the butterfly effect. In layman’s terms – how much of an impact can a simple, routine activity (such as a butterfly flapping it’s wings) have on a larger scale? And, if it does have an impact, can we predict when and where the outcomes will be seen?
In nursing, we don’t have a radar that shows us the whirlwind influence of our proverbial flapping-of-wings. We see our patient that is right in front of us and though we can romanticize about how we’ve made a difference once they have left our care, it’s hard to imagine that our seemingly mundane daily tasks have any lasting effects because there are so many factors that are immeasurable and intangible.
Realistically, you can’t follow the air pattern from a single butterfly to a typhoon that is millions of miles away, just as you can’t follow your patient home to observe whether they learned from your patient teaching or quantify if their gratitude increased because they were inspired by your compassion.
I spent five years working in mental health. During that time, I saw many patients struggling with the chronicity of their illness through repeated hospitalizations and volatile behavior. I spoke to them with patience and treated them with respect, but they often associated me with the negative experience that they were struggling with. They swore at me. They called me names. They threatened me. Sometimes, they attempted to act on their threats. I don’t blame them. After all, it’s not my place to determine how much value they should place on my efforts.
Many times, I thought: how can I continue doing this when all of my efforts appear to be futile? I try to mentor them on appropriate management of their emotions and symptoms, but so many of them keep requiring this almost-barbaric control of being locked in a building so that they remain safe. What quality of life is that?
It felt like a game of Russian roulette, except there’s only one chamber that is NOT loaded and that’s the lucky patient that gets better and lives a great life. I never see them again and I probably don’t think about them because I’m too busy cleaning up the mess of the next unfortunate person pulling the trigger.
Don’t get me wrong – there were countless moments that were very uplifting. There were people that were genuinely thankful. One patient burst into tears and hugged me for getting her a cake because she said that her family stopped acknowledging her birthday. One time I sang Bohemian Rhapsody with five of my patients because they wanted me to help them cheer up one of their peers. (I’m no Freddie Mercury, but it worked.) I received letters, cards, and drawings from patients thanking me for being present and caring through their moments, days, weeks, or months of tumult. If they did not come back to the hospital, I usually never heard from them again. I had to rely on the hope that they were flourishing, but it still felt like the impression that I made on my patients was both transient and fleeting.
As I sat in the nurse’s station one day, in the throes of an existential crisis, I saw a picture of Maslow’s Hierarchy of Needs taped to the wall. Someone had highlighted the bottom two categories of the pyramid – physiological needs and safety. That’s when I realized that my efforts were not without merit. Providing the most basic needs can be the catalyst for our patients to progress towards self-actualization.
Scientists did not intend for chaos theory to become an inspirational belief that we can shape history through our actions. In fact, Lorenz sought to deconstruct the notion that there is certain cause-and-effect in nature because he found that the smallest factors are too imprecise to accurately link to one specific result. If one Brazilian butterfly can cause a Texas tornado, who’s to say which butterfly of the millions that inhabit the earth is responsible?
So, what if I turn my focus from the hypothetical tornado across the world to the tangible movement of my own fluttering wings? After all, just because a flower blooms for a limited amount of time does not negate the fact that it needs the butterfly to pollinate it. Through this symbiotic relationship, the butterfly is provided the sustenance that it needs and the flower can reproduce and bloom year after year. Likewise, I have found fulfillment through the resiliency of my patients. And through this notion it became less important to me that I change the world and more important that I positively impact the life of the person that is before me, as they are, in this moment.