It’s time for our last psychiatric patient of the day in rural Florida. It’s 4:00 p.m., and by now the cows have been fed and the crops have been harvested.
Suddenly, there was a heavy tapping at the door and a swift shuffling of feet. A loud voice erupted, “Doc, I gotta talk to you!”
Mr. X came in frantically drenched in sweat and said, “Doc, I did something bad.” His chin furled inwards, his head flexed down, his eyes sunk into the floor, and a look of disdain appeared on his face. Concerned, the doctor said, “What do you mean?”
Mr. X took a big breath and said, “I almost got into a fight.” In unison, the doctor and I, a third year medical student, exhaled a sigh of relief, as we were aware of Mr. X’s past impulsive behavior. Mr. X stated that he was in a Target check-out line, and another customer cut in front of him. Mr. X confronted the customer. Thoughts of aggression burned inside of him like a furnace, but he was able to control his impulses and maintain his composure, deciding that the fight was not worth it.
When we asked Mr. X how he managed to be successful, this is what he said: “What I have learned from my many years since being diagnosed with bipolar disorder is that when I feel impulsive, it’s as if my mind is like a jar of butterflies. My thoughts are the butterflies, and once I have an intrusive thought, I feel like I can’t stop myself and at that point the butterflies flutter off. Their wings flap, flap, flap, and then all of a sudden, SNAP! The butterflies’ wings crumble because once my decision has been made, I have to face the devastating consequences.”
“So,” we asked, “what did you do differently this time?”
“I tried imagining that ‘my butterflies’ don’t need to escape. They are content in their jar because I have everything I need. I have my family: they are the branches the butterflies can perch on for support. I have my medications: they are the nectar the butterflies need for health. And I have my hobbies: they are the sunlight the butterflies need for warmth and comfort.”
While I drove back home that day away from the rural setting back to my suburban home, I drove past cows and horses. But my mind was focused on one thing only: Butterflies.
Ricardo Maldonado-Puebla
Tampa, Florida
6 thoughts on “The Bipolar Butterfly”
great story!!!
Wonderfully written story! The ability to reflect on such experiences is a crucial skill to have as you move forward and you clearly have that skill already
As a physician this story illustrate some of the wonderful successes we have in medicine. Beautifully written story.
Thank you so much for your kind words!
Very awesome story! I got chills reading the last line.
As the author, I am grateful to have been able to share this story with you all about Mr.X. A little context I would like to share is that, I am currently a fourth year medical student but this fruitful experience occurred during my third year rural rotation where I was lucky enough to be able to rotate at an outpatient psychiatric clinic.