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  • Writer's pictureBruce Campbell MD

The Sign

A slightly differerent version of this essay was published in my book, A Fullness of Uncertain Significance: Stories of Surgery, Clarity, and Grace (Ten16 Press, 2021). I also performed it as a spoken word contribution at the Fall 2022 MedMoth storytelling event at MCW. To read other MedMoth presenters' work, visit the Transformational Times issue here.

“Dr. Campbell, this is Maurice’s sister, Tanya,” says the caller. “I have something I want to bring to your office to give you.”

“Okay,” I respond, uncertain what to expect. Maurice was a long-term patient of mine who died several months earlier after losing an extended battle with tongue cancer. I have met Tanya briefly and only once. She gives no clue as to why she wants to see me. I do not know whether or not to be nervous.

On the appointed day, she stops by my office carrying a small bag. We talk about Maurice, her only sibling. The family was close-knit, and she confirms that he had been a loving, gentle, and hard-working perfectionist.

Maurice spent his working life employed by the county doing physically and technically demanding jobs. His career had been cut short when, in the prime of life, he developed tongue cancer. Following surgery and radiation, he did well for several years. Unfortunately, the cancer returned. Despite more surgery and additional radiation and chemotherapy, the cancer grew over the course of several months. He had reluctantly stopped working and, eventually, there were no more options. He found peace and prepared for the end of his life.

Tanya sits and explains how she and Maurice differed. He was always optimistic, she tells me, an attitude that did not change even as the cancer progressed. Consistent with his approach to life, Tanya remarks that his approach to death was “rational” and “logical.”

I tell her I am not surprised by this. During his office visits, Maurice was always upbeat and analytical even as we discussed very specific details of his cancer and its treatment. I recall one visit near the end of his life when we had a frank discussion about dying as though we were talking about someone else.

Tanya tells me that she, on the other hand, had struggled mightily as his death approached. Compared to Maurice, she is a devoutly spiritual person who views life and its transitions through a very different lens. “He knew that about me, of course,” she says, “so he wasn’t surprised when I kept asking him to send a sign when he was safely on the other side.”

I am intrigued. Is this why she has come to see me? “What did he say to that?” I ask.

“He was a man of few words,” she smiles. “Whenever I asked, he nodded but never said much. Late one evening a few days before he died, though, he gave me an answer. ‘Remember when you asked for a sign?’ he said. ‘Of course,’ I replied. ‘A white butterfly,’ he said. He never mentioned it again. I didn’t know what to think.”

I try to imagine Tanya’s reaction. A butterfly? It was the middle of winter in Wisconsin. Had he said something just to appease her? In any case, Maurice died a few days later.

White butterfiles

She continues. “So, when I returned from the visitation at the funeral home, a magazine was in the mailbox,” she tells me. “I flipped it open and the first article I saw was illustrated with dozens of white butterflies.” From her bag, she pulls a framed copy of the illustration, and we look at it together. “I want you to have this to remember him. This is for you.”

I take the gift from her. “Wow,” I say. “Thank you very much. I am speechless.”

In medicine, we claim that we are anchored by certainty and precision but, if we look carefully, we notice moments we cannot explain; all sorts of things that fall outside of our scientific, rational, and logical world. As Anais Nin wrote, “The possession of knowledge does not kill the sense of wonder and mystery. There is always more mystery.”

The picture remains on my bookshelf, reminding me of Maurice and Tanya. I still don’t know exactly what to think of the white butterflies, but I remain grateful for the gift and for the life it represents.

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