The Ripple Effect



In the fall of 1992, fresh from residency training, “…including sudden death” was the standard ending to my “risks of surgery” informed consent spiel. Usually my patients recoiled, shivered, sighed, and ultimately signed by the “X.”

But her response caught me off guard.  She smiled a grandmother’s smile.  And as though to comfort me, she offered, “I’m not worried.”

Then, noticing my curious half smile, she bobbed her arthritic index finger down and up one time, gazed at me warmly and answered, “That’s why.”


Worry can be paralyzing. So how can you cope?

In my career as a Navy flight surgeon, anesthesiologist, pain & addiction specialist, husband, father, and son I have been blessed with the opportunity to connect intimately with people on many levels. I’ve noticed those who preserve their joy despite insurmountable challenges seem to share certain themes. To beat worry, they “prep” themselves.

P R E P 

healthy body


Firstly, they address their PHYSICAL needs. You live inside a body. And your body has tremendous influence on how you handle stress. You should promote its physiological well-being.  Get enough sleep. Eat well. Exercise. Also, since we are what our chemicals tell our brain we are, do what you can to optimize your chemicals. This means if your serotonin is low, your hormones are deficient, your endorphins are depleted, or any other ailment needs medical attention – tend to it. Your body is the only vessel you will ever have on life’s journey – better to patch the holes than to be constantly bailing.



Secondly, they RESEARCH.  Compared to other animals, humans have huge frontal lobes. This allows your brain to analyze facts. Do this. Uncertainty breeds worry. The more you understand a situation, the more likely you are to find solutions. So when faced with worry, gather as much information as possible, realistically predict what might happen, and then take actions to improve the likelihood of the better outcomes.



Thirdly, they have an EXTERNAL focus.  Doing something for someone else or a cause that benefits others, with passion, selflessly, will make your problems seem less ominous. Frankly, it is impossible to think about yourself when you are locked into thinking of someone else. Living at the center of the universe can be very lonely.



Finally, they have PERSPECTIVE. Humans are the only organisms aware of concepts like the past, the future, beauty, love, death, and eternity.  Try as you may, the past cannot be undone. The future is no different than a dream. You have complete control of your perception of beauty and how deeply you love. These certainties coupled with awareness that one day the mystery of eternity will be answered should prompt you to ask yourself, “Do I really want to spend so much time worrying about _______ (fill in the blank)?” You probably have bigger fish to fry.

* * * * * *

That morning my grandmotherly patient went on to explain the significance of her bobbing finger. “Your life is like dipping your finger in water. No matter how much you want it to be different, you only make ripples that just fade away with time.”

I have never forgotten that simple metaphor of a finger dipping into water. A life’s dissipating ripples in time are more harmonious when sheltered from the dissonance of worry.

It is essential to PREP.  Optimizing your physical health, researching the facts, externalizing your focus, and gaining perspective are effective techniques to conquer the paralysis of worry. This is not always easy and takes some discipline, but I have witnessed remarkable people overcoming unbelievable challenges – this has been their path. These are the ripples they have left behind for us.


James Patrick Murphy, MD, MMM

Note: This article was first published as the President’s eVoice, Louisville Medicine, December 2013.

2 thoughts on “The Ripple Effect

  1. Friends, 2015 started with very sad news…

    On New Year’s Day 2015 my dear friend and medical practice manager, Debbie Tichenor RN, passed away at her home – suddenly and unexpectedly. She was only fifty-seven. It is impossible to adequately describe the care and inspiration she gave to the many lives she touched.

    Debbie was a blessing to so many people… her loved ones, family, friends, patients, and to many she never met. At our chronic pain treatment center, Debbie was our backbone and our heart. She brought hope to countless patients over the years.

    Though too humble to ever accept such praise, Debbie was the consummate nurse. She made everyone around her better. She made me a better doctor. She made me a better person. I am grateful to all she has done for my practice, for my family, and for me. Debbie’s faith and love for God was unwavering and unshakable. I will miss my dear friend everyday, but I am comforted in knowing that she is home now and has left our world a better place because of her life.

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