Running head: COMMUNICATIONS 1

Communications in The Diving Bell and the Butterfly

Katie Button
Empire State College

Unit 5: Do You Mean What You Say... and Say What You Mean?
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Communications in The Diving Bell and the Butterfly

Communicating in the health care setting

As health care professionals, the way that we communicate with our clients can

either promote positive feelings and relationships, or hinder them. For nurses to be

effective in their interactions they must have good communication skills (Blais et. al,

2005). Personal biases and prejudices influence how we treat our clients, so it is

important to be aware of our verbal and nonverbal cues and make sure that they are

sending the same message. We also need to be aware of our own prejudices so that we

can recognize them and prevent them from interfering with our patient interactions.

Every interaction a nurse has with her client should be professional and encourage open

and honest communication. In Julian Schnabel’s film, The Diving Bell and the Butterfly,

the viewer is given the opportunity to see how ineffective communication can negatively

impact a client’s feelings, while effective communications make a negative experience

that much more bearable.

Dr. Lepage, ineffective communication

While Dr. Lepage, Bauby’s neurologist, appeared to have the best of intentions,

he often times exhibited many ineffective communication techniques. To Dr. Lepage,

Bauby appeared to be just another patient. In one scene, Bauby was seen being wheeled

around in all directions in a new wheel chair. “Sorry to inflict this on you, Jean-Do,” Dr.

Lepage apologizes. By making this statement, Dr. Lepage is acknowledging that this

may not be a pleasant experience for Bauby, however he continues to do it anyway

because he is using this as a teaching aide for his residents. Even though Dr. Lepage

knew that Bauby could understand everything and still had feelings, he did not appear to
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think of him as an individual person. When Bauby first came out of his coma and met

Dr. Lepage, the Dr. was very informative when explaining to Bauby what was going on.

Dr. Lepage stated facts, but he lacked empathy for his patient. Dr. Lepage also made the

mistake of falsely reassuring Bauby by telling him not to worry and telling him that his

speech would come back. Unwarranted reassurance block the fears, feelings, and other

thoughts of the client (Blais et. al, 2005) and is a barrier to effective communication. The

closest Dr. Lepage came to showing empathy towards Bauby was when he told him in the

beginning that he would like Bauby to think of him as a friend, and he would therefore

call him Jean-Do, as he heard that his friends did. If a patient were able to communicate

effectively, a physician would first ask that patient how they would like to be addressed.

With some time and effort, Bauby was able to communicate, and had Dr. Lepage made

that attempt, he would have realized that Bauby did not feel comforted, nor did he want

him to call him that. Dr. Lepage may have had good intentions, but his view of Bauby as

just another patient, and with Bauby’s inability to move or speak, the Dr. seemed to think

of him as less of an individual, and lacked effective communication skills.

Henrietta, effective communication

This film uniquely captured Dr. Lepage’s distant relationship with Bauby by not

filming him very frequently. Likewise, Bauby’s speech therapist, Henrietta, is an integral

part of Bauby’s life and of this film. Henrietta recognized Bauby as a human being and

as an individual and invested a lot of time in him and his life. Henrietta seemed to have a

friendship with Bauby, and a therapeutic relationship. Presence, or an attitude of being

wholly there for the client, is part of therapeutic communication (Blais et. al, 2005). Not

only was Henrietta there for Bauby, but also when his friend came to visit him for the
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first time, Henrietta explained how to communicate with Bauby, and also offered to stay

nearby for support. When you wish to be therapeutic and empathetic, you need to listen

very carefully and attentively (Schuster 2000). By staying in eyesight and maintaining

eye contact, Henrietta encouraged positive communications and showed empathy with

her nonverbal actions. Empathy means placing yourself in the patient’s place and seeing

the human side of the patient (Schuster 2000). When Bauby told Henrietta that he wished

for death, she responded in a very personal way, saying, “there are people who love you,

to whom you matter. How dare you.” She was not just speaking generally, but had

herself formed a close friendship with him. Whereas Dr. Lepage just assumed he could

address Bauby by his informal name, Henrietta took the time to get to know him on a

friendship level, and then she asked his permission to call him Jean-Do. The progress of

their therapeutic relationship was confirmed when Bauby was comfortable with Henrietta

calling him Jean-Do, and was again reinforced on Henrietta’s part when she took Jean-Do

on a boat ride for a change of scenery and gifted him with his favorite novel.

Jean-Dominique’s feelings

Bauby’s feelings were often expressed in his thoughts. “Sundays are a long

stretch of desert” he reflected once, referring to the weekend staff as “skeleton staff”. He

looked forward to the weekdays, when his therapists, Henrietta especially, worked.

Unable to show nonverbal cues due to his paralysis, the viewer of the film was able to

hear what Bauby was feeling. It was obvious that Bauby was uncomfortable around the

physicians, who treated his paralyzed body as an empty shell. When the optometrist was

sewing Bauby’s bad eye shut, he said “Don’t worry, I have done this 1,000 times.” But

Bauby was very scared, and in his head was pleading for the physician to please not sew
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his eye. He was fearful, and this fear was partly due to the physician’s lack of

communication. Bauby did respond well however to his therapists’ gentle touch and

interest in him as a person. He was comfortable being honest with Henrietta and sharing

his feelings of wanting to die. The viewer could also see Bauby’s comfort around

Henrietta in his ability to see humor, such as when the telephone people came to his

room. A lack in communication caused confusion and fear, in contrast to the calm and

openness seen when one took time and respected Bauby and treated him as a regular man.

Encouraging growth in the individual patient

If it were not for Henrietta’s patience and dedication, Bauby’s story may not have

ever been told. Both Henrietta’s verbal and nonverbal cues built Bauby up and

encouraged him. In Bauby’s diving bell, Henrietta was a glimpse of hope for him,

supporting his butterfly. Had Bauby not had his family and Henrietta, he might have lost

himself, as the physicians did not seem to encourage his growth. This film is a good

reminder of the impact that we each have on our patient’s lives, and reminds us that even

though we see 1,000 patients, each patient needs to be treated as an individual. [We]

need to develop a natural, spontaneous response to patients and families that conveys

acceptance and interest in a genuinely nonjudgmental manner (Schuster 2000).

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References

Blais K., Hayes J., Kozier B, Erb G. Professional nursing practice: concepts and
perspectives. Fifth ed. Alexandria, VA: Prentice Hall. 2005.

Schuster P. (2000). Communication: the key to the therapeutic relationship. 1 ed.

Philadelphia: F.A. Davis Company, 2000.
The Diving Bell and the Butterfly. Dir. Julian Schnabel. Perf. Mathieu Amalric,
Emmanuelle Seigner, Marie-Josée Croze. Miramax, 2007. DVD.