The mind is a fabulous thing, but what can one do with only a mind—that, and the ability to blink an eye? The Diving Bell and the Butterfly, a film made by neoexpressionist artist Julian Schnabel, opens with a blur, silhouettes floating in and out of focus. From the start, the film is claustrophobic. We discover that we are trapped within a patient's mind, looking out through his eyes, later a single eye. The filming device of having his gaze wander away from the person talking to him forcibly situates us in him, reminds us that we can only see through him. Jean-Dominique Bauby (Jean-Do), the real-life editor of the French fashion magazine Elle, suffered a pontine stroke at 43 that left him with “locked-in syndrome”—complete paralysis of all his voluntary muscles except for those of the eye and eyelid. The film is based on Jean-Do's remarkable memoir of his illness, dictated with 200,000 eye blinks to his amanuensis.
Awakening from his coma, Jean-Do is at first confused and then panicked when he realizes he cannot speak. But he soon subsides into a restless helplessness, buoyed a bit by the doctors' assurances that his speech will come back. Hope will decay. Once the novelty of his situation has worn off and he has adjusted to the horror of his immobility, Jean-Do realizes that he has to make do with the moment and memory. The meeting with the mother of his children brings the first note of remorse, regret about having treated her and the children so badly, being unable now to make amends. This moves him to think about the ways he has been self-indulgent, a sensualist, thoughtless, a bit of a prick. He can look forward to a lifetime of painful reminiscence. Alone in his room he conceives that his whole life has been a string of near misses—the women he was unable to love, the chances he failed to seize, the moments of happiness he allowed to drift away. He muses, “Did the harsh light of disaster make me find my true nature?”
We will watch the image of a glacier breaking off and imagine that a facade is crumbling, as over time we see Jean-Do melting, no longer protesting, beginning to mourn his losses. He thanks his speech therapist, Henriette, for enduring his tantrums, and she is touched, grateful. He declares that he has decided to stop pitying himself. His memory and his imagination are not paralyzed, the butterfly can escape the scaphandre (diving suit). And with that his mind takes flight. He is Burt Lancaster in the beach scene in From Here to Eternity, he is bowing before Ozymandias, king of kings. He recalls his boyhood ambitions—surfing the waves, the matador with the bull, playing Brando in Candy, skiing down a totally vertical slope.
And then in the moment the film has spent 40 minutes preparing us for, we see Jean-Do face-to-face. Earlier, as he confided his woes to his imagined Empress Eugenie, he wrote, “An unknown face interposed itself between us. Reflected in the glass, I saw the head of a man who seemed to have emerged from a vat of formaldehyde…Whereupon a strange euphoria came over me. Not only was I exiled, paralyzed, mute, half deaf, deprived of all pleasures, and reduced to the existence of a jellyfish, but I was also horrible to behold.” And feeling helps. Bauby wrote, “To keep my mind sharp, to avoid descending into resigned indifference, I maintain a level of resentment and anger.”
Robert Winer, M.D., is co-chair of the New Directions writing program, the close attention psychotherapy program, and the institute's Psychoanalytic Studies Program at the Washington Center for Psychoanalysis. He authored Close Encounters: A Relational View of the Therapeutic Process.
Bruce H. Sklarew, M.D., an associate editor and co-founder of the award-winning Projections: The Journal for Movies and Mind, organizes the film programs at meetings of the American Psychoanalytic Association and has co-edited two books on psychoanalysis and film.
Human consciousness is arguably the greatest miracle of evolution. The development of our brain and the associated development of language have given us a transcendent capacity to create our world. Jean-Do's consciousness is unimpaired, it is structured on an emotional bodily core, it supports prodigious memory, and it creates a platform for imagination and invention. But there is a third thing that Jean-Do needs to survive: desire.
Schnabel found seven breathtakingly lovely actresses to play the women in Bauby's life. When I first heard his neurologist tell Bauby that his various therapists would be really beautiful, I imagined that he was using their beauty to provoke Jean-Do into doing the hard work of rehabilitation. And erotic hallucinatory wish fulfillment can work for a while. If that is all there is, of course, the infant starves to death. But depression staunches desire. Jean-Do said that he felt like a hermit crab dug into his rock. My second thought was that Schnabel was trying to make the film's contraction bearable for the audience by indulging our gaze, engaging our desire. I sense that there was considerable concern that we would find this film unwatchable.
Jean-Do plans a story. “A hospital room in which Mr. L., a family man in the prime of his life, is learning to live with locked-in syndrome brought on by a serious cerebrovascular accident. I already have the last scene. It's night. Suddenly Mr. L., inert since the curtain rose, flings off his bedclothes, jumps from the bed, and walks around the eerily lit stage. Then it goes dark again and you hear Mr. L.'s inner voice one last time. ‘Shit, it was only a dream.’”
“It was only a dream” is what I am thinking when I wake up from a great dream, and that thought signals disappointment, probably bitterness. Why can't I stage that fabulous show in my real life? Why can't I have her? That's the crux of it of course, it was only a dream. But hold on for a second. It was real in the dream. Isn't that the point of dreams—that they feel entirely true? So why do I discount the experience? Broadly speaking, I have two forms of consciousness, waking and sleeping, and both are phenomenologically totally compelling when I am in them. The reality I experience when I am dreaming does not feel less real than the reality I live in when I am awake. So why do I give short shrift to my experience in dreams?
The most obvious reason is that I cannot make them happen and I cannot control them. When I wake up, I cannot choose to fall back asleep and pick up where I left off. And in that moment I feel the loss. But the exquisite cruelty of the situation is that, as Freud discovered, the dream is the realization of a personal wish. My good dreams are not just happy scenarios, movies I have stumbled into; they are expressions of specific longings that are very important to me. That's the rub. And so, when I awake, I have to bear that the realization of my desire has been deleted: It was only a dream.
And so, in addition to memory, imagination, and desire, we need a fourth thing, a future we can create. In our extendedly conscious minds, the minds we live with, we are continuously not only invoking a past—this is a hammer, I know how to wield a hammer, I used my hammer to shingle my roof—but, just as important, we are always imagining a future. I will turn the page, I will stop by Starbucks on the way to the office, I will play with my as yet unborn grandchildren. Every moment carries anticipation. That's the pain of “Shit, it was only a dream.” With dreams we can imagine a future, we awake and we are back in present time. Bauby wrote that his past was receding, the shore disappearing, reduced to the ashes of memory. His future was as a castaway, adrift on the ocean, haunting the hospital in Berck-sur-Mer.
The ability to implement desire is critical. For a theoretical physicist, paralyzed in a wheelchair, the ability to think creatively may be enough, this sublimation sufficing, a universe in the mind. Julia Tavalaro suffered strokes at 32 and was thought to be in a vegetative state for six years until a relative saw her trying to smile at a joke, and her doctors discovered she was locked-in. Emerging from this solitary confinement, she learned to communicate the way Bauby did, blinking at letters, and spent the next 36 years working as an author and poet. Jean-Do recounted the story of his illness, inscribing his memory, and, being neither a poet nor a cosmologist, according to Schnabel, he lost his raison d'etre. He died days after the publication of his memoir. Once, when he was attempting to ask for his glasses (lunettes), Henriette, misunderstanding, asked him what he wanted to do with the moon (lune). Jean-Do could not reach for it.