Group Analysis: The Diving Bell and the Butterfly in Healthcare

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This report analyzes Jean-Dominique Bauby's memoir, 'The Diving Bell and the Butterfly,' focusing on its relevance to healthcare and medical professionals. The assignment explores themes of patient isolation, communication, and the ethical dimensions of care, particularly concerning the locked-in syndrome. It highlights the importance of effective communication, empathy, and ethical practices in improving patient well-being. The report discusses the impact of Bauby's experiences on the understanding of patient needs, the challenges faced by healthcare providers, and the significance of factors such as kindness, support, and cultural considerations in patient care. The group also reflects on internal conflicts during the prompt and limitations in the current healthcare system, emphasizing the need for improved patient-centered care. The report concludes that healthcare professionals can learn from Bauby's account to enhance the quality of care and ensure patients feel supported and valued.
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Introduction
The book ‘The Diving-Bell and the Butterfly’ by Jean Dominique Bauby provides deeper insights
for health and medical professionals with regard to humanity and ethics that is lost between
patients and healthcare and medical nurses today, or so it is believed to. The novel explores the
pain and uncertainty of living that a patient suffering from the locked-in syndrome experiences,
by highlighting the sufferings, memories, and mental situation of a man in a coma. In more ways
than one, The Diving Bell and the Butterfly is a reflection of the care and support offered by
physicians, and how the same has a troubling effect on the mental and physical condition of the
patient. Thus, The Diving-Bell and the Butterfly is an autopathography that medicine and
healthcare professionals can rely on and peruse in order to improve the quality of healthcare and
the amount of attention given to patients in severe conditions, such as the locked-in syndrome3.
Main ideas of the prompt
The beginning chapters of the story revolve around how Bauby is a successful magazine editor,
who has a sudden stroke and is left in a coma. After being rushed to the hospital, he realizes his
condition and the pain and disappointment that engulfs him motivates him to write a memoir
while his stay in the hospital. He does so by blinking his eyes to the letters read out by his
assistant and is able to communicate his ideas and sentiments by penning this memoir. Therefore,
one of the first and most important things that the story teaches us is communication1. Effective
communication is the key to the betterment and well-being of patients, both emotionally and
physically. For medical and health professionals, effective communication with patients is
emphasized to a great extent, which is also found to be a crucial tool in improving the quality of
patients’ lives. Communication serves as a foundation for ethical principles that are followed by
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nurses and medical professionals and is highlighted as one of the most important tools in The
Diving Bell and the Butterfly5.
Another element included is isolation, which Bauby feels from the moment he is admitted in the
hospital. Because he is almost in a locked-in situation where he cannot feel his limbs or involve
in any movement, but his brain is sharp allowing him to think about his condition and go through
further pain and isolation. Thus, he starts looking at the hospital as a prison ward, especially after
noticing the freedom and carefree attitude of the nurses and residents in the hospital. The fact
that Bauby had turned like a newborn, where is unable to eat and shower on his own leaves him
helpless, sad, and isolated, despite having friends, family members, and nurses around. It also
goes to show the trapped situation that even nurses and health professionals feel in a healthcare
environment such as a hospital, owing to the low retention and high rates of burnout amongst
health and medicine experts9. This way, what Bauby feels is not necessarily true only for a
patient, but also holds true for nurses and care professionals who are trapped in their
responsibilities in their own ways. This leads to Bauby attempting to communicate and let his
feelings out by blinking his eye to the correct letters read out to him, which is also seen as the
needs for nurses to make patients more comfortable and to draw them out of their isolated minds
and bodies. In order to let out positivity in the patient and the environment as a whole, it is
important for nurses to try their best and communicate with patients that can help them
understand their situations better and thus, take appropriate measures to help them improve their
situation12. Simple things like kindness, caring, and effective and effortless communication can
turn out to be the best therapeutic gift for any patient admitted for complications like a coma.
Additionally, Bauby’s memories recorded in the ‘The Wheelchair’ shows the lack of care and
sympathy that nurses and physicians show to patients these days. “He is then dumped into a
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wheelchair for “the test.”His spastic head is carefully cushioned. “‘You can handle the
wheelchair,’13 was what Bauby’s physician commented. While the physicians were interacting
about this matter in a light-hearted way, the same pinched Bauby because he realized that he will
be trapped on the wheelchair for a long time now, which definitely didn’t go well with him. This
necessitates the importance of valuable feedback and bad news that nurses and physicians
usually need to work on, in order to ensure that such news does not impact the patient negatively.
Sometimes, some patients do not take such pieces of information favorably, which may further
impact their physical and mental conditions11. Thus, it is the responsibility of nurses and
physicians to understand the situation of the patient and break bad news in a way that does not
harm their condition. Similarly, physicians are required to stay by the side of their patients,
holding utmost support and confidence for them. According to Bauby, ‘Silent presence and
careful explanation are palliative medicine.13 Despite the fact that Bauby was undergoing a
number of tests that can improve his condition, he still felt that more support, kindness, and care
from nurses can serve as the best medicine for patients than just medical tests. This asserts the
need for physicians and nurses to go beyond the practicality and effectiveness of medical tests
and other formalities and start practicing activities that are more ethical and humane in nature8.
Something as simple as holding a patient’s hand can sometimes work wonders, without anyone
actually realizing.
Other aspects useful for health and medicine professionals included shower and prayer, which
vary according to the patient’s cultural influences, opinions, beliefs, and backgrounds. All nurses
and physicians may not realize it, but activities like showering and belief in religion and God can
be immensely powerful in treating patients, and also provides them with a level of comfort that
their vulnerabilities and needs are actually being attended to by the nurses and physicians. These
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habits of patients may seem unimportant, but the same has an unexpectedly greater effect in
supporting patients, emotionally9. This goes in parallel with improving the outlook and attitudes
of nurses and physicians. With standard ethical guidelines, nurses and physicians have become
more attentive to patients and always act in a way that is morally and ethically right. For
example, disinclined to chat with normal patients, [the doctor] turned thoroughly evasive in
dealing with ghosts of my ilk, apparently incapable of finding words to offer the slightest
explanation”13(p. 53) describes Bauby’s encounter with his ophthalmologist when he wakes up one
fine morning. The callous attitude of the physician makes Bauby very uncomfortable and leaves
him searching for answers, which the physician does not bother asking about and answering. In
this case, the ophthalmologist is seen treating Bauby like a thing, instead of a human being,
wherein he is sewing one eye shut for Bauby without giving him any explanation or showing
solace to the pain and discomfort that his patient is going through4. This is seen as a simple and
true case of burnout and insensitivity in nurses and patients. Very similar to patients, even nurses
and physicians suffer from the burnout syndrome very regularly, which affects the attitudes and
working behaviors of everyone around them. Therefore, nurses and physicians need to not only
care for each other but work in a way that can reduce burnout and stress levels amongst
physicians, which only leads to better care and attention provided to patients2.
Conflicts in the team
While discussing these prompts, there were a number of internal conflicts within the group, with
respect to cultural background and ethical preferences. Accordingly, crucial elements such as the
positivity and resilience of Bauby as a patient to the callous attitudes or nurses and physicians
sometimes have been excluded in the prompt as a result of team conflicts. Additionally, the
group felt that the care and concern provided to Bauby could not have been more than what is
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written about, simply because cost becomes an essential factor in healthcare and medicine
today7. Therefore, the judgments and conditions expressed by Bauby during a time where costs
were not really a factor cannot necessarily hold true for the healthcare field in the current
scenario.
Conclusion
In conclusion, the group has observed the power of communication and its direct correlation with
positivity and patient well-being. The pain, suffering, and isolation that Bauby was going
through were later resolved by an appropriate communication technique, which could have also
been used by the nurses and physicians much before Bauby was tormented by his thoughts and
memories6. There is a lot that nurses, healthcare and medicine professionals can learn from this
remarkable account of Jean Dominique Bauby in the Diving Bell and The Butterfly. Also,
considering that Bauby was still in a better-off position as he was always surrounded with loving
friends and family members, physicians need to go that extra mile to make sure that patients who
are not always surrounded by people can also feel the same level of comfort and warmth. Ideas
and beliefs that revolve around taking care of a patient need to be improved and refined in the
health and medicine sector to focus on positive results for patients3.
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References
1. Dudzinki D. Tethered to the Diving Bell: Beyond Vulnerability to Autonomy. Virtual
Mentor. 2009; 11(8): 603-606.
2. Johansson, V., Soekadar, S. & Clausen, J. Locked Out. Cambridge Quarterly of
Healthcare Ethics. 2017; 26: 555-576.
3. Kearney P. Autopathography and humane medicine: The diving bell and the butterfly--an
interpretation. Medical Humanities. 2006; 32(2):111-113.
4. Kelly K, Fisher E, Dumas A. Alexandre Dumas's The Count of Monte Cristo. Edina,
Minn.: Magic Wagon; 2011.
5. Frank A. The wounded storyteller. Chicago: University of Chicago Press; 1995.
6. Merleau-Ponty M. Phenomenology of perception. London: Routledge; 2011.
7. Dudzinski D. The diving bell meets the butterfly: identity lost and re-membered.
Theoretical medicine and bioethics. 2001; 22 (1): 33–46.
8. Haan J. Locked-in-Chapter 2: The Syndrome as Depicted in Literature: The Syndrome as
Depicted in Literature. Progress in Brain Research. 2013; 34-112.
9. Laureys Steven et al. The locked-in syndrome : what is it like to be conscious but
paralyzed and voiceless? Progress in Brain Research. 2005; 150495: 511-611.
10. Dumas A. The Count of Monte-Cristo. London: Penguin; 2013
11. Fraser M. & Greco, M. The Body : A Reader. London: Routledge; 2005; 167-1814
12. Laine, T. The Diving Bell and the Butterfly as an Emotional Event. Midwest Studies In
Philosophy. 2010;34(1):295-305.
13. Bauby J. The Diving Bell and the Butterfly: A Memoir of Life in Death. Harper Perennial.
2008; 1-144.
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