ISPUB.COM The Internet Journal of Neurosurgery Volume 8 Number 1 1 of 3 Editorial: A Butterfly Locked-In A Diving-Bell – Is Freedom Possible? G Matis, D Silva, O Chrysou, T Birbilis Citation G Matis, D Silva, O Chrysou, T Birbilis. Editorial: A Butterfly Locked-In A Diving-Bell – Is Freedom Possible?. The Internet Journal of Neurosurgery. 2012 Volume 8 Number 1. Abstract “I am locked in. I am as good as dead” [1]. Name: Jean-Dominique Bauby (Jean-Do) Age: 43 Profession: Journalist, Editor-in-Chief of the French Elle magazine Diagnosis: Brainstem stroke – Locked-in syndrome (LIS) Date: December 8 th , 1995 In 2007, the film Le Scaphandre et Le Papillon (The Diving Bell and the Butterfly) directed by Julian Schnabel and written by Ronald Harwood was released. This was the movie version of the best-selling Bauby’s autobiography previously published in 1997 [1]. The film describes the true life story of Bauby, a man who had everything and consequently lost everything after a brainstem stroke. A man bed-bound with no ability to speak or move anything but his left eyelid [2,3,4,5]. By blinking not only was he able eventually to communicate with his physicians, nurses, speech therapists and family members, but also to write his own memoir via a code of alphabet letters [4,5,6,7]. He was locked-in [5]. The locked-in syndrome (LIS) or maladie de l’emmuré vivant or cerebromedullospinal disconnection can be defined as the presence of sustained eye opening, preserved cognitive abilities, aphonia or sever hypophonia, quadriplegia/paresis and a mode of communication with vertical or lateral eye movement or blinking of the upper eyelid [2]. The most common etiology is damage of the basis pontis through vertebrobasilar artery occlusion [2,7]. Bauby remained comatose for almost three weeks. He woke up paralyzed [6], “reduced to the existence of a jellyfish”, “rigid”, “mute”, “deprived of all pleasures” and in despair: “I am plunged into despair.” “The feeling of doom wouldn't leave.” “Is this life? ... a constant repetition.” “This is hell.” “This is a nightmare.” “I do want to die. I really do.” His body became a prison [5]; a diving bell [6]. “My heels hurt, my head weighs a ton, and something like a giant invisible diving-bell holds my whole body prisoner.” He just wanted to be the cartoon of a frog he was watching on the TV; a frog swimming and hopping insanely (“If I could only be that frog”). Slowly, his past dissolved… [3] “Like a sailor who watches the shore gradually disappear, I watch my past recede. But more and more of it is reduced to the ashes of memory.” A memory considered as “a jigsaw puzzle with pieces missing.” Bauby felt alone (“Sunday. I dread Sunday. No therapists, no visitors, a skeleton staff. Sunday is a long stretch of desert”). He needed protection (“But my favorite sight of all is the lighthouse, tall, robust, reassuring in red and white stripes. I place myself under the protection of this brotherly symbol, guardian not just of sailors but of the sick whom fate has cast to the far edge of life”). He needed approval as well (“What children we all are, we all need approval”). Admitted in the Naval Hospital, at Berck-sur-Mer (Normandy), where “wheelchairs are as commonplace as