Leave To The French

October 29, 2008 11:36 AM

Why was that eye-blinking code in Diving Bell and the Butterfly chosen?

Saw the movie a couple weeks ago and one thing drove me nuts: the eye-blinking alphabet code. Here are my issues with it:

*Inefficient. It was essentially a guessing game that required sequencing through the entire alphabet (in the film they never explained how numbers were done).

*The patient was not in control of the process.

As I was getting agitated at this (patience <> my long suit) I thought of Morse Code. It was perfectly suited to the situation and would have resolved the issues above.

So, I wondered if anybody with more knowledge of the situation had an explanation for why Morse Code was not used, other than "they didn't think of it"?

posted by trinity8-director to health & fitness (23 comments total)

Not sure if you don't know that it was based on a true story, and that a french frequency-ordered alphabet was used.
posted by neustile at 11:53 AM on October 29, 2008 [2 favorites]

Because it is a true story, and that is how Jean-Dominique Bauby actually wrote the book 'The Diving Bell and the Butterfly'.

I have no idea why the therapist/doctors Bauby was seeing selected that method ahead of others.
posted by HighTechUnderpants at 11:53 AM on October 29, 2008

I think the two previous comments are missing the point. I read the book but didn't watch the movie. Even if its a true story, the question stands: Aren't there more efficient ways of communicating?

The chosen french frequency does minimize eyeblinks but it can be painfully slow (reciting the entire alphabet to get to the least-frequent letter?)

There is no explanation in the book of why Morse code wasn't used. So it remains a mystery. There is some skepticism as to whether this is how the book was really written.
posted by vacapinta at 12:01 PM on October 29, 2008

I'm still looking for the link, but don't assume that going through the entire alphabet is slow. I'd read that before long the entire alphabet was being said at incredibly rapid speeds.
posted by bonaldi at 12:17 PM on October 29, 2008

There are definitely more efficient ways of communicating, but a dry, scientific analysis of what was an extremely difficult situation doesn't work. While it might have been technically viable to teach the guy some sort of efficient communication system, I suspect that just didn't occur to them over such a stressful time.

Having read the book myself, I am certainly convinced Jean didn't write the book in its entirety and that a lot of editing took place. I suspect the stories were given in a very piecemeal, slapdash fashion given the medium of communication. This doesn't detract from his story IMO, however.
posted by wackybrit at 12:17 PM on October 29, 2008

There would be very few times you are reciting the whole alphabet - once he got to the letter he wanted they started over. That and it was something they already knew. Have you ever tried to learn Morse code? I would think learing a whole new alphabet before starting to write would be even more work.

Great movie. I had an uncle who was in that state for a year or so after having a large brain tumor removed, and this movie helped me understand that he really was in there afterwards. I wish I had taken the time to communicate with him.
posted by Big_B at 12:23 PM on October 29, 2008

*The patient was not in control of the process.

This may be a positive, if blinking takes a lot of effort. You can go as fast as someone can recite the alphabet, as long as you can make that one difficult blink at the right time.

Given that, nowadays a predictive texting system would probably be the best choice to minimize blinks.
posted by smackfu at 12:23 PM on October 29, 2008

Reading off the frequency ordered alphabet and watching for one or two blinks to confirm a letter is a lot less work on the part of the writer, though it is slower. Using Morse code would have required both the patient and the transcriber to know or learn the code. I tried to learn Morse code a few years ago and I gave up, I can't imagine what it would be like to have to learn it in that situation.

And really once a rhythm is developed and the transcriber gets to know they language style of the author, he can just guess at the next word and confirm it rather than spelling out each and every letter.
posted by Science! at 12:37 PM on October 29, 2008

Thanks for the replies.

Morse code can be very fast. Think telegraph. Every Boy Scout learns it, so yes I have. Quick brown fox, and all that. I didn't keep it up as I had no application for it. I passed it off and moved on to other things. It took me a week or so, as I recall.

I understand that speeds increased over time but that's no argument in favor of letter frequency, as any method would get faster over time. Still, getting to the latter parts of the alphabet would always be slower than the Morse version. Morse has a max of 5 dot-dash combinations (not counting punctuation).

If blinking was too difficult that would be a good reason to go with the code they used (which also required learning on the part of at least one person).

Perhaps this is a question without an answer in this forum? Might be that only the therapist knows the ultimate answer.
posted by trinity8-director at 1:06 PM on October 29, 2008

Using Morse code would have required both the patient and the transcriber to know or learn the code. I tried to learn Morse code a few years ago and I gave up, I can't imagine what it would be like to have to learn it in that situation.

I think that this is likely the best answer. While Morse code would certainly have been more efficient, it also assumes that they both knew it. I'm also sure that learning Morse code would have been an exercise in frustration if there was no way to say "Oh, damn, what was the code for 't,' again?" At least, it couldn't be said easily.
posted by InsanePenguin at 1:25 PM on October 29, 2008

Not everyone knows morse code. Few people do. He needed to communicate to speak with his friends and family, not just to write the book - anyone can spell out an alphabet. Many doctors would need to learn it, he would need to be taught it, anyone who wants to communicate with him would need to know it. It's probably very tiring - as you saw in the movie, he didn't have great control of the blinking thing. It took effort. It's just as, if not more so, cumbersome than the alphabet method - the only real downside of which is that it takes more time.
posted by Solon and Thanks at 1:27 PM on October 29, 2008

I thought the same thing when I saw it but figured it may not have been really what happened, they just didn't want to confuse the watchers perhaps.
What would have been more efficient was using up, down, left, right and blink all as symbols. Two gestures could represent the majority of alphabet (blink blink = A; blink up = B; etc). Also single eye winking would have expanded the number of gestures to 7 and more clever things could be done.
posted by wolfkult at 1:55 PM on October 29, 2008

I saw a television program about someone with locked-in syndrome who communicated using a table of letters that resembled something like the following:

1: A B C D E F
2: G H I J K L
3: M N O P Q R
4: S T U V W X Y Z

The interviewer would first ask the patient which row the letter was in (1? 2? 3?...), and would only have to recite the letters in that row.

I doubt that the letters where in alphabetical order like my example above. They were probably arranged in an order to take advantage of which letters are most common.
posted by upplepop at 2:32 PM on October 29, 2008

I remember a lot of guessing ahead of words by the transcriber so that common words would be cut to a couple of letters.

I'm not sure that someone in that position - depressed, frustrated, angry etc - would have the patience to learn a complicated system and they just wanted him communicating as soon as possible. Also I think they expected him to gain some sort of even minimum verbalization with therapy; which he kind of did just before his death.
posted by fearfulsymmetry at 2:42 PM on October 29, 2008

I found a chart here. This seems to be a fairly efficient method.

E T I N D P
O A R H F W
S C M G V Q
L U B K Z ?
P Y J . ,
1 2 3 4 5 6
7 8 9
posted by upplepop at 2:43 PM on October 29, 2008

upplepop, interesting chart...and no zero! I checked and you didn't leave it out. Kinda funny. They also list Morse Code as an option along with some other codes. Good link.

fearfulsymmetry, yes, now that you mention it, I do remember the therapist guessing words from the first few letters + context. That would help in any code.

I admire the therapist for coming up with a blink code and the accomplishments of all involved. I don't want to take anything away from that. As the link from upplepop shows there are several options available for people in this terrible state.

And yet, sorry, but I don't buy into the idea that Morse is too hard to learn, having, you know, done it. Too difficult to blink that much in a rythmic fashion over a period of time, though, I can accept that as a reasonable argument against.

If it were my family member I'd be thrilled to learn it to be able to communicate more efficiently.
posted by trinity8-director at 3:28 PM on October 29, 2008

As an aside, I was a Boy Scout and I just did a little IM chat with a few other friends who were also Boy Scouts, none of us ever learned Morse code in the scouts. Basic semaphore yes, but not Morse code.

However who knows what systems the patient and transcriber were working on, communication evolves. They could very well have been adapting and changing their methods as they went and learning a system like Morse code on the side in hopes that one day they could communicate in more detail and at a faster rate. But the author's death was pretty sudden and his medical condition was mysterious as all get out so they may have defaulted to the easiest system to get the job done, in hopes to develop a better system in the future.
posted by Science! at 3:43 PM on October 29, 2008

And yet, sorry, but I don't buy into the idea that Morse is too hard to learn, having, you know, done it.

Just because you found it easy doesn't mean everyone will. I picked up the piano like a pro, but wouldn't expect the same of others.
posted by Solon and Thanks at 4:22 PM on October 29, 2008

did you, you know, learn morse while you could only communicate with hard-to-control blinks? Seems transparently more difficult by orders of magnitude.
posted by bonaldi at 5:56 PM on October 29, 2008

According to my friend, who visited a locked-in patient in 2002, this is not far off. She used a version of this code to communicate.

For each letter the patient first picked half of the alphabet (presumably A-M or N-Z) and then the depressingly slow recital of the letters began. The patient continually looked up and looked down once the desired letter was reached.

It was an extremely slow, sad, painful way to communicate. My friend had trouble picking out the right letter. The patient became tired quickly.

That's about all I had the heart to ask.
posted by Izner Myletze at 6:30 PM on October 29, 2008

i imagine morse code would be more taxing, ultimately--instead of blinking once per letter, the patient would blink up to three times. i imagine the patient would tire more quickly, either having difficulty coordinating the dots and dashes, or simply having to communicate less.
posted by thinkingwoman at 6:35 PM on October 29, 2008

Test this hypothesis. Go ahead and try to do morse code with your eye muscles for 5-10 minutes.
posted by a robot made out of meat at 7:29 PM on October 29, 2008

All: I very much appreciate the vigorous discussion. I hope people understand that I'm not attacking anyone and, as stated above, admire the therapist for doing what she did.

Science!: Good chance I was in the Scouts long before you and your buddies, which might be part of the reason. I haven't been involved in the program since so I have no idea how things have changed.

Izner Myletze: Binary search! Great idea.

Test this hypothesis. Go ahead and try to do morse code with your eye muscles for 5-10 minutes.

Yeah, for some reason I edited out that I had, in fact, tried this. Blinking rapidly over time is hard to maintain, especially in a rhythmic fashion. Our blinky muscles aren't well developed for this. I can imagine that a stroke patient may have even less control, so valid points there. Its possible these would develope/improve over time but not necessarily when a brain injury is involved.
posted by trinity8-director at 2:15 PM on October 30, 2008