Animal Sacrifice & the Democratic Primary
Near record warmth this afternoon...

Vision in Perspective

When I sit down to blog, it is to easy to get sucked into quick reactions to news stories. I had a really fascinating experience the other day which I've been meaning to blog, but other things kept getting in the way. So here we go.

About a week ago, I read Oliver Sacks's book An Anthropologist on Mars: Seven Paradoxical Tales. One of the seven tales, "To See and Not See" [this link will work only if you have a credit card on file with Amazon], concerned a blind man named Virgil who had his sight restored in middle age. The surgery worked, but the consequences of restoring his sight were disastrous. It's very Flowers for Algernon; in fact the similarity is so strong that I wonder if Daniel Keyes may have taken his plot from early case histories like this.

Virgil begins as an economically independent massage therapist with a devoted fiancee, and ends as an angry disabled man, unable to work, even blinder than he started out. The case is medically complex, so Sacks doesn't come out and say this, but there is the sinister implication that the demands of sight borrow processing power from the parts of Virgil's brain that control his heart and lungs. (In an earlier case history, a man whose sight was restored died within two years.)

Nor was Virgil's restoration to sight much like the Biblical scales falling from the eyes of the blind. He had to be taught to see, and it only partly worked.

A few days after reading this, I got a phone call: my friend Deena was in Boston, staying with Sarah Smith. She had picked up a car and was driving it back to Colorado. I immediately invited her to say with me on the return trip. Our house is extremely difficult to find under the best of circumstances. I hadn't seen Deena in about seven years, but I had some faint recollection that she didn't see very well. So I was a bit surprised that she was driving. Despite our best efforts, it took over an hour for us to get her from the center of Pleasantville to my house. When she arrived, she explained that she'd only been driving for a few years, following surgery to correct her vision.

It was only then that I remembered that when I had last seen her, she walked with a blind person's cane. While not entirely blind -- with really thick glasses she had been able to see things that were close -- she had been "legally blind." I remember her making some remark about her vision being "80% imagination."

The story goes that her vision had deteriorated further, and that she had fallen on her head repeatedly. After five or six concussions and some unsuccessful vision therapy, it was decided that she needed surgery to correct her vision. The surgery was successful, but like Virgil, she lacked a lot of the basic skills for seeing.

Most fundamentally, she lacks skills for visual prioritizing. She said that initially she was unable to have a conversation with someone wearing patterned clothing because the patterns were too distracting. Even now, four years after surgery, she finds it difficult to converse in our kitchen because of the intrusive pattern of our 70s wallpaper. (We moved our conversation to the living room).

Perspective remains difficult, though she was able to teach herself how to see it. She bought a digital camera and took pictures of scenes she didn't understand -- a street, sidewalk, and house. She asked people to explain the scenes: How do you tell where the street is? How do you tell the house from the sidewalk? At this she was successful, though she says she still has problems with uphill and downhill.

On the other hand, faces have defeated her. Though she can recognize a generic face, efforts to learn to recognize people by their faces and to tell how people feel by their faces have defeated her, despite some very hard work. She says she used to be able to tell with some precision how people felt by their voices, but she is losing that ability: the demands of trying unsuccessfully to understand by facial expression erodes older coping skills. Also, her inability to recognize faces really upsets people and causes frequent social difficulties.

I have a book of optical illusions around, so I got it out and tried them on her. I would have expected that she could not recognize all the different ways to see the pictures. Instead, she saw what I saw, plus additional botanical images that I didn't see -- seemingly on the basis of small parts of the images that looked a bit like petals or branches.

What she feels she has gained from the surgery is mobility: she can drive, so she can go many more places. But in general she would rather go back to the way she was. Vision does not work for her as well as her older ways of gaining information, but the demands of vision erode these older skills. It reminds me of upgrading a computer operating system to find that one doesn't like it as well as the older system.

I told her she really must write about her experiences trying to learn to see, which I found quite fascinating. This was all especially startling, since I had not really thought of Deena as blind in the first place.

(I do wonder, now that I've written all this down, whether my wandering off into cyberspace from what I intended to blog, as recounted in the very first paragraph, is neurologically similar to Deena becoming distracted by the wallpaper. Perhaps later generations will have better prioritizing skills for this kind of information feed.)

UPDATE: Read Deena's comments on my observations in the comments.