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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.

Kathryn Cramer at November  3, 2003 07:35 AM | Link Cosmos | Purple Numbers  | Edit

Comments

As I understand it, there is a part of the brain that is specifically devoted to recognizing people's faces. People who have this part of the brain damaged in  an accident, say, may have otherwise excellent vision but have great difficulty recognizing even close friends and relatives. It sounds like your friend may not have been able to develop this portion of her brain, if she was visually impaired for so long, or has let it lapse.
  I tend to think that my own ability to recognize faces isn't that great. I find that I often recognize someone not only from their face--for example, I might recognize you because you're slender + have pale blond hair + happen to be carrying a baby, rather than only by your face Actually, my ability in this regard isn't totally lacking, so I probably would recognize your face, but in general I feel my facial recognition software is not as well developed as I would like. If your friend has trouble with this, she might be able to develop a lot of workarounds: if she's losing her ability to recognize voices, there are still height, body shape, gait, distinctive items of clothing or shoes or jewelry, hair color...tattoos can be especially helpful, since they tend to be distinctive.
  I find it slightly odd that your friend is driving, though I can see how it might be relatively easy to just look ahead at taillights. But navigation is part of driving...

Posted by: Robert L at November  3, 2003 07:58 AM

Thanks Kathryn, you've summed this up much better than I ever have.   I have sent you a rough draft of a writeup, please let me know if I have the right email.

There is a website for face blindness--it is a great explanation and you can't imagine how wonderful I felt when I first read it:
http://www.choisser.com/faceblind/

Of course, a lot of this was actually realizing that people use faces to recognize other people.  This hadn't dawned on me until 2 years after I had my sight.  I asked Stephanie Strickland, another hypertext poet, how people seemed to be recognizing each other at the hypertext conference we were attending.  The conference did not have name tags, and people hadn't seen each other for a few years. Yet they could call out to each other across the room.  I had had a feeling there was some visual clue, but  I didn't know what.

It is these bases of assumptions that get to me. You never say oh a tree stays where it is all night and doesn't move--that is assumed. You don't say oh, people have different features and you look at the face and can tell who it is, that is assumed. (By the way, no one has yet given me a good explanation of WHAT they look for in a face.  Eyes change, expressions in mouths change.) I would love a detailed explanation of how you use faces to recognize people. 

I have researched the computer IT folks progress in facial recognition, but this is also based on a static picture for the most part, with some complicated algorithms that would take me more than the moment usually alloted for facial recognition.  Ahh...thanks for letting me vent.

Before I could see clearly, I could hear very well. I still can.  I could tell who someone was within a word or two of them speaking. I still can, usually, but the ability has dimmed. I can still listen in a crowded room and pick out voices I know and follow up to about 6 conversations.  I can no longer do this and carry on a conversation at the same time--but I used to be able to.   So my abilities to recognize by hearing have diminished.

Also, I no longer carry a cane and people expect me to recognize them as I can now see.  At first, I tried and faked it, with horrible results.  When I realized it was a problem, I tried very hard to memorize faces and learn people.  Now I am becoming more resigned to not being able to do this.  I do memorize what a person wears for that day and once I meet a person I can tell who they are, as long as they don't put on a sweater or a jacket.

I also look for height, shape, style of walking, hair --hair is very misleading.  I also use contextual conversations--we are in a grocery store but you are talking about work, so I know you from work... But most of these take a few minutes and people often will not take the time I need to recognize them.  I am finally becoming up front about the issue and warning people ahead of time that I will not recognize them. This has lead to a few practical jokes, but for the most part, people are good about it. Most of my friends now come up to me and say "Hi Deena it's so and so."    You could say this is my anti-spam method in person ;)

Posted by: Deena at November  8, 2003 01:35 AM

While I am intrigued and heartened by the track of Deena's abilities, I am skeptical that she belongs behind a wheel. I can imagine too many driving scenarios where her gaps and additional processing time could be lethal to others.

Posted by: David Lubkin at September 13, 2004 12:39 PM

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