Monday, 14 March 2011

Oliver Sacks - The Mind's Eye

From the occasional book reviews department


I have this little mental game I play with myself to pass the time - when I'm walking or driving by myself, usually. If it had a name, it would probably be called something lame, like 'Choices'. In it, two or three options for a particular choice are available, and I have to justify to myself why I pick the option I do. It's like debating with myself, I guess, and it goes something like this:

Palmerston North, Wanganui, or Hamilton? (Hamilton)
Taller or thinner? (Taller)
Live to 70 or live to 80? (80)
Live to 80 or live to 90? (80)
Smarter or prettier? (Prettier)
Amputation or paralysis? (Amputation)
Paralysis or head injury? (Depends on the severity)

Oliver Sacks is a neurologist (if you don't know that already - he's up there with Dawkins in the recognisable scientists list, and I don't believe Richard Dawkins has ever been played by Robin Williams). This is Sack's 11th book, most of which are filled with case studies of his patients or correspondents, as he seeks to "show us what is often concealed in health: the complex workings of the brain and its astounding ability to adapt and overcome disability". 'The Mind's Eye', as the title suggests, is focused on brain damage - usually stroke - that leads to visual disorders.

'The Mind's Eye' had me playing a different kind of Choices. Blind or Deaf? (Deaf). Lose your stereoscopic or peripheral vision? (Stereoscopic). Prosopagnosia (inability to recognise faces and/or places) or alexia (inability to read)? (Alexia. Just. Agonisingly.)

It was the case studies of alexia that filled me with horror. I tried to imagine getting up one morning, flipping open the laptop, and not being able to read. Not just not able to piece together the letters of the alphabet, but not even recognising the alphabet. Having those 26 little shapes, so deeply engrained in my brain, appear as unfamiliar as Cyrillic script. Perhaps not only not being able to read, but suddenly, unable to write. Or worse yet, total - global - aphasia: the loss of the ability to process language in anyway, to make sense of words spoken to you, to speak, even, in some cases, to think. Sacks quotes psychologist Scott Moss, who had a stroke at 43 and became aphasic:

When I awoke next morning in the hospital, I was totally (globally) aphasic. I could understand vaguely what others said to me if it was spoken slowly and represented a very concrete form of action ... I had lost completely the ability to talk, to read and write. I even lost for the first two months the ability to use words internally, that is, in my thinking ... I had also lost the ability to dream. So, for a matter of eight to nine weeks, I lived in a total vacuum of self-produced concepts. ... I could deal only with the immediate present. ... The part of myself that was missing was [the] intellectual aspect - the sine qua non of my personality - those essential elements most important to being a unique individual. ... For a long period of time I looked upon myself as only half a man.

'The Mind's Eye' is Sacks' most intimate book yet. Not only does he talk about bis own prosopagnosia (so severe he may not recognise his assistant and friend of 20 years when she's waiting in a cafe for him, or be able to distinguish his face in a window from the face of a man on the other side, or remember how to get to his own house if he deviates from his familar path: qualities that have lead to him being described as everything from pathologically shy to having Aspergers Syndrome). But he devotes a long chapter, 'Persistence of Vision', to excerpts from the journal he kept after a malignant tumour appeared next to his fovea behind his retina in his right eye. The tumour was treated first by inserting a radioactive plaque for several days; then with several lasering sessions; he nonetheless lost his stereoscopic vision (depth perception) and a large chunk of his central vision: after a bleed, his lost his peripheral vision.

It seems a strange thing to say, but sight really matters to Sacks. From childhood (I thoroughly recommend his autobiography of his childhood, 'Uncle Tungsten', my favourite of his books). h has been obsessed with sight in all its manifestations, played out in photography and stereoscopy (he is a member of the New York Stereroscopic Society, a group that gets together to marvel over three-dimensional imaging). 'Persistence of Vision' tracks Sacks' experiences and feelings over several years, from sanguine to panicky to despairing. From the day he first noticed first a fluttering in his vision, and then a scotoma (blind spot), visits an opthamologist and is referred for a later appointment with a surgeon:

Back at my apartment that evening, testing my right eye, I was startled to see that the horizontal bars on the air conditioner all seemed to be warped, converging and collapsing into one another, while the vertical bars diverged. I cannot remember how I spent the rest of the weekend. I was very restless, I went for long walks, and when I was inside, I paced to and fro. The nights were especially bad - I had to knock myself out with sleeping pills.

Inevitably, self-pity seeps through: at Christmas he looks at the NYT list of people who died in 2005, and wonders if he will appear on the 2006 list. It's not really self-pity, though: it's part of the relentless self-examination he places himself under, tracking each change and quirk (his scotoma is the shape of Australia - “complete with a little bulge in the southeast corner — I thought of this as its Tasmania.”; he learns he can fill it in, with patterns from the carpet, the leaves of a tree, the blue of the sky).

Sacks' case studies have fascinated me since I first read them in my third year at uni, when taking a neuropsychology paper. One of the reasons I dropped psych and stuck with art history is the appalling damage psychologists and scientists have done, often inadvertently (but not always) as they seek to understand the human brain. You can't hurt anyone with art history, I reasoned. Sacks' humaneness though continues to shine though. Recommended, even if you just read the bits about himself.

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