An Anthropologist on Mars (1995) (18 page)

He leaps out with a startling, ticlike suddenness and celerity—I follow at a slower, “normal” pace—and starts talking with two giant young men on the tarmac, Kevin and Chuck, brothers, both fourth-generation pilots in the Rockies. They know him well. “He’s just one of us”, Chuck says to me. “A regular guy. Tourette’s—what the hell? He’s a good human being. A damn good pilot, too.”

Bennett yarns with his fellow pilots and files his flight plan for the return trip to Branford. He has to return straightaway; he is due to speak at eleven to a group of nurses, and his subject, for once, is not surgery but Tourette’s. His little plane is refueled and readied for the return flight. We hug and say goodbye, and as I head for my flight to New York I turn to watch him go. Bennett walks to his plane, taxis onto the main runway, and takes off, fast, with a tailwind following. I watch him for a while, and then he is gone.

E
arly in October of 1991, I got a phone call from a retired minister in the Midwest, who told me about his daughter’s fiancé, a fifty-year-old man named Virgil, who had been virtually blind since early childhood. He had thick cataracts and was also said to have retinitis pigmentosa, a hereditary condition that slowly but implacably eats away at the retinas. But his fiancée, Amy, who required regular eye checks herself because of diabetes, had recently taken him to see her own ophthalmologist, Dr. Scott Hamlin, and he had given them new hope. Dr. Hamlin, listening carefully to the history, was not so sure that Virgil did have retinitis pigmentosa. It was difficult to be certain at this stage, because the retinas could no longer be seen beneath the thick cataracts, but Virgil could still see light and dark, the direction from which light came, and the shadow of a hand moving in front of his eyes, so obviously there was not a total destruction of the retina. And cataract extraction was a relatively simple procedure, done under local anesthesia, with very little surgical risk. There was nothing to lose—and there might be much to gain. Amy and Virgil would be getting married soon—wouldn’t it be fantastic if he could see? If, after a near-lifetime of blindness, his first vision could be his bride, the wedding, the minister, the church! Dr. Hamlin had agreed to operate, and the cataract on Virgil’s right eye had been removed a fortnight earlier, Amy’s father informed me. And, miraculously, the operation had worked. Amy, who began keeping a journal the day after the operation—the day the bandages were removed—wrote in her initial entry: “Virgil can SEE!—Entire office in tears, first time Virgil has sight for forty years—Virgil’s family so excited, crying, can’t believe it!—Miracle of sight restored incredible!” But the following day she remarked problems: “Trying to adjust to being sighted, tough to go from blindness to sighted. Has to think faster, not able to trust vision yet—Like baby just learning to see, everything new, exciting, scary, unsure of what seeing means.”

A neurologist’s life is not systematic, like a scientist’s, but it provides him with novel and unexpected situations, which can become windows, peepholes, into the intricacy of nature—an intricacy that one might not anticipate from the ordinary course of life. “Nature is nowhere accustomed more openly to display her secret mysteries”, wrote William Harvey, in the seventeenth century, “than in cases where she shows traces of her workings apart from the beaten path.” Certainly this phone call—about the restoration of vision in adulthood to a patient blind from early childhood—hinted of such a case. “In fact”, writes the ophthalmologist Alberto Valvo, in Sight Restoration after Long-Term Blindness, “the number of cases of this kind over the last ten centuries known to us is not more than twenty.”

What would vision be like in such a patient? Would it be “normal” from the moment vision was restored? This is what one might think at first. This is the commonsensical notion—that the eyes will be opened, the scales will fall from them, and (in the words of the New Testament) the blind man will “receive” sight.
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66. There is a hint of something stranger, more complex, in Mark’s description of the miracle at Bethsaida, for here, at first, the blind man saw “men as trees, walking”, and only subsequently was his eyesight fully restored (Mark 8:22-26).

But could it be that simple? Was not experience necessary to see? Did one not have to learn to see? I was not well acquainted with the literature on the subject, though I had read with fascination the great case history published in the Quarterly Journal of Psychology in 1963 by the psychologist Richard Gregory (with Jean G. Wallace), and I knew that such cases, hypothetical or real, had riveted the attention of philosophers and psychologists for hundreds of years. The seventeenth-century philosopher William Molyneux, whose wife was blind, posed the following question to his friend John Locke: “Suppose a man born blind, and now adult, and taught by his touch to distinguish between a cube and a sphere [be] made to see: [could he now] by his sight, before he touched them—distinguish and tell which was the globe and which the cube?” Locke considers this in his 1690 Essay Concerning Human Understanding and decides that the answer is no. In 1709, examining the problem in more detail, and the whole relation between sight and touch, in A New Theory of Vision, George Berkeley concluded that there was no necessary connection between a tactile world and a sight world—that a connection between them could be established only on the basis of experience.

Barely twenty years elapsed before these considerations were put to the test—when, in 1728, William Cheselden, an English surgeon, removed the cataracts from the eyes of a thirteen-year-old boy born blind. Despite his high intelligence and youth, the boy encountered profound difficulties with the simplest visual perceptions. He had no idea of distance. He had no idea of space or size. And he was bizarrely confused by drawings and paintings, by the idea of a two-dimensional representation of reality. As Berkeley had anticipated, he was able to make sense of what he saw only gradually and insofar as he was able to connect visual experiences with tactile ones. It had been similar with many other patients in the two hundred and fifty years since Cheselden’s operation: nearly all had experienced the most profound, Lockean confusion and bewilderment.
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67. The removal (or, as was first done, the dislocation or “couching” of the cataracted lens) leaves an eye strongly farsighted and in need of an artificial lens; and the thick lenses used in the eighteenth and nineteenth centuries, and indeed until quite recently, markedly reduced peripheral vision. Thus all patients operated upon for cataract before the present era of contact and implanted lenses had significant optical difficulties to contend with. But it was only those blind from birth or early childhood who had the special Lockean difficulty of not being able to make sense of what they saw.

And yet, I was informed, as soon as the bandages were removed from Virgil’s eye, he saw his doctor and his fiancée, and laughed. Doubtless he saw something—but what did he see? What did “seeing” for this previously not-seeing man mean? What sort of world had he been launched into?

Virgil was born on a small farm in Kentucky soon after the outbreak of the Second World War. He seemed normal enough as a baby, but (his mother thought) had poor eyesight even as a toddler, sometimes bumped into things, seemed not to see them. At the age of three, he became gravely ill with a triple illness—a meningitis or meningoencephalitis (inflammation of the brain and its membranes), polio, and cat-scratch fever. During this acute illness, he had convulsions, became virtually blind, paralyzed in the legs, partly paralyzed in his breathing, and, after ten days, fell into a coma. He remained in a coma for two weeks. When he emerged from it, he seemed, according to his mother, “a different person”; he showed a curious indolence, nonchalance, passivity, seemed nothing at all like the spunky, mischievous boy he had been.

The strength in his legs came back over the next year, and his chest grew stronger, though never entirely normal. His vision also recovered significantly—but his retinas were now gravely damaged. Whether the retinal damage was caused wholly by his acute illness or perhaps partly by a congenital retinal degeneration was never clear.

In Virgil’s sixth year, cataracts began to develop in both eyes, and it was evident that he was again becoming functionally blind. That same year, he was sent to a school for the blind, and there he eventually learned to read Braille and to become adept with the use of a cane. But he was not a star pupil; he was not as adventurous or aggressively independent as some blind people are. There was a striking passivity all through his time at school—as, indeed, there had been since his illness.

Yet Virgil graduated from the school and, when he was twenty, decided to leave Kentucky, to seek training, work, and a life of his own in a city in Oklahoma. He trained as a massage therapist and soon found employment at a YMCA. He was obviously good at his job, and highly esteemed, and the Y was happy to keep him on its permanent staff and to provide a small house for him across the road, where he lived with a friend, also employed at the Y. Virgil had many clients—it is fascinating to hear the tactile detail with which he can describe them—and seemed to take a real pleasure and pride in his job. Thus, in his modest way, Virgil made a life: had a steady job and an identity, was self-supporting, had friends, read Braille papers and books though less, with the years, as Talking Books came in. He had a passion for sports, especially baseball, and loved to listen to games on the radio. He had an encyclopedic knowledge of baseball games, players, scores, statistics. On a couple of occasions, he became involved with girlfriends and would cross the city on public transport to meet them. He maintained a close tie with home, and particularly with his mother—he would get hampers of food regularly from the farm and send hampers of laundry back and forth. Life was limited, but stable in its way.

Then, in 1991, he met Amy—or, rather, they met again, for they had known each other well twenty or more years before. Amy’s background was different from Virgil’s: she came from a cultivated middle–class family, had gone to college in New Hampshire, and had a degree in botany. She had worked at another Y in town, as a swimming coach, and had met Virgil at a cat show in 1968. They dated a bit—she was in her early twenties, he was a few years older—but then Amy decided to go back to graduate school in Arkansas, where she met her first husband, and she and Virgil fell out of contact. She ran her own plant nursery for a while, specializing in orchids, but had to give this up when she developed severe asthma. She and her first husband divorced after a few years, and she returned to Oklahoma. In 1988, out of the blue, Virgil called her, and, after three years of long phone calls between them, they finally met again, in 1991. “All of a sudden it was like twenty years were never there”, Amy said.

Meeting again, at this point in their lives, both felt a certain desire for companionship. With Amy, perhaps, this took a more active form. She saw Virgil stuck (as she perceived it) in a vegetative, dull life: going over to the Y, doing his massages; going back home, where, increasingly, he listened to ball games on the radio; going out and meeting people less and less each year. Restoring his sight, she must have felt, would, like marriage, stir him from his indolent bachelor existence and provide them both with a new life.

Virgil was passive here as in so much else. He had been sent to half a dozen specialists over the years, and they had been unanimous in declining to operate, feeling that in all probability he had no useful retinal function; and Virgil seemed to accept this with equanimity. But Amy disagreed. With Virgil being blind already, she said, there was nothing to lose, and there was a real possibility, remote but almost too exciting to contemplate, that he might actually get reasonable sight back and, after nearly forty-five years, see again. And so Amy pushed for the surgery. Virgil’s mother, fearing disturbance, was strongly against it. (“He is fine as he is”, she said.) Virgil himself showed no preference in the matter; he seemed happy to go along with whatever they decided.

Finally, in mid-September, the day of surgery came. Virgil’s right eye had its cataract removed, and a new lens implant was inserted; then the eye was bandaged, as is customary, for twenty-four hours of recovery. The following day, the bandage was removed, and Virgil’s eye was finally exposed, without cover, to the world. The moment of truth had finally come.

Or had it? The truth of the matter (as I pieced it together later), if less “miraculous” than Amy’s journal suggested, was infinitely stranger. The dramatic moment stayed vacant, grew longer, sagged. No cry (“I can see!”) burst from Virgil’s lips. He seemed to be staring blankly, bewildered, without focusing, at the surgeon, who stood before him, still holding the bandages. Only when the surgeon spoke—saying “Well?”—did a look of recognition cross Virgil’s face.

Virgil told me later that in this first moment he had no idea what he was seeing. There was light, there was movement, there was color, all mixed up, all meaningless, a blur. Then out of the blur came a voice that said, “Well?” Then, and only then, he said, did he finally realize that this chaos of light and shadow was a face—and, indeed, the face of his surgeon.

His experience was virtually identical to that of Gregory’s patient S.B., who was accidentally blinded in infancy, and received a corneal transplant in his fifties:

When the bandages were removed—he heard a voice coming from in front of him and to one side: he turned to the source of the sound, and saw a “blur.” He realized that this must be a face—He seemed to think that he would not have known that this was a face if he had not previously heard the voice and known that voices came from faces.

The rest of us, born sighted, can scarcely imagine such confusion. For we, born with a full complement of senses, and correlating these, one with the other, create a sight world from the start, a world of visual objects and concepts and meanings. When we open our eyes each morning, it is upon a world we have spent a lifetime learning to see. We are not given the world: we make our world through incessant experience, categorization, memory, reconnection. But when Virgil opened his eye, after being blind for forty-five years—having had little more than an infant’s visual experience, and this long forgotten—there were no visual memories to support a perception; there was no world of experience and meaning awaiting him. He saw, but what he saw had no coherence. His retina and optic nerve were active, transmitting impulses, but his brain could make no sense of them; he was, as neurologists say, agnosic.