An Anthropologist on Mars (1995) (2 page)

These are tales of survival, survival under altered, sometimes radically altered, conditions—survival made possible by the wonderful (but sometimes dangerous) powers of reconstruction and adaptation we have. In earlier books I wrote of the “preservation” of self, and (more rarely) of the “loss” of self, in neurological disorders. I have to come to think these terms too simple—and that there is neither loss nor preservation of identity in such situations, but, rather, its adaptation, even its transmutation, given a radically altered brain and “reality.”

The study of disease, for the physician, demands the study of identity, the inner worlds that patients, under the spur of illness, create. But the realities of patients, the ways in which they and their brains construct their own worlds, cannot be comprehended wholly from the observation of behavior, from the outside. In addition to the objective approach of the scientist, the naturalist, we must employ an intersubjective approach too, leaping, as Foucault writes, “into the interior of morbid consciousness, [trying] to see the pathological world with the eyes of the patient himself.” No one has written better of the nature and necessity of such intuition or empathy than G.K. Chesterton, through the mouth of his spiritual detective, Father Brown. Thus when Father Brown is asked for his method, his secret, he replies:

Science is a grand thing when you can get it; in its real sense one of the grandest words in the world. But what do these men mean, nine times out of ten, when they use it nowadays? When they say detection is a science? When they say criminology is a science? They mean getting outside a man and studying him as if he were a gigantic insect; in what they would call a dry impartial light; in what I should call a dead and dehumanized light. They mean getting a long way off him, as if he were a distant prehistoric monster; staring at the shape of his “criminal skull” as if it were a sort of eerie growth, like the horn on a rhinoceros’s nose. When the scientist talks about a type, he never means himself, but always his neighbour; probably his poorer neighbour. I don’t deny the dry light may sometimes do good; though in one sense it’s the very reverse of science. So far from being knowledge, it’s actually suppression of what we know. It’s treating a friend as a stranger, and pretending that something familiar is really remote and mysterious. It’s like saying that a man has a proboscis between the eyes, or that he falls down in a fit of insensibility once every twenty-four hours. Well, what you call “the secret” is exactly the opposite. I don’t try to get outside the man. I try to get inside.

The exploration of deeply altered selves and worlds is not one that can be fully made in a consulting room or office. The French neurologist François Lhermitte is especially sensitive to this, and instead of just observing his patients in the clinic, he makes a point of visiting them at home, taking them to restaurants or theaters, or for rides in his car, sharing their lives as much as possible. (It is similar, or was similar, with physicians in general practice. Thus when my father was reluctantly considering retirement at ninety, we said, “At least drop the house calls.” But he answered, “No, I’ll keep the house calls—I’ll drop everything else instead.”)

With this in mind, I have taken off my white coat, deserted, by and large, the hospitals where I have spent the last twenty-five years, to explore my subjects’ lives as they live in the real world, feeling in part like a naturalist, examining rare forms of life,—in part like an anthropologist, a neuroanthropologist, in the field—but most of all like a physician, called here and there to make house calls, house calls at the far borders of human experience.

These then are tales of metamorphosis, brought about by neurological chance, but metamorphosis into alternative states of being, other forms of life, no less human for being so different.

New York O.W.S.

June 1994

E
arly in March 1986 I received the following letter:

I am a rather successful artist just past 65 years of age. On January 2
nd
of this year I was driving my car and was hit by a small truck on the passenger side of my vehicle. When visiting the emergency room of a local hospital, I was told I had a concussion. While taking an eye examination, it was discovered that I was unable to distinguish letters or colors. The letters appeared to be Greek letters. My vision was such that everything appeared to me as viewing a black and white television screen. Within days, I could distinguish letters and my vision became that of an eagle—I can see a worm wriggling a block away. The sharpness of focus is incredible. BUT I AM ABSOLUTELY COLOR BLIND. I have visited ophthalmologists who know nothing about this color-blind business. I have visited neurologists, to no avail. Under hypnosis I still can’t distinguish colors. I have been involved in all kinds of tests. You name it. My brown dog is dark grey. Tomato juice is black. Color TV is a hodge-podge…

Had I ever encountered such a problem before, the writer continued; could I explain what was happening to him—and could I help? This seemed an extraordinary letter. Colorblindness, as ordinarily understood, is something one is born with a difficulty distinguishing red and green, or other colors, or (extremely rarely) an inability to see any colors at all, due to defects in the color-responding cells, the cones, of the retina. But clearly this was not the case with my correspondent, Jonathan I. He had seen normally all his life, had been born with a full complement of cones in his retinas. He had become colorblind, after sixty-five years of seeing colors normally—totally colorblind, as if “viewing a black and white television screen.” The suddenness of the event was incompatible with any of the slow deteriorations that can befall the retinal cone cells and suggested instead a mishap at a much higher level, in those parts of the brain specialized for the perception of color.

Total colorblindness caused by brain damage, so-called cerebral achromatopsia, though described more than three centuries ago, remains a rare and important condition. It has intrigued neurologists because, like all neural dissolutions and destructions, it can reveal to us the mechanisms of neural construction—specifically, here, how the brain “sees” (or makes) color. Doubly intriguing is its occurrence in an artist, a painter for whom color has been of primary importance, and who can directly paint as well as describe what has befallen him, and thus convey the full strangeness, distress, and reality of the condition.

Color is not a trivial subject but one that has compelled, for hundreds of years, a passionate curiosity in the greatest artists, philosophers, and natural scientists. The young Spinoza wrote his first treatise on the rainbow; the young Newton’s most joyous discovery was the composition of white light; Goethe’s great color work, like Newton’s, started with a prism; Schopenhauer, Young, Helmholtz, and Maxwell, in the last century, were all tantalized by the problem of color; and Wittgenstein’s last work was his Remarks on Colour. And yet most of us, most of the time, overlook its great mystery. Through such a case as Mr. I.’s we can trace not only the underlying cerebral mechanisms or physiology but the phenomenology of color and the depth of its resonance and meaning for the individual.

On getting Mr. I.’s letter, I contacted my good friend and colleague Robert Wasserman, an ophthalmologist, feeling that together we needed to explore Mr. I.’s complex situation and, if we could, help him. We first saw him in April 1986. He was a tall, gaunt man, with a sharp, intelligent face. Although obviously depressed by his condition, he soon warmed to us and began talking with animation and humor. He constantly smoked as he talked,—his fingers, restless, were stained with nicotine. He described a very active and productive life as an artist, from his early days with Georgia O’Keeffe in New Mexico, to painting backdrops in Hollywood during the 1940
s
, to working as an Abstract Expressionist in New York during the 1950
s
and later as an art director and a commercial artist.

We learned that his accident had been accompanied by a transient amnesia. He had been able, evidently, to give a clear account of himself and his accident to the police at the time it happened, late on the afternoon of January 2, but then, because of a steadily mounting headache, he went home. He complained to his wife of having a headache and feeling confused, but made no mention of the accident. He then fell into a long, almost stuporous sleep. It was only the next morning, when his wife saw the side of the car stove in, that she asked him what had happened. When she got no clear answer (“I don’t know. Maybe somebody backed into it”) she knew that something serious must have happened.

Mr. I. then drove off to his studio and found on his desk a carbon copy of the police accident report. He had had an accident, but somehow, bizarrely, had lost his memory of it. Perhaps the report would jolt his memory. But lifting it up, he could make nothing of it. He saw print of different sizes and types, all clearly in focus, but it looked like “Greek” or “Hebrew” to him.
2

2. I asked Mr. I. later if he knew Greek or Hebrew; he said no, there was just the sense of an unintelligible foreign language; perhaps, he added, “cuneiform” would be more accurate. He saw forms, he knew they had to have meaning, but could not imagine what this meaning might be.

A magnifying glass did not help; it simply became large “Greek” or “Hebrew.” (This alexia, or inability to read, lasted for five days, but then disappeared.)

Feeling now that he must have suffered a stroke or some sort of brain damage from the accident, Jonathan I. phoned his doctor, who arranged for him to be tested at a local hospital. Although, as his original letter indicates, difficulties in distinguishing colors were detected at this time, in addition to his inability to read, he had no subjective sense of the alteration of colors until the next day.

That day he decided to go to work again. It seemed to him as if he were driving in a fog, even though he knew it to be a bright and sunny morning. Everything seemed misty, bleached, greyish, indistinct. He was flagged down by the police close to his studio: he had gone through two red lights, they said. Did he realize this? No, he said, he was not aware of having passed through any red lights. They asked him to get out of the car. Finding him sober, but apparently bewildered and ill, they gave him a ticket and suggested he seek medical advice.

Mr. I. arrived at his studio with relief, expecting that the horrible mist would be gone, that everything would be clear again. But as soon as he entered, he found his entire studio, which was hung with brilliantly colored paintings, now utterly grey and void of color. His canvases, the abstract color paintings he was known for, were now greyish or black and white. His paintings—once rich with associations, feelings, meanings—now looked unfamiliar and meaningless to him. At this point the magnitude of his loss overwhelmed him. He had spent his life as a painter; now even his art was without meaning, and he could no longer imagine how to go on.

The weeks that followed were very difficult. “You might think”, Mr. I. said, “loss of color vision, what’s the big deal? Some of my friends said this, my wife sometimes thought this, but to me, at least, it was awful, disgusting.” He knew the colors of everything, with an extraordinary exactness (he could give not only the names but the numbers of colors as these were listed in a Pantone chart of hues he had used for many years). He could identify the green of van Gogh’s billiard table in this way unhesitatingly. He knew all the colors in his favorite paintings, but could no longer see them, either when he looked or in his mind’s eye. Perhaps he knew them, now, only by verbal memory.

It was not just that colors were missing, but that what he did see had a distasteful, “dirty” look, the whites glaring, yet discolored and off-white, the blacks cavernous—everything wrong, unnatural, stained, and impure.
3

3. Similarly, a patient of Dr. Antonio Damasio, with achromatopsia from a tumor, thought everything and everyone looked “dirty”, even finding new-fallen snow unpleasant and dirty.

Mr. I. could hardly bear the changed appearances of people (“like animated grey statues”) any more than he could bear his own appearance in the mirror: he shunned social intercourse and found sexual intercourse impossible. He saw people’s flesh, his wife’s flesh, his own flesh, as an abhorrent grey; “flesh-colored” now appeared “rat-colored” to him. This was so even when he closed his eyes, for his vivid visual imagery was preserved but was now without color as well.

The “wrongness” of everything was disturbing, even disgusting, and applied to every circumstance of daily life. He found foods disgusting due to their greyish, dead appearance and had to close his eyes to eat. But this did not help very much, for the mental image of a tomato was as black as its appearance. Thus, unable to rectify even the inner image, the idea, of various foods, he turned increasingly to black and white foods—to black olives and white rice, black coffee and yogurt. These at least appeared relatively normal, whereas most foods, normally colored, now appeared horribly abnormal. His own brown dog looked so strange to him now that he even considered getting a Dalmatian.

He encountered difficulties and distresses of every sort, from the confusion of red and green traffic lights (which he could now distinguish only by position) to an inability to choose his clothes. (His wife had to pick them out, and this dependency he found hard to bear; later, he had everything classified in his drawers and closet—grey socks here, yellow there, ties labeled, jackets and suits categorized, to prevent otherwise glaring incongruities and confusions.) Fixed and ritualistic practices and positions had to be adopted at the table; otherwise he might mistake the mustard for the mayonnaise, or, if he could bring himself to use the blackish stuff, ketchup for jam.
4

4. In 1688, in Some Uncommon Observations about Vitiated Sight, Robert Boyle described a young woman in her early twenties whose eyesight had been normal until she was eighteen, when she developed a fever, was “tormented with blisters”, and, with this, “deprived of her sight.” When she was presented with something red, “she look’d attentively upon it, but told me, that to her, it did not seem Red, but of another Colour, which one would guess by her description to be a Dark or Dirty one.” When “tufts of Silk that were finely Color’d” were given to her, she could only say that “they seem’d to be a Light-colour, but could not tell which.” When asked whether the meadows “did not appear to her Cloathed in Green”, she said they did not, but seemed to be “of an odd Darkish colour”, adding that when she wished to gather violets, “she was not able to distinguish them by the Colour from the surrounding Grass, but only by the Shape, or by feeling them.” Boyle further observed a change in her habits, that she liked now to walk abroad in the evenings, and this “she much delighteth to do.”