AN ANTHROPOLOGIST ON MARS
To See and Not SeeEarly in October of 1991, I got a phone call from a retired minister in the Midwest, who told me about his daughter’s fiance, 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 the retinas. But his fiancee, Amy, who required regular eye checks herself because of diabetes, had recently taken him to see her own opthalmologist, 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. He 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 the 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.
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 rivited 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 tought 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.
And yet, I was informed, as soon as the bandages were removed from Virgil’s eye, he saw his doctor and his fiancee, 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?