A Scintillating Scotoma

This is an unedited version of my review of Oliver Sacks’s The Mind’s Eye in the Telegraph.

The Mind's Eye by Oliver SacksLate in 2005 the writer and neurologist Oliver Sacks, then aged 72, began to notice something odd during his habitual daily swim. While he did the backstroke, a pattern of close-set wavy lines and starry coruscations played on the ceiling above him. Sacks dismissed them as artefacts of his visual cortex, lingering symptoms from his frequent migraines. But a week before Christmas, as he entered a cinema, a more pronounced fluttering started up in his right eye. By the time the film began, a quivering scotoma or blind spot had flared up before him ‘like a white-hot coal, with spectral colours’. Two days later he was diagnosed with a malignant melanoma behind the retina and wrote in his journal: ‘I am in the best possible hands, but I feel a terrified child, a child screaming for help, inside me.’

Sacks’s own adventure at the edges of seeing – the cancer itself proving curable, but his vision permanently impaired – forms the core of his new book. The Mind’s Eye is a reflection in seven essays on the optical effects of certain neurological disasters and on the response of the brain to partial or complete blindness. As in his previous ten books – Awakenings and The Man Who Mistook His Wife for a Hat remain the best known – Sacks proceeds mostly by anecdote. If there’s a central thesis in this book – an argument about the essential adaptability of mind and body to extreme circumstance – it emerges in the physician’s encounters with individual patients. Though we might also say the guiding spirit for these stories of physical and mental resilience is Samuel Johnson, who Sacks reminds us suffered a stroke in 1783. With amazing presence of mind, Johnson wrote to a neighbour for help: ‘Dear Sir, It hath pleased almighty God this morning to deprive me of the powers of speech.’

Some of Sack’s case studies are no less impressive. In 1999 he received a letter from Lillian Kallir, a sixty-seven-year-old pianist who inexplicably could no longer read music and had to rely on memory to perform. Her reading of words had declined too, and she had difficulty recognizing faces or ordinary objects. Despite all this, she was capable of writing a perfectly coherent letter, and though in the time Sacks has known her things have gotten worse, she maintains an active life in a world she can see but of which she can make little sense. Kallir’s predicament, writes Sacks, was ‘a lesson in what could be done to hold together a life in the face of ever-advancing perceptual and cognitive challenge’.

In the latter half of the book Sacks draws lessons from the inverse experience of actual blindness, and the vastly different neurological or imaginative responses people may have to the loss of sight. At one level there is the ‘deep blindness’ of John Hull – a professor of religious education at the University of Birmingham – who became blind at the age of forty-eight and gradually lost all visual memory and power of picturing the world, becoming instead a ‘whole-body seer’ through his remaining senses. At the other extreme is Zoltan Torey: an Australian psychologist who, having been blinded in an accident at twenty-one, simply refused to give up his visual purchase on the world, and is now so adept at seeing with his mind’s eye that to his neighbours’ alarm he once replaced all the gutters on his house himself, in the dark.

Sacks tells such stories with his customary sympathy and acuity. His literary and scientific models for these, as earlier, essays are the case studies of such nineteenth-century physicians as Silas Weir Mitchell and Jean-Martin Charcot. But while there is a wealth of medical detail in these anecdotes, when compared to the vivid portraits of his predecessors there is something oddly flat or lacking about Sacks’s writing in this latest compendium. The neurological portraits never truly grip or engage in the way the account of his own illness does, with its unconsoling and ambiguous outcome. It seems there might be a non-literary reason for this: Sacks himself, he tells us, suffers from a lifelong inability to recall or recognize faces, and is even known to blank friends, colleagues and family members. Perhaps he just doesn’t recall the texture of a consultation or encounter with the precision one might hope. Or maybe – because The Mind’s Eye is nonetheless deeply interesting – the topic simply deserves a more sustained and richer treatment.

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