“I feel agitated now…I think I may have to sedate myself.” Oliver Sacks, a neurologist and well-known author, has just discovered a jet-black spot on the skin of his left shoulder. Two years earlier, a physician found a cancerous tumour on his retina, removed it with lasers, and administered radiation treatment. Now Sacks worries that the cancer has spread to his skin.
The black spot episode is just a tidbit about Sacks’s personality, although it’s not the only one that readers will find in in his latest book, The Mind’s Eye (Knopf, 2010), which explores the human experience of vision. As in some of his previous books, Sacks presents case histories of individuals suffering from neurological injury or disease, and uses these histories as a means to probe the capacities of the mind. Lilian Kallir, for example, is a pianist who loses the ability to read, even though the rest of her vision remains intact and, puzzingly, she can still write. Sacks follows Lilian’s story over a period of three years, describing the coping strategies she develops, such as color-coding items in her home, as well as the new talents that arise unexpectedly with her condition, such as the ability to re-arrange musical pieces in her mind without consulting a score. Howard Engel, featured in another case history, is a writer who also loses the ability to read, but he approaches his situation differently: he rejects audiobooks, refuses to give up the world of text, and painstakingly learns his ABCs all over again.
Lilian’s and Howard’s cases both suggest that the brain has a specific location dedicated to reading. But it is not at all obvious why this should be so. Unlike spoken language, which evolved over hundreds of thousands of years, written language is a relatively recent cultural invention that offered no survival advantage to humans in primitive societies. Plasticity offers a potential answer to this conundrum: we can and do use structures in the brain for purposes very different from those for which they evolved. Sacks casts a wide net to gather evidence for this idea. He describes case histories of nineteenth century neurologists, who treated patients with symptoms similar to Lilian’s and Howard’s. He cites evolutionary thinkers from Charles Darwin and Alfred Russel Wallace to Stephen Jay Gould and Elisabeth Vrba, tracing the history of the notion of “exaptation,” a biological adaptation which gets put to a new use. He presents key results from imaging studies which demonstrate that different areas of the brain are active during reading versus listening. And he summarizes a computational study of over 100 writing systems which shows that, despite their diversity, these systems share basic visual signatures which resemble those found in natural settings.
The Mind’s Eye thus offers narrative science writing of the most satisfying kind. We delight in pedagogical moments because Sacks weaves them seamlessly into the case histories. We get drawn into the topics of evolution, brain imaging, and computation because we want to follow people like Lilian and Howard. “Make characters the matter of your narrative,” advises James Shreeve in A Field Guide for Science Writers, “and let the science spill from their relations.” Sacks does precisely that.
Back to the black spot – and the need for sedation. After discovering the spot on his skin, Sacks visits Dr. Bickers, a dermatologist, the very next day. The spot isn’t cancerous. The dark color came from a little bit of bleeding, and should clear in a few days. So the black spot episode has nothing to do with Sacks’s eye tumor, and it therefore has nothing to do with vision, the purported topic of the book. But it has everything to do with Sacks as a character. Dr. Oliver Sacks needs sedation? He isn’t playing the role of the neurologist anymore. With cancer, he’s playing the patient.
This role reversal, which occurs in two of the book’s essays, “Face Blind” and “Persistence of Vision: A Journal”, works partly because of the manner in which Sacks develops his characters more generally. He specializes in describing the details which relate most directly to the mind and its capacities: One morning, for example, Howard opened up his morning paper. To his surprise, the headlines were in Serbo-Croatian. He suspected his friends, some of whom are pranksters, had played a practical joke on him. In reality, however, Howard has suffered a stroke which impairs his ability to recognize printed words.
But Sacks takes care to provide other details, even when the link to the mind proves less direct. At the initial visit to the emergency room, Howard is unable to pinpoint his relationship to the person who accompanied him there — his son. Returning home from the hospital three months later, Howard’s home looks peculiar to him, and the room which looks most peculiar is the one where he used to read most often — his office.
In order to develop full-blown characters in a narrative, Shreeve advises in A Field Guide for Science Writers, “you need to become intimate with their backgrounds, their hopes and fears, strengths and weaknesses, foibles, tics, grievances, grooming habits, and manners of speech, not to mention their method of hailing a taxi, removing a hair from their coffee cup, and unwrapping a candy bar.” With subtlety, Sacks does precisely that.
The most striking aspect of The Mind’s Eye, ultimately, is that Sacks treats himself the same way that he treats his other characters. This means that the “details” which he uses to portray his other characters now become vulnerabilities, but Sacks reveals them fearlessly. Again, some of these details relate directly to questions of the mind and its capacities: Sacks, who has always suffered from a serious difficulty in recognizing names and places, needs his guests to wear nametags when he throws a birthday party. He gets lost in the rain for two hours because he cannot find his own house. He recognizes his neighbors’ dogs, but not his neighbors themselves.
But other vulnerabilities leave a stronger emotional wake, partly because they do not connect directly to the topic of the mind. Sacks has a brother, Marcus. We learn that for a period of thirty-five years, they scarcely saw one another. Sacks has a work assistant, Kate. We learn that when Sacks goes to the doctor and receives a diagnosis of cancer, it’s Kate who accompanies him, not a partner, not a son or daughter. Oh, and on a lighter note: Sacks smokes cannabis, at least on occasion.
For a book about vision, these two portrayals of Oliver Sacks — as doctor and as patient — seem especially appropriate. The portrayals differ from one another, just as the visual images which reach our left eye versus our right eye also differ. The result, when we put the two together and compare them, is depth perception: or in other words, a far deeper understanding of the world than we could otherwise have.
Sacks, Oliver. 2010. The Mind’s Eye. New York: Alfred A. Knopf.
Shreeve, James. 2005. Narrative Writing. In Deborah Blum, Mary Knudson, & Robin Marantz Henig (eds.) A Field Guide for Science Writers. Oxford University Press.