TO SEE AND NOT SEE
by OLIVER SACKS
Issue of 1993-05-10 Posted 2006-06-12
What happens when an adult who has been blind since childhood suddenly has his vision restored? The experience of Virgil, a fifty-year-old Oklahoman who regained his sight after forty-five years, raises questions about perception that have haunted philosophers and scientists for centuries.
Early 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 had 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 nearly a 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 Thomas Willis, 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
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from early childhood—hinted of such a case. “In fact,” writes the ophthalmologist Alberto Valvo, in “Sight Restoration after Long-Term Blindness” (1971), “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...