A singular view

Oliver Sacks returns with a new series of unusual case studies, this time sharing his own journey into the terrors of eye cancer and shattered vision

By Floyd Skloot
Globe Correspondent / October 24, 2010

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Oliver Sacks published his first book, “Migraine,’’ 40 years ago. A provocative mixture of scholarship, personal experience, and case studies, it approached the malady as experience rather than illness, viewing the patient in full human dimension and not simply a collection of symptoms, signs, and test results. The book showed Sacks’s gifts, even at the start of his career, for accurate description and fresh prose, such as his characterization of migraine’s hallucinatory aura as a “dance of brilliant stars, sparks, flashes.’’

Over his long career as a neurologist and writer, Sacks has addressed a range of subjects: “Awakenings’’ (1973) dealt with patients immobilized and silenced by sleeping sickness who were briefly returned to active function by the administration of a drug that failed to sustain its benefits; “Seeing Voices’’ (1989) was a journey into the world of the deaf; “Musicophilia’’ (2007) concerned the human passion for music. In all his work, Sacks has been fascinated by how the brain’s failures of function, its neuro-strangenesses, reveal essential truths about what makes us human. His books are populated by people — those with autism or Tourette syndrome or aphasia — whose experiences with and adaptations to neurological problems encourage us to think about our own perceptions of the world.

From those earliest studies of migraine through his accounts of misperception in “The Man Who Mistook His Wife for a Hat’’ (1985) and congenital colorblindness in “The Island of the Colorblind’’ (1997), Sacks has returned to the subject of sight and the neurology of visual perception. Now in “The Mind’s Eye,’’ his 11th book, Sacks takes on the subject fully, offering seven essays about vision and what it is like when the sense of sight is radically changed or lost because of neurological damage. His exploration of this subject is deepened by personal experience, as Sacks’s own visual health becomes compromised.

At first, “The Mind’s Eye’’ seems to be another collection of Sacks’ absorbing case studies. One chapter is about a concert pianist suffering from visual agnosia, a condition rendering her unable to read music or words because part of her brain has atrophied. In another chapter, a novelist loses the ability to read — including letters or words he himself writes — as the result of a stroke. He sees normally but cannot recognize that what he is seeing is written language. A third chapter concerns people, including Sacks himself, with varying degrees of “face-blindness,’’ or prosopagnosia. Some fail to recognize their own spouse or child; Sacks does not know his own psychiatrist when encountering him outside the office. We also meet people unable to perceive depth, movement, or color, and blind people who experience themselves as “whole-body seers,’’ envisioning the world with their entire bodies.

These chapters are rich with the sort of observation and insight that makes Sacks’s writing satisfying. As the stricken novelist’s eyes scan a page, he begins moving his hands, “tracing the outlines of words and sentences still unintelligible to his eyes’’ or, using his tongue, “tracing the shapes of letters on his teeth or the roof of his mouth.’’ A woman, unable to identify any shapes she sees, organizes kitchen items according to size and color, but is stymied by spices because “they all came in identical red-topped bottles, and, of course she could not read the labels.’’ Repeatedly, Sacks reminds us of human resilience and ingenuity, our tenacity for life. A woman no longer able to express herself in words uses gesture, mime, and pictures, allowing her “a remarkably full and exact expression of her needs and thoughts.’’

But then, just past halfway and with the introduction of long chapter called “Persistence of Vision,’’ the book becomes something altogether more personal, terrifying, and urgent. This chapter includes a journal kept by Sacks when he was diagnosed with ocular melanoma, a cancer of the eye that shattered his vision and threatened his life. Intimately, relentlessly, Sacks shares his experience, turning the familiar analytical focus, experimental curiosity, and descriptive rigor upon himself.

He includes drawings of what the world looks like to him now, and seeks language to describe his strange, elusive experience: “I have a large ‘nowhere’ in my right visual field and my brain, a nowhere of which I am not and can never be directly conscious.’’ It is as close as he can come “to describing the experience of nothingness and nowhere.’’ Inquisitive and horrified at once, Sacks shows us knowledge, discipline, and imagination confronting the terrors of illness and loss. He also demonstrates the often astounding human capacity for adaptation, as when the brain’s visual cortex “no longer limited or constrained by any visual input’’ becomes “hypersensitive to internal stimuli of all sorts,’’ enhancing auditory, tactile, verbal, and even emotional experience.

“The Mind’s Eye’’ reminds us that we see with both our eyes and our brains. Our eyes receive input from outside ourselves, but it is the parts of the brain devoted to vision that make sense of that input. When the brain fails, the sense of sight no longer functions properly though the eyes may be as sharp as ever. Sacks’s eloquent combination of clinical history, scholarship, wisdom, and — now — personal experience, brings us close to what that might be like. Readers may never take the view of a sunrise or of their child’s smile the same way again.

Floyd Skloot’s memoir of living with brain damage, “In the Shadow of Memory,’’ won the 2004 PEN USA Literary Award. His 16th book, a collection of short stories titled “Cream of Kohlrabi,’’ will appear next year from Tupelo Press. He can be reached at

By Oliver Sacks
Knopf, 263 pp., illustrated, $26.95