Harvard Book Store; WGBH Forum Network; Oliver Sacks: The Mind's Eye

So this evening on behalf of Harvard bookstore I'm thrilled to welcome Dr. Oliver Sacks and Colin Murphy to the stage to discuss Oliver Sacks most recent book The Mind's Eye. Colin Murphy is the editor at large at Vanity Fair and was the managing editor at The Atlantic Monthly where he worked for over 20 years. Mr. Murphy has also authored a number of books including rubbish the archaeology of garbage. The word according to Yves his most recent highly acclaimed book Are We Rome the fall of an empire and the fate of America was published in 2007. I'm so pleased that he is here with us tonight. I'm going to turn the instructions to him now. But first ladies and gentlemen please join me in welcoming both of our guests. Colin Murphy and Dr. Oliver Sacks. Thank you very much Heather and thanks to all of you for joining us this evening. And thanks especially to Oliver Sacks who will talk to us about his new book The Mind's Eye and other topics. The format for the next hour or so will be the usual one. Will be talking with Oliver Sacks

about this and that for half an hour or so and then we'll open up the conversation to questions from you. So the standard protocol here is that people who need no introduction get one anyway. It's a particular pleasure to be here with you tonight Oliver but by way of full disclosure I'll own up to the fact that you and I share a corporate connection. Both of us publish some of our work for The New Yorker under the auspices of the publishing behemoth condé Nast who is building in New York is known to writers as the Death Star. But it's a good Deathstar because it publishes you. Oliver Sacks is a professor of neurology and psychiatry at Columbia University and he also holds the title of Columbia University artist which I think means something like Do whatever you want. He was born in London attended Oxford became a doctor and in the mid

1960s moved to the United States where he has lived and worked ever since. By the 1970s Oliver Sacks had added a burgeoning literary career to his clinical practice producing one bestseller after another. Almost all of his books have been centered around accounts of acute and sometimes bizarre neurological disorders. But in Oliver Sacks his hands we come to understand that the abnormal often offers a portal into the normal Sachs's a superb stylist and it obviously runs in the family. His first cousin was the late Abba Eban the Israeli diplomat and no slouch when it came to matters of the pen. We all use a kind of shorthand to describe certain genres of work and everyone knows what you mean when you say and O'Henry story a John Cheever story a John McAfee story and to this we can add an Oliver Sacks story. Oliver Sacks His latest book his 11th is the mind's eye a series of case studies involving people with impairments to certain sensory capabilities. For instance

people who cannot recognize faces people who cannot recognize everyday objects people who cannot see in three dimensions. People who continue to write even though they have lost the ability to read and as will see and as I hope you'll explain. Oliver Sacks himself in this book comes under his own scrutiny in a deeply personal way. So it's a pleasure to have you here. And let me begin by asking a foundational question about how you came to pursue the interests that you that you have pursued. I know that as a boy you were deeply interested in chemistry. You were a child during the Blitz and I know you have memories of the Blitz. I can't help but wonder how those scenes of physical and psychological trauma may have affected you. Could you just put us in mind of some of the formative experiences that that turned your mind in the direction that it turned.

Well in the war. I was evacuated and separated from my parents for four years and put it on a school with a somewhat capricious somewhat sadistic headmaster. And so would I return to London at the age of 10. I very much wanted to order for dictabelt and sign seemed to promise that some chemistry in particular but both my parents were physicians and both in fact had studied in you know hey but then gone on to general practice. And the house was full of medical talk. My two older brothers were medical students and then doctors. There was a special interest in the visual I think partly because I had visual migraine and then attacks a visual migraine

colors may change objects may flatten out. You may see giant scintillating arcs. I was very bewildered and frightened when I first had an attack at about four or five and I mentioned that to my mother who also had such attacks and she explained that this was in terms intelligible to her 5 year old. Although I think a precocious one that this was the visual cortex having a fun. Time and that was all all settle down and leave no trace. After a few minutes. And so what had been fighting then became I think for me an early and rather precocious portal to use your word into brain function and gave me the strongest feeling that that all experience was related to brain function on the visual side. I was also passionately attached to photography but in particular to colour

photography and Styria photography which was a way of wondering how. How we construct colour and depth and in my first book on migraine. A third of the book is devoted to visual experiences and vision has always been a hot topic for me and also a personal topic for you. Now you experience something that has a long name that I can't pronounce which is prosopagnosia. You do it very well. But you've had a lot of practice was that something also that you were aware of as a as a child and can you tell us what that is. I think not as a child but. When I was in high school. I am. I am. It was apparent that I had difficulty recognizing people.

I could be with people all day and then five minutes later not recognize them. This was a source of embarrassment and annoyance and sometimes a and sometimes outrage. It was thought that I was snooty or peculiar and maybe I am. In addition. But but this this brought home to me although I don't think I mentioned it to others that I had a peculiar difficulty recognizing faces and that until people spoke. Or unless they had some very striking single feature for example on the Amtrak train coming here was a train conductor with a gigantic beard. Who looked just like the the postman. I don't mean the. Hoodoo I mean. Or the. And also at that point I became very fond of going for

bicycle rides. But I got lost fairly easily. I am I sometimes didn't even recognize my own street and so I always had to go with someone and so I recognize them that I was deficient or defective in these areas. But I didn't know what was part of a syndrome and I don't think I felt that way too. I visited my brother in Australia an older brother whom I haven't seen for 30 years. He had exactly the same problem. And then I thought the two of us must have some some family genetic condition. As I recall there was a footnote in your wonderful book that relates exactly to this. You wrote a memoir called Uncle Tungsten and as I recall when you put a picture of Uncle Tungsten you put in the wrong picture or seven and his.

His family were furious. My. My mother was was one of Uncle Tungsten that was one of eighteen children and I had nine uncles and I put in another call. I call Tom some children said the two of them look nothing like each other. Anyhow I correct the mistake in the paperback. So let's let's talk a little bit about your your new book because it bears directly on some of the issues that you've been talking about before getting to the personal part of the book. Let me ask you about some of the case studies. They're united largely by the common theme of visual perception or the lack of it and they're deeply haunting and in some cases they're actually inspiring and and happy. You know a haunting story is one about a woman who can no longer read and can recognize colors but not

shapes. So she tries to organize her life by grouping things according to color and then gets thrown in this in the spice cabinet because everything has a red top. And then there is the story of a woman who has had. An opposite kind of story a woman who has had monocular vision all her life and then suddenly acquires stereoscopic vision later in life and her entire view of things changes. I wonder can you give us one of these case studies and tell us why it is that the pathologies of vision seem to speak so centrally to our sense of ourselves. Well most I get hundreds of letters and from people who tell me of their experiences most of these are experiences of loss and sometimes cries for help

but especially an unusual one was. Related to a very different experience. This was someone whom I met at a launch party some years before her husband was an astronaut and we got talking then and she mentioned that she'd been born with a squint with crossed eyes and and though she had had various operations the eyes alternated so she was only using one eye at a time. I asked if this affected her life much and she said no she said she and she could play a mean game of tennis and that she sometimes teased binocular athletes by suggesting they wear a patch and then they would miss the ball by 20 feet and she would drive a

car and to most other things. And I said to her but can you imagine binocular vision or stereo. And she said that. So she said I'm a professor of neurobiology. I've read all the relevant papers. So I left it there but then 10 years later she sent me a letter she would call this conversation and she said I was wrong and she said she and now she could say this because in the interim she had developed stereo vision and she said no information no imagination could do justice to the wonder of it. She'd been to a vision therapist and had had some training. And then she said she went out to her car one day and the steering wheel was popping out of the dashboard. And first she thought this was some bizarre

or something to do with the afternoon sun. Then she closed one eye and the other and she realized that this was it. This was the mysterious vision which everyone else had on most other people had it. It was something she was in rapture with this and many years later she's still in that church. She she says she she said she couldn't imagine a parallel unless it was that of someone totally colorblind or who had never encountered colors suddenly being in a world of color. And the. There was a certain fearlessness and flatness to experience and perhaps a feeling that she was looking at a picture and could not enter into a space. In some sense in some way she didn't have a sense of space nor quiet of herself as a being or a thing in space. And and this has now changed changed

completely and something which one might think is this is as trivial as using two eyes rather than one is absolutely essential to one's visual being in the world. And so I was very struck by that. And in recent years you've had reason to be struck even more powerfully by this because one of the stories that is told in the mind's eye is Oliver Sacks going in the other direction. About a third of the book. Takes the form of diary extracts in which Oliver is recounting the progress and the aftermath of a disease you are diagnosed with ocular melanoma. And I wonder if you could take us through you know in a brief way that that particular circumstance and what happened to you how you coped in the

aftermath but come back also to this notion of seeing with one eye versus two. Well I'm nearly five years ago and just before Christmas in 0 5 I was a weekend a Saturday morning. I started as I do every morning with a swim and then I thought I would go and see a movie and I was sitting watching the previews when I suddenly became conscious of some fluttering and a sort of sparking to my left. And at first I thought this is one of those visual migraines. But then it was apparent that this was a different creature and that it was affecting one eye only and was not in the brain.

I said my green is and. The fluttering became stronger. It was a brilliant incandescence. And then I realized that I couldn't see the lights in the cinema going out on the left and a chunk of my visual field was missing at that moment. I sort of panicked. I wondered what was happening. I wondered if if the retina was detached if I was bleeding in the eye if I was going to go blind. But I also didn't know what to do. So I sat still hoping it would get better by itself and it didn't. And that afternoon I went to see an ophthalmologist and described things to him and he went and looked in my eye to look at me in a different way. I had sort of been a colleague before now I was a patient and he said I had something behind the retina and he would refer me to a colleague. And I

saw his colleague who is in fact the man to whom I dedicate the book. A couple of days later and I went through various tests and then I was shown a model of the eye and a black object like a sort of wrinkled cabbage a small black cap which was put there and this for me meant you have a tumor it has a black tumor it has a melanoma. And when I was a medical student melanomas were a death sentence but he was quick to say that melanomas and the eye were much more benign. They rarely spread and they could be pretty effectively treated. That's in the old days you'd remove the eye. You couldn't let it stay there but now you could radiate it. So I had radiation and lasering. And I had various visual symptoms

while other ones if I want to say more interesting ones. The an area of the visual field was missing with that eye. This was a scotoma. But the scotoma for me was rather like a window because I would see figures and landscapes and and charming little hallucinations. Inside the scotoma I could easily ignore these but I would some if I had nothing better to do I sometimes. Gazed at them. Later I started getting very close distortions with the vision of that high in this book for the first time ever I've put some of the grotesque drawings which had made these included a drawing of people as I saw them at one point when they were enormously elongated and attenuate heads

and tilted to one side. And so now you say that they're grotesque but you also compare them to Van Gogh. Well no that that was the I'm doing it. I think actually the ungated One is I think look like I compared them. Oh that's right. Yes I am. However I would also sometimes if I looked at her face or anything else there would be a sort of diffusion of the flesh and sort of protoplasmic sort of translucent swellings would appear that reminded me a bit of Francis Bacon face. And this these would in fact want a fast vision generally. And I increasingly kept the eye closed a lot of pad and the tumor was very close to my Favia the fixation point with you know with the most acute vision and I knew that if that was destroyed I would lose central

vision of that so-called. But by this time. Well then I did have a procedure which removed Center which removed the rest of the tumor. In fact this was a great relief because instead of seeing grotesque distortions I simply had no more competition from the side. And effectively I found myself one on the now. I loved stereoscopic vision. I mentioned that I used to do stereoscopic photography as a boy. I was an active even ardent even fanatical member of the New York stereoscopic society which consisted of fellow nuts. And time when even when I was a little boy I would find clothes closing one

eye instantly flatten the world for me though this was not so apparently for most people so I thought whether. I thought probably I was more biased towards stereo and I probably saw the world more deeply than other people and so I had such a passion for stereo was now the first monocular member of the New York stereo scruffiness the if I came and somewhat hesitantly it books I don't see steps. All I see is as lines on the ground. See I've accommodated to some extent and when I call someone a glass of wine I don't port straight into their lap as you know as I would do originally only to some extent. I am

really the near and far are conflated for me as it were on a single plane. Well I think I mentioned in the book that on one occasion when my music teacher my piano teacher was introducing a new piece I am I saw slivers of wood twigs coming out of her arm or into her. And then I realize that in fact these slippers were tweaks were on a twee 200 foot away across the road where she was two foot away. But I can't really distinguish two feet from two hundred feet and. So with me I sometimes have Styria dreams. I love I love them stereo dreams for me with dreams of looking into a stereoscope and now I still have it. But when I wake up to a very flat cluttered

world with no space between things everything is on top of each other. My fan is about to crash into my bedside lamp. I know that there's six foot between them but so far as I'm concerned they are about two to collide. It's orderly. It's. A couple of research shows here at Harvard have suggested that Rembrandt. Which is why I will come on to this a bit later. And that Rembrandt with his wife set slightly divergent ties could not have had binocular vision. They feel the same of. Some other artists who did self-portraits and they feel in fact that the Knockhill a vision may interfere. With the practice of painting

or photography photography. Of course most people use you find a single viewfinder. Of course I had a stereo camera but most people don't and they will sometimes look through a tube. And they wondered whether. Renouncing or not having binocular vision might actually be an advantage to an artist eye. I thought this was an absurd theory until I lost my own binocular vision and now I have to say the world is somewhat like a painting or cinema screen. Before that there were objects situated in space. Now the only surfaces juxtaposed with one another. Well you'll be able to see some of those drawings for yourself in the book because you've reproduced about 10 of them.

Yeah a few. The other thing and possibly the reason why hit the microphone. The. Last year I had a hemorrhage in the eye which removed the little vision it had. And now I see nothing to the right of my nose I can't see my hand and I'm losing this chunk of vision. Well it also looses in one's imagination or one's mind's eye the day this happened or the day after. I am. I ventured out onto Greenwich Avenue a very crowded street in New York and I was absolutely terrified because people suddenly materialized on the right. I got no warning there was no peripheral vision to alert me and I was crashing in to them. And I went out with Kate my assistant editor and friend is she. She stood guard on the right when I got back to the building. I got on the elevator

and waited for her and she didn't come and I thought maybe she's checking the mail speaking to the doorman until a voice her voice said What are we waiting for. And I turned around with some difficulty because somehow the idea of things anything being on the right side is gone. I found she was there. Well not only had she come in without my seeing her but it hadn't occurred to me that she could have done that and still a year later it doesn't occur to me that that anything can happen there. Although I have to make a special effort to sort of and to turn around and Pia and to to to to just sort of crane here people disconcerts them. They feel they're being safe while they are being stared at. So I chose my seat

wisely. Yes. No I lose things and people to my right one of the issues that you talk about in your book and it relates exactly to this has to do with the relationship between visual perception and simply the way the mind is structured to think and you give an example for instance of a particular person who at one point had had sight and then had lost his sight. And this person writes about the fact that over time concepts like here and there lose meaning and the faces and faces that they're facing are facing. And I wonder if can you can you talk a little bit more about that this relationship between site and the ordering of the mind. Yes. Well these these were described by me in a very remarkable book a memoir

by a man called John Howard Hughes who was a professor of theology in England. The but I have I've sort of describe my world as having become flat. And for me near and far have have disappeared. But if one is completely blind I think one's entire sense of space may collapse or disappear. And of relationships in space as when people are facing each other or two objects for for John how space was recreated partly as auditory space but the effects of losing a sense of very very very profound.

This doesn't happen to all people who when I wrote an article I wrote a review with her of Howze book because I thought this was what might happen happened to all blind people. And I got an onslaught of puzzled sometimes indignant letters from blind people who said this hadn't happened with them. Someone said that lost their site 30 years before and they were still very visual and one woman said I could see my hands as that typing and it became apparent to me then. That there are many different responses to losing one's sight. I think the most striking. Was mentioned by an Australian philosopher and psychologist who who was blinded by a chemical explosion when he was 20 he was told to turn to the other senses and he he refused. He'd actually he was the son of a film director

would be in vain. His father would ask him to visualize scenes and he he determined to create a virtual world of sight in place of the actual one and to have a sort of controlled hallucination. If you want the it and he has become a virtuoso there and indeed there's a whole category a sort of subspecies of the visible blind. It's fascinating. You you just use the phrase about different responses to a particular trauma and I think anyone who has who has read a lot of your work has that very matter in mind continually. On the one hand you are presenting these case studies you've done scores of them at this point. On the one hand the readers reaction is my God what a fragile thing. My mind is what little provocation it

takes to alter it in some catastrophic way. And on the other hand the reader also thinks oh my god what a horrible thing. My mind is how inventive and adaptable it is and this tension runs through many if not most of the case studies that you talk about. And I wonder if you could say a few words about that tension. No. Well you're exactly right and I think coming I think this hit me especially with my Awakenings patients who had been filled sometimes overnight by a disease. And you should say these are sleeping sickness. I have by the sleeping sickness and within and some zombie like state for decades.

And and yet when they came to although some of them had lost 30 or more years of their lives doctors that come from their 20s to their 60s the 1920s in the 1960s they were able to reconstruct their lives remarkably. But in general as you imply in my my enthusiasm and my feeling is to do with survival I want to say I love to see the different ways in which people survive after seemingly catastrophic things. And and some of this is human conscious consciousness ingenuity. But some. Occurs quite automatically. Instead I haven't mentioned animals non-human animals in this book

but I got a letter a couple of days ago from a woman who told me you're going to say from an animal. She says hug her cat. Lost an eye and a fight and she now observes that when the cat is going to pounce it moves its head quickly from side to side and then pounces. So the cat didn't figure this out head. It just happened. I am I think one of the most remarkable adaptations I describe in the book is with regard to a novelist Howard Engel a very good Canadian novelist who one morning had breakfast felt fine went down to get the newspaper which the Toronto Globe and Starbucks looked OK at a distance but for years

unintelligible when he brought it to his eyes he thought it was some strange fallen script. He said it was like Serbo-Croatian. I don't know such language Serbo-Croatian. V and his first thought was that the this in fact had been printed for an ethnic minority in Toronto and somehow being placed on his doorstep by mistake. But then when he opened the paper all the advertisements were like that he realised he'd had a stroke. He he he went into his library he hope books were different but his entire library had become unintelligible to him and as a lifelong passionate reader and a writer he he was he was he was terrified of this condition of suddenly losing the ability to read or Alexia

doesn't mean that one can't write. In fact he could write but he couldn't read what he'd written. And he didn't know how he could continue very remarkably. And this was not of sort of his conscious doing. He started to find that he could read a bit and he went to be retested. But the Alexiou was still total. But what was happening at that stage was that he was involuntarily copying letters with his index finger and then moved on to involuntarily copying things with his tongue. On the back of his teeth or the roof of his mouth. So reading for him became writing or copying with his tongue. And that worked works pretty well. But other people with Alexia might find completely different ways.

Extraordinary story. But as you say we are infinitely fragile and infinitely tough both. So in just a moment I'd like to turn this over to questions from the audience so if you could think about your questions right now and I'll ask you one more slightly embarrassing question. I'm thinking I'm thinking of my sins. It's not. It's not that embarrassing. But I hope you don't give the guy especially bigger chairs. I bet I. I get ready to confess all. I'm not sure this church believes in science but. You can it for a person who reads non-fiction you can't help but be struck how many physicians are terrific writers. You know Louis Thomas and and chape Nuland and Jerome Groopman and yourself you know you almost think that

instead of going to the Iowa Writers Program you should go to medical school. And. How did you learn to become the kind of writer that you became because of anything to do with you know writing medical histories or what is it. Well I never did a writing course saw anything like that at home. At school. Essay writing was it was a central thing in English history. I am. I've kept journals full for more than 60 since I was 14. I am I sort of it was an imperative need of something if I was going through something unusual if experience was intense. I had to somehow translate it will transform it into words. You know both my parents as I said the. Doctors and the

house was full of medical talk. Doctors are storytellers. And I think as you suggest for me the case history became the central sort of exemplar or pit of nonfiction writing. But although I haven't stuck the case histories I've sort of written a few other things I have I have to do it it somehow came to me I should say that the First off of what I write is often monstrously hyperbolic and dumb and I depend on revising with a cool head to get at also on my my good editors to cool

things down and move me from contradiction and hyperbole to mild reasonableness. Well I wanted to ask you it's a pleasure to be here and to hear you speak. You were talking about catastrophic events. My wife had a catastrophic event of having a stroke and I was wondering because you've talked a little bit about case histories and change of personality. My wife sort of struggled before the stroke with depression but she's now had these incredible barriers of aphasia and specificity and being confined to a wheelchair and yet she's incredibly joyful. And I was wondering could you speak a little bit about when someone's had a catastrophic event and that that change of personality. Yes. Only in that way. Well precisely such a change as you describe is described in one of the stories of my book about a woman prone to severe depression who has a

catastrophic stroke as paralyzed and loses expressive speech. And realizes that's life as it was lived before in some sense is was over. But in fact this woman has become my patient has become a sort of genius at communicating in non-verbal ways. And I mention her daughters felt wondered why she didn't commit suicide. But on the contrary now she is she really was so glad to be alive and to be able to communicate and that people's good feeling for her. I don't know how much was an organic change in the brain something sort of you know the bottom we might do. And how much is just a reaction to having something catastrophic about surviving

and then then life as is infinitely dear to one. And one is infinitely grateful and one feels that is a blessing. You know it sounds like the microphone is working fine. Is that right for everybody. Great. Thanks. I want to thank you first for work which is based on inquiry and curiosity and not just a deficit model. I frequently work with people who have extraordinary ability in visual processing memory perception with concomitantly weak auditory skills and vice versa. I wanted to ask if you see that frequently and whether you think it's ever the case that the prodigious strength keeps the weaker thing from developing as opposed to a model where you've got a compensatory

mechanism. Well this is a good deep question and I and I don't know that it's going to be I'm either either or the. Congenitally blind children and I should say that say absolute pitch is fairly rare. Like one in 10000 in professional musicians is one in 15 in the congenitally blind it's one and two. And and this this probably goes with the fact that the blind infantile the blind child has to solve all possible meaning out of the out of the ordinary world. And they they become gifted that way this can happen in adulthood as well. I mentioned how how who would become blind in his 40s. Found himself becoming more adept at construct creating auditory space to make up for the visual space which he

lost and something called Williams Syndrome. All the people with Williams Syndrome seem to be enormously sensitive to music and many of them are gifted where they have major major visual difficulties but then the fun parts of their brain. They're also very very talkative. Yes. And on and and endearing and make contact with them invariably the front part of the brain is well-developed where music and language are involved. The back part of the brain where vision is as poorly developed so so this may just be the way their brain is with dyslexia which has now been recognized as affecting 10 15 percent of the population that's common to have visual gifts

whether it's a compensation or what. So I don't know. I mean all I can do and all I do is multiply examples. Thank you. All right. Dr. Sacks I'll start by measuring something which I wasn't going to mention because I think you get a lot of questions on it. But given the previous Jones talk about traumatic catastrophic injury I've spent most of my spare time last four years researching Phineas Gage and in the course of that I've read a lot of warrior. And so I will say that I ever really thought of the warrior general area and I was very struck by your introduction to his works. That you've written probably very very long ago and I would be interested to hear just any reflections you have about work. I just I found your treatment of him as an introduction to not putting you on the spot.

Well this is a I'm I'm not sure what to say if my my idol got that impression. In 1968 Louis was a great Russian neuropsychologist I should say a Soviet neuropsychologist although he spent he spent his entire life somehow dealing with the murder of a murderous bureaucracy which could have put him in the gulag at any point. But in addition to pioneering detailed study of the brain he said he'd love to look at individuals in great depth and not just as the previous person said in terms of their deficits but in terms of the impact the sort of life they lead. I read one of luteus books called the mind of an M and asked about a man extraordinarily gifted in memory and imagery but strangely defective in

some other ways. I was the first 30 pages of this thinking it was a novel and it had the pathos and the poignancy and the humor and the drama and and then I realized in fact it wasn't a novel but it was a case history and the most detailed and in the way objective case history I had I'd ever read. But in this case histories have been have been a sort of model model for me. But there's but I could go on too long about him. Well well thank you for that. I really appreciate your reflections. Thank you. Dr. Sacks excuse me. I personally would like to thank you for your brilliant mind and as a teacher I was struck by your concept about survival for people who are struck this way. And it struck me that there's almost a model for how genetics works and how evolution works

where these people are given a genetic package that unless they choose to survive and or find a niche with that survival skill can flourish that in fact could be a pathway to another genetic pathway into the future. And I was just struck by that and I think I might use that in the classroom as I talk about genetics and evolution because I think to a certain extent you. It happens to you. You're a part of that process and when you're struck the way you've described. But you have one short question. The people who have faced blindness do they use careening accessories like eyeglasses and earrings and necklaces to you know get through some of that vagueness. Oh absolutely. So you would be remembered by your beard although you might be confused with other bearded people. And I should say in relation to that that I've always apologizing to

a large bearded man. In Mira's. And that on one occasion when I was at a restaurant with tables outside I got a pop up to do. I was sort of. Combing myself and then I realized that my reflection was not combing itself. But on the other side inside the restaurant there was a man with a beard who was puzzled. As to why I was preening myself in front of. Me. Yeah yeah it has to be extraneous features and this is is a reason why I and other face blind people find caricaturist and cartoons easier to recognize because a salient feature gets exaggerated.

Thank you very much. I worked with artisan for 17 years. He just met a colleague who I hadn't seen here and read all your books and I have a couple of questions about sensory integration. Mostly using sort of avant garde techniques of trying to change the inside from the outside. You know I'm afraid I'm ignorant then I can't say anything on that. OK. All right. I think my answers are. And the second question. OK. I second my second question is on synesthesia. If you'd like to comment on why colour's seemed to have specific emotions. Yeah. Yeah essentially talking about time with synesthesia. One sense one sensation one mood one sense is converted into another one. So that for example one might see color associated with with music

sometimes if one had absolute pitch with a particular Keys this is not something which is this is something which is built in. People have synesthesia have synesthesia but to their first memories the coupling a particular coupling and they have never changes throughout life and time. And this is not just a metaphor or a fanciful way of doing things. If you say two functional brain imaging you may find that when music is played the parts of the brain concerned with color light up at the same time. The colleague of mine compares synesthesia to metaphor or to creativity. I think I disagree with him because I think Metafont creativity is essentially open and flexible and synesthesia has a fixed and rigid so

often delightful quality. I speak as I speak in envy because I don't have it except briefly if I'm stoned. Why do certain colors have specific emotions. Is it from an idea they may do for you. But I don't think that so generally as I wanted to ask about autism I read reports by parents who say that their children become almost normal when they have a fever. And I wonder if you speculated about why that might be or read any suggestive speculations about that. And then I also want to compare it to one of your patients stories I'm told that children with autism if you put them in front of a toy piano will play one note indefinitely. It doesn't occur to them to move one note over one way or the other. And one of your patient stories concerned a man with Tourette's syndrome who was a jazz

pianist and they gave him an anti dopaminergic medication to control the Tourette's which worked. What he found he couldn't improvise. So if I recall the story correctly he went off his meds on the weekends so that he could play jazz and then went back on it on Monday so he wouldn't curse at his wife at random times and things like that. And I'm wondering if a child getting autism and a child with autism getting a fever is sort of in the state of this guy going off his meds. Yeah. Is dopamine more active during a fever or do we have any other knowledge of what happens that might be useful in explaining this. Right. Well that's very interesting. I haven't heard that before but I will I will try to sort of find out more. I think fever could have have all sorts of effects on one. And it's one is usually not so much normalized by

fevers as Esmay delirious but yeah. But I'm thinking first for certain mental functions it can be helpful to have more noise in the system and for most of us that perhaps fever puts us gives us all a state of a higher noise to signal ratio. And for most of us that might be bad perhaps for someone with autism really a good thing they make such incredibly precise distinctions and they're unable to give them up. And maybe in a fever they can give them up maybe. I'm sorry I was reading recently about work involving people who are considered blind even though their retinas and optic nerves are fine because of some damage further back in the brain and apparently in some of these cases the people can actually see to a certain extent not not read and watch movies but distinguish objects and walked down the hall without bumping into tables because some

other area of their brain can take over. I wonder if you can elaborate on that and if that maybe has something to do with some of the adaptations in cases where the eyes are actually destroyed. Yeah absolutely. Well the term blindsight is used to this phenomenon when people. Who maintain that they see nothing will nonetheless. If they're asked to guess what is happening what is being held and found some. Will guess right. They will guess this is two fingers or five fingers or that as a cube rather than a sphere and as you say they may be able to thread their way around an obstacle course this. And this can occur even if the visual cortex has been severely damaged. But it seems as if more primitive parts of the visual pathway

can give one this sort of implicit unconscious notion of vision. But then why should this be restricted to the blind. Maybe all of us have this sort of sight. As well as more conscious vision. The one of my patients the lady whom you mentioned who finally became unable to recognize objects and how to organize them by color. But even though she couldn't recognize objects sometimes she could instantly categorize them as living or non-living. And one she had to use guessing as well and sometimes in a fascinating way one can guess right when one has no knowledge available to consciousness. I think this is a deep subject and perhaps one to end with is that is certainly something we all

use because if the person can guess whether it's living or not living. A lot of complicated information is being processed somewhere. Thank you