Review : An Anthropologist On Mars

Continuing my trend of picking up cheap books I would not otherwise give a second glance at. A random assortment of seven unusual neurological conditions, all wrapped in a silly title* and a proverbially bland cover ? Doesn't seem like my thing at all, really.

*It isn't really, of course. I just tend to prefer more direct sales pitches.

(Also, as an aside, never use Goodreads. The comments there have an incredibly high fraction of morons.)

Once again I was delighted to be wrong. What made me decide to give it a go was the philosophical aspect. Rather than stating the surface conditions, the behavioural problems and the details of neurology (which even in the outstanding The Idiot Brain did at times feel like a litany of which bit of the brain does what), Sacks concentrates on the subjective aspect of what it's like to be someone experiencing these conditions. Just because we can't know for sure doesn't mean we can't try.

Sacks never falls into the obvious trap of creating a freak show. He writes with warmth and compassion for what are at times tragic conditions, emphasising that these are real people as entitled to dignified treatment - both medically and socially - as much as anyone else. The philosophical aspect is kept very much implicit (he only mentions qualia once), but it's no less interesting for that.

Overall, what emerges is a world view far more subjective than we often suppose. That is not, to nip the idea in the bud, at all to say that reality itself is subjective - it isn't. But our perception of it is essentially totally subjective. What we perceive has to be broadly self-consistent, but there's no particular reason our internal reality has to be anything like the way it happens to be. For many people, their entire inner world is radically different to that of the rest of us.

Perhaps the easiest examples of this to understand concern vision. Sacks details an extreme case of a painter who, through an accident, overnight became entirely colour blind. Not just the usual red-green colour blind, but perceiving the world in something like greyscale. But not exactly like slipping on a pair of nightvision goggles : something altogether stranger was at work, almost like perceiving a colour entirely different to anything we usually see, with a contrast range that was extremely sensitive to context. Initially tragic for an artist dependent on colour, he eventually came to terms with - and even embraced - living in a fundamentally altered world.

Motion blindness is sadly mentioned only in massing, but is even weirder. Like a reverse T-Rex, sufferers cannot sense motion. They can see objects, but their brain is unable to register movement correctly. When something as fundamental as movement is perceived subjectively, the idea that our eye is something equivalent to an objective camera would seem to be nothing more than an exceptionally common but blatant fallacy.

Just how far this goes is demonstrated by a patient who had his vision restored decades after going blind as a child. We're all familiar with optical illusions, but we tend to think of them as demonstrating some weird quirks. Not so - they actually reveal just how fundamentally subjective our vision is.

I once had my my ears bunged up for a few days. After they were syringed - a pretty icky and thoroughly weird experience - I was expecting it to be like that moment when your ears un-pop after a flight, or if you've got a bad cold : fully restored to normal in a singular moment of blessed relief. But it wasn't like that at all. Initially I was worried something was wrong. I could hear all kinds of strange noises, which I gradually realised were the doctor adjusting some equipment way across the room. The slightest sound was clearer and more distinct than I'd ever experienced before, a strange but not unpleasant experience. Pretty soon though, my brain decided this superpower was unnecessary and after a few days everything was normal again.

In the case of vision, it seems that something analogous can occur if the loss was only for a short period. But with a period lasting decades (perhaps especially with the loss occuring in early childhood), things are not the same at all. The brain loses all of its heuristics for making sense of the world. Far from seeing the world directly, it's more like we're constantly reading the images around us, transforming raw shapes and colours into meaningful objects : tables, kittens, boobies, dinosaur ninja pirates, and so on. Without these heuristic tricks, the poor patient had to learn to read the world essentially from scratch. As with hearing, there wasn't a moment of revelation, no pulling back the veil - but things were, unfortunately, so much worse than that.

With a lifetime of exploring the world through touch and sound, vision meant very little to him. His was formerly a world of time, with no concept of distance. Motion blindness ? With even space itself being a new idea, he had far more difficult challenges. Suddenly this new sense was thrust upon him and the experience was overwhelming, particularly as everyone around him fully expected an awakening, an instantaneous moment of clarity, and could not understand the scale of the change he was experiencing. Even perceiving shapes and colours was difficult. He went through a highly variable process, sometimes able to perceive colour but not shape. At other times he experienced blindsight, the condition in which the brain processes the visual signals unconsciously, with no conscious awareness of it at all.

But blindsight may not be as weird as his generally condition. Arguably we all do something like blindsight when we daydream, but what he had most of the time was the reverse of this : his brain was not doing any of the unconscious processing of the visual signals. He could see, consciously, a flower or his wife but have absolutely no idea what they were. The visual information was all there but simply had no meaning. He did, to some degree, eventually learn to read the world visually, but never achieved the fluency that most of us take for granted.

"Meaning" is a running theme throughout the book, and goes far beyond vision or the other senses. Sacks focuses particularly on autism. While the sighted usually take the idea of distance for granted, most people are able to take the idea of meaning itself as a given (the only time we'd try and define it is as a philosophical exercise). But the autistic, and those with similar conditions, do not have this. They can know things without understanding them in the slightest. They might "know" what being happy is but never experience it for themselves. Or, less debilitatingly but no less strange, they may be completely enthralled by (say) music or drawing, but have little or no understanding of anything else. They can have normal (or sometimes extreme) intelligence and emotional awareness but only in very specific areas, with otherwise vacant individuals becoming essentially non-autistic when confronting their field of interest. Sometimes they can learn to judge the emotions of others, even predict how they'll react, but still have absolutely no idea of why people react in a certain way. They have no in-built theory of mind at all; everything they do to understand people is done consciously.

There are definitely hints here that intelligence can be remarkably specific. Rather than being a general property, intelligence itself - not just knowledge, but the very capacity for understanding and problem-solving - can be limited to incredibly specific areas : music, mathematics, dance, animal psychology. It's not that they're just not interested, it's that they fundamentally cannot understand anything outside a narrow area.

Often this is simply tragic - there's no compensating ability, no way for them to productively interact with the world. Their seems a great deal of controversy over whether they're emotional but unable to express themselves or genuinely lack emotions, or if they're triggered differently to the rest of us. Many need constant help. But others do manage to get by by themselves, and sometimes achieve great success - albeit not without issues. There's more than a little of the stereotypical scientist about the whole thing :

What one does see in Temple's writings are peculiar narrational gaps and discontinuities, sudden, perplexing changes of topic, brought about by Temple's "failure to appreciate her reader does not share the important background information she possesses". In more general terms, autistic writers seem to get "out of tune" with their readers, fail[ing] to realise their own or their readers' state of mind.

A more perfect description of an academic paper I cannot imagine. Small wonder that the negative stereotype of a scientist is someone broken ! But then of course we can flip this around : as an astronomer, I just "don't get" why more people aren't thrilled about galaxies. I don't get the appeal of team sports or why you'd rabidly follow the antics of brain-dead celebrities. That, of course, is very different to lacking a "theory of mind" - even the most inane socialite could probably at least realise when I'm thrilled about some discovery without understanding it, just as I could understand said socialite's idiotic glee at the new outfit some washed-up actor has dredged up.

Nonetheless, there are similarities between obsession and autism. While it's obvious specialist knowledge does not automatically translate into expertise in other fields, perhaps it's more fundamental than that. Perhaps intelligence is not some global, general property at all, but a multiplicity of abilities, a plurality of interests that can be aligned in remarkably specific ways. The evil genius may be more than about an inability to overcome personal bias : someone could be conceivably exceptionally talented at gaining power but have no clue whatever as to how to use it.

Sack's book is a mixture of the tragic and the hopeful. Some of these conditions are simply awful and ultimately fatal. But others can, if managed properly, bring advantages as well as disadvantages, with individuals having unique and valuable perspectives and abilities. I suspect Sacks would have some sympathy for the idea of "neurodiversity", with at least some of the autistic fiercely defending their condition as an integral and important part of their identity. Some conditions undoubtedly do need treatment. Others may only need compassion and acceptance.