Review of THE ISLAND OF THE COLOUR-BLIND by Oliver Sacks

Ann Skea (annskea@zeta.org.au)
Wed, 04 Dec 1996 10:34:49 -0800

Title: THE ISLAND OF THE COLOUR-BLIND
Author: Oliver Sacks
Publisher: Picador, Pan Macmillan (1996)
ISBN: 0 330 35887 1
Price: A$16.95(paperback) 346 pages

Reviewed by Ann Skea

Knut Nordby cannot see colours, yet his world is far from colourless.
His sister, Britt, similarly colour-blind, once knitted a jacket with
intricate designs that glowed for her in twilight gloom, but the design
disappeared in sunlight and could barely be discerned at all by
colour-sighted people. And in a dark hut on a coral atoll in the
Pacific, another woman weaves palm-frond mats with beautiful patterns
which you have to be totally colour-blind to appreciate.

Knut, Britt and the mat-weaver of Pingelap all suffer from a rare
hereditary condition known as achromatopsia. Their eyes lack the
functional cone-cells which allow most of us to distinguish colours and
which are responsible for the perception of fine detail. They are
acutely sensitive to bright light and need high-powered magnifying
glasses to see clearly, but they each have a rich perception of
luminosity and special sensitivity to form, texture, perspective and
many other subtle visual cues.

Oliver Sacks, who experienced loss of colour vision during childhood
migraine attacks, was intrigue by this condition. Yet, unlike most
neurologists, his interest went beyond the physiological details of the
disorder, to a curiosity about the lives of the people it affects.
Would, for example, a community of congenitally colour-blind people
consider colour vision a disability or hindrance, rather as sight was
considered by the blind people of H.G.Wells' story, 'The Country of the
Blind'? Would language differ when 'colour' words had no referent or
meaning? And how might "tastes, arts, cooking and clothing" be affected?

In 1993, Sacks learned of the Pingelap community in Micronesia where 1
in 12 of the people suffer from hereditary achromatopsia. And the first
part of this book describes his visit to this island. Much of the
interest of this part lies in Sacks' record of the interaction between
Norwegian scientist, Knut Nordby, who accompanied him, and the people of
Pingelap who shared Knut's colour-blind condition. There was instant and
mutual recognition of their strange kinship, and instant rapport between
them, which made for a very open exchange of knowledge (Knut is a vision
researcher at the University of Oslo) and skills. Sacks, with his usual
humorous and quirky appreciation of human adaptability, records this
exchange delightfully and keeps the associated medical details clear and
simple.

The same is true of the second part of this book, which is partly a sort
of medical detective story and partly a eulogy to the primitive cycads
which have been a lifelong passion for Sacks. These two parts, however,
are not unconnected, for the detective story concerns the cause of a
degenerative neurological disease, endemic on the island of Guam, which,
it has been suggested, is caused by the traditional use of cycad seeds
as a source of food.

Lytico-bodig, as the disease is known locally, manifests itself in a
great variety of ways: sometimes as a progressive paralysis, sometimes
with parkinson-like symptoms, sometimes with both. There is no
uniformity, no standard form of the disease. Whole family groups (and
not just blood-relatives) suffer from different forms of it; there is an
unspecifiable latent period before it develops; it appears to be
non-infectious, non-transmissable, and have no evidence of genetic
origin; and, most curious of all, since the 1950's the disease appears
to be dying out.

Sacks tells anecdotes about visits to the homes of suffers with his
colleague, Dr John Steele, who lives and works amongst the Chamorros
(the native people of Guam). He tells of his scuba-diving adventures in
shark-alley and of being plunged into darkness in a restaurant because
tree-climbing snakes infest the local electricity sub-stations. But
along with all this is his account of all the various theories which
have been put forward to explain lytico-bodig. There is irony in this
urge to solve the lytico-bodig problem before the disease vanishes
altogether, but for those involved in the research the puzzle is
irresistible.

Oliver Sacks' writing is always interesting and very readable. He writes
about people, not patients, and he is willing to acknowledge that his
own instincts as a doctor are not always appropriate. Confronted by
Estella, who is catatonic, he writes that, "Part of me wanted to say:
"But she is ill, catatonic, she can't fully respond - don't you want to
bring her back? She has a right to be medicated, we have a duty to
medicate her!". But he sees, too, the local sensitivity to the needs of
sick family members, the support and love which is given them, and the
acceptance and acknowledgment of disease within the community. In
Estella, he recognises "an achieved equilibrium both within her, and in
relation to her family", which medication might imperil. And he
recognises a society where the sick have dignity and remain a living
part of the community, unlike his own patients in New York who are
"getting the best of modern medical care", but who are often alone,
avoided and "written...out of the book of life".

Who would not want a physician as sensitive to human needs as Oliver
Sacks? And who cannot warm to his enthusiasm for the ancient and
primitive cycad trees - "Heavy, armoured, slow growing, gigantic - they
seem to bear, like dinosaurs, the imprint of the Mesozoic, the 'style'
of two hundred million years ago"?

Leaving Guam, Sacks visits the neighbouring island of Rota, which is
thick with cycad forest. There is no medical pretext for this visit
(although his guides are a traditional medicine-woman and her son), he
is simply indulging a passion. He is transformed suddenly, and rather
disconcertingly, from neurologist to botanist, but underlying both is an
undiminished scientific curiosity and an imagination which brings
science to life.

So, this book is medical mystery, botanical record, autobiography,
travelogue and scientific paper, complete with bibliography and notes.
But most of all, it reminds me of the scientific writing of an earlier
era - elegant, jargon-free, wide-ranging and full of interest. Its
finely etched illustrations add to this impression. Only the e-mail
address and Web-site references for The Achromatopsia Network* make it
thoroughly modern.

*The Achromatopsia Network - PO Box 214, Berkley, CA 94701-0214.
e-mail:Futterman@achromat.org Web site:http://www.achromat.org

***************************************************************
Copyright (c) Ann Skea 1996
http://www.zeta.org.au/~annskea/

Standard disclaimers apply.
For permission to reproduce this text in any form contact Dr Ann Skea.