Georgina Kleege is a writer who by the age of 11 was declared legally blind as a result of macular degeneration.  Primarily she is a writer of fiction but took pen to paper or fingers to keyboard to write very differently about blindness in our society and how blindness is portrayed in movies, literature, and art and its effect on her as a person and on us as a reader.  She spent many years working hard so that others around her might not actually know that she was blind.  She also brings up many issues, which we might just deal with differently with our patients after reading this book.  I know I will.

Here is a section from the introduction:

Both my parents were visual artists.  I grew up surrounded by there are and an awareness that vision involves more than merely aiming the eyes at a particular object.  Viewing a painting requires conscious mental effort, an understanding of the choices the artist made, a knowledge of the aesthetic traditions and conventions that the artist works within or against, a familiarity with the methods of applying and fixing pigments.  Similarly, viewing a movie require the ability to decode a complex array of visual messages.  The pleasure I derive from visual media, and from the visible world in general, suggest that although my eyes are blind, my brain is still most sighted.

In the opening section, “Blindness and Culture”, she spends a good deal of time talking about the word blind and all the things it triggers in people.  It is apparent that she has had some very traditional eye care but that she has also come in contact with some vision care professionals who go well beyond this.  From that section:

To express the opposite of blindness, however, we need at least two words.  Generally, we use the words sight and vision interchangeably, though recently some eye specialists make a distinction, using sight to refer to the functioning of the eye itself and vision to refer to the functioning of the eye and brain together.  Originally vision was used to mean spiritual or metaphysical perception.  Later it became synonymous with sight.  In common usage positive connotations predominate.  Seeing, after all, is believing.   We speak of vision as a virtue.  We want our leaders to be at clear-sighted, if not possessed of “that vision thing.”  We hold dear our views, outlooks, and perspectives.  We know a picture is worth a thousand words.  We want to see eye to eye. (Page 22)

She puts to rest the idea that blind people hear better or have their other senses become more acute.  She states:

You discover not that you hear better but that you are better able to make sense of sounds.  (Page 32)

In a section entitled, Blind Phenomenology – The Minds’ Eye, she states:

The sighted can be so touchingly naïve about vision.  They apparently believe that the brain stays out of it.  Or at best, they extend the camera metaphor and envision a tiny self seated inside the skill, passively watching images as they are projected on a movie screen, then pushing buttons and pulling the levers that will make the body respond appropriately by speaking, running, reaching, or closing the eyes.  (Page 96)

The sighted preserve this absolute faith in the image despite everyday experiences when their eyes deceive them or when they see more (or less) than actually meets their eyes.  For example, picture this.  You are waiting to meet a friend in a crowded train station.  You are able to spot him from across the large waiting room, a distance of perhaps forty yards or so.  The next day you are there again, waiting for someone else.  Your friend of the day before also shows up and walks toward you, buy you do not recognize him until he is much closer, perhaps only a yard or two away.  Why?  The image projected on your retina is pretty much the same.  And you’re alert to it, actively scanning the crowd.  Your friend’s image is there in your eye on Tuesday as it was on Monday.  You should see him but you don’t. (Page 97)

Throughout her treatment ophthalmologists have consistently treated her in certain ways that she talks about at length in the text.  To sum up some of what she learned she states:

Ophthalmologists are not necessarily well versed in the neurology and psychology of vision.  What goes on in the brain is someone else’s province. (Page 102)

Later in the same section where she is explaining how she experiences her visual condition she states:

The unimpaired human eye provides the brain with such a surfeit of visual information that only a certain amount consciously registers at any moment.  In effect, your brain privileges certain aspects of the retina’s images and disregards others.  Each eye sends the brain a billion messages per second.  Together the two eyes transmit twice as much information to the brain as the rest of the body combined.  With all this information flooding in every second, the perceptual system seems designed to adapt readily to losses and distortions, whether because of eye damage or other circumstances. (Page 107)

In talking about a type of visual training she talks of a prominent athlete who worked on improving his vision.

Certain people in certain lines of work seem to train their perceptual systems to perform specific visual tasks that other people would find impossible.  Such people may have only average eyesight but seem to see more, more quickly and more accurately.  Senator Bill Bradley claims that during his basketball playing days he trained himself to use his peripheral vision more accurately, as a way to give himself an advantage on the court.  He would walk past a store window with his eyes aimed straight ahead and try to identify the objects on display.  Then he would go back and check.  Over time, he claims, he actually expanded his visual field.  (Page 109)

Relative to the type and degree of our conditions, we learn to interpret the world through minimal visual information.  We learn to combine these imperfect and incomplete images with our other sensory perceptions, plus what we know about the laws of nature, and call it the world.  (Page 110)

Later she gets into the concepts of compensating for visual loss with gadgets and devices.

…no single device, or even a gambit of gadgets, can completely compensate for the sight you’ve lost.  To be an informed consumer of all the equipment now on the market, you will have to think of vision is a new way.  Vision is a series of discrete activities, not a constant, seamless, pervasive ebb and flow of information.  What’s more, you will need to prioritize, decide which activities are worth performing visually.  Otherwise you may leave the doctor’s office laden with cumbersome and expensive paraphernalia but little guidance on how to deal with the world without sight. (Page 114)

 

In the last parts of the book she talks about the manner in which society has classified books-on-tape as a sort of second-class type of reading.  Many busy people who listen to books on tape while driving or exercising seem to be apologetic and consider this form of “reading” inferior to the actual process of reading.  She talks at length about this actually being a different manner of experiencing written text and how she uses it in her own life.  She is an English composition and writing teacher at a college and must grade papers.  I found it very interesting her discussion of what she looks for in a good reader. 

She also addresses the issue of learning Braille, which she did not do until late in life, when you are not supposed to be able to do this.  She laments not having been exposed to Braille much earlier in life.  However, this was seen at that time, as shouting to the world, “I’m BLIND” and this was not a step to be taken lightly.  All the ophthalmologists and other people in her life just thought that using more magnification of better devices that they could just keep moving on.  Although with devices she can read some text in a very laborious style using what sight she has left, learning Braille freed her from the extreme physical efforts involved and allowed her another way to access written language.  I certainly will consider suggesting to some people who may be in a similar situation to Georgina that they learning Braille earlier in life as a direct result of reading this book.  There is so much more to be harvested from this book.  This is a must read. 

Available from Amazon