Thursday, May 11, 2006.
According to a New York Times report at the following URL, this article won a "profile writing" award for Esquire yesterday, and they have re-published it today.
INTO THE LIGHT.
by Robert Kurson,
June 2005, Volume, 143, Issue 6.
Michael May had everything. Happy marriage, great family, successful business. He was even a world-class athlete. What kind of a man would upset such a perfect life by doing something as crazy as trying to get his sight back?
Humanity has paused on Jones Street near the summit of Russian Hill in San Francisco. Tourists, businessmen, café workers, the homeless-all seem to have taken a collective breather at this steepest of places, a city peak where stairs are carved into the sidewalks so people don't topple. Only one person keeps climbing, and he's talking, too; he's saying that you can't stop here, that if you just keep pushing, you'll see things no one else will see, that Macondray Lane is just over the hill and that it's the most magical place in all of San Francisco, but you'll never see it if you don't keep pushing, you'll never see Macondray Lane unless you really know how to look.
Mike May keeps climbing. He is fifty years old and sweeping a red-tipped cane in front of him, a blind man's cane. He lost his sight at age three, blind for life at three. He learned as a boy to listen to his cane echo off cement curbs and street signs, but now he doesn't hear a thing. There's not so much as a pebble in his way, and it doesn't matter that every person seems to have stopped to catch his breath; he won't stop climbing until he reaches the top.
At the peak, May's cane finally stops moving. "There's Alcatraz," he says. He is pointing directly to the site. "Look how the sun glints off the water in front of it."
May takes in the scene for a minute, then begins walking down the hill. A minute later he turns right onto Macondray Lane, a tiny turnoff more pathway than street.
"Look at how green the trees are here. Look how low they overhang the street," he says. "It's like we stepped into Old Europe. It's like we stepped into a whole new world."
May is due at the office of his ophthalmologist, Dr. Daniel Goodman, in an hour. There, Goodman might give him a life-changing verdict. May won't hurry. He just keeps absorbing Macondray Lane, keeps remarking on the yellow of a woman's sunflowers and the splatter patterns made by a man hosing down windows.
Six years ago, on a day much like this one, May had a chance encounter with Goodman, a purely accidental meeting. The doctor asked if he might use ultrasound equipment to peer into the back of May's right eye. May assured him that he was permanently blind, a diagnosis made by renowned ophthalmologists. Goodman looked anyway. He told May about a recent surgery, a stem-cell-and-cornea-transplant procedure, the rarest thing.
Then Goodman told May, "I think we can make this happen, Mike. I think we can make you see."
All May had to do was give the okay.
Give the okay? And out of gloom and darkness, the eyes of the blind shall see (Isaiah 29:18). Sight was biblical. You had to give the okay.
May did not jump up and down, and he did not scream out. He was fairly stunned by the offer, and he sensed the hugeness of the opportunity. But he also knew his nature. He was a thinker who needed to consider every facet of a decision, especially one so monumental. He asked a few technical questions. He made a few jokes. Then, in the soothing and measured way in which he had spoken since boyhood, he told Goodman that he would consider it.
At home in Davis, California, May started thinking, but his thoughts were not about eurekas or new worlds or a new life. Rather, they were about the life he had now, one he had often told himself he wouldn't trade for anything. He was happily married to a wonderful woman. He deeply loved his two young sons. He was the founder and CEO of Sendero Group, a successful start-up that had designed a portable global-positioning-system unit-a real breakthrough-for the blind. He was fantastically mobile, capable of getting himself anywhere in the world. He was a sky diver, lecturer, guitarist, mentor. He had been the first-ever blind CIA analyst, lived in Ghana, come face-to-face with evolution on the Galapagos Islands. He still held the world speed record in downhill skiing for the blind-sixty-five miles per hour. He was thought by some blind people to be the epitome of what a nonsighted person could be. "In the world of really cool blind guys," his friend Bryan Bashin would tell people, "Mike is about the coolest."Most of all, May didn't feel as if he was missing out on a thing.
Weeks passed. When May mentioned the surgery to people, their responses were predictable and explosive: Sight means you get to see your wife and children; isn't that reason enough? But May didn't conceive of it that way. He felt so fully invested in his family, so in love with them, that he couldn't imagine anything-not even vision-deepening his connection to them. I already see my wife and kids, he would think to himself. And he felt that way about much of his life-that everything already seemed so wonderfully vivid.
There were risks to vision, too. What happens, he wondered, when a person introduces an earthshaking event like new vision into a thing so finely balanced as a good marriage? Marriages come undone from financial setbacks or job transfers. Here, he would be changing the universe.
Business demanded his full attention. Start-ups pass through a critical stage, and May's was precisely at that point. There was no telling how profound his obligations to new sight might be-the surgery, the adjustment, the checkups. It was tough enough to spare a day to go skiing. It seemed impossible to ask Sendero Group to spare its CEO time for a new life.
There were also physical risks. He would be forced to ingest highly potent antirejection drugs, which posed the serious prospect of kidney failure, liver failure, and systemic malignancy-cancer. He might suffer pain. And if the operation proved unsuccessful, May might lose the sliver of light perception he had retained since childhood, the bit that allowed him to distinguish between brightly and dimly lit rooms. Light perception can be precious to the blind. When he talked to his wife, Jennifer, about the prospect of surgery, she told him that she didn't worry about their marriage or the side effects of the drugs or even that he might not think her beautiful when finally he saw her. She said she worried only about his light perception.
Dr. Goodman placed the chances for successful surgery at fifty-fifty. And that was just for the first year. Even if the procedure worked, May's new cornea could be rejected at any time. He might have sight for a few months, a few years, or a lifetime-no one could say.
And what of his blind world? For years, May had been part of a community of blind friends, agencies, and colleagues. The notion of seeking vision felt like a divorce to him in ways, and he found himself thinking in those terms, wondering if he still would have visitation rights and who might take custody of his relationships. He asked two close blind friends about how the community would receive him if he became sighted. They could only say, "We'll still be your friends. But the community overall? We just don't know."
Then came the whispers. Some arrived via e-mail, others in conversation with the vaguely informed. They all said the same thing: People given sight after a lifetime of blindness had hell to pay for it. And there wasn't a damned thing a person could do about it once the terrible gift of vision had been granted.
More weeks passed, then months. May's life continued to be good. He grew his business, savored his family, and knew, better than he'd ever known, why he wouldn't trade this life for anything. He had devoted himself fully to the proposition that while life with sight might be wonderful, life without sight was wonderful, too. And here was the final proof of that: Nine months had passed and he still had not given Dr. Goodman the okay.
Then he heard the rumbling. It was a sound May had known since boyhood, the sound the world makes when it pauses for that fleeting moment while a person decides whether to stand still or leap forward. It was a sound he had learned to hear from distances no one else could imagine.
On a sunny spring morning in 1957, Ori Jean May sent her two young children, Diane, four, and Mike, three, outside to play while she finished washing dishes. The Mays recently had moved to Silver City, New Mexico, where Bill May had taken work mining copper. Inside their nearby garage, Mike found a glass jar packed with powder, perfect for making mud pies. He dumped the contents into some nearby sitting water. A plume of gas rose from the water. Nearby, a pile of garbage sat burning.
Inside the house, Ori Jean dried the last of her dishes. A moment later she heard an explosion. She ran to the garage. Mike was lying on the ground, covered in blood and pocked with glass. Diane sat in shock. Ori Jean wrapped Mike in a blanket and rushed him inside.
Outside the Silver City hospital operating room, a doctor told Ori Jean that Mike was going to die. She asked if there was any hope. He told her there was none. Ori Jean kept waiting.
Doctors sewed five hundred stitches into Mike. They still expected him to die. The next morning, they told Ori Jean that they now believed Mike would survive but that his eyes had been terribly damaged. She had one thought: The eyes don't mean anything-the only thing that matters is that he's alive.
For six months, Mike could do little more than lie in bed. His left eye had been obliterated, his right eye irreparably damaged. May's father blamed himself for the accident. The powder was calcium carbide, a chemical that reacts violently with water to produce the explosive gas acetylene. If only he'd cleaned out the garage when the family moved in.
Ori Jean read the Tolkien trilogy aloud to her son and found herself, curiously, thinking of her own father. He had lived in Mexico, eloped with his wife, moved to Chile, raised his kids on two continents. While most people allowed life to happen to them, her father had always stepped forward and hunted experience, demanded it, and when it came he accepted it, good or bad. And it was that part-the good or bad-that mattered to her now. It was the stepping forward, no matter what, that would be everything.
Ori Jean told the family's social worker she wanted Mike enrolled in traditional kindergarten, not blind school. She wanted him involved in as many normal activities as possible. She wanted him, she said, to step forward. Before school, Mike was fitted for a pair of dark glasses. He broke them walking into a wall. Ori Jean bought him another pair. He walked into a pole. She got him more glasses, dozens more, as many as it took.
When kindergarten began, Diane and Mike walked to the bus stop by themselves, holding hands. On the bus, Mike sat down backward and missed the seat. On the playground, he walked into a swing set full of flying children, one of whom crashed into his mouth and sent him sprawling backward. At home, Ori Jean listened to Diane's and Mike's stories from school. She told them that school sounded fun.
By the time Mike was six, his father was drinking heavily and had stopped working. Ori Jean moved the family to California so that she could find her own employment; she would not wait around hoping for someone else to fix things. She now had four children. All the kids did chores, especially Diane and Mike, who cooked dinner, cleaned the house, and baby-sat the youngsters. Ori Jean treated Mike no differently from his siblings, and the kids took the cue and ran with it. They paired blue and red socks while folding his laundry. They gave him dog food and told him it was cereal. Ori Jean shrugged it off. So long as no one was getting hurt, children had to learn to solve their own problems. Soon, Mike was telling his siblings that the "cereal" was more delicious than corn flakes and asking for seconds.
Ori Jean kept Mike in regular school and encouraged him to try things, to try everything, to jump in. See what's over there, she told him, and that way of seeing made sense to Mike-he could always see like that. He learned to ride a bike, then smashed Diane's. He asked to try his brother's. Soon, there were four mangled bicycles in the May garage. Ori Jean told him that kids fall down all the time when they're trying to make things happen.
In fourth grade, Mike joined the after-school flag-football program. His strategy on defense was to rush in and, since he could not see who had the ball, grab everyone's flag. He crashed into his own players, into benches, into referees. He scared the hell out of opposing players. He joined soccer, kickball, and baseball and ran full speed into everything-his sister could barely stomach the sight of his daily bumps and bruises-because to do it any slower meant he might miss something, and Mike was quickly becoming unwilling to miss anything at all.
The same year, he applied to be a street-crossing guard. The principal forbade it. Mike could not stand the idea of standing around when he had the chance to try something. He suggested that other kids could tell him when to put up his stop sign. The principal told him that the idea was to look for cars. He insisted that he could hear the cars coming and could see them that way. Soon Mike was wearing a Day-Glo orange vest and escorting kids across the street.
At home, Ori Jean waged a full-scale war on her maternal instincts. When Mike came home and explained his bloody face by saying he'd had a bicycle race in which he hit a tricycle, flipped, and skidded down the sidewalk, she shouted down her impulse to banish bike riding and instead asked him who won the race. After Mike asked permission to ride another bike downtown by himself, she pushed a thousand nightmare scenarios out of her mind and told him, "Of course. Just stay on your side of the street." While the mother of Mike's best blind friend continued to fix the boy's meals for him, Ori Jean enrolled Mike in cooking school.
After Mike turned thirteen, Ori Jean asked Bill to move out; his drinking had worsened and he was no longer fit to live with the kids. Mike scarcely missed a beat. He got interested in ham radio, then decided to build an eighty-foot tower to maximize range. Ori Jean bit her lip as she watched Mike put up the first ten-foot section, then the second. By the time he was teetering at forty feet, she could no longer stand it and got in her car and drove away; she still doesn't remember where. When she returned home, there was an eighty-foot tower on her property.
When Mike was sixteen, a blind friend invited him to check out his parents' Honda 90 motorbike. The boys drove it up and down the driveway, learning to use the gears. Then they had an epiphany: If they could just drive it to the school grounds, they could ride gloriously unimpeded around the track. Mike got on the front, his friend sat on the back. They turned off the engine, listened for traffic, then started the bike and drove across the street. They repeated the procedure numerous times-engine off, listen, engine on, ride-until they arrived at the school. On the track, they began to circle slowly, getting a feel for the arcs of the turns. Soon they had the Honda cruising, opening the throttle on the straightaways. A police siren wailed. Mike managed to stop the bike. He told the policeman that he and his friend were blind. The cop flat-out didn't believe him. Mike finally proved it by showing him his braille watch. The officer told the boys he had to call this one in, that they could have killed someone.He kept lecturing, but Mike could hear a certain admiration in his voice, too. The officer walked the boys and their bike home. He didn't tell their parents. He didn't call it in.
And this is how it went for Mike as his youth unfolded. He drove his sister's Datsun 510 up and down the driveway. He joined the wrestling team. He used echolocation to hold his own in Ping-Pong. He played guitar. The more he did, the harder it got for him to imagine stopping there, and this held true even when his experiences had rough endings, even when he crashed into poles or fell off bikes, and soon Mike got to thinking that as long as he could try things he'd always be okay.
After high school, May enrolled at the University of California at Davis. On his way to a degree in political science, he played intramural soccer, dated girls, and lived in a mud-hut village in Ghana. He earned a master's in international affairs from Johns Hopkins, then began wondering what it might be like to work for the CIA. The agency had never employed a blind analyst. That made the place intriguing. The CIA was out of favor politically and had lost its romantic public sheen. That made the place irresistible. They made him a political-risk analyst on Africa. His work was exciting and important, and the agency called on him when tumult hit his countries. Yet, at bottom, the CIA was still government work. No matter his talent, he would always move up the wage-and-promotion ladder predictably. By now, predictability to May was beginning to feel a little like death.
He took technology-based jobs with the Bank of California and TRW. He also learned to ski. Fast. At the 1982 World Winter Games for the Handicapped he stunned competitors by placing his sighted guide-also on skis-just a few feet in front of him; most everyone in the world used guides safely stationed yards behind. May's method allowed for more precise direction but greatly increased the risk of high-speed collision and entanglement. The other skiers did not know that May had been crashing forward his entire life. He won three gold medals.
In 1984, organizers of the Winter Olympic Games in Sarajevo invited amputees to compete in a skiing exhibition but refused the blind; there just wasn't room enough for both skier and guide. That struck May as unfair. He and his guide paid their own way to Sarajevo. He wrangled press passes from KCBS radio in San Francisco, which put them on the mountain. May interviewed athletes, moving from place to place on his skis. After the amputees took their turns, May's guide said, "Hey, Mike, I think we can take our shot." At first, the idea sounded crazy: There were guards everywhere, he was in a foreign country, his own organization had forbidden his participation. Then he heard the rumbling.
A few minutes later, spectators began pointing to the top of Mount Jahorina. Cheers erupted. May and his guide were flying down the course, the tips of their skis separated by their trademark twenty-four inches, the first blind skier in Olympic history. A Yugoslavian guard stepped onto the finish line and drew his gun. The guide yelled, "Get out of the way!" May knew there was trouble. He crossed the line anyway.
It was in this year, too, that May helped launch his first start-up business. He joined several engineers to design and market the world's first laser turntable, a machine that played vinyl records with lasers, not needles, the true precursor to the CD player. The company raised $7 million from venture capitalists. When investors pulled the plug four years later, May was devastated. But he'd gotten a taste of what it felt like to be a pioneer, a feeling he wanted to last. In between, he set the world speed record in downhill skiing by the totally blind-sixty-five miles per hour. The record still stands.
At around the same time, May met a woman who had volunteered as a ski guide for the blind. He was immediately drawn to Jennifer for her overarching curiosity about the world and her attraction to the artistic. He could tell by the reactions of others that she was a looker, too. They began dating. She found him charismatic and a wonderful conversationalist. He took her to ride horses, sightsee in Europe, ski in South America. Best of all for May, she didn't seem overly impressed by his capabilities as a blind man.
May tried a few other start-ups before founding Sendero Group, maker of a handheld braille-and-talking GPS tool for the blind. Early on, he trained a blind Vietnam vet on the device; the guy's fondest wish was to go to the grocery store by himself. He and May followed its prompts to the store. When they arrived, the man borrowed May's cell phone and called his wife. "Is there anything I can get you from the store?" he asked, and May heard an immense pride in the man's question. He knew then that Sendero Group was the most worthwhile endeavor he could have dreamed for himself and that growing and nurturing this business was the most important thing he could do. To consider Dr. Goodman's offer of new vision, at such a critical juncture for his business, in the midst of so finely balanced and rewarding a life, at such great risk to his health, seemed the very definition of crazy.
Then he heard the rumbling. For forty-three years, he had lived his life one way, by crashing through at that most fleeting of moments, at the time when the world stopped just long enough to allow a person to decide whether to stand still or leap forward.
He called Dr. Goodman.
"Dan," he said. "I'm in."
Macondray Lane is swallowing May. He stops to examine a stone bench outside one residence, a vaguely crooked balcony at another, and a cast-iron lamppost at a third. He lifts away overhanging vegetation as if it were a wedding veil. He marvels at the size of things.
"Look at that huge eucalyptus tree!" he says. "It must be eight feet in diameter. And look how the lane narrows. You can almost touch the front doors on both sides of the street at the same time. This is the kind of place trolls might live."
May is cutting it close for his appointment with Dr. Goodman. He is already overdue by three months, which is not like him. And this one is important. Still, May won't rush. There are a million things to absorb on Macondray.
"We'll be fine," he says. "Let's keep looking."
Dr. Goodman explained the surgery in detail to May. There would be two operations, each on his only remaining eye, the right eye. The first, a transplant of corneal limbal stem cells from a donor cadaver, had been conceived by a Colombian doctor as early as the mid-1960s but had only recently become practical in application. Corneal limbal stem cells provide a clear protective surface over the cornea, the window to the eye. Like all adult stem cells, they constantly divide and grow new cells to replace the old ones that have sloughed off and fallen away. That replenishing keeps the surface of the cornea clear. Without these cells, the cornea becomes like a dirty windshield in a car without washer fluid to clean the surface.
The chemical burns that robbed May of his sight also had destroyed his ability to make these stem cells. That is why May was never supposed to see again. But when doctors figured out, in the early 1990s, how to transplant the cells from the eyes of donor cadavers, things began to change. May's donor had been a young kid killed in a motorcycle accident-a frequent kind of contributor. The donor cells, if they took, would function as if they were May's own, dividing and replenishing, and would allow the surface of his cornea to remain clear, possibly for his lifetime.
May would then go on a program of immunosuppression drugs to keep the stem cells from being rejected. In the near future, science might be able to grow a person's own corneal limbal stem cells in a petri dish, thereby eliminating the risk of rejection. But for now May would have to wait months until his body accepted the donor cells. After the cells took, he would have a second surgery-a routine corneal transplant. Fewer than five hundred people in the world had undergone the stem-cell procedure. Dr. Goodman knew of none who had been blind for life. But if it all worked, May's sight might be restored, even to 20/20.
Goodman placed the first-year chances for success at 50 percent. The medical risks were as May remembered them: loss of light perception, spontaneous cell rejection, and side effects from drugs, including possible kidney failure, liver failure, and cancer.
There were other risks, these harder to quantify. Goodman told May that while there had been only a handful of patients in written history who had gained sight after a lifetime of blindness, many of them had suffered depression in the aftermath. Goodman had come to know May since meeting him nearly a year before and said he believed May could handle the outcome emotionally. But he also warned that even with a perfect anatomic result, the visual outcome was uncertain. Little was known about the nature of long-standing visual deprivation. The mystery, Goodman said, was whether vision for May would be the same as vision for the normally sighted.
Ordinarily, May, a man of great curiosity and resourcefulness, would have researched the case histories and made himself an expert on new vision. Instead, he confirmed the date of the surgery with Goodman, then resolved not to learn very much at all. He was in this for the experience, and he would not skew his own adventure by ingesting the reactions of others. "I don't expect this to change my life," he told his friend Bashin. "I do expect it to be interesting."
But history had amassed against May. Woven into obscure medical texts and out-of-print monographs on the subject of restored sight, a single truth emerged: Nobody messes with new vision after a lifetime of blindness and comes out of it okay. Nobody.
In 1688, a Dubliner named William Molyneux posed a now classic question to his friend, the philosopher John Locke. He asked Locke to imagine an adult who had been blind for life and who had been taught to distinguish between a cube and a sphere by touch alone. If such a man were then made to see, could he distinguish, by sight alone, the cube from the sphere?
Molyneux argued that such a man could not distinguish between the two by sight alone. Locke agreed, as did Bishop George Berkeley, another of the day's giants of philosophy. Their reasoning boiled down to this: Experience with vision was a necessary component of sight. Without visual experience, one could not truly see.
History records only about twenty cases of sight restored to a person blinded for a lifetime. There are a few dozen more cases in which long-blind patients who'd once had useful vision regained their sight. The experience of both groups is largely similar. Together, they form a landscape for the kind of fate that looked to await Mike May.
Many patients experienced an initial euphoria as light rushed into their repaired eyes. They saw color and motion immediately-a miracle. But they soon discovered that they could not perceive space; they could not perceive height, distance, depth, or three-dimensional shapes. Steps looked to be a collection of parallel lines drawn on a floor. Cups and plates seemed a group of circles. The moon was a "white round thing...as near as someone standing nearby." The patients were, essentially, seeing the world in two dimensions.
Spatial perception was just part of the problem. The newly sighted also found it difficult to make sense of an object by sight alone, to see an object as meaningful rather than as just a pattern. And this was true even if they'd had a lifetime of experience touching and using that object. One patient saw his familiar radio as a "red mark," his window frames as a "series of lines." Another was shown a cross. She was able to identify the length, breadth, and even the shape. But she could not give the object the name "cross"-it did not have that meaning to her-even though she had traced the shape across her torso daily in religious ritual. It looked as if the philosophers had been right: Visual experience was necessary in order to truly see.
But where was one to get such experience? It turns out that the visual experience needed by the newly sighted person is not the kind he simply can accumulate after surgery. The experience he needs is the kind compiled and assembled in early childhood, while the brain is still fantastically plastic and capable of assimilating massive amounts of information. Young children process trillions of visual and other sensory experiences in their earliest years to form a meaningful and predictive picture of the world. Newly sighted adults cannot do this. Their brains, like the brains of all adults, are much less flexible. That's why adults find it so much harder to learn a foreign language than young children do. The newly sighted person cannot hope to amass and incorporate even a fraction of the experience of a small child. Yet without that experience, his world cannot help but look like an abstract painting, a colorful collection of flat and meaningless shapes.
Lacking the power of experience, the newly sighted person takes in the universe in ways the rest of us can't imagine. When he opens his eyes, he is bombarded by information, most of it too abundant and complex to process. Even if he manages to keep up, he cannot readily distinguish important information from the trivial. Nor can he perceive how parts fit together to form a whole. Objects seem to run together. "Three days after surgery," writes neurologist Oliver Sacks in his classic study, Virgil and his wife "had gone to an IGA, and Virgil had seen shelves, fruit, cans, people, aisles, carts-so much that he got scared. He needed to get out of the store and close his eyes for a bit."
The ability to read facial expressions and detect gender-hugely important human traits that begin developing in infancy-is severely impaired in the newly sighted, a potentially devastating blow. "I cannot say whether a person is beautiful or ugly, nor what expressions he has," one patient said in Sight Restoration After Long-term Blindness, a monograph published by the American Foundation for the Blind in 1971. Others dreamed of people without faces.
Such were the physical and experiential problems associated with new sight. They might have been the least of the patients' worries. There was a world of psychological issues looming, any one of which seemed enough to undo a person.
The very prospect of learning to use new vision could be overwhelming. "This is too long and unhappy a road, leading one into a strange world," a patient said. Others felt dislodged from their previously comfortable existence. "How comes it that I now find myself less happy than before?" asked another patient. "Oh, I was much more at ease in my blindness!"
A patient might begin to feel as though he belonged neither to the sighted world nor the blind world. Or he might buckle under expectations from his family or society, who had expected him to see as the sighted do. Some expected hallelujahs and new lives. Their letdowns crashed heavy.
Some patients lost confidence. Once able to move assuredly about the world, they now saw danger in speeding automobiles and swooping birds. Others seemed shaken by how different objects seemed than they had presumed them to be. Vision also delivered ugly images. One man was distressed by the sight of another blind man walking in the street. Professor Richard Gregory told how his subject, S.B., had become disturbed by the sight of chipped paint. While blind, he had conceived the world as perfect, as a sort of heaven. The sight of imperfection in the form of chipped paint shattered that conception for him.
The final tally was devastating: Patients who had their sight restored after years of blindness suffered from depression, most often severe. The crisis might express itself in weeping spells, anger, irritability, even a clawing at the eyes. Some patients resisted further progress. Others refused to use their vision. In Gregory's celebrated case, S.B. simply withered and died.
The case histories go on and on, and the more you read, the better you understand how it must be so, how human nature cannot help but buckle under the weight of new vision, a gift nothing like what anyone could imagine it to be.
And yet when you look deeper into the lives of those patients, especially in Sacks's and Gregory's detailed accounts, you notice that none of these patients lived to leap forward, none of them hunted experience, none of them seemed the type to open the throttle of a Honda 90 on the straightaway of his high school running track.
None of them heard the rumbling.
Near the end of Macondray Lane, May turns and takes a last look at the path he has traversed. "I think people walk by this place every day and don't know it's here," he says. Then he makes his way to a twisting set of wooden stairs, walks down, and emerges at Taylor Street. He unfolds his red-tipped cane, plugs in his company's talking-and-braille GPS unit, and programs the machine to guide him to Dr. Goodman's office.
"We've got one more big climb," he says. "But we'll make it."
In November 1999, May entered the hospital for the first of the surgeries. Goodman scraped off the bulk of the scar tissue and transplanted a doughnut of stem cells into May's eye. Goodman sent May home to allow the cells to take. He got sick from the anti- rejection drugs. There was no visual benefit.
Four months later, Ori Jean arrived at Mike's house to care for his two sons. May and Jennifer were due at Dr. Goodman's office the next morning for the second surgery, the one for sight. The corneal transplant was routine. Goodman placed bandages over May's eye and told him to come back the next morning for a quick exam. May figured it would be weeks before the bandages finally came off.
The next day, Goodman sat May in an examining chair and pulled off the bandages. He held open May's eye. Torrents of light rushed in and the world lit up, shiny objects whooshed against a dark wall, and a person-a person!-with arms and legs and a white coat stepped aside, it was all pouring in, the person stepped aside and there were flashes, everything was everywhere, and it was all light and colors, every color, and May saw Jennifer, and he knew it was her, and he looked at her hair because he knew she was blond, and he finally put together his thought, everything was still rushing in, and his thought was this, his thought was, Okay, that's blond.
"Holy smoke," May said.
"Can you see a little bit?" Goodman asked.
"I sure can," May said.
Goodman brought Jennifer to May's chair.
"Hi, sweetie," she said, her voice trembling. "Uh-oh, you're making a funny face!"
May looked into Jennifer's eyes. He reached for her shoulders and found them perfectly. He pulled her toward him.
"Come, baby!" May said. He kissed her.
May stared at Jennifer's face. He could see her cheeks bunched up, and he knew that bunched-up cheeks meant a smile. He saw her nose but needed to touch it to understand how it looked. He stared longer. She was definitely smiling.
May asked Dr. Goodman about a shiny object across the room. Goodman told him that it was a mirror. May stood up and walked gingerly across the room to the mirror. For the first time in forty-three years, he saw himself.
"Oh, what an ugly cuss," he joked.
"What do you see?" asked Jennifer. "Do you see your beard?"
"I can see my cheeks raising up and my beard, dark shirt..."
"That's navy blue."
May looked longer. The sight of his beard felt strange to him, this dark splotch on a light-colored face. And he thought, That guy looks tall.
May looked at everything in the office, and everything was fascinating. Light and information kept blasting in, and he wanted to keep up with it all, to catalog this incredible parade. When Goodman finally sent him on his way, he could not take a step down the hallway without asking Jennifer, "What's this? What's that?" He touched everything. Is that a step? Is that a flower? That's a painting? Let me feel it. Can I touch that plant? Let me touch a car. That's a red zone on the street. I can see the red."
Driving home, the world rushed in. He saw a tree that Jennifer told him was, in fact, a cement divider. He saw exit signs and recognized letters but could not read the words. He saw the water below a bridge and that the water was moving. He told Jennifer, "I'm thrilled. It's endless. This is thrilling."
An hour later, Jennifer pulled the car into their driveway in Davis. May's two boys, eight-year-old Carson and six-year-old Wyndham, were in the backyard playing. They ran into the house, said, "Hi, Dad," and scrambled upstairs to play in their rooms.
"Wait, I can see now!" May called after them.
The boys kept going, and May loved that-it was no big deal to them. He asked them to bring him their homework and drawings. He wanted to see the blues of their eyes. He'd always heard that they were different blues, one deep and the other pale, and he wanted to see what this blue was all about. The boys ran downstairs and climbed into May's lap. He saw both blues. He asked Carson, "Where's that missing tooth?" Carson opened his mouth, and there was the black space next to a bunch of white teeth. Carson showed him a spider. Wyndham showed him a ceramic dish he'd made. They showed him a picture book of animals and asked him to guess which ones were which. May got the camel right, but the rest he didn't know. He'd call a dog a horse, which made the boys laugh hard and May laugh harder.
Ori Jean took in the whole scene. May had not seen his mother since he was three years old. He stood and moved toward her. He looked into her eyes and took his hands and felt her face. He didn't say much of anything. He just kept looking and touching and looking and touching.
May's older sister showed up later. On the way to his house, she'd purchased a rubber nose and glasses and a crazy wig. May opened the door and felt his sister's face.
"You haven't changed a bit," he said.
Anatomically, May's eye was near perfect. His vision was about 20/80. He could see buildings from hundreds of yards away but also the grain in a piece of wood and the wisps of hair on Jennifer's arm. His ability to see detail from any kind of distance was weak, though his vision was not blurry. Like the patients in the case histories, he could distinguish color and detect motion excellently but struggled to perceive space and to see height, distance, depth, and three-dimensional shapes. To May, the moon looked like a big streetlamp. He made very little of faces or facial expressions. Why did faces look so spastic when people spoke? And faces told him nothing about a person's gender. Information rushed in, much of it too complex and too fast to process. All of it fascinated him. All of it felt like an adventure.
He seized on the practical advantages immediately. At a business conference just two weeks after surgery, he stood in line at the hotel without his cane and marveled at the power of knowing when to move forward without asking. He rode elevators for the pleasure of finding the lobby after the ride. In conversation, faces flapped and eyelashes flickered so distractingly that he had to close his eyes to concentrate. A woman's low-cut top proved especially interesting.
A few days later, Wyndham asked him to play catch in the backyard. The conditions were excellent: sunny day, green grass, white-and-black soccer ball. Wyndham kicked the ball, and May could see it rising off the grass and moving toward his right, and he found himself moving to the right, too, and he got near the ball before it skidded by him. He missed a few more. Wyndham kicked another ball, this one to the left by ten feet. May ran and jumped into the air, reaching his hands above his head. The ball hit his fingertips, and he pushed his hands together, pushed them as hard as he could, and the ball stuck there, and it kept sticking even after May hit the ground. "Nice catch, Dad," Wyndham said. By the end of the day, May had caught twenty balls. That night, he told Jennifer he felt like a kid again but that the best part was that he and Wyndham had played exactly as they'd played since the day Wyndham had been born.
May wanted to touch everything. Even when he could clearly perceive and identify an object, he felt as though he couldn't truly see it until he touched it. Molyneux, Locke, and Berkeley had been right: May could not distinguish a sphere from a cube by sight alone. After he touched it, then he could see it.
He continued to struggle to see things in three dimensions, and his world stayed much like an abstract painting, a huge collection of colorful, flattened shapes that didn't always make sense. Information flooded his head, a never-ending flow that he could sometimes stem only by closing his eyes. High-speed events, such as the passing of cars and bicycles, became frightening; his brain simply didn't have time to interpret the information. Things often looked very close, scary close. Previous patients had been undone by these kinds of threats. May told himself that this was part of the adventure, that the leap forward wasn't really a leap at all if everything felt safe. He began to contemplate skiing without his guide.
Every day seemed like a new adventure. Once, while walking to get a haircut, May smashed into a gray concrete bench that he couldn't distinguish from the gray sidewalk-depth again. The collision tore the skin on his leg and face. At the salon, for the first time in his life, he saw his own blood, a brilliant red swirl in a stylist's sink. On another occasion, while flying on business, he told the woman seated next to him about his surgery. She asked if he could identify her eye color. She leaned in very close. May had never before looked closely into a stranger's eyes. He was overwhelmed with emotion and couldn't speak. That day in his journal he wrote, "I understand a bit better now why so much is made of expressions in the eyes as it is talked about and written about passionately and poetically."
May attended a Santana concert and marveled at how much movement came from the musicians and how closely that movement matched both the sound and the feeling of the music. He watched his first fireworks show, standing down terrible memories of the explosion that had taken his sight at age three. He videotaped Wyndham's Little League baseball games. He gawked at women, sometimes with Jennifer's helpful play-by-play; it might take him five full seconds to identify a halter top, but it was worth it.
Most gratifying, however, was that he seemed to be living life just as he had before the surgery. He ran his business with the same single-minded focus. He traveled to conferences, brainstormed improvements, wrote grant proposals. He still laughed with Jennifer at the same parts in movies, took her to the same restaurants, argued about the same little things. He coached soccer, cooked dinners, and learned to sort laundry. He stayed frustrated that she was disorganized. She stayed frustrated that he couldn't drive. People were astonished, even horrified, to learn that May had not made a list of things to see, despite the fact that he might lose his vision at any moment and without warning. "You literally haven't seen the stars?" people would ask. Too busy, May told them. "You haven't made safari plans?" I've got homework to help with, May said. It would have made no sense for May to tell these people that the best thing was that while vision was fantastically interesting, it hadn't really changed his life.
About six months after his surgeries, May came to the attention of vision scientists, who asked to test him in a laboratory setting. He agreed, expecting it to be interesting. He didn't know the half of it.
Ione Fine and Alex Wade slid May into a functional-magnetic-resonance-imaging scanner, a technology used to measure brain activity. When asked to distinguish colors, detect motion, or identify two-dimensional shapes, the parts of May's brain responsible for processing that information lit up like a pinball machine. But when asked to perceive an object in three dimensions from different angles, distinguish faces from other objects, or identify common objects, the parts of his brain responsible for those bits stayed dark; there simply was no activity. May's eyesight was fine. It was parts of his brain that were no longer working.
Why these parts? The question fascinated Fine and Wade. They spent months with May in the lab. They came to this answer: The areas of the brain responsible for processing color and motion and for identifying two-dimensional shapes are more primitive, more hardwired into human evolution. They are formed very early and can survive nonuse. The parts of the brain responsible for spatial perception, judging faces, determining gender, and identifying common objects in three dimensions, however, reside in more plastic areas that cannot survive years of darkness.
That made sense to the scientists. Human beings don't encounter new colors or new motion as they go through life. Green is always green. Motion is always distance over time, regardless of our experience of the world. This is the kind of thing the brain seems to take care of earliest, before experience is an issue to humans. But perception of three-dimensional space, facial expressions, and common objects-these rely on a very sophisticated knowledge of the grammar of the world, on tiny clues highly dependent on context and experience. Knowing whether someone is happy based on a one-millimeter shift in her upper lip or that the slight difference in shading on an object means that it is thicker than a virtually identical object is not instinctive; it is learned. Without the nourishment of such learning, the parts of the brain responsible for those processes go dark. And, Fine and Wade told May, they were likely never to come back.
That meant May would have to use cumbersome work-arounds to see much of what sighted people see automatically. He would have to build a database of clues-earrings, long hair, plucked eyebrows-to help determine gender by face. He would have to employ usable context-an orange, round blob on a basketball court is most likely a basketball-to identify simple objects. He would have to spend time thinking about whether a skyscraper was a big thing far away or a little thing close up. All of it would require massive cognitive effort, the prospect of which had been enough to threaten the emotional well-being of May's predecessors.
"He put huge amounts of work into all this," Fine says. "We could see him laboring. We knew about all the depression in the case histories. We kept asking him, 'How are you feeling? Are you okay?' And Mike would look up with that smile of his and say, 'I'm fine. What's the problem?' And he just kept working."
May continued his adventure, even as his life unfolded much as it had before the surgery. He experimented with binoculars, which brought vistas rushing closer. He soloed on Jennifer's bicycle for a half mile after Carson assured him he would call 911 if May got hit by a car or flipped over a pile of leaves. During a camping trip, his sons talked about the stars. After he put them to bed, he took his binoculars out to a field, lay on his back, and finally looked to the sky. The sight was wondrous, but the part that really moved May was that it was his sons who had inspired him to look. The blind community embraced him. And in 2001, Sendero Group received a $2.25 million grant, an event May told people was among the most important in his life. He had promised his sons to do something dramatic if the grant came through. He let them shave off his beard. They all looked at his strange, smooth face in the mirror for what seemed like a very long time.
May arrives on time at Goodman's office. Near the examining room, a woman with a guide dog asks, "Is that you, Mike?" May stops and says, "Yes, it's me." The woman is there to consult with Goodman about sight-restoration surgery. She asks, in so many words, how May has been handling it.
May takes her hand. He does not promise her the moon. He says nothing of a new life. Instead, he tells her that if she's the kind of person who embraces change, sight can be an incredibly interesting experience.
"But I'm still Mike May," he says.
In the examining room, Goodman and May discuss their kids' Little Leagues and compare opinions on Barry Bonds. Goodman then dims the lights and uses sensitive equipment to look into May's eye.
For minutes, Goodman doesn't say a word. May's expression never changes. Then Goodman steps away and brightens the lights.
"All healthy," Goodman says. "Things are looking nice."
Into the Light,
By Robert Kurson,
June 2005, Volume, 143, Issue 6.
End of article.
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