The River of Consciousness and Oliver Sacks


It was torture.  I knew that the posthumous collection of ten previously published essays by Oliver Sacks was due to be released in the United States on Monday, October 24.  But the local B & N in Scottsdale showed on their computer that the book had already arrived in the store last Friday, so I made a beeline down the 101 for the Desert Ridge Marketplace only to find that the Sacks books hadn’t been  unpacked yet.  I offered to go into the storage room and help, but they do have their regulations and politely advised that I’d have to wait until Monday.

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I picked up my copy on Monday and savored it during morning coffee this week at Starbucks.  Each essay invites one to meander through; one needs the right time and the proper frame of mind to plumb the depths of the waters into which Dr. Sacks wades.  I thumbed directly to the signature essay from which the book draws its title, originally published in the NY Review of Books in January, 2004.

NY Review of Books Cover Page

There is a considerable amount of space devoted toward vision in this essay, and it factors significantly into an understanding of what goes wrong when the visual process is disrupted.  Being as gifted a synthesizer as he was, this is not surprising given the wide range of books that Dr. Sacks reviewed while piecing together his insights.  They were listed as a table of ingredients in the original article in the NY Review, and each one is a gem that stands on its own merits:

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I used this essay as a driving force for a chapter I co-authored with Dr. Bob Sanet on Spatial Vision in the classic book on Vision Rehabilitation co-edited by Drs. Peneolpe Suter and Lisa Harvey.  In re-reading The River, Sacks’s words are as scintillating as ever:

“But I could not help wondering then whether visual perception might in a very real way be analogous to cinematography, taking in the visual environment in brief, instantaneous static frames for “stills” and then, under normal conditions, fusing these to give visual awareness its usual movement and continuity … but this is not enough.  We do not merely calculate movement as a robot might; we perceive it.  We perceive motion, just as we perceive color or depth, as a unique qualitative experience that is vital to our visual awareness and consciousness.  Something beyond our understanding occurs in the genesis of qualia, the transformation of an objective cerebral computation to a subjective experience … Vision, in ordinary circumstances, is seamless and gives no indication of the underlying processes on which it depends,  It has to be decomposed experimentally or in neurological disorders, to show the elements that compete it.”

This became such a powerful metaphor, the notion of neural insult fragmenting an otherwise coherent visual stream into scattered pieces, system components, or discontinuities.  And that our principal role in neuro-optometric rehabilitation is to guide the patient on re-assembling those fragmented pieces into a coherent and seamless visual narrative.

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