Retinal scan image courtesy of Teju Cole.
One night in April 2011, I stayed up late, reading the final pages of Virginia Woolf’s diaries. Those pages, written in late 1940 and early 1941, were about the loss of her London home in the war, her terrible nervousness about the ongoing air raids, the unexpected death of Joyce, her love for Leonard, her engagement with literature and, above all, her losing battle against depression. But the pages held a radiance too, because of Woolf’s prose, the intensity of her attention to life, and the epiphanic moments that intermittently illuminated the gloom. I went to sleep in the glare of her words. It was late, around three. I slept dreamlessly. When I woke up, there was a grey veil right across the visual field of my left eye. The blindness wasn’t total – I could see around the lace-like edges of the obstruction – and there was no pain. At the bathroom sink, splashing cold water into the eye, I wondered if this was simply my subconscious at work. Was I like those highly suggestible people who, out of sympathy with something written, drift into an area of darkness?
I have always had weak eyes. From the age of eleven I wore glasses for myopia, and over the years the prescriptions got stronger. My brothers and my mother are severely myopic, as was my grandfather. Was I like those highly suggestible people who, out of sympathy with something written, drift into an area of darkness? Glasses, inconvenient as they are, are also an occasion for gratitude at not having to live life in an impressionistic blur. But blindness was another matter. Blindness happened in literature and films, it happened to blues musicians, to mythical figures, to those unfortunates one encounters on the streets of Lagos or on the subways of New York. I leaned over the sink and splashed cold water into my eye once again. But the gray veil remained, and try as I might, I saw almost nothing out of my left eye.
I felt concern, not panic. Why should I suddenly lose my vision, without warning and with no apparent cause, one fine morning in my mid-thirties? There was nothing to worry about. At the beautiful and remote writers’ residency where I was staying in upstate New York, with several other people, I went down to the communal kitchen and told them what was happening. Quickly, a car was organized to take me down to hospital in the small town of Hudson, some twenty minutes away. If it is a detached retina, one of them said, which is what it looks like, you should have it looked at right away. It can be fixed, but only if it’s done quickly. And when I heard those words, which were meant to be reassuring, I worried.
After my colleague dropped me off at Columbia Memorial Hospital, I did my insurance paperwork and was asked to wait on a bed in an emergency triage area. From the other side of the screen, I heard a family discussing the kidney problems of the man on the bed. They spoke in troubled tones, and I could hear that the man, whom I couldn’t see, was in some pain. At length, a doctor arrived and examined me. He asked a few questions and, puzzled, wrote me a referral to a private ophthalmologist nearby. And so I picked my way gingerly down to the Union Street address he had given me, about four blocks away.
It was a bright day, hot for April. The ophthalmology practice was set back from the street, a low brown building at the end of a tarred lot. There, too, the first order of business was about my insurance bona fides – the sense of relief at having insurance, or the distress at not having it, is part of any medical procedure in the US – and then I sat in the ophthalmologist’s chair in a darkened room, and she leaned over me in that solicitous way that medical practitioners share with barbers and flight attendants, and that I have always liked. She tested my vision on the alphabet charts, irrelevantly, I thought, since I wasn’t there to have new glasses made, and then, dilating both pupils with mydriatic drops, examined each eye with a powerful lamp. She looked closely. In the vision-cancelling intensity of the lamp, my grey veil became a thick red cloud of pure vision, and I imagined I could see my own optic nerve. The doctor asked questions. Had I had the problem before? Had I carried anything heavy lately? No, not that I could think of. I did not mention Mrs Woolf’s diaries. I can tell you it isn’t a detached retina, the doctor said. You’d better see a specialist, in Albany or in New York City.
As I stepped out of the office, I made an appointment at the New York Eye and Ear Infirmary for that evening. It was mid-afternoon, a Thursday. I had begun to feel the curiously woolly effect of dilation on my eyes. Darkness encroached by degrees and in the afternoon sun, I could hardly see out of my right eye, and not at all out of the left. I had become almost completely blind. I began to walk down Union Street in the direction of the train station, glaring and squinting, trying, and mostly failing, to see what was ahead of me.
Hudson is old and elegant, settled by the Dutch in the seventeenth century, and retaining much of its nineteenth century built environment. One uncertain step at a time I began the walk past the old houses, to the station which was a little more than a mile away. Is this real? Am I stumbling alone and almost blind down a quiet street in an unfamiliar town? The sun was as strong as a hallucination. The houses were brightly painted, crisp against the sky, making of the whole street a collage, foggy in parts, clear in others, grainy in the distance, so that all of a sudden, I was no longer in the present at all but back in the era of the earliest photographs.
I heard faint noises, the occasional car going down another street, a voice lightly thrown from its unseen body, the hum of distant machines, and the sound of my own breathing as I put one foot in. As I handed the menu back to the waitress, explaining to her that my pupils were dilated, I was ambushed by a sudden shame: that she would think me illiterate and a liar. front of another. My body made its way down the bright street, mystified and almost inadvertent. The journey took a long time, twice as long as it should have taken, and I was afraid I’d get knocked down at one of the intersections. Each house looked much the same as the next, polygonal, almost flat, neither more nor less substantial than the sky above, each successive block glowing like the built landscape in the very first street photograph, the view from Niépce’s country house in Le Gras in 1826. The view seemed on the perpetual verge of vanishing. I myself felt like a cut-out: diminished and simplified because the sense of sight on which I was so dependent flickered with each step.
At long last I reached Front Street. As I had eaten nothing all day, I went into a diner. It wasn’t particularly full but I sat at the counter because it was near the door, and I was given a menu that I couldn’t read. I blinked and squinted, but the words refused to resolve in the meaningless hieroglyphics of my right eye and in the total darkness of the left. As I handed the menu back to the waitress, explaining to her that my pupils were dilated, I was ambushed by a sudden shame: that she would think me illiterate and a liar. The thought, foolish as it was, caught me by surprise. At the far end of the counter was a party of four, all young, two blonde women and two men, also fair-haired. Their laughter tinkled around the diner, then ceased, and they went back to talking in hushed tones. I distinctly heard one of the women say: Disfarmer. But I could make out nothing else of the conversation. I was afraid.
When we write fiction, we write within what we know. But we also write in the hope that what we have written will somehow outdistance us. We hope, through the spooky art of writing, to trick ourselves into divulging truths that we do not know we know. My novel Open City, published two months before my eye troubles began, is in part an examination of the limits of sensitivity and of knowledge. One passage, narrated by Julius, the young psychiatrist at the centre of the story, reads as follows:
Ophthalmic science describes an area at the back of the bulb of the eye, the optic disk, where the million or so ganglia of the optic nerve exit the eye. It is precisely there, where too many of the neurons associated with vision are clustered, that the vision goes dead. For so long, I recall explaining to my friend that day, I have felt that most of the work of psychiatrists in particular, and mental health professionals in general, was a blind spot so broad that it had taken over most of the eye. What we knew, I said to him, was so much less than what remained in darkness, and in this great limitation lay the appeal and frustration of the profession.
I arrived in Manhattan that evening. My pupils had gone back to normal size, and I could see out of my right eye again. The left remained obscure. That night was the first of more than half a dozen visits to the New York Eye and Ear Infirmary. Not until the following Monday, after several exams by several doctors, after contrast scans and high-resolution photographs of my retinas, I heard faint noises, the occasional car going down another street, a voice lightly thrown from its unseen body, the hum of distant machines, and the sound of my own breathing as I put one foot in front of another. in which they billowed like mysterious red planets, after sitting in waiting rooms with the sad, quiet blind, many of whom were elderly, after overhearing those who had been told that nothing further could be done for them, only after this unguided tour of misery did I receive a diagnosis. By then the grey veil had retreated and my eyesight had come back. The scans had been alarming: my left retina was strewn with exploded blood vessels, which showed up in the photographs as wiry black tangles against the red field. Where those vessels had bled over the retina, the vision was obscured. That accounted for the field of grey: I had been trying to look through a hemorrhage. You have papillophlebitis, said Dr L, who had a thick Russian accent and a laconic manner. He was friendly, and a little impatient, as all specialists are. It is idiopathic, he said, so I can’t tell you what caused it. It just happens, it begins on its own, something occludes your retinal veins. It’s also called Big Blind Spot Syndrome. It’s a young man’s disease and as far as we can tell, it has nothing to do with diet, or genetics, or anything we can trace. But don’t worry, it probably won’t happen again. We’ll just cauterize some of these damaged vessels with a laser. Simple procedure. Big Blind Spot is benign. He smiled, like a matador who’d just wrestled down a calf, like a man who hadn’t gotten quite the challenge he’d hoped.
On my next visit, Dr L did the laser surgery, and I returned to normal life, to regular myopia. But of course Big Blind Spot did happen again. That insurgent area of darkness took over my eye, and I returned to the hospital later in the year, and again it cleared up. And I expect will happen again, and again, until it is supplanted by something worse, as it was written. ?