Part 7 (1/2)

”Yes. He's not propelling himself . . . he's pus.h.i.+ng his center of ma.s.s from side to side, using his legs as leverage.”

Across the street the pedestrian traffic was suddenly heavier-to D levels. A bus stop up ahead might have disgorged its commuters. A tall raincoat hurried a small raincoat along, all but their connected hands hidden under waterproof clothing. I thought about what it was like to be a young person dragged through an adult's days. Walking with my son had already made me less likely to drag him anyplace, and instead to follow his lead (read: we have become experienced sidewalk loiterers).

Perhaps to have true empathy for one's patients, one must know how to become a child, or a middle-aged woman, or a man with spinal stenosis and an anaerobic lung infection.

There is a likely neural explanation for the empathy those pract.i.tioners of medicine like Lorber and Johnson have, and it has just recently been discovered. In the early 1990s, an Italian researcher named Giacomo Rizzolatti and his colleagues were looking at monkey brains. In particular, they were recording, using single-neuron microelectrodes of brain activity of awake and alert macaque monkeys, which neurons in an area of premotor cortex called F5 fired when the monkey reached for a peanut. They were able to find particular neurons that were active for the reaching and nut-grasping. One day, Rizzolatti noticed something unusual. The brainwave recorder was turned on as an experimenter set up the apparatus, placing a nut in front of the monkey. The machine captured evidence of those same neurons firing even as the monkey was sitting still, watching the preliminaries to the trial. The neurons were active just as the experimenter reached for the peanut; the monkey's arm was by his side, unmoved. In other words, the monkey's neurons fired both when doing an act and when seeing it done by others.

This was remarkable: the individual neurons had been implicated in specific behaviors and the neurons fired at two very particular times. Let us reflect again on the scene. Macaque monkeys are beautiful, small-faced creatures with overhanging brows that give them extra expression. On that day, one monkey, forced to sit in a small chamber with his head immobilized and his skull cut open to record from his brain, watched a human in a lab coat come into his room and mess with some peanuts on a platform. The monkey's brain, whatever else was going on, also registered two things: that that person was another individual-and that he was doing just what the monkey himself would soon be doing.

This result has since been replicated and refined, and we now know that these ”mirror neurons”-cells that fire at doing something and seeing it done-are found in various areas of the brain, in humans as well as monkeys. Two such areas are the insula and the amygdala, a part of the limbic system involved in feeling emotion and perceiving emotion in others' faces, tone, and words. These mirror neurons may be part of our ability to match our behavior to others'-and, indeed, to cringe when we see someone twist his ankle and fall in pain; to be infected by a smile or laugh of a friend; or to feel real fear when in a darkened room watching actors play out a contrived horror scene on a film screen. These cells may be part of our ability to learn, as infants, how to toss a ball, tie a shoe, or turn a doork.n.o.b by merely watching someone else do it. And they may be what allows for the empathy that, for most people, comes along with seeing others' behavior and emotions.

Without the benefit of seeing inside their brains, I can make a pretty good guess that Lorber and Johnson's mirror neuron systems are heightened to notice even more aspects of others' physique and movement that map to their own bodies, because of their experience with the variety of ailments typical to their professions. In one research study looking at brain activity of expert dancers, ballerinas were asked to watch ballet dancers perform. Their mirror neuron systems went wild: they could feel all the moves the dancers were enacting. When nondancers watched, their brains showed evidence of mirror neuron activity, but it was much more modest. When capoeiristas, whose dance forms overlap in many ways with ballet, watched the ballet, their mirror neuron systems also fired wildly, though somewhat less than in the ballerinas themselves. Likewise, ballerinas watching capoeira had less activity than the experts in that dance, but both had more than the nondancers. Expertise matters, but it builds on something we all share: a propensity to feel others' movements in our own bodies.

Lorber and I had toured around a long square block and were headed back to the college. Fewer people pa.s.sed by, and for a moment we fell into the silence of those who have finished their dinners and are gazing at their cleaned plates admiringly. Then Lorber brightened.

”Like that?”

”Yes!”

I was pleased. I knew just what he meant: a woman with the Philadelphia Look had pa.s.sed us. Just as he was sharpening my attention, I had tickled his awake. I cannot tell you exactly what Lorber saw, but somehow he extrapolated from a few examples and came to identify an instance of what I was beginning to think was an imaginary category. Those who study facial proportions might tell us that we could map this look. ”Anthropometric” research uses facial landmarks to measure distances and alt.i.tudes and angles, then compares the proportions of one measurement to another. Instead of the eyes, nose, and mouth, there are less obvious markers: the lowest browline point, the bridge and tip-top of the nose, the outer edge of the eye, the place where a jowl would hang if you had jowls, the outer edge of the mouth, the most concave point of the chin, and so forth. Researchers use this to get an average measurement-the ”average” face-and to mark divergence from it in anomalous faces. Perhaps different ”looks” might differ from the average look in similar ways. The typical six-year-old has an eye opening about one third as tall as it is wide, a mandible height half its width. To us he just looks six-but his look can be measured.

As we reached the college, I shook Lorber's hand-strongly, I hoped, though I feared my hand was just cold and clammy. Certainly my thumbnails did not catch his attention . . . or did they? A smile flickered on Lorber's face and he turned and jogged up the steps.

On walking back to my hotel I found that I was looking much more deliberately at pa.s.sersby-as though they were still presenting themselves for inspection. In short order, I found that this encouraged people to look that way back at me (or simply look at my looking). Ack! Had I already forgotten the lesson from my son, staring too hard? I ceded to the rules of human interaction and looked away.

Some of what both Lorber and Johnson had seen was hardly visible to me, but none of it was invisible. While I had a vague sense of Hmm, something's amiss . . . , they could diagnose. It is not only the diagnosis that I valued; it is the way that knowledge orients their looking-an ability to ”see what they see,” as it were. I felt I had looked behind the curtain-and there, instead of a small man pretending to be a great wizard, I found a great wizard, expert at simply using his eyes.

1 Speedwalkers define a much less hilly arc: their acceleration is directed more toward going forward and less toward falling down.

2 According to those who have spent preposterously long periods looking at gaits, the number is actually more than half: each step is divided into 62 percent stance (contact with ground) and only 38 percent swing (no contact with ground).

SENSORY CITY:.

Things That Hum, Smell, or Vibrate

”Look, with all your eyes, look!”

(Jules Verne).

Seeing; Not Seeing.

”A breeze lured me from down the street and I reflexively pursued it.”

Begin taking a series of walks around the block and, if ironic twists tend to befall you, soon enough you may find yourself unable to walk. This was what happened to this walker. A few weeks after herniating the disk in my back, I found that I could not push myself forward with my left leg. That is how it felt: I could use my leg at all, but I was not using it at all well.

My sciatic nerve was not on speaking terms with my left foot. I was frustrated that I could not run (a minor obsession) or pick up my son (a necessity), but I was alarmed to have a temporary disability: I could not walk normally. I was lucky: I could still walk, in an ”ish” sort of way. Walking was an awkward, slow affair. Even after I had back surgery, I was still not walking well: my foot was paralyzed and I was forced to swing my leg around to the side instead of propelling it forward.

The street changed for me during those months, as it certainly changes for anyone who is temporarily or permanently injured, or suffers the ultimate injury of simply aging. I had no balance on my left side, so to maneuver I had to plant my right foot. This meant that small adjustments-stepping back to make room for someone on an elevator; moving slightly to the side to let someone pa.s.s on a narrowed sidewalk-were impossible for me to do quickly, and even with time were laborious and graceless.

I became aware of the little movements that we do naturally when we see people approaching us on a path. I had learned from Fred Kent (and Whyte by implication) about the pedestrian sidewalk dance. Though interaction with your fellow pedestrians feels as though it begins when they come within handshake distance, you are each adjusting your path and stride to the other well before that. In theory. Now I saw it in practice. Without the nerves relaying messages to the muscles to make that adjustment, a walker becomes a blundering target. I made more personal, tactile contact with people in those months than I had over the decade of my urban residency.

I was very much in the throes of this handicap when I met Arlene Gordon. The day was still with heat. Along the sidewalks, air conditioners gurgled and thrummed with an unseen number of chilled apartment dwellers sealed away behind their windows. Park benches sat lonely. I could almost hear the ”gra.s.s grow and the squirrel's heart beat.”

I turned a corner onto a broad street unshaded from the sun. A generator was sputtering nearby; a siren dopplered across the horizon, the toenails of a small dog being dragged out for his const.i.tutional sc.r.a.ped the concrete, other sounds melted into the air. Hoses snaked the sidewalk and emptied themselves into tree pits smelling of moist dirt. At the third building on the left side of the street, inset more deeply than its neighbors, I approached the doors. They sighed open for me. I pa.s.sed through the marble-floored lobby, pulled myself up a few stairs, weaved over to the elevators, fingered their engraved b.u.t.tons, entered, and emerged after six beeps. On that, the seventh floor, I turned left and heard someone call my name: ”Alexandra?”

Gordon stood in the doorway across the hall. Tall, smiling, with perfectly white well-coiffed hair, she held the door open with one hand and held out the other. Her fingers were directed slightly to my left, but as I greeted her, she looked me straight in the eyes. Highlighted by her shocking blue s.h.i.+rt, Gordon's eyes shone an iridescent blue-green. She led me into a compact, tidy apartment. The blinds were drawn and there was a low light on. A bookcase held a television, neat lines of hardbacks, and shelves and shelves of treasured objects: delicate porcelain boxes; figurative objects; tiny stone sculptures of seals, elephants, birds.

As I moved to examine these tchotchkes, Gordon spoke up: ”Pick up anything; I'll tell you about the trip.”

I placed one of the objects in her palms. She grasped it gently, gazing down at her hands. Her fingers quickly worked over its surface. As she dislodged a lid she said, ”Oh, this is one of my little boxes. Let's see what this is . . . this has a picture on the cover . . . flowers . . . I'm sure I got this in China. I've been to China twice-actually three times if you count Hong Kong.”

Over the last forty or so years Gordon has traveled the world, often with friends. She once took a three-week cruise up the North Atlantic, around Iceland and Greenland. On each trip, she gathered mementos, these souvenirs, which she calls her ”pictures.” On this summer's day, she had just returned from a visit to Storm King, an open-air art museum north of the city whose large-scale sculptures and site-specific pieces are scattered across a few hundred acres of manicured landscape.

”Storm King!” she smiled to tell the story. ”I was absolutely flabbergasted when I got there because I was there many years ago. And nothing fit my memory of it.”

This flabbergastery, her many trips, and the souvenirs there-from might seem unremarkable were it not for the fact that for the last forty-two years Gordon has been blind.

Her memory of Storm King was a creative one-not concocted, but also not experienced entirely through her own senses. It was formed partially from the descriptions provided by her companions. Gordon experiences most trips through those she travels with. She prompts them to describe what they see, and not just the spectacles but also the ordinary details of every eyeful come alive for them both.

”I've traveled with friends all these years,” she offered. ”Each one has said how much more they see because they're walking with me.”

Her memory of Storm King was also the memory formed by experiencing the world with all her nonvisual senses. She might have captured the smell of the air, the way sound bounces off lawn and metal and into open sky, the scale of the s.p.a.ce as felt by the amount of time spent traveling from one artwork to another.

I grappled with this while sitting in her cool, dusky apartment, Gordon three feet away, bolt upright and facing me. When speaking, her eyes seemed to find mine, then traveled someplace up and to her left, just as they might in a seeing person. Indeed, she was the model of conversational eye contact.1 When listening, she stared calmly in my direction, her eyes locked onto mine. We chatted about her family and she pointed to a s.p.a.ce over my left shoulder, roughly to the wall behind a wide couch. Following her point, I saw what she cannot herself see: two photographs that she nonetheless described perfectly. Her son, now grown, took them, ten minutes apart. They showed a natural jetty in the north Atlantic covered by waves and then bared as the tide receded. Light played on the water in just the way that Gordon said it did.

I had come to meet and walk with Gordon exactly because she is blind. After a handful of city walks I realized that what many of them were missing was any experience other than a visual experience. This was not terribly surprising. After all, humans are visual creatures. Our eyes have prime positioning on our faces. We have trichromatic vision, which is sufficient to paint a Technicolor, million-colored landscape of the world. Our brains' visual areas, with hundreds of millions of neurons designed to make sense of what we see, takes up a full fifth of each of our cortices. The resplendent scene our eyes carry to us is entrancing. As a result, we humans generally do not bother paying attention to much other than the visual. What we wear, where we live, where we visit, even whom we love is based in large part on appearance-visual appearance.

But the world around us is not entirely or even mostly defined by its light-reflective qualities. What of the odors of the molecules making up every object, and those loosened odors wafting in the s.p.a.ce around us? Or the perturbations of air that we can hear as sound-and the frequencies higher or lower than we can hear? I imagined that someone who has lost her sense of sight could lead me, however superficially, into the invisible block that I miss with my wide open eyes.

The notion that the blind might use their other senses better than the sighted is not fanciful conjecture. Born of necessity, and supported by a nervous system that is much more adaptable than scientists thought even a few decades ago, the blind simply use their other senses to see. Often, people blind from birth get around so smoothly in a seeing world that it is hard to tell from their movement that they cannot see where they are going.

Gordon went blind half a lifetime ago, when she was in her forties, after years of deteriorating vision and unsuccessful surgical interventions. At the time, coincidentally, she was working in the city at a facility that helps the visually impaired manage and negotiate the world. As a social worker and advocate for her blind clients, she knew about and had access to the best technologies for aiding herself. But going blind in adulthood is a slightly different prospect than hereditary or early-childhood blindness. In all groups whose blindness is due to problems in the eyes, the visual cortex remains intact: ready to interpret what we see, but suddenly getting no visitors, no information from the optic nerve. Waiting for the flood through a door that never opens, it eventually starts to get some noise from the side doors: the other sensory organs, or even other cortical areas. Rather than turn off, the area becomes busier than ever.

The result is striking. Though blindness is hardly trivial, the brain of a baby born without the ability to see can undergo significant reorganization, enabling the developing child to depend on other cues to entirely replace vision. Scientists first learned this, as well as most of our knowledge about our brains, not from examining our own brains, but from peering at monkey brains. The monkeys did not submit to this voluntarily, of course: the content of the words you are about to read come from the poignant sacrifice of enough monkeys to type that Shakespearean play after all. A monkey's brain is similar enough to ours that scientists find it informative about human brains, but different enough that the same scientists are willing to sacrifice a monkey life for that bit of information.

The similarities are many. First, our brains are shaped much the same: each resembles an overstuffed dumpling, a generous half-sphere with an extra dollop (the cerebellum, which controls movement, and thus is a crucially important dollop) on the back. In the early twentieth century a German neurologist named Brodmann made a map of the primate cortex, the outer layer of the brain, identifying dozens of distinctive areas whose cells essentially do different things. There are visual areas; smelling areas; hearing areas; areas that register when you are being tickled in your belly; areas that coordinate your reaching for a cup. What Brodmann effectively demonstrated with this mapping was that the brain does not serve as a general-purpose depository for sensation: when our eyes spy the horizontal line of a knife blade held over our thumb, that event registers in one specific area of the brain; the pain we feel when the blade slices into our thumb involves another area. What was stunning about Brodmann's work, and the reason that the areas of the brain he identified still carry his name, is that he was able to create a map showing the shape and approximate location of each area in every brain. The ”visual area” of your brain is going to match up, more or less, to mine (the ”more or less” is important, too, of course, in making you you and me me). Were we skilled at such things, and if neurons regenerated like succulent roots (which they do not), we could each lop off this portion of our brains and we could swap. It appears that the role of the cells of the brain are designated in the genome. All else being equal, twins are born with the same brain.2 Later, as their lives unfold and their experiences diverge somewhat, their brains develop differently-as, indeed, does every brain. But no one's brain reorganizes itself so much that it is not recognizable with Brodmann's map.