Book Report
The
Island of the Colorblind
Oliver Sacks, Vintage Books, New York, 1998, 311 pgs.
Review by: Dr Al Parmet
What do you do after you’ve been portrayed by Robin Williams in the movies? Neurologist Oliver Sacks just keeps on writing. His stories have gone beyond his case reports of "Awakenings" and "The Man Who Mistook his Wife for a Hat" into investigating individuals with neurologic disorders that change their perceptions of life. In "An Anthropologist on Mars" he introduced the reader to an autistic PhD and a pilot/general surgeon with Tourette’s syndrome.Now Sacks has gone to the far Pacific to investigate two populations of people. In the first, the title group are congenital achromatopes. Descended from the survivor of a 1775 typhoon that wiped out 90% of the population, the tiny atoll of Pingelap in Micronesia now has the largest percentage of truly colorblind people in the world. We are not talking about the protans, deutans or tritanopes we encounter daily. They lack one of the three kinds of cone color sensors in their retinas. Achromatopes lack cones completely-they have only rods. Therefore their best vision is 20/200 and they are blinded by the intensity of daylight. At night they have certain advantages, sensing motion better than those with normal vision. How their society accepts them and adapts them is in part the quiet observations of Sacks and the others who accompany him.
The second investigation is to the "Island of Cycads". On Guam there is a neurodegenerative disease called lytigo-botig. Most neurologic texts will relate that this illness is due to eating cycad nuts which contain neurotoxins. The illness presents much like amyotrophic lateral sclerosis. However the specific findings tend to be limited to native Chamorros. Lytigo-botig has some special characteristics in its two forms. One is a parkinsonian like syndrome very similar to the post-encephalitis parkinsonism that Sacks himself became famous for in his first book, "Awakenings". Hence the invitation to Guam. Sacks takes us along for the ride, meeting local communities where the disease is prevalent and noting that in others it is nearly absent. The science of the work is in the footnotes, which comprise the last third of the book. The first two thirds are the travelogue and gentle insights of living with such diseases. Sacks entertains and enlightens. Truly a pair of pleasant stories of a wandering neurologist in search of humanity.
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