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Shots - Health News
Mon May 26, 2014
The Blind Woman Who Sees Rain, But Not Her Daughter's Smile
Originally published on Wed May 28, 2014 8:37 am
Imagine a world that is completely black. You can't see a thing — unless something happens to move. You can see the rain falling from the sky, the steam coming from your coffee cup, a car passing by on the street.
This was the world that Milena Channing claimed to see, back in 2000, shortly after she was blinded by a stroke at 29 years old. But when she told her doctors about these strange apparitions, they looked at her brain scans (the stroke had destroyed basically her entire primary visual cortex, the receiving station of visual information to the brain), and told her she must be hallucinating.
"You're blind and that's it," Channing remembers them saying to her.
Frustrated and convinced these visions were real, Channing made her way from doctor to doctor until she finally found one who believed her: Dr. Gordon Dutton, an ophthalmologist in Glasgow. He told her he'd once read about such a case — a soldier in World War I who, after a bullet injury to the head, could only see things in motion.
Here's why: If this is about motion, only being able to see things in motion, she'd be able to see the stationary world, at least a little, if she herself started moving.
It helped. In the weeks and months after her visit (after employing other techniques like shaking her head), Channing began to see the world more vividly. And when she finally visited a team of neuroscientists in Canada (five years after her stroke), they filled in the picture. It turns out that one area of her brain 's cortex — an area reserved specifically for processing motion (visual area MT, for middle temporal area) — had been preserved. So even though information wasn't going through the primary visual cortex, somehow it was still getting out to the part of the brain that can register objects in motion.
Cue the cars. And the rain. And the coffee steam. Channing was truly seeing them.
But here's the catch. Though this compartmentalized nature of vision may have been Channing's blessing, it's also proving to be a quiet curse. Just as there seems to be an area of the brain that processes motion, there is one for faces; and as much as Channing's vision continues to improve, she still can't recognize — even perceive — a face.
Channing says that every now and then, that hard boundary of what she can and can't see frustrates her. "Who does she look like?" Channing wonders, as she gazes straight at her daughter's face.
For an artist's rendition of Milena Channing's world, watch the video above, which also explains a bit more about the modular nature of vision.
MELISSA BLOCK, HOST:
This next story is a medical mystery involving blindness. And one woman's insistence that what seemed like bizarre hallucinations were, in fact, real. Here's NPR's Lulu Miller.
LULU MILLER, BYLINE: To explain, let me introduce you to a Scottish woman named Milena Channing.
MILENA CHANNING: Colin (ph)?
UNIDENTIFIED MAN: Yes?
CHANNING: You need to be quiet. Sorry, sorry. The husband and daughter are upstairs having a little chat, and we're picking it up.
MILLER: She's just getting settled for the interview in her home in Wishaw, Scotland.
CHANNING: Right, we're OK now.
MILLER: Which is exactly where she was 15 years ago, when one bright blue day in February, she suddenly started feeling extremely feverish and short of breath.
CHANNING: The last thing I remember is lying here, in my own bed. And I vaguely remember being taken to the hospital. And then, after that, I don't remember anything - until I wake up, 52 days later.
MILLER: She had had an infection so bad that she had fallen into a coma, and while in the coma had a stroke that left her with short-term memory problems, terrible circulation problems and most important for this story, blind.
MILLER: What is the world like when you wake up?
CHANNING: Well. When I woke up, it was completely black. Couldn't see a thing. Nothing.
MILLER: The doctors informed her that she was blind. That due to the damage, there was no hope of her vision ever returning.
CHANNING: She's blind, and that's it.
MILLER: But then, a couple months later, she got a flash.
CHANNING: Caught the color green. I was still - I was lying in the hospital, and it was actually our wedding anniversary. And somebody had brought me in a gift. And they had it in a green gift bag.
MILLER: And they sort of tossed it toward her.
CHANNING: And I said to Colin, I can see green.
COLIN: I was over the moon.
MILLER: That's Colin.
CHANNING: But then, they went and told all the doctors. They said, all the trauma and everything she's been through, she thinks she's seeing green - but she's not.
COLIN: She's not seeing it. She can't see it.
JODI CULLUM: If you could see her brain scans - this is a woman who is missing most of the brain regions involved in vision.
MILLER: This is Doctor Jodi Cullum, a neurologist who would later review Milena's case. And she explained that though Milena's eyes are perfectly good, the stroke destroyed what you can think of as the main receiving area of visual input to the brain.
CULLUM: Primary visual cortex.
MILLER: And without that, the doctors explained to Milena, you simply can't get vision.
CULLUM: Because although the information from the eyes is fully intact, it's not getting into the brain properly.
MILLER: So that flash of green, the doctors told Milena, simply must have been a hallucination.
CHANNING: They said, it's her imagination.
MILLER: Milena said that moment was devastating because she was so sure what she had seen was -
MILLER: But, assured that she was blind, her life returned to darkness.
MILLER: Although, every now and then she would think she would catch a glimpse of something. Like -
CHANNING: The rain coming down from the sky. The windscreen wipers on. The steam coming from a coffee cup.
MILLER: And at some point, it hit her that she was seeing one very particular kind of thing.
CHANNING: Seemed to be things that were moving.
MILLER: Like, she couldn't see huge trees, though she could see their leaves shaken. And she couldn't see her daughter sitting across from her at the table, but if she turned to walk away -
CHANNING: I would see a ponytail moving left to right. You know, and I just kept saying to everybody, well, something's happening to my eyes. But nobody believed me.
MILLER: Which had an effect on the vision itself. Those flashes remained occasional, until -
CHANNING: Until, thankfully -
MILLER: About two years after her stroke, a friend of hers referred to her an ophthalmologist, who happened to have a hobby of reading about rare and poorly understood neurological conditions documented during World War I.
CHANNING: Gordon Dutton, in Glasgow.
MILLER: Riddoch's phenomenon, he told her.
CHANNING: He just knew exactly what I was talking about.
MILLER: Riddoch's phenomenon was first documented in 1917, after a soldier was shot in the head and afterward could only see objects in motion. And after running Milena through a couple of tests, Dr. Dutton was pretty sure that Milena, in fact, had this. And so, he prescribed her a rocking chair.
CHANNING: Which I thought was quite strange.
MILLER: The idea was, if this was about only being able to see things when they are in motion, well, (imitation of rocking chair).
CHANNING: He told me to sit in that rocking chair and rock back and forth to help my eyes.
MILLER: And did it help? Did you do it?
CHANNING: Yes. Over the months, it was as if the rocking movement would bring something into focus.
MILLER: He told her to try shaking her head if she dropped something on the floor. To pay extra-close attention if she was riding in a moving car. And most important, to trust all of these weird flashes and glimmers she was seeing.
CHANNING: He just says, use the site you've got. Because the more you use it, the better it should improve.
MILLER: And the other important thing Dr. Dutton told her was to go see his friend, Doctor Jodi Cullum, in Canada.
CULLUM: I'm a professor at the Brain and Mind Institute at Western University in London, Canada.
MILLER: Cullum's team of Canadian neurologists was intrigued enough by Milena's case that they brought her out to their lab.
CULLUM: We were very interested in her case. She sounded fascinating, but we didn't really know what to expect with her.
MILLER: Their thought was that maybe the motion area of the brain was still intact.
CULLUM: This area that's known to be critical for motion, called MT Plus.
MILLER: Because it turns out that area is actually a sort of satellite area, separate from the rest of the visual cortex.
CULLUM: MT is on the side of the brain, basically behind the ears.
MILLER: And their thought was maybe - just maybe, that MT Plus area was still getting information, even though the rest of the visual cortex was broken.
CULLUM: Yeah. That's the basic idea.
MILLER: So they put her into a brain scanner with a plan to show her -
CULLUM: Checker boards. Black and white checkerboards that look like they're expanding and contracting, or rotating.
MILLER: Oh, cool. Not just cool, says Cullum - but as a potential stimulus to trigger that motion area of the brain -
MILLER: So they put Milena in the scanner. They show her the trippy checker boards, and... Nothing.
CULLUM: There wasn't anything happening.
MILLER: They figured they'd found their answer. No brain response - no actual vision. Until someone in the lab happened to notice they'd left the lens cap on the video projector.
CULLUM: So we took the lens cap off the projector. And as we were sitting in the control room watching her, we could see some funny expressions on her face.
CHANNING: Actually, I started crying. It was a happiness really. Because I could see it.
MILLER: And in the brain scans?
CULLUM: We saw this huge increase in the amount of blood oxygen going to her MT Plus.
MILLER: Which suggests that somehow, the information coming through her eyes had found a way to do something almost nobody believed it could do - bypass the main way station.
CULLUM: She's missing the main connections, but she's got these little dirt side roads that are enabling the traffic to still get to her and to her MT Plus.
MILLER: In other words, Milena's strange vision of a world only in motion was-
CHANNING: Real. And I'm not lying, and I'm not making it up.
MILLER: Though Milena's condition is still poorly understood, in part because it's just so rare, Cullum's team has documented another case just like it.
CULLUM: Right. So we had another patient who was from France.
MILLER: He was a gardener who couldn't see his garden.
CULLUM: And yet, he was still able to ride a motorcycle.
MILLER: (Laughing) That is insane.
CULLUM: Exactly. And there were lots of other...
MILLER: As for Milena? It's been nearly 15 years since her stroke, and she says that first day in Dr. Dutton's office began a domino effect. Once her belief was sanctified by science, her sight just got better and better.
CHANNING: It's just amazing what I can see. I can avoid obstacles and fill the kettle. I'm seeing colors better.
MILLER: But that compartmental nature of vision? The thing which may in fact have saved what vision she did have, is also proving to be a quiet curse.
CHANNING: Colin, can the two of you come down?
COLIN: Hi there.
MILLER: See, like motion, there's a separate area in the brain for processing faces. And as much as Milena's vision improves -
CHANNING: I don't see your face. Stephanie (ph) - she's sitting in front of me. And I can - I know her head is, and she's waving now. She's waving her hand.
CHANNING: But I can't see any features. I just see the shadow.
STEPHANIE: She gets frustrated.
CHANNING: Why can't I see my daughter's face, or my husband's face? Who does she look like?
STEPHANIE: She can only remember me when I was wee. But my dad tells her what I'm like now.
COLIN: Five foot seven. Long brown hair. Smiling face - happy face.
STEPHANIE: It doesn't worry me, it doesn't bother me. She still knows me inside and out. Maybe it will change.
CHANNING: That's all I would like.
MILLER: Lulu Miller. NPR News, Washington.
BLOCK: You're listening to ALL THINGS CONSIDERED. Transcript provided by NPR, Copyright NPR.