Hallux and Pollex

Don’t read this unless you’re brave. And don’t unsubscribe from this blog: next to come is the delightful story of the little Dolphin constellation and the musician who rode on the dolphin’s back. There’s also the strange eclipse that will sweep from Oregon to Texas on October 14.

Actually, only the paragraph just after the picture, beginning “On September 2,” could be a shock. The rest is at worst boring, and at best could be my contribution of data for researchers into the neurology of hallucinations.

After all, no one can photograph a hallucination, and no one can get inside a hallucinator’s brain to see it. My drawing tries to suggest some of the features of what I’ve been seeing, but these harmless hallucinations changed, dwindled in size and color, and, after about 33 days, disappeared. I rashly and slowly wrote most of this description over four hours in the middle of the first night after coming home, vision still impaired and plodding single finger often perhaps aiming at the hallucinated copy of a keyboard letter. Trying now to complete it, I can see the earlier images only in memory, and have had to change the present tense to the past.

I used to be told that, because of my light long build, much exercise, and clean diet, heart health was something I didn’t need to worry about.

Alas.

On September 2, at the Royal Papworth Hospital in the new medicalopolis now covering the landscape south of Cambridge, surgeon Francis Wells sawed along the middle of my breastbone, put the ribs out of the way, and repaired the mitral and tricuspid valves in the heart, to make them resume efficiency in pumping blood in the right direction.

He had given me the option of a slighter “keyhole” operation in which instead of repairing the valves he could clip them. (I never quite pictured the valves or what clipping them meant.) But that might not prevent them from “regurgitating” blood in the wrong direction and might not cure the symptoms.

One of the staff later remarked to me: “I think he could do it with one hand, he’s done it so many times.” I had had to make a preliminary journey to Cambridge to be tested for fitness (among the very slight risks is death). My left wrist was recovering from a fracture caused by a bicycling crash. Then my operation nearly had to be postponed because Frank broke his own hand in a bicycling fall caused by a hit-and-run motorist. But his hand healed in time.

Successful open-heart surgery has a long gradual history, starting in 1801 with an operation by Francisco Romero, a Catalonian, at Almería in Spain.

The heart has four chambers. The upper right chamber (right atrium) sends blood through the tricuspid valve to the lower right chamber (right ventricle); which pumps it through the pulmonary valve to the lungs; which put breathed oxygen into the blood, and send it to the upper left chamber (left atrium); which sends the oxygen-rich blood through the mitral valve to the lower left chamber (left ventricle); which pumps the blood through the aortic valve along arteries to all the organs of the body, including the muscles of the heart, which need the oxygen for fuel; the oxygen-depleted blood then returns through veins to the upper right chamber, completing the cycle.

It will be interesting to know whether life on another planet has had to evolve the same intricate pretzel-shaped system.

The great arteries that carry the blood out of and into the heart did not have clogging deposits – the more usual cause of heart disease – which would have required serious extra surgery.

I then spent night after almost-sleepless night in my small curtain-doored hospital room that felt like a cell inside a machine. You can’t curl beside the one you love. You’re on a machine-like bed. Your head is tipped back too far. You’re a bit too cold. (Hospitals are careful not to err on the side of warmth, which could foster infections.) About six needles and other devices remain stuck into you, lines hanging from them, monitoring systems or supplying chemicals. The food requires an act of will. You long for a shower. And you fear that making any free movement in a wrong direction could apply torque to the bones that are beginning to heal back together. You fear to cough or sneeze. You can’t breathe too deeply.

(An unresolvable ambiguity. I mean that I shouldn’t take a breath that is beyond a certain painful strength. But it could be a sense of the type of “You can’t have enough of a good thing” – the opposite!)

All the female and almost all the male nurses were skilled and kindly. They have to be on call through successive long night shifts, with short days of rest between, to look after unattractive patients in sordid ways. It’s no wonder that few British people agree to do it, and all were immigrants from countries such as Nigeria, Egypt, China, India (one from whom I learned most was from Kerala).

Another chatty taxi driver, like the one who asked me which was the best American president of my time, asked me which I thought the best British prime minister, and I answered “Clement Attlee.” Governments are for the well-being of people. Britain’s National Health Service was the best achievement, of any kind, of any government in world history.

Another moral: the lowest circle of hell, if there is such a state, is deserved by those who bomb hospitals, along with the torturers and bear-baiters.

To my relief, I passed tests to be able to go home, and am in the gradual up-slope of recovery – hopefully to better than before. Told “6-12 weeks” before any heavy pushing, pulling, or lifting. Advised to stand up from a sitting position by holding the arms in a “self-hug” and using the legs only and rising on the third bounce – next to impossible! Still I fear night; it has deserts, in which I think hours have passed but find, by touching the screen of my iPad, which serves as a clock, that only minutes have. Sometimes I cuss time for moving backward!

Hallucinations

A harmless side-effect is hallucinations and other disturbances to the visual system. There may be other types of hallucination that are large and frightening – the Charles Bonnet syndrome?

A component that at first covered most of the field of view was a geometric network or grid. It was always at least faintly present, even in daylight, behind or in front of other systems. Like graph paper, with major line thicker. Or in rectangles, like bricks. At first I could not be convinced that the large white wall in front of me (and sometimes instead appearing to be overhead) was not made of tiles with grooves between them. But moving the head made the network slope, or blocks of it slope or migrate. The graph-like areas came to look convincingly like city maps, of the kind with single lines for streets, read for main highways (arteries!) and other colors for the streets crossing then. Occasionally there were city-map-like patterns of the kind with double lines for streets; the block, had round corners.

The individual pieces of a hallucination, such as a head, or an area of map-like lines, or a circle containing something, could be called “halluces,” rather like linguistic phonemes (units of sound) and morphemes (units of form). The halluces retained their distinct edges as they floated in front of each other.

Shapes appeared, flakes, and became pieces of the network of lines or became mechanical objects. An element in the real scene, such as a bit of the pattern of a rug, if stared at, became a halluce. Sometimes a small black hole appeared, and enlarged and became a shape. Sometimes a shape began as an extension of another shape, such as a face, and drifted away from it. They looked surprisingly precise, “real,” but, focused on, they distorted unpredictably. A section of a horizontal steel tube blinks our of existence yet the tube did not drop.

Dots, that usually started red, changed color, rearranged. Once they formed a small constellation, but usually they were myriad,. They could initiate the grid of lines, becoming points in it like knots in a net. Or they became, or were accompanied by, drifting snow or rain. Or they filled small horizontal rectangles, or river-like bands that followed the boundaries of shapes and were in downward flow. And dots, looked at, enlarged into circles, drifted across each other.

Advertising and announcements, with lines of text, white on red, in what seemed clear letters, but, as I tried to read them, rows of capital As extended themselves to the right.

Pieces of the real scene were copied and printed elsewhere. To the right of Tilly’s face was a copy of that side of it.

Sharp complex boundaries grew around selections of the scene. Then their interiors shimmered, became lakes, became sub-networks or sub-scenes, going into spinning motion.

All shapes if I looked at them drifted to the right. I could halt them by holding my eye still, even transplant them somewhere to the left, but in general if looked at they hurried with increasing speed to the right.

People. Typically the face and body down to a little below the waist, sometimes only the head, more rarely the whole person. All were clearly seen, paintable, unlike those in dreams, except that they soon began to change. Some were like etchings, with shading made by lines. But most were like oil paintings, with waxy yellowish-brown or deeper brown complexions. Emphatic white splashes, luckily dashed on as in a Frans Hals painting, from light coming from above: line in the fold of the chin or on the cusp of the temple, sheet from the cheekbone down, light-mound on the forehead. If eyeglasses appeared on a face (with or without handles), reflections on them, as from a window above, were impressuvely accurate.

How large were the faces, indeed any hallucinated objects? Always uncertain, but never huge. If they seemed to float just in front of, or be pasted onto, the surfaces of the real scene, their size presumably depended on comparison with that background, and they were perhaps up to a couple of feet high, later only a few inches.

Surrounding fuzzy or ropy masses, oblong-rectangular, sometimes beginning like green parsley, more often forming out of the map-like network and then desaturating to cyan or to a mixture of white and blackish bits so as to average into gray, and thus suggesting a surround of hair and beard, and making almost all the faces male.

Tremendously distinct shapes and characters, engaged in vigorous conversation or dispute or admonishment, at each other or at crowds off-scene. They could be actors, Roman senators and conspirators, lecturers, bush surveyors, ballerinas. No, most often ayatollahs, Islamic warlords. Mood ironically humorous even when angry or indignantly surprised.

Two, three, or rarely more persons appeared, in front of or behind each other, drifted apart. Each retained the crisp outlines from which it was born, slightly coruscating or twinkling (reminiscent of “aliased” pixels at the edge of a form pasted into an Adobe Photoshop image?).

Persons drifted toward each other, batted fans toward each other; but avoided kissing or biting, by last-moment maneuvers such as finding ways between each other’s legs.

All heads were in constant stately-slow rotation, usually to the right (their own left). Heads or bodies lost whole pieces, which floated away, becoming other objects. Right arms folded back before gesturing fiercely forward, during which they shriveled to sticks and detach and floated away. Human faces change into long-snouted animals.

There was no violent movement, except: the inaudible jabbering could pick up speed, jaws going into vibration like a power drilling tool. And dots that had become large circles could replace eyes, and then the crosses or other shapes inside then spun like Catherine wheels.

Where did all this come from? It was not my kind of imagination.

It seemed that any time I “looked at” – let my awareness focus on – the macula, the densest spot of the retina, the eye-brain system could find, in slight variations of receptivity across it, what it could interpret as what it is most interested in: a face – human or sometimes more like a lion: the darks of the eyes and under-nose, and the lights of brow and nose and cheeks.

Yet these clues could not be in either of the maculae, since the same face-suggesting pattern appeared with either eye open or neither. It had to be in the visual area of the brain, though perhaps fed in some way by the deficiencies of my maculae.

The clues consisted mainly of the two darker streaks, sometimes connected suggesting eye sockets. They sloped slightly downward to my right. And the exact center of attention was in or near the right eye (left from me). That was why, if I tried to look at other parts, the whole drifted to my right.

Deeper into neurology would be the explanation of how it goes further, to discern eyelids within the eye-darks, to produce another such shape, to set them rotating and drifting, and to invent all the other variations in their shapes and expressions.

Against my will: I wanted to say “Go away!” The hallucinations could help to pass the night hours, but I had had more than enough of them.

The halluces dwindled, and, a month after the operation, I noted that they had ceased. But, no, months later, ooking” at a spot still produced a halluce. The still slanted, were centered on their own right eyes, tended to drift to the right. Instead of having their own tanned color, they had the color of whatever was their background, perhaps tending toward bluish or gray, darker version of it in the eyes and under-nose, lighter in the brow and cheeks; still widely surrounded by the fuzz that suggested hair and beard and therefore patriarchal male, expressions vividly varying with the angle of slant and displacement of the leonine “nose”.

The word

Hallucination derives from Latin, but not from hallux, “big toe.” The great scholar Thomas Browne apparently invented the English word, out of Latin alucinari, “to wander in the mind” (related to the root of lux, “light”?), in his 1646 book Pseudodoxia Epidemica [popular false doctrines], or, Enquiries into very many received tenets and commonly presumed truths, a massive and witty debunking of counter-scientific beliefs.

Pollex is “thumb”; the two Latin words look like parallel developments.

You can see the twin stars Castor and Pollux. You don’t see their copies that waver into existence beside them and drift away to the west, Hector and Hallux.

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