Can We “See” God? Vision and Religion

Rabbi David Starr: I’d like to call up Rosalie now and also to introduce my friend, Dr. Darren Orbach, who’s online with us. Rosalie, the subject for today is really vision and religion, but just a quick introduction.

First of all, again, thank you to Phyllis for making all this happen. But think about how we learn, right? Think about the things that we learn based upon being told, maybe via tradition – how do you know something is true? Maybe your parents told you when you trusted them. Maybe there’s a tradition in your village. Tradition is one way – the kind of the authority of a tradition, however it comes. That’s one way of learning – how you know something is true.

Number two is cognition. You use your rational faculties.

And number three are the senses. We are very careful and kind of agnostic about that. There are some things that we are happy to have our kids learn by their senses, but of course, the famous example people always give is that we don’t want kids to learn that the stove is hot by touching it, because that would be a very painful lesson. But our senses are a huge source of learning for us.

So those really three things, in some ways, it seems to me, are what we’re talking about today.  So I’m going to give it over to Dr. Rosalie to take over, and Darren will chime in however he chooses to see fit. He’s an interventional radiologist at Children’s Hospital. He pokes around in kids’ brains.

How The Eye Works

Rosalie Reszelbach: So what I have here is a simplified diagram of the eye, and I’ll go through how light is focused on the retina, and the structures that allow that to happen.

Vision is our primary sense of understanding the world around us. The eye is the organ that gathers all the information, but to truly understand vision, you have to understand more than how our eyes work – you have to understand how our brains make sense of the outside world. Approximately 80% of everything we learn comes through our eyes. Light enters the eye right here, and the first thing it encounters is the cornea, which is a refractive – which is part of the refraction that allows the eye to focus on the fovea.

The next thing that’s encountered is the lens. The lens focuses the light, and it changes its length and width via the muscles on either side, so that light that comes in will focus exactly on the macula, the area of best vision.

When we look at an object, the light that is reflected off the object, as I said, enters the eye through the cornea. The cornea bends the light before it passes through the aqueous humor, which is just this watery area here, and travels through the center of the iris. The iris can constrict and dilate to control how much light gets through to the lens behind it.

As I said, the lens adjusts its shape to bend and focus the light a second time, so you have a clear image of what you’re looking at. The light passes from the lens through to the back of the eye, which is filled with clear, gelatinous substance we call the vitreous. That’s here. And the vitreous is in the central part of the eye, because it keeps the eye from collapsing on itself. If you puncture the vitreous and the eye collapses, you’re not in good shape.

The light that passes from the lens to the back of the eye reaches the retina. The retina is the most important part of the eye. The retina is the light-sensitive layer at the back of the eye. The light, when it focuses, goes through the retina, which contains nerves called the photoreceptors. The photoreceptors are made of rods and cones, and are responsible for transforming light rays into electrical impulses. While the light is focused through the retina, most of the light enters. The nerves of the retina collect all the information, and they give out electrical impulses, which travel through the optic nerve up to the occipital lobe in the back of the brain.

This is a simplified explanation. The retina has the rods and the cones, which – the cones are responsible for bright light. They also have different types of cones. We have cones that are sensitive to different wavelengths of light, so you will have a green cone, a red cone, and a blue cone. And the light waves are different wavelengths, so they stimulate the retina. The retina sends the electrical impulse to more photoreceptors, and these then gather together and go through the optic nerve and to the brain.

Color is not something that is done by the eye. Color is done by the brain. And there’s a certain area of the brain that interprets the color, and that is how we see color.

So, besides the cones, there are the rods. The rods are in the periphery of the retina, and they are responsible for seeing in the dark, and they are also responsible for our peripheral vision. So, if for some reason we lose our ability to see with the cones, we can still navigate the world, because the rods are still there, and so we still have peripheral vision.

Vision and sight aren’t necessarily the same thing. Sight is what your eyes do. Vision is the entire process that starts with sight and ends with your brain processing what your eyes see in a form your brain can understand.

The retina, besides having the rods and cones, has other neurons, each of which do a different thing. Some of these neurons sense shape, they sense angles, or they sense motion, and they send that information to different parts of the brain. And it’s integrated so that we can see the whole world and the brain. Believe it or not, when we look at the world, we only see 1% of the world. The rest is put together by our brain. And the reason we can do this is because we have eye motion. Our eyes move three times a second, and if we did not have eye motion, we could not see the world.

So basically, the rods and cones send light down through the retina. The rods and cones are at the back of the eye, and then there are other layers of photoreceptor cells. The photoreceptor that collects the electrical signal from the rods and cones is called the bipolar cell, and it is called that because it can intake the electrical impulses and then send them out to the optic nerve.

What Eye Problems Tell Us

Now, I wanted to tell you something about looking at the back of the eye. As an optometrist, my job was to check people’s eyes, glasses, contact lenses, but also check for diseases. When you look at the back of the eye, it’s the only place in the body where you see functioning blood vessels. There is no place else in the body you can do that. When you look at the back of the eye, you can often diagnose diseases – systemic diseases. So, people who are diabetic come in at least once a year, sometimes twice a year, because a diabetic’s blood vessels are leaky. And you can see that if there’s a problem, you can look at the back of the eye, and you can see hemorrhages, and you know that they’re not controlling their diabetes. Well, there’s a problem.

The other thing you can diagnose is high blood pressure. Sometimes when you have high blood pressure, the blood vessels in the eye can hemorrhage. You have a large hemorrhage – and that’s happened to me – I sent a patient to Mass Eye and Ear when I noticed this immediately, and their blood pressure was sky high, and then [they were] put on medication.

The other thing you can diagnose is – okay, so the blood vessels go to the optic nerve. Where the blood vessels go into the optic nerve is called a blind spot because you can’t have retinal cells in front of the optic nerve. So that one of the reasons that we can see, even though we have a blind spot, is we have two eyes and they cover for each other. And the two eyes are responsible for binocular vision – for having the ability to see 3D vision.

But the optic nerve is connected to the brain. If you have a brain tumor, it can cause the optic nerve to swell. And so I have had a friend who has diagnosed, somebody with a tumor in the brain, because they noticed the optic nerve was swollen.

So the eye is an incredible organ, and they are learning every day new things about how the brain interprets the signals that are sent from the photoreceptor cells to the brain, and trying to figure out how all this information is put together so that we can see the world that we see now. And that’s about it.

If you lose vision in one eye and your brain is sort of maxed out in terms of its – does your brain tire more easily when that happens?

Darren Orbach: No, I don’t think that’s true. There actually is still some binocularity, even with only one eye. It’s not as accurate as when you have true binocular vision, but you still do have some sense of depth, and you can give people various tasks and show that they don’t lose – the world doesn’t become completely flat, as you can see yourself if you close one of your eyes and look around. The world doesn’t become completely flat, but you do lose some accuracy.

David Starr: Okay, other questions?

I had a friend for just about 31 years who was considered legally blind. He was not totally blind, and he wore very, very thick glasses. Does the thickness of the glass make a difference?

Rosalie Reszelbach:  It magnifies things. Nowadays we use computers for that. When people have low vision, they have computers with large print. And what the glasses do is magnify that, but it’s not the same. I mean, you still have very diminished vision, and you could not drive.

At the same time, I also knew somebody blind the first 18 years of his life and was able to have some type of surgery to correct his vision, [so] that he later was able to drive a car.

Rosalie Reszelbach: I have no idea what caused that. It could have been a number of things. He may have had an undiagnosed cataract. Often children, when they are born, you check their eyes, because sometimes they are born with cataracts. And if they are not detected, their brain does not learn how to distinguish the information that they are getting. I had a friend in optometry school who, just by accident – he had just had a child, and he was looking at their eyes, and he found that the child had a cataract, so that they could do the surgery and the child would be able to develop full vision.

Let me just say, there are two types of macular degeneration.

One is called dry macular degeneration; one is called wet macular degeneration. Wet macular degeneration is where you have – it’s called neovascularization. You get new blood vessels, and the blood vessels are leaky. And if you get a bleed in the eye, you can lose your vision. So what they give you is something that will inhibit the growth of these blood vessels. And that helps a lot.

Dry macular degeneration is totally different. Okay, so the macula has – this is called the fovea, but you call it the macula. It has the most cones of any part of the retina and is responsible for detailed vision, really clear vision. But in order for that to happen, you cannot have blood vessels in front of it. All the rest of the eye has blood vessels that give nutrients to the retina, that sustain the retina. But there is an area of the back where there are blood vessels. So the macula only has one source of blood vessels. And as you get older, the blood vessels can get – They don’t deliver as much blood to the macula. People smoke, people drink, people don’t have a diet.

David Starr: Not Jews.

Rosalie Reszelbach: No, not Jews. And the blood vessels degrade at the back of the eye pigment – retinal pigment, epithelium. And so you get things you call drusen, which you can see, that are a part of losing that blood supply. And the macula slowly degrades. And they’re working on it, but at present, they don’t have anything to really stop that. I mean, they have a type of vitamin. They call it the AREDS, vitamins and minerals that, once you’re diagnosed with the dry macular degeneration, they recommend that you take them, and they help somewhat. But they haven’t figured out yet how to really cure dry macular degeneration.

The Role of Vision in Religion

David Starr: So what is the role of vision in religion? What do you think?

Rosalie Reszelbach: You wake up in the morning, say, Modeh ani.  I mean, and your eyes open and there’s light.

David Starr: – you’re supposed to. The world is like this vast, glorious tableau of things that you’re supposed to appreciate. If you think about Judaism, over and over again, we dilate on one of two things as a kind of original source or origin story for why we should follow God. One is creation and all that that entails, both the act in historical terms, but also the fact. Uv’tuvo mechadesh b’chol yom tamid ma’aseh v’reishit. Every day we get up – “hey, we’re still here.” nature is working. We can see it, we can in all kinds of ways, touch it, taste it, etcetera.

And the second, of course, is yitzyat Mitzrayim, God’s redemption of us from Egypt. We talk about those two things over and over again. So if you take the first one, which is creation, you think, “Okay, so Judaism is very pro-sensory, right?” The senses ostensibly bring you closer to a deep apprehension and gratitude for reality. The world is good, and the more you can focus on that, the more you’re going to feel grateful, you’re going to feel connected to God, et cetera.

But consider a couple of passages. One: the third paragraph of the Shema. It says: “The Lord spoke to Moshe, spoke to the people of Israel. Every generation, they should put these tassels on the four corners of their garments.” What do you do with them? You look at them. “You shall look at it and remember all the mitzvot.” Just in case you were thinking, “Oh, I think I’ll go to – you know, my boss called me up with box seats to Fenway on Saturday afternoon.” Don’t take it – it’s Shabbos, right? You look at the cheap seats and you say, “Oh, I’d really love to go, but I can’t.” I’m at Fenway. Those Fenway Franks smell really good. I look at my tzitzit. Don’t order the Fenway Frank. Right?

So the point is: that would say that vision is super important as a kind of normative statement thing. You look at it, and it begins that process that Rosalie was referring to, where you’re looking at stuff, and then your brain is somehow cognizing it and then turning it into normative command stuff.

But then look what the rest of the paragraph says, if you remember this from the book of Numbers. You look at the tzitzit, you remember the mitzvot – that’s the good side – and fulfill them and “not be seduced by your eyes and heart, as they lead you astray.” What’s the problem with the senses?

Rosalie Reszelbach: Can’t always trust them.

David Starr: It goes both ways, and it can lead you – the world is a full, rich, beautiful place. So is your imagination, right?

The Rambam has this very famous thing that says, “In Gan Eden, in the garden of Eden, a pre- social world, you had Adam and Chava. They didn’t know anything about the world. All they did was they thought about God.” They were like God minus one. This is Maimonides as a sort of a Platonist, right? Plato had this idea of pure thoughts. God was like perfect, pure thought. And we were so close to God that we were like perfect thought, minus one. There was no world to observe.

But of course, the experiment was doomed. How come? Because: were we only thought machines? No. We had bodies, we had senses. We had the power of imagination. We could do all the things that Rosalie and Darren are alluding to, the fact that most of this stuff ends up being about brain work and our imaginations, our baggage – stuff we got from our folks, traditions, ways we’re socialized. So it’s never a pure sensory experience. It’s always become something else.

Our Lenses for Sensory Experience

And so, then the question becomes: what are the lenses (I’m using that term not in the physical sense, but in the sort of psychic sense, in the cultural sense). What are the lenses through which we filter sensory experience? Because – and of course, what the Torah is saying in Bamidbar, and Darren reminded me – the most famous example of this, in terms of the narrative of the Torah, is the spy story. What happens with the spies?

 Rosalie Reszelbach: They say two different things.

David Starr: They send out twelve. Ten say, “You know, we can’t beat the Lakers. They got Wilt, they’ve got Elgin, they’ve got Jerry West. They’re too much for us.” The other… this is a generational comment. Evan is saying, “Who’s Wilt?” They’ve got LeBron, they’ve got Kobe. We have no shot.

The other two say, “Hey, but we’ve got Russell, we’ve got Bird,” right. The problem is, you know, you ask a different person. And of course, those of you – any lawyers here? Amazing. All you guys care about is optics. You don’t care about law. You ask, you know, ten people for a recollection, “What did you see?” Ten different stories. So optics will lead you astray, because our brains are super-complicated.

Rosalie Reszelbach: They sure are. And our memories – when you recall an old memory, the connections are severed and they have to reconnect, and your memory changes.

David Starr: That’s right. And the Rambam’s take on that is his story about how idolatry came into the world. Who’s Avraham? Avraham is this little boy genius. He looks up at the heavens, he looks at the stars, he sees the celestial bodies, and he says, “Oh, this is amazing. And behind the creation there must be a creator.” So that’s the beginning of monotheism. That’s the origin story of monotheism, according to Maimonides.

What’s the problem? The problem is, the Rambam dies. Later generations, they forget that learning. They also look up at the stars, and what do they see? They see just these amazing little beautiful orbs – this magnificent set of lights. And they say, “Maybe these things are gods.” And they begin to worship the stars.

So again, most of this is brain work. It’s really what you do with the sensory experiences that you have. Yeah. Phyllis?

To me, it just comes back to one thing. Our eyes, our vision, are gifts from God, the original gift.

David Starr: Who’s the rabbi here? Who’s the rabbi here? (Laughter) Phyllis said our eyes are gifts.

First thing when we are born, all of a sudden, we are a breathing creature, because we see something we do not see well, but we see a new world.

Rosalie Reszelbach: Children have enormous amounts of neural networks when they are born, and a lot of plasticity. But as they get older, it’s whittled down so that the brain is more efficient. The brain in a child uses 60% of the calories that child has. As adults, 20% of the calories go into our brains, because our brains have been whittled down to be the most efficient. If we wanted to see the whole world, not just 1% of it, our brains would have to be 600 times larger, and our optic nerve would have to be the size of a garden hose. Can’t do that. And therefore we, the brain is programmed to be the most efficient it can and give us the most it can with what we have.

David Starr: Any last comments?

To what extent are we filtering things in such a way that we’re not totally exposed to everything?

It’s a really good point. I had not thought about it that way. Anybody? Any reactions to that question?

Rosalie Reszelbach: We’re not supposed to see everything.

David Starr: We’re not supposed to see everything.

The Construction of Our Sensory World

Darren Orbach: One general comment, I would say, is that the sensory world is, to a huge extent, constructed by the brain, that it’s not a passive perception of what we’re seeing. The eye is not a camera, but even more than that, the brain is definitely not a camera.

So, for example, after the retina, the next station in the brain is the thalamus, which is the sensory processing set of nuclei in the brain. And interestingly, there are far more fibers going from the thalamus to the eye than from the eye to the thalamus. So the feedback is actually greater than the forward-direction fibers, and that’s true for all the sensory pathways. And you can show, through various experiments, that the way we perceive the world is largely a construction of our brain rather than just a passive act of reception. And you can look at the way different animals perceive completely different parts of the environment, some of which are invisible to us. So what we’re perceiving is a tiny fraction of what’s actually out there and is actively constructed. It’s not just sort of taking in more or less in a passive way.

David Starr: It’s amazing. Absolutely amazing. Sharon, did you want to respond to what Darren just said? Sharon just asked: the relationship between what we ostensibly are seeing and then the fact that it actually produces almost an instantaneous physical response, like a nerve response. Fight or flight  – the tingling. You’re getting a nerve reaction as you’re seeing something. Is that eye and/or brain?

Darren Orbach: Well, you’re getting a nerve tingling as you’re seeing something – your adrenaline, your brain. That’s all responsive – your brain.

David Starr: The fight-or-flight thing. Yeah. Last comment, which – and I cannot answer this, the question is, the extent to which communities, traditions, cultures, in effect, try to involve themselves with this sort of process of the brain doing most of the work – in other words, you know, conditioning the way people learn. Something to think about – I think all religions, all communities, all political systems have an interest in this. So that’s really what you’re reading in the Torah. They’re trying to tell you, “Oh, let’s use these objects. We will create these rituals, and that will, in effect, mold the way we apprehend reality.”

So what Darren said in terms of the relationship – I mean, each one of us, as a learner, a thinker, a creator, we are not just free-floating creatures out there in some kind of wilderness. We’re living in societies, and societies are doing a lot of that work for us, trying to influence our brains as well.

When a baby gets too much oxygen and becomes legally blind, is that reversible?

Rosalie Reszelbach: I don’t think I’ve heard of that.

Darren Orbach: Well, there are lots of causes of potential impairment in young infants, and some of them are reversible, some are not. Part of the issue, and I think Rosalie alluded to this, is that as vision develops, there are these critical periods in development, during which the expected input has to come in. And if it does not during that specific time, then the brain will never develop the appropriate circuits for doing the kind of visual analysis we expect it to.

So, for example, if the two eyes are not getting coordinated vision during the critical period, that person will never have binocularity, regardless of what you may try to do afterwards. So there is this interplay between the brain acting on the sensory input, but also needing to develop at appropriate times in order to be able to do that.

David Starr: Carol wants to know what an interventional radiologist at children’s hospital does.

Darren Orbach: I treat mostly vascular malformations in the brain and the spine – abnormal blood vessels, either too much flow or too little flow.

Okay, so I’m that person who was born preemie in an isolette, had too much oxygen. Anyone who’s looked at me or spoken to me before knows that only one of my eyes is focused at a time. So if I cover one eye, my left eye is focused. If I cover my right eye, my right eye focuses. It’s called alternating exotropia strabismus, and it has everything to do with the thalamus pathways. So in theory, I should see two of all of you, because your eyes look out and they fuse on a point, and mine don’t. Mine work completely independently, one at a time – alternating exotropia. So where the brain takes over, so I should see two of all of you, but I don’t because the pathways from the thalamus are greater than the pathways from the eye to the brain. The pathways from the brain to the eye are greater, so my brain knows there’s only one of all of you and that you’re not flat. Again – you’re not Flat Stanleys, right, you’re not all flat against a wall – but, well, sometimes there is a way to actually fix it. You were asking, what can you fix? So, there is a surgery that can fix it if there’s a combination of muscular – which I have – and neurological – which is from too much oxygen, from spending three months in an isolette.

So if they fix it – I haven’t had it fixed, and I’m in my 50’s, right. And it was a choice to have been fixed, because if they fix it for a given amount of time, I will see double until my brain takes over, like it’s taken over now. And I won’t take that chance, just because I’m a little bit of a chicken.

Other audience member: And I have a friend who just had eye muscle surgery because she sees double at night. And they moved where her eye was, and I took care of her for three days and went out in the dark – it only happened at night. And the surgery fixed that, and she sees single now at night and can drive at night. So we just don’t know.

David Starr: I want to give a Yasher koach – I mean, you can talk to Darren offline, Tony, but advice about that. But thank you for sharing that. Yasher koach to Darren, and above all, to Rosalie for the presentation. Very interesting. So we can.