While Marlene experienced protracted perceptual changes as well as hallucinations after a massive occipital lobe hemorrhage, even a “little” occipital lobe stroke can evoke striking, though transient, visual hallucinations. Such was the case with a bright, deeply religious old lady whose hallucinations appeared, “evolved,” then disappeared, all within the space of a few days in July of 2008. I got a call from one of the nurses in a nursing home where I work—we had worked together for many years, and she knew that I was especially interested in visual problems. She asked whether she could bring her great-aunt Dot to see me, and between them, they reconstructed the story. Aunt Dot told me that her vision had seemed “blurry” on July 21, and the following day, “it was like looking through a kaleidoscope . . . all this rotating color going through,” with sudden “lightning streaks” to the left. She went to her doctor, who, finding that she had a hemianopia to the left, sent her to an emergency room. There it was found that she had atrial fibrillation, and a CAT scan and MRI showed a small area of damage in the right occipital lobe, probably the result of a blood clot dislodged by the fibrillation.
The following day, Aunt Dot saw “octagons with red centers . . . moving past me like a film strip, and the moving octagons changed into hexagonal snowflakes.” On July 24, she saw “an American flag, outstretched, as if flying.”
On July 26, she saw green dots, like little balls, floating to the left, and these turned into “elongated silvery leaves.” When her niece remarked that an early autumn was on the way
in Canada and the leaves were already changing color, the hallucinated silvery leaves immediately turned reddish brown. These ushered in a day full of complex visual hallucinations, including
“daffodils in bouquets” and “fields of goldenrod.” They were followed by a very particular image, which was multiplied. When her niece visited that day, Aunt Dot said,
“I’m seeing sailor boys . . . one on top of the other, like a film strip.” They were colored, but flat and motionless and small, “like stickers.”
She did not recognize their origin until her niece reminded her that she (the niece) often used a sailor-boy sticker when she sent her aunt a letter—so here, the sailor boy was not a complete
invention, but a reproduction of the stickers Aunt Dot had once seen, now multiplied
The sailor boys were replaced by “fields of mushrooms” and then by a golden Star of David. A neurologist in the hospital had been wearing such a star prominently when he visited her, and she continued to “see” this for hours, though not multiplied like the sailor boys. The Star of David was superseded by “traffic lights, red and green, turning on and off,” then by scores of tiny golden Christmas bells. The Christmas bells were replaced by a hallucination of praying hands. Then she saw “gulls, sand, waves, a beach scene,” with the gulls flapping their wings. (Up to this point, apparently, there had not been movement within an image; she had seen only static images passing in front of her.) The flying gulls were replaced by “a Greek runner wearing a toga . . . he looked like an Olympic athlete.” His legs were moving, as the gulls’ wings had been. The next day she saw stacked and serried coat hangers—this was the last of her complex hallucinations. The day after that, she saw only lightning streaks to the left, as she had seen six days before. And this was the end of what she called her “visual odyssey.”
Aunt Dot was not a nurse, like her great-niece, but she had worked for many years as a volunteer in the nursing home. She knew that she had had a small stroke on one side in the visual part of her brain. She realized that the hallucinations were caused by this and were probably transient; she did not fear that she was losing her mind. She did not for a moment think that her hallucinations were “real,” although she observed that they were quite unlike her normal visual imagery—much more detailed, more brightly colored, and, for the most part, independent of her thoughts or feelings. She was curious and intrigued, and so she made a careful note of the hallucinations as they occurred and tried to draw them. Both she and her niece wondered why particular images popped up in her hallucinations, to what extent they reflected her life experiences, and how much they might have been prompted by her immediate environment.
