A sight beyond seeing

When tall, blonde, Bethan Collins walks briskly into the room, she smiles confidently and looks us square in the eyes

When tall, blonde, Bethan Collins walks briskly into the room, she smiles confidently and looks us square in the eyes. The Irish Times photographer and I share a puzzled expression. She is not what we were expecting. For the first few moments of small talk, I'm afraid to say what I'm thinking.

Bethan makes us cups of tea, shows us to our chairs.

Have we got the wrong girl? Summoning up courage, I say, trying to be tactful: "Bethan, you are blind, aren't you?"

"Yes. Completely," she answers, smiling directly at me. I smile back, and the warmth in the look we share convinces me that either she's lying, or she's a darned good actress.

READ MORE

There are all kinds of seeing. That's what you learn spending a morning with Bethan at the Royal Hospital, Donnybrook, where she works with patients with dementia and chronic disabilities. It turns out that when Bethan was a little girl, her mother would constantly say to her: "Look me in the eye when you talk to me." Other little girls are told not to fidget, or to eat politely or not to interrupt. Bethan was told, over and over again: "Look me in the eye."

And from the age of eight, she was taking the bus into town. Alone.

She did most of the cooking at home, because both her parents worked in UCD and it was "easier that way".

She went to mainstream schools, among them Our Lady's in Templeogue, and it is only recently that she learned Braille and got a guide dog (much better than carrying a white cane and being yanked across the road by strangers, she says).

"I was brought up as a sighted person," she says. "My Mum was the best advocate. As a very young child she knew I could not see, but she did not equate that with my not being able 'to see'." There was nothing, her parents told her, she could not do. One day while she was at Trinity College, Dublin - where she came top of her year, won a gold medal and was made a Trinity Scholar - she attended a cricket match.

When she got home, her father asked her: "You weren't playing cricket, were you?" "No," she laughed.

"Well, there's no reason why you couldn't have bowled," replied her father.

That was always the attitude.

Bethan has a genetic form of blindness which her father, David Collins, a lecturer at University College Dublin, shares. It's a degenerative condition on a dominant gene, so she and each of her three siblings had a 50/50 chance of inheriting it. At birth, she had about 10 per cent sight.

Bethan has an older sister who is sighted and two younger brothers (both in university) who are visually impaired. She's not sure of the extent of their impairment.

"We don't discuss 'how much can you see'?" says Bethan.

As a young child, Bethan had some sight, although she is told that she could never see colour. As a five-year-old, she was asked to paint an elephant. The teacher praised her elephant as the most original done by anyone in the class. All the other children's elephants were grey; Bethan's was bright pink. It might as well have been grey.

Not being able to "see" colour because of damage to the optic nerve does not mean you cannot "see" colour at all, Bethan argues.

"What is the colour of green grass?" she asks. "How do you know that your definition of 'green' is the same as my definition of 'green'?" She "visualises" the room, the street, the buildings around her. She "visualises" objects. Her mental map of the world is so detailed (20 paces from O'Connell Bridge to the bus stop, for example), that sometimes she thinks she can "see" more than she actually can. For this reason, she's taken to walking with her eyes closed. It also gets her off the hook with her friends. When her eyes are open and she passes a friend or acquaintance she says that it's embarrassing. "People forget you're blind and think you're snotty," she says.

I ask her what she'd be doing now if she weren't blind. "Well, I don't think a blind brain surgeon would have gone down too well," she answers.

Then adds, seriously, "If I hadn't been blind, I wouldn't be me, so I don't know. What would I do if I was only four feet tall? Or more artistic? Or less? is just a characteristic like anything else.

"Historically, people with disabilities are seen as inferior. We don't help ourselves by the way we think of ourselves," she says.

"Some people think that people who are blind or who have other disabilities are intellectually less able. People react to me differently when they know I'm blind. Sometimes I'm chatting to someone - in a pub, say - who hasn't realised. Then I stand up and they see the guide dog and - the change in them! I can tell straight away."

There are 7,000 blind people in the Republic; Bethan doesn't see herself as a spokeswoman for any of them. All blind people are different, just as we are all different. But this young woman is an appropriate person to deal with others who have disabilities. At the 232-bed Royal Hospital, in Donnybrook, she works with people who are cognitively impaired or who have dementia. She helps people with limited movement as a result of strokes to use "power chairs" (wheelchairs with motors). She teaches them to turn the TV on and off, or to operate light switches. She teaches them to wash and dress themselves. Small victories make all the difference to quality of life.

She visits clients' homes and helps them to learn to adjust, with the help of her talking tape-measure and her "Braille lite" lap-top.

At the Royal Hospital, there has long been a shift away from the attitude that it was essentially a hospice. "There's hope here," says John Kennedy, hospital CEO. "We're stopping the attitude of the one-way trip up the avenue." Today's ethos is to help people have a good quality of life to the very end.

Bethan is part of a team of occupational therapists that keeps people mentally and physically active with cooking, painting, music and exercise. Even patients who seem completely unreachable are brought to a "multi-sensory" room - where music, lights and smells stimulate minds that can seem very far away. Even the smallest reaction is gratifying for the team.

"They do know what they are doing. They do know what's going on. They recognise me and at the end of the day, they are people. It's our problem if we can't understand what their existence is like. They may not talk verbally, but they can communicate. If we feel they cannot communicate, it's we who are failing," says Bethan.

The Royal Hospital is a charity-based voluntary hospital funded by the Department of Health and Children. Conor Leonard, the hospital's project manager and a former member of the occupational therapy department, admits he took a risk taking Bethan on.

But he's found the only difference between Bethan and the rest of his staff is that she's dragging them into the information technology age, using voice-sensitive software to run her PC (the screen of which stays blank, since she cannot see it). Her special equipment is funded by FAS, under equality legislation which guarantees people with disabilities the right to be enabled to work.

The hospital itself, founded in 1743, is the oldest of its type in Britain or Ireland. With the help of fund-raising by the Friends of the Royal Hospital and capital funding from the State, a £10 million building programme is gradually doing away with the vast, 20-bed halls that the hospital has been associated with. The new building is modern and more intimately scaled. There is a rehabilitation unit for people under the age of 65 with chronic disabilities and a day hospital with 30 places, as well as an education centre, sheltered housing for 29, a concert hall and, under development, a wheelchair assessment unit and workshops.

The Aos╙g programme, which involves teachers and senior students, makes sure that young people help bring life into the hospital.

Because it is charity-based voluntary hospital - with an independent ethos guaranteed by legislation - it can afford to cut through bureaucracy. When someone needs a power chair, they get it without the usual six-month wait. One patient even holds weekly audio-visual conferences with a sister in Italy. People in their 90s with late stage dementia are never seen as being beyond hope. Anything that can be done to keep their minds alive is done.

"The acid test is, if it was a relative of mine, would I be happy for them to come here? And I'd have to say 'yes'," says Bethan.