Views & Reviews Medical Classics


BMJ 2010; 341 doi: (Published 20 October 2010) Cite this as: BMJ 2010;341:c5680
  1. Ross Elledge, foundation year 1 doctor, Worcestershire Royal Hospital, Worcester
  1. rosselledge{at}

Blindness could serve as standalone testimony to why José Saramago was awarded the 1998 Nobel prize for literature. In the novel Saramago explores a public health nightmare as a society is faced with an epidemic of contagious blindness. A man goes blind at the traffic lights while sitting in his car; he is helped by a stranger who promptly goes blind himself.

Central to the book is an ophthalmologist who goes blind before he can finish reading the textbooks and stand a chance of solving this affliction. He remains a beacon of hope and solace throughout the book for his blind companions, a voice of reason in a world that is slowly turned upside down as the blindness spreads like wildfire through the city. Despite being powerless to do anything to cure the blindness, he assumes the role of a natural leader and touchstone for sanity, a reference point for all that was civilised and is now lost, a physician in the truest sense of the word. “What good is a doctor without eyes or medicines?” he asks. “You have some authority,” comes the reply from a trusting group of frightened companions.

Saramago’s fictional society descends quickly into chaos as Thomas Hobbes is vindicated and the social contract abandoned. All niceties are done away with, and the state quickly begins to treat the new blind as pariahs, herding them into the wards of an abandoned and ramshackle mental asylum. Here a new order is imposed, as the ophthalmologist and his companions begin to rebuild some semblance of a communal life as they get to grips with a life without vision. Saramago paints a vivid picture of blindness and of being newly deprived of a sense that robs the person of his or her independence in the early stages, and we are witnesses to the pain and anguish of the interns of the asylum as they face this challenge in the most arduous of circumstances.

The state soon forgets its new wards; and as the food rations begin to tail off the soldiers guarding the asylum become increasingly trigger happy in their nervousness over succumbing to the contagion, and factions begin to arise in the asylum. A band of thugs begin hoarding supplies and holding to ransom the other interns, who “having lost the light of their eyes [have] even lost the guiding spirit of respect.” They are aided by a rare advantage: a man blind from birth can navigate this strange new world that they all inhabit. But there is something that is suspected by many but voiced by no one in this mêlée: the ophthalmologist’s wife can still see. The question remains whether she will use this advantage to do the desperate acts that a desperate situation calls for.

As the asylum fails to contain the growing number of “patients,” our protagonists are returned to a world that they scarcely recognise. How can humanity be regained? How can a society rebuild itself? The ophthalmologist’s wife has the answer, “By organising itself, to organise oneself is, in a way, to have eyes.”


Cite this as: BMJ 2010;341:c5680


  • Blindness

  • A novel by José Saramago

  • First published, in Portuguese, as Ensaio sobre a Cegueira (Essay on Blindness) in 1995

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