I entered a period of several decades characterized by gradual loss of more hearing and punctual increase in the power of my hearing aids.
My earliest hearing aids were analogical devices, installed in the ear. They were replaced every six years or so, as dictated by my disability insurance.
It wasn’t long before my hearing degraded to the point that only the most powerful devices on the market would be helpful to me. During the same period, the devices became digital sound processors, with multiple microphones and various processing algorithms designed to enhance understanding in difficult contexts.
To make a long story short, the only help I ever received from these hearing aids was the amplification of sound. None of the other features—reduction of background noise, directionality of sound, the supposed benefits of compression and so forth—were ever of any use to me.
In a sense, it is miraculous that I was able to continue my professional activity as long as I have. For many years, I have worked as a consultant and a trainer. My whole livelihood depended on the oral, face-to-face interaction with my customers.
Well, in the final two years of the training courses I led, I started to have significant difficulty in understanding everything my students would say to me. It was embarrassing and frustrating.
I decided to take my training courses on line. No longer would they be live interactions. Instead, I bought a lot of equipment to record my lectures, which are available on demand to the students. Exercises, quizzes and tests required no hearing on my part. I only led live, online sessions once a week. My exposure to the problems of inadequate comprehension was very limited.
Today, real time sub-titling technology could possibly be exploited to enhance my professional interactions. But at the time, such technology was not available.
Loss of Hearing
I distinguish between the loss of hearing and the loss of comprehension (even if I sometimes confound the two). Until very recently, my hearing aids could always amplify human speech sufficiently for me to hear them. The problem has not been there. Instead, the problem has become one of understanding what I hear.
That being said, there were always sounds that I would not hear at all, whereas another person could readily hear them, soft though they be.
I remember one day, not long after I got a new and more powerful hearing aid, I was sitting at home when I started to hear some loud cracking sounds, percussive sounds that I could not identify. After some investigation, they turned out to be the sound of a shotgun being fired by a local farmer who was attempting to prevent the formation of hail. I live in a wine-producing region where a single hail storm can destroy a year’s crop. I knew that this was a relatively common practice during the summer season of storms, but I had never heard the sounds before.
Loss of Comprehension
That loss of hearing is much less important that the loss of comprehension. About two years, I started to realize that I could hardly understand completely anything most people would say to me. There were exceptions, of course. I never have difficulty comprehending my siblings’ speech.
But, when I am obliged to ask my wife to repeat virtually everything she says, the situation becomes barely tenable. As frustrating as it is for me, it must be terrible to not be understood and to have to constantly repeat what one says.
What is to be done?
From time to time, I would ask my otorhinolaryngologist if there were anything to be done to help me, in addition to the hearing aid. Aware that technology advances rapidly, I wanted to know about potential solutions.
The answer I always received was that the auditory nerve on my right side, where I had the failed stapedectomy, had not been stimulated for a long time. Due to this long desuetude, it was too late, in the doctor’s opinion, for any solution depending on that nerve to improve my comprehension.
As my dependency on and interaction with medical professionals has increased, I have gained in understanding about the dynamics of those interactions. Some patients seem to abdicate responsibility for their health. They might ask questions of a doctor, but do not seek to develop their understanding beyond the bottom-line opinion proffered by the doctor. Other patients think they know more than the doctors, but depend on them as gateways to care and to medicines. And yet other patients try to understand as much as they can, take responsibility for their own decisions, but realize they need help from professionals. They depend on the doctors’ knowledge.
Similarly, some doctors offer their opinions and do not expect to be questioned about them. Others are frank about what is known and what is not known, but fail to provide the key information needed to make decisions. Some are very sensitive to the emotions and needs of their patients. Others less so.
As they say, it takes all sorts to make a world. But problems arise when the parties do not understand themselves and when there is a mismatch between what the patient needs and what the doctor is able to offer. Of course, similar issues exist between any two people, no matter what roles they play.
In the end, it was an audiologist, not a doctor, who triggered my entry into the next phase of my hearing odyssey. It was my audiologist who encouraged and supported the idea of getting a cochlear implant.