‘I Can Hear Birds, Wind, Rain!’ : Experimental Aural Implant Holds Hope for Some Deaf

John Meier can hear again.

“I walk outside, and if there are birds around I hear them sing,” he says. “I can hear the wind. I can hear the rain. I can hear kids laugh.”

Six years ago, Meier contracted spinal meningitis. He thought at first that it might have been a case of the flu, but soon realized that it was something much worse. On the way to the emergency room he went deaf.

Meier spent his 19th birthday in the hospital. It was his first birthday without sound.

“It was very lonely. I lost a lot of friends,” Meier recalled. “I couldn’t use the phone. I couldn’t hear the television. It was pretty scary.”

Today, Meier studies geography at California State University, Northridge, and can understand his professors without the help of a sign-language interpreter. He talks on the telephone with friends. And he listens to birds sing.

The 24-year-old Studio City man is one of a few hundred people worldwide to take part in the experimental use of a hearing aid that is implanted in his head.

The device, which works in conjunction with a pocket-size processor, converts speech and other sounds into electrical impulses that bypass the damaged ear and feed directly into the auditory nerve that links the ear to the brain.

Since Meier’s operation in September, the U. S. Food and Drug Administration has given pre-market approval for widespread use of the 22-channel cochlear implant. Doctors hope the device may someday restore at least partial hearing to as many as 200,000 deaf Americans.

“I think that this implant is going to redefine deafness for thousands of people,” said Dr. J. Stephen Sinclair, an associate professor at CSUN and one of the audiologists who has monitored Meier’s experimental implant. “We are not saying this is a panacea for all deaf people. But there’s no question that this device works.”

Several weeks after Meier received the implant, he pulled up at CSUN’s audiology clinic with his car radio blaring.

“We knew then that this was going to be a success,” Sinclair said.

Cochlear implants are now being used only with post-lingually deaf adults; that is, people who lost their hearing after having learned to speak. Such deaf people are better able to understand the implant’s “sound” because they have heard before. There are about 200,000 post-lingually deaf people in the country, according to a 1974 census conducted by the National Assn. of the Deaf.

The cochlear implant is physically unobtrusive. Meier wears the compact computer processor in a holster under his shirt. The quarter-sized implant itself is surgically placed in the mastoid bone behind his right ear and is not visible. On the outside of his head, however, also behind the right ear, Meier wears a small, disc-shaped microphone.

In simplified terms, the device works like this:

The microphone picks up outside sounds and relays them to the computer processor. The computer breaks the sound into frequencies, from high to low, and translates the sound into electronic impulses. These impulses are transmitted to the implant inside Meier’s head. The impulses then run through a coil that is inserted into the cochlea, or the inner ear.

Nerve Endings Alive

The sensory cells in Meier’s cochlea, which would normally detect sound, are damaged. But, the nerve endings beneath these cells are still alive. They are able to receive the electronic impulses and transmit this “sound” information to the brain.

What Meier actually hears is only partly like the hearing of a normal-hearing person. The richness of sound is lacking. There are only the bare bones of high and low tones.

“It’s kind of fuzzy,” he said. “It’s kind of like listening to an AM radio from 10 feet away.”

If there is a lot of background noise or several conversations going at the same time, the signals sent to Meier’s brain are confused. But he can follow a single conversation with relative ease.

Meier applied for an experimental implant last year, after he heard that CSUN’s department of communicative disorders was working with a local hospital on researching the device. He, like others given the implant on an experimental basis, was selected because he could not be helped by conventional hearing aids. In addition, Meier had only recently lost his hearing and was deemed psychologically able to handle disappointment if the experiment failed.

“I never got my hopes up really high,” said Meier, who was warned by doctors that the device might help him only slightly or not at all.

Humana Hospital-West Hills, a Canoga Park medical center that is sponsoring cochlear implants, paid the $25,000 in costs for surgery and rehabilitation. Dr. Jerome Dickman, who heads the cochlear implant program at Humana, performed the surgery in less than four hours.

For the next three weeks, the device was left turned off while Meier recovered from the surgery. The day it was to be turned on, Sinclair showed up at his office an hour early. He found Dickman already there, pacing in the parking lot.

“Everybody sounded like little green men, like they had inhaled helium,” Meier recalled. “I got home and everybody wanted to talk to me. I got pretty tired talking to people that first day. I went to bed early.” Meier’s use of the device is still improving. It will be another six months before doctors know for sure how much he has been helped. At this point, halfway through the rehabilitation, he has been termed a “mid-level success.”

The implant is expected to, at the very least, help deaf people with speech reading, allow for the detection of changes in sound and eliminate some of the isolation that post-lingually deaf people suffer when they are cut off from the normal, ambient sounds of life around them.

Meier has gone a step further. He recognizes environmental sounds--a passing skateboard, sirens, cars honking. He will interrupt a sentence to proudly point out that he can hear a helicopter flying overhead. Yet, he still relies on both his new sense of hearing and lip-reading to understand what is being said.

Doctors say some patients with the device implanted may be able to follow conversations without lip-reading. Meier may reach that stage.

Experimentation with the idea of directly stimulating the auditory nerve fibers began in France in the late 1950s. By 1972, a single-channel implant had been developed and was being tested. About 1,100 people now use such devices, which work similarly to the 22-channel device but transmit “sound” in only a monotone buzz, with no pitch perception.

It was in 1983 that the FDA gave approval for experimental implants of the newer, more sophisticated 22-channel devices in the United States. Several companies manufacture multichannel implants. Among them is Nucleus Ltd., of Sydney, Australia, which makes the device that Meier wears.

There are 28 teams of otologists and audiologists around the world versed in cochlear implants. In Southern California, only CSUN, the House Ear Institute in Los Angeles and the University of California, San Diego are now involved in cochlear implants. Kaiser Permanente is planning to start another program in Los Angeles, Nucleus officials said.

And, this week, another CSUN student, whose name was not made public, will receive an implant. There is also experimentation with implants on deaf people 10 to 17 years old.

“A lot of patients don’t really know that the device is available,” said Judith Brimacombe, a clinical coordinator for Cochlear Corp., Nucleus’ U.S. subsidiary. “They’ve been told by doctors that nothing can be done to help them. We need to educate the public about this implant.”

Sinclair believes that more success stories like Meier’s will help spread the word. “I think the good Lord smiled on us when he sent us John,” he said. “He’s extremely intelligent and highly motivated. He has a supportive family. He’s the ideal patient.”

“He thought he was destined to be in the deaf world forever,” said his father, Hans. “All the things he lost he has gained back.”