A World Muffled and More Distant
The atmosphere in the restaurant is all they couldn’t wish for. Dim lights. Romantic music. Big glass windows affording twinkling city vistas.
Nothing wrong with the vistas. But the glass is bouncing noises all over the room. The poor lighting is stopping 47-year-old Ann Boyd--an accomplished lip reader--from seeing what people are saying. And the music is adding even more noise to a place already thick with the crash of crockery and glass and the rumble of dinner table talk.
All four people are struggling to hear, even though three of them are wearing hearing aids. “One on one, the aids are great,” says Boyd’s good friend, 53-year-old Teri Wathen. “But here? In this situation? It’s the pits.”
It’s also life-much-as-usual for Boyd and Wathen, and for the vast ranks of the hard-of-hearing to which they belong.
Twenty-six million Americans have mild to severe hearing loss and struggle each day to make out the voices around them. Their ranks are soon to swell. The rock ‘n’ roll-raised baby boomers have reached midlife. Ears age as bodies age, slowly losing their acuity as the insults of life take their toll--none more insulting than the crashes, bashes, screeches and twangs of life, the very things ears were designed to detect.
Noise, according to the National Institutes of Health, is at least partly responsible for one-third of adult hearing loss. One leading noise researcher goes further, calculating that environmental assaults--noise chief among them--could account for fully three-quarters of the hearing loss in 65-year-old Americans.
The problem is worsening. From 1971 to 1990, there was a 17% increase in the number of people 19 to 44 years old with hearing impairment, and a 26% rise in hearing impairment among those 45 to 64, according to government statistics. Two decades’ worth of mobile-van hearing tests of 64,000 Americans and other studies also report steady, significant increases. And today, all over America, hearing specialists report that boomers are showing up at clinics with hearing loss in their 50s, a decade or so earlier than the generation that preceded them.
After all, no generation before the boomers has exposed itself to so much noise for pleasure’s sake. And their children will probably follow in their footsteps.
Fun Often Means Noise Too
Workplace noise has been regulated since the 1980s. War noise has touched relatively few Americans since the Vietnam conflict. But never has there been such a cacophony of fun, exciting sounds to fill the leisure hours--blasting us in movie theaters with thundering, wraparound, 120-decibel effects; assaulting us on the road as the static of wind whips our ears and the bone-shaking boom of car stereos pounds our bodies, and filling our homes and the ears of adolescents as they gyrate to Britney Spears and the Backstreet Boys.
The fallout comes later--too late.
“Once the cells of the ear are damaged, they die and they aren’t replaced,” says William Clark, hearing researcher at the Central Institute for the Deaf in St Louis. “You can advise them to stay away from loud noises and wear hearing protection--but that advice should have been given 30 years earlier.”
What is it like to hear sounds only faintly--and more faintly with each passing year? Surely hearing loss can’t be nearly as bad as losing one’s ability to see--to navigate the world with a million and one shapes, shades and hues as trusty guides.
But if the effects of hearing loss are subtle, they are no less stark. Imagine not being able to hear whispered sweet nothings or the chirps of a grandchild. Imagine straining to keep up as people chatter on around you, with you wondering what you missed.
Then imagine the smiles eroding from the faces of loved ones as communication stalls, marriages wear down and life loses much of its richness.
Hearing aids can alleviate much of that hardship. But only 5 million Americans use hearing aids, just one in four who could benefit from them.
There are many reasons why: the slow, silent onset of the loss, which can render it unnoticeable to the sufferer for years, the aids’ sheer cost (insurance usually doesn’t cover them), limitations of the technology (aids don’t restore hearing perfectly) and embarrassment.
“Maybe vanity was the reason; I just didn’t want to appear old,” says Laguna Woods resident June Spritz, 78, a lover of music and conversation, who lived 15 years with hearing loss before finally buying her two aids. She says, “I denied it. I’d tell my husband he was mumbling. He’d say, ‘You’re getting deaf!’ and I’d indignantly reply ‘No I’m not; you have to stop mumbling!’ ”
In fact, deep inside Spritz’s head, cells had probably been dying for decades. The ear is a fragile thing, despite the body’s best efforts to protect it.
When most of us think “ear,” of course, we tend to think of fleshy flaps on each side of a face. But the real business of hearing happens deep inside our heads. That’s where the inner ear resides--snugly encased in the toughest bone of the body, far from easy reach of surgeon and scientist.
To learn about the ear, researchers have had to be creative, as is amply illustrated by their eclectic tool kit: mathematics, electronics, human cadavers, little cells in dishes, furry chinchillas trained to pull on levers, centuries-old strains of deaf mice, and saws, mallets and drills.
On a day not long ago at the House Ear Institute near downtown Los Angeles--a leading center for hearing treatment and research--doctors visiting from around the world are learning to bore through that tough bone, so they can restore hearing with implants or remove tumors on the hearing nerve.
For practice, they cut away on donated cadaver bones that are kept in a grisly pile in a fridge tagged with a yellow Post-It: “Store Temporal Bones Here.” During a break they watch a live feed of an ear operation from the hospital across the street. In a nearby office, hearing researcher Federico Kalinec slides a videocassette into his VCR, and a much prettier show begins to roll.
The video is artsy, and French, as well as edifying: It features gorgeous Gallic men in linen shirts wailing “Ayaiii!” into the wind, and shows what happens when that “Ayaiii” funnels into the ear as ruffles in the air, then hits the eardrum.
The drum moves in and out like the woofer in a stereo. It jiggles three bones and the third plunges back and forth against the entrance to a small, snaillike structure.
In that structure sit row after row of little cells--17,000 per ear, each with a thatch of tiny hairs at its tip. These “hair cells” sense the plunging of that bone. They turn the noises of the world--boss bossing, yeller yelling, jackhammer jackhammering--into electrical signals that journey on to our brains.
Kalinec has another amazing video in his collection. It’s of one of those hairy cells in a dish, flexing its tube-like body in perfect rhythm to the cancan. Just like one of those goofy, novelty flowers that jiggle around to music.
We’d hear very little, he says, if certain hair cells couldn’t “dance.” When those cells move--in ways that still mystify scientists--they sharpen and amplify all the sounds streaming in from the world, turning garbled and faint noises into crisp and easily heard ones.
Teri Wathen’s “dancing” cells would do nothing if you played them the cancan. Because of some genetic mistake, they slowly died, forcing her at age 12 into her first hearing aid--a bulky one back then, with a microphone the size of a cigarette pack hooked onto her bra. She didn’t need the bra. Her mother bought it just to hold the aid. (“I hated it,” Wathen says. “I was very embarrassed.”)
And Connecticut audiologist Mark Ross has also lost many dancing cells: They were mowed down in a Georgia boot camp during World War II, shaken to bits by explosions and rifle cracks that left his ears ringing.
The fact that noise can hurt ears is no sudden revelation. The ancient Romans not only had nuisance ordinances banning chariots from the cobbled streets at night, they also compensated their armor-makers for the deafness that came from the clash of metal on metal. In the 17th century, “boilermaker’s deafness” was well-known.
What’s new, though, is the growing appreciation that noise is causing much of the hearing loss we view as inevitable, sands-of-time stuff. Animal studies--in which chinchillas and other mammals are exposed to chronic noise--suggest so. And so do two classic studies with people.
In a quiet, rural Sudanese village in the 1960s, a scientist discovered that the hearing of elder tribesmen was sharper and crisper than that of 20-year-olds in industrialized societies.
And on remote Easter Island, 2,300 miles off the coast of Chile, researchers in 1986 found that hearing was similarly crisp--except, that is, for people who had spent years off the island in noisy cities.
But noise is not the only threat to ears.
There are scores of genes that, when malformed, cause bones of the ear to fuse and hair cells to die, or never to form properly to begin with. There are marauding bacteria and viruses that infect the ear, damaging the hearing bones and killing off hair cells in droves.
Certain prescription drugs can harm the ear. Immune cells can turn traitor, mistakenly turning on our bodies and attacking the hair cells as if they were foreign interlopers. And then there are tumors, the dwindling of blood supplies--and simple aging of the ear.
But whatever the root of a hearing loss, the problems it presents are drearily unifying, though they wouldn’t necessarily cross the mind of someone who doesn’t have to strain to hear every word.
“It’s as if you almost have to get poked in the eye to understand what a blind man goes through,” says Steven Mogol, 51, of Los Angeles. For years, Mogol had suffered from tinnitus, a ringing in the ears often triggered by ear damage. Then in May came a mysterious, precipitous hearing loss in one ear. The bitter irony was that the tinnitus remained, even louder than before.
Mogol was depressed for months, he says. He felt inadequate. Vulnerable. And while the initial shock has passed, he’s still learning about changes that are here to stay, now that he doesn’t have two ears to tell him where sounds are coming from.
He’s a sociable guy: He used to love to hang out in restaurants and bars with friends. No longer. The first time in a restaurant after his hearing loss, he says, “I felt like I’d entered a foreign country. I couldn’t make out the language.”
And he never would have guessed before it happened, he says, how important it would become--even in quiet places--to make sure his good ear was angled the right way. How awkward it would feel to have to ask people, repeatedly, to repeat themselves. How sad he would feel that a young child can no longer spontaneously call out but must stop, walk up and speak clearly, formally, to be heard.
Banding Together for Support
Hearing loss puts up walls between people. In small ways, sometimes: Steve Sirell, June Spritz’s son, says he could see his mother’s distancing as her hearing loss progressed. They’re a family of “yakkers,” says Sirell, and there, suddenly, was his mom, not quite in the thick of the fray any more with her wry two cents’ worth.
With stresses like these, it’s no wonder that some people who are hard of hearing choose to band together. At a convention in New Orleans not long ago, members of Self Help for Hard of Hearing People, (SHHH) a national advocacy group, crowded the meeting rooms, some of them with hearing-ear dogs trotting at their sides.
This year there’s been no snafu like last year’s, when fire alarms went off in the night and no one--except for the folks whose dogs pawed their beds or licked their faces to wake them--knew anything about it till next morning. (“If it had been a real fire,” says Ross, “it would have been the end of SHHH.”)
Instead, for days, members have been soaking up sessions with titles like “Is My Hearing Loss Genetic?” and “Being a Hard of Hearing Grandparent.” They’ve squeezed into exhibit halls to learn about the latest devices for the deaf: special phones, vibrating alarm clocks and other electronic gadgets that bring sounds right to your ear. And they’ve left the halls laden with freebies: hacky-sack balls from a leading hearing-aid maker, bone-shaped refrigerator magnets from Dogs for the Deaf, you name it.
For five days, they’ll learn as much as they can from each other. About equipment that can help them. How to ease the tension in their lives. You have to help each other, they say: You can’t rely on the “hearing world” to do it for you.
Wathen, a Houston teacher, learned this way back in the 1960s, after a Los Angeles teaching job she wanted badly was whisked away after authorities found out that she wore hearing aids.
Boyd, who’s been hard of hearing since childhood, marvels that she could live in Texas all of her life and never know that country and western songs are often sad. She only found out after she and a pal persuaded a local rodeo to display the lyrics and play-by-play on a captioning screen.
Ross, the Connecticut audiologist, says he and his fellow sufferers simply have to not be ashamed of asking for more light and less music, or of speaking too loudly, or of looking odd with the flesh-colored plastic behind the ear.
One time, at a meeting, a listening device that a friend of Ross’ was wearing broke down. The only way the friend could hear anything was to share Ross’ own device. And so they sat, two old men snuggled together with a gray plastic wire looped around both their necks, not bothered by the strange stares they were getting.
You do whatever it takes.
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Hearing Demographics
Hearing loss by age and gender:
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Source: National Academy on an Aging Society
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* SPECIAL SECTION ON HEARING
Today’s Health section is devoted to problems of hearing loss and efforts at remedies. S1
