Was it the hours listening to Bruce Springsteen full-blast in my parents' living room or the mornings daydreaming with a hair dryer directed at my head? Was it a childhood fever, that kidney infection when I was 5 or the daily cacophony of my children as they sing, shout and cry their way to adolescence? Perhaps a genetic flaw from my hearing-impaired grandfather and uncle, or exposure to toxic fumes the summer I painted college dorms?
The origins of my hearing loss are as unknown as its progression is unpredictable. With luck and better attention to decibel levels, the loss may not worsen, according to my doctor. More likely, it will continue to deprive me slowly of other sounds, the nuances of daily life, the ability to distinguish a child's cry of pain from her shout of joy.
At 36, being fitted for binaural hearing aids (one for each damaged ear) is an introduction to a world of disability. I had not expected this passage to come so early in my life, though it is certainly easier to live with than other chronic health problems. I thought my own middle age was around the corner, not on my own street. But my hearing loss is a traffic cop, telling me to quit jaywalking and watch where I'm headed.
For the last four or five years, I have had more and more trouble following conversations. In a room where several people were speaking, I heard none of them clearly. Symptoms seemed to accumulate, but I ignored them. Instead, I nodded agreeably or asked people to repeat themselves. I cranked up the volume on the stereo and the television but would still have to ask my husband to repeat what characters had said.
Talking on the telephone became increasingly difficult, a barrier to my professional life as a writer. My children's conversations began to fade, until I could not distinguish much of what they had to say.
One day last summer, a girlfriend called to give directions to her house. I kept asking that she repeat herself. After several minutes, she said, "I'm yelling, Janice. What's wrong?" A few weeks later, I had a similar conversation with my mother.
In October, I took my hearing problem to my general practitioner. When the exam was finished, he asked: Had I served in the military? Played in a rock band? Been exposed to industrial chemicals or machinery? Suffered repeated high fevers? I had not, although memory dredged up a decade's worth of concerts at arenas, bars and stadiums. If there were a voice-over to memory, it would be my mother's, urging me to turn the volume down or to sit farther away from the speakers, or my grandmother's, warning me that one day I'd be deaf.
Next came the ear, nose and throat specialist (ENT), who began by tapping a tuning fork and asking me when I could hear the sound. Then he pointed to a wall poster of the human ear and its interior, explaining the areas where mine might have broken down.
In the audiologist's small soundproof room, I went through a more sophisticated hearing test, raising my hand when I heard tones from a sound system, attempting to repeat words she called out away from my line of vision. I could not distinguish "seal" from "peal," or "stay" from "stray." After more tests, she walked me back to the examining room.
The ENT held up a chart on which two lines ran across a grid, one representing sounds distinguished by my left ear, one my right. The horizontal line that started at zero, he explained, represented normal hearing in both ears. But the point at which my two lines plunged represented decibel levels necessary for my brain to perceive sound. My particular hearing loss, diagnosed as sensorineural (nerve damage), he said, was severe and most likely irreversible. Before referring me for hearing aids, he wanted blood tests to rule out other causes such as thyroid disease, diabetes and high blood pressure. The tests were negative.
Later, I went through sticker shock and technological confusion as the audiologist explained an array of hearing aids, which my insurance did not cover.
The most sophisticated version is the in-the-ear-canal, digital programmable aid, which analyzes the frequency of incoming sounds and increases or decreases volume accordingly. If a wearer is in a room with a humming fan, for instance, and someone speaks, the digital version will amplify the speech and muffle the sound of the fan. These devices can cost as much as $5,000 a pair. The least expensive models use in-the-ear, non-programmable analog circuits with adjustable volume controls; they begin at about $1,200 a pair.
The programmable aids, much like the ones President Clinton sometimes uses, sounded and looked great. They fit in the ear canal, leaving only tiny antennae protruding from the ear shell.
I opted for a lower-tech, in-the-ear device at $1,800 a pair. The audiologist made molds of my ears and called days later to let me know they had arrived. The ride home, with my new devices in place, was noisy and overwhelming. The wind whipped around my car, the keys jangled from the steering wheel, the traffic squealed and honked and roared. All five children were home from school and my house exploded with noise. When they shouted, I covered my ears, only to encounter painful feedback. (The microphones in the hearing aid make a screeching noise when they are covered.)
"Please, use your school voices," I implored. They began to whisper and I could hear every word.
Later that day, the children were at the top of the driveway. Or were they? It was a few minutes before I realized that they had actually run to the woods, where they were laughing and playing. For the first time in years, I could distinguish their voices, pick out the emotion behind what they were saying and realize that everything was okay.
Nevertheless, I feel self-conscious and somehow vulnerable whenever I wear my hearing aids. They can irritate the outer ear by trapping moisture and creating an itch. I worry that people are watching when I adjust the volume controls.Wearing the devices to business meetings and social outings has given me a glimmer of how life must be for others whose health is impaired in some evident way.
Although the hearing aids nestle in the shell of my ear, they are still obvious. I let my hair grow to cover my ears, but my wayward curls go where they please.
I can tell when people notice the devices; they look right at me as they speak slowly and carefully. "Look, I'm not deaf," I have wanted to say. But that is denying the truth, which is that, in some circumstances, I am. And when I have not been able to hear what's going on around me, I have understood too clearly how it feels to be isolated, excluded, frustrated.
Yet I know just how lucky I am to have devices that restore my hearing to a normal level, that bring me back into the fold of conversation and words, exchanges and whispers, the small voices of my children, the quiet talk of my husband.
The Bethesda-based SHHH (Self Help for Hard of Hearing People Inc.) offers information on hearing loss, screening and assistive technology. The group's Web site is www.shhh.org. The group can be reached by phone at 301-657-2248 or TTY at 301-657-2249.
The American Academy of Audiology offers consumer information on its Web site at www.audiology.org.
Janice Lynch Schuster is a writer living in Riva.