From a Body Hearing Aid to a Cochlear Implant

Editor: Here's Mark Ross with some reflections on his hearing loss journey, which began back in 1951. This article was originally published in "Hearing Loss Magazine" and is reprinted with the author's kind permission. Sadly, this is Mark's final contribution to that magazine, to which he has been contributing for 18 years! We will miss him!

This is Part One of two parts.

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I have been writing bimonthly articles for this journal for almost eighteen years, ever since I "retired" from a full and thoroughly rewarding professional career. It has been my pleasure and privilege, one that has added meaning and purpose to my later years (when this article appears, I will be eighty-five years old). It's time now to call it a day and finally, really "retire." So I'm afraid this is my last one. Our indulgent editor, Barbara Kelley, has agreed to permit me to be somewhat more autobiographical in this one, as I review my personal experiences in going from a body aid in January l952 to the cochlear implant I received four years ago. In recounting some of the events in my personal journey, I'm also going to comment on a few of the lessons that can be drawn from my personal experiences.

In late l951, I was told by an Otolaryngologist that I had a progressive hearing loss and would eventually go completely deaf. And that was it. As I'm pleased to note, he was completely wrong. Evidently he was basing his prediction on a medical model which ignored the potential role of hearing aids to keep me auditorially connected to the world. . And, thanks to developments in hearing aids and cochlear implants, there has never been a time when I was functionally "deaf." With every significant decrement in my hearing, there has always been some technical development that could help offset its full impact. Nowadays - I'm pleased to say - I doubt that any Otolaryngologist would offer such a grim prognosis without, at the least, informing the patient of non-medical remediation measures that could be taken.

In January l952 I was enrolled in the Aural Rehabilitation (AR) program at Walter Reed Army Hospital. There I soon received my first hearing aid. It was a vacuum tube body aid that was worn either in a harness under one's shirt or, as I mainly did, placed in one's shirt pocket. The aid was provided to me as one component in a comprehensive AR program. The program lasted for two months, eight hours a day for five days a week. Our days were filled with speechreading and auditory training exercises of various kinds, some quite ingenious, as well as informational lectures. Yet, as much as I may have learned, looking back now it seems to me that the chief benefit of the program was basically a side-effect of the group setting and not the formal curriculum.

There were approximately twenty or twenty-five men in my group, and we not only went to classes together but bunked and ate our meals in the same facility. It was in these informal settings (plus the frequent, unplanned, discussions that would arise in our classrooms) that we learned to acknowledge our hearing loss and to accept the value and necessity of the hearing aids. We would joke with one another with such comments as "Are you plugged in yet?" or "Are you on the air?" In short, we were not alone; other people shared our plight. This helped reduce the sense of isolation and anxiety that so bedevils many adults with a late onset hearing loss.

I think the biggest weakness in contemporary hearing aid dispensing practices is the fact that most people receiving hearing aids do not receive this kind of opportunity. While effective communication training and hearing aid management can be carried out on an individual basis, it should complement and not substitute for the psychosocial benefits that a group experience can provide. Clearly, the kind of program I received cannot be emulated today, but there is evidence that demonstrates that even a short-term AR program, optimally associated with the hearing aid selection process, can be beneficial to the recipients. Some Audiologists now offer such a program, but they are, unfortunately, still very much in the minority.

Beyond its auditory benefits, the body aid proved to be advantageous in other respects as well. For example, in noisy places I could take the aid out of my pocket and place it close to the lips of my conversational partner. In other words, in some situations it functioned as an effective assistive listening device. It also gave rise to some amusing experiences, like my being asked what the score was during a World Series game when someone noticed the aid in my ear and mistook it for a radio. Or, when at a USO dance, in bringing my dance partner close to me, I felt and heard a "thunk." Now as a young man full of overactive hormones, I expected (and hoped for) some kind of sensation, but certainly not that one. But I persevered, brought her close to me again, and again felt and heard a "thunk." It turned out that the lady also wore a body aid and that our hearing aids were colliding as we drew together. It made for a good laugh and a pleasant evening; certainly a comparable experience is impossible nowadays.

I served in the Air Force for three more years after receiving the hearing aid. During this period, I traveled widely both in the States and abroad. In some places, as in North Africa, I was likely the first person that other people saw with a hearing aid, and I myself cannot recall ever seeing anyone else using one. But wearing a very visible hearing aid never became an issue; I did my job and functioned and socialized normally. I made no attempt to disguise the hearing aid; when someone noticed it and asked what is was, my typical response was to simply say "It's a hearing aid, it helps me hear better the way those glasses you're wearing help you see." I can't remember a time when that simple explanation didn't suffice. I did not, I'm sure, convey the feeling that the aid revealed some personal flaw, some stigma that had to be denied or disguised. I'm now convinced that it was my personal acceptance of my condition, an attitude that I must have at least subliminally conveyed, that led to others accepting me as I was. There's a lesson in this that, unfortunately, is still very pertinent today. In my judgment, self-acceptance is the key factor in successfully adapting to the hearing loss and the use of hearing aids. And the hearing aid industry doesn't help with its obsessive focus on invisibility, an appeal that simply reinforces the feeling that a hearing loss is a shameful condition, one that has to be denied and disguised at all costs.

I started my professional training after my discharge from the Air Force. My B.A. and M.A degrees were as a Speech and Hearing Therapist (Audiology as a separate profession barely existed in those days), and I worked with people who had speech and/or hearing problems. Again, I made no attempt to disguise my body aid. And, again, I'm convinced that my personal acceptance led to its acceptance by others. It was not until I began my doctoral work that I functioned primarily as an Audiologist. I wore body aids for about fifteen or twenty years, and switched to behind-the-ear (BTE) hearing aids when the V.A. made them available. For the first time, BTE aids made binaural hearing a realistic possibility, as few adults would accept the inconvenience of wearing two body aids. Selecting which ear to use, not always obvious, became a crucial clinical skill. For myself, I opted to alternate ears, sometimes in one and sometime in the other; this was my attempt to provide stimulation to both ears. I believe that this effort ultimately paid off, when I used a BTE aid in each ear.

Here's Part Two