Few things strike as much unmitigated terror into a Baby Boomer’s chest as being told that he or she needs a hearing aid. It’s such an obvious sign of getting old. According to the Internet, two doctors I saw, three audiologists, NPR, two magazine articles, and the guy down the street who wears noise-cancelling headphones when he uses his snow blower, one in three Americans aged 64–74 suffers from some degree of hearing loss; after 75, it’s half of us. And it doesn’t go away.
I know this because a few months ago, I realized that I was asking my students (I’m a middle school teacher) to repeat themselves 8-10 times during a 42-minute class. I’d ask them to speak up, take their hands away from their mouths, say that again, please. Sometimes I’d walk over and stand next to the kid who was answering. It was annoying.
So I went to the local walk-in clinic and had the excess wax cleaned out of my ears. I do that every couple of years or so and that usually fixes everything; but this time, it didn’t work.
Reluctantly, I went to an ear, nose, and throat doctor who peered into my ears and said he wanted to check the level of my hearing loss, which did not elicit the kind of response I think he was expecting. “I don’t want to wear hearing aids,” I announced. I thought I was going to cry. OK. I did cry.
And I wasn’t old. OK. I’m old. I’m 65, but I don’t consider myself old. I don’t think I’m “old.” Whatever. I was sent into a little glass soundproof room and listened to a recorded voice say random words, like “grapefruit” and “playground.” Mostly nouns. Spondees, I noticed. I’m an English teacher. Then I listened to some musical notes and some high-pitched whining, but that may have been me.
Two weeks later, I walked out of a doctor’s office wearing hearing aids. It was not what I had been saving up to spend my money on. The cost of hearing aids varies greatly—anywhere from $1,000 to $7,000 a pair—and they are generally not covered by insurance. Medicare does not cover them.
I couldn’t remember doing anything that would have damaged my ears. That wasn’t me leaning against the speakers at Woodstock.
But even researchers aren’t sure what causes hearing loss as we age. Unless a loss of hearing was caused by illness or prolonged noise exposure in the workplace (carpenters, plumbers, teachers, and musicians report the highest incidence of hearing loss), it could be anything. Genes? Cheap wine? Playing our Walkmans full blast?
Usually, the condition creeps in so gradually that many people, like me, are surprised when they’re told that they would benefit from wearing hearing aids.
“It’s normal to say ‘What?’ two or three times day,” says audiologist Linda Schulman. “When you find yourself asking people to repeat themselves more than that, you might want to consider getting your hearing checked. Generally, though, by the time people get to us, we’re not telling them something they don’t already know. They just don’t want to admit it.”
And typically, she adds, she sees more women in her practice than men, but Schulman has a theory about that. “Men deny that they have a problem. They tell me they hear fine. They say, ‘I hear what I want to hear.’”
Dr. Anne Reap, of Parker Ear, Nose, and Throat in Norwalk, Connecticut, goes one step further. “When given the same hearing loss diagnosis,” she says, “women will take action within six months. For men, it’s an average of seven years.”
She believes that men think hearing aids signal weakness, even senility. “I have a client who’s the CEO of a big company. He’s only 48, and he says, ‘I can’t sit in a meeting wearing hearing aids.’ But he has to hear people. He can’t keep saying, ‘What? What?’”
So Dr. Reap has fitted him with hearing aids that are virtually invisible; they fit completely into the ear canal. “The sound quality may not be good as aids which fit over the ear, but his business presence is more important than perfect hearing.”
Another client, a prominent psychiatrist who wears the CIC (acronym for “completely in canal”) hearing aids, says, “Sometimes I have to work to hear what my patients are saying, but I can’t sit there with a visible handicap.”
“No matter how you present it, it’s always perceived as negative,” says Schulman. “It’s a really hard sell.”
Yet loss of hearing affects us in a profound way. “Loss of vision separates us from things,” says Schulman. “Hearing loss separates us from people. More than that, memory and brain processing are dependent on clear hearing.”
“Of the five senses,” says Reap, “[hearing] may be the richest, the most layered, the most food for the brain, and it’s critical to present our brains with a clear signal. With hearing loss, consistent stimulation isn’t possible. Over time, the neural pathways disappear, resulting in compromised speech.” Recently, researchers have linked this sensory deprivation to early Alzheimer’s and dementia.
But we’ve come a long way since sailors held up metal horns like trumpets to their ears to hear other sailors calling across the water, and people fit oversized metal ears over their real ears so they could better hear their dinner companions. People struggled to hear the world around them, and it was impossible to hide the disability which was threatening to cut them off from society.
Poor Beethoven, not even addressing the tragedy of not being able to hear his own music, was reduced to asking his friends to write in what he called his “conversation books.” In 1801, he himself wrote, “How sad it my lot! I am resolved to rise above every obstacle, but how is that possible?”
It was more than 100 years later that scientists actually came up with something they would call a hearing aid, greatly aided by the groundwork laid by the inventors of the telephone.
One of the first built was about the size of a cigar box which was strapped to the user’s chest. Several tubes connected the box, which held a microphone, battery, and amplifier to the ears. Not only was this remarkably ugly, but the battery only lasted about a day and it weighed nearly 10 pounds. As recently as the 1970s, this was the case, although the box holding the electronics was much smaller after the introduction of the transistor, and we can thank Bell Laboratories for that.
Still, there had to be a better way.
As fast as the telephone morphed from a black instrument heavy enough to be used as a weapon to the pocket-slim cell phones with internet access we carry today, the hearing aid changed from a practically useless embarrassment to a microscopic sliver of technology that does the job.
The typical modern hearing aid is a tiny speaker that nestles behind the ear with a clear thread of tubing that delivers sound to the ear canal. They’re not the old Silly-Putty-jammed-in-your-ear hearing aids of our grandparents. They’re sophisticated works of technology and art, controlled by a remote small enough to be attached to a key chain. The aid’s internal computer chip is programmed by an audiologist for the wearer’s individual needs, taking into consideration the amount and type of hearing loss, the wearer’s job and environment, and, frankly, what the wearer wants to hear. With the remote, the wearer can adjust the volume and filter, even focus on a single speaker in a room filled with chatter.
As early as 2006, manufacturers introduced lines of trendy hearing aids in bright colors, stripes, and leopard prints. They even tried to re-position them as PCAs (Personal Communication Assistants), but even when The New York Times featured the leopard-print PCAs in the Sunday Fashion section of the paper, they were still referred to as hearing aids.
Trinity, a 12-year-old girl from Norwalk who has been wearing hearing aids since she was a toddler, is so used to them that she’s happy when she has to get new ones. They get tinier and prettier as her ears grow to adult size, and she likes it when they are referred to as “ear jewelry.”
However, most people resist showing off their hearing aids so much so that they’ve come up with a hearing aid that is small enough to fit entirely inside the ear canal. This is the CIC (completely in canal) as opposed to the BTE (behind the ear). Microscopically tiny, the CIC doesn’t have room for the all the buttons and wheels that effectively control directional voice receiving and noise filter. Therefore, the CIC is better for minimal hearing losses.
All in all, today’s hearing aids are a modern wonder, kind of like a little GPS for your brain. Some even talk to you. When you adjust the volume or filter, a kind voice will tell you what you’ve just chosen. I have the voice of a gentle woman programmed into mine, but I think when I go back to see the audiologist, I am going to see if I can get the voice of a handsome man with a foreign accent.
By Sherri Daley