GENERAL ARTICLES

I CAN HEAR!

The writer lived in the murmuring solitude of deafness until surgery let the voice of the world return in a glorious shout

GEOFFREY YATES March 1 1947
GENERAL ARTICLES

I CAN HEAR!

The writer lived in the murmuring solitude of deafness until surgery let the voice of the world return in a glorious shout

GEOFFREY YATES March 1 1947

I CAN HEAR!

The writer lived in the murmuring solitude of deafness until surgery let the voice of the world return in a glorious shout

GEOFFREY YATES

TM* i* tha surgeon's "window" which carries sound to the inner ear.

Magnified ear section. Black line shows normal sound path; red line is channel after operation.

LET ME tell you about an operation that brought me back to this world.

For more than 10 years I was hard of hearing. On the outer edge of everything. Almost out of this world.

Eighteen months ago my hearing was restored. It still seems like a miracle to me, but actually it wasn’t. It WHH the result of an operation which literally “opened the window” in my skull which permits the sounds of the outside world to reach my brain.

I don’t know how long my hearing had been impaired. But in my thirties (I am 48 now) I began to wonder why so many people mumbled.

I would complain bitterly of this to my wife. Then domestic arguments began about the radio. When I turnedit on my wife turned it lower. I would grumble that, it was too low and turn it up again. Then she asserted it was too loud.

That, I believe, finally made us suspect that my hearing was poor—both of us suspected it, but because we were so afraid of it, we didn’t discuss it. I became seriously frightened, but I stubbornly refused to share my fear, even with her.

I remembered my grandfather. He had been hard of hearing from the age of 13 until his death—-the result of scarlet fever, I had been told.

The family frankly called him deaf. Actually he wasn’t—quite. He could hear if a person

spoke slowly and distinctly into his ear. He was a tall, impressive-looking man, with shaggy eyebrows and a heavy white beard. Anyone who made the mistake of shouting at him, which I frequently did, was instantly repulsed by a fierce frown. “Don’t bellow!” he would bellow.

This embarrassing affliction kept him apart. He even insisted on having his meals served in another room.

Now I know why. It became agony for me to attend dinner parties and social evenings, where good manners demanded participation in small talk. The effort to hear became too much of a strain. Fatigue forced me to drop entirely out of conversations. I found out something interesting then, though—a lot of words are sheer repetition. If I caught one word in 10 I usually managed to understand the conversation—provided I knew the subject. Strangers must have thought I was not too bright. I was forced to think fast to make sense of the few words I caught.

Then came the war and—maybe you can’t figure it out, and frankly I can’t myself—I got into the Army. There I suffered agony. For five years I held responsible appointments (when I was discharged last fall I was a lieutenant-colonel) which called for frequent attendance at conferences. Keeping track of the subject, which was always changing, was a terrible ordeal. One trick I used was to tell the chap next to me that my hearing was temporarily impaired due to a heavy cold and would he mind jotting down each new subject under discussion. This usually

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I Can Hear!

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worked. But as my hearing continued to deteriorate, and my responsibilities increased, I began to find ways and means of dodging all meetings.

I did as much work as possible by telephone, over which I usually could hear quite well. Long-distance calls generally were clearest. On one occa-

sion I talked from Winnipeg with a colleague in Vancouver. I heard him perfectly, yet when he was in the same room I could barely hear him.

I finally reached the point where I dreaded meeting people. My neighbors must remember me as a surly, standoffish sort of churl, but it is hard for a man of normal hearing to appreciate the feelings of the chap who cannot hear well enough to exchange greetings

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across the street or from sidewalk to veranda. I had come to the conclusion that self-imposed ostracism was the only solution.

By that time it was late in 1944. I had gone to doctors, and found out that the technical term for my deafness was otosclerosis. Briefly, this is a bony growth in the middle ear, whereby three delicate little bones become stuck and cease to function, thereby preventing sound vibrations against the eardrum from reaching the auditory nerves, a harplike system in the inner ear.

The three little bones, each about the size of the head of a match, are known as the hammer, the anvil and the stirrup. They are encased in a capsule which fits in the middle ear. Sound waves striking the eardrum normally are transmitted through the middle ear by means of these bones to the inner ear.

In sufferers from otosclerosis, like myself, the stirrup bone, last of the series, becomes welded to the membrane through which it usually transmits sound vibrations to the spiral labyrinth containing the nerve endings. These nerve endings pick up sound and transmit it to the brain. My hearing system was like a' telephone with a plugged mouthpiece—the nerves, or wires, were in working order but sound was stopped before it got to them.

I learned more. A relatively new operation, called fenestration, first performed in Canada and the Únited States in 1938, could help sufferers from otosclerosis. To perform this operation, the surgeon first enlarges the outer ear channel slightly. Then, in a very delicate manoeuvre, he reaches through this enlarged passage to the damaged middle ear. He pushes the eardrum to one side, reaches past it and the three small bones, and drills a tiny hole in the bony casing dividing the middle ear from the inner ear. This hole is the “window” for which the operation is named (from the Latin, fenestra, window). After it’s over, the eardrum returns to its normal position.

When the operation is a success, sound waves hit the eardrum, then bypass the little bones and reach the inner ear through the new window. They press upon membranes beyond the window, and these in turn transmit the vibrations to the fluid surrounding the battery of auditory nerve endings. As the waves pass through this fluid they stimulate the nerves, the nerves transmit messages to the brain, and the patient once more hears.

Taking the Plunge

I had heard that doctors had achieved remarkable results with this operation. But I hesitated. I did not relish the prospect of a hole being bored in my skull with an electric drill. Also, I’d been told—correctly—that fenestration operations did not always have permanently good results.

For several months I had been trying out a mechanical hearing aid. I used it only sporadically, and I certainly had not become happy in its use, even though it made a marvellous difference. Had I been convinced there was no alternative I should most certainly have continued its use. But inside me I always had a feeling that my case was not hopeless and that my hearing could be improved.

Early in 1945 a vacancy occurred in the Army overseas which my superiors wanted me to fill. They were hesitant because of my poor hearing. It was decided that if my hearing could be brought up to the required Army standard I would get the appointment.

This made my decision for me. I

wanted to get overseas. I arranged an interview with an ear specialist in Toronto. He told me that his tests showed my hearing was more than 50% deficient in each ear, but he could improve my hearing.

I walked out of his office on air. I checked in with Army authorities again, and they told me that if the operation was successful I would get the overseas appointment I wanted so much. My operation was set for April 21. It would be performed on my left ear; one good ear is enough.

Waiting for the operation I found out more about it. Fenestration is effective only against the type of ear trouble I had—growing together of the bones of the middle ear. It is of no use against the deafness which comes with advancing age, for instance. And even in cases like mine it is not always successful. Sometimes the bones are cleared for a time, but grow back together again and the old condition returns.

If you were deaf and went to a specialist to ask if this operation would help (there are only one or two doctors in Canada who perform it, but several in the United States), he would test your hearing with electrical sounding devices. If he found your deafness due to failure of the auditory nerve system, he would tell you frankly that nothing can be done. If he can operate, and if the operation is successful, and if improvement in hearing is maintained for a year, it is reasonable to count on a permanent improvement.

The Critical Moment

/ With that information behind me it won’t be hard for you to understand the excitement and hope with which I checked into a Toronto hospital on the evening of April 20.

The next morning I was taken to the operating room, and from the stretcher was carefully laid on my back on a narrow operating table, about chest high from the floor. My head was turned to-one side and a sort of shelf surrounded the left ear, which was uppermost. I had been given sedatives and was quite comfortable and relaxed.

I was to remain conscious during the three-hour operation. I found out why later.

When the local anaesthetic had taken effect, the doctor started. First he made an incision moire than two inches long at the top front of the ear. Later I couldn’t see what was going on, but I knew when he was drilling by the grating noise in my head. I could also recognize the scraping sound when he cleared the tiny bore of bony debris.

Two nurses watched me closely, giving me sedatives orally or by injection and feeling my pulse at regular intervals.

Then suddenly the room whizzed round and round me. The staff was prepared, and I have never known an involuntary vomiting spell pass off so neatly. Apparently the doctor had reached my centre of balance while opening the way to the auditory nerve.

Then I heard his voice very distinctly.

“Can you hear me?” he asked. “Perfectly,” I replied.

Though I didn’t known it then, this is the critical moment in the operation. If the patient hears him, the doctor knows he has achieved success. That is why the patient must stay conscious.

However, in all previous conversations with my surgeon, I could always hear him distinctly. He has a resonant voice and clear enunciation. I did not realize how important that moment was, because I did not know then that he had dropped his voice quite low.

Some days later, while still in hospi-

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tal, the significance came home to me. The doctor told me of a patient he had operated on that morning. This patient, a man of 50 years or more, had been wearing hearing aids for 25 years. When the critical point in the operation was reached the doctor asked the same question: “Can you hear me?”

“Yes,” said the patient casually. Then, after a short pause, he blurted: “Do you know that is the first time in 25 years I have heard the human voice without a hearing aid?”

I’ll always remember one day in hospital a week or so after my operation. I complained to the nurse about the hissing noise the radiators were making. She seemed surprised. She told me the heat was not on, and with no steam in the radiators she couldn’t see how the radiators could be hissing.

Then I realized the truth! I was hearing the voice of a city, which I suppose a normal person never notices but which I had not heard for years. The outside noises of streetcars, motor cars, trucks, horns, shouts, rustlings, all merging into one glorious prolonged hissing, swishing sound. I could hear again. No more skulking on the outer rim of conversations. I could hear again. I belonged.

It was not quite so easy as that, however. You don’t just say to yourself, “I am cured. I can now hear as well as ever.”

I found I had to train myself to hear again; to concentrate upon what was being said.

After years of relaxation, retiring into a world of my own thoughts, I still find myself unconsciously slipping back into this old custom. I have to haul myself back and pay attention.

Hearing—Normal

I found, too, that prolonged poor hearing had had a marked effect on my voice. Frequently when I think I am almost shouting, I now find I am speaking in an extremely low pitch.

I'or several weeks the operation left me quite dizzy. It affected my sense of balance slightly. My immediate

recovery was complicated by colds and sore throats. There was a real danger of losing my hearing again. Colds are a menace following a fenestration operation.

So I was sent back to hospital to shake off the bad throat. My hearing remained. In the meantime my posting for overseas came through. Àn Army doctor tested me and pronounced my hearing normal, and on July 1 I sailed.

I was weak when I boarded the vessel, and found it quite a chore to carry a suitcase and an extra coat. I was still a bit Shaky when I reached London and reported to Canadian Military Headquarters. I took no chances and at once phoned a London specialist who had been recommended to me. He tested me and told me the results were good. I was still improving.

I don’t know whether the dampness of London was the cause, but my ear suddenly started discharging. This needed careful and steady treatment. It had no effect on my hearing, though it persisted until September.

The doctor assured me that the inside of the ear was in perfect shape but that the discharge might continue for some months or stop suddenly. But, he emphasized, it would have no effect on the result of the operation.

That fall I was sent to Europe on duty—with only a few minutes’ warning. As soon as I reached Amsterdam the condition in the outer ear cleared up and I had no more trouble. My hearing continued to improve. I renewed acquaintance in Europe with many old friends, and they were all amazed at the improvement in my hearing. New acquaintances did not suspect there had ever been anything wrong.

I saw the doctor again in London late in November. He gave me another test, and told me my hearing showed further improvement.

It has continued to improve ever since. I’m out of the Army now, and own my own newspaper in Val d’Or, Quebec. And I doubt if any of the new friends I’ve made there ever realize that I’d once been hard of hearirig, on the fringe of the world, it