Tuesday, October 15, 2019

Book Review: 'Volume Control: Hearing in a Deafening World' by David Owen

Hearing gets no respect. We can imagine blindness by closing our eyes, but there’s no way to shut down our ears. And because they seem to bounce back after every abuse, from stereo speakers and earbuds to circular saws to motorcycles to rock concerts, we think we dodged a bullet and that we can take it.

But David Owen says that is not true. In Volume Control, he visits the experts, sees the experiments and the measurements, and shows that every incident causes irreversible damage. It often only starts to appear later, but plenty of people become hard of hearing in their prime years, with the prospect of a largely silent future. And every incident from fireworks to gunshots to power tools and kitchen appliances has the potential to plant permanent damage in our ears.

Unless they also develop tinnitus (he says it’s pronounced like tin-itis, with accents on the first two syllables). This constant hissing or ringing in the ears, 24/7, merits two chapters in the book. For one thing, it is far more common than we think. It can be so annoying it drives people to suicide. He makes it clear there is no cure, no specific ways to cause its onset, and usually leads to other hearing problems. Early diagnosis is too late. And it continues even when you’re totally deaf. Avoidance means avoiding shocks to your hearing, next to impossible in our world.

The whole book is rather downbeat this way. Damage is not repairable. Even with cochlear implants, hearing can only be restored to a low level. Our whole civilization operates not just on fossil fuels, but on loud noise. Meanwhile, our ears have evolved to pick out tiny noises in otherwise total silence. The coming together of those two states can only lead to permanent damage in hearing.

Our solutions range from nothing to pathetic. Owen points out that while glasses actually build up vision back to the perfect range, we have nothing to restore the quality of hearing. The result is while people have no problem employing glasses and changing them often, hearing aids are typically put off for a decade of annoying everyone else with “What?” and “Huh?” People who plunk for them often put them in a drawer after the first use, where they sit for years. Where glasses are stylish and become people’s signature identifier, hearing aids are pure stigma. So we hide them, if not in a drawer, at least behind the ear.

Hearing aids are a scam, as we all know, and which Owen confirms in no uncertain terms. They cost less than $100 to make, but we get charged $6000 for a pair. And all they are are miniaturized loudspeakers and tiny microphones. Manufacturers have lobbied states successfully, so that in most jurisdictions, customers cannot order or even adjust them themselves. Only a professional, licensed audiologist can turn up the volume. More reason not to go that route.

And because they don’t have a workaround for the loss of range we made the appointment for in the first place, all they can do is boost the volume to exploit the range we still have left. They do not restore the higher tones most people lose first, so everything remains distorted and difficult. They sound tinny and in general, worse than a lousy cellphone connection.

Instead, like most hi tech, all kinds of add-ons (bloatware) are offered, including a choice of constant sounds to cover the tinnitus, to even a personal alarm-clock only the wearer will hear. There are lots of color choices to complement glasses or clothing too, but nothing to restore hearing.

The book is quite comprehensive, delving into the differences of the deaf at birth from those who lose hearing early and those who lose it over a lifetime. He examines the history of sign language, and goes over the arguments of ASL vs vocal training. The conclusion is both are legitimate, full-featured languages and deserve the same respect.

One thing missing, and I can’t believe this myself, is that no one is using noise cancelling headphones to eliminate the single tone of tinnitus. Owen knows his is about 6000 Hertz, or cycles per second, but he doesn’t pursue Bose, which makes top of the line noise cancelling equipment, to program a unit with the inverse of 6000 Hz, which should, in theory, silence it. If that is a foolish notion, he should at least explain why, because noise cancelling headphones now offer masking noises to hide tinnitus, rather than zero them out. That is correct: noise cancelling headphones now offer additional noise to muffle noise. How wrong is that?

On the hearing aid front, there is modest hope, at least financially. Bose, which rates a lot of coverage in Volume Control, even to a profile of the founder, now sells a hearing aid it cannot by law call a hearing aid. It does of course perform exactly as a high-end hearing aid, with all the same components, but don’t call it a hearing aid. It’s a Hearphone. You wear it around your neck, and plug earbuds into it and your ears. It is rechargeable, stylish and carries no stigma because it looks like a music appliance. It has all kinds of adjustments for noisy restaurants, quiet rooms, traffic, cinemas, airplanes, loud conversation and on and on. And no audiologist is required to change the settings. You can do it on a phone app. Best of all — $500 to find out if it works for you. Beats the hell out of $6000.

There is an even greater important revelation in Volume Control, concerning the tiny hairs in our ears. Damage to them has long been blamed for increasing deafness and loss of range, as well as tinnitus. But we’ve been looking in the wrong place all this time, simply because the light was better under this lamppost. The real culprit apparently lies farther inside our skulls, where the synapses that transfer sounds to the neurons of our brains have shrunk back, no longer making the connection. It seems that when we apply too much noise, synapses disconnect rather than annoy our brains with painful, endless, not to mention useless sounds. Just like how we ignore a constant droning sound so we don’t even notice it, the brain physically disengages from harmful sound. This has big implications for actually restoring quality hearing, but it will take years to figure out.

Owen weaves his usual easy to read and digest text, filled with stories of people he knows, and in this case his own hearing issues. It is a fast and pleasant read, but most of all it is a critically important read. Volume Control offers really valuable information. Everyone needs to act on this information right away, from using earplugs, to turning down the volume, to educating children. The harm is gigantic. As Owen explains in comparing loss of sight and hearing, it is far more difficult to sit among friends and family and be unable to hear their stories, laugh at their jokes and (not) respond with your own, than to be blind but still participate in human social activity. The subtleties and cues from our irreparable hearing are taken for granted, and you don’t know what you’ve got till it’s gone.

Editor's note: This review has been published with the permission of David Wineberg. Like what you read? Subscribe to the SFRB's free daily email notice so you can be up-to-date on our latest articles. Scroll up this page to the sign-up field on your