So it has effects that we don’t necessarily associate with it and that pervade all parts of our lives. And then, because of human nature, we tend to ignore it. The average wait for a person who first notices a hearing problem — the average delay between that moment and going to the doctor — is 10 years. That’s the average. We don’t treat it the way we treat other sensory problems.
If you have trouble seeing things, you get glasses. But people tend to put off getting hearing aids for a long time.
On why it’s difficult to hear conversation in a loud bar or restaurant
The reason it’s problematic there is there’s sound going on all around you. It’s hard to focus on the person that you want to hear. … Young people have less trouble with that. Their auditory systems are more able to filter out unwanted conversation.
But restaurants, unfortunately, take advantage of this. They tend to turn up the sound as the night goes on, both to make diners talk less and, therefore, drink more, and also to drive out older, lingering customers who don’t run up … big checks. Get them out and turn the tables over faster. … And then, perversely, paradoxically, even people who hate loud restaurants tend to avoid really quiet ones, because they figure, it’s so quiet, how can it possibly be any good?
On tinnitus (a ringing in the ears) and its treatment
I learned from reading about tinnitus that there’s basically nothing you can do. You can’t make it go away. There is no known cure for it. The therapy for tinnitus is to learn to accommodate it. And, luckily for me, I have the kind of personality that makes that fairly simple. When I was told that there was nothing I could do about it, I thought, “Oh, good. Then I’ll do nothing.” And that’s kind of what I’ve done. … I can always hear it, but mostly — usually — I can ignore it.
There are people for whom that’s very difficult. It’s loud, and there even have been suicides [among] people who just can’t tolerate this phantom noise in their head. And for them, the treatment is often cognitive therapy, behavioral therapy, or the kind of … medications that are used to treat anxiety or depression — just basically learning to live with this thing. And most people can improve their response to it significantly.
Sometimes hearing aids can help you. If you have some hearing loss and you eliminate that, you bring up the sound of everything else. Then this phantom noise becomes less bothersome. You can’t hear it as much. A therapist described it to me as, “You’re in a room with a candle. The candle is the tinnitus. But if you turn on the lights, then the candle is less noticeable.” And that’s what sometimes happens with hearing aids with somebody who has tinnitus.
On the cause of tinnitus
Tinnitus isn’t noise. It’s something that’s going on in your brain. There are no physical vibrations to counteract. It’s not sound waves. It’s this electrical activity that is impervious to sound suppression technology. … I think that the current theory about tinnitus is that it’s similar to phantom limb pain. You’ve heard about when somebody loses a limb — they have an amputated arm — they feel that that arm is still there, or they feel pain where that arm was but no longer is. Even itching. You can feel itchy fingers on a hand that’s no longer there.
The idea is that the brain is accustomed to receiving nerve signals from this part of the body. It’s no longer receiving them. So it makes, in effect, its best guess about what should be coming from it. It supplies the last thing it felt from there, or something like it. And the idea is that tinnitus is very often something like that. You lose hearing in some frequency. The brain is used to receiving auditory signals at those frequencies; it isn’t anymore. So it fills in the gaps with what seems like a sound but is actually just electrical activity in the auditory system in your brain.
On different kinds of auditory problems
The person with the most depressing auditory problems that I’ve ever encountered had something called hyperacusis, which is where it’s like the opposite of deafness. Everything is louder to him than it is to anybody else — so much so that even inside the house he will wear huge earmuff-like headphones. The crinkling of paper can drive him out of the room. … He said, “Sometimes, hours later [after a conversation] I would hear some phrase that he would say repeated over and over in my head.” That’s a form of tinnitus. Somebody else I know, he said that he often hears just what sounds like a crowd of people talking in the background — so much that he can almost feel that he can almost make out what they’re saying. It’s male voices, sort of babbling in the background. People sometimes hear music. So it takes many forms.