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An Update on Cochlear Implant Improvements

BEGIN TRANSCRIPT

RUSH: This is Mark, a trucker in Ogden, Utah.  Great to have you on Open Line Friday.  Hello, sir.

CALLER:  Hello.  Thank you for taking my call.  My question is, when you have both cochlear implants turned on, have you regained any 3D spatial awareness?

RUSH:  Well, I'm still experiencing that and still testing that.  Last night I did go to dinner in a very loud restaurant, and I was part of a group of five.  There were two couples and me.  And it was the kind of place that conversation would have been impossible, literally impossible, except for the person sitting on my immediate left. I would have been able to talk to her, or I would have had to turn my head if I wanted to hear the person on my right. 

Last night I didn't have to do that.  I was able to hear the person and the people on my right and the people on my left, and I was able to arrange some settings that focus what I heard from the front of me, which canceled out half the noise of the restaurant behind me.  It's a setting that they can do with this digital program. They couldn't do it with the old one.  Well, they could, but it wasn't as effective.  But because I've got this thing on my right ear I do know when people are talking to me from the right side.  I still don't think I know, if I don't see where a noise is made, I don't think I know where it's coming from. Well, I know I don't. 

I was sitting out on the patio of my spacious and fashionable hotel suite yesterday, and some noise started. It sounded like a jackhammer to me. I couldn't tell you where was it 'cause I couldn't see it, and it sounded like it was everywhere. So I don't think yet that I've got pinpoint spatial perception yet, but who knows.  It's getting better.  Every week I'm noticing improvement.  That's a great question.  I appreciate that, too.

CALLER:  Thank you.  So with training I think you'll probably get that spatial awareness back.

RUSH:  Well, it's something that's gonna require paying special attention to it.  If I'm not aware that a sound is coming or going to be made, I don't think I'll ever be able to figure out where it is, but if I know -- not see it -- but if I know where a sound is going to be made, then I might be able to pinpoint where it's coming from. The reason why that matters, it's a safety thing more than anything else.  If an intruder happens to get into the room where you are, you'd like to know where they are, and that's why something like this is important.  And there are other reasons, too.  But look, Mark, I appreciate the call, I really do.

BREAK TRANSCRIPT

RUSH: I want to pass off a somewhat funny but instructive little cochlear implant story, because that's why I'm here.  I had to come out for another tune-up of the new implant I got on the right side. I had the appointment yesterday after the program.  Yesterday I had come across on a website a five-minute video that purported to help people understand how those of us with cochlear implants hear things.  I sent it up to Koko, and I had him post it so that you could all see it. 

Now, the only caveat I had to offer, I can't verify it because I'm hearing it through a cochlear implant.  Now, I do hear. If you watch the video, what it did, first they just hit some tones, various frequencied tones as they normally sound, and then they simulated how it sounds to somebody with a cochlear implant.  I could hear the difference in the two, but, remember, I'm hearing everything through an implant itself, so I can't testify to the accuracy of it.  That's the thing. 

But a lot of people talked to me about it, watched it.  “Hey, you know, I think I know what's happening here. It's clipping this and it's clipping that bit over there and now that bit's not firing. You let me, I think I could fix it.”  I got it covered, thanks.  But I took the video to my appointment and I played it for my audiologist.  Now, this is not to get anybody in trouble or anything of the sort.  This is just to make a point. 

I have been working with the audiologist team at the place I go for 13 years, and I have been describing for them how the various tune-ups and programs that we create sound.  And based on my feedback, they tweak them to try to improve the way I sound.  But, at the end of the day, it is impossible. It's always amazed me about the inventor and management side of cochlear implants.  The people involved have no idea what it sounds like to the people using them.  Yet they work!  It would be like somebody blind inventing a TV set. 

I don't know how they've done it.  I know they use meters and graphs and charts and all that.  But when you get down to the real-world application of it, it still stuns me that people have no way of knowing how their device -- well, they know how it works, but they can't possibly experience the device they've invented as the end user does. 

So, anyway, I said, "You gotta see this." 

"Well, we've got a guy here that's put one of these together." 

I said, "I know, I know, but this is a different one."  She knew who this guy that had made the video was.  He's famous in the audiologist community.  So I watched her watch it, and she looked at me.  Now, remember, I've been doing this for 13 years, and I've been telling her how things sound to me.  And she looked at me, “Do things really sound that fuzzy to you?” 

I said, “Yeah.”  In fact, I told her, what I hear, the sound on that video that I posted at the website, sounds much better than what I hear.  "Really?  It sounds that fuzzy?”

I said, “Well, what does chipmunk mean?”  That didn't sound chipmunky, but I only mention this, not as criticism.  It's a real testament.  These people, that those of us who have implants -- and there's like 324,000 of us in the world, that's all. Stop and think. If you're gonna be in the cochlear implant business, you've got a finite number of customers.  You gotta hope for deafness.  He-he.  You don't, really.  But the business side of this is also a fascinating thing to me.  In the whole world, 324,000 people with cochlear implants.  I looked it up, in the whole world.  Now, there are many more people that need them, just can't afford them. Obamacare doesn't cover it in Nigeria and other places.  But even people I’ve been working with for 13 years, "Does it really sound that fuzzy?"  Which just told me it's not possible to tell people what sound sounds like.  It's just not possible.  If a highly trained specialist, if I can't convey how things sound -- I mean I've been telling her for 13 years how things sound, she heard that reproduction, “Does it really sound that fuzzy?”  Then there's no way I can make anybody understand how things sound to me.  That's the point that was driven home.  And I wish there were, ‘cause it would help, it would help in communicating with people if they knew. 

I mean, you know, for example, somebody blind can't see.  You know what that is.  You can imagine that.  But bionic sound is something -- and, see, the problem here is, if I may get deep.  Being able to communicate with people is required if you're going to have intimate, meaningful relationships with people.  And what happens is the people who can't hear you get mad at you.  One of the most frustrating things -- and I'm sure you've experienced this too.  When somebody says to you, "What? I didn't hear you, can you say it again?" 

"Okay."  And you yell it.  And if they don't hear it that time, then you really get mad.  Who wants to repeat what they say?  And the hard-of-hearing or deaf person doesn't want to cause that kind of angst in people, so two things happen.  The hard-of-hearing person will either lie and pretend he or she understood what's being said, instead of saying, "I'm sorry, I didn't hear you. Could you repeat that," 'cause nobody wants to make other people mad.  Nobody wants to be responsible for tension being created in just a simple conversation. 

So you pretend that you heard what you didn't hear and hope that that covers it, or you just withdraw and you don't go to places where it's gonna be hard to hear so that you don't cause that kind of tension.  So the hard-of-hearing either withdraw or they fake it.  In either case you are not building meaningful relationships with people.  That is the main problem.  That's why I wish I could come up with a way to explain to people how I hear things, 'cause it would help them make whatever effort they have to make for me to understand them and hear them. 

You know, getting mad at people is a two-way street.  It didn't happen last night, but let me use last night as an example.  Crowded, loud restaurant.  Everybody there knew I had a second implant, obviously, and they've heard me say that it's an improvement.  And so people -- it didn't happen, but it does, people will speak to me in a crowded, loud environment and will not raise their voice. They'll not get closer. They'll make no effort for me to understand them.  It's just an instinctive thing with them. 

So, in that case, I have to nod my head and act like I know what they're saying, when I don't have the slightest idea what they're saying.  Then, you try to use association.  The way that works -- for me, anyway -- having a conversation with somebody about subject A. Then the conversation pauses for a few seconds. Then they say something else that you don't hear. The next thing they say you don't hear. I don't hear it, I assume -- if I heard it but don't understand it, I'm trying to lightning fast comprehend what I just heard, what I'll do is “maybe it has to do with what they just said.” So I'll try to put together what I think I just heard based on something I heard moments ago, but it's still a wild guess.  And, if I then say something that is not related at all to what they just said, that makes 'em mad or frustrated or what have you. 

So what it really results in is people participating less in conversation, 'cause it just causes too much tension.  It causes people to get mad, and nobody wants to be the cause of that.  So you withdraw or you don't go places or you don't talk to people.  In some cases, I will not go. I'll not accept an invitation if it's gonna be a certain place where I know it's gonna be impossible to hear people.  I'm not gonna put myself in the situation, 'cause it's not fun, it's not enjoyable, and all it does is cause tension. Especially, if somebody thinks in a situation like that they've really said something really important and I have no clue what it is, and never knew what it was, they think I know it, the next time they bring it up I'm totally in the dark, have no idea what they're talking about, that causes tension. 

So I've always thought that if I could just come up with a way of telling people how I hear, it would help them in speaking to me.  And so when the audiologist said to me yesterday, “Does it really sound that fuzzy?” it just told me it's not possible.  To actually let people know how things sound.  So it requires just a further effort.  In fact, I'll tell you something.  I am a little guarded here even in talking about improvement or, “Wow, this right side, oh, the magic happened, that's so much better.”  Well, it is from my baseline.  But it still isn't anywhere near normal, and never will be. 

So you have to be very, very careful how you explain to people when it's getting better, because the assumption is -- the expectation, everybody hopes that the implants can restore your hearing to normal, and that will never be the case because it's not possible.  But that's everybody else's baseline.  My baseline is much, much below normal, and so improvement, to me, is far different than the way people hear me talk about it being improved.  So if you know somebody who's hard-of-hearing or maybe even has an implant, just trust the fact that they're lying to you half the time when they tell you they heard you.  And they're doing that because they don't want you to get mad at them.  They don't want to be the cause of tension. They don't want you to think they're not trying. They don't want you to think they're not paying attention.  It's just they’re not able to. 

So if they're not accepting invitations, if they're not being open with you, it's just because they can't hear you and they're tired of trying to explain it.  'Cause this told me yesterday it's impossible to convey to people.  But it doesn't mean I'm gonna quit trying.  It's one of the challenges I have is to find -- there's gotta be some magic way that I'm gonna be able to show people how things sound to me. 

One thing that I have going, and every hard-of-hearing person, any crowded environment it's tough for even the normal person to hear in a very loud place.  So there is that. There is an ability to relate on that score.  

BREAK TRANSCRIPT

RUSH:  Okay.  So here come the snarky e-mails.  "Hey, Rush, my wife never hears a thing I say.  What's her excuse?"  Folks, I get the jokes.  I know you're sitting or you're watching TV or you're reading and somebody comes in the room and says something to you and you're not paying attention so you have to ask 'em to repeat it. 

I'm talking about when you're doing nothing but talking to somebody and you only hear half of what they say. Most often you're gonna fake hearing the whole thing rather than ask them to repeat it cause it's gonna frustrate them.  I mean, when you're just doing nothing but having a conversation and you only get half of it.  When I'm in a conversation with people, and I only get half of it, the odds are I'll fake it. 

I'll act like I heard the whole thing, just to avoid saying, "I'm sorry, could you say that again?" 'cause they just get mad. That's avoidable.  You know what one of the funniest manifestations of this is?  When I'm out on those rare occasions when I do a public appearance. If there's a line of people, say, for photo or a handshake or what have you.

If there's a lot of noise, I don't hear half or more what people say. So I just assume they're there because they're listeners, and they enjoyed it. So I just say, "Thank you."  You ought to see their faces when they have complained about something or said something negative and I say, "Oh, thank you. Thank you very much." They get the weirdest look on their face. 

That's one of my fallbacks is just to be polite. I just say thank you when I don't understand what people have said. Sometimes it's funny, and at that point they'll say, "Wait a minute. Did you hear what I said?"  And if they ask, I'll say, "No, I actually didn't," and then they're happy to repeat it, if they figured out that it didn't get communicated.  

END TRANSCRIPT

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