Hearing
BY THE SUMMER OF 1998, it had become clear that there was something wrong with my hearing. It didn’t happen suddenly – it wasn’t like one week it was 20/20 and the next week it was down to 15/20 or 10/20 – but softly, so softly I almost wasn’t aware of it happening; sound seemed to have stolen away. There was no pain, no sound of sound retreating, just the gradual understanding that something was less.
In January I’d been able to hear the traffic outside in the street. By March I could hear a few auditory exclamation marks – the bang of a door slamming, the blare of a horn – but not the noises that linked them. Noises which had been vivid seemed muffled while sentences which were once bordered by clear lines were now smoothed to a blur. Without the definition to speech – the sibilants, the corners and turns, the verbal signposts – I couldn’t seem to find my way. Meetings became no more than a low seaside roar, and I kept connecting with the wrong end of a sentence. All the things which had once been so easy to navigate were now full of blunders.
For a while I did what any other sensible, evolved adult would do in the same situation – I ignored the problem. When that was no longer an option, I made an appointment with my GP, who referred me to the audiology department at St Mary’s Hospital in London.
Steve the audiologist was in his early forties with pink shoes and a tie with images of Scooby Doo on it. His skin had the faint luminescent sheen of someone who rarely saw daylight and for whom exhaustion is a basic state of being. He took a history and then directed me to a soundproofed room containing a pair of headphones before he took his place inside a separate booth filled with dials and machines.
He clicked a switch and his voice appeared in the headphones. ‘Just nod when you can hear something.’
After a couple of seconds I could hear a low electronic tone, a single note. As I heard it, I nodded. The next tone was maybe five notes higher. I nodded again. And so it went, up the scale from bass to soprano. Across from me I could see Steve marking up his notes.
‘Here,’ he said when we’d finished, passing me a couple of sheets of paper on which were printed two sets of graphs, one for the right ear and one for the left. On each graph, the vertical side was marked from 0 to 100 with a black line at 50 in the centre. The horizontal side showed eight lines of equal thickness, one for each additional increase in volume. Steve had pencilled in a line linking the marks he had made showing the exact point at which the sound had become audible. Each of the lines swung up and down a bit, but none of them looked exactly 100 per cent.
I looked at the graphs and then back up at Steve.
‘It’s not great,’ he said. ‘I’m not sure exactly what’s happened because the picture we’re getting is contradictory, but it looks like those head injuries you told me about may have put pressure on your temporal lobe. You’ve pushed your skull down towards your spine and that’s pulled all the muscles in your neck tight, which means you’ve ended up with less mobility in your neck than you should have. That means in turn that all the bones of the ear have been pulled around, and if those bones aren’t able to move properly, then they’re not conducting sound as they should do.’
‘So,’ I said, ‘I’ve got a bottleneck.’
‘And if the pressure could be relieved, will this get better?’
Steve looked at me. ‘I don’t think so,’ he said. ‘The pattern of hearing loss that you’ve got is inconsistent, but what I’m seeing suggests there’s been some damage to the hair cells in the cochlea. So I doubt very much that the situation would improve even if you did straighten your neck out.’
‘But if the bones could move again …’
‘The damage has probably been done.’ On his desk was an unsexed human half-head, a model showing the side of a skull and the mechanism of the ear modelled in primary plastic. He picked it up and pointed at a red bit.
‘Do you know anything about how hearing works?’
From school biology I knew that the ear had inner, middle and outer sections, but that was about it. ‘No.’
Steve pointed at the portion of the model closest to the centre of the skull. ‘The trouble is that so much of hearing takes place in a part of the body that we can’t access. If you break your leg, we can X-ray. If you get cancer, we can do a biopsy or a scan. In most situations, we can get an actual physical picture of what’s going on inside you. But with the ear, we can’t. We can do an MRI but even that won’t give us that much information. If you had punctured one of your eardrums, we’d be able to look at the damage from outside because it’s part of the outer ear, but we can’t see inside the inner ear because the inner ear is way down deep inside your skull and the cochlea is a tiny enclosed spiral within that space.’
He set the model down on the desk in front of me. ‘All we can do instead is to look at the clues provided in your audiogram and, from the pattern of it, make an educated guess about what’s going on. It’s usually a pretty accurate guess but it’s still a guess because we can’t physically see in there. And, generally speaking, for exactly the same reason, once anything within the inner ear is damaged, it stays damaged. In most cases, we can’t do anything about it because the inner ear is so very inner that surgery on it wouldn’t be ear surgery, it would be brain surgery.’
He paused to give me time to digest this. ‘The good thing is, your high-frequency hearing is still reasonable.’
I looked at him, blank.
‘OK,’ he said. ‘Hearing loss isn’t just like going from total hearing to total silence. It’s not something you have and then you don’t. Or not normally anyway. Everyone hears across a range of frequencies from high to low. When it’s at its best – usually when you’re young – the human ear can pick up everything from twenty hertz to twenty kilohertz. But that’s unusual. What happens normally is that people get older or they’re idiots and they go to festivals and stand too close to the speakers and their hearing across certain frequencies starts to wear out. But it doesn’t wear out evenly across all frequencies.’
He turned the plastic model round to face him and pointed at a tiny shell-shaped spiral deep within the inner ear. ‘Do you know anything about the cochlea?’
I shook my head.
He kept his finger against it for a second. ‘The cochlea is minute. It’s no more than the size of a sunflower seed, but it’s lined with thousands of cells called stereocilia. Because they stick up like the tufts of a rug and move with the vibrations of sound, they’re known as hair cells. And because it’s a spiral with the high-frequency hair cells at the front end and the low ones in the centre, that means that even if you’re hearing a low-frequency sound, it has to pass over the high-frequency hair cells before it gets to the low ones.’
I nodded. I wasn’t taking in much, but it was good to show willing.
‘And because the high-frequency cells are getting so much more traffic, they tend to wear out more quickly. Think of it like a rug. Like any rug, it gets worn more in the parts which get heavily used than the ones that don’t. So the high-frequency goes first, then the mid, then the low.’
He pointed back at the top two graphs of the audiogram. ‘You don’t seem to have lost that much of your high frequencies, but if you were to average out the loss across all areas, I’d say you’ve lost about forty to fifty per cent of normal hearing.’ He paused, still looking at the page. ‘I’m surprised that you’ve put up with this for as long as you have.’
‘But,’ I said, ‘I’m twenty-seven. Why am I losing my hearing?’
‘But,’ he smiled, ‘you keep hitting your head on things.’
I smiled back, perversely cheerful.
‘If you were a bird,’ he said, ‘it would be different. In humans, the hair cells don’t regenerate. You get one lot, and that’s it. But in birds, if those cells are destroyed, they can grow back. Because if birds can’t hear other birds they can’t find a mate, and if they can’t mate then the species can’t survive. Plus of course it always helps to hear a predator sneaking up on you. But even if every hair cell is destroyed, they grow them again. They can hear again within a month.’
I wasn’t interested in birds. I was interested in whether this was going to get better or not, and now I knew it wasn’t. I’d never heard of a cure for deafness. There were no cures for deafness.
Steve looked at me and for a moment I saw a whole other conversation open up in his eyes, a conversation in which there was compassion and a kind of acknowledgement. Then he glanced at his screen and pushed his chair back.
‘Look,’ he said, ‘I know it’s a lot of information to take in. But for the moment, what we’ll do is show these results to the doctor. And then we’ll fit you up for some hearing aids.’
BACK IN 1990 I had gone together with a group of university friends on a skiing trip. Somehow one of us had managed to pull off a cheap end-of-season deal in one of the big French resorts, an all-inclusive thing with a self-catering apartment plus a coach trip at either end. It was booked for right at the end of March and, whatever our level of skiing expertise, all of us were looking forward to it.
It wasn’t until the coach pulled up opposite the ski lifts that we realised there was no actual snow. Nothing. Not a flake. Cheap, in this instance, meant dustbowl. Higher up the mountain, the ground was bare and flat, the soft brown of new hide. Farther down, the grass had already begun to return, shading what would have been the beginner slopes in fresh green. Outside some of the larger hotels the snowdrops had already come and gone while daffodils bloomed by the roadside. For a moment we sat back, enjoying the sound of meltwater rebounding down the gullies.
‘Oh well,’ said Clare beside me. ‘Never mind. How about rollerblading?’
Beside us, an Italian coach pulled up. Through the windows, we watched them react as we had: dismay, laughter, animated chattering.
There was no point in remaining where we were, so we got out and unloaded our bags.
‘Pas de neige?’ I said to the woman in charge of keys for the apartment, pointing over my shoulder. ‘Où est la neige?’
The woman smiled. ‘Pas de problème!’ She gestured towards a kind of thin white B-road twisting down the mountain beside the main ski lift. It glittered in the sun, not the powder-blue shadow of real snow, but the hard refraction of ice. ‘Neige artificielle! Pour tous!’
‘Oh, oui, d’accord!’ we agreed politely, ‘Absolument!’
The next morning, having kitted ourselves out with the necessary boots and skis, we set off. Only a few of the lower lifts were still open and the remaining runs had a thin trail of compacted permafrost covered with a dusting of artificial snow replenished nightly by the snow cannons. The pisteurs had been up and down the runs with their ploughs, ridging the ice in brittle lines. Farther up, a few blobs of unmelted white helped to give a feeling of what the place might look like at the moments when it looked like it was supposed to look.
Despite this, the runs which did remain open were full. Children hurled lumps of mud at each other instead of snowballs, and parents sat sunbathing in the cafés. For the first couple of days we got used to the impressive braking effects of sliding from ice to earth, stumping up and down from the cafés in T-shirts and sun cream.
On the third day we all decided on a trip farther up the mountain. In the cable car, hikers in boots and anoraks grinned at us or unfolded maps showing the network of walkers’ footpaths. Even up here, right at the top, only about half the runs were open. In every direction the great jagged panorama of the Alps lay before us. The higher mountains were still tipped with white but wherever we looked, the murk of the snowless valleys crept almost to the summits. We split off into different groups according to ability. Three of us wanted to see whether there was any off-piste worth skiing at all, while there was one long red I wanted to try. The others set off, skis rattling. I looped the straps of the ski poles round my wrists, turned on my Walkman and headed off.
The weather was bright and clear, and the contrast between the bits where the sun reflected off the ice and the black behind the rocks was so stark it was sometimes difficult to see even with sunglasses on. Up here, the problem was less in sliding from ice to stone – which was at least visible – but from those few patches of snow back to ice again. Either way, the result was fast and unpredictable. I could hear the different textures beneath my skis – the bony clatter of compaction and the punctured hiss of slush as I twisted downwards, skiing more by feel than by sight. Beyond the sounds of my own skis, I could hear birdsong – not just one bird, but hundreds, thousands, a great spring chorus all singing for their lives in the turn of the Alpine seasons. I wasn’t wearing a helmet so I could feel the warmth of the sun on my head and I was beginning to hit a nice easy rhythm when I hit one of the invisible patches of ice, went back on my skis, spun out of control and slammed head first into a rock.
For a couple of moments, I must have blacked out. Then I came to, lying beside the rock with the skis and poles scattered somewhere behind me, levered myself up and ran a hand over my forehead. It hurt, and there was quite a lot of blood. As I levered myself to my feet and began groping around for the lost poles, two skiers appeared behind me. They looked at me, then at the rock, then at the blood on the ice. One of them helped me retrieve my belongings and the other said something urgent in German, repeating the same phrase several times before they looked back at me one more time and then skiied away fast down the mountain. I wrapped my scarf tightly around my forehead, stamped my boots back into my skis and set off very slowly in the same direction as them.
It can’t have taken that long to get to the end of the run, though it felt like many things happened in that time. It wasn’t so much that I was having difficulty with the ice, it was more that something seemed to have happened to my conception of three-dimensional time-space. During the sixties those in search of the ultimate mind-altering experience were fond of drilling holes in their foreheads, a practice known as trepanning. The theory was that if you opened up the route to the frontal lobe of the brain – the bit then thought to filter consciousness – then you removed those filters, thus awarding yourself a VIP pass to the seventh dimension. By smacking myself against a rock, I’d just done the same thing to myself for free. So on the way down the mountain I was experiencing two completely separate versions of reality, both equally persuasive and equally complete. In one, I was inching my way along the ice, half blinded by my own blood and staring at the few inches of ground in front of me. In the other, I was back at home having a vigorous argument with a friend about cooking. The argument wasn’t a dream or an hallucination, it was real – as real as the mountain. Some atavistic part of me knew it was vital I kept a grip on one of those realities, though I couldn’t always seem to figure out which one.
I don’t know how long it took for the tussle between the ice and the friend to resolve itself in favour of the ice, but at some point later I arrived at the base of the run and the little wooden cabin beside the ski lift. As I appeared, three Ecole de Ski first-aiders were adjusting their goggles and making last-minute checks to the blood-wagon sled. I stood in the doorway.
‘Je pense que j’ai besoin d’aide,’ I said. ‘J’ai mal de tête.’
One of the guides looked at me kindly. ‘Allez,’ he said, shepherding me into the hut. ‘Asseyez-vous.’ I sat down and unwrapped the scarf. He looked at me and smiled. ‘I think,’ he said in English, ‘that looks like more than a headache.’
‘I’m fine,’ I said, and started to cry.
Down at the bottom of the mountain, the local doctor X-rayed me before running a neat seam of prickly stitches from the top of my forehead into my hairline.
‘Go home,’ he said. ‘Really. Forget trying to ski. Go home.’
When we met again at the apartment, the others did their best to persuade me to do the same, though I had no intention of going home. I was twenty and therefore immortal, and as far as I was concerned there was nothing about a major head injury that couldn’t be solved with Nurofen and paint-stripper wine. I think I did get an upgrade from the floor to the sofa, but when my friends saw I was determined to stay, we all just carried on as normal.
At the end of the week we took the coach back to London. I had found a cap to cover the worst of the mess on my forehead but my face had swollen up and the area around my eye sockets had begun to bruise. It hadn’t occurred to me to tell anyone at home, so when my father opened the door he saw a stranger, a rainbow-hued B-movie monster.
‘It’s interesting,’ he said once he’d got over the shock. ‘Almost Cubist.’
‘You look better like that,’ said my youngest sister, round-eyed. ‘Will you always be purple?’
SEVEN YEARS LATER, when the scar on my forehead had faded to a discreet white line, the ice and I met again. As I drove out from Edinburgh on a frosty March night, the car hit a patch of black ice, skidded, hit the hedge on the other side of the road and flipped over.
I came to rest upside down, my head separated from the road by a thin strip of metal. The driver’s window had shattered in the impact, and I could hear diesel spattering out onto the road. I wriggled out of the window and stood for a while on the verge, shivering with shock. A haulage truck travelling in the opposite direction stopped and the driver rang the emergency services.
Not long before I’d seen the David Lynch film Wild at Heart in which the two main characters come across a recent car accident in the Nevada desert. One of the victims looks OK – she’s standing, she’s worrying about her purse – but shortly afterwards she dies in Nicolas Cage’s arms. Finding myself by the side of the road on a dark night after a car accident, I thought about the film again. Maybe I looked all right on the outside, but what if I was like the girl in the film, just seconds away from collapsing into a haulier’s front cab? I didn’t want that to happen, so until the ambulance arrived I crouched by the trees and recited my name and address over and over in case I’d left something important – memory, identity – by the side of the A702.
It was shortly after the accident that I had started to go deaf. Abruptly, life seemed to have become one long cliché: pushing up the volume on the TV or the stereo, needing people to repeat things, missing the phone or the sound of my boyfriend Euan’s key in the lock. I had to be up close to hear the hiss of unlit gas on the stove. Euan complained that I’d stopped laughing at his jokes and even when I did it was three minutes later.
It would probably be good to say that it was the decline of children’s voices or the vanishing of Euan’s laugh that finally forced me to go and do something about it, but to be honest, it wasn’t that – it was the fear of being bad at my job. At the time I was working as a freelance journalist and had just started on my first book, an account of the Stevenson family of engineers who built all the Scottish lighthouses and then produced Robert Louis Stevenson. Much of my time was spent in archives going through family papers, but my researches also took me out to the darkest corners of Scotland to interview the last generation of lighthouse keepers.
Keepers, I soon discovered, fell into two distinct categories: unstoppable, or silent. Either all I had to do was switch on the tape recorder and let it flow or I was there for hours, tweezering out each individual word. But when I transcribed the interviews afterwards I noticed how often I had misheard or leapt in at the wrong moment. Admittedly some of the interviews had been conducted outside and lighthouses are by nature high and windy places. But even so, there seemed to be a lot of gaps. All the grace of a conversation had gone and now there were only a series of jolting observations. I could hear how hard I was trying but I could hear how hard the keepers were trying too – the note of bemusement in their voice when I failed to pick up on something they’d said or came back with something completely unrelated. They were all polite, but behind that politeness was a distance, a gap which I kept trying to cross but which always slid farther away.
It was frustrating, sitting there at my desk, turning the volume up on my own mistakes. Every time I listened to one of the tapes I could hear – at top volume, and as many times as I chose to repeat it – just exactly how many times I hadn’t been able to hear.