Sound And Silence

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0:43I literally feel like I'm a different person. Yes. Do you feel that way? Ideas worth spreading. From TED and NPR.

0:57I'm Manoush Zomorodi. What if your job depended on listening, but you had trouble hearing? It's, I guess, one of the biggest ironies from the department of you could not make this up. that, yes, my job is to ask people questions and then listen, like really, really listen to the answers. And I can't really hear. This is Mary Louise Kelly. You might recognize her voice because she is one of the hosts of NPR's All Things Considered. It's All Things Considered from NPR News. I'm Sasha Pfeiffer. And I'm Mary Louise Kelly. Coming up in Louisville, protests are underway. Yet another prominent conservative is urging Republicans to cross party lines.

1:45She's covered everything from the Trump-Putin summit in Helsinki to life in North Korea. Do you remember when you started losing your hearing? I don't know exactly when I started to have hearing loss. It's a funny thing. I think it's a little more complicated than realizing you don't have the same eyesight you did when you were 16 and you need glasses. With hearing, it's more nuanced. You don't know if you're not hearing everything that somebody else is. In my case, I had, you know, a moment where it became undeniable. I was 42. I had just published a book. I was on book tour, and it became apparent at event after event, I couldn't hear the questions.

2:40It felt like everybody was mumbling all the time, and you can ask people to repeat or speak up, or I would ask if I had a friend in the front row to kind of relay things. But after a while, it just becomes embarrassing, and I realized I should go get this checked out. and I did it was humbling in part because I still to this day can pass with flying colors the little minimal hearing test that we all get with an annual physical where they say you know raise your hand if you hear the beep I can hear the beep what I can't do is distinguish between consonants. No matter how loud the volume is, I can't make out words anymore.

3:28And when I went to the full workup at the audiologist, they did a test with me and they said, I'm going to say a word, just repeat the word. And I said, okay. And it would be park bench. And I would say park bench. I would say skateboard. And I would say skateboard. And And I would say purple. And I would say purple. It was fine. I didn't do great. But I think I got something like seven or eight out of ten. And then they repeated it the same test. Park bench. Park bench. But holding just a piece of printer paper. Skateboard. Skateboard. Up in front of their lips so that I could not see the audiologist's lips move.

4:13Purple. Purple. And I think I got three out of 10. And I realized how much without even realizing it, I had come to rely on being able to see somebody's face, being able to see their lips move. And when I can't do that, I really can't hear. And they told me I had severe to profound hearing loss, particularly at higher frequencies, which means I was missing an awful lot. I got hearing aids. Um, and that was a revelation. The first day I got them, everything was so loud in ways, good and bad, good ways. I'd kind of forgotten pop music had words and I was bopping along singing and thinking, I haven't actually heard what they were saying.

4:58And I don't know how long, but it's been a while. Um, I realized I was driving my kids around just doing school carpool back in the days when they actually had carpool and went to school on campus. And I realized they're chattering away, my children in the back seat. And it had just been this hum for years. I hadn't been able to hear what they were saying. And now I could listen to them. I mean, what a moment of joy. On the flip side, I remember the first time I walked into Starbucks with hearing aids and I burst into tears and had to walk right back out because it was so loud. I hadn't heard the coffee grinders in their full glory for years and they're really, really loud.

5:45And so there's an adjustment as your brain relearns how to process all of those sounds and help you make sense of them. It takes a little bit longer than just putting on a pair of glasses and suddenly being able to see. Sound surrounds us. Some sounds inundate us and invade our ears. Others we choose to seek out. From total cacophony to the beauty of complete silence. Depending on how we hear, the world can be a totally different auditory experience for each of us. And so today on the show, ideas about how we experience sound. and why we also need silence to make sense of it all. And for Mary Louise, her hearing aids were a huge help.

6:33But now she's dealing with some new hurdles. When you have hearing loss, it's a nightmare for a couple of reasons. One is the social distancing. I'm used to being able to lean in. If I can't hear you, I'm going to get closer so that I can see your lips, so that you're louder, so that you're right in my face. And when you have to stay at least six feet away from somebody, you can't do it. Then there's the terrible double whammy of masks. And I should say, for the record, I'm all for masks. I wear them. I hope everyone wears them. However, they muffle your voice, any of them, and they prevent me from seeing your lips.

7:15And those two things together conspire to make it so, so, so much harder to engage in just casual conversation, or in my case, to go out and interview somebody on the street, in the field, and have any idea what you're telling me. I had a moment where it dawned on me just how difficult this was going to be. This was that period for me in D.C. where we were past full lockdown. I could contemplate going to the local CVS. But I had to pick up a prescription for my youngest son. So I masked up. I brought my hand sanitizer. I had the prescription. I was all set to go just in and out. and obstacle number one, there's plexiglass everywhere, but separating me from the pharmacist.

8:07So, okay, there's a sound barrier right there. Hard to hear. Um, and then we're both wearing masks and the most simple transaction, you know, two blocks from my house became so difficult. I come in, I tell him I'm here to pick up a refill for my son. And he looks at me and says, mumble, mumble, mumble, mumble, mumble, or at least that's what I'm hearing. And I'm thinking, okay, logically, he's probably asking for my son's name and birth date. So I tell him that. And the pharmacist, I can see his eyes and he's giving me this kind of weird look and he mumbles again. And I think, okay, what else would he need?

8:46And I pull my insurance card from my wallet, hold it up. He gives me another weird look. He starts speaking more slowly. He gets the bored look that a lot of people who are hard of hearing are familiar with. And I get it. It's frustrating to talk when the other person isn't understanding you. And I can't decipher a single word. And we go through this, I know, pantomime for a few minutes. And finally, he leans back and says, what is the phone number on file for your son? And I say, oh, and I give him the phone number. And, you know, five minutes later, I left. I got the medicine. It's all fine.

9:27I just remember going out, standing on the sidewalk and feeling scared and defeated and thinking, I cannot manage to pick up a prescription refill at our neighborhood drugstore. How am I going to do my job? It was a moment that gave me a great pause. and, you know, you can stand there and feel sorry for yourself for a little while and then you figure out, okay, how do I still do this? Where are you on answering that question? Yeah, I mean, obviously I find ways to do it. I anchor a national news show despite the fact that I have significant hearing loss and I'm doing it with hearing aids. You find ways to make it work.

10:16I have never, as an anchor, as a host on NPR, found my hearing a handicap just doing daily interviews for the show. And I think one reason for that is context is everything. When you're only catching every second or third word, it helps to know what I'm talking about. And, you know, none of it is easy. But there's always a way, or at least I hope so. That's the plan. That's Mary Louise Kelly. You can hear her almost every day on NPR's All Things Considered. And Mary Louise's hearing loss is actually pretty common. In our society, about 10 % of the populace, that's 30 million people, have significant hearing problems.

11:07By the time that we're on the order of 70 years old, about a quarter of us have significant hearing loss. And by 80, it's more than half. This is Jim Hudspeth. I'm a professor at Rockefeller University in New York City, and I'm a neuroscience researcher. So I work particularly on hearing. And Jim says to understand why hearing loss is so common, we need to understand how the ear works. Oh, yeah. So here we go. Sound is, of course, a vibration in the air. And that's really obvious when a jet plane, for example, rattles a window. There's energy or power flowing through the air. Sound energy hits the eardrum.

11:55It moves three little bones in the middle ear. And finally, it causes pressures to change in the spiraling cochlea. That's our organ of hearing. The cochlea is about the size of a chickpea, a garbanzo bean. It's a little thing. There's one in each ear. And within the cochlea, there are 16 ,000 sensory receptors. Wow. They're called hair cells. Jim continues his explanation from the TED stage. Now, these hair cells are unfortunately named because they have nothing at all to do with the kind of hair, which I have less and less. These cells were originally named that by early microscopists who noticed that emanating from one end of the cell was a little cluster of bristles.

12:40With modern electron microscopy, we can see much better the nature of the special feature that gives the hair cell its name. That's the hair bundle. It's this cluster of 20 to several hundred fine cylindrical rods that stand upright at the top end of the cell. This apparatus is what is responsible for your hearing me right this instant. In a minute, Jim Hudspeth on how, over time, we lose those tiny hair cells in our ears, and why chickens don't. On the show today, ideas about sound and silence. I'm Manoush Zomorodi, and you're listening to the TED Radio Hour from NPR.

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14:15Start today, risk-free, at greenlight.com slash NPR. This message comes from NPR sponsor Charles Schwab. Financial decisions can be tricky. Your biases can lead you astray. Financial Decoder, an original podcast from Charles Schwab, can help. Download the latest episode and subscribe at schwab.com slash financial decoder. It's the TED Radio Hour from NPR. I'm Manoush Zomorodi. And we were just hearing from neuroscientist Jim Hudspeth describing the sensory receptors in our ears, hundreds of microscopic hair cells that make up the hair bundle. Now, I must say that I'm somewhat in love with these cells.

14:58I've spent 45 years in their company. And part of the reason is that they're really beautiful. There's an aesthetic component to it. Hair cells are found all the way down to the most primitive of fishes. And those of reptiles often have this really beautiful, almost crystalline order. But above and beyond its beauty, the hair bundle is a machine for converting sound vibrations into electrical responses that the brain can then interpret.

15:31Those little bristles get tickled or moved by the sound energy. And when that happens, the cell develops an electrical response that it then communicates to the brain. So that's all the brain knows. These 16 ,000 cells each send information about a particular sound that flows into the brain, and the brain then says, okay, I heard a middle C. I heard whatever tone it happens to be. Is it fair to say that these little hairs are antennas, or are they more like little amplifiers? Yeah, well, now you've just exactly hit on the head what I've been doing for the last 40 years. It turns out that the hair cells, and indeed the hairs, are not just passive recipients of sound.

16:22Instead, each of them is a little amplifier that enhances the signals going in. Let me tell you how it works. First of all, the active process amplifies sound. So you can hear at threshold sounds that move the hair bundle by a distance of only about three-tenths of anatomy. That's the diameter of one water molecule. Why do we need this amplification? The amplification in ancient times was useful because it was valuable for us to hear the tiger before the tiger could hear us. These days, it's essential as a distant early warning system. It's valuable to be able to hear fire alarms. or contemporary dangers such as police cars or the like.

17:12This active process also enhances our frequency selectivity. Even an untrained individual can distinguish two tones that differ by only two-tenths of a percent, which is one-thirtieth of the difference between two piano notes.

17:32And a trained musician can do even better. This fine discrimination is useful in our ability to distinguish different voices and understand the nuances of speech. When the amplification fails, our hearing sensitivity plummets. And so what exactly is happening in Mary Louise's ear, for example, in all our ears, when we hear and then when we lose our hearing? The answer is that that amplifier begins to burn out. Basically, any noise that's loud enough to be uncomfortable, to make your ears hurt, is doing some damage to the cells of the ear. The little hairs no longer actively amplify the incoming sound, and therefore hearing becomes harder and harder, particularly in places where sound is very faint or in crowded circumstances where sound is very confusing.

18:26Consonants, for example. So the difference between B and P and things like that is somewhat subtle. And the high frequencies that are necessary to convey that information are the first thing to go. And so one begins to have trouble understanding speech. And then as lower and lower frequencies are affected, the difficulties become greater and greater. So there is technology that can give people the choice as to whether or not they can resolve their deafness. Cochlear implants, correct? Exactly right. The idea of the implant is to replace the hair cells that have died. And I should say that when hair cells die in our ears, they are not replaced by cell division.

19:11So they're unlike the skin or the liver or other organs. When they're gone, they're not replaced. And that, of course, leads to cumulative damage. It all adds up. And this is also true for daily listening. People who listen for hours and hours a day continuously are quite likely to damage their ears. You get one shot, basically. You get one shot as it stands. Of course, we're interested in trying to change that. And this isn't totally ridiculous because mammals have the problem of no regeneration. But fish and amphibians, reptiles, all can regenerate their hair cells. In fact, some of these animals are losing them all the time and continuously growing new ones just as we grow new skin.

19:58What about birds? Birds can do it 100%. In fact, this is where it was first observed. People noticed in pigeons and then in chickens that they could take them to, say, a heavy metal concert, blast the ears really to oblivion. And then within days, new hair cells would begin to sprout. And within a few weeks, hearing was more or less back to normal. It's really extraordinary. How would you explain why evolution would grant amphibians and reptiles, you said, and birds this quite extraordinary power? Well, I think it's not a question so much of why they have it as why we've lost it. Because if you look at more primitive vertebrates, the earliest are fishes, then amphibians, then reptiles.

20:49Each of them has it. Somewhere along the line, mammals lost it. And there is no certainty why we have lost that capacity. It's true of many forms of regeneration. We can't grow our hearts back. We can't grow nerve cells back. Part of the issue may simply be that we live longer. If you have cells that can readily regenerate, you also have cells that can more readily become cancerous because they have the chance to grow. So if you're a fish that's going to live two years, you may not spend much time worrying about cancer. But if you're a radio announcer who hopes to live 95 years, you have to take it into consideration.

21:34As someone who understands how sound and hearing works more intimately than 99.9 % of the rest of the population, what have you observed about your own hearing over the years? Well, the principal thing I've observed is I was stupid in the 1960s, but then so was everybody. So I spent much too much time at loud concerts or with my head between two speakers turned all the way up. And I'm paying some of the price of that now. Those of you in the 60s, I'm thinking of me in the late 80s going, sitting front row at a Guns N' Roses concert and having that ringing in my ears for three days afterwards. And big mistake.

22:20Yeah. It's worth it to hear slash. But I agree. you know, if that's the last thing you hear, you might rue the experience. That's neuroscientist Jim Hudspeth. You can watch his full talk at TED.com. On the show today, ideas about sound and silence and technology. Because the way devices can help us here now, it's almost like science fiction. Hello, my name is Rebecca and I am a cyborg.

23:01Okay, so maybe not that kind of cyborg. But Rebecca Nill does think of herself as part robot. So a cyborg is somebody who has both organic or natural body parts, as well as, like, biomechanical body parts, plus a computer interface which relies on some sort of feedback. So with the cochlear implant, which is what I have, I do have computer chips inside my head which basically rebuild my sense of hearing because I have no natural hearing. Rebecca describes how she became a cyborg from the TED stage. The good news is I come for your technology and not for your human life forms. Actually, I've never seen an episode of Star Trek.

23:52But there's a reason for that. Television wasn't closed captioned when I was a kid. I grew up profoundly deaf. I went to regular schools, and I had to lip read. I didn't meet another deaf person until I was 20. Electronics were mostly audio back then. My alarm clock was my sister Barbara, who would set her alarm and then throw something at me to wake up. My hearing aids were industrial strength, sledgehammer volume, but they helped me more than they helped most people. With them, I could hear music and the sound of my own voice. Did you know that hearing occurs in the brain? In your ear is a small organ called the cochlea, and the cochlea is lined with thousands of receptors called hair cells.

24:43My hair cells were damaged before I was even born. My mother was exposed to German measles when she was pregnant with me. With a cochlear implant, computer chips do the job for the damaged hair cells. Imagine a box of 16 crayons, and those 16 crayons in combination have to make all of the colors in the universe. Same with the cochlear implant. I have 16 electrodes in each of my cochleas. Those 16 electrodes, in combination, send signals to my brain representing all of the sounds in the universe. I have electronics inside and outside of my head to make that happen, including magnets inside my skull and a rechargeable power source.

25:35Radio waves transmit sound through the magnets. The number one question that I get about the cochlear implant when people hear about the magnets is whether my head sticks to the refrigerator. No, it does not. I know this because I tried.

25:57Before we talk more about your implant, just tell us a little bit more about what it was like growing up deaf. It really wasn't that different. I mean, I didn't have anything to compare it against. I was raised orally. The oral method is basically lip reading and speaking versus signing and not using speech at all. And it was very controversial back then because deaf children were forced to be raised orally. And I think over time, people have come into the perspective of total communication, of, you know, letting kids sign as well as speak. or maybe they won't speak at all. It's just an individual type of thing with what a kid is comfortable with and really how much hearing you have and how were you raised.

26:48Were you raised in a deaf family, which I was not. I'm not culturally deaf, but there are many deaf kids who were and sign language was their primary, their first language. But for me, I am a very, very good lip reader. I probably functioned more like a hard of hearing person, even though on paper, the scars were just horrible. I mean, they were profoundly deaf. And my family was very, it wasn't something we ever talked about. Really? I don't think I ever once had a conversation with my parents about hearing loss. It was just what we did. It was just what was there. It was what it was. We just went on with life.

27:31How would you describe your relationship with sound growing up? I feel like that would be a really weird question to ask someone with typical hearing capabilities, but as someone who had atypical hearing capabilities, do you think that you related to sound differently? I do. I did, and I do. I would say I'm neutral on sound. I think that People with people, I don't dislike sound, but I do think that people who would be considered to be hearing people are very pro sound and they romanticize it and have very complex emotions about sound. And I'm neutral. I personally couldn't care less whether I experienced the world through audio or visual.

28:20Frankly, I prefer visual because that's just less work for me. And I'm used to that. That's normal to me. So I really, I am just neutral on the concept of sound. I am anti-noise. But sound in general is, it's not something that I feel a longing for or really care about in any way. hearing people assume that the deaf live in a perpetual state of wanting to hear because they can't imagine any other way but I've never once wished to be hearing I just wanted to be part of a community like me I think that sense of belonging is what ultimately connects our stories and mine felt incomplete when cochlear implants first got going back in the 80s the operation was Frankenstein monster scary.

29:20By 2001, the procedure had evolved considerably, but it still wiped out any natural hearing that you had. The success rate then for speech comprehension was low, maybe 50 percent. So if it didn't work, you couldn't go back. At that time, implants were also controversial in the deaf culture. Basically, it was considered the equivalent of changing the color of your skin. I held off for a while, but my hearing was going downhill fast, and hearing aids were no longer helping. So in 2003, I made the tough decision to have the cochlear implant. I just needed to stop that soul-sucking cycle of loss, regardless of whether the operation worked, and I really didn't think that it would.