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The science and suffering of hearing loss

Former Baltimorean Katherine Bouton abruptly lost the hearing in her left ear at age 30. One minute she could hear, and the next, she could not.

Over the decades, her impairment worsened. By the time she was 60, she was functionally deaf. But her reluctance to disclose her ailment only increased. And who can blame her? She worked in a highly competitive environment, as a senior editor at The New York Times.

In retrospect, Bouton says, remaining silent was a mistake; her hearing impairment contributed to her abrupt departure after 22 years at the newspaper.

And once she decided to bring her reporter's tenacity to the subject that had dominated much of her life, she knew that secrecy no longer was an option.

The result is, "Shouting Won't Help: Why I — and 50 Million Other Americans — Can't Hear You." In addition to relating her personal story, Bouton delves into the science behind deafness, describes the pros and cons of the devices and surgery dedicated to improving hearing, and explores the social ramifications of what she describes as a growing epidemic.

The author spent a formative decade in Baltimore beginning in 1954 when she was in the first grade. And her book discusses several research studies being conducted at Johns Hopkins Hospital. So Bouton made sure that Baltimore's Ivy Bookshop, where she will read on Thursday, was a stop on her current book tour.

The following interview was conducted by email and has been edited and condensed for space.

Your book made me realize that hearing, perhaps more than any other sense, is connected to emotional intimacy. It's the primary way that humans communicate, the key to our social identities.

With a really serious hearing loss, it's hard to be totally intimate. You can do it with one other person, I find, if you are alone and looking at each other.

But if it's combined with physical intimacy — say, sex — it gets really hard. My implant and my hearing aid are both intrusive and if I was being physically intimate with someone I'd probably take both off. That would mean I couldn't hear them and might not even know they were talking.

It's also really hard when I'm with a group of friends. Everyone talks over each other, jumps in to complete each other's sentences. Suddenly everyone's laughing, or crying or hugging, and you're going "Whah?" You just entirely miss that exchange. It's very hard to ask everyone to go back and reconstruct the conversation, so you don't.

In you book, you describe the toll that your hearing impairment took on your career.

I asked one of my colleagues on the New York Times magazine, Alex Star, if he had noticed my hearing loss.

"I did notice that you often held back at meetings, and didn't necessarily engage in conversational back-and-forth after you'd given your own assessment of a piece," he wrote in an email.

"I could tell from your reading of our knottier science stories that your analytical gifts were considerable, and yet I sensed a reluctance to use them fully in face-to-face interactions. I attributed this reticence to temperament, or to discomfort with the management of the magazine, or to that all-too-common phenomenon: a waning of interest in the workaday routines of journalism after years in the trenches."

In September 2009 I moved from the magazine, where I'd been the deputy editor, to the culture section for the daily paper, where I was the editor for theater and books.

About a year into the job, the editor who hired me was replaced by someone I had a long, unpleasant history with. I didn't want to tell him right off the bat that I was deaf. I thought I could fake my way through a few months and let him see that I was good at my job (which I was) and then tell him.

That backfired. In a really ugly series of events, I discovered that he planned to move me out of the department, and I took a buyout. His main complaint was that I wasn't "a team player." I probably wasn't.

At least in part because of my hearing loss, and because it had taken me such effort to adjust to a new job, I didn't want to start over again. Also, I knew even then that I wanted to go back to writing, and I thought I wanted to write about hearing loss.

Can you talk more about the stigmas associated with deafness?

The biggest stigma is age. A majority of the elderly have hearing loss, which makes it seem like a condition of the elderly, even though many of them have had it for 40 or 50 years. A study last year found that 19.5 percent of all teenagers have some degree of hearing loss. And who wants to seem old?

There also are several severe syndromes that have hearing loss as one of their symptoms. Developmental delays, especially serious ones, are often accompanied by hearing loss.

The third thing is that people who have been deaf or hearing impaired since early childhood usually speak in a noticeably different way. Yesterday, I had lunch with someone who sent me an interesting email after a talk.

At first I was dismayed — he had a pronounced "deaf" accent. I made the same negative, instantaneous assumption that he was somehow mentally impaired that others do about people who have hearing loss. In fact he has a Ph.D. in biostatistics and it took about three minutes to realize how smart he was.

I was fascinated by your discussion of the association between hearing loss and dementia.

I don't want to leave the impression that hearing loss causes dementia. There's no evidence of that. But they do seem to be correlated.

Frank Lin [a surgeon and researcher] at Hopkins tracked people with and without hearing loss over a period of time using the Baltimore Longitudinal Study of Aging as a database. Those who had hearing loss also had a higher incidence of dementia of all kinds, making him suspect there might be an underlying biological mechanism that causes both.

This is of course very distressing for anyone with severe hearing loss. You've already lost your hearing, now you have to worry about losing your mental faculties as well.

But there's one unknown factor, and this is what Lin is studying next: How well were hearing aids used? Were they carefully fitted and calibrated? Did the person wear them all the time, or just to watch TV? So his next study is going to try to determine whether good hearing aids, used consistently, can help diminish that correlation.

mary.mccauley@baltsun.com

If you go

Katherine Bouton will read from her new book at 7 p.m. Thursday at the Ivy Bookshop, 6080 Falls Road, Baltimore. Free. Call 410-377-2966 or go to http://www.theivybookshop.com.

About the book

"Shouting Won't Help: Why I — and 50 Million Other Americans — Can't Hear You" was published Feb. 19 by Sarah Crichton Books. 288 pages, $26

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