The first time was in the fifth grade, where I sat in the back of the room, with a large window behind me. One late-winter day, I heard a shrill whistling. Startled, I made a dramatic jump to the window. While not outgoing, I liked getting attention, and I got it, causing a stir in the class. Irritated by the disruption, the teacher asked, “What are you doing?” followed by a glare more stinging than the words. I said, “I heard something.” Not impressed, she said, “Sit down.” While my behavior was inappropriate for a phonics lesson (or whatever the subject was), the teacher’s harsh tone surprised me. I wasn’t playing a game. I did hear something, though I couldn’t prove it. Through the metal-framed window, I saw only the faded, winter grass sprinkled with gravel and dirt next to the building and a swing set in the distance, with no hint of the origin of the noise that interrupted our humdrum instruction. I sat down, chastened by the glaring adult and embarrassed by the giggling kids. So went my earliest acquaintance with tinnitus.
Tinnitus, “a ringing or similar sensation of sound in the ears” without an external stimulus, is most often associated with age-related hearing loss, afflicting up to a third of adults over sixty-five. Although not everyone who is hearing impaired has tinnitus, everyone with tinnitus has a hearing deficit, sometimes minor but sometimes significant. Incessant ringing due to genetics, obstruction, or damage to the fragile inner ear can bring on fatigue, sleep deprivation, memory loss. The resulting stress and anxiety can induce, in some sufferers, psychological problems, including depression.
I no longer have a silent moment. When an audible activity has my attention—street bustle, people talking, running water—I don’t notice the tinnitus, but when it’s otherwise quiet—the moments before falling asleep, reading a book, sitting at a stoplight—I’m aware of a droning sensation. It may be a muted but rapid, cicada-like humming, though occasionally it will take on a piercing timbre like worn-out brakes. There are moments when I’m not sure of the source of what I’m perceiving: Am I listening to actual cicadas on a summer evening, or is it an illusion? Either way, the constant, internal hubbub is always present.
When in my fifties, an audiologist told me exposure to loud machinery in my youth caused my tinnitus. As a teenager, I drove a tractor each spring and summer for seven or eight years plowing, mowing pasture and hay. The old tractor’s worn-out muffler did little to stifle the engine’s thunderous eruptions. Some days I’d sit on it for an hour or so, some days for eight to ten hours. There were times, too, when other machinery—a hammer mill for grinding grain and a hay baler—engulfed me in a clamor.
Since seeing the audiologist, I notice my hearing has declined: I may have trouble determining what someone is saying if on the phone or if the other person has a quiet or piping voice. And while the steady humming in my ears still doesn’t irritate me, the intermittent shrillness I experience does. I’m troubled by the possibility that someday the shrillness won’t end. Fifteen years after the first exam, I had a second one with an ear, nose, and throat specialist who said the primary cause of the tinnitus came from hearing loss, though he didn’t deny the impact of loud noise. When he learned my mother was nearly deaf in her last years, he told me I inherited my problem from her.
My mom was in good health until a few months before her death, in all but one aspect. Her inability to discern what people were saying progressed from an inconsequential annoyance to an acute infirmity during the final two decades of her life. From when she was around seventy-five, I often had to speak up and repeat myself. She would become embarrassed when she failed to comprehend what someone said to her but compensated by learning to read lips, at which she became adept though not flawless. She refused to acknowledge her limitation. One night, while I drove her and my dad home from our house, she asked, from the back seat, how my daughters were doing. However, she couldn’t see my lips and didn’t register what I said. She asked again, and I answered in a raised voice. After her third request, I was shouting, not only sounding but feeling angry. I couldn’t control my wrath. I resented her unwillingness to accept her condition. She didn’t catch what I was saying, but she knew I was yelling. I saw her hurt frown in the rearview mirror and detected an aggrieved tone in her mumbled words, acting as if she understood me. Abashed, I kept my eyes on the road.
About six months before he died, my father went to a nursing home, and my mom moved to an apartment complex for senior citizens. In some respects, it reminded me of a cruise ship, with social events, daily activities, and wine with afternoon snacks in the common area, yet, because of Mom’s poor hearing, she couldn’t follow conversations, thwarting her penchant for mingling. There was also a well-appointed dining room with wait-staff, and despite sitting at a table with other residents, she ate dinner in silence, isolated by her disability. My wife and I would see her every week, making small talk for ten or fifteen minutes—we talked while she pretended to listen— before taking her to church, and my sister would drop by on a different day. Mom seemed to get pleasure out of these visits, but they amounted to just two or three hours a week. The rest of the time, she was alone, reading the closed captions on a cable news channel.
In the last few years of her life, my mother made sporadic comments, when we were alone, about the other occupants of the residence. For no apparent reason, she would say most, or all, the women living there were men. Incredulous, when she first said it, I thought I misunderstood her. I asked (in a loud voice), “What are you talking about?” She repeated, “I know they don’t look like it, but they’re men dressed as women.” Her resolute expression conveyed she wasn’t kidding or being ironic. I made a mild protest during several subsequent reiterations of this tale but eventually dropped it. I knew arguing with her would be a wasted effort.
I later found out that while aberrant, her behavior wasn’t rare. People who have hearing problems are more likely to hold beliefs that defy proof, to be delusional. For instance, some see peril in non-threatening surroundings, believing others are denigrating them or, as with my mom, trying to fool them. Stress is a leading trigger, with isolated individuals being the most vulnerable. Deliria of this sort runs in families.
I grew up and lived most of my life convinced that my mother and I were not alike, and in some ways, opposites. She was religious, and I’m not. She was precise in her language—saying she’s going to “lie down” to rest, while I, not a stickler for correctness, say “lay down.” In some situations, her speech struck me as pretentious, causing me to cringe: I recall a stranded motorist, waiting at our house for someone to get her stalled car running, asked my mom if she was from England. Yet, realizing my hearing has diminished brings to mind various of my traits that mirror hers.
My mom was vain about her looks and wouldn’t admit it. To hide the gray strands of middle age, she dyed her hair black, changing the shade to a mature bronze as she grew older. I, too, am preoccupied with my appearance. I used to dislike my thick, hard-to-comb, curly hair, but with age, my hairline has receded, the curls are gone, and I have a bald spot. Trying to hide it, I carefully brush my hair back to make it appear thicker than it is.
And Mom always looked young—a handyman painting our house one summer guessed she was twenty-five when she was forty. She never told her age (misleading the handyman to think he’d made an accurate guess) until her grandchildren began entering high school. But even at ninety, she was elated when a doctor, taken aback when told how old she was, exclaimed, “I don’t believe it.” As for me, I like to think I look half a decade younger than I am. On several occasions, an old (older than me) lady in a nursing home has told me I’m “fine-looking.” I make an effort to appear unmoved, but such compliments are secret thrills.
We shared another kind of self-centeredness. For eight years, my mother had to look after my partially paralyzed father. They were in an assisted living facility where staff did tasks such as dressing and bathing him. Still, Mom had to keep a constant eye on my dad and aided him with less demanding undertakings, such as eating. Even with the help, she resented having the extra responsibility and sometimes moaned that she couldn’t keep caring for him. I could see she felt sorry for herself, becoming more vocal about her travails as his condition worsened.
For as long as I can recall, I’ve fixated on evidence of my insignificance. After my sister was born, I was no longer the center of my parents’ attention, which led to frequent tiffs and a sense I was a victim of unfair treatment. I desired to be among the most favored, such as being someone’s best friend or the top choice when choosing sides for schoolyard games. But I was no one’s boon companion and a middle-of-the-pack pick for competitive contests. As an adult, I was the outsider, the guy who ate lunch at his desk, not understanding the cliquish jokes or in on the latest gossip. Though my circumstances have been different than my mother’s, I often feel sorry for myself.
About six weeks before she died, the place where Mom lived contacted me. They told me there were several incidents in which she was making nonsensical statements and appeared disoriented. Two days later, she fell in her apartment, and the staff had to call an ambulance to transport her to the emergency department. By my arrival, a doctor had seen and admitted her to the hospital. When an aide was taking her in a wheelchair to a room, I heard my mom tell her, in a weak voice and pointing at me, “He’s my son. He’s my favorite.” I was embarrassed and confused; from my viewpoint, she held us all in the same regard. So, I don’t know if she meant what she said, was humoring me, or her mind was slipping away. And I can’t say with certainty my hearing wasn’t playing tricks on me.
I didn’t realize until the doctor’s exam revealed my mother had an advanced case of shingles that she had been suffering from severe pain for a couple of weeks, overlapping the period her troubling figments had escalated. Despite the pain, she didn’t tell anyone. Initially, her silence mystified me, but I now see she didn’t want to worry us or be a burden.
Some people adapt to the noise, and tinnitus doesn’t rattle them. So far, I’m in this category, but tinnitus is associated with hearing loss, and as mine worsens, I’m concerned other problems will emerge. I worry about latching onto fanciful beliefs and becoming emotionally agitated.
The cicada-like hissing and teakettle whistling never stop. I relive memories of my mother stepping out of reality, and I wonder if there is a connection between my tinnitus and her delusions. As I grow older, I envision the discomfort I may face one day. Chronic or infrequent, mild or acute, the images vary, but they are simplistic reveries. I’m painting a picture of my situation with a drab backdrop in which shadows are absent, without nuance. Fearing I’ll become delusional as my mother did, I overlook her example of selflessness in considering her family’s feelings. Her fantasies didn’t vitiate her humility and kindness. My musings about my future mental stability have missed the point: I’ll have the capability to deal with what happens to me until I don’t. Ingrained habits and character will determine how I grapple with a fate I can’t foresee.
Photo at the top of the page: “[mb] Tinnitus” by Merrick Brown is licensed with CC BY-NC-SA 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/2.0/