“Close your eyes.”
The specialist intoned a prompt to drift into the drone.
“Can you see voices?”
Some see better in music. I could not. So I snapped back from hypnosis, panting like I just got my neck out of the water.
Deaf or blind, I’d much rather diminish and lose my hearing of all senses.
“For most people, it’s the least of their priorities,” said Susan Javier, a hearing care specialist at the Manila Hearing Aid. “We take hearing tests for granted like it weren’t as urgent as an ECG or a blood test.”
Until you recognize a lot is gradually dying in silence.
Downward spiral
Deafness can begin in the womb. Sometimes it’s progressive. That’s how it can sneak up on people.
Hearing loss has many levels. Instead of demonstrating the profundity of damage with decibels, Javier puts it simply on a scale from 10 as profound to one as mild.
She equates frequencies to a flight of stairs: “High frequencies are the first steps and they wear out sooner.”
It’s prudent to keep tabs on early signs.
Trust your senses, but never a constant ringing in the ear. Do you have to strain to understand what the other person is saying? Does he have to enunciate his words, paint pictures with gestures, put on a sheer face?
Some who are hard-of-hearing are ill-equipped with knowledge and are relieved by amplifiers, cheap over-the-counter devices often mistaken for medical hearing aids.
“OTCs are not programmed to a patient’s specific needs. Each case of hearing loss is unique: Say, you need an amplification of 10 percent on the low frequencies; 50 percent, high. You need aids programmed to suit that 10- and 50-percent amplification,” Javier said.
“For an OTC, we cannot do that. It doesn’t do anything other than amplify volume. You just rev it up to amplify the high, while over-amplifying the low. It’s [a one-size-fits-all blanket solution]: loose here, tight there, which will only aggravate the condition.”
Hearing aids do not fix ear damage; they protect residual hearing, averting decline of comprehension — a brain process that diminish when not utilized.
In other words, uncorrected hearing loss can shrink parts of the brain that process sound, leading to a gamut of complications like depression, even dementia.
Odd, odd thing
The ear procedure is innocuous and is nowhere near one’s paranoid ramblings about Victorian medicine.
“At Manila Hearing Aid, patients are assessed according to the degree of hearing loss and where the damage is. Fitting will ensue to find the appropriate aid,” Javier said.
“We do otoscopy into the outer ear canal. There are days we see cottons, days we see beans! It was a curious child playing with it. Can you believe it? A mung bean had been sitting there for a long time it started to sprout! The case is especially typical in the provinces, where people are not even conscious about their health.”
There are barriers. Those days in yore, acquiring prescription were not like a casual trip to an optical clinic for a chic pair of specs.
“When I started working at Manila Hearing Aid in 1987, it was very hard to convince people. Some would come in to inquire but it would take them so much to bring a family member for diagnostic tests and prescription,” Javier said.
“Medical hearing aids were not as accepted then as eyeglasses. Eyeglasses make you look good. Hearing aids did not.”
The mass appeal of hearing aids used to merit derision. “Big beige bananas” they’re called: obscene, bulky devices that cling like an extra appendage to the back of the ear and associated with old people.
“Soon, hearing people would notice and say, ‘What’s that? That’s funny!’ The hearing-impaired are being mocked and laughed at in the day. Even now, some would rather choose to do without it, which causes denial.”
Lumity
A seismic industry shift came about when Phonak Lumity was recently announced to the Philippine market, a revolutionary technology that encapsulates form and function in a hip and compact shell.
“New models of hearing aid come out every year. Lumity is special because it provides adequate amplification and gracefully splices a well-balanced mix of conversation and environment.”
Speech Auto Sense, Lumity’s winning AI feature, studies ambient noises, so that you clearly understand speech while being aware of the world around you.
Lumity on both ears is pegged at the price of a decent sedan. Or an Audemars Piguet.
“It’s a joke I have been telling people. I had a patient, a doctor with tinnitus, who rang me up to say he was tossing hearing aids meantime to buy an expensive watch. I said he needed to prioritize his hearing; he had patients who’d ask questions and his answers did not match! A timepiece could not make him hear. Lumity can.”
Hearing aids are special. It’s the entire stadium-scale bombast shrunk into something elegantly wearable like an Hermes tie to impress a client.
The bulk in billions of dollars churned to come up with something like Lumity goes into research.
“They can be very expensive but there are a lot of models under P25,000. Manila Hearing Aid even used to tie up with PCSO and local governments to give the device — and the services that go with it — free of charge to some people.”
“If you present a PWD card, you are entitled to a considerable discount. We offer flexible payment terms. If you take it seriously, you can manage the cost of hearing aids.”
Full citizens, limited functions
Manila Hearing Aid first opened in 1976 on Quezon Avenue.
“I was wondering what a clinic was doing there when Quezon Avenue was not even a business district. It was either Cubao or Makati. But you could only be surprised about the number who checked in, mostly old people waiting in line for an hour or two to be attended.”
She parted her arms to illustrate a chasm: “The [hearing-impaired] community is this much.”
Manila Hearing Aid opened another clinic in North Mall Ayala Center in Makati (now Glorietta), where Javier has been serving for 37 years. Now it has 16, sprawled across Metro Manila and the provinces, such as Cebu, Angeles and Laguna.
The audiologist was trained by pioneering and Manila Hearing Aid founder, the illustrious Dr. Jose Abaño.
It was a sunrise industry in the Philippines. There were no unis in Manila offering a master degree in audiology. Javier engaged abroad to be abreast with the latest technologies in diagnostic hearing test and aid-fitting.
It’s a rare career that saw a lot of radical changes in many fronts, but less in terms of PWD rights in a country not built and holistically designed for disability. Just because we have a hearing Congress doesn’t guarantee everyone is heard.
“Here, we have ramps for cripples. In Japan, US and Europe, churches, theaters, classrooms and offices are outfitted with assistive listening devices — transmitters posted in each corner compatible with hearing aids. It’s very expensive, but the government must pay attention to [full citizens with limited functions] whose challenge is to cope up with [a society perceived as equal].”
You can’t see deafness. It’s a disability that doesn’t present itself with sticks, seeing-eye dogs and wheelchairs. But while, in the US, the differently able strut signs on their chests for the world to see that they’re deaf, Filipinos are essentially sensitive and considerate.
“We are aware. Those who are able are not blind to the old and the frail we help across the street, onto the bus or carefully up the stairs.”
Small wins
There are hard-won gains, but it’s still a long fight ahead.
Javier had a patient who, as a child, had a very mild case of hearing loss. Through the years, his ears had deteriorated. Jeered in class, he stopped going to school and isolated himself. Eventually the kid was convinced to go to the clinic.
“He hurdled odds and became a lawyer. He uses a roger [a receiver] he’d hand over to the judge who would happily oblige. He passed the bar three years ago.”
Another patient has been under Javier’s care since he was a boy. He wears a Phonak, studied education, passed the board, became a teacher.
When the hearing aid is defective, he goes to school without it. Once, the clinic had to send his device abroad for a month for repairs.
The students noticed he would miss the bell, at times ringing all through five minutes. They started talking behind him until it reached the principal’s office, where he was encouraged to find another job because he’s deaf.
Javier was enraged by the news. She confronted the principal.
“How can you, an educator, tell my client not to work in your school simply because he’s hearing-impaired? That’s unfair. Is he not good? He’s actually very good. Teaching is his passion.”
Javier managed to provide a backup unit after a week.
What also came to mind was a tiny story of a first lady.
“She socialized most of the time. All while secretly suffering from profound hearing loss after hiding it for 20 years.”
She would smile no matter clueless about what’s going on in the party.
They fitted her with hearing aids and her life had become normal again.
Mundane
The world has many glories, say the advantaged. There’s dignity in disability, even when you have no arms and legs.
If you struggle to hear but have a clear set of eyes, you begin to see deafness in an altered point of view: That life is never a tragedy when you often get a good night’s sleep or spared from hearing a lot of dumb questions.
Thus, it has become so easy to miss the calm when it begins to rain, the A on the piano, the wind rustling through the trees.
Or the powerful pauses in an impassioned speech. The quiet in the car when the engine stops. A father with children panting at his ear now that he is able to listen: “Thank you, Susan, for making me hear the world again.”