Medical Examiner

“Oh, Your Hearing Won’t Be Coming Back”

After surviving a traumatic brain injury and a coma, I was prepared for baddish news—but not for it to be delivered so swiftly and decisively.

A man getting a hearing test.
Is that a distant beeping noise? Photo illustration by Slate. Photo by Huntstock/iStock/Getty Images Plus.

This article is adapted from the book The Night the Lights Went Out: A Memoir of Life After Brain Damage by Drew Magary. Copyright © 2021 by Drew Magary. Published by Harmony Books, an imprint of Random House, a division of Penguin Random House LLC. All rights reserved.

My right ear wasn’t getting any better. I kept snapping my fingers by the ear but couldn’t tell if I was hearing anything with it or if my left ear was doing all the legwork. I visited my general practitioner—man, was it refreshing to visit an everyday doctor and not a doctor specializing in orthocerebrogastrohypmentiology—and he waved off the loss. “It’ll come back,” he reassured me. “These things just take time.” It had already been months. In terms of recovery from a traumatic brain injury like mine, two months is jack shit. But YOU try living with a bum ear for that long. Ever have one ear get plugged up when you’re swimming? It’s fucking annoying, right? You tilt your head and jump up and down to get the water out, and the longer your ear stays plugged, the more frustrated you get. OK, now imagine that, but forever.

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I wasn’t convinced by my GP. I was now old enough to know that doctors didn’t know everything. When I was a kid, I assumed my pediatrician could also perform major surgery, or perhaps even stitch up a nasty head wound, in a pinch. I knew better now, brain damage or not. So I went to Dr. Kent, an ear, nose, and throat specialist (or otolaryngologist, now that we’re back swimming in the medical profession’s alphabet soup), and asked him about my prognosis. (“Dr. Kent” is not my doctor’s real name; it’s a pseudonym for this book.) I was prepared for baddish news, but not for it to be delivered so swiftly and decisively.

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“Oh, your hearing won’t be coming back,” Dr. Kent said. “You see, when you fractured your skull, the fracture tore through your inner ear.”

“Can it heal?”

“Not with damage this extensive, no.” He brought up an MRI of my head to show me the proof. A diagnosis of single-sided deafness (SSD) was already in my extensive medical file from Mount Sinai. But doctors there either ignored that I had pulled a Van Gogh, forgot to tell me, or were simply so determined to get me upright and back home that it wasn’t high on their priority list. It wasn’t high on mine while I was in there, either.

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Now I could see, with improving vision, what they had ignored. It was right there on the MRI. Your brain is protected by your skull. It’s a good, solid shelter for your internal hard drive. But your skull has more than a few apertures. Eighty-five of them, to be precise. These are necessary trapdoors that are the product of human evolution. They do more good than harm. But when they are compromised well, that means uh-oh for you.

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You know some of the obvious trapdoors. You have open eye-holes in your skull called orbital fissures, plus two optic canals that allow the optic nerves to carry information collected by your eyeballs through the ethmoid bones—Ethmoid Bones sounds like the name of a character from a Victorian horror story—behind them and into your brain to be interpreted as sight. Your nasal cavity is split right down the center by a mixture of bone and cartilage called the nasal septum, which gives each nostril its own doorway to your sinuses. And of course, your skull has no floor. After all, your neck and the rest of your body are already there to protect the underbelly of your head. If you had no body, then your skull would need a bottom. Let’s all hope that happens when we live on as disembodied, cryogenically frozen heads later in this century.

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Seeing as how these openings are, you know, openings, they can be breached. This is true of your nasal cavity and the underside of your jaw. These are the orifices that get penetrated with regularity in any quality action movie. But let’s delve now into the more artisanal trapdoors of the human skull.

Specifically, I’d like to acquaint you with the internal auditory meatus. “Meatus” is the term for any opening in the body and usually refers to the hole where urine flows out of you. Another, less comical meatus is the highway linking your outer ear—go ahead and give it a tug to let it know you’re still there—to the astonishing sound factory that is your inner ear. Your outer ear is nothing more than an organic satellite dish. It captures sound from the outside, funnels it through the ol’ ear meatus, and delivers it to your inner ear, where that sound is harvested, processed, packaged, and delivered to your brain as human speech, pieces of music, and loud farts.

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The internal auditory meatus is located due south of the temporal bone. Men break the temporal bone three times more often than women, because breaking shit is my gender’s lifelong passion. Given how hard it is to break the temporal bone, you’d be correct in assuming that, once displaced, it can break a few things of its own. In my case, the fracture tore through the meatus, cutting my inner ear off from the outside world. The inner ear and its nerve bundles assist in controlling human balance, which explained my dizziness. It also explained why I no longer had any echolocation: the ability to tell where sounds are coming from. You need both ears working to have this. Without echolocation, accidentally walking in front of an oncoming car behind you becomes a more likely occurrence.

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Dr. Kent showed me all of the damage I had suffered: hairline cracks in my skull, a breached auditory canal, visible scarring in the brain. It was all right there on his monitor. I put a lot of work into that brain, man. It was like seeing a prized car dented.

“OK, so here’s the brain damage,” Dr. Kent said, wasting no time. I flinched. When I thought of the term “brain damage,” I thought of people who had been permanently incapacitated. I didn’t care to think of myself as such. I didn’t care to think of my own brain as a tangible object that could be destroyed. How damaged was I, really? After all, I could still see and feel and remember and think.

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But I couldn’t hear. I looked away from the scan as Dr. Kent told me that I would never hear out of my right ear ever again.

“So there’s really no way to bring it back?” I asked him. I knew the answer, but I still held out hope that he’d be like, Actually, yeah, just eat more fiber and the meatus should be groovy in no time. But no, he said. The ear was dead. There was no way to resurrect it. Not by natural means, at least.

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“Well, that sucks,” I told him. I didn’t collapse to the floor in despair. I didn’t cry. I didn’t star in my own impromptu Oscar clip. I just bitched, same way I did when I came out of the coma. I left Dr. Kent’s office, got in my Kia, and drove back home. Alone. I was well enough to drive myself anywhere I pleased now, but that was little solace as I sat behind the wheel and took in the impact. Trauma is a vine: a parasitic entity that latches on to a thriving host and, over time, grows on and around it. It can take a while, even years, to make its presence fully known. It doesn’t surround you all at once. It just needs time and sunlight, and on my drive home it had both in equal measure.

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It got worse. Dr. Kent sent me to an audiologist named Dr. Michael Morikawa, so that they could get a full survey of the wreckage to my internal stereo system. Dr. Morikawa took me into a soundproof booth and tested each of my ears separately, not unlike hearing-test day back in elementary school. He played a distant beeping noise, and I could have sworn I was hearing it through the dead ear. A FUCKING MIRACLE. I told him I’d heard the bad ear spring back to life.

I was wrong. I walked out of the booth and Dr. Morikawa showed me my test scores. For the right ear, I scored a perfect 0.0. I recognized no sound at all with that ear isolated. As a crowning blow, my “good” ear on the left had also been damaged. I’d missed out on a lot of high-frequency noises with it. My aggregate hearing capacity was at less than 50 percent. Dr. Morikawa told me that the left ear must have been damaged in the fall. I actually didn’t agree with this, because I’ve spent my entire life with my music turned up to 11 through my headphones, and because my father has a similar kind of high-frequency hearing loss in both ears: a natural byproduct of aging. I was due for this shit. But I didn’t tell Dr. Morikawa that. I didn’t want the insurance company to be like, Oh, well, if it was inevitable this whole time, let’s not cover anything.

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“What about the sound I heard on the right?” I asked him. This is when Dr. Morikawa gave me an impromptu lesson in the biological miracle that is bone conduction. When he’d played a ping into my dead ear, it sent vibrations rippling across my skull that my left ear picked up, interpreted as sound, and sent to my brain, which then processed the sound as coming from my right. That is how the brain rewires itself. That is the miracle of biology.

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But that meant the apparent resurrection of my right ear was a mirage. I was deaf. And what little I could still hear, I hated.

Book jacket showing the title, author, and an illustration of a man collapsed on his back and limp on the ground
Harmony Books
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