Jun. 9--DURHAM -- Duke audiologist Molly Justus looked like a recording studio engineer as she adjusted a 16-band equalizer designed to improve the performance of Joan Ernst's cochlear implant, a high-tech hearing device inside her ear.
Justus was aiming to make what Ernst heard through the computerized device resemble as closely as possible the nuanced notes that used to come through her trained musician's ears. A retired teacher and choir director in Hertford, Ernst is one of an estimated 36 million Americans with hearing loss, but one of only about 38,000 who have received cochlear implants.
Using cochlear implants, people like Ernst have for more than two decades been able to receive sound through the stimulation of nerves in the inner ear. However, in recent years, manufacturers and academics have joined to make the devices ever more sophisticated at reproducing the complexities of natural hearing.
"At first, all voices came through like they were computer-generated," said Ernst, who received her implant last month and uses it along with a conventional hearing aid in her other ear. "If I had just my implant, I couldn't tell the difference between a male and a female."
Hearing loss is often age-related, affecting nearly half of people older than 75, so the numbers will increase dramatically as baby boomers hit their Social Security years. The industry has already seen 20 percent growth in recent years, and manufacturers such as Med-El, an Austrian company with U.S. headquarters in Durham, are competing by sharpening their customers' ability to enjoy music, as well as pick out conversation in crowded and noisy settings.
"Music is a particularly difficult thing to restore with a cochlear implant because so many different things go into it," said Dr. David Kaylie, a Duke hearing specialist and neurologist.
Pitch, rhythm and timbre all contribute to the overall impression music makes, Kaylie said, and to a lesser degree make up the elements of speech. Ernst, who taught music in Long Island schools for 30 years, says her ability to distinguish speech has improved dramatically while working with Justus and others at Duke.
"I could understand what my husband said without looking at him and without reading his lips," she said. "I wouldn't even answer the phone, and now I can. Those two things have been very positive and encouraging."
The challenge of music
But Ernst is still working on hearing music.
"I know that will take more time because it is a much more complex sound than speech," she said. Ernst has gotten encouragement from people such as Ruth Miller, a Chapel Hill resident who performed on piano, trumpet and French horn before having profound hearing loss.
"Music has become much more enjoyable for me," said Miller, 65, who has had two cochlear implants for about five years. "And I understand they are coming out with new programming to address that issue."
The Holy Grail, according to Kaylie, is a device under development that combines the properties of a conventional hearing aid with digital enhancements in the same ear. "That's going to be the big thing," he said.
Social life improves
Academic research and interviews with implant recipients come to the same conclusion: The ability to hear music can have a positive effect on the lives of older deaf people. In another benefit, studies have shown that older people who receive cochlear implants see improved quality of life because better communication prevents loneliness and isolation. Perry Miller, Ruth's husband, can attest to that.
"They go to a party and get some of what's being said, but not all of it," said Perry Miller, 65. "It was always a great disappointment before to think your wife might not be hearing the jokes that might be shared or the stories that were told."
Joan Ernst is continuing to work with her church choir in Hertford, using a combination of some improved hearing, some intuition and some signals from husband John to get the music into shape. A practice this week didn't leave her as exhausted as she used to feel before the implant. And after decades of lost hearing, there's a chance that she'll regain at least part of a cherished ability.
"For the first time in 25 years, I'm hoping that music will improve," she said. "The experience that I have gained back in speaking and in day-to-day interaction with people gives me that much more hope.
"Why shouldn't music come back as well?"
thomas.goldsmith@newsobserver.com or 919-829-8929
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