From Lawn Mowers To Rock Concerts, Our 'Deafening World' Is Hurting Our Ears

Nov 5, 2019
Originally published on November 5, 2019 4:44 pm

Our ears are complicated, delicate instruments that largely evolved in far quieter times than the age we currently inhabit — an early world without rock concerts, loud restaurants, power tools and earbuds.

Writer David Owen describes our current age as a "deafening" one, and in his new book, Volume Control, he explains how the loud noises we live with are harming our ears.

"When we talk about age-related hearing loss, the assumption is that this is something that happens to old people," Owen says. "It is something that happens to old people — but it's something that's caused by things that we do when we're young."

Owen warns that even small household appliances like food processors and hair dryers can generate noise at levels that lead to permanent damage. He notes that people who live in places without significant background noises tend to experience less hearing loss.

"There have been a couple of studies done with populations of indigenous people who live in places where there is very little background noise and elderly people in those populations tend to hear as well as infants do," he says.

Owen recommends that people carry earplugs with them — and not be bashful about using them. Recently he popped in a pair of musician's earplugs before watching Dunkirk, a movie long on explosions and short on dialogue.

"[Earplugs] made a big difference to me at that movie," he says. "I think there are a lot of places to wear hearing protection."


Interview Highlights

On the ways hearing loss affects people

People who have trouble hearing tend to have more unrelated health issues of all kinds. It, sort of, overworks our brains. If you can't quite hear what people are saying, you have to work harder to figure it out, and the brainpower that you use to do that is brainpower that you can't use for anything else. People who have trouble hearing also tend to withdraw. ...

If you have trouble seeing things you get glasses, but people tend to put off hearing getting hearing aids for a long time." - David Owen

So it has effects that we don't necessarily associate with it and that pervade all parts of our lives. And then, because of human nature, we tend to ignore it. The average wait for a person who first notices a hearing problem — the average delay between that moment and going to the doctor — is 10 years. That's the average. We don't treat it the way we treat other sensory problems. If you have trouble seeing things, you get glasses. But people tend to put off getting hearing aids for a long time.

On why it's difficult to hear conversation in a loud bar or restaurant

The reason it's problematic there is there's sound going on all around you. It's hard to focus on the person that you want to hear. ... Young people have less trouble with that. Their auditory systems are more able to filter out unwanted conversation. But restaurants, unfortunately, take advantage of this. They tend to turn up the sound as the night goes on, both to make diners talk less and, therefore, drink more, and also to drive out older, lingering customers who don't run up ... big checks. Get them out and turn the tables over faster. ... And then, perversely, paradoxically, even people who hate loud restaurants tend to avoid really quiet ones, because they figure, it's so quiet, how can it possibly be any good?

On how hearing loss affects veterans

The largest single purchaser of hearing aids in the United States is the [Department of Veterans Affairs]. The No. 1 and No. 2 service-related health claims made by military veterans are hearing loss and tinnitus. Exposure to gunfire, especially exposure to blast explosions, but then also just the extraordinarily high sound levels of military service, even on a base outside of combat. One of the loudest work environments in the world is an aircraft carrier. And simply sleeping on an aircraft carrier, you can expose yourself to sound at levels that are sufficient to do permanent damage to your hearing.

On tinnitus (a ringing in the ears) and its treatment

I learned from reading about tinnitus that there's basically nothing you can do. You can't make it go away. There is no known cure for it. The therapy for tinnitus is to learn to accommodate it. And, luckily for me, I have the kind of personality that makes that fairly simple. When I was told that there was nothing I could do about it, I thought, "Oh, good. Then I'll do nothing." And that's kind of what I've done. ... I can always hear it, but mostly — usually — I can ignore it.

There are people for whom that's very difficult. It's loud, and there even have been suicides [among] people who just can't tolerate this phantom noise in their head. And for them, the treatment is often cognitive therapy, behavioral therapy, or the kind of ... medications that are used to treat anxiety or depression — just basically learning to live with this thing. And most people can improve their response to it significantly.

Sometimes hearing aids can help you. If you have some hearing loss and you eliminate that, you bring up the sound of everything else. Then this phantom noise becomes less bothersome. You can't hear it as much. A therapist described it to me as, "You're in a room with a candle. The candle is the tinnitus. But if you turn on the lights, then the candle is less noticeable." And that's what sometimes happens with hearing aids with somebody who has tinnitus.

On the cause of tinnitus

Tinnitus isn't noise. It's something that's going on in your brain. There are no physical vibrations to counteract. It's not sound waves. It's this electrical activity that is impervious to sound suppression technology. ... I think that the current theory about tinnitus is that it's similar to phantom limb pain. You've heard about when somebody loses a limb — they have an amputated arm — they feel that that arm is still there, or they feel pain where that arm was but no longer is. Even itching. You can feel itchy fingers on a hand that's no longer there. The idea is that the brain is accustomed to receiving nerve signals from this part of the body. It's no longer receiving them. So it makes, in effect, its best guess about what should be coming from it. It supplies the last thing it felt from there, or something like it. And the idea is that tinnitus is very often something like that. You lose hearing in some frequency. The brain is used to receiving auditory signals at those frequencies; it isn't anymore. So it fills in the gaps with what seems like a sound but is actually just electrical activity in the auditory system in your brain.

On different kinds of auditory problems

The person with the most depressing auditory problems that I've ever encountered had something called hyperacusis, which is where it's like the opposite of deafness. Everything is louder to him than it is to anybody else — so much so that even inside the house he will wear huge earmuff-like headphones. The crinkling of paper can drive him out of the room. ... He said, "Sometimes, hours later [after a conversation] I would hear some phrase that he would say repeated over and over in my head." That's a form of tinnitus. Somebody else I know, he said that he often hears just what sounds like a crowd of people talking in the background — so much that he can almost feel that he can almost make out what they're saying. It's male voices, sort of babbling in the background. People sometimes hear music. So it takes many forms.

On how classical musicians — just like rock musicians — experience hearing loss

The impact on your hearing probably has less to do with the instrument that you play than with the instrument that the person who sits behind you plays. So if you have a loud instrument right behind you, you're the one who gets the impact. ...

It's only recently been acknowledged as a problem. But there was a lawsuit recently of a musician in an orchestra who sued because he said that his hearing had been damaged by musicians sitting behind him. Now you'll sometimes see a violinist, for example, when she might have a plexiglass shield behind her to deflect some of the sound coming from instruments behind her. It's not only in those performances. Musicians practice, especially nowadays, for hours and hours and in small rooms with loud instruments and it takes a toll on their hearing very definitely — not necessarily as rapidly as a death-metal guitarist, but it's loud stuff. An orchestra playing in a big symphony hall is playing at a very high decibel levels.

On how the market for hearing aids is changing

The revolution that's coming is that it's going to be increasingly possible to buy over-the-counter, less expensive hearing improvement products — hearing aids and other products. ... I have a pair of Bose headphones called "Hearphones." They contain the same kind of microprocessor that's in hearing aids. Plus, because they're a big, looser kind of headphone, the sound is much higher fidelity. They're easier to control. They function as noise-canceling in addition to noise enhancing. I have a friend who lost a lot of hearing, wears hearing aids. He wore his Hearphones to a restaurant and found them much superior to his hearing aids — the quality of the sound, the ability to focus on people that he wanted to listen to. There are a lot of products that are available now and that are also coming. It'll be tricky for a while, I think, for people to sort out what is a scam and what is not.

Sam Briger and Mooj Zadie produced and edited the audio of this interview. Bridget Bentz and Molly Seavy-Nesper adapted it for the Web.

Copyright 2019 Fresh Air. To see more, visit Fresh Air.

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry GROSS. Our guest, journalist David Owen, says you might want to lower the volume on the music in your earbuds and maybe insert some protective earplugs when you ride the subway or mow your lawn. If not, you might be straining to hear conversations in restaurants or at parties in a few years. Owen says our ears are complicated, delicate instruments that evolved in a far quieter world than the one we live in. We tend to take them for granted and expose them to way too many loud noises. As a result, most of us have some hearing loss before we reach retirement age.

In his new book, Owen writes about the many forms of tinnitus, or ringing in the ears, one of which he has. He also reviews the remarkable changes in hearing aids and medical interventions for some hearing problems and the debates they've spurred on whether deaf children should still be taught sign language.

David Owen is a staff writer for The New Yorker who's written more than a dozen books. He spoke with FRESH AIR's Dave Davies about his latest, called "Volume Control: Hearing In A Deafening World."

DAVE DAVIES, BYLINE: Well, David Owen, welcome back to FRESH AIR. What are some of the ways that moderate - even moderate hearing loss affects us that aren't so well-known?

DAVID OWEN: There are many, and it has an impact on health generally. People who have trouble hearing tend to have health - unrelated health issues, more unrelated health issues of all kinds. It puts a - it sort of overworks our brains. If you can't quite hear what people are saying, you have to work harder to figure it out, and the brainpower that you use to do that is brainpower that you can't use for anything else.

People who have trouble hearing also tend to withdraw. You know, I have an acquaintance who, at cocktail parties - he has a reputation for being just a grumpy, sullen person. But when I was working on this book, I realized that - I said, you know what? He really is - he can't hear, and the reason he sits at parties and glowers out at the crowd is that he doesn't know what's going on. So it has effects that we don't necessarily associate with it and that pervade all parts of our lives.

And then, you know, because of human nature, we tend to ignore it. The average wait for a person who first notices a hearing problem - the average delay between that moment and going to the doctor is 10 years. That's the average. So it's - we don't treat it the way we treat other sensory problems. If you have trouble seeing things, you go - you get glasses. But people tend to put off hearing - getting hearing aids for a long time.

DAVIES: Yeah, so people might be happier if they paid a little more attention to this.

OWEN: That's right. It's worth paying attention to.

DAVIES: You know, when I choose a restaurant, I think one of my highest priorities is finding a place where you can actually have a conversation. I'm an older guy now, and it was interesting when I read your book that this is kind of, to some extent, an age-related phenomena, isn't it?

OWEN: It is. And I should say first that when we talk about age-related hearing loss, the assumption is that this is something that happens to old people. It is something that happens to old people, but it's something that's caused by things that we do when we're young. The damage that we do to our hearing - this kind of damage begins when we're kids and doing the things that I assume you did, too. You go to too many rock concerts. You use too many lawnmowers without hearing protection. You use power tools. You just basically ignore your ears, and it takes time for those effects to become obvious.

But one of the places where they do is in restaurants, at cocktail parties. And when I would talk to friends and say, you know, how's your hearing?, they say, well, you know, it's pretty good, you know, except in restaurants. And the reason it's problematic there is there's sound going on all around you. It becomes - it's hard to focus on the person that you want to hear, and part of that is - young people have less trouble with that. They're more able to - their auditory systems are more able to filter out unwanted conversation.

But restaurants, unfortunately, take advantage of this. They tend to turn up the sound as the night goes on, both to make diners talk less and therefore drink more and also to kind of drive out older, lingering customers who don't run up as big of checks and get them out and turn the tables over faster. So it's actually something that restaurant owners take advantage of. Perversely, paradoxically, even people who hate loud restaurants tend to avoid really quiet ones because they figure, well, it's so quiet. How could it possibly be any good?

DAVIES: Now, it's interesting that you say that younger people can pick one voice out of the din of a busy room. Is there something about the kind of hearing loss that we tend to get with the damage over the years that makes it harder to focus on a particular voice?

OWEN: There is. It's both - you know, you lose frequency. The higher frequencies tend to go first in most people who lose hearing. That makes consonants disappear, and when the consonants disappear, the conversation kind of turns to mush. That makes it hard in a restaurant. There's also some - when your hearing is undamaged, your auditory system has an ability to kind of channel the stuff that you don't want to hear into dead ends in your brain so you're not listening to it, and that ability declines as we age.

There's some question about whether so-called age-related hearing loss is just associated with age or is caused by aging. There have been a couple of studies done with populations of Indigenous people who live in places where there is very little background noise, and elderly people in those populations tend to hear as well as infants do. So it's not necessarily age that causes our hearing to get worse. It's a big factor, at least. It's just all the sound we've exposed ourselves to over a lifetime.

DAVIES: Right, and I assume that one of the reasons that we - our ears get damaged so much is that these complicated instruments were evolved at a time when our ancestors just were in a very different audio environment.

OWEN: Yes. The world we evolved in was quite different, and sort of the crucial event was the invention of tools and especially tools that were pounding on metal. There is a particular kind of hearing loss, a sort of shape of hearing loss, that's still sometimes referred to as boilermaker's notch because it was common among people who pounded on the boilers that made possible the steam engines that made possible the industrial revolution. It's a high-frequency sound when you bang a hammer against that metal, and people who did that lost the ability to hear in that frequency range, and that became known as the boilermaker - a boilermaker's notch. And it's - there are other threats. I think another modern threat to hearing is gunfire.

DAVIES: Right.

OWEN: The largest single purchaser of hearing aids in the United States is the Veterans Administration. The No. 1 and No. 2 service-related health claims made by military veterans are hearing loss and tinnitus. The exposure to gunfire, especially exposure to blast explosions, but then also just the extraordinarily high sound levels of military service, even on a base outside of combat - one of the loudest work environments in the world is an aircraft carrier. And people - simply sleeping on an aircraft carrier, you can expose yourself to sound at levels that are sufficient to do permanent damage to your hearing.

DAVIES: You know, hearing loss in military service presents a particular problem - right? - because one thing you obviously need to do is protect your ears when you're in a particularly loud situation. But in battle, you need to be able to hear other things like, you know, the commands and other shouts of your fellow combatants.

OWEN: Exactly. Hunters - the same thing. They say, you know, I can't protect my ears because I need to be able to hear the footsteps of a deer walking through dry leaves. And then the paradox is that if you expose yourself to enough of those gunshots, you can't hear those things anyway. So it's a - it pulls in both directions. There's now technology that makes it possible for soldiers to actually hear better when in quiet environments and then instantly, or almost instantly, shut down when there is a blast, like a gunshot or an explosion. But it's - you know, the threat to hearing posed by combat has been known for centuries. And it's only just recently that solutions, that ways of preventing this damage have been implemented in the military.

DAVIES: And you say there's - there are some kind of technology that allows - that soldiers can wear, which actually will permit them to hear more subtle sounds but will protect them from explosions.

OWEN: Yeah, there's a whole system now that you - it's like you have headphones that act like hearing aids in quiet environments. They act like they're part of the communication system. You communicate with other soldiers. But then in - when an explosion goes off within a small fraction of a second, they shut down so that you can't - so that the exposure is hugely reduced. Hunters have had hearing protection like that for a long time. There are complications with the military. One is that they require batteries, and it's not necessarily easy to recharge battery-powered devices in the field. Another is that there's this sort of tradition in the military, that doing something to protect your hearing - it's soft. There are old-timers who view it as sort of - almost as cowardly, the idea that you would do something to protect your hearing.

So soldiers have had to improvise for as long as there've been soldiers, as long as there's been gunpowder. I talked to some Vietnam veterans who said that they used to put cigarette butts in their ears to protect them, or the, you know, spent rifle cartridges - stuff those in their ears, trying to get some kind of hearing protection. But the - it's still looked down on. Even on, you know, on the firing range - don't put on those earmuffs. You're not going to be able to wear them in-country. So there's a stigma.

DAVIES: We're speaking with David Owen. His book is "Volume Control: Hearing In A Deafening World." We'll continue our conversation in just a moment. This is FRESH AIR.

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DAVIES: This is FRESH AIR, and we're speaking with David Owen. He's a staff writer for The New Yorker. He has a new book about hearing, it's called "Volume Control: Hearing In A Deafening World."

There's this condition that is characterized by a ringing in one's ears. People often call it ti-nitis (ph). I guess the clinicians call it tin-nitus (ph). It's a chronic condition. You suffer from this. When did that begin?

OWEN: It began about a dozen years ago. I took a - I was on a reporting trip to China. And while I was there, the air quality was just - you couldn't see across the street, literally couldn't see across the street. I got a cold that was probably the worst cold I've ever had. And it got worse on the flight home. And it took about - it felt like it took a month to go away. And when it did, I noticed this ringing in my ears. And I ignored it for - I don't know - six months. And I went to see my doctor and I explained it to him. And he goes, ah, tinnitus. And he took a little tuning fork, and he banged it on the table. And he held it up, and he told me to tell him when I could no longer hear it. And so we sat there in silence. And then eventually, he leaned forward because he could no longer hear it. And he was about the same age that I was. And - but he said, well, you have tinnitus. You have - you don't seem to have much hearing loss, but you have this ringing in your ears.

And then I learned from reading about tinnitus that there's basically nothing you can do - you can't make it go away. There is no known cure for it. The therapy for tinnitus is to learn to accommodate it. And luckily for me, I have a - the kind of personality that makes that fairly simple. When I was told that there was nothing I could do about it, I thought, oh, good, then I'll do nothing. And that's kind of what I've done.

DAVIES: Huh. So are you hearing it right now?

OWEN: Sure. I can always hear it. But mostly, usually I can ignore it. There are people for whom that's very difficult. It's loud. And there even have been suicides from people who just can't tolerate this phantom noise in their head. And for them, the treatment is often, you know, behavioral - cognitive therapy, behavioral therapy, the kind of counseling - sometimes, the kind of medications that are used to treat anxiety or depression, just basically learning to live with this thing. And most people can improve it - their response to it significantly. Sometimes it can - hearing aids can help. If you have some hearing loss and you eliminate that, you bring up the sound of everything else, then this phantom noise becomes less bothersome. You can't hear it as much. Some - a therapist described it to me as the - you're in a room with a candle. The candle is the tinnitus. But if you turn on the lights, if you turn up the other lights, then the candle is less noticeable. And that's what sometimes happens with hearing aids with somebody who has tinnitus.

DAVIES: Yeah. You wrote in the book that one of the things that you sometimes do is, just as a way of accommodating it, is you pretend that this is a noise that you wanted to hear. This is music you're playing.

OWEN: Right. Well, this - people with tinnitus will often - and I do this myself. You'll sleep with the fan on or the air conditioner, something to mask the sound. Or people who have hearing aids, they'll play a masking tone inside the hearing aids. And then I thought, well, what if I just told myself that the sound of the tinnitus is a sound that I'm playing in order to mask the tinnitus? It kind of cut out the middleman and...

(LAUGHTER)

OWEN: It doesn't always work, but sometimes it does. And it then seems like - then it's easier than getting up - getting out of bed to turn on a fan.

DAVIES: And in a summer evening when there are, like, crickets and cicadas...

OWEN: Yes.

DAVIES: You don't hear it. It matches the tinnitus and it doesn't bother you?

OWEN: It comes very close. The sound of my tinnitus, it's like, if you've heard the sound of halogen lights on a dimmer, this high-pitched sound, or the sound of - plus the sound of cicadas during the summer. So when those sounds - sounds like those are present then I notice those and then don't notice the tinnitus.

DAVIES: You also write that this isn't just characterized by a ringing in the ears. There can be other kinds of sounds. Like what?

OWEN: There can be really dreadful ones. The person I know with the most depressing auditory problems that I've ever encountered had something called hyperacusis, which is where it's, like, the opposite of deafness. Things, everything, is louder to him than it really is, than it is to anybody else. Much louder. So much so that he, even inside in a house, he will wear huge, earmuff-like headphones. He - the crinkling of paper can drive him out of the room. And he has a form of tinnitus in which he will sometimes hear - have a - we had a conversation. He said, sometimes I will - hours later, I would hear some phrase that you had said, repeated over and over in my head. And that's a form of tinnitus. Somebody else I know who said that he often hears just what sounds like a crowd of people talking in the background. And so much that he can almost - feels that he can almost make out what they are saying. It's male voices sort of babbling in the background. People sometimes hear music. So there - it takes many forms. And I think probably, you know, there are different ones that people will say are the worst. Some say that, you know, pure tone tinnitus is the worst. Or a writer friend of mine who had lived with tinnitus for a long time and had gotten pretty used to it, he said, until it started beeping. And at first, he ran around his house looking for, you know, is it the microwave? What is it? What's making the sound? And then realized that it was in his brain.

DAVIES: Wow. Do we know what causes tinnitus? Is it understood?

OWEN: The current theory about tinnitus is that it's similar to phantom limb pain. You've heard about when somebody has a - loses a limb, they have an amputated arm, they feel that that arm is still there, or they feel pain where that arm was but no longer is. Even itching. You can feel itchy fingers on a hand that's no longer there. And the idea is that the brain is accustomed to receiving nerve signals from this part of the body. It's no longer receiving them so it makes, in effect, its best guess about what should be coming from there. It supplies the last thing it felt from there, or something like it. And the idea is that tinnitus is very often something like that. You lose hearing in some frequency. The brain is used to receiving auditory signals at those frequencies. It isn't anymore. So it fills in the gaps with this, what sounds, what seems like a sound but is actually just electrical activity in the auditory system in your brain.

DAVIES: Does it come and go? People have said that sometimes they notice it, sometimes they don't.

OWEN: Well, I think it's typically always there, but you notice it or you don't. The mind changes sometimes. And some people's fluctuates wildly. It takes on different characteristics. There are lots of different ways. People have sometimes asked, well, what about - the people at Bose have been asked, why don't you make noise-canceling headphones for tinnitus? And the reason they don't is that tinnitus isn't noise. It's something that's going on in your brain. There's no - there are no physical vibrations to counteract. It's not soundwaves. It's this electrical activity that is impervious to sound-suppression technology.

DAVIES: So it makes sense that you could deal with it by - with some of these mental tricks that you play on yourself.

OWEN: Right. And there's this kind of a thing you can do where you just kind of snap your fingers on the back of your head. That gives some people some relief from it. There's a clinic that injects lidocaine directly into the middle ear. So people who have tinnitus, and for the period when they're undergoing that treatment, the tinnitus goes away. But it's a temporary relief. For some people, that's terrific. It makes - they can hear - they can see what it was like before they had tinnitus. I'm not sure I would - I'm not sure I would prefer that. I think I'd rather try to just ignore it. I was better at ignoring it before I started writing about it. When you write about it, you think about it all the time.

DAVIES: You have a lot of interesting discussion of hearing aids in this book. You toured a plant where they're made and talked to a lot of people who make them and design them and people who wear them. A lot of that is changing in this world of hearing assistance. One thing I found interesting was that people who can suddenly hear a lot more than they're used to are surprised by sounds they had never heard.

OWEN: (Laughter).

DAVIES: Like what?

OWEN: (Laughter) There was the fact that fire doesn't sound like a continuous explosion. That rain makes a noise, but snow doesn't. That music plays in grocery stores. That you can tell one song from another. That - many things that we take for granted, of course, that, if you've never heard anything before, would be surprising.

DAVIES: And when you have flatulence, other people can hear it. (Laughter).

OWEN: That's right. And students, deaf students, have to be told, you know, when you burp, when - (laughter), when you make these natural - when these natural things occur, other people can hear you, and you have to say, excuse me, or you have to control yourself. They're, really, people can hear that?

GROSS: We're listening to the interview FRESH AIR's Dave Davies recorded with David Owen, a staff writer for The New Yorker and author of the new book "Volume Control: Hearing In A Deafening World." After a break, he'll talk about remarkable new developments in hearing aids and medical treatments for hearing loss, and he'll give us some tips for protecting our ears. Also, Kevin Whitehead will review a reissue of Nat King Cole's early recordings. I'm Terry Gross, and this is FRESH AIR.

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GROSS: This is FRESH AIR. I'm Terry Gross. Let's get back to the interview FRESH AIR's Dave Davies recorded with New Yorker staff writer David Owen. His new book is about hearing in the modern world - all the ways loud noises damage our ears, how hearing problems affect us and how new technologies and medical treatments are changing things for the hearing-impaired. His new book is called "Volume Control: Hearing In A Deafening World."

DAVIES: There have been some big advances in hearing aids, and there's something of a consumer revolution going on here. What are the complaints about hearing aid manufacturers?

OWEN: Hearing aids are very expensive, as anybody who's shopped for one knows. The process for buying them is kind of complicated. It has to be done through a hearing professional. The whole - there's always a middleman, and the hearing aid doesn't cost very much per unit to manufacture, but they're immensely expensive. Health insurance tends not to cover them or to cover them only partially. Medicare doesn't cover them. So when people resist, it's not only because they're resisting the idea of being deaf. But also, it's an enormous investment in something that's also - that's very easy to lose. I mean, we - my wife and I found my mother-in-law's - one of her hearing aids on the street where she suddenly lost it. They're easy to lose track of.

The revolution that's coming is that it's going to be increasingly possible to buy over-the-counter, less expensive hearing improvement products - hearing aids and other products. It already is. I have a pair of Bose headphones called Hearphones - contain the same kind of microprocessor that's in hearing aids. Plus, they have - because they're big, because they're a kind of headphone, they - the sound is much higher in fidelity. They're easier to control. They function as noise-canceling in addition to noise-enhancing. I have a friend who lost a lot of hearing, wears hearing aids. He wore his Hearphones to a restaurant and found them much superior to his hearing aids - the quality of the sound, the ability to focus on people that he wanted to listen to.

So there are a lot of products that are available now and that are also coming. It'll be tricky for a while, I think, for people to sort out what is a scam and what is not, what is - but it's tricky now, too, with legitimate hearing aids. And when devices are less expensive, you can afford to make a mistake in your - on the way to finding out what really works.

DAVIES: Now, tell us about cochlear implants. What is the procedure? What does it do?

OWEN: It's - a cochlear implant is a - it's been described to me as the most remarkable prostheses for a sense that has ever been conceived. And what it amounts to is threading a tiny electrode into this tiny, tiny, unimaginably tiny inner ear and - so that it bypasses the non-functional parts of the inner ear and connects directly to the nerves, to the auditory nerve. And the - someone with a cochlear implant - there's a part that's visible on the outside. There's a part that's attached to the skull. There's a device that looks like a hearing aid, and there is this inside. The inside the bone of the skull and the inner ear is this electrode that goes into the - that winds into the curling shell of the cochlea.

If you go on YouTube, you can see videos of, like - they're switching on the cochlear implant of this infant who's never heard before, and the face lights up. And, you know, it makes you cry. It made me cry when I saw it. It's not - I spoke with a scientist who actually does cochlear implants and says that, you know, the reaction is - you know, you have to look closely at those videos. The reaction is more likely to be tears or nothing or confusion.

DAVIES: For an infant, yeah.

OWEN: For an infant or for an adult. The sound from - it's not like...

DAVIES: It's not normal hearing, is it?

OWEN: It's not normal hearing. It's something you have to learn to work with, and it doesn't work for everyone.

DAVIES: There's a stigma attached to hearing loss. Partly, it's seen as connected to old age. And then among kids that are born deaf, you know, there was a long-held belief, you write, that they were just hopelessly impaired and there was a tendency not to see them as somebody - people who could be educated. And this changed with the development of American Sign Language. And you write about a remarkable thing that I had never heard about, and that was this community on the island of Martha's Vineyard in Massachusetts called Chilmark and the way that community integrated deaf people into the community. Tell us about this.

OWEN: It's remarkable. You know, my wife and I have gone to Chilmark every summer for decades. And I didn't know about this until I learned about it later, but in the 1700s and 1800s and late 1600's, about 4% of the population of Chilmark had a congenital form of deafness that was - it had come over in genes in some early settlers from England. And as a consequence, the community had developed a form of sign language that was probably based on one that they had used in England, and it was used by - not only by the deaf members of that community, but also by the hearing.

Every family had a connection with deafness. Everybody learned sign language from birth, essentially, and communicated freely back and forth. And even people with perfect hearing would often use the sign language when no deaf people were present because it - you know, you could tell a punchline of a dirty joke. You could talk across a noisy room. You could communicate from one fishing boat to another.

And what was interesting - there's a wonderful book about it called "Everyone Spoke Sign Language," I think it was called, about this community on Martha's Vineyard. And people who were remembering years later what it had been like didn't always distinguish between people who had been able to hear and people who had not. There was a woman who talked about having a - shouting with somebody, having an argument with somebody, and then stopped and said, you know, come to think of it, I guess we were shouting in sign language.

DAVIES: (Laughter).

OWEN: So it was - you know, the inability to hear was clearly a deficit, but it was not treated as a handicap. And it - the - it was fascinating to read about someplace where - you realize that a handicap is a social construct. This was a place where there was no - there were no activities that were conducted exclusively for the deaf. There were no activities from which the deaf were excluded.

People from that community who later traveled to the mainland were surprised to find that there weren't as many deaf people in other places as there were there. And those people - children from Chilmark were among the - in the early 1800s, among the first students at the American School for the Deaf. And we don't know what their sign language was in Chilmark, but remnants of it exist in American Sign Language today.

DAVIES: You know, with cochlear implants and other improvements - you know, cochlear implants can be given to infants. And there is now an intense and passionate debate about whether kids with hearing loss are best educated using sign language or an approach called oralism, where the emphasis is on teaching deaf students to read lips and speak so they can be integrated into the world of the non-hearing impaired. There are schools that integrate both approaches. Can you just sort of outline this debate for us?

OWEN: Yeah. It's a - I hesitate almost to have an opinion about it because it's so fiercely contested among the deaf, the so-called capital-D Deaf for whom the inability to hear is more of a cultural identification, and the lower-case D deaf would - where it simply refers to a sensory deficit. And there's been for, you know, decades - for more than a century, there's been this tension between people, often hearing people who believe that the deaf should be forced to learn to read lips and to speak. And between them and with the - within the capital-D Deaf community, where the desire is to teach people who can't hear to communicate by the best means available, which is, for somebody who's deaf, is always going to be sign language.

The complication in recent decades has been the development of cochlear implants. So - because now it is technologically possible to give someone who can hear nothing at all a useful amount of hearing and makes it possible to teach - to make it possible for somebody born deaf to actually hear to a useful extent and to communicate with the hearing. And it's a - the - to say that there's tension is an understatement.

There's also - there's been a transformation in hearing education. You know, people don't - people find it surprising, but the vast majority of children who are born deaf are born to hearing parents. And you would think that might be an advantage. Their parents can hear. But it's actually a disadvantage because if those hearing parents don't know sign language, they have no way of communicating with their non-hearing infants in - early in their lives, when we are wired to learn language. You know, if a child can't hear and is living in a house with parents who have no way of communicating with them, they miss that window. One thing they - you find is that the sign language interpreters, the people you see interpreting sign language for people who can't hear - are almost always the best ones - very often are hearing children of deaf parents who...

DAVIES: Because at that very early age, they learned sign language...

OWEN: They did.

DAVIES: ...When they could really pick it up with all of its nuance.

OWEN: They did. They learned sign language from their parents. They learned English or whatever language at school from their friends. They grew up bilingual with these two very useful languages and are able to fluently translate between them.

DAVIES: Do you see this debate getting resolved in the next...

OWEN: No.

DAVIES: ...Few years?

OWEN: No. Like many things in modern life, it's made more complicated by technology and by technological solutions. We feel that we're solving a problem, when, in fact, we're just kind of enlarging it and spreading it out, adding, you know, new complications and nuances. So there's this extraordinary technology that makes it possible to give useful amounts of hearing to people who can't hear at all, but that creates cultural conflicts and other conflicts and it - distortions in the educational system where - because it doesn't always work exactly the way we want to. We don't - it's not necessarily giving us what we think it is.

I think one of the most interesting descriptions of what it's like to live with a cochlear implant comes from Rush Limbaugh, who lost all his hearing. He's had two cochlear implants now. He's described it in his radio show. And he describes it as, you know - he can't identify songs. He has trouble hearing. He's able to speak on the radio because he has his implants but also because he has simultaneous transcription of telephone calls that are coming in. He has lots of help. It's changed his life, but it's a - this operation has. But it's not what - it didn't throw a switch in his head and make him able to hear the way he once did. He requires a huge amount of technological assistance to get by.

DAVIES: We're speaking with David Owen. He is a staff writer for The New Yorker. His new book is "Volume Control: Hearing In A Deafening World." We'll take a break here and talk some more in just a moment. This is FRESH AIR.

(SOUNDBITE OF MUSIC)

DAVIES: This is FRESH AIR, and we're speaking with David Owen. He is a staff writer for The New Yorker. He has a new book about hearing. It's called "Volume Control: Hearing In A Deafening World."

Give us some practical advice. I mean, those of us who've already like, listened - gone to a thousand rock concerts, it's too late. But if you're a little younger or if you're not, what should you be protecting your ears from that you might not think about?

OWEN: I think, you know, almost - the danger line that's often given is about 90 decibels. It's kind of lawnmower, food processor, chainsaw.

DAVIES: Really? Food processor?

OWEN: Many...

DAVIES: When you're making pesto, you got to have ear protection?

OWEN: Yeah - or, you know, blow dryer. My wife's hairdresser just got bilateral hearing aids from years of exposure to professional-quality blow dryers. Lots of sounds that we expose ourselves to - turning up the TV too loud, listening to music too loud, gunshots, riding on the subway in New York, police sirens, ambulance sirens, fire truck sirens. Many of the sounds of daily life - horn honking, the taxi drivers who sit in what are obviously traffic jams that are not going anywhere...

DAVIES: (Laughter).

OWEN: ...And just lay on the horn. These are all reasons to carry earplugs with you somewhere and then to put them on when you encounter these situations.

DAVIES: OK. And what kind of earplugs are effective, and which should you avoid?

OWEN: Any earplug is better than none. There are foam earplugs that people like. They're a little tricky to put in. The - my favorite ones are - they look like little silicone umbrellas, a stack of three silicone umbrellas. And you kind of - they're a little tricky to pull in - put in, too. What you do is you reach over the top of your head with one hand, lift your outer ear to kind of straighten out your ear canal and then push it in until it closes it off.

A mistake that people make sometimes is to treat their AirPods or their music headphones as earplugs and to deal with things like police sirens by turning up the music, which is compounding the problem rather than solving it. So noise-canceling headphones, they're good. You know, people increasingly work in offices where there are no walls between co-workers, and there's a lot of ambient sound. And they'll often wear noise-canceling headphones just while they're at work because they're working in an open environment. That's a good thing to do, too.

DAVIES: When you were looking into hearing aids, you tried one on. You were fitted for a hearing aid, right?

OWEN: Yes.

DAVIES: What was it like?

OWEN: It was very strange. The sound quality was a little bit different. It sounded - the fidelity was not as good as normal hearing, but I could things that I ordinarily couldn't. My pants made noises that I had never suspected they made. The sound of turning a page in a book - all these things that were - I was much more aware of than otherwise than I had been before.

And the people who fitted me said, you know, don't give up on them. Wear them for a month. It takes the brain a while to get used to these new inputs. This often happens to people with - who get hearing aids. Suddenly, they can hear sounds that they hadn't heard before, and they think that it's made their hearing worse because now there's something that they're not used to paying attention to that now is getting in the way. The brain has to get used to it.

The hearing system, it's more than our ears. It's our ears plus our brains plus our eyes, to an amazing extent. A great deal of the information that we get about sound comes through our eyes. And there have been experiments done with - where if you are listening to a sound, but you are watching the lips of the speaker making a different sound, you hear the different sound. You hear the sound that the lips are seeming to make rather than the sound that your ears actually hear because the brain makes - the visual system overrides the auditory system. That's the way our brains have evolved.

So it's this - I think that helps to account for the reason - you know, if you've gone to a music program - watched your children in a music program and you feel as though if you look from face-to-face in the group of children singing that you can hear the individual singers - and you can. It's the - your brain, your visual system working with your auditory system to give you this - what seems like a superpower when you think about it. But it's - we - our hearing is more than just our hearing.

DAVIES: David Owen, thanks so much for speaking with us.

OWEN: Oh, thank you.

GROSS: David Owen is a staff writer for The New Yorker. He spoke with FRESH AIR's Dave Davies about his new book "Volume Control: Hearing In A Deafening World." After we take a short break, jazz critic Kevin Whitehead will review a new reissue of Nat King Cole's early recordings. This is FRESH AIR.

(SOUNDBITE OF RAY CHARLES' "DOODLIN'") Transcript provided by NPR, Copyright NPR.