Most of us enter the world with the ability to hear sounds, and we don’t remember the process of learning to differentiate one sound from another or learning that certain sounds or sequences of sounds communicate thoughts, ideas, emotions. We learn to hear and respond to language without being aware that we are doing so. But if we learn a second language at a later time, we are well aware of the struggle to match sounds with meanings and context. But what if you had to relearn how to decipher all sounds, whether it’s the doorbell or the sounds of your native language?
A couple of weeks ago my friend Pit Pinegar was here for a few days – one of our far too infrequent visits. Pit is a marvelous poet, fiction and nonfiction writer, and a gifted and inspiring teacher, having taught creative writing until recently in an arts magnet school and giving multiple writing workshops and residencies around the country. Pit has been profoundly hearing impaired for as long as she can remember, and over the years, has become extremely adept at lip reading.
Pit’s visit reminded me yet again about brain plasticity and the marvelous ability of our brains to change – to adapt to new circumstances, to learn new information. Because at the age of 73, Pit decided to get a Cochlear implant. (Cochlear in caps is a brand name; lower case refers to generic use of the term. There are three manufacturers making FDA approved cochlear implant devices.) In case you wonder why I am writing about a cochlear implant in this blog about music and the brain, bear with me.
Cochlear implants are not advanced hearing aids. Hearing aids amplify sounds that your ear is already hearing. Cochlear implants completely bypass the damaged ear and send signals directly to the auditory nerve. The brain has to relearn how to hear via the electronic signals coming from the implant rather than from the hair cells in the inner ear. Imagine if all you could hear was noise and your brain had to learn how to translate that noise into language?
But Pit’s brain has rewired itself to hear through the implant – even though she has been able to hear little in her right ear for decades. So what’s the experience like of having to learn to hear again at the age of 73? From an e-mail on November 11, the day following the surgery, Pit wrote:
“This has been a long long road. I knew I didn’t hear what others heard when I was 10 or 11. My father’s friend had, in the days when they were the latest thing, a new ultra sound system–stereo–with huge speakers. We were all crowded into his den to hear it. It had come with a birdsong track. Everyone else oohed and aahed. I didn’t hear a thing. Gulls, owls, crows have been my entire bird repertoire. I knew I was reading lips and compensating (pretty effectively) all these years. Taking a walk with a friend one summer night eons ago, my friend said, “I don’t think I’ve ever heard cicadas this noisy before.” “I can’t hear them I said.”
But Pit certainly heard the night sounds at our house, a variety of crickets, katydids, and cicadas. These are night sounds she wouldn’t have been able to hear in the past, even though they are, to me, extraordinarily loud.
A cochlear implant has two parts: 1) the internal component, which is an electronic device surgically implanted behind the ear, connected to electrodes that are inserted into the cochlea, and 2) the external component, which hooks over the outer ear, containing the microphone to capture sounds and a speech processor that translates the sounds into electrical signals.
Pit had the surgery on November 10. On December 1, the processor was turned on. If you’re assuming that, once it’s turned on you hear normally, that would be a mistake. What you hear is noise – undifferentiated noise – or as Pit described it, “chirps, buzzes, clicks, screeches, squawks, a hideous panoply of high-pitched chaos.” The brain has to rewire itself to make
sense of the signals that the processor is sending to it, just as we as infants have to learn to process sound coming into our inner ears and eventually decipher those sounds as language (or something else).
Cochlear implants, as yet, do not process music well. (Actually, that’s an understatement. Music is not recognizable as music with a cochlear implant.) Pit delayed getting one for years because it would ruin the experience of music for her and because her anecdotal research found results to be mixed.
She could initially hear lots of sounds – water running or the doorbell ringing – but not know what the sounds were. In that same November 11 e-mail, she wrote “Will I stop SEEING and TASTING and SMELLING things in super-duper techno-sensitivity because i hear things I’ve never heard? Will newness trump everything else?” Ten months later, she says her other senses haven’t taken a back seat to hearing.
By the end of March, she began to decipher isolated words, then phrases. At first she had to scramble to put those words and phrases into context. She found herself choosing which ear to listen with, the left, which still retained some acoustic hearing, or the right, which was “electronic.” She began working with an aural therapist and progress has been steady. By the end of June, the sounds had integrated and she was hearing with both ears.
“There are things that have proved stunning,” says Pit. “For the first time ever, this summer, I did not have to get up and move to the other side of the seminar table in order to be able to read my students’ lips; I could hear them, even if I couldn’t see them.
“In mid-summer sitting under a tree by the Connecticut River, I heard a racket. A baby bird, too young to fly, had hopped onto my foot and was squawking. A nest had been dislodged from a tree in a storm and six tiny birds were letting the world know they were in distress. Only because the cacophony coincided precisely with their open beaks and pulsing throats did I know I was hearing baby birds. How could anything so small make so much noise? And how amazing that I could hear it…and know what I was hearing.”
Relearning to hear requires a tremendous amount of work – as does learning to play a musical instrument. And in both cases, it’s the neuroplasticity of the brain that makes it possible.
Neuroplasticity, or plasticity, is the ability of the brain to change, both in structure and function, in response to experience, learning or injury. Pit’s brain has changed as a result of the cochlear implant. It has rewired itself to hear “electronically” rather than via the hair cells in the inner ear that work for most of us. And while the 8 – 9 month period over which that happened may have seemed interminable to Pit, it seems remarkable to me that the brain can adapt so quickly to an entirely new way of hearing.
Our brains also rewire themselves when we learn to play a musical instrument, and the brains of musicians have actually been found to be larger in some areas due to the amount of practicing we do. Plasticity is what makes learning an instrument possible. It’s also what makes it possible for us to improve our technique, to learn complicated new repertoire, to learn an instrument even if we have a disability, and to relearn to make music after some seemingly debilitating injuries.
So in future posts, I’ll write about neuroplasticity and what it means for a musician – or for anyone who wants to make music.