Cochlear implant brings sounds, but no Aha! moment

TAMPA

On the morning he was sure his life would change forever, the man with a silver crew cut and the shoulders of a fullback sat in the quiet fluorescence of a doctor's office, his knee bouncing and his breaths long.

The door opened.

"We're ready," said a thin woman in dark slacks and a white coat. "Are you?"

"Let's rock and roll," he said.

Mike Gray, who is 44, had struggled to hear much of anything since he was a toddler. With hearing aids and by reading lips he could, in most circumstances, communicate. But his deafness had always held him back — from education, jobs, dreams. He was tired of funny looks and rolled eyes. Of saying "Pardon?" Of missing all those jokes at work, even the ones at his expense.

This year, Gray decided, he would become his best self.

On Aug. 8, he got a cochlear implant, which bypasses damaged hair cells in the inner ear and sends sound electronically to the brain. In recent years, the devices have become so common and successful that they have spawned their own category of YouTube videos, which show people hearing for the first time.

Now, two weeks after the surgery, the woman in the white coat, Dr. Michelle Blanchard, was ready to activate his device.

Gray downplayed his expectations that morning. He said he didn't anticipate a miracle, but he had spent hours the day before gorging on those videos of other people's miracles. Young and old, men and women, sobbing and gasping and cupping their hands over their mouths.

So Gray, grinning, sat beside his wife, Brenda, and waited for his moment.

Blanchard pressed a button on her laptop, linked through a wire to his implant. It switched on.

"I love you, Mike," said Brenda, her cheeks wet. "Are you ready to shoot for the stars?"

Gray's grin vanished. His eyebrows raised, then tightened. He scanned the carpet. He turned and looked at his wife.

"I said, 'I love you, Mike,' " she repeated. "Are you ready to shoot for the stars?"

He looked back at the doctor. Then, through dark-rimmed glasses, his brown eyes fixed on the graphs across her computer screen, as if they contained the answer.

He didn't understand a word.

• • •

Two weeks earlier, Gray took his usual seat at the end of a long table. He worked as a supervisor at a glass manufacturing plant in Nokomis. It was near the end of his graveyard shift but the worst of it had just begun: the morning meeting.

He leaned forward on the table, creating a line of sight to every person in the room. His eyes opened wide. He was ready.

Behind the back wall, in a space as big as two high school gyms, whirling belts sanded cut glass, and furnaces roared. The industrial drone flooded into the meeting room. But Gray was focused.

Just to Gray's right, his boss, a patient man with glasses, spoke first. He faced Gray and talked slowly, clearly.

Quickly, people interjected. Like he was following a tennis match played with five balls, Gray's eyes darted around the room, chasing the words. He almost never caught an entire statement, but Gray had learned that people tend to use the same phrases, so with just a part he could deduce the whole — as if he were playing Wheel of Fortune. It worked most of the time.

A man at the far end of the table cracked a joke. Gray didn't notice. Everyone laughed, except him. He almost never joked because he seldom got the timing right. Sometimes, Gray laughed when he saw other people laugh, just so he wasn't left out.

A bushy-faced man sitting across from him began to speak, voice low, lips concealed. Beards and accents were Gray's enemies. He fell farther behind: talk of glaze, reorders, broken glass. Someone with his back to Gray reviewed lost product figures. He didn't even look.

In 1969, his mother had just turned 17 when she had him near Baltimore. She discovered his disability when he was 3 and soon gave him to her parents. A World War II Army vet and a homemaker, they wanted Gray to be "normal," so he didn't learn sign language and almost never interacted with deaf children.

He struggled in school, but not because he lacked intelligence. He later earned the rank of Eagle Scout, and his mom swears he once scored 130 on an IQ test. But when teachers turned their backs, Gray couldn't hear them. That led to disinterest, which led to bad grades.

Kids also taunted him relentlessly. Gray was suspended so often for fighting that he says he should have failed middle school.

He had big aspirations for life after graduation. Maybe earn his college degree or fly jets in the Air Force or patrol the streets as a cop, like the father he barely knew. Instead, he worked at a department store and later McDonald's. He smoked pot and sometimes sold it. Most nights ended at bars.

At 23, he followed his grandmother to Florida after her husband died. Gray built computers at home for fun, but for 19 years he made money delivering pizzas. In 2003, he got an entry-level job at the glass company. Until four years ago, when Brenda discovered a specialized alarm that vibrates the bed, someone had to wake Gray up every day of his life.

In the meeting room on that August morning, the conversation then well beyond him, Gray slouched back in his chair. Arms crossed, eyes glazed.

A few minutes later, the meeting over, colleagues stopped by to wish him luck. It was the day before his surgery. They talked of how different he might be when he returned. Gray smiled and thanked them. On his way out, he stepped into a side office to say goodbye to an engineer with thick black hair and an even thicker Boston accent.

"We'll see you in three weeks," the man said. "A new bettah you."

"A bettah me?" Gray said, squinting, perplexed.

"Yeah," he said. "A bettah you."

"A bettah me?"

"Yeah," the man repeated, with emphasis. "A bettah you."

Gray smiled.

"Yeah," he said. "A better me."

• • •

The next morning, in waiting room A-288 of Tampa General Hospital, clothed in a white gown, Gray did not want to talk about what was at stake. He wanted to talk about how hungry he was. About potatoes, and red meat burned to a char, the way his grandfather liked it.

"He's trying to keep his expectations low," Brenda said, "so he's not disappointed."

Raised in Chicago, she often said what he wouldn't. "Big and boomy," Brenda called herself. They had met outside a bar in 1995 when Gray offered her a ride home. Divorced four times, she had lived with one former husband near a deaf community. Gray's slurred, nasally voice didn't sound like drunkenness to her, so she took the ride. They married two years later.

Four decades of smoking had left her with emphysema, and overweight. But Gray took care of his wife just as Brenda took care of her husband.

She knew how dearly he wanted the surgery to work.

Days before, Blanchard, Gray's audiologist, had reminded him that it could take months, even a year, for him to adapt to the implant. Despite all the videos on the Internet, the people who immediately heard sounds and understood them were unusual.

But at the hospital, Gray's expectations showed.

"Hopefully," he said, "I'm changing from a Chevette to a Lamborghini."

The cochlear surgery, though, came with real risks. It sometimes destroyed the healthy hair cells that remained, leaving patients with limited options if the procedure failed. Gray didn't hesitate. He had even wanted to get both ears done at the same time, but doctors wouldn't let him.

It took an hour for the surgeon to insert an electronic receiver under the skin behind Gray's right ear and then slip 16 electrodes into the pea-sized cochlea, the tiny spiral-shaped cavity deep inside the inner ear.

The procedure went perfectly.

• • •

Gray didn't look ready to shoot for the stars. Twisted in his chair, he looked at his wife as she asked him that question for the second time.

Gray shook his head, insisted everything was too loud.

"I don't know," Gray said to his audiologist. "I guess I expected to be hearing more now than what I'm hearing, you know?"

"We'll take it a day at a time," she said.

"Pardon?"

"We will take it one day at a time and follow along as this nerve is changing," she said. "This is going through its major transition right now."

Gray ignored that.

"I mean, am I going to be understanding more at the end of the day than I do now? Am I going to be understanding more at the end of the week?"

Probably not, Blanchard said. Progress would come slowly.

After 20 minutes of frustrated questions and unsatisfying answers, the couple made their way into the lobby where a reporter on the TV sounded to Gray like Charlie Brown's teacher. They scheduled his next visit, passing the wall that displayed a Bible verse: "He that hath an ear, let him hear. …"

Gray had thought the transition would be like learning a new language. It wasn't that simple. Gray was like a newborn that couldn't distinguish a man's voice from a dog's bark.

They drove to the IKEA east of downtown Tampa. It seemed a strange choice for his first stop, post-activation — like taking a kid with epilepsy to a rave party — but the Port Charlotte couple seldom came north and had planned the visit for weeks.

Inside the store, escalators churned and announcements blared. Ratatouille played on a TV. In the cafeteria, plates clanked, trays clacked, voices chattered, carts squeaked, chairs screeched, Europop pulsed.

Gray couldn't take it. He switched off the implant and put his hearing aid in the other ear.

An IKEA employee who was deaf had spotted Gray's device and stopped by their table. He wanted to know more.

"I had to turn it off," Gray said. "I couldn't hear anything."

"So it's going to improve?" the man asked.

"It's supposed to," Gray said. "It's supposed to."

• • •

"I am quite disappointed," he wrote in his journal that first evening. "A little fear creeps in because now I have destroyed what is left of my hearing and what if it doesn't get any better than this?!"

Gray found a video that night of a woman playing the trumpet. He thought he could hear the horn. It made him feel good.

On the second day, he heard himself breathing, peeing, flushing the toilet, pressing buttons on his Droid cellphone. As Gray watched TV, he heard one of his mutts, Gidget, drinking water in the kitchen. Gray thought he caught "southwest" during the commercial of a football game.

Before bed, like drinking a nightcap to dull the disappointment, he listened again to the trumpet.

On the third day, Brenda found a story about another implant recipient who experienced similar troubles.

That night, again, the trumpet.

On the fourth day, he practiced with an online program but it just frustrated him.

More trumpet.

He returned to work two days later and explained to his co-workers that the process hadn't gone as well as he hoped. They didn't seem surprised. At that morning's meeting, his implant remained off.

• • •

Gray stared at the computer screen's glow and listened.

It displayed a grid of two-syllable words — aja, aba, ava — that he was supposed to match with sounds coming from the computer — ah-jah, ah-bah, ah-vah.

In the six weeks since his return to work, Gray had seen his audiologist three times so she could adjust his settings: loudness, pitch, sensitivity. She assured him he was ahead of schedule, with results typical of just one in five patients.

He didn't notice. Some moments did give him hope, like when he caught the phrase "change your life" on the radio, but most moments offered none.

This was one of them.

"Ah-ha," said a voice through the computer's speaker. Gray pressed "aza."

Computer: "ah-nah." Gray: "ana."

Computer: "ah-fah." Gray: "ada."

"They all sound the same to me," he said. Wearing a tie-dye shirt and gray sweat shorts, he had spent the day installing new windows in their 1,500-square-foot fixer-upper.

Gray had many projects. The Suzuki motorcycle in the garage and the 25-foot sailboat in the yard both needed work. Gray was drawn to things that represented freedom — like racing cars and flying planes. But without hearing, he could never pursue them as more than just hobbies.

If the implant works, Gray thought, who knows what I can do. Perhaps captain a charter boat, even a plane. Anything.

Computer: "ah-bah." Gray: "apa."

Computer: "ah-pah." Gray: "aka."

Out of 40, he got 11 correct.

"That," he said, "is the best I've done."

• • •

Time went on, but progress came slowly.

At a company picnic in October, he recognized the band was playing a John Mellencamp song but a few weeks later, with his ear pressed against the speaker of a Dr. Seuss greeting card, he couldn't make out a single word of the message: "Today is your day. You're off to great places. You're off and away." Sometimes, he heard too much. Sipping coffee in his back yard, accompanied now by barking dogs and buzzing lawn mowers, was far less peaceful. He asked Brenda how she could stand so much noise.

More troublesome, the implant had made meetings at work even harder because of all the new noises. Now he skipped them as often as possible.

Gray, though, had reached some conclusions.

He knew progress would never come as fast as he wanted it to. Hearing — rather, understanding — was meant to be a process, Gray had decided, not a moment.

"It's not always like they show in the Youtube videos," he said. "I know it's going to get better."

And so, with faith, Gray decided that before year's end he would get a cochlear implant for his other ear.

• • •

Gray arrived at work just after 5 p.m. on a late November evening. His device was on, and his hearing aid was buried in a duffel bag slung over his shoulder. He entered the first floor hallway and shut a door that led to the machines. "The noise," he said.

Straight to the first meeting.

He sat near the door in an office the size of a two-car garage. A half-dozen others lounged in a sporadic huddle of chairs.

"So," Gray asked, "how we looking?"

They discussed the work ahead and the work behind. Gray squinted as he tracked the conversation around the room.

"Pardon?" he said.

"If what?" he said.

George Denisulk, a fellow supervisor, stood next to Gray in the doorway. As the discussion continued, Denisulk walked across the room and opened a safe. He pulled out a stack of envelopes stuffed with paychecks for his team. Out of courtesy, usually when Gray retrieved the checks for his employees, he also picked up Denisulk's. Denisulk, though, often forgot to return the favor.

He strolled back to the doorway and sifted through the envelopes. He talked of the unusual schedule, with Thanksgiving just two days away.

Gray, his eyes on the floor, interrupted.

"You got my checks in there, too?"

Denisulk paused, mid-sentence, and smirked. He popped Gray on the shoulder.

All the guys laughed.

Gray smiled.

His timing was perfect.

Times researcher Caryn Baird contributed to this report. John Woodrow Cox can be reached at jcox@tampabay.com or on twitter @JohnWoodrowCox.

Cochlear implant brings sounds, but no Aha! moment 12/23/13 [Last modified: Monday, December 23, 2013 11:24pm]

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