An evaluation of Hear and Now
I am a computer network engineer and I am hearing impaired (binaural loss, wear two hearing aids - about 65 dB loss more or less flat across the frequency spectrum). My wife has two cochlear implants, one done in 1996 and the second ten years later in 2006. She lost her hearing at age three (post-lingual - that is important for what follows).
This film is less a documentary than a kind of home movie about the experience the producer's mother and father have getting cochlear implants after 65 years of deafness. My impression is that it is short of qualified technical/medical advice and guidance. While Sally and Paul are pre-lingually deaf and therefore far more challenged to make use of sound, it struck me that they did not get the kind of rehabilitation training required to take full advantage of the sound they were getting from the implants. Moreover it does not appear that either Paul or Sally had frequent visits to the implant center for re-programming of their speech processors. This whole aspect of post implant therapy seemed missing. They had one visit at 6 months but it seems to me that there should have been a much tighter feedback loop with speech processor programming. One wonders about the Rochester clinic program and its evident weakness (or perhaps the producer of the film left this out?).
Post-lingual deafness means you lose your hearing AFTER you have acquired speech. That means that the brain has already formed strong association of sound with meaning (words, sounds in the environment). Young children who are implanted at ages 6 months to a year have the benefit that their brains will learn to understand and interpret sounds including speech as they develop in the normal way. Even though the implants do not deliver the same fidelity as normal hearing, they are remarkable in their ability to assist with hearing and understanding in speech frequencies.
My wife's experience was remarkable. About 20 minutes after her speech processor was activated, she and I talked on the phone. Not a complex conversation - that came later - but she was understanding speech in basic forms very quickly because she had auditory memory from 50 years before which a pre-lingually deaf person would not have and would have to acquire through rehabilitation and training. Her second implant was activated and within 24 hours she was understanding speech and distinguishing speakers. My son is a video camera operator and captured the second implant and my wife's experiences with it - I hope he makes a documentary of it. He interviewed the surgeon and audiologists, speech pathologists as well.
My wife developed an extremely aggressive listening training program (because the implant clinic did NOT have one for adult implantees). She listened to hundreds of books on tape to attach meaning to sound or to learn to pronounce words she knew but did not know how to pronounce; got auxiliary microphones to improve the acuity of telephone and live speech in noisy settings; she got patchcords for listening to movies on airplanes; she got an infrared receiver to use with movie theaters; she got an FM transmitter/receiver to use at lectures (putting the transmitter on the lectern). One of her first comments after her implant was activated was "I don't have to look at you anymore!" I hope she meant she didn't need to look at me to understand my speech! After her first implant, she would announce every bird chirp she could hear when we walked the dog.
Now ten years later, she has started 3 book clubs, uses the phone constantly, still listens to books on tape, has noisy dinner parties, etc. Music is still of limited appreciation - simple instrumentals like a flute solo or piano solo seem to work well but complex instrumental orchestral pieces are too hard.
Adult, pre- and post-lingual implantees need vigorous rehabilitation programs and there are few if any. Most of the effort in this area goes into helping children with implants (a good thing) but there is a great deal that could be done for adult rehabilitation and I hope that this message might stimulate some discussion.
As to the film itself, I found the message disappointing and the lack of technical/medical information disturbing. A documentary that deserves the name should have more information in it than this film. Deafness is a very complex condition with many, many variations. Rehabilitation is idiosyncratic and the needs of each individual patient and their response to treatment require careful tracking and analysis. Judging from the information in the film, Paul and Sally did not have the benefit of enough of this. One cannot simply install an implant and expect a miracle to happen. It takes a lot of work to achieve the kind of miracles that I have seen in my wife's case. I hope some more informational documentaries are filmed in the future. This one is unnecessarily discouraging.