State of War

He was sitting in an exam room in the ENT office at the FBI/Net Force Clinic, having his hearing checked. Nadine had been after him for months to do that. His right ear had been bugging him on and off since that shoot-out in Gakona, Alaska, almost two years ago. Blasting away with a.357 without earplugs was a risky thing. Sometimes, though, if you wanted to stay alive, you did what you had to and worried about the cost later.

Net Force’s annual physicals were fairly perfunctory, and didn’t routinely include a hearing test unless the patient brought it up. Howard never had. It wasn’t as if he was deaf, after all. He could hear the doctor asking his questions, and that had been enough for the physicians to sign off on him each year. Besides, it hadn’t really seemed that bad until recently, but it was becoming obvious that his hearing was no longer quite up to par.

Howard said, “No, I don’t hear the ringing anymore. But I have noticed if I’m not right next to the phone, I might not notice its cheep. And my wife says I miss half of what she’s saying. Sometimes I can hear her voice, but not quite make out the words. We can’t talk from room to room, if she’s in the kitchen and I’m in the den. She can hear me just fine, but I can’t understand her. And my virgil’s alarm? I don’t pick that up at all.”

The doctor nodded, making a note on his flatscreen with his stylus. “What about in a crowded room? Any problems?”

“Sometimes it’s hard to pick a single voice out of the background noise. But that’s normal, right?”

“Mmm. Let’s have a look.”

The doctor put the flatscreen down and pulled the ear instrument from where it hung on the wall next to the exam table. He put a little throwaway plastic sleeve on the end, dialed up a light, and stuck it into Howard’s ear.

“I always meant to ask, what’s this thing called?”

The doctor pulled it away from Howard’s ear and showed it to him. “This? It’s called an ‘ear-looker.’ ”

Howard grinned. “Funny,” he said.

But the doctor, a young guy who looked to be in his early thirties, shook his head. “No, General, I’m serious. The technical name for this is an ‘otoscope,’ but that translates literally as ‘ear-looker.’ ”

With that, he stuck it back into Howard’s ear and resumed the exam.

Howard bore the tugging and poking. After a few moments the doctor pulled the scope out. He slipped the plastic throwaway off and tossed it into the foot-operated trash bin. Switching off the instrument’s light, he reracked it and turned back to Howard.

“The tympanic membrane — your eardrum — looks fine,” he said. “And I don’t think there is any damage to the bony structures past that.”

“Malleus, incus, stapes,” Howard said.

“Yes. Hammer, anvil, stirrup. Good to see you’ve done your research.”

“So what are we talking about here?”

The doctor leaned back against the wall. “Nerve damage,” he said. “My guess would be that it’s probably in the organ of Corti — those sensory hair cells that make up the auditory epithelium are there. That’s pretty common. In fact, unless you live in a quiet forest all alone and don’t listen to music or have a TV, you’re bound to lose some of your hearing if you live long enough. It’s just one of the costs of a mechanical civilization. Mostly, it’s gradual, and you don’t notice it until it gets bad. Sometimes, though, after a very loud blast very close to one’s unprotected ear, the effect is sudden and pronounced.”

“Like a gun going off.”

“Yep.”

“So what do we do about it?”

“I’ll have the audiologist give you a hearing exam. When we see what that shows, we’ll know what we can do.”

Howard nodded, thanked the man, and went straight over to the audiologist’s office.

The technician there turned out to be a very good-looking young black woman. She asked Howard to sit in a chair, put a set of headphones on him, and handed him a wireless control with a single button on it. There was a sign on the wall certifying that one Geneva Zuri was licensed to practice audiology in the state of Virginia.

“What kind of a name is ‘Zuri’?”

“Swahili.” She had a deep, throaty voice. “Some generations removed. My grandfather went back to the old country as a young man and found our distant kin. After that, he started using the family name from before slavery.”

Howard nodded. Interesting.

“Okay,” she said, “I’m going to generate some tones from the computer here. When you hear one, push the button.”

“Okay.”

She did that for a while, first one ear, then the other. At one point, she introduced a roaring waterfall-like noise in his good left ear while she sent tones to his bad ear. Curious, he asked her about that.

“What we’ve learned is that people with one weak ear tend to recruit their stronger ear to help out. They are not aware of this, of course. What is actually happening is that the sound is traveling through your head by way of bone conduction. You think you’re hearing a tone in your right ear, but actually you are picking it up in the left, compensating without realizing it. So we mask that ear with white noise to prevent that.”

After he pushed the button a bunch of times and she made notes on the computer, she gave him another test that checked how loud a noise could get before it became painful.

The next test included a recorded voice that spoke certain words at various speeds and different volumes. His job was to repeat whatever he heard. The voice had a syrupy southern quality, which drew out some of the sounds and made them harder to distinguish.

Finally, the audiologist did a repeat of the tone test, then took the earphones off him.

“All right, sir,” she said. “We’re all done. Take a look.”

She turned the computer’s flatscreen around to show him a pair of charts. “This one is your left ear, the other is your right. The red lines on both charts represent the norms. The blue lines show the results of your tests. As you can see, for your left ear you’ve dipped some in the high frequencies, but you are pretty solid in the middle and bass range. Over here in the right ear, however, it’s not so good. You’ve dropped way down on the high and middle ranges.”

He could see that easily enough. “What does it mean?”

“Well, I’m not a doctor. Your physician should be the one to discuss this with you. I’ll send these results to his flatscreen right away.”

“Come on,” Howard said. “You do this for a living. You know what it means.”

She paused, then nodded. “Okay. My guess is you are having trouble hearing people talk, or the phone ring, or the high notes on your old Ray Charles CDs. This chart shows that, and it also shows why. It’s pretty clear that you’ve damaged your hearing.”

Howard frowned. He’d expected that, of course, but he still didn’t like hearing it. “Will it heal?” he asked. “Will it get any better at all?”

She shook her head. “No, sir. Not on its own.”

“What about fixing it, either medically or surgically? Is that an option?”

She shook her head again. “No, sir. Not in this case. It’s just not that bad a loss, not nearly enough to warrant a cochlear implant. You’d have to be almost stone deaf for that. And we haven’t figured out how to regenerate the nerves in the labyrinth via stem cell or gene therapy. So there’s no medicine that will heal them. It’s a lot like scar tissue, really.”

He started to ask another question, but before he could, she added, “We can fix it, though, so you will hear pretty much as well as you used to.”

That sounded interesting. “How?” he asked.

“Electronic augmentation.”

Howard felt his stomach twist. A hearing aid, he thought, just like his grandfather used to wear. He shook his head. He was only in his forties, after all. He wasn’t ready for some big, ugly lump behind his ear. What would be next? A cane? A walker? He shook his head again, pushing the mental image away.

She could tell what he was thinking, of course. She must have seen that same reaction countless times.