As I relearned how to hear human speech through the combo of a cochlear implant and conventional hearing aid, the ability to hear music was also slowly coming back.  Especially with familiar music, my brain could bridge my memories of how music should sound, with the reality of my new sonic inputs.

In speaking to some friends who had also gone through the cochlear implant (CI) journey, I knew that ability to appreciate music varied wildly.

John, a management consultant, had learned how to play piano in a new way after he received his CI, relying on sound as well as touch, intuition, kinetics and sight. John also placed more focus on rhythm and dynamics, since the ability to distinguish pitch was sometimes difficult. This reminded me of Scots percussionist Evelyn Glennie, who is deaf and uses multiple senses to perceive music and perform at an international level.

Shelly, a retiree, was starting to enjoy live classical performances again after many years of not attending due to hearing trouble. Suzanne, a health researcher, was still struggling with how bad music often sounded.

“Music is a much larger part of our life than anyone realizes, until they lose the ability to hear it,” Suzanne* told me. She switched from a direct-care role to research after her hearing loss caused increasing difficulty in communicating with patients. She had a cochlear implant (CI) several years ago.

Music language and loss

“Music is a universal language — it can affect your mood, your emotions, your overall well being,” she said. “I cannot express the enormity of losing music.”

Her cochlear implant assists with speech but listening to music can feel unbearable. Occasionally, Suzanne enjoys a music memory, replaying a song in her mind from her youth, from the time when her older sister had all the Beatles’ albums.

Neil Hockley, an Audiologist in hearing aid development at Swiss-based Bernafon, said: “the real key to music and CI/hearing aids is that while there are guidelines to help, there are no rules. So it is really important that clinicians work with their clients to find out what sounds best.”

Conveniently for me, audiologist Neil is married to my cousin Jennifer. She also works at Bernafon — a world leader in hearing technology — in its marketing department. At a family event some years ago, I noticed Neil in my peripheral vision, to my left. I turned to that side and caught him peering at my left ear. Once he had had a good look, Neil declared: “Oh sorry, I’m always curious — I worked on the program for your hearing aid!”

Thanks Neil!

Perception is personal

On the question of music, Neil believes that “perception is incredibly personal. What works for one individual might not work for another, even it their favorite instrument is the same and their hearing loss is the same.” He notes that human speech patterns fall into a more defined band, while music patterns have a wider sonic range and much greater segments of intensity.

In an interview with Live Sound, a magazine for sound engineers, Neil noted that noise reduction applications on hearing aids may help to understand speech but interfere with hearing music.

His audiology colleague in Toronto, Dr. Marshall Chasin, has worked to create special music-hearing options on hearing aids. These customize music hearing by disabling sound reduction and feedback reduction while also enhancing certain frequencies and sound directions. Dr. Chasin has spearheaded the discussion of music in the hearing aid industry. Audiologists continue to investigate how digital hearing aids can better handle the intense inputs of music.

I went online to the website of Medel, the manufacturer of my cochlear implant, and learned a few encouraging things about CIs and music:

— Young children with cochlear implants have huge potential to play and enjoy music as they learn the new hearing pattern

—  Some former musicians who regained lost hearing through a cochlear implant are now playing again, even though the sound they now hear is quite different; this is the case of my friend John, who has played piano since childhood

— It is important to actively engage with music in some way, to work at listening and/or playing, to engage with the different elements of music.

At Sunnybrook Hospital, where I received my CI surgery in 2017, I agreed to be the guinea pig in a new study in collaboration with the University of Toronto. It explores how the brain sorts out different musical sounds heard through a cochlear implant.

After researchers attached about 50 electrodes to my head, I listened to duets of two different instruments — such as guitar and a flute. My task was to focus in on one of the sounds, as they tried to map how my brain was responding. I was reasonably successful at isolating a single instrument, but I found it painful how bad the instruments sounded. With practice, would the music sound better? I came away disheartened. I could empathize with Suzanne’s comments about music feeling unbearable.

Neil pointed me to the work of Scientist Charles Limb. Dr. Limb, who is also an ENT surgeon, has studied how the brain flexes to generate creativity in musical forms such as jazz and rap. You can find his fascinating lecture on TED Talks.

During creative musical expression, the brain’s energy is refocused. Certain parts of the brain are able to disassociate, allowing spontaneity and creativity.  Limb mentions the jazz tradition of “trading fours.” This is meaningful to me because I used to get a chance to improvise on the drums on four-bar segments while playing with Barry Cartwright’s jazz band.

Creativity in “trading fours”

Likewise, when I was a percussion student, my teacher Glenn Price and I would trade fours on two drum sets, face to face. One of us would keep a structured beat while the other improvised, then we would switch. The improvised segments involved a different mindset than keeping the beat. Improvisation required fluidity, and an ability to respond creatively to another musician’s improvised theme. Finally, trading fours fostered inspiration to create and develop a musical theme.

My thinking on how to relearn musical appreciation and performance was moving in a new direction. I had been focused on what I called a holy trinity — consisting of two quite different sonic inputs (hearing aid and CI) plus my memory. My brain blended the three.

As I learned more from friends, and experts, I felt I had to add three key factors: 1) music engagement, 2) creativity and 3) the use of multiple senses.

I was facing the music: my holy trinity of hearing had become a holy sextet.

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For more info:

Interview with Neil Hockley and Marshall Chasin in Live Sound:

http://digital.livesoundint.com/publication/?m=24712&i=548311&p=26

Dr. Marshall Chasin website: http://marshallchasinassociates.ca/

Dr. Charles Limb TedTalk:

 

*Suzanne asked to be anonymous for this article — her name is changed.