Monday, July 27, 2009

Into The Void Part 5 : Switch-On

Switch-on was the unofficial title given to the day when the internal parts of the cochlear implant were activated by the external microphone and speech processor. For me, this took place on Thursday 30th April 1998 and what follows is the full text of the e-mail I circulated the following day. The photograph shows Isobel, a very young Alexander and Salim Khan the technician from the Implant Service.
The problem was I had no idea what to expect. My worst fear - one that has been gradually gathering momentum for the last few days - was that there would be nothing. My best hope was that I would once again be able to "hear" sound, and after a good few months of practice, I would begin to be able to translate it into something more meaningful.
There had been a competition running on the First Class Network over recent weeks to nominate a suitable "person" to perform the switch-on (Red Rum, the late Aintree racehorse received the most votes!). In fact the switch-on was performed by a computer (Joe and Andy please note it was an IBM not a MAC). The technical wizard explained that the first thing we would do is to switch on each of the 22 channels (each channel stimulates a different electrode) one by one. Keys were depressed and everyone watched the screen expectantly. I sat there with a dazed look on my face. rigid with fear. Nothing seemed to happen. More keys were depressed. I began to accept my worst fears as reality. Then, all of a sudden, I heard it. A tone - quite pleasant - hovering somewhere in my head. Fighting with the constant tinnitus at first. But this was Tyson at his best versus Bruno at his worst. No contest. The tinnitus quickly gave way.
I could hear again. A single tone. But what the hell, it was noise, it was working. The computer stepped up the strength of the signal until we found a good comfortable level and then we moved on to the next channel. Again, I could hear. My God, two frequencies! Channel followed channel. At the medium and high frequencies I have had no hearing for 13 years and the whole process was unbelievable. Such frequencies could not exist surely. Each time I felt that we had reached the limit of perceptual hearing, a higher frequency kicked in, until all 22 channels had been tested. All 22 worked.
At this point I would have been quite happy to have packed up and gone home. Just to hear those odd noises was quite enough. Why go further and spoil things. Salim (the technical wizard) gave me a card to read saying that he would now get the computer to switch on all the channels at once. This was "Switch In". The most extraordinary sensation passed through my brain. Salim said (to Isobel and Alex who were sat there) "Of course it will take some time to find the right settings". I said, "No these seem to be fine". Suddenly we all sat dumbstruck as we realised what had happened. I had heard him.
"Can you hear me" they were all saying at once. I was too shocked almost to answer. A voice - completely unrecognisable to me - answered "Yes". I had read about what the "sound" would sound like at first. Micky Mouse most people said. Near, but not quite. More Minnie Mouse on speed. I had - in my more optimistic moments - expected other people to sound like this, but what I had never realised was that I too would sound like that. But who cares. I could hear. I could bloody-well hear. Not perfect, not everything. If everyone spoke at once it confused me. If people spoke too fast I lost the thread. It all sounded strange. But I could sodding-well hear.
Later, Salim told us that it was very rare and only happened in about 1% of cases. Normally it takes months to reach the level I had managed in minutes. It was all quite unusual. Everyone was either grinning or crying. I was shaking. We spent a bit of time tuning the various settings and Salim explained all the bits of the various mechanisms (he had an Indian accent, how remarkable. I had forgotten people had accents). I listened to myself again and realised that I had picked up an American accent from somewhere. Good God, after fifteen years of silence I had come back with an American accent!
We took a break and I escaped outside to smoke my pipe (really to just try and come to terms with what had happened). Strange sounds all around me. A waterfall crept up behind me - no it was not a waterfall it was a car. A door squeaked somewhere - no it was a bird singing. I came back into the building and heard my footsteps on the concrete stairs. They echoed. That is not sound - raw sound - that is quality sound. I will never walk down a corridor again without thinking it is one of the most beautiful sounds on earth. To get back into the Cochlear Implant Centre there is one of those dreadful doors with a voice-box (the kind that had driven me mad for the last 15 years). I pressed the button and heard the mechanical buzz of the speaker. I asked to come in and heard the bolt shoot back.
We did more tests. Nobody could quite believe it. I certainly couldn't. Eventually we came home. More sounds - the noise of the car, the clicking of the indicator, the annoying sound the computer makes when a programme is activated. The sound of Alexander's voice. A dog barking.
A long-standing engagement last night took me off to a Malt Whisky tasting in Sheffield. The room was full - seventy or eight people - but I could pick up great chunks of what people said to me. When the woman from the Malt Whisky Society gave her talk I was able to follow parts of it. By the end of the evening I was drunk and unable to decide whether any of this was for real or not. This morning I woke up early and with some apprehension plugged the system in again. It still works. This is no dream.
It will take some time yet. My two objectives for the coming months are the telephone and music. All the books say that "eventually", with practice, you can begin to get a bit of these. Give me a week - or two.
I feel grateful to all sorts of people. To the technical expertise of those at the Yorkshire Cochlear Implant Centre. To all my friends for coping so well with my deafness for so long. To Isobel and Alexander for their encouragement and their belief. But perhaps most of all to the NHS (like me it is 50 this year) for enabling me to experience this. But there are still people waiting. Worse still, there are areas of the country which will not fund adult cochlear implants for financial reasons. No deaf person should ever be denied the pleasure I am experiencing just because we are unwilling to provide the financial resources necessary.
(Tomorrow, I will round this whole "Into The Void" theme off by bringing people up-to-date with what has happened over eleven years since that marvellous day in 1998).


  1. Wow. Now that instalment was worth waiting for. I think you have given me a whole new appreciation of what you have been through (and what many others have been through or may have to face).
    Well written - if anything would help to improve the funding of cochlear implants, your story will.

  2. Really amazing--it was such a good idea to post something written at the time the procedure took place-- the details about confusing sounds (waterfall for car) & about footsteps ringing in a corridor are just great.

  3. Wonderful stuff, Alan.

    I had visons of the sound being converted to morse!

  4. Fascinating and funny about the American accent!! Guess it was lurking around in your brain the whole time, huh?

  5. Thanks for the comments :
    Kabbalah - I'm glad to say that the battle for funding has now been won.
    John - thanks John. Retyping the e-mail after all these years brought it flooding back to me.
    Bill - if it had have been converted to Morse I would have been hopeless at interpreting it.
    Willow - no idea where the American accent came from. It faded after a few days.

  6. It must have been truly wonderful for you. I hope the next eleven years were even better.

  7. This is truly an amazing story! Brought tears to my eyes. I'm so glad you are sharing this part of your's just great!

  8. Amazing ! Yes, we should never take things for granted.It must have been so Liberating.
    I take your point about people missing out in some areas,But your Post is a Great Advert for the NHS & we should be proud of that.
    Have A Nice Week Sir!


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