Southern Health

Before March 2006, I took for granted dinner table conversation with family and friends, music, dogs barking, birds chirping, even impatient car horns and urgent sirens.  Then one morning my wife could not wake me, and she called 911.  The ambulance raced to the nearest Emergency Room, DeKalb Medical Center on North Decatur Road.  I lay in a coma for three weeks with meningitis, raging fevers, tubes, respirators, massive doses of antibiotics. After that, in the Emory East Rehab Center on U.S. Highway 78 in Snellville, I read an article that said, “So you’ve had meningitis, and now you are deaf.  Boy, are you lucky!”

In the bed at the rehab center, among the many things I could not do was operate the remote control to keep the television optioned for closed captions.  So I began watching only baseball games.  From the time I was 10 years old, my Daddy took me to Atlanta Cracker baseball games at Ponce de Leon Ballpark across from Sears.  I do not need to hear anything some television sportscaster might say to know who’s on first.

My wife brought me a white board the size of a notebook, dry markers, and a fiber eraser, so we could communicate through my deafness.   I came home from the rehab center in a wheel chair, barely able to stumble from the bed to the bathroom, the most important milestone I had reached.  We scheduled an appointment at Northside Hospital on Johnson Ferry Rd with a top Atlanta area hearing specialist, an otolaryngologist.  Tests yielded an official diagnosis of what I already experienced daily: profound deafness, permanent 100 percent loss of hearing and balance function in both ears.  A cochlear implant would be the only alternative to total silence for the rest of my life. Sometimes called a “bionic ear,” the cochlear implant is actually an ear bypass, computerized mini-electronics transmitting sounds directly to the brain without traveling through the ear.

My insurance company, one of the biggest, a ubiquitous advertiser, and health benefits provider to major corporations like my employer, denied coverage for my cochlear implant, costs starting at $50,000 on top of my medical expenses already incurred while I was at death’s door.  My wife searched the internet and found the Let Them Hear Foundation, Palo Alto, California, pro bono lawyers with an impressive track record against insurance company denials of coverage for hearing treatment.  Let Them Hear cited their court victories and reminded my big, ubiquitous insurance provider of “consequential liability.”  What if I got run over by a train I could not hear, as had happened to Miss Deaf Texas? My insurance company still denied the claim.   Months went by.  The appeal was referred to the head of the corporate legal department of my employer, who responded at the eleventh hour to Let Them Hear, cc to me, “Your case law is weak, and your legal reasoning is flawed.  However, we have decided to change our policy and provide coverage.”  I was completely deaf for more than six months before my cochlear implant.

Now that I have come to need doctors, my confidence in so many of them would be improved if they did not look like friends of my children.  Fortunately, my cochlear implant surgeon was my age, maybe even a few years older.  He had the social manner of a poker player with paper money on the table in denominations carrying portraits of people who were never U.S. President.  At the same time he conveyed an intense awareness that the Constitutional right to bear arms applied to every citizen who played poker.  This struck me as the perfect attitude in someone who would cut holes in my head and wire things up to my brain.

I checked in Northside Hospital at 5:30 in the morning for my surgery.  A nurse shaved off a patch of hair behind my left ear.  An anesthesiologist told me to count to 1,000.  I do not remember getting past 10.  I woke up in time for lunch and was sent home that afternoon with a pill bottle full of painkillers.  I did not have to take so much as an aspirin. I have endured dental procedures that were worse.

Two weeks later, I received the external device to wear behind my ear, miniaturized microphone, controller, and computer.  I heard sounds immediately, paper rattling, a pencil dropping to the floor, conversation.  After months of total silence, the noise came as an assault.  Everybody sounded like Alvin and the Chipmunks announcing the stops on the subway at the Atlanta Airport.   I would get used to it.  A cochlear implant isn’t perfect, only a miracle.

For the first four years, annual checkups and reprogramming (mapping) of my cochlear implant yielded little change from the first sounds I heard.  My satisfaction level stalled at about a two on a scale of 10–which is not to say I would rather be 100 percent deaf.  All complaints presume this caveat.  Then in 2010, a breakthrough of some kind, still unexplained, perhaps unexplainable.  My satisfaction level jumped to a five on a scale of 10.   Since then, I have experienced small isolated improvements in what I hear, no change in the hardware or computer settings, only what my brain tells me things sound like.

Meanwhile, I also had to learn to walk again. The damage to my inner ears also left me with a 100 percent loss of balance function, no gyroscopic axis.  After two years of extensive physical therapy and rehabilitation, I was able to walk, carefully as someone leaving a bar at closing time. But I walk.  Eventually, I was able go to the Wellness Center, in front of DeKalb Medical, at least three days a week. The Wellness Center includes workout machines, weights, a swimming pool, and an indoor track, 15 times around for a mile. The first time I visited the Wellness Center I could not walk around the track once.  Little by little, I built to a routine of walking five laps, then stretch exercises for my arms, legs, and lower back.  For balance exercises, I do some lateral crossovers, followed by walking a straight line heel-to-toe, like a field sobriety test. Then I jog three to four laps.   After the jog, I keep walking laps until I catch my breath. Then I put in ten minutes on a combination of the bicycle and stair-step workout machines.  I finish by walking however many laps I need to complete a mile for the day.

Then I go home and take a nap.

I used to tell people I could not do a pirouette–on purpose. Now, one of my proudest accomplishments is that I am able to put on my trousers, one leg at a time, just like anybody else, while standing.  Accompanying me around the track at the Wellness Center every time are survivors of health crises from orthopedics to cardiology, cancer to stroke, keeping on keeping on.  The Wellness Center is the only place I know where the majority of its parking spaces are painted blue.  A large banner displayed along the indoor track reads, “TRIUMPH OF THE HUMAN SPIRIT.”

Illustration via YouTube.
William Cotter

William Cotter

I actually remember when THE ATLANTA JOURNAL claimed it "Covers Dixie Like the Dew," because 50 years ago, when I graduated from high school, I landed my first full-time job there as a copy boy. Thanks to city editor Harold E. Davis, I was promoted to city desk clerk, then later became the youngest of his young reporters, when they were still located at 10 Forsyth St., next to the train station (have I preceded your memory yet?). Before I left journalism in the 1970's to try and earn a living, I also had worked for THE DAILY JOURNAL of Elizabeth, N.J., had been a stringer for NEWSWEEK, and had written articles for Atlanta weeklies CREATIVE LOAFING and THE ATLANTA GAZETTE. In 2006, I was hospitalized with meningitis, three weeks in a coma, waking up with 100 percent hearing loss in both ears. I received a cochlear implant, which provides me a miraculous electronic approximation of hearing, although everybody sounds like Alvin and the Chipmunks announcing the subway stops at the Atlanta Airport. After I was discharged from the hospital, I began to write a blog to see if anything about my brain still worked and if I could still type. In addition to my own blog COTTER PEN, I have been a contributor to the arts blog SOUTHERN CREATIVITY and helped design and launch other blogs about writers and artists.

  1. Frank Povah

    William, congratulations. I am slowly losing my hearing – though not from the causes that plagued you – and know what the loss of balance feels like. As a one-time almost full-time musician, when in my callow youth I often claimed I would sooner be blind than deaf. Sometimes I think I may have been right.

    1. William Cotter

      Loss of music, even with my cochlear implant,  has been one of the major issues for me.  Look up my blog, where I have discussed this.  My music hearing has improved.  The problem is not  volume but rather tone.   The difference between one tone and another may be x+y or x+z, and I may hear it as x+n.   Nonetheless, I go to The Metropolitan Opera Live in HD broadcasts at the shopping center mall movies and enjoy the tremendously, if not perfectly.  See my blog also about this.

  2. I can relate somewhat to your experience.  In September 2010, I had surgery to fuse some neck vertebrae whose disks were ruptured.  Until that point, I was losing use of my right arm, but the surgery to fix this problem is routine.  I was referred to a surgeon with a long, stellar track record with this particular surgery.  Imagine everyone’s surprise, when I woke up with my original problem completely gone, but a new one in its place.  Over the next 24 hours, I lost use of my voice.  Somewhere along the line of the surgical process (anaesthesia, surgery, recovery, recuperation), my right vocal cord was paralysed.  And so it remains.

    A temporary procedure involving injections into the tissue next to the vocal cord provides a voice approximating my original, but it wears off after three or four months.  I have been referred to a otolaryngologist  with particular expertise at a more permanent fix involving implantation of tissue recovered from a corpse.  It has been quite a nuisance.  At the time this happened, I was unemployed but searching.  I couldn’t even talk on the telephone very well.  I could approximate the hiss of an aroused Komodo dragon, but that left my throat irritated.  Interviews became extremely challenging, and I suspect my voice had some negative consequences for my interviews regardless of how impressive my resume is or my demonstrated abilities, it is hard to imagine managing projects requiring a great deal of talking.  There was one unexpected benefit.

    It is impossible for others to hear my hissing in noisy settings such as restaurants or large social settings.  As a consequence, we saved money by not going to restaurants.  Occasional take away, but trips to restaurants are rare.  I take a small note pad and pen in order to write when I cannot avoid such settings.  Drive-through at fast food, pharmacy, or bank is now a thing of the past.  I don’t sing anymore, something for which my family is probably grateful.  The only reminder of my old voice is the voice greeting on our home telephone.  At first, I would occasionally call my home phone just to hear my old voice.

    My experience was nowhere as traumatic as yours, and at no point was my life in jeopardy, but just as you grieved loss of your natural hearing, I grieved loss of my voice.  I never realised just how much we use our voices.  Things that simply did not occur to me.  Calling a number and getting a voice response robot and being trapped in telephone limbo.  Calling for a tow truck is largely useless.  It is doubtful that calling 911 would be effective if ever I needed to do so.

    Did you realise that when a vocal cord is paralysed that one cannot regulate airflow out of one’s lungs.  Climbing stairs is a real challenge, because the harder I breath the more my air “leaks” out.  It becomes quite winding.  My limit is about three flights.  I also had to learn how to swallow.  Vocal cords are what close the pharynx when one swallows to prevent food going down the wrong way.  It is pretty easy for me now, but I had learn to swallow to the left.  I still get strangled particularly when eating food that contains a lot of spice or vinegar.  Life is not horrible, but it is different.

    1. William Cotter

      Thank you for sharing your experience as well.  Fifteen or twenty years ago, there would have been no cochlear implant for me.  Medical technology available to address your needs will likely change every year compared to the previous one.  I use 711 telephone service over my computer.  Although this is designed for the hearing impaired, I do not see why you would not find it useful also.  I type my end of the conversation and read on the computer screen what is said back to me.  Thank you again for taking the time to read and to share.  

  3. Great article, Bill.  Everyone needs to know about this.   I well remember your difficulties with the insurance company.   “If it’s broke, don’t fix it if it costs too much” is their philosophy.    You were lucky to have an intelligent and stubborn wife to serve as your ears and spokesperson during those difficult first months.
    Something tells me that cochlear implants are just the beginning–the dawn of better help for deaf people.   Who knows what might be available 50 years from now?

    1. William Cotter

      Intelligent. yes.     Stubborn, let’s call her determined.  Without her determination, we would have to call me dead.  

  4. I can testify, as someone who knew him those 50 years ago, that Bill may have lost his hearing, but not his first rate voice.

  5. Well, Billy, I’m glad you followed Bill Hedgepeth’s advice about committing your story to electric type. You did a good deed while accomplishing two things:
    First, you proved to yourself that you can still tell a complex tale in a straight line as you did when we both were young and competing reporters. Second, and more important, you told people with similar tragedies that guts and perseverence (maybe bone-headed stubbornness) can make a bad situation better.

    1. William Cotter

      Considering the source, I could not be prouder of these comments.

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