Dr Stephen Kirsch
Before I had ever heard of the study of audiology it was evident my appreciation for hearing was unique. Growing up in New Orleans live music was the norm. In my early teens, I fell in love with the performing art of Ray Charles and Stevie Wonder, among others in my father’s album collection. It was then I concluded hearing was our most valuable sense. After all, I was unaware of anyone who was deaf with the ability to influence tens of millions of people throughout the world the way Ray Charles and Stevie Wonder could without their sight.
“If you had to be deaf or blind, what would you choose?” I must have asked 100 people this question during my high school and college years. The incredibly high percentage of people responding “deaf” only fueled my contrary convictions and motivated me to persuade them to reconsider. Meanwhile, I graduated from the University of New Orleans with a B.S. in Finance, served as a combat medic in the Louisiana Army National Guard, and worked in multiple restaurants in New Orleans enjoying the art and labor of serving patrons. It seemed my life changed suddenly in 1997 after a brief interview with an old friend from high school, Rob Scheuermann, Au.D., chronicling his newfound career as an audiologist. Helping people hear better! I’d love that! I was passionate about this prospective venture instantly and have remained so for nearly 20 years now. My life has been enriched from the experiences this profession has afforded me. I’m forever grateful and humbled by the responsibility of treating the hearing loss of so many fine, deserving people.
Sport (participating and spectating) has probably been the most consistent hobby of mine over the years. LSU athletics, professional basketball and football, late 20th century tennis, and now golf has captivated my interest. It’s fascinating to dissect the slight margin between winning and losing. I’ve always considered my calling to involve coaching or teaching. Thankfully, there is much to teach and coach when it comes to audiology; particularly, as it pertains to the causes and effects of hearing loss, the decision for treatment, and the implementation of hearing devices. I believe it’s crucial for the patient to understand the details regarding diagnosis and treatment recommendations. We should be our first resource for caregiving and decision making on matters of health. I take pride in the teaching process for the duration of care, and I think patients and their families appreciate it.
Hearing loss is an invisible handicap which usually effects more than one person at a time. It’s a communication barrier in relationships. I often tell patients ‘it’s hard enough to be understood in life without hearing loss’! As you might expect, the most common relationship hampered by hearing loss is that of spouses. It’s not uncommon for a marriage counseling session to unfold amidst a hearing evaluation. “He doesn’t listen!” “I do try, but she mumbles.” “I hear what I want to hear.” “Don’t come home until you get a hearing aid!” I’ve heard it all. It’s sometimes comical, but the truth is communication is the cornerstone for establishing and maintaining relationships. Incomplete hearing leads to incomplete communication and frustration in relationships.
One important piece of information I convey to those contemplating what to do about hearing loss is this impairment makes it very difficult to accurately represent yourself. Pretending to hear something you didn’t or just ignoring what you’ve missed as not to interrupt the flow of conversation again with “excuse me?” prevents you from offering your opinion, approval, rebuttal, whatever. Your lack of response is a statement in itself, not usually the one you would have made with accurate reception of the dialogue. These misrepresentations are often continual and lead to absolute misconceptions of one’s compassion, intelligence, senility or general persuasions.
Another effect of hearing loss which is often underappreciated is the challenge of influence. It’s unfortunate to disallow your mates from having influence on you with their profound words, but perhaps more debilitating to relinquish a large portion of your influence of others. Sharing opinions, experiences, perspectives to influence others is gratifying to many. The lack can be depressing. The point is: much of life is reciprocal. People generally do not have a great interest in listening if they feel their thoughts are not being heard.
As mentioned above, my first college degree was a B.S. in Finance from the University of New Orleans. Gratification was crucial to my contentment with work. I think because I didn’t grow up in wealth, I couldn’t envision managing money being gratifying; so, I was content showing people a good time in New Orleans serving them good food and drink. Until my friend, Rob Scheuermann, Au.D., introduced me to helping people hear better. I was proud to be accepted to and later graduate from L.S.U. Medical Center with a Master’s Degree in Communication Disorders. L.S.U. was home of the Kresge Center for audiological research and was one of the most highly esteemed schools in the nation for audiology. Ultimately, I earned a Doctorate of Audiology (Au.D.) from the world’s first osteopathic medical school, A.T. Still University, which instilled the importance of treating the whole person not just the symptom.
My mom and dad, Rose and Glenn Kirsch, taught me compassion and patience. I’m blessed to have had their steady examples to emulate. I think those qualities are important for medical professionals to convey.
I’m also thankful for the tutelage of my audiology mentor, Rob Scheuermann, Au.D., for showing me how the importance of authenticity and generosity as a clinician. These qualities, along with competence, have solidified trust and loyalty (and true friendship in some cases) among patients.
The first resort for treating sensory neural hearing loss is hearing aids. There are a great variety of styles and models of hearing aids. Style refers to the size and shape of the device, while model refers to the level of performance and is determined by the capabilities of software or computer chips. The cost of hearing aids was once dictated by the size or style. Deep fitting, inconspicuous devices were the most expensive and larger devices were more affordable. Since the turn of the 21st century, the digital age of computer chip design has transformed the pricing structure. Now, the cost of hearing aids is governed by the model or the sophistication of the software employed in the device. Tiny, completely in the canal (CIC) devices cost nearly the same as a large device if the computer chip is the same. It takes nearly two and a half years for a given manufacturer of hearing aids to introduce a new model (or computer chip upgrade). My philosophy is it takes at least two generations of improvement in hearing aid technology to warrant consideration of an upgrade. Because the cost of hearing devices typically range between $2000 to $7000 for the pair, we must consider this to be a long term investment. Making the best decision among many devices is crucial; therefore, so is the professional guidance one receives throughout the process. The variables which are important to evaluate when trying to choose the best hearing aids for a given patient are hearing loss type and degree, size and shape of the outer ear, aesthetic priority, dexterity, variety of listening environments, financial constraints, and, most recently, bluetooth connectivity. This is not a simple process. The professional’s experience, education, and empathy are paramount when it comes to optimizing the physical fit and acoustic performance of a hearing device.