• Jena Martin MD

When I was very little, a man lived inside my ear.

Updated: Jan 30

Oddly, he only made appearances to pound on a piano, usually as I lay in bed. I imagined him with long tuxedo tails that he’d ostentatiously flip out to sit down, like in a cartoon segment on Sesame Street. I would lay in bed and listen to him whir and rumble deep inside my hot and heavy ear. ‘Can’t you hear that?’ I would ask my mom. It seemed strange that so much sound could be audible only to me.


After one of these appearances, my pillow would be covered in a brown crusty mess, the lava from yet another of my earaches. I stood in tears in the bathroom as my dad tried to clean up my hair and face with a green washcloth. The man left a trail of waxy debris embedded and caked into my long brown hair.

The man behind the piano heralded an ear infection. I had, I would now estimate, about 20 of them until my right ear went quiet in my teens. My childhood tasted like creamy cold pink antibiotics. I underwent 7 surgeries before I was 10. Each one was a crisis. My fault. My U-station tubes, I learned, were not working. I studied the anatomy on the anatomic posters in the ENT surgeon’s office - these faulty tubes connected the snail living inside my head down to my throat.


My visits to the hospital left a big impression on me. Even now, as an adult and a doctor, those are the old fashioned rooms I imagine when reading a novel set in a hospital. I still see the small bathrooms and big black TV’s hanging on the wall, already antiquated when I was a child. I can taste the ambrosia-like pancakes and see the beautiful nurses’ aide with feathered blonde hair and blue eyeshadow who told me to not touch the bandages. Many years later, I visited that hospital when my dad spent his last days there. It had not been remodeled since my last operation. It had the same views behind bars on the windows, the same nursing stations and same beige hallway chairs. Being there felt unreal, like I'd walked into my own sort of novel. Now I’d give anything to walk back into one of those dilapidated rooms and tell my dad how much I was going to miss him.


My ears finally quieted down just in time for my parents to get divorced. And, since I was a non-communicative teen who seemed healthy, there was no need to see any more doctors. I didn’t hear so well in my right ear, I’d tell people. No big deal. It made sense after all of those bouts of infection. So I was surprised when at age 24 and uninsured, the piano man came back.


I learned then that you are not supposed to allow your eardrum to have a hole in it, unrepaired for years. Your middle ear is not supposed to be exposed to air. Over the intervening years, as the quiet in my ear deepened, skin was growing behind my eardrum. It eroded into the bone through slow inexorable division, forming a growth called a cholesteatoma. It required many surgeries to finally extirpate. I have the crater where it lay examined annually. My mastoidectomy (the thick bone and part of your skull just behind your ear) cost thousands that I didn’t have at the time. Now I’d legally be allowed on my parents plan until age 26; then I was on my own and received care at the general hospital as an indigent patient. I was haphazardly treated by medical residents who inspired me to go to medical school.


Ear infections are less common now and they are managed better, with fewer automatic prescriptions for antibiotics. There is better ear hygiene; no bottles to babies laying down, less formula, vaccinations for influenza and no second hand smoke. All of these factors contributed to my ear infections. Children who live with smokers, of which my dad was one, get more ear infections because the smoke irritates the eustachian tube (the correct spelling). Its yet another thing I’m glad he didn’t live to know. Like all parents, he would have been upset to learn he was passively harming me. One of my happy memories is watching the evening news with him, eating peanuts from the shell as the smoke curled around us. It's humbling - what harms am I unknowingly inflicting on my own children?


Now the piano man has become a muffled alarm, like a deep sea diver ringing a bell inside my ear. The drilling from surgeries so agitated the tiny hair-like nerves in my ears that they shake and ring constantly. I’m supposed to consider this noise, tinnitus, a problem.


There aren’t too many GenExers, my people, who yet suffer from tinnitus or age-related hearing loss. But when the tidal wave of hearing loss lands on the first users of Walkmans, it will be a disaster. Deafening. I don’t consider the tinnitus a serious condition; it’s a faint echo of actual damage, a scar. I think it will fill the silence as I lose more of my hearing in the years ahead.

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