My hearing is shot. And I’m hoping that chickens will help me.
Millions of people suffer hearing loss when the hair cells in their cochlea die. Chickens—those lucky devils—don’t have this problem
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Too bad the old saying, “You are what you eat,” isn’t really true. If it was, given my frequent craving for roast chicken, I’d probably have better hearing. Why? Because humans can’t do something that chickens manage routinely: regenerate essential inner-ear cells to reverse hearing loss.
My hearing has been deteriorating for many years now. In my left ear I only hear faint, distorted noises; my right ear is better, but a long way from good. My wife demonstrated major-league patience by enduring my replying “What?” for too long, until I finally got hearing aids. She deserved better.
I used to take my hearing loss for granted, as an unfortunate fact of my existence. No longer, because in recent weeks I’ve been digging a bit into the possibility that science—possibly the research under way at a Stanford University lab—will someday let me hear sounds as they truly are.
Regrettably, there’s no War on Hearing Loss—no massive federal or international push to cure it. There should be.
Yes, there are far worse medical problems, things that kill people or totally ruin their lives. But the hearing-loss numbers blew my mind: an estimated 360 million people worldwide, and more than 30 million of them in the United States, including huge numbers of baby boomers and a significant percentage of returning veterans from Iraq and Afghanistan.
So on behalf of the millions of folks in this situation, allow me to suggest that it needs more attention! (The italics indicate that I am shouting this loud enough for everyone to, uh, hear it.) Let’s encourage some good old-fashioned greed, especially now that scientists are making progress in figuring out the mechanics of hearing loss, and a handful of startups are investigating new drugs and rethinking the way users control their hearing aids.
I don’t expect government—especially when the Republicans who control Congress seem to think that science is irrelevant—to get off the dime anytime soon. So I ask philanthropic funders of research to kindly take another look. And to capitalists and especially entrepreneurs, I’ll just say: Hey, folks, there’s nowhere near enough going on in this field. You want to disrupt something? How about hearing loss?
Some people are born with it. I probably did it to myself. I played music for a living when I was in my 20s, living in Vermont and touring with a band, mostly around New England. We had amplifiers pumping out sound from behind us. In those days musicians didn’t know enough to do what’s more routine now: wear in-ear filters to dampen the frequencies and levels that cause the most damage.
The ranks of aging, semi-deaf players — and far more numerous listeners to loud music — have swelled.
One day when I was in my late 30s, my brother-in-law, a physician, mentioned that I tended to favor my right ear in conversation, literally turning my head slightly. It turned out that I’d lost a fair amount of my hearing even then, and now it’s fairly dramatic.
I pretty much gave up trying to fully understand anyone talking to me in even a semi-noisy room. (Countless baby boomers can relate.) When MP3s came along I remixed all my stereo music to mono so I could hear it better when I used headphones.
A colleague recommended hearing aids. Amazingly, few health insurance plans cover hearing aids. Given the scope of the problem, this seems just ridiculous, especially at the devices’ high price. Several thousand dollars went from my bank account into the cozy oligopoly of hearing-aid manufacturers, but I have to say it was worth it.
The hearing aids were tuned for my hearing-loss patterns, and there are several somewhat useful settings I can adjust for better performance in situations like sitting across from someone in a busy restaurant. Annoyingly, I can’t make further granular adjustments myself. I have to return to Costco, where the man in the little booth plugs them into a computer, unlocks the software and tweaks away. This is medicine’s version of “Digital Rights Management” locks on software and entertainment that technology users have come to loathe, with good reason. I’ve been glad to learn that hardware hackers have set their sights on this, too, though no doubt the industry incumbents will do their best to prevent customers from having any serious control over what we’ve paid so much to own.
However much hearing aids help, they’re still electronic devices poking into the side of my head. Call me old-fashioned, but I’d rather walk around with fully functioning ears.
So I’ve made my way to the sunny campus of Stanford University, learning about the mysteries of avian anatomy in a lab that’s part of the Initiative to Cure Hearing Loss, a multi-disciplinary team based at the medical school. It’s not the only place working on the problem, but it’s clearly a leader—and where I’m putting a personal bet on a substantial upgrade to my hearing.
I had attended a hearing-initiative talk at the university last spring. It turned out that one of the project’s most ardent proponents is Vint Cerf, a Google vice president who is one of the chief architects of what became the modern Internet. Like mine, Cerf’s interest is personal. He has major hearing loss, and he also wears hearing aids. He calls himself “a layman in this space,” but it’s clear from our conversation that he’s done some serious homework. “They clearly have a way to go,” he says of the hearing-loss initiative. But he’s hopeful.
Though noise exposure probably caused my hearing loss, complications resulting from his premature birth are probably related to Cerf’s. Other people have lost hearing, or have been born profoundly deaf, for a variety of other reasons including reactions to certain drugs.
What’s wrong is simple to describe, even if, so far, impossible to repair: Cells with tiny hairs in our cochlea have died.
The cochlea, a fluid-filled bone shaped like a snail, is a key part of the auditory system. Sounds enter the ear and hit the eardrum in waves. The eardrum vibrates, and nearby bones in the middle ear amplify and send the waves into the inner-ear cochlea. The sounds then stimulate those tiny hair cells, which convert the vibrations into electrical impulses that head into the brain via the auditory nerve. (This National Institutes of Health animation shows the process.)
Several things can kill those cells. Loud noises are one, hence the common occurrence of hearing loss in war veterans who’ve been around explosions of various kinds, not to mention baby boomers who listened to high-volume bands in their teens and 20s. Certain antibiotics, mostly not used in the U.S. but all too common in some developing countries, are also deadly to hair cells. Some people are born with profound hearing loss.
When those super-sensitive hair cells die, from whatever cause, the hearing process is interrupted. If you’re a mammal, you’re basically out of luck, because the hairs don’t regrow in mammals. But — as I learned from Stefan Heller, the lead researcher at the Stanford project — if you’re a chicken, they do regrow. He’s trying to figure out how and why, and then translate what happens to humans.
Each hair cell is surrounded by partners called “supporting cells” — they all come from the same progenitors — that keep the hair cells apart from each other. When a hair cell in a chicken dies, something interesting happens. Heller explains: “A surrounding supporting cell will fill that gap and will become a hair cell and then another supporting cell will say, ‘Well, this supporting cell is missing. I now need to divide and fill that gap.’”
Recent advances in technology are transforming this line of research. Now scientists can analyze and experiment on one cell at a time, as opposed to much larger tissue samples — Heller calls it a “major breakthrough”—so researchers can pick an area of tissue and look at every cell as it undergoes various changes. “With the advent of single cell analysis methods,” Heller says, “we have begun to overcome these limitations that have hampered the field now for decades.”
In the chicken ears, Heller and his team are analyzing undamaged and damaged hair cells over a period of time, seeing what changes and, ideally, why. If and when they figure it out, they’ll have a lot more to do before my hearing will improve. First, they have to translate the process to mammals, starting with mice. And they’ll have to solve another non-trivial problem: Even if they can regrow the hairs, the new hairs will have to re-establish contact with the auditory nerve that sends the signals into the brain. Needless to say, I’m not holding my breath.
And what if the chicken ears turn out to be a dead end? Research in this field has eggs (cough) in a number of baskets, including a variety of other projects at the Stanford initiative. One of Heller’s colleagues, Anthony Ricci, may have found a way to prevent the antibiotic-caused cell death.
Researchers at many other institutions are also in the hunt. Their work spans a wide range of activities, from more traditional techniques such as cochlear implants to genetics to stem cells (one of Heller’s specialties) and more.
In an especially promising development, several pharmaceutical companies, in a “sudden flurry of activity,” are smelling big bucks in this arena, according to a recent story in the New York Times. I’ve donated to the Stanford initiative, but I hope all of the people working to cure hearing loss will stay hyper-competitive. May they all race to the finish line, the sooner the better.
I don’t mean to whine, but I really miss hearing music as it’s supposed to sound. Not to mention being able to have conversations in noisy restaurants.
Even if medical science doesn’t solve this soon enough for me, computer science is making some fairly amazing strides with tools that take advantage of the enormous processing power in modern devices. Some manufacturers offer iOS and Android apps that turn mobile phones into controllers for the hearing aids, giving users more flexibility in adjusting for various conditions.
Maybe, one day, the tech industry could bypass the relatively slow-moving hearing aid companies entirely — if tech upstarts don’t get hammered into the ground via federal and state rules that unfairly protect the incumbent industry. Yes, some regulation is necessary, but an expensive system like the current one is just ripe for disruption. Millions of baby boomers would take advantage. Who’ll be the (better behaved) Uber for hearing aids? I volunteer for the beta test.
