Month: May 2024

May 2024

By Richard Fleming

Photo courtesy of Mark Paton

I could pick any number of body parts to complain about but today’s ire is directed at my ears. They are not functioning up to par. Many of my body’s organs have to perform complex jobs all alone. I have one nose, and it seems able to do its work without complaint. Ditto for my one mouth and one heart and one liver. Despite having no coworkers, they seem to function just fine. So what is up with my ears? I have two, but they are simply not fulfilling their job responsibilities.

Now, I do understand that being able to complain about my ears is a luxury and a matter of luck. I am fortunate to have most of my body parts functioning fairly well, as far as I know at the moment. I could have many more serious problems to rail at. But allow me a brief period of whining, then I will cease and desist.

My hearing loss first manifest about two decades ago when I was in my early 50s. I’ve been wearing hearing aids ever since. I admit to being a mite resentful about this problem. It was not self-inflicted by mistreatment of my ears in earlier years. I did not attend loud concerts nor did I blast my ears through headphones. For me it is a genetic issue. My father had early-onset hearing loss and had to wear bulky hearing aids starting in his 50s. Two of my three siblings have hearing loss also.

Actually, it took some time for me to realize my ears were on the fritz. For a while I had been having some trouble hearing patients in the exam room. I attributed the problem to them speaking too softly, combined with ongoing background noise from the ventilation system. But one day, after repeatedly asking a nice elderly lady to speak up, I realized it was unlikely all my patients had suddenly conspired to communicate with me sotto voce. It was time to sign up for a hearing test.

My audiogram showed a definite problem, especially in the higher frequency ranges of people’s voices. The audiologist recommended hearing aids and I reluctantly agreed to a trial. They surprised me. I found it easier to understand what patients were saying. And, not long after, my kids told me they’d noticed my hearing loss about a year earlier. They had been hesitant to say anything, fearing it would embarrass me. But when I started wearing hearing aids, it opened the door for them to tell me how frustrating it had been to talk with me.

The first few years, I was reluctant to use the hearing aids consistently. I would wear them exclusively in situations where it seemed hearing loss could be a problem. Seeing patients was an important venue, so I wore hearing aids in the exam room, though I had to remove them to use the stethoscope.

For some reason and for some time, I felt that wearing hearing aids was embarrassing. Society seems to stigmatize hearing aids more than other assistive devices, like glasses. Glasses are no big deal. They do not imply frailty nor are they a sign of old age. Glasses can even be a stylish accessory to alter one’s appearance. But hearing aids are viewed as a sign of withering, a marker of inability to function normally. They do not make a sophisticated fashion statement.

After a few years, I got past my hearing aid embarrassment phase. My patients helped by reassuring me it was fine to pop the devices out of my ears to listen to their lungs and heart. I eventually decided the heck with it, and began to insert my hearing aids in front of other people when I needed to hear better. I still occasionally catch a little side-eye from someone when I do so, though my perception may be more a reflection of some lingering feeling of awkwardness. It’s likely the person’s glance reflects curiosity more than a judgment about my frailty and oldishness.

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As time has passed, I have had to replace my hearing aids several times, and they seem to be getting a little better with each new version. But I have also found something else to complain about: hearing aid controls are becoming too technological, too sophisticated, and too complicated. When I first got hearing aids, adjusting them was straightforward. I turned them on and put them in my ears. I could increase or decrease the volume with a small rocker switch on the right heading aid. No big deal.

But today’s hearing aids require adjustment with a smartphone app. And the options for controlling them are myriad and mind-bending. I can – using the app of course – set multiple possible programs for the devices, including “noise/party,” “outdoor/traffic,” “(i)focus 360,” and others. Seriously, I have no clue what these programs do. I can change the “sound balance” to various settings between “sharp” and “soft.” What on earth do these concepts mean? And I can set up the hearing aids – using the app – to automatically connect to my cell phone. After two days of trying to accommodate that function, I was getting stressed out and my blood pressure was rising. I prefer a simpler life, one in which when the telephone rings, I hold it up to my ear and say, “Hello.” It took about 30 minutes of fumbling with the darn app to figure out how to disable that feature.

I do appreciate that companies which manufacture hearing aids are trying to make them better. They think that introducing lots of digitally-controlled fancy features will make these devices more useful. Well, I have a small piece of advice for these companies:

Hearing aids are principally used by old people, and most of us folks do not like using apps on our phones to control devices we need and use every day, including our hearing aids. Apps are complicated. Smartphone screens are small and hard to read. We don’t want app-controlled stoves, refrigerators, doorbells, canes, glasses, or vacuum cleaners. So please, just stop it.

OK, now I feel better. A little venting can be therapeutic.

I readily acknowledge that hearing aid problems pale in comparison to the other difficulties brought on by aging. Growing old is a mighty peculiar process. It can happen at various speeds for various people. Sometimes it advances as quickly as a thunderclap. One moment a person is fine and walking and talking and eating and smiling. The next moment the doctor’s office calls with some test results. Or a person’s heart decides it has had enough. Other times, aging proceeds slowly over the years, inexorably, chronically, bringing us down through a thousand small cuts. Hearing aids fall into this second category. They are just one more small nuisance as we journey onward. I should be grateful I can complain about them.

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On a different note, I want to let readers know I will be taking a break before publishing my next post. Since starting the blog two years ago, I have posted twice a month. The coming few months will be busy for my family and I won’t have time to continue this same schedule. I have plenty of topics to write about and will resume later in the summer or early fall.

I’m also considering redesigning the blog. I have not made any changes in its appearance and will look into several possible new formats. The content will remain largely the same. I will continue to ruminate, complain about, extol, bemoan, and celebrate this ever-more-complex journey through time we are making together.

And I promise to never use so-called artificial intelligence to generate my posts. My words and ideas are all of natural origin. Whether they reflect any form of intelligence remains to be seen.

I deeply appreciate and am sincerely grateful to you for reading these posts and for your comments. I have learned from you, and the sharing of ideas and experiences helps make our trek into the future more understandable and somewhat easier. Thank you.

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May 2024

By Richard Fleming

Photo courtesy of Gilberto Parada

My wife and I were awakened by a phone call at 6:03 am on Sunday, April 28. It was Cora, the manager of the care home where my younger brother lived. “I’m sorry to call so early, but Chris is not doing well,” she said. His oxygen level was dropping despite supplemental oxygen. He was not responding to people’s voices. His breathing had become a bit labored and he had been given a small dose of morphine a couple of hours earlier. We had enrolled Chris in hospice in early April because of recurrent aspiration pneumonia, dementia, and Down syndrome. While we knew his time was limited, we were not expecting this particular call at this particular time.

We should not have been surprised, since an omen appeared several hours before the phone rang. My wife’s bedside light turned on spontaneously in the middle of the night. That happened once before, 16 months ago, when another family member experienced a significant health problem. We should have known the light was turning on for Chris.

After the call, my wife and I got out of bed, braced ourselves for whatever may lie ahead, brewed coffee in to-go cups, and drove to the care home. Along the road, I called my sister, who lives in the area, to come as soon as she could.

When we arrived at Chris’ bedside, the sun was an hour above the horizon, the sky was cloudless, and the air was cool. Cora, her face grim, quickly ushered us in to Chris’ room. A hospice nurse sat at his bedside. She gave us a report on his status. He had another lung infection and it was clear his time on earth was drawing to a close. I texted our older brother in Colorado, who quickly responded he would fly out that afternoon.

Chris appeared serene. His eyes were closed and he was breathing slowly. We tried rousing him, but he made no movement. We spoke to him, telling him we were there, letting him know we loved him and that things would be OK. While he did not respond, we hoped our words would breach the barriers to the outside world which were quickly rising in his brain and provide him some sense of solace and security.

His breaths became raspy again and the hospice nurse gave another dose of morphine. His coarse breathing improved and his respirations slowed further, down to six breaths a minute for a while, then to four.

The nurse excused herself, since she had other patients to see that morning. The people left in the room with Chris were our sister, my wife, and myself. We sat surrounding him, hands resting on his shoulders and feet, periodically letting him know we were there. His breathing slowed to three breaths a minute. Then two. Then Chris took one last breath. It was deep and calm. Full but final. We waited. But he had no more breaths to take. After 61 years of a vibrant, challenging, and joyful life, Chris died.

We told him we loved him and to take care, and we asked him to say hello to mom and dad. Did Chris hear our words? Impossible to know, but they issued from our hearts more than from our minds, and had to be spoken aloud.

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A commonly-held notion is that a person does not truly become an adult until both parents die. This concept makes sense. It is only after the protective parent figures in our lives are gone that we are fully on our own.

There is a corollary idea I’m beginning to embrace: a person does not fully enter old age until they lose a sibling. It is then that we truly appreciate what old means and what old feels like. (This corollary applies to people who are at least in their 60’s, since young people can tragically lose a sibling.) I’m in my early 70s, and I know that many people in my age range have lost a sibling. But it is the first time for me. And the impact has been profound.

Losing anyone – a parent, a spouse, a close friend – is incredibly painful. Losing a child is a pain beyond any possible measure.

Losing a sibling is different. It is painful, but in a unique way. The loss of a sibling makes a forceful statement about the brevity of life. When you lose a brother or sister, it transforms you. You had the same parents. You shared countless childhood experiences known only within your family. As you grew up together, you jointly wove a tapestry of life so rich and complex it is impossible to explain fully to anyone else, including your spouse and close friends. When you lose a sibling, you lose someone who played one or more important roles in your life – colleague, comrade-in-arms, crew member, peer, competitor, confidante, friend.

Chris’ death has precipitated much reflection. He was a brother, but having Down syndrome, he was much more than a sibling. It is hard to explain, but he was always present, always there, every day of my life, even though he mostly lived with other people. In the days after Chris died, my two remaining siblings and I, along with my wife, spent hours around the lunch and dinner tables, talking, ruminating, and deconstructing our family’s ups and downs over the six decades of Chris’ life, and even the years before he was born. Many things became clearer, though there is still much to sort out. Chris’ influence on our family was profound. His life largely governed where we lived. His life impacted what we thought and felt about our family and each other. It significantly influenced the way our parents treated us. Though small of stature, his presence in our lives was massive.

Chris’ death has closed the door on some important parts of my family’s evolution. It has impelled me to reconsider parts of my past and my future. I will continue living, hopefully for many more years, but it will be without my younger brother.

I feel more like a senior now than I did before Chris died.

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All of Chris’ belongings are now sitting in our garage, in random sacks and boxes. Someday we will need to sort through them, but not today and not next week. One thing I retrieved was his eyeglasses, which I placed on top of the piano in our entryway. I see his glasses every time I walk by. Sometimes I touch them. They provide a small measure of comfort and remind me of times past, before the door closed, when Chris graced our home and our lives, smiling, and arguing, and joking, and crying, and walking, and breathing, and frequently saying, “I love you” for no apparent reason. Seeing his glasses makes me feel happy and sad. And they make me feel older, but not in a depressing way. It is hard to explain, but they help me feel more at peace with my place on the path as I navigate hesitantly into the future.

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