Monday, July 17, 2000

In/Exhale - February 6, 2001 - Part II

February 6, 2001 - Part II

Kai was anxious. Really, really, really fucking anxious. So anxious he was glad he hadn't eaten, despite Jon's nagging, because if he had, there was no way he would have kept himself from puking all over the ENT's waiting room. Despite how much they’d accomplished with Dr. Miller that morning, as soon as Kai had arrived at the hospital, his anxiety had begun to spike. It didn’t help that the ENT’s waiting room was packed, so Kai was wearing his mask, which he knew automatically drew attention. He could hardly breathe; he wanted to take the mask off, but every time he started to, Jon stopped him. And every time, Kai startled, his heart racing even faster in his chest.
Kai began tapping his fingers against each other in rhythm, thumb-to-pinky, thumb-to-ring, thumb-to-middle, thumb-to-index, then back again, both hands, over and over as fast as he could go. He shut his eyes and tried to see blue, to breathe, because he felt like he wasn't getting enough air.
Jon's hand on Kai's forearm made him flinch, his eyes flying open. "Take an extra Xanax. I know you didn't want to, but you'll do better on the test calm, even if you're a little drowsy, than if you're like this."
Kai looked pleadingly at his brother. Kai was supposed to be relying less on the benzos, not more, but Kai seriously was ready to leave, because the anxiety was only getting worse, and if he didn't take the meds, there was a good chance he'd have a panic attack and have to do his hearing test and exam another day. Kai took a few deep breaths, even though they felt like the desperate gulps of a drowning man, and nodded.
Jon rose easily from his seat--especially when Kai's mind was beginning to spin into the negativity express, as the combination of his anxiety and depression worked in tandem to try to destroy him--Kai couldn't watch his brother move without a stab of jealousy. Except for his diabetes and insomnia, Jon was perfect. And Kai was so disastrously broken in so many ways. And--oh shit--he was going to start crying if he didn't get a handle on things. But wasn't that the point? Kai couldn't control anything. Not his body, not his thoughts, and certainly not his emotions. Not anymore.
Jon returned with a paper cup of water from the water cooler, and a mint tin that he apparently used as a pill case. “Take half,” Jon said since his hands were full.
Half?” Kai signed for confirmation. Kai normally only took a quarter of a pill, double that if he was especially anxious. It had been a couple hours since Kai’s last dose, but an extra half a pill now added up to three quarters.
Jon nodded.
Kai plucked one whole pill from the tin. It’d be nice to take the whole thing, but then he’d definitely be in no shape to take the hearing test. Instead, he broke it in half, replacing one and then shifting his mask just enough to pop the rest in his mouth. He washed it down with the water, praying the drug would kick in faster on an empty stomach. It usually did.


#


The next twenty minutes were torture as Kai's anxiety expanded to the point that it was sheer luck that he didn't have a full panic attack or pass out or both, his breathing ragged and sweat sliding down his face. Kai kept his eyes tightly shut to help himself focus on his mindfulness work, to make himself aware of his body and thoughts but let them go. Maybe it was that, and not luck, that kept the full panic at bay.
But when the drug finally hit his system, peeling away the anxiety, the relief was so intense it was almost like orgasming. (Though maybe part of the euphoria was that Kai hadn't orgasmed, not properly, not awake, in months.) Like he'd had this giant fist crushing his chest and now it was gone.
Kai almost laughed as the tension in his body lifted and his heart slowed to nearly normal, his breathing, too. It felt amazing to breathe and not feel like dirt was filling his airways and making it impossible to inhale a full breath. "I feel so much better," Kai signed, smiling, although the mask covered it.
But Jon must have been able to tell anyway, or maybe he saw how Kai's posture had transformed, sinking back into the waiting room chair. Jon gradually--trying not to startle Kai--set his hand on his brother's shoulder and squeezed.
Kai leaned his head back against the wall and let his eyes slide closed, still smiling. Fuck, he felt good. If three quarters of a bar of Xanax could make him feel this amazing, what would happen if he took more?


#


The Xanax had relaxed Kai enough he was nearly asleep beside Jon. Good. Kai had been inches away from a panic attack like the one he’d had at the diner, and Kai needed this exam and hearing test, because if this hearing loss was permanent, he needed to get hearing aids ASAP so he could function better, especially at school.
Kai was leaned back in his chair, his legs stretched out, his head tipped back so it rested on the wall. His arms lay still in his lap--no more of that anxious fidgeting--and his breathing had slowed and evened out. His eyes were shut, but he kept opening them part way, as if he were afraid he would miss something if he let himself fall asleep, although he never managed to leave them open for more than a fraction of a second.
Jon patted Kai’s head the way he used to when he was a little boy, smoothing his hair in a soothing gesture since he wasn’t sure how well Kai could hear him right now, and he didn’t want to disturb the peace Kai had finally found.
A few people were staring at them--maybe because of Kai’s crutches, which he had leaned against the seat beside him, standing up like two bare flag poles--or maybe it was Kai’s mask, or the fact that he was all but sleeping in the waiting room. Whatever it was, it was good for Kai to keep his eyes shut so the stares wouldn’t fuel his anxiety. Kai was used to people gaping at him--they had even when he was a young child, and Jon had no reason to expect that to have changed while they were separated--but when he was anxious, it didn’t matter that Kai normally didn’t care if people stared. It just made him worry more that they’d be witness to his breakdown.
Jon ignored the other patients and grabbed a magazine from the table beside him. It had a smiling geriatric couple on the cover, Hearing Health Today emblazoned in bold font above their heads. Text on the bottom right advertised an article about Hearing Aid Types: Which One Is Right For You? Jon knew nothing about hearing aids, so he flipped until he found the article. He skimmed it, scanning the pictures, quickly deducing this magazine was a glorified ad for a particular hearing aid manufacturer, but the information still seemed decent enough, so Jon began to read.
The magazine talked about the different types of receivers and cases, including one that fit completely inside the ear, making it nearly invisible, but all of them seemed to have downsides, including discomfort and something called “the occlusion effect” that made sounds coming from inside the person’s head--like talking or chewing--painfully loud or echoey. And all of them were designed to work best for one-on-one conversation in a quiet room.
Jon closed the magazine and surveyed the waiting room. It wasn’t loud by his standards, but if he really listened, he could hear the hum of the heating system’s fan above their heads, the numerous conversations, the phone ringing and the reception’s voice as she answered it. What would Kai’s hearing be like, even with assistance, in a place like this? Guilt swarmed him even though he knew he’d made the right decision and would do it again in a heartbeat.
Jon’s gut churned, and he felt that unease in the center of his chest almost like heartburn. Fortunately, he didn’t have long to ruminate before he heard Kai’s named called. A nurse in teal scrubs was standing in the doorway to the exam rooms. Jon glanced down at his brother, who didn’t stir. So Jon nudged Kai.
Kai startled, but not nearly as intensely as he would have without the extra medicine. He seemed a little groggy, but he blinked it away.
Jon pointed toward the door. “They’re ready for you.”
Kai nodded. He placed his hands on the armrests of the chair and pushed up to get himself in a more upright position. Then he used his hands to make sure his legs were flat on the floor. Then he grabbed his crutches, slipped them on and planted them on either side of his body at a slight angle. Kai pushed, lifting himself to his feet, leaning a little to get his left leg to lock. Kai nudged his chin toward the door to indicate Jon should go first, so Jon did, following the nurse.
“We’re going to test your hearing first,” she said.
Jon turned to see if Kai had caught that. He shook his head, so Jon interpreted.
“OK,” Kai said. His eyes were a little hooded, but he was walking fine. He was probably at the peak of the dose, and he metabolized it quickly. Jon just hoped it lasted long enough for Kai not to panic when they closed the door to the audio booth.
The nurse held the door for them, and it was proof of how mellow Kai was that he didn’t glare at her, but instead smiled--despite the mask, Jon could tell. Though Kai did flinch when the door shut behind him.
They’d been led into the audiologist’s office, which looked like a fairly typical office on one half, while the other half had the audio booth, with a window the opened onto her desk where her computer and her audio tech rested. Kai eyed the booth a little nervously, shifting his weight on his crutches.
It says in your paperwork that you prefer ASL. Is that right?” the audiologist said in sign. She was a woman about Vicky’s age, maybe a little older, with coffee-colored skin with a red tone, like wet clay, but her green eyes suggested she was part Native American and part Caucasian. She was beautiful in an exotic way, her dark hair swept up into a fancy bun Jon was certain there was a name for, but he had no idea what.
Kai nodded. Jon could see how relieved he was that he wouldn’t have to read her lips.
Have a seat. Please. Both of you.” She indicated the two chairs near the audio booth.
Jon sat and accepted one of Kai’s crutches when he handed it off. Kai then used one crutch and a hand blindly thrust behind him to begin lowering himself down. When his hand found the armrest, he used that as further support to sink the rest of the way down. Then he slipped out of his other crutch, took the one Jon was holding, and laid them against the wall between himself and the door. He reached down and unlocked his knee, then used the armrests to help settle himself back in the chair.
Kai let out a nasal breath and turned his attention to the audiologist. Some of his nervousness was seeping back, one of his hands fidgeting in his lap, albeit not as frantically as earlier.
I’m Jessica Underwood,” she said with a smile, then demonstrated her namesign, which looked a lot like the sign for “receptionist,” like an earpiece mic headset.
Kai,” Kai said, demonstrating his standard namesign, the “K” rolled out from his lips. “And this is my brother, Jon,” Kai explained, spelling Jon’s name and then demonstrating his namesign, an upside-down J drawn on the lips.
Jessica smiled. “Have you had your hearing tested before?
Kai glanced at Jon for some reason before nodding. “But it’s been a long time.
OK. No problem. How this will work is you’ll go sit in the booth--if the chair I have in there won’t work for you because of your disability, let me know and we’ll find you something else. You’ll put on the headset and we’ll do the standard chime test you’re probably familiar with. I play a tone; if you hear it, you press the button. Clear so far?
Kai nodded. Fidgeted a little more, his eyes darting between the closed door of the office and the currently open audio booth door.
Once that part of the test is done, I’m going to read some words to you, and you need to repeat them back to me.
Kai seemed uncertain. He looked at Jon again, but Jon couldn’t tell what he was trying to telepathically convey. “I can see you through the glass? I have a . . . a phobia of closed doors. Plus I have a bad memory . . .
She smiled as if she’d heard this before. “Yes. You’ll be able to see me sign to you when necessary. Of course, you won’t be able to see my lips when I’m reading off the words, because that’d spoil the test, right? But if you become overwhelmed at any point, we can stop the test and give you a break. Sound fair?
Kai let out a long breath, and his shoulders relaxed. He nodded enthusiastically.
If you don’t have any other questions for me, we can get started. I won’t close the door until I’m going to start the test. OK? Let me know if you need another chair.
Kai nodded and took a few steadying breaths. “Thanks for making me take the Xanax,” he signed, hiding it with his hand to partially prevent Jessica from seeing what he was saying.
Jon smiled and nodded. “It’s pretty small in there. Do you want me to help you so you can leave your crutches with me?
Kai swallowed. He seemed to be debating whether he wanted to do that or not. Finally, he took a deep breath and nodded. “But I’ll get myself up. I should be able to manage getting in there on my own. I might need your help standing up again, and I’d prefer to have my crutches with me. It’ll make me less nervous.
Jon nodded.
Kai stood much as he had before, and once he was on his feet, he handed his crutches to Jon one by one, making sure he had his feet firmly planted before he did so. Then he shuffled forward, lifting his right foot with effort, planting it, then leaning to that side to help drag his left leg forward. It wasn’t easy for him to cross the small distance, but he managed well enough even though Jon felt like a nervous parent watching his toddler walk for the first time. Jon knew Kai could walk without his crutches, that he did at home sometimes, but since the major MLS attack in the fall in which he’d injured his right quadriceps, walking wasn’t as easy for Kai as it had been at various times in the past.
Once Kai got within an arm’s length of the doorway, he reached out for it with both hands, using it to pull himself along the rest of the way. Jon stood to the side, still holding his brother’s crutches, giving Kai space, but nearby in case Kai needed him. Kai, of course, didn’t, at least until he got to the chair. It was a swivel model, like a computer desk chair, and although Jon couldn’t see Kai’s face, he suspected Kai was eying it warily. Kai touched it and it swung around, and Kai almost flinched backward.
Kai used the wall to help him turn around a little. “Help me? Hold the chair so it won’t move?
You sure you don’t want a different chair?
I don’t want to wait. I need to get this over with before the medicine is out of my system.
Jon nodded. It would be a tight fit for two men their size, but Jon would manage. At least he was skinny. he squeezed in beside Kai and held the chair steady, meeting Kai’s eyes to assure him that he wouldn’t let it move.
Kai took a breath. Then, using the wall and the edge of the tabletop that was mounted into it, Kai eased himself down into the chair. It sank with his weight and Jon could see the tension snap into Kai’s body, his hands pressing into the wall and gripping the table a little more intensely, but once he realized he was secure, he relaxed.
I’ll be right outside,” Jon signed once Kai looked his way. Jon made sure Kai’s crutches were in his reach and then finally backed out of the booth.
The booth was apparently fitted with some kind of light system so Jessica could get Kai’s attention visually, because the lights flickered almost as soon as Jon exited, and when he looked over, Jessica was signing through the glass to Kai, instructing him to put the headset on and reminding him how the first part of the test would go. Once Kai was apparently ready, she went over and shut the door, then returned to her station.
Jon watched as she fiddled with various sliders and buttons and things that probably regulated how high or low the pitch or frequency of a tone was while the computer kept track of what she did and whether or not Kai pressed the button when he was supposed to, or at least that’s what Jon assumed was going on. After several minutes of this, she flicked a switch and Jon could tell the lights were flashing from his vantage of the door, which had a small window in it.
Do you need me to open the door? We’ll have to close it again for the second part of the test.” Jon couldn’t see Kai’s answer, but he saw Jessica nodding and then she said, “OK. We’ll move on.” Apparently Kai just wanted to get it over with. She explained the second part of the test again. “Feel free to guess--go with your gut on the words. But if you really have no idea, you can just say ‘I don’t know.’ Got it?
Kai apparently nodded.
OK. I’m going to flash the lights again when I’m ready to start. The first couple are just for me to make sure everything’s working, that I can hear you, etc., so just relax. Oh. And make sure you take off your mask so your words aren’t muffled. You can put it back on again when we’re done.
Jessica fiddled with her equipment, this time putting on a headset of her own with a mic attached to it--ah, so that’s where she got her sign name--and she went through her test words. “Gun,” she said out loud in a clear voice.
“Gun,” Kai echoed after a moment, as if he had to think for a second before responding. Jon was surprised that he could hear Kai with the door closed.
“Road.”
Kai hesitated a fraction of a second longer this time. “Road.”
Jessica got Kai’s attention again with the lights. “OK. You’re doing great so far. I’m going to start the test, OK?
Then Jessica started going through the test. All simple three- to five-letter words, maybe fifty or so. Jon wasn’t sure. But he did notice that Kai was getting a lot more wrong than he was right. Most of his guesses were close, like when Jessica said “choose,” Kai said “shoes,” but a few, like “life” and “kill” Kai ended up admitting he had no idea.
Jon’s guilt festered, but he knew things could have been worse, and Kai could have died, so he tried to focus on the positives instead of placing blame the way Dr. Miller had directed him to.
Soon the test was over and Jessica opened the door. Jon gave Kai a few minutes, figuring he’d say something if he needed help. By the time Kai emerged, wearing his mask again, slipping on his crutches, Jessica had his audiogram and test results compiled.
She smiled. “You OK?
Kai nodded. He was a little tense, but the meds had evidently kept his anxiety under control and although their potency had likely faded, he was all right. Jon could tell even though Kai was seemingly fine.
OK. Let me take you to an exam room. The doctor will go over your results once he’s had a look at your ears. This way.” She smiled and the brothers followed her, and part of Jon hoped that the doctor would have good news for Kai.


#


The ENT’s name was Feingenbaum, and to Jon’s surprise, he not only signed to Kai, he did a full head and neck exam even though Kai was only seeing him because of his inner ear issues. However, once the exam was over, Feingenbaum brought in an interpreter--apparently his signing skills were good enough to direct Kai to open his mouth or follow his finger, or whatever the case might have been for the exam, but when it came to actually sitting down with Kai and Jon and reviewing the results of his hearing test, he needed an expert.
So the four of them were all seated--it had taken a second for the interpreter to find a chair since Kai prefered everyone was at eye level, and he needed to sit--as the doctor asked Kai and Jon a few basic history questions. How long had Kai's hearing been an issue? How frequently did he have tinnitus or balance or vertigo problems? Did he have any other symptoms? Etc., etc.
Finally, he seemed satisfied enough and settled in to give his diagnosis and prognosis. “The tests confirm that you have suffered some inner ear damage as a result of the antibiotic treatment you were given a few months ago. It’s fairly common for the effects to present themselves several weeks to months after the drug was administered.
“The good news is that your vertebral system is relatively unaffected. I would have expected you to have much more vertigo based on the particular drugs they used.”
And the bad news?” Kai asked and the interpreter interpreted.
The doctor presented a grid that Jon recognized as an audiogram, even if he didn’t know how to interpret it. It showed two lines that started at the top left and curved sharply downward to about two thirds of the way down. The two lines weren’t identical, but they were close, almost like one was the shadow of the other. “What you’re dealing with here is a bilateral mild-to-severe high frequency sensorineural hearing loss. In all likelihood, you’ve been dealing with a milder form of high frequency hearing loss for weeks, but it was only when you began dropping into the moderate to severe range that you began to really notice a problem.”
Kai was outwardly stoic, offering a nod to signal he understood and for the doctor to continue.
Dr. Feingenbaum pointed to the audiogram. “This area here,” he said, making a rough “U” shape over the top center of the page, “is the language zone, sometimes called the speech banana. Higher frequency sounds, like the ‘S,’ ‘TH,’ and ‘F,” are up here,” he said, indicating the top right. “The harsher consonant sounds are here,” he said, pointing a little farther down and to the left. Then the vowels, here, and the remaining consonants here,” he said, pointing to each in turn. “Your hearing level is this line, one for each ear. Everything above this line is out of your range, and everything below you can hear.” Feingenbaum paused a moment and drew on the paper, marking the various speech sounds he’d already pointed out to them. Then he gave Jon and Kai an opportunity to visually take it all in.
Most of the major speech sounds were above Kai’s level of hearing, and the lines cut right through all but the lowest letters. No wonder Kai had been struggling to understand speech.
“What this means in practical terms, as I’m sure you’ve realized, is that speech sounds mumbled and indistinct at best, and almost impossible to distinguish when a woman or child is talking, especially if you’re unable to see their lips.”
Jon could tell Kai was getting tense, nervous, but he refused to let it show. “Will hearing aids help?” Jon decided to ask when Kai said nothing other than letting the interpreter know he’d understood.
The doctor sighed. “The severity of Kai’s high frequency hearing loss means that he could potentially be hard to fit. Hearing aids will definitely improve his ability to hear and understand speech, but it’s possible that some of the highest sounds, including the ‘S,’ may still be inaudible, and women and children could potentially pose a problem.” Feingenbaum paused, perhaps expecting Kai to have something to say about that, but when he didn’t, he continued. “However, one of the higher-end models features some relatively new technology that could help with that. Not all patients respond to it, since the brain has to retrain itself in a way, but Kai has the advantage of his hearing loss being recent, which can help.”
“And will the hearing aids help with the vertigo and tinnitus?” Jon had these questions anyway, but he also suspected Kai would want to know the answers to them, even if he’d slipped into his withdrawn silence in an clear effort to control his emotions.
Feingenbaum nodded. “Yes. It’s one reason I recommend hearing aids in cases like this, even when the hearing loss is profound and outside the range of amplification.”
Finally, Kai asked a question, his affect surprisingly flat considering he was signing, and the interpreter mimicked it in her monotone voice. “And the hearing loss is permanent?
The doctor nodded slowly. “Theoretically it’s possible for your hearing to recover--and wearing your hearing aids regularly will help it from degrading further--but in most cases like yours, once the hearing loss has gotten this severe, it’s far more likely that the damage is permanent.”
Kai nodded, as if he’d been expecting that answer. The only thing that betrayed Kai's true reaction was the way his Adam’s apple bobbed as he swallowed, and how one of his hands dropped to his leg and seemed to grip the thigh support of his brace through his pants. Though to the casual observer, it would have looked like Kai was just adjusting the fabric of his jeans, since he didn't leave his hand there long.
“You’re really very lucky, all things considered.”
Kai, who hadn't replaced his mask after the exam, smiled, but it had an edge to it. Subtle enough that only someone who knew Kai well would have seen that smile for what it was--Kai was angry. Out loud, Kai remarked, not dropping that disturbing grin, “So I’ve been told my whole life.”


#


After getting the news, Kai sent Jon on to the hearing aid specialist while he detoured to the bathroom. He needed to be alone for a few minutes to make sure he didn’t crack. Fuck Dr. Miller and her “it’s OK to show your emotions” shit.
Even though Kai had known he’d failed his hearing test, even though he’d figured the loss was permanent, having the doctor say it, flat out, and then tell him how lucky he was? Dammit, Kai knew he was “lucky,” and yet he was the luckiest unlucky son-of-a-bitch he knew. His whole life the universe had been a sort of “Indian Giver”: he survived, but there was always a cost, almost like the universe was trying to say, “haha, just kidding,” constantly trying to destroy his life, sometimes literally and sometimes in subtler ways.
Kai’s gaze ravaged the all-purpose accessible bathroom typical of doctor’s offices, searching for something he could throw or destroy to help him release this illogical anger. He didn’t even know why he was so fucking furious. He should be grateful. Not pissed. After all, Martin was dying, and Kai was still alive thanks to Jon and the drugs that had taken his hearing. And it could have taken it all. Even if he could never hear those higher sounds, like the “S” again, he’d still be able to function in the hearing world.
“Dammit,” Kai said, beginning to shake. He slipped out of his crutches and leaned them against the wall near the sink. Then Kai glared at his reflection.
Dr. Miller insisted that the crying spells and fits of rage that would wash over him despite any logical explanation were all due to his PTSD, but Kai wasn’t so sure. Nothing about any of today was triggering him in that way. Making him anxious, yes, but Kai had learned to separate his general, panic disorder anxiety from his PTSD anxiety. Sometimes they merged, like in his writing class, and that’s when he was afraid of flashing back, but the Xanax had controlled Kai’s fear while in the audio booth, and focusing on the test--and he’d had to concentrate hard on the spoken portion--had also helped.
But the drug was apparently beginning to wear off. As much as Kai loved Xanax, his fucking fast metabolism meant that it didn’t last long, especially not at full potency. Like the Valium, it meant that he probably would have to keep increasing his dose, and though Kai had never become addicted to his muscle relaxant--it was too associated with the kind of pain he didn’t like, not to mention it could make him sick--Xanax would be far too tempting. Though right now, Kai really wished he had another half bar or more.
Kai really, really, really needed to throw something. Break something. His eyes darted to his crutches. He could throw them. But then they’d fall to the floor and he wouldn’t be able to pick them up, depending on where they fell. And though the sticks wouldn’t break--they were titanium--the cuffs were plastic and Kai didn’t want to risk it.
Kai was breathing heavily now, and he could feel his blood pulsing in his ears. Kai gripped the sink tighter, closed his eyes, and tried to meditate. I feel my anger, but my anger is just an emotion. My emotions aren’t who I am. They are part of me, but they aren’t me. I feel my heart beating fast. I feel my skin is hot. I feel the desire to break things, destroy things, including myself. I feel all these things. I acknowledge them. I let them go.
Kai spent several minutes doing this mindfulness exercise, making himself aware of his emotions and related physical feelings first, then moving on to make himself aware of his whole body. There was a technique where you tensed and relaxed all your muscles, but Kai had reluctantly tried that while in the hospital and he’d ended up spasming, so instead he just acknowledged his body, little bit by little bit, focusing on slowing his breathing, trying to calm himself down.
He began to feel heavy, relaxed, and he knew it was working, in a dim corner of his mind, but he kept going. I feel my stomach as I breathe, expanding out and then withdrawing. I feel my hips. They ache, but I let that go . . .


#


Jon checked his watch. Kai had been gone more than fifteen minutes. Even though they’d agreed this morning--again--that Jon would step back and give Kai the chance to take care of himself, that was easier said than done. Kai had been upset by what the ENT had told him. Understandably. He’d needed space. Jon had given it to him. But Kai should have been back by now.
“I’m going to go check on him,” Jon said to the hearing aid specialist.
She nodded. Maybe she was used to people reluctant to get their first hearing aids. Maybe she just sensed how nervous Jon was. Or maybe . . . Jon didn’t care. He had to go see that Kai was OK. That’s all that mattered.
Kai didn’t respond to Jon’s knocking, but it was possible he couldn’t hear it. Jon’s stomach twisted while his brain went through every possible disaster scenario, including flashes of the visual of his mother the day Kai was born, lying on the kitchen floor, her wrists and pregnant belly cut, blood everywhere. Jon knocked harder, his palm flat against the door, imagining Kai had hurt himself, or maybe he’d had some pills Jon didn’t know about and taken them, or--
“Sir, it’s occupied.” A nurse, trying to calm him down.
Jon took a breath so he wouldn’t seem like a crazy person. “My brother’s in there. He’s . . .” Jon didn’t want to say anything about Kai’s mental illness, but he had to say something. “He’s disabled and he’s been in there a long time. He’s not responding when I knock. Can we get this door open?”
The nurse went from being irritated with Jon to concerned, nodding quickly and dashing off. A moment later, a different nurse came with a key. She knocked and called out, saying she was going to open the door, even though Jon had explained Kai probably wouldn’t be able to hear her.
She got the door open, and Jon managed to convince her to let him go in first. He’d been expecting the worst, but instead he found Kai at the sink, his crutches leaned against the wall beside him, just standing there. Jon signaled to the nurses to give him a moment, and, making sure his steps were light, crept forward. He didn’t want to startle Kai. So Jon headed slightly to his left, toward the commode, hoping that Kai would see him in his peripheral vision if the mirror didn’t pick him up. But as Jon grew closer, he saw Kai’s eyes were closed. It reminded him almost of how Kai had been in the waiting room, like he was nearly asleep, though Jon knew Kai couldn’t be if he was standing. His braces did a good job of keeping him upright, but they could only do so much, even with Kai’s hands on the sink. Plus Kai’s head wasn’t drooping.
Jon had no choice but to touch Kai’s arm. He kept his distance, in case Kai lashed out, but to Jon’s surprise, Kai barely flinched in response. His eyes opened slowly and tracked to his brother. He seemed loggy. Had Kai somehow found more Xanax and taken it? Or something else?
“I’m fine,” Kai said, his eyelids still a little heavy. “I was meditating.”
Jon let out a long breath, felt some of the tension leave his body. “I was worried. You’ve been in here twenty minutes.
Kai took a slow breath and smiled faintly. “I’m sorry.
Jon couldn’t resist grabbing his brother and enveloping him in a tight hug. He tried to internalize the fact that Kai could take care of himself and that his brother was OK.
Kai patted Jon’s back, clearly surprised, and pushed him away. “I’m fine,” Kai said again. “Really. I’m sorry I worried you.”
Jon couldn’t explain his irrational fear, not to Kai, not without telling him more of the truth of how he’d come into the world, so Jon just nodded. “I know I need to trust you. Worrying is just so engrained--”
“You don’t need to explain yourself,” Kai said. He smiled. It was tired, but didn’t seem fake. “Let’s go get my hearing aids.


#


Kai had been impressed with how many people in this practice signed, but the hearing aid lady apparently didn’t, or at least she didn’t sign well enough that she trusted herself to explain the complexities of the various options, or maybe she preferred to stick to English for Jon’s sake. Whatever the case, the interpreter who had taken over for the doctor was in place again, sitting beside the hearing aid lady--she had a name, but Kai preferred to think of her that way--with Jon and Kai sitting across from them.
She’d laid out a bunch of different hearing aids, from the smallest to the largest, some of which had a case that rested over the ear and some which looked like they fit entirely inside the canal. Somehow, seeing them all laid out made everything more real, and Kai’s stomach churned uneasily. Maybe he should have made himself throw up, unhealthy or not. He swallowed down bile and tried to keep his discomfort from showing on his face. He also tried to ignore how his heart was beginning to pick up in his chest, that faint buzz in his arms that meant the Xanax was continuing to wear off, and if he wasn’t careful, he’d panic. Deep breaths, Kai.
The hearing aid lady began to talk, introducing the different hearing aid options, and although Kai was polite enough to the interpreter, he wasn’t fully paying attention. He was half groggy and half wired, in that weird place past the peak of his Xanax dose when it hadn’t worn off enough but had also worn off too much, and he was trying not to fidget, trying to focus. And most importantly, trying not to dwell on what all of this meant for him, for his future, for school, for his relationship with Renee.
The hearing aid lady didn’t really get Kai’s attention until she set half of the hearing aids aside, almost dividing the row in half, and focusing on the smaller ones, which had a very tiny earpiece that linked to a small or miniscule case via a clear wire. He pointed to them.
What’s the difference between these and those?
The look on the hearing aid lady’s face suggested she’d just explained that difference, but she smiled a patient smile and launched into a fresh explanation. This time, Kai carefully watched the interpreter so he wouldn’t miss anything. “These over here,” the woman explained, indicating the larger models, “are generally used for more severe hearing loss than what you’re dealing with.” She held up one, waiting for the interpreter to finish so Kai could look at it with more than just his peripheral vision. “See how this earpiece fills the entire ear?” She demonstrated on a model that was essentially just an ear and part of a head that she obviously used for demonstrative purposes. “Some of these models are cheaper, but for someone like you, you may find them very uncomfortable. Not just physically, because the fit has to be just right since they’re molded to your ear canal, but also because you’ll experience what’s called the ‘occlusion effect.’”
Kai’s nose twitched as he watched the interpreter’s fingerspelling and visual explanation of the English term. “So with those, it’ll block some of the sounds I can hear?
The hearing aid lady nodded. “You don’t have issues with lower frequencies, so a earpiece like this will block your ability to hear those sounds on your own. Additionally, it’ll mean that your own voice, or any other sounds coming from inside your head, like chewing, coughing, etc., will be echoed. Many users find this very annoying, and some even stop using their hearing aids because of it.
Kai frowned, but then he nodded to signal he’d understood.
She held up a tiny hearing aid that didn’t have a case. “Some users prefer this model, or one like it, because it fits entirely in the ear, thus making it nearly invisible.” Again, she demonstrated on the model. “But for you, with your type of hearing loss, I’d recommend one of these.” She indicated the other half of the line, the ones with the miniscule earpieces and small cases.
Kai stretched a finger toward them, his instinct to touch taking hold before he forced his hand back.
“It’s OK. These are non-working demos. You can touch them if you’d like.”
Kai looked to Jon before he gave in and picked them up, one by one. He’d been around Deaf people his whole life, many of whom used some kind of hearing aid, but he couldn’t recall seeing anything like these.
As if reading his mind, she explained, “These are called open-canal, or OC, models, because the earpiece doesn’t completely fill the ear canal.” She put one on the model, using one of the smallest examples, which was so inconspicuous it nearly disappeared. The case in this demo was red to help it be seen, but Kai could see how a flesh- or hair-colored case could make the whole thing nearly invisible. “The benefit of these are you can still utilize your natural hearing for lower frequencies, and it’ll prevent the occlusion effect we spoke of earlier. Additionally, you get the cosmetic benefit of the in-the-ear model,” she said, holding up the one she’d demonstrated earlier, which had no case, “plus the over-the-ear, or OTE, case, which helps reduce feedback.”
Kai’s brows furrowed. “Feedback?
“If the receiver and microphone are too close, you can get some noise, or feedback, as a result. Like whistling, scratching, etc. It’s a problem with the complete ITE models, but it’s unfortunately an issue with all hearing aids. It can be another reason people stop using their hearing aids, because it can be distracting at least and painful at worst.”
Kai frowned as he took this all in. “So these are better because the receiver--in the case--is farther from the microphone, which is here?” Kai said, pointing to the earpiece of one of the models he’d been playing with. It was so freaking tiny, it got lost in his huge hand.
She nodded. “Also, the more expensive models have better microphone position to prevent feedback when high frequency sound is amplified, which is unfortunately where a lot of the feedback occurs. And in your case, you need a lot of amplification of those sounds, which means a higher likelihood of feedback.”
Kai’s nose twitched as he took this all in. “So which of these would you recommend for me?
“All of these are a decent options based on your level of hearing loss. These are called thin-tube, BTE, OC hearing aids, by the way--behind-the-ear, open-canal--” and she said it like she’d explained that already but wanted to make it clear again for his sake. Kai actually had a feeling he’d missed a lot despite how intently he was trying to focus. “But these here are the top of the line when it comes to comfort, size, and microphone technology,” she said, indicating a couple models in particular that were definitely smaller than the rest. “These are likely to have the least problems with feedback and will work best in a noisy environment, or if you’re far away from the speaker. However, keep in mind that two to four feet, directly in front of the speaker, in a quiet room is still going to be the optimum listening environment for any hearing aid.”
Kai pointed to the last one in the row. Its case was still tiny, but a little larger than the ones immediately beside it. “And what about that one?
“This is actually the one Dr. Feingenbaum recommends for you, if money isn’t an object. It’s only been on the market a couple years, but it has a special technology called Frequency Lowering Enhancement that in some people with severe or profound high-frequency hearing loss, can help you hear sounds that might otherwise be out of your range, even with a traditional hearing aid.”
Kai couldn’t resist touching it, even though he knew it was silly; rubbing his fingers over the contours of the case wouldn’t give him any indication of how he’d hear with it.
“Can you explain?” Jon asked.
“When the high frequency hearing loss gets too severe, it’s impossible for the ear to hear those sounds, even if we make them louder with a hearing aid. So the individual loses the ability to hear some of the most important speech sounds in English, including the ‘S,’ which makes hearing plurals and tense impossible. However, with FLE, the hearing aid is able to sense these high frequency sounds and drop them 1000 or more Hertz into a range in which the patient can hear, enabling speech to be more comprehensible.”
Kai wasn’t entirely sure he understood what that meant. “So with any of these other models, there’s a good chance I won’t hear much better than I do now, right?” Hadn’t Feingenbaum warned him about that?
“You will hear better, because the midrange sounds will be amplified. But you’ll still find yourself missing parts of words and struggling to understand most children and women, especially if you’re not in a one-on-one situation. You’ll likely wish to face the speaker so you can read their lips to confirm what you’re hearing, and you’ll probably still prefer ASL, especially in noisy environments or in groups.”
Kai let some of this sink in. “But with this, I’ll hear like before?” he asked, holding up the FLE model, even though he knew his life would never be the same, fancy hearing aid or not.
She shook her head. “No. Unfortunately, no hearing aid technology is equivalent to natural hearing. And these have a bit of a learning curve. Because they lower high frequency sounds, speech can sound slightly slurred, or like people are speaking with a lisp, especially those with higher voices like women and children. However, because your hearing loss is fairly recent, your brain should adjust, perhaps in as little as two weeks--and you may find your hearing to be as close to as it was before as is possible, especially in quieter situations. It’s why Dr. Feingenbaum recommends it for you.”
Kai frowned. Tried not to let the depression take hold, took a breath, and focused on the positive. He hadn’t lost his hearing entirely. He hadn’t died. Renee loved him. Jon loved him. David loved him. And he already was fluent in ASL, so he’d always have that to fall back on. “How long would it take me to get any of these?
“These I can fit you with and have you out the door today,” she said, indicating the BTE OC models. “The ITE ones I will make the mold, but you’ll have to come back for fitting and adjustments.”
Kai glanced at Jon, his eyes and eyebrows a question. After all, it was Jon’s money.
“How much does insurance pay and how much would we need to pay out of pocket?”
“I took the liberty of working that out while I was waiting,” she said, being extremely polite about how Kai spent more than twenty minutes in the bathroom. She slid a sheet of paper toward them.
Kai flipped it open and his eyes bugged out when he saw some of the out-of-pocket costs, especially for that fancy frequency adjusting model, and he knew what his braces, crutches, and wheelchair cost. He cast a look Jon’s way, but Jon ignored him.
“We’ll take the best model.”
Kai had never liked anyone speaking for him unless he gave them permission to, and he growled, grabbing Jon’s arm, using his voice for the first time. “Can you give me a moment to talk to my brother?”
The hearing aid lady must have been on some good drugs, because she hardly seemed fazed. “Do you need the interpreter?”
Kai shook his head. “We’ll manage. Thanks.”
She nodded, and she and the interpreter stepped out of the room for a minute.
Kai barely waited for them to go before the signs were flying off his hands. “Are you crazy? There’s no way I’m letting you spend that kind of money. I can live with one of the cheaper models.
Jon blinked as if it was taking him a moment to process Kai’s rapid, emotional signing. “Let me do this for you. It’s my fault you need hearing aids.
Kai rolled his eyes. “It’s not your fault I got sick.
It’s my fault you lost your hearing.
Most of Kai’s anger subsided. “You’re responsible for my being alive. The medicine is to blame for my hearing loss. Stop doing this to yourself.
Jon sighed. “You’ll use your hearing aids every day, all day. You deserve the best. I don’t want you not to use them because of feedback or because you can’t hear well with them. I don’t want you to struggle in school because you can’t hear. I want you to have options. Situations like this is why I took the money I could from my own trust and made one for you. You may have had to ‘make do’ in the past, but you don’t have to anymore.
Kai was still reluctant. Jon had given him so much over the past four years, and Kai felt like accepting his brother’s help here again, even if the money was “his,” was a blow to his bid for independence. But Jon was right. And it would be a lot harder to be “independent” if he had shitty hearing aids he didn’t even use. And hadn’t the ENT emphasized that if Kai didn’t use his hearing aids regularly, his hearing loss could worsen? Maybe to the point at which Kai couldn’t hear speech at all?
Fine,” Kai said. “Fine. OK. The best.
Jon smiled, though the guilt was still heavy in his eyes.
“Jon,” Kai said, switching to English. “This isn’t your fault. OK? I don’t blame you, and you shouldn’t either. Don’t make me kick your ass. You know I can.”
That made the shade of a smile appear on his brother’s face. “Not my fault. Not my fault. Not my fault,” he repeated, as if it were a mantra, and maybe it was. Just like Dr. Miller had given Kai the “my feelings are real” schtick to repeat, maybe she’d told Jon to do the same to try to assuage his chronic, debilitating guilt.

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Continue to February 6, 2001 - Part III ------->

5 comments:

  1. It always amazes me how thoroughly you make your research. One could learn so much about hearing loss and aids in this chapter! And you presented it in a much more fun way than reading about it in Wikipedia!! :)
    I'm still feeling for Kai because he has lost so much. Also, I wouldn't want to be in Jon's shoes because the guilt in this situation is inevitable although technically he can't be blamed for Kai's hearing loss.
    Thank you and looking forward to the next chapter!

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  2. Thanks. Wonderful and informative as always.

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  3. Great episode! Can't believe we have one more before your break.

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  4. What a fascinating chapter, and what a wonderful last scene!

    -Clair D

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  5. Very very enjoyable. This episode seemed to be about 'communication' on so many levels.

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