Aug 2020 The BMJ
Life throughout the pandemic has been one of cancelled plans and changing roles. As a neurology trainee, I was redeployed to a general medical ward, caring for older patients. The long days, changing guidance on personal protective equipment, difficulty containing the virus, and liaising remotely with relatives over complicated discharge arrangements was exhausting.
But I had an additional burden. I am profoundly deaf and have been since birth. Even with a high-power hearing aid I rely on lipreading which became impossible with masks, isolating me from my colleagues and more so my patients as many were themselves hard of hearing. End of life conversations do not lend themselves well to being shouted through a mask or written down on bits of hospital paper. I had more to worry about. I feared for the loss of my livelihood and childhood ambition to be a doctor. I have spent twenty years in medical training and now it seemed that my deafness was going to jeopardise this.
Then in early June I was offered a cochlear implant. Having been on the waiting list for months and the operation postponed due to covid, suddenly I was offered a lifeline. New guidelines meant that I had to self-isolate for 14 days prior to surgery. I felt a fraud, sitting alone in my flat. I was not physically unable to go to work, only prevented from doing so by this plague. I used the time to write, read ahead of a forthcoming consultant interview, and dial into a plethora of webinars—an unexpected bonus of the lockdown.
The surgery went well, but communicating with mask-wearing staff was a challenge. Some took the time to write things down, or stand at a distance without a mask, so I could lipread. Being included in conversations mattered so much to me. After a week of convalescing I returned to the hospital for a follow up appointment. Unfortunately, a repeat scan showed that the electrodes had migrated, and another operation was needed. The surgeons were disappointed. I was devastated. I began to question whether proceeding with the implant in the first place had been the right decision after all. I tried to appear a calm, professional doctor and yet felt like an anxious, needy patient. The prospect of a further period of self-isolation and more surgery just seemed too much. But I felt I had no choice. A future with no meaningful sound, and the loss of my career, or the chance of hearing the world around me, in a fullness and beauty that I have only ever been able to imagine.
My second operation, three weeks later, meant a further period of shielding, in silence. I rearranged bookshelves, sorted photos, finished academic papers and started new ones. I returned to the familiar comfort of reading. Even as a small child, I loved picture books. They gave me a world in which I could piece a story together; a space in which I spent hours in peace and comfort, even though I had no communication with the adults around me.
It will be several weeks before the implant is switched on, and even more before my brain learns to transcribe a series of electronic signals into useful sound. I am living in silence, save for the constant ringing in one ear, which has been present for years. I have learned to make my peace with this tinnitus. Still, there are nights when I am woken by it, and believe that the sound of a fire alarm is real, and that I must escape. It is invariably worse when I am stressed or anxious. Juxtaposed with this are musical hallucinations; a repeating motif of Beethoven’s moonlight sonata. The irony that the only pleasant thing I can now “hear” is the music of a deaf composer is not lost on me.
My experiences as a doctor at the start of lockdown, and as a patient at the end of it, could not be more different. As a doctor, I have learned much about coronavirus and its impact on older patients. Yet, it is the profound isolation, silence, and disappointments of patienthood that have been the hardest lessons to learn and the ones that will remain with me long after this pandemic is gone.
Helen Grote is a neurology registrar at Chelsea and Westminster Healthcare Hospital.