The following article is written by Local 30-73 member and former
Minnesota Orchestra Principal Cellist Janet Horvath.
Reprinted with permission
It’s 2011, and my husband can’t kiss me, even on the cheek, because the slightest touch sets off ripples of pain in my head, my face, my jaw. Every noise is an assaulta car alarm goes off, a baby squeals, a group of giggling teens race into the elevator. The ping of an ATM machine. Cicadas chirping. The roar of a leaf blower feels like a knife rotating in my ear. In sympathy, my husband and son tiptoe around me and recoil with each ding. When I must go out, I stuff my ears with custom earplugs and wear Bose noise-cancelling headphones, but they don’t help much. It is impossible to predict when noise will bring me to my knees.
I am a professional musician who can’t tolerate sound.
I should have recognized that my career was over that night. It was August 2006, an evening of Broadway favorites, and I was sitting dead center in my spot as principal cello for the Minnesota Orchestra, with the drum set, piano, electric guitars, keyboard, and conductor directly in front of me. Vocalists, three Broadway singers wearing brilliantly colored sequined outfits, pranced across the stage clutching their hand-held microphones, while speakers blasted the music back onto the stage toward us so the singers could hear themselves. During a typical non-classical performance, the stage would hold three of these speakersbut tonight there were eight, one of them no more than two feet from my left ear.
There was no time to move the speaker, the stage manager told me, so I stuffed my ears with musician’s earplugs and swallowed my objections that it was too close. I’d be a bit shell-shocked, I assumed, but nothing more than a temporary annoyance.
After an encore from The Phantom of the Opera, the program came to a close with thunderous applause. As I exited the stage, I suddenly felt an excruciating sensation in my ears, which radiated down my neck and into my face, neck, tongue, teeth, and jaw. Pain hardly describes it. Meanwhile, the fluttering sensation in my head was making me feel faint.
I hurried out of the building to escape the backstage commotionevery noise, I quickly discovered, was making it worse, including the sound of my own voiceand I hurried out of the building to escape the backstage commotionevery noise, I quickly discovered, was making it worse, including the sound of my own voiceand drove home, barely able to see through my tears. Sleepless, I lay in bed praying the pain would simply subside overnight. The next morning, I showed up for work, a three-hour dress rehearsal of the opera Carmen, pretending all was well. I had spent hours preparing the cello parts for the entire section and perfecting my solos. But the voices of the singers, usually thrilling, was ear piercing. I had to wear earplugs for a classical program for the first time in my long career, too worried that my playing was off to actually focus on the music. I had loved the cello, the instrument whose sound is closest to the human voice, since I began playing at age 16but now, with the world’s volume stuck on high, all I could think about was escaping to silence.
Over the next few weeks, I saw otolaryngologists and neurologists, heading from one appointment to another in a flurry of anxiety. The ENT exams, neurological assessments, and MRIs revealed no abnormalitiesin fact, my hearing tests came back better than normal. I could actually be a spy, I heard so acutely. The specialists recommended psychiatric tests. Perhaps meditation, relaxation exercises, or therapy would help, they told me.
No TV, no radio, no telephoneand worst of all, no music.
Finally, one of my many doctors offered me a diagnosis: I had sustained an acoustic-shock injury to my left ear. Ear trauma is permanent, with no real treatment. The best I could do was load up on vitamins, abstain from caffeine and alcohol, and keep my life as silent as possible to see if the pain subsided.
I spent the next three months in near-solitary confinement. I avoided social situations. All communication was restricted to email and texts. No TV, no radio, no telephoneand worst of all, no music. Cut off from life outside my home, isolated from human contact and from the thing I loved most, the monotony became nearly intolerable.
The silent exile seemed to help, though. I returned to my position, with a major compromise: I would always have to wear a left earplug, and for the time being I would be excused from performing in any amplified programs. Soon enough, my brain and my life adapted themselves to this new normal. My playing hadn’t deteriorated, but as a precaution I kept all noisy activities at bay, even avoiding the car radio. At home, my husband did the vacuuming and the dishes as quietly as possible. My son kept his friends out of the house when I was home. We all stayed away from the television.
But beneath it all ran an undercurrent of worry: What kind of a musician was I now? Would I be able to maintain a high level of playing if I couldn’t even hear myself fully because of the earplugs? And most worrying of all, what if it got worse, to the point where I had to leave music entirely?
In 2009, the worst-case scenario arrived: My right ear, like my left, could no longer tolerate normal activities. The orchestra had scheduled several massive works for the upcoming year, and walking into the orchestra hall for rehearsal without earplugs became intolerable.
After a second months-long round of doctor-hopping, I finally met an ENT who seemed to understand my condition. I had developed a noise-induced ailment called hyperacusis, he told me, an auditory injury caused by repeated exposure to high decibels or a single acoustic shock. It was characterized by abnormal sensitivityin other words, the total breakdown of tolerance to all sound.
As the doctor ran through his explanation, my first reaction was one of relief. So, I thought, I’m not going crazy after all. The severe pain, the dizziness, the fear of sound, all were caused by my brain processing noise as much louder than it actually is.
I left a note with my goodbyes and promptly sunk into depression.
I had decades of hearing ahead of me, the doctor told me gently, but prolonged exposure would only make things worse. It would be best if I left my job and did something else, something quiet.
Right away, I knew I wouldn’t listen. Giving up a 34-year career was unthinkable; playing cello was at the core of my identity. And besides, that summer, the orchestra was set to embark on a three-week tour of Europe’s most prestigious concert hallsLondon, Berlin, Amsterdam, Vienna. I couldn’t miss that. Surely I would be able to hang on at least a few more months.
But the programs on the tour included Beethoven’s Symphony No. 9, with its famous Ode to Joy, which calls for massive forces onstagea 250-voice chorus, vocal soloists, and more than a hundred orchestra members. I writhed through the\ concerts; in between, I hid in hotel rooms. The worst pain came during one of the last performances, which took place in London’s Royal Albert Hall in front of more than 5,000 audience members. Weeping afterwards in the recesses of the dressing room backstage, I knew I was done.
When we returned to the U.S., I made an appointment with the maestro and the upper management of the Minnesota Orchestra and resigned my position of 31 years as associate-principal cello. Unable to face my colleagues, I left them a note with my goodbyes, returned to my cloistered existence, and promptly sunk into a deep depression.
For months, getting out of bed was a feat of willpower. Taunted by a closet full of elegant black clothing, the uniform of orchestra members, I donated it all to Goodwill. My cello sat unused in its case, a reminder of what I’d lost. My normally animated personality changed as I became subdued and soft-spoken. I spent a lot of time wondering how athletes deal with careerending injuries, about how they rebuild their lives after being carried off the field for the last time on a stretcher. My own sense of identity crumbled. It was excruciating that what I loved so much could bring me so much pain.
The ear has 20,000-30,000 hair cells, the nerve endings responsible for carrying the electrical impulses through the auditory nerve to the brain. These delicate receptors bend or flatten as sounds enter the ear, typically springing back to normal in a few hours, or overnight. But over time, loud sounds can cause more permanent damage as hair cells lose their resilience. Frequent and intense exposure to noise will cause these receptors to flatten down, stiffen, and eventually break. The damage can interfere with the ability to determine the location of a sound, cause extreme sensitivity and pain, and make it impossible to discern language with background noise. One in 20 Americans, or 48 million people, report some degree of hearing impairment.
An alarming statistic, but hearing protection isn’t a health habit that’s often discussed. The National Institute for Occupational Safety and Health (NIOSH) and the Centers for Disease Control cap the continuous exposure to decibel levels at 85 decibels (dB) for an eight-hour day. Decibels work logarithmically: Permissible exposure times must be halved for each increase of three decibels. Any exposure above 115 decibels, even for a few seconds, is risky. But life is noisycity traffic can reach 85 dB, restaurant racket exceeds 100 dB. In crowded spaces like a stadium or an orchestra performance space, the sound can hit around 120 dBand the exposure time and the proximity to the sound exponentially compound the risk of damage.
But still, people willfully jeopardize their hearing every day. Sound exposure is cumulative, creeping up on those who listen to music or cellphone conversations with ear buds for hours at a time or multiple times a day. According to the American Medical Association, one in five teens now suffers from hearing damage and cannot hear whispers, raindrops, or consonants. Noise, not aging, is the leading cause of permanent hearing injury in the U.S.and even a small amount of hearing loss can have a profound, negative effect on comprehension and social development. Untreated, hearing impairment can affect brain function and is associated with early-onset dementia.
The doctors didn’t know what else to tell meresearch about my condition was scarce, and it seemed there was nothing more I could do. But still, my husband researched tenaciously for months, until finally, late one night, he stumbled upon a clinic that specializes in hyperacusis and tinnitus, at the Oregon Health and Sciences University in Portland. It would be three months before they could fit me in.
When the time came to make the trip, I boarded the airplane with the heaviest-duty earplugs I could find. In a tiny examining room at the clinic, my ears convulsed every time they were touched. After two days of 12-hour appointments filled with tests and exams from multiple specialists, the clinic staff fit me with modified hearing aids that I could control with a remote. The specially programmed devices, I was told, would lower the volume of sound without altering its clarity.
The final step was to test them. The doctor banged on a glass dish with a spoon, and I recoiled in anticipation before he even made a soundbut it didn’t hurt. We ventured out to the common areas of the hospital, even passing by the noisy cafe. No pain. A woman wearing high-heeled shoes clattered by. Nothing.
With the protection of my new hearing devices, they told me, I could embark on the next phase of treatmenta desensitization strategy to teach my brain to accept sound again. I would need to learn to tune out the noise around me. In other words, I’d need to un-learn my musician’s ability to pay close attention to sound. The specialists gave me an armload of CDs of ambient noiserainfall, wind blowing, ocean wavesthat I was to play several hours a day for the next few months, as low-volume background noise to all my normal daily activities. I should take it slow, perhaps a year or more, they warned me, gradually increasing the volume, and eventually my tolerance might start to improvebut because it was already so low, they added, it was unlikely that it would ever return to normal levels.
Then I asked the question I’d been steeling myself to ask since I arrived: What about music?
The answer that came back was crushing and hopeful at the same time. I would never be an orchestral musician again, they saidbut while the retraining program couldn’t guarantee success, it was possible that in time, I might improve enough to someday play the cello.
This time, I became a perfect, zealous patient.
Months later, I was able to tolerate moderate levels of sound. With my hearing devices in, my husband and I could once again go to quiet romantic films, dine in restaurants if we avoided the weekend crowds, and invite a small group of friends over. But my fingers itched to play. Two years after my trip to the Oregon clinic, gingerly at first and with the left earplug in, I started to play the cello again, but it no longer came as easily as it once had. My muscles ached, my fingers chafed against the slender metal strings. I sounded like a complete beginner. Almost a decade after my trip to Oregon, I can comfortably play with three or four other musicians in a modest-sized room. It’s not an orchestra, but it’s enough. Life is unthinkable without music.