April 14, 2011

Being Deaf Is Not a Medical Issue?

Don Grushkin left a comment under this article discussing how skin bleaching in Jamaica parallels cochlear implantation.

He said:

Being Deaf is NOT a medical issue, either. It is NOT a life-threatening condition. Therefore, cochlear implant surgery is "cosmetic" -- only to attempt to "enhance" quality of life (and I am not debating here whether that "enhancement" actually happens or not).

Interesting. In some ways I agree with the notion that my hearing aid enhances the quality of my life. I cannot deny that it does. However, I mainly see hearing aids and cochlear implants as medical devices, not cosmetic.

Being deaf or hard of hearing is a medical issue in my opinion. 

If I did not have my hearing aid, surely I would not die or become gravely ill. However, I may not be able to perform many of my job's duties which involves interacting with a variety of people in different settings. My hearing aid helps me hear the other person speak more clearly when I am in a noisy environment or if I am in a room where other people are talking. Somehow its tiny microphone will move on its own towards the speaker's voice, which helps tremendously.

Without my hearing aid, I would have to ask for more accommodations and would have to struggle more as I try to understand what is being said.

Without my hearing aid, I cannot for the life of me understand what children are saying. With my hearing aid I can understand what they are saying with their tiny voices somewhat, not 100%, but it is better than nothing.

If I did not have my hearing aid, I don't think I would want to continue working where I work now. I probably would not be able to perform my job as well. 

It is a medical issue because my hearing loss keeps me from performing certain basic job duties that involve listening that many people take for granted.

It is a disability. It is lacking a sensory that typically developing humans are supposed to have. That is the reality, at least in this world.

Even if the entire world was fully equipped for all of us who are deaf or hard of hearing (everyone understands and uses sign language, every movie theater includes movies with captioning or subtitles, hearing aids and cochlear implants will always be fully insured, etc.), it is still a medical issue.

If you believe that being deaf or hard of hearing is not a medical issue, you would probably agree that missing a limb or two is not a medical issue. They are not dying or gravely ill. It is not a life threatening issue. You would describe their prosthetic leg or arm as cosmetic in that they only enhance their quality of life. You might as well consider wheelchairs cosmetic too.

And you might as well say that sign language interpreters are cosmetic, not medically necessary, which I am sure some of you may want to view this service as cosmetic anyway, to take the focus off of deafness being a disability.

You have to understand that some people did not ask to lose their hearing later in life. Some lost it due to an illness or a traumatic injury. They should have every right to view deafness as a medical issue.You cannot expect most of them to accept or understand the concept of deaf culture or viewing deafness as a way of life. If they want to get a cochlear implant or use hearing aids to help, it would be hard to view them doing this just so they can enhance the quality of their lives. I see it more as them attempting to recover from the trauma they experienced in losing their hearing.

To say that cochlear implants and hearing aids are cosmetic devices is a slap in the face for those who depend on them. It makes me mad because most of us have been fighting to get insurance companies to stop viewing them as cosmetic and understand that for those who depend on them, they are medical necessities!

For those of you who do not view deafness as a medical issue, good for you. That is wonderful that you can fully accept being deaf and hard of hearing and get by without any need for hearing aids, cochlear implants, or using speech. That is great (and I am not being sarcastic here). But, for those who view being deaf or hard of hearing as more of a culture or ethnicity, don't expect thousands and thousands of other deaf and hard of hearing people, who may have acquired their hearing loss differently from you or live a different lifestyle from you, to agree with you.

I think it would be great if I felt I did not need my hearing aid. But, in my opinion, I feel that I do. In fact I know that I do. I don't want a hearing aid, I NEED it.



  1. Well said!

  2. Unfortunately, Dr. Grushkin focus on the capital D as Deaf, who were prelingual as well as "born" deaf along as being an ASL User. That is my understanding that is his primary focus. He is not focusing on people, who have lost their hearing at a later age in adult, but I am not sure about kids, who lost their hearing due to ototoxic drugs, viral/bacterial infections, traumatic injury as you mentioned, and other related ear/brain "injury" issues. Even kids and adults with Diabetes, they lose their hearing as their disease progress. For those people, which I do agree with you, need their mechanical devices to hear rather than cosmetic because they are used to hearing things for quite some time and does have a devastating effect on their lives. Again, I agreed and Dr. Grushkin does not focus on those issues except for the beginning comments I made in regards of (D)eaf. The blog was well written. I appreciated it.


  3. Good point about medical necessity vs. cosmetic device!

    "And you might as well say that sign language interpreters are cosmetic, not medically necessary, which I am sure some of you may want view this service as cosmetic anyway, to take the focus off of deafness being a disability."

    Right, the ADA Act doesn't cover "cosmetic" accommodations. ;)


  4. LOL

    I hadn't seen his comment over there, but it's interesting how Dr. Don Gushkin would say that the hearing devices are cosmetic after I had said that bleaching was cosmetic.

    He knows better, really. From what I understand, he used to wear a hearing aid and because he wants so much to be part of the deaf culture, he has decided not to wear them and have decided not to use his voice (except when he is at home with his family).

    Cosmetic? Really? I don't decorate my hearing aid. Although there are those that do. But, these hearing devices - HA or CI are meant to help people hear. They're not cosmetic. If I could do away with wearing them, I'd do it in a sec - only and only if I can hear normally.


  5. It's about values...a person who has previously heard or has partial hearing will value it highly and feel its loss more keenly, so that they actively seek treatment. At present the treatment is medical and/or involves physical contact in fitting and implementation.

    For the Deaf person, the value is on other things and hearing is not missed or useful. This is why many Deaf ditch hearing aids or take off external CI processors. With other things valued higher than maintaining devices or keeping appointments with professionals, it would be an annoyance to attend to something that is not useful enough to be worth the time.

  6. Dianrez..

    I don't know where you have been but, I still meet many "deaf" people who wear hearing aids and who still wear CIs. I also am aware of peer pressure by certain deaf people who pressure their friends to ditch hearing aids and CIs on the basis of it not being part of deaf culture. Truth is hearing aids and CI are a big part of deaf culture just as much as deaf peddlers are.

    I think deaf folks need to stop with that pressure. Let people be themselves. Let it be. Deaf culture will be stronger as a result, evolved but stronger.


  7. Let me emphasize something. Keep in mind I do not use d/D. But, for the sake of argument, I am referring to the big D's when I said "I still meet many deaf people who wear hearing aids and who still wear CIs." Yes, they all are big "D"s. Yup. Your point about value of D and d are different. I don't think so. There are way too many Deaf still value hearing aids. Way too many. I should know.


  8. Candy, of course there are Deaf who use CIs and hearing aids, and at least in my experience, there is NO pressure on them to ditch them. Those who find them useful aren't going to "drawer" them, anyway, and those who don't, DO stop using them at the first sign they are more hassle than useful.

    How do I know this? I did evaluations including asking questions about devices used (in case they need VR assistance with maintenance or expenses) and if they no longer use them, I ask why.

    This is what they tell me. Generally, as people become older and residual hearing declines, more do ditch the aids. Perhaps it is a function of greater priorities in life as well. Certainly it involves increasing expenses.

    No one has told me that it was because of peer pressure; more have told me that it was because of parents or teachers that they continued to wear them until the time they ditch them.

    Those that still found them useful would be referred to audiologists for check-ups, tune-ups and possible upgrade to newer devices and/or batteries, depending on their rehabilitation plan. Perhaps a dozen or two dozen per year got this referral; most (my caseload was about 300 per year, all ages) turn it down.

  9. Dianrez..

    I'm not the only one witnessing peer pressure by those who have CI and are involved in deaf culture. It is not more of people with mob mentality. It is more of EXPERIENCE one had with Deaf folks and as a result, because of that horrible experience, those with CI have resorted to taking them off when they are in a deaf event where deaf cultured people congregate.


    Guy very involved in deaf culture also wears CI, he shows up with CI left in car. When finish with event, he puts it back on.

    There was no confrontation on him wearing CI that day. Why did he take it off? Because he had several experience in past. He does not want to go through it again.

    I'm talking about deaf adults who LOVE their CI. Why do they take it off when they go to deaf events? But they do not ditch them completely. As for hearing aids, lets face it - hearing aids don't work well for some who will not benefit from it. CI is different, if they had gotten AV training and it was successful to a point where they can understand what other people are saying - they most likely will not ditch it.

    There are many deaf who ditch hearing aids, yes. Many shouldn't even got them in the first place unless there is guarantee that it will work with proper training. For many, they only hear environmental sounds or hardly anything at all.

    With your experience as DVR counselor, have you met any successful CI wearer within the last five years?


  10. Our experience will be different due to our different roles and experiences in the Deaf Community. In this city, I see CI wearers at many Deaf events, some are my friends. Perhaps in this locale it is less of an issue than in yours.

  11. Dianrez, unfo there are some negative peer pressure against Deaf people wearing CIs. A friend of mine doesn't wear her c.i. when she goes to Gallaudet. She isn't the only one. Someone else reported the same thing last week.

    I was sorry to hear that. During my coverage of UfG, two of my regular readers were Gallaudet students and they wore c.i.s during that time. I don't know what had happened since then.


  12. The technology in Hearing Aids has advanced considerably over the past few years, just imagine what they will look like and do in the future. Hopefully everyone in the future will be able to hear.

  13. Although hearing isn't as vital to life as breathing, it does improve the quality of life (which is more than I can say for cosmetic procedures). I know for a fact that if everyone could hear properly, all medical billing specialists would be happy!


Keep it civil.