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The Sound of Spoken Language

Oscar Statue
"Academy Award Winner" by Dave B. is licensed under CC BY 2.0

April 30, 2021

The award-winning film “Sound of Metal” portrays a musician in recovery from substance use disorder who is confronted with sudden, complete hearing loss. The experience shatters his life. Lauded by some with hearing loss for its realistic depiction of this experience—the fear, the frustration, the uncertainty—the film’s creative use of sound earned it an Academy Award.

As a former audiologist and practicing ear surgeon and physician, I have worked with countless individuals who have been challenged by the life-altering loss of hearing as an adult. To have this state of sudden and complete hearing loss portrayed so movingly on film is a great contribution, worthy of accolades and awards.

In an ideal world, a presentation of sudden bilateral hearing loss (in both ears)—which is quite rare and not typically associated with exposure to this level of noise—would be followed by a prompt and thorough medical evaluation to determine if the hearing loss is treatable, and a full discussion of potential treatments and/or rehabilitation. While integration into the Deaf community, with use of sign language as the major mode of communication, is an option in this setting, such a path is rarely taken by those with sudden, adult-onset hearing loss. The depiction of the role that addiction recovery plays in the main character’s decision to initially pursue this path is both novel and interesting.

Cochlear implants, which are an option for treatment in this case, are a “miracle” of modern technology and medicine. These surgically implanted devices allow for restoration of hearing and, while not perfect, they restore the ability to communicate with spoken language in the vast majority of cases. 

While not entirely inaccurate, the film errs in making key points, and this depiction may discourage many who could benefit from seeking care. First, cochlear implant cost is covered by most private and public insurers, enabling access to this vital surgery. Second, the medical and audiological evaluation is extensive, both to determine appropriateness of the intervention and to provide counseling and preparation for what will occur post-implant. Third, the surgical placement of the implants is only the beginning of the rehabilitation process, which requires months of initial and follow-up programming and rehabilitation exercises to obtain full benefit. To portray cochlear implantation as a “quick fix” which, in this telling, ultimately falls short of expectations, is not an accurate reflection of the typical experience.

So, while I’m grateful for the spotlight this film shines on the impact of profound hearing loss, I encourage all adults who are interested in cochlear implantation to discuss this option with their hearing health care team to gain an accurate understanding of this intervention that can provide hearing restoration and the Sound of Spoken Language.

“Sound of Metal” won Oscars for best sound and best film editing at the 93rd Academy Awards.

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