Every hearing professional encounters patients with tinnitus. However, unless they suffer from the condition themselves, most practitioners cannot fully comprehend what patients with severe tinnitus endure. This First Person report by George R. Brown, MD, describes most eloquently what life with “the tormentor” can be like. His article is based on the presentation he made last year at the Annual Appalachian Spring Conference on Tinnitus in Johnson City, TN.
George R. Brown, MD, is Chief of Psychiatry, Mountain Home Veterans Administration Medical Center, and Professor and Associate Chairman, Department of Psychiatry, East Tennessee State University.
Correspondence should be sent to Dr. Brown at George.Brown@med.va.gov.
I'm am writing not as a psychiatrist nor a physician learning from patients, but as a patient trying to express what it is like to have an unwanted tormentor with you for 24 hours a day, 7 days a week, 365 days a year.
This tormentor came into my home like an obsessed psychostalker at least 15 years ago for no apparent reason and with no invitation. Oh sure, I had cracked the door a few times—an Ozzy concert here and there, cranking up some Journey or Boston on the old Craig Power Play speakers in a '75 Nissan pickup truck from time to time, but the door was generally closed.
I later bolted the door, spending hundreds of dollars on “security equipment”: custom-made electronic hearing protection with primitive peak dB limiters of the early 80s, a series of custom silicone earplugs, and ultimately, after the terminator was in my home, apparently to stay, tinnitus maskers in the form of white noise machines ranging from $8 fans purchased at Wal-Mart to contraptions made especially for the purpose by Sharper Image.
Obviously, I was not alone, given the abundance of these devices. With these fancy machines, I had gone upscale, trying to outclass the tormentor, hoping he would be embarrassed and maybe leave me to torment someone else who was less sophisticated, less careful, less willing to buy the gear. All of this was to no avail, however, and he continued to overstay his “welcome.”
NOWHERE TO HIDE
Once he was in my head and my home, I tried to avoid areas where he reigned with impunity. The quietest places were his undisputed throne rooms. He tormented me most in my bedroom, now designed to limit his devastating effects on my sleep, a respite I rarely know, as he rules the night. I tried to bar him from that place by making it soundproof and windowless in the process of designing a new custom home with his presence felt at the arm of my architect at all times.
“Are you sure you want 6-inch walls around your bedroom with R-40 exterior grade insulation in the inside walls?” the architect would ask, as if he didn't see or hear the tormentor laughing and hissing in the background, controlling my life, costing me more money, and alienating me from my wife. She couldn't hear him either.
When I try to retreat from my house or am forced to by my job responsibilities, his bags are packed before mine. They are the first to be loaded, even if I take only a small backpack. My gear comes second, and always must include a series of special situation earplugs and white-noise generators, both AC and DC, lest the tormentor's friends at power plants or electrical substations rob me of my precious electricity. Have you ever experienced a building with the power off? No computers. No air-conditioning noises, no reassuring 60-Hz hum from fluorescent lights. Just the unmitigated torture of the tormentor, unopposed by any friendly forces. It is hell on earth, and it is in your head. No escape. No running away.
The tormentor once followed me on a tour of a cave, deep underground in upstate New York. It was a popular tourist attraction, and he was obviously interested in whatever mischief he could cause there. The guide shut down the power when we were about 500 feet below ground to show the visitors what it would be like to be trapped in total darkness and total silence. She told us that most humans wouldn't last more than a few days before they would go crazy and begin to hallucinate, talk to themselves, become depressed, and maybe even become suicidal.
The tormentor loved what he was hearing, celebrating having found the ideal environment to perfect his craft by dramatically increasing his infernal hissing—or so it seemed to me. Others appeared unfazed. I was hoping he would leave me for the guide, given how smitten he seemed to be with her. But she turned the power back on and the hum of the powerful lights and the whir of a Briggs & Stratton power generator threw a cold blanket on his infatuation with her. He chose to stay with me, as I feared he would.
If nothing else, he is totally loyal, always by my side: on dreaded camping trips, in every hotel room, on trips home, in airports, and on airplanes. I have discovered one vulnerability: He has a hard time holding on when I put the top down on my convertible and drive just slightly over the posted speed limit. Sometimes I drive fast enough to shake him off me for a while, but since he travels at the speed of sound he quickly overtakes me at the next rest stop, settling in for the rest of the ride. I know it is useless in the long run, but even a little time away from him lightens my spirit.
Here at the VA, I am aware of many others who have fallen prey to the kinfolk of my tormentor. Like siblings, these tormentors have traits in common, but they also have their own unique personalities and quirks. Some are not as obnoxious, loud, or ubiquitous in their presence as mine; some allow their human hosts respite, making it easier to co-habit with them. I think my tormentor was the black sheep in his family, never resting, always into mischief, driving his poor parents crazy before leaving home early to take up permanent residence with me.
But, I have not surrendered. I still hold out hope that my tormentor can be evicted from my home, or at least contained in a few rooms, leaving me with some solace, lifting my usually low spirits, if just for a while. I can't surrender. I won't surrender.
I would use just about any means available to stifle him, to eradicate him from my life, or just to reduce his overwhelming influence on what I have of a life. Other unwilling hosts just like me have more sinister goals for the whole race of Tinnitus Tormentors: Nothing short of genocide will suffice. Others like me want to say to the clinicians and researchers on the leading edge of audiology research: Give us new weapons in our struggle for liberation. We will try just about anything.
Thank you for reading this communication from the front lines. Unfortunately, there will be hell to pay tonight.
First Person is an occasional column in The Hearing Journal in which practitioners share personal experiences that are of interest and relevance to other hearing healthcare providers.