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Sound and Silence

The emotion of learning that your baby was born profoundly deaf. The challenge of learning sign language so you can communicate with her. The angst of deciding whether or not to have a device to help her hear implanted in her head. A Dartmouth Medicine staff member shares the twists and turns in an unexpected parental journey.

By Jennifer Durgin

At first, after we found out Geneva was deaf, I couldn't help feeling angry. I'd sit there and stare at her perfect-looking little ears as she nursed and think to myself, How dare you not work? But that's when I was still focused on all that we had lost—or that I thought we would lose. Geneva, then six weeks old, had, for example, never heard my voice.

It took two rounds of screening tests at the small community hospital where Geneva was born in January 2007, plus a couple of hours of diagnostic tests at DHMC in March, to determine that Geneva was deaf.

"I'm seeing a pattern consistent with profound sensorineural hearing loss," I remember the audiologist telling my husband and me. What? I thought. When I go to the doctor, I usually can comprehend whatever medical jargon is thrown my way. After all, as a member of this magazine's staff, I read and write about medicine every day at my job. But this time I had to make sense of an unfamiliar term while I was trying to contain the emotions welling up inside me.

"So is that like what you'd call deaf?" I asked. As the words popped out of my mouth, I suddenly wondered if the word "deaf" was politically incorrect and that's why the audiologist had used doctor lingo. "Yes," she answered. I think my next question was "Are you sure?" She was very sure.

Things became clearer for my husband, Christian, and me when the audiologist pulled out a graphic representation of sound. This chart, known as an audiogram, had volume (measured in decibels) on one axis and frequency (measured in cycles per second, or hertz) on the other axis. It showed the volumes and frequencies for everyday sounds—such as a bird chirping, a dog barking, a phone ringing, a person talking. It also showed where different speech sounds in the English language are found—between 20 and 60 decibels and 200 and 8,000 hertz. The audiologist explained that she had tested Geneva's hearing up to 100 decibels and 4,000 hertz but had seen no brain response at all. That meant Geneva could be right next to a running lawnmower or a helicopter taking off and hear absolutely nothing. I felt something sink inside me.

Since Geneva couldn't hear, her parents began learning sign language so they could communicate with her. Here, her mother signs "panda" as Geneva looks at a book.

So I understood that my daughter was deaf. But I still had lots of questions. "What does sensorineural hearing loss mean?" I asked. And does it mean she has brain damage? I was wondering to myself.

There are three regions of the ear, the audiologist explained—the outer ear, the middle ear, and the inner ear—and different hearing tests can help pinpoint which part of the ear may not be working. Judging from the tests she'd had, Geneva's outer ear and middle ear were just fine. The problem seemed to be in her inner ear, where sound waves travel into the snail-shaped cochlea, and tiny hair cells convert those waves into electrical impulses. The impulses then

Geneva Durgin was born into a totally silent world; she was six weeks old when she was diagnosed as profoundly deaf.

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Jennifer Durgin has been a senior writer at Dartmouth Medicine since June 2004. Her other recent features for the magazine include "All Together Now," about a collaboration between DMS and Dartmouth's Thayer School of Engineering that is the nation's most advanced effort to develop effective alternatives to mammography, and "Compound Interest," about two promising chemopreventatives that were developed at Dartmouth and are now in clinical trials.

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