What if you could hear a sound so shrill, so alarming that you had no other option but to hear it, even when you didn’t want to hear it? And what if that sound was always there, day and night, awake or asleep? That sound is called tinnitus. I have it, and it’s getting worse.
Tinnitus is the legacy of what is perhaps my most profound passion — music, both the playing of and the listening to it. I began playing the piano at around the age of six. I began listening to music through headphones as a teenager. I had several ear infections throughout this time, and I remember noticing intermittent ringing as a teen. The ringing became permanent sometime in my 20s, but not at a volume that disturbed me enough to remember precisely when. Despite warnings from my mother, I never cared for my hearing as much as I ought to have done. I eschewed earplugs at concerts and band rehearsals. And with the advent of MP3 players, I embraced the deluge of music that followed.
One day, listening to David Bowie’s “Young Americans” while cycling in heavy traffic, I took out my earphones and was suddenly aware of a ringing that was louder than it had ever been. I paid it little mind, because the ringing always died down after a day or two, not going away entirely but slipping into the background. This time, it was still audible, undiminished, a day later, two days later, a week later, a month later. I had a sinking feeling it wasn’t going to go away this time. I consulted an ear specialist. He had a look inside my ears and tested them and told me my hearing was comparable to that of a combat soldier.
The sound I hear is nearly identical to that of a sound that features in an early scene of Kubrick’s 2001: A Space Odyssey. A group of astronauts are taking happy-snaps of an ancient black rectangular monolith recently discovered buried under the surface of the moon. Suddenly the monolith starts emitting a crippling, high-pitched noise that leaves the astronauts writhing in agony. That sound is the sound of my tinnitus. It isn’t as loud, but it is as high. And it never ends.
I long for silence. Now I will never hear it. I have lost the capacity to hear nothing. I will always hear that high, constant ringing. I try to imagine what silence sounds like. I only have vague memories of childhood silence, as I never paid much attention to it then. Having spent my childhood in quiet places, I always thought of silence as something to escape.
Noise is absolute, but silence is relative. The quieter our environment, the more of our inner world we hear — blood rushing through the capillaries around our ears, our heartbeat, our breath. Absolute silence would be torturous. Part of an astronaut’s training is spent in an anechoic chamber to prepare for the total silence of space. But I would very much like to be reacquainted with the pleasures of relative silence. Inner silence. I want to turn off the alarm bell in my head. I can hear it now. It is my constant companion. It makes silence all but unbearable, for the quieter it is outside my head, the louder it is inside it. This high, constant tone will accompany me to the grave.
Tinnitus is, in the purest sense of the word, an illusion. It’s an involuntary hallucination, in the sense that the sufferer hears a sound that doesn’t actually exist as such in the real world. It is perhaps precisely because tinnitus is an illusion — the illusion of sound where there is none — that it remains poorly understood. There are several theories as to what causes it. One possible explanation is that the condition is the result of the brain’s adaptation to hearing loss. Neural circuits compensate for damage to sensory hair cells by turning up the volume. The sufferer thus becomes more — not less — sensitive to noise, and the tinnitus is the acoustic equivalent of an amputee’s phantom pain.
The prevalence of the condition has doubled since the 1980s and it’s still growing. Recent research suggests the number of adult Americans with chronic tinnitus (currently about one in six) will rise to about one in four over the next four decades. The cause of the spike needs no explanation: prolonged exposure to loud noise, delivered through tiny wires inserted directly into the ear.
But the condition predates the industrialization of war and music by a long way. There are references to it in the literature of ayurvedic medicine, and in classical China it was thought to be caused by an imbalance of yin and yang. Mesopotamian remedies included exorcism and chants dedicated to the god of water. The ancient Egyptians tried treating it by infusing a mixture of oil, frankincense, tree sap, herbs, and soil through a reed stalk into the external ear. Greek and Roman treatments included exercise, rubbing, gargling, dieting, and the application of a balm consisting of radish, cucumber juice, honey, and vinegar. Aristotle and Hippocrates advised masking the inner sound with an outer sound, still commonly advised today. A medieval Welsh remedy — applying a hot loaf of bread to each ear — resembles candling, a practice still in use. And one Renaissance writer hypothesized that tinnitus was the wind trapped in the ear, and recommended surgery.
My tinnitus is a constant ring, severe enough to be audible whenever I tune in to it — and often when I am trying not to tune in. But it could be worse. Among reported instances of tinnitus, Wikipedia lists whines, buzzes, hisses, humming, whistles, clicks, roars, chirrups, melodies, songs, beeps, sizzling, the whoosh of waves or the wind, and human voice-like sounds. It can be intermittent. It can be influenced by the movement of muscles in the shoulder and face, or even by the flow of blood. For some it’s perceptible only when it is quiet. For others it is louder than everything else.
For many sufferers, tinnitus is accompanied by hearing loss. Their deafness isn’t a slipping away into silence, but the gradual replacement of outer sound with inner sound. This seems to have been Beethoven’s lot: “My ears whistle and buzz constantly day and night,” he wrote. “I can say I am living a wretched life.”
Because tinnitus is caused by prolonged exposure to loud noise, it’s a common condition among musicians and soldiers. In the United States, it’s the most common disability among veterans. Louis-Ferdinand Céline, one of French literature’s most influential and irascible figures, contracted it in the trenches during World War I. His tinnitus was an ever-changing cacophony. Here is how he describes it in Death on the Installment Plan:
I possess all of nature’s sounds, from the flute to the Niagara … I get about to the sound of a drum and an avalanche of trombones … I play the triangle for entire weeks … I fear no clarion. I have all to myself an aviary full of three thousand five hundred and twenty-seven small birds that will never calm down … I am the organ of the Universe.
The effect of this aural barrage, he continues, is madness and exhaustion.
Years later, Céline slipped into a fit of anti-Semitic rage that lasted till the liberation of France. It is tempting to wonder if his tinnitus contributed to his decline. Recent research suggests that tinnitus does indeed change how our brains work. One study by the University of Illinois indicated that in the long term it triggers increased brain activity and fatigue. Another study found that sufferers also experience increased anxiety levels. Both of these findings strike a chord with me. Much of my own anxiety regarding tinnitus centers around the thought that, as long as I am alive, it will never stop. For while there are various treatments, there is no cure. This should come as no surprise, given how little we understand about this essentially illusory condition.
The most common treatment is counseling. We may not be able to stop it, but we can perhaps teach ourselves not to focus on it, to think about something else. Thankfully, this is something our minds are very good at. If I am to be tortured by an illusion, perhaps the best strategy at my disposal is also illusory. Sometimes, when I weary of that ever-present ring, I try to think about that phrase of Céline’s: the organs of the universe. I think of the ringing as the clarion call of my own personal monolith on the moon: what is ringing in my ears is existence, life itself, the sound of Plato’s spheres. It is the ransom payable for the gift of music, without which, as Nietzsche tells us, life would be an error. And it is a constant reminder — an alarm bell of sorts — that death is coming, and that when it comes, for good and ill, the music will, at least for me, finally end. Then, at last, there will be silence.
Alex Landragin is a writer whose fiction explores place, migration, and literature’s formal possibilities. He was born in France and migrated to Australia as a child. His novel Crossings will be published by Picador Australia in 2019.