Chapter 1: No Response, Part II
When Grace was two and a half months old, I brought her back to Sibley for another hearing test. It was in the basement of the building, and as I sat waiting for our turn, I remember there was an older couple there, and they spoke proudly of their grandchildren, and asked how old Grace was, and murmured kindly coos at her and I tried to contain my nerves. The technician called to us to come into the testing room. She was shy but seemed confident and professional. There were a couple of computers in there, stacked close together on a crowded desk; it was a small room. When we got there, Grace was sleeping. The technician put some sort of monitoring electrodes on Grace, and little plug-type things into her ears that were connected to cables that linked to the computer. On the monitor, there was a circle that looked like a pie. This is the display for the OtoAcoustic Emission (OAE) test – the same test they’d done when Grace was a newborn. In theory, the pie is supposed to fill in with color as the child’s ear “responds” to various sounds.
The technician started the test. After ten or fifteen minutes, Grace woke up and started crying a bit. The technician suggested I nurse her. I tried hard to suppress my strange shyness about breastfeeding in front of anyone else, and to be at ease while I tried to calm her down. I found the most comfortable position I could manage on the hard-armed chair, and made a little silent prayer to the nursing gods that she’d latch on okay and quiet down. She did.
I don’t know how long the test is supposed to take; it felt like quite a while. I recall wanting to ask questions about what was happening, but on a hearing test, you don’t want to be blamed for making any noise. I think it took at least fifteen minutes for the pie to fill as she tested Grace’s right ear. Maybe even more like half an hour. But it filled. On the left side, it would start to fill, then dip back down, so that there never was a complete pie. But almost. I remember at one point the technician urged Grace gently on. “Come on little baby… what’s going on?” Finally, the testing program ended; Grace had timed out. “She passed on the right side,” the tech said. “She almost passed on the left.” I exhaled. Smiled. Okay, I thought. Not bad. She suggested I make an appointment at Georgetown, where they have better equipment and more broadly trained staff, to try to find out why Grace hadn’t passed completely.
I left feeling great. I had watched those little pies fill up for myself. Had “seen” Grace ‘respond’. In my mind, partial hearing loss, in just one ear, was an underwhelming problem. I might have actually been gliding as I wheeled the stroller down the hallways toward the elevator.
Partial hearing loss on one side. When I made the appointment at Georgetown, it didn’t occur to me to ask Jason to take time off from work to come along. It would be easy. The way I saw it, the worst-case scenario I might expect was not really so bad at all.
I got to Georgetown early, and took Grace for a walk through campus. Although it was summer, there were students all over the quad. It felt to me like we were in a bubble – we were of another space and time than these people, who all seemed very young to me suddenly, as I pushed Grace down the winding brick paths and service vehicle roads, trying to get her to fall asleep. It was near Grace’s nap-time, and she was calm, but awake. Unsure what that would mean for the appointment, I took her to the audiological center – in a building shared by the Department of Family Medicine, where I had had a part-time job as a graduate student several years before.
I must have been at least a little nervous, but honestly, I don’t remember it that way. Mostly, I remember having the same feeling I had every time I took Grace for a check-up, or to meet someone new – excited to show her off, curious about what she’d do, in her already reliable fashion, to connect with everyone. What specific little thing the next person, and the next, would remark about her.
One of the audiology staff said so long as Grace was calm and quiet, it was all right to proceed with the testing, even though she wasn’t asleep. I strolled her down a little ramp and into a room to the left. The windows looked out onto the quad. The audiologist’s name was Miranda. She was prim and pretty, soft-spoken and serious. She took out her equipment and began setting it up. She gently placed a pliable nodule, connected to a cable that linked to the screening instrument, in Grace’s right ear.
“Oh” I said, “She’s fine on that side. She passed completely on the right at the last test.”
She smiled at me, patronizing but not unkindly, and told me it was standard procedure to do comprehensive testing on both sides.
I expected to be there for a while; the last test had taken close to an hour. But only a couple of minutes later Miranda said “I’m not getting anything on this side.”
“What do you mean?”
“I’m not getting anything on this side. No response.”
There was nothing reassuring in her words. She left nothing open for interpretation.
“Let me try the other side.”
A few minutes more, and then, “Nothing on this side either.” In a voice that was exasperatingly reserved and practical she told me, “I’m going to take her up the hall for a tympanogram, to see if she has fluid in her ears that might be preventing her from responding. It’ll just take a few minutes. You can wait here.”
But the tympanogram showed that there was no fluid in her ears. That left us with… what exactly?
Panic began to set in. You know when you’re having that falling dream? The one when you are floating along, and then you suddenly know that you’re going to crash. You will yourself to wake up but you are utterly terrified that you will hit the ground before you manage to escape the dream?
I felt like that.
“What do we do now?” What do I do now?
She said that now, we should make an appointment for an ABR. An Auditory Brainstem Response test. This would give us a fuller understanding of the extent of Grace’s hearing loss. Beyond that, Miranda was tightlipped.
“But before, she passed on the right. And she nearly did on the left.”
“Why would that happen?”
My mind was racing. Had it been technician error? Rapidly progressive hearing loss?
Divine intervention with a horrible sense of humor?
“How…” I searched for the right word … “how conclusive is this test you did today?”
“Conclusive. We need to do the ABR to learn how severe the hearing loss is, but it’s a conclusive test.”
I liked Miranda a lot less now. Felt like shooting the messenger. She was awfully unflappable. No-nonsense. As if she was afraid to be sympathetic because that would be saying there was a reason for sympathy; that it was a big deal. And then she’d have a messy, emotional me to deal with. I wondered whether audiologists got any training in bedside manner. In breaking bad news.
I found myself standing at the reception counter, my hands trembling in a way I don’t ever recall happening before or since, on the edge of losing it, trying to make the next appointment. The guy at the desk had kind of creepy eyes and a creepy voice, and appeared not to notice in any way my extremely fragile state, though I can’t imagine how anyone could have missed it. I remember thinking that if someone bumped into me, I might shatter in a million tiny pieces on the floor. The soonest they could see us wasn’t for another month. It would be the end of summer, and Grace would be four and a half months old.
 The OAE measures the “echo” made within the ear when it hears a sound. With normal hearing, the microphone placed in the ear picks up this echo. If the test subject does not “hear” normally, the echo is absent.
 For an ABR, electrodes are stuck like bandaids to the test subject’s head, and tones are played in the ear. The electrodes pick up the response of the auditory nerve to the tones. Tones are played across the array of decibels (loudness) and frequencies (pitch).