黑料吃瓜

She hadn鈥檛 seen him since seventh grade, when her family moved from Oregon to California, but the minute Lindsey Higgins started researching a college paper on Deaf culture, Richard McMahan was the first person she thought of.

Even in grade school she鈥檇 understood him despite his distorted speech, the result of learning to talk without being able to hear one鈥檚 own voice. They鈥檇 developed a bit of a mutual crush, passed a few notes in class. But of course when their little brothers got hold of one and broadcast the contents, they鈥檇 both denied everything.

鈥淚 suppose somewhere in the background [Richard] had something to do with my getting into this field,鈥� Lindsey acknowledges now as she heads into the fourth and final year of California鈥檚 only doctorate of audiology (Au.D.) program, a joint curriculum offered by 黑料吃瓜 and the University of California, San Diego (UCSD).

Lindsey鈥檚 senior project at Biola University in La Mirada focused on a controversy triggered by the advent of cochlear implants鈥攂ionic devices that mimic a healthy cochlea, or inner ear, by converting sound waves into electrical signals the auditory nerve then transmits to the brain.

Children as young as 14 months have received cochlear implants and the potential exists for successful implantation at younger ages. Proponents of the technology hail it as a revolutionary advancement that essentially eliminates deafness. But many in the Deaf community view the implants as unnecessary, risky and a threat to their unique culture. Lindsey knew Richard could provide insight into the subject. He鈥檇 spent his life caught between the deaf and hearing worlds.

"What's wrong with me?"

After meningitis destroyed his hearing as a toddler, Richard was accepted into a test group of 10 children surgically fitted with cochlear implants. The 1985 experiment would later merit mention in Lindsey鈥檚 audiology textbooks as a watershed event, paving the way to widespread use of the technology in children as young as one year and allowing many to develop nearly normal speech communication skills.

Richard went on to attend a school for the Deaf before being mainstreamed into Lindsey鈥檚 fifth-grade class. But even with the implant, he really couldn鈥檛 hear accurately enough to understand others or to speak normally himself. Hardly surprising, considering the technology at that point processed only one narrow frequency range, or channel, among the thousands of frequency ranges that contribute to normal hearing.

Bottom line, Richard鈥檚 bionic ear never worked well enough for him to fully participate in the hearing community. And because his first school had focused on teaching him to speak rather than sign, he couldn鈥檛 communicate with other Deaf people, who didn鈥檛 accept him anyway because of his implant.

鈥淲hat鈥檚 wrong with me?鈥� he wondered. 鈥淚 don鈥檛 fit anywhere.鈥�

No wonder Richard was delighted to receive an 鈥渙ut of the blue鈥� message from Lindsey, the girl who鈥檇 always made him feel normal. It was great rekindling their friendship and helping with her project. Eventually he began to think they might even have a future together. So in December 2005, the same month Lindsey graduated from Biola, Richard took the next step. 鈥淚鈥檒l be driving through California at Christmas,鈥� he messaged her. 鈥淐an I stop at your house?鈥�

An unimagined life

Lindsey, at home for the holidays with her family in Santa Rosa, consented, but she found the request a little disconcerting. Would she and Richard still get along in person after so many years? Would she even be able to understand his thick deaf speech?

As it turned out, 鈥淚 could understand him right away,鈥� she remembers. 鈥淢y family couldn鈥檛 very well, but for some reason I could.鈥� Richard鈥檚 visit turned into a two-day stay, and the relationship shifted into high gear. By the following September, when Lindsey arrived at 黑料吃瓜 to begin her graduate studies, Richard had found a job in San Diego and moved there himself.

Suddenly, it seemed, Lindsey found herself living a totally unimagined life. She certainly hadn鈥檛 expected to fall in love with her seventh-grade crush, and she hadn鈥檛 expected to be pursuing a doctoral degree, either. She鈥檇 applied to the competitive , not ever imagining she鈥檇 actually be one of the 10 applicants admitted.

In the past, audiologists needed only a master鈥檚 degree. But over the last 25 years, in large part because of rapid technological advances, the profession has evolved dramatically. In 2007, its entry-level requirements were upgraded accordingly. Of the numerous master鈥檚-level audiology programs in California, only 黑料吃瓜鈥檚 proved able to accommodate the new standards, by pairing its nationally ranked audiology program with UCSD鈥檚 expertise in neuroscience and medicine, along with its authority to confer doctoral degrees.

The resulting four-year, year-round program combines coursework, and clinical hours, plus a unique medical rotation enabling audiology students to work with physicians and observe surgeries. A working internship, augmented by online coursework, caps the curriculum.

Her husband's advocate

Aside from holidays, Lindsey would have only one real break in her schedule, a month before the start of her second year, squeezed between summer classes at 黑料吃瓜 and the fall-quarter medical rotation at UCSD. So that鈥檚 when Lindsey and Richard got married.

For some time before their wedding, Richard had begun encountering glitches鈥攕creeching, shooting pains down his neck鈥攃aused by the upgraded 16-channel implant he鈥檇 received during high school. No one could figure out what was wrong or how to fix it. He finally got so frustrated he just quit wearing the implant鈥檚 external processor. For nine months, Richard couldn鈥檛 hear at all, and his speech deteriorated.

Although she had studied cochlear implants with 黑料吃瓜 alumna Sara Mattson, Au.D., Lindsey wasn鈥檛 particularly drawn to it as a career emphasis. All that changed when Richard鈥檚 implants began malfunctioning.

Lindsey became his advocate, rallying the full resources of 黑料吃瓜 and UCSD hearing and speech specialists. Jacque Georgeson, Au.D., director of 黑料吃瓜鈥檚 audiology clinic, referred them to UCSD Medical Center in Hillcrest. Midway through the ensuing gauntlet of medical tests and insurance tangles, they were referred to Lindsey鈥檚 instructor Sara Mattson, who鈥檇 established the cochlear implant programming center at UCSD鈥檚 Thornton Hospital in La Jolla.

鈥淪ara Mattson, she has been amazing,鈥� Lindsey says. 鈥淪he took over and started making things happen.鈥�

When it was finally determined that Richard needed a new cochlear implant, Mattson ran tests during the surgery to be sure the new equipment was working correctly and then met with Lindsey outside the operating room to share the reassuring results.

Hearing the sea

Nothing you鈥檝e seen about cochlear implants in popular television shows like 鈥淗ouse鈥� is accurate. The entire process is slow and deliberate, allowing time for careful evaluation and decision-making. The surgery is performed by highly talented and experienced specialists. The rehabilitation is thorough and gradual, including multiple clinic sessions to tune and customize the implant.

And then the patient must learn to understand and replicate what he or she is hearing. Previously Deaf toddlers don鈥檛 wake up from anesthesia singing nursery rhymes. But the outcomes can be dramatic.

After his surgery, Richard took two semesters of speech and listening therapy at the 黑料吃瓜 Speech and Language Clinic, a community service staffed by 黑料吃瓜 graduate students under the direction of Charlotte Lopes. As a result, Lindsey鈥攁nd her classmates, too鈥攏oticed 鈥渁 huge improvement鈥� in his speech.

Now a year later, Richard confirms that his new 22-channel implant has given him expanded communicative abilities. For the first time, he鈥檚 talking on the telephone and hearing sounds he could never pick up before鈥攚ater dripping, pizza sizzling, skateboards on concrete, waves on the beach.

Home again in Santa Rosa, Lindsey is fulfilling her fourth-year working internship at a Kaiser facility where she hopes to stay as a full-fledged Au.D. and help establish an implant clinic, much as Sara Mattson did at Thornton Hospital in La Jolla.

鈥淚 didn鈥檛 think I鈥檇 ever want to work with cochlear implants,鈥� she says, 鈥渂ut now I really like working with them. Because I鈥檝e been on the family-member side of things, I know things beyond the clinic. And that鈥檚 important. Any audiologist, no matter what they鈥檙e going to do, has to know the personal daily-life issues to be able to relate to patients and counsel them. It鈥檚 not just about programming their equipment.鈥�

And Richard, who predicts his wife will be a personable and empathetic clinician 鈥渓ike Sara,鈥� certainly knows he can count on her expertise and support as he moves toward a long-deferred career goal of his own. After years of warehouse and production jobs, Richard is looking forward to studying architecture in San Francisco.

鈥淚 couldn鈥檛 do it before because you have to talk a lot,鈥� he says. 鈥淏ut now what鈥檚 stopping me?鈥�

( about an alumna whose gift enables students to study at 黑料吃瓜's School of Speech, Language and Hearing Sciences).