Monday, September 11, 2017

Tinnitus


I’ve had tinnitus since age eighteen. I began to experience it after a terrible LSD trip in December, 1966. After getting myself into a hospital and dosed with chlorpromazine, I awoke the next morning to a ringing and hissing sound in my ears, which has been there ever since. It is sometimes louder, sometimes quieter. I’ve been living with it so long I don’t notice it most of the time. Lately, I’ve become a little fascinated by it.
There are two types of tinnitus: objective and subjective. Objective tinnitus is an actual noise generated by structures near the ear and will be perceptible to a doctor with a stethoscope. Subjective tinnitus is perception of a sound in the absence of an acoustic stimulus. No doctor will be able to hear it. It doesn’t exist. Except, of course, for you, the one with the tinnitus. It exists quite emphatically for the person experiencing it. But the absence of a clear physical cause makes it a curious phenomenon indeed. Is it mental? A hallucination? An auditory illusion?
Current theory espouses a problem with auditory neurology. The nerve cells in the auditory region are overactive and compensating for partial hearing loss. But what if there’s no hearing loss? My hearing has gotten a little worse with age, and my tinnitus has worsened, so there might be something to the relationship between tinnitus and hearing loss, but it’s a weak one. I might ask my wife to repeat herself occasionally (she has a remarkably soft voice), but on balance my hearing is still pretty good. I feel on a gut level that it has more to do with something gone a little haywire in the auditory brainstem.
The reaction I received when I complained about it for the first time continues to be the same one today when I mention it to anyone fifty years later: a shrug. Nobody thinks it’s a big deal. Doctors especially. They tell you to go to home and learn to live with it. Doctors are like that. Show up with a freshly severed arm and an alien bursting out of your stomach and they’ll stand there and stifle a yawn. It must be all that science, I don’t know. That’s worth a study in itself: what makes doctors – male and female  - so uniformly similar to Charles Grodin?
There are, however, people who do think tinnitus a big deal and will fully empathize with you. These would be people who suffer tinnitus. Trust me; it’s a big deal to them. Think about it: you never have silence.
Let me say that again: you never have silence.
There is no cure.
Which isn’t entirely true. Not long ago I read an article about TMS (Transcranial Magnetic Stimulation). According to recent studies, low-frequency repetitive transcranial magnetic stimulation is able to reduce cortical hyperexcitability.
Say what?!
I called the neurology department of our healthcare provider and asked if they offered TMS. Yes, they did. It would require a treatment of approximately eight days. How much? $9,000, roughly. The treatment is still in the experimental stage so there’s no way our insurance would cover it. It would be out of pocket. Can’t do it. Can’t afford it. Ain’t our healthcare system wonderful?
Here’s another curiosity: people with tinnitus who have taken ecstasy say that it made their tinnitus go away.
The University of Aukland in New Zealand has done an actual study investigating this.
Ecstasy, whose official chemical designation is 3,4-Methylenedioxymethamphetamine, was administered to participants in two separate trials in doses of 30 mg or 70 mg. These are very small doses, not enough to produce a high, whatever one’s concept of a high happens to be. No euphoria, for starters. Nobody felt that. Thank God.
Many of the participants reported an easing of tinnitus after three hours.
So: not very conclusive.
But still, quite interesting. What effect on the auditory neurons was this drug having? Did it feed the neurons something they liked, light them up with a happy cosmology of glow sticks and dreampop so they stopped bothering the brain with the whistling and hissing to get attention?
This theory of neurons going a little haywire appeals to me in a greater philosophical sense as a possible explanation for this stubborn phenomenon called tinnitus. If life is a reality which is making itself in a reality which is unmaking itself, or inversely, if life is a reality which is unmaking itself in a reality which is making itself, then this surplus of neuronal activity is reaching for something. It wants something. It needs something. It is a superfluity in quest of a fulfilling sensation. It is a testament of flux. Of becoming. It is making up for a lack. It is compensation for something I can’t quite hear. Perhaps a choir of angels or planetary music that will finally lull that hiss and whistle into oblivion.
I’m hearing something that isn’t there. Not a voice, or voices (that would really freak me out) but a hiss, a whistle. Neither the hiss or whistle have meaning. They indicate nothing. They indicate that something in my nervous system has experienced trauma, but for whatever reason, they continue to make that signal, although the trauma has long since ceased to exist.
Or has it? Isn’t life itself an ongoing trauma? That would be putting a slightly histrionic spin on the problem. But hey, isn’t it a little bit true? Because at the base of life, of the human condition, is mortality, and mortality is a son of a bitch. It’s a hell of a thing to reckon with. The Buddhists are right: attachment is pain. Try not to get attached to things, especially people. Because nothing endures. Nothing lasts. It’s all impermanent. Ephemeral. Do you see this butterfly flitting by? That’s us. That’s life. Here today, gone by sunset.
Some people are born into a life of ease, but who are they? I’ve never met any. Most of the people I’ve known have had to deal with a lot of pain, a lot of loss, a lot of conflict.  As Heidegger puts it, existence is “care” (Sorge): to exist is not simply to be, but to be an issue for oneself, a concern, a problem, an argument. The first person I have to contend with in the morning is myself. It might be a memory, a dream, a regret, but there’s a guarantee that something will haunt me throughout the day, will cling to my consciousness with the same tenacity as this tinnitus.
Does anybody really like being alive? Because I’ve known very few people over time who didn’t require a little alcohol now and then, a little meditation, an antidepressant, a benzodiazepine, a strip of licorice, a cherry cordial, a little porn, a little tenderness, a little kick in the pants.
A buzz.
Who doesn’t like a buzz? Not the sound buzz, but the euphoric buzz, the metaphysical buzz, the inner buzz, the buoyant buzz.
It may not be the same kind of buzz several glasses of wine on the Boulevard Saint-Germane in Paris are apt to produce, but there is this lovely thing called transcendence, which provides a great balm to the wound of existence. It is chiefly a philosophical disposition, so drugs and alcohol aren’t really necessary, though they may have a synergistic effect. Transcendence has a great appeal to me as it not only helps with my tinnitus but the acceptance of things in general, phenomena for which I have no control, phenomena which may be irritable or deeply painful, and which are intimately linked with the process of being alive. It all comes down to weight: the burdens of daily existence, the encumbrances and worries that forever intrude on our buoyancy. Transcendence is helium. Transcendence is the flame shooting warm air into the sphere of one’s balloon.
Weight is a natural byproduct of mass. We all have mass: muscle, bone, blood, skin. We also have family, jobs, plans, ambitions, projects, responsibilities, and bills.
There is the weight of having to be, pure and simple. This was at the heart of Hamlet’s famous soliloquy on the subject of suicide: to be or not to be. It’s an option. And because we have this option, albeit a rather grim one, our burden is lightened a little.
Suicide is a little extreme. There’s also just letting things drop. Ka-thump! Or, as they say in Zen, “let go, don’t be dragged.”
Transcendence is a function of choice. I can decide not only to be or not to be, but how to be. I can be a certain way, dress a certain way, talk a certain way, eat a certain way. In other words, every moment is a possibility. We create ourselves. I can’t take credit for hands and fingers, for my eyes and ears, nature did that. But I can assume some agency in how I choose to use them.
In the same way, I can choose my response to tinnitus. Immersion in the world, for example, will help disperse my concerns into a larger context. Anything that bugs me will loosen its grip. I am absorbed in the world and so lose my sense of isolation. I join in the flux. What we are is Being, and so is how we are. “Smell the sea and feel the sky / Let your soul and spirit fly into the mystic.”


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