The Hearing Aid's Pursuit of Invisibility

The device has a history of shaming, rather than helping, the hard of hearing. An Object Lesson.

A microchip designed for a hearing aid by Sonic Innovations in 1999 (Reuters)

I was 6 years old when I received my first pair of hearing aids. For many years, I felt self-conscious about the standard, behind-the-ear pair I wore. I was sure they made my ears stick out. My hair, tied in a long braid as per Sikh tradition, did little to hide them—or to limit snickers, glances, and finger-pointing from other children. “They help me hear,” I would reply to their never-ending questions. “So I can hear like you do.” The second answer was a lie. I knew no matter how hard I tried, I could never hear the way they did. My hearing was broken.

When the first electric hearing aid was developed, in 1898, it ushered in a wave of innovation for the hearing-impaired. Modeled upon the principle of the telephone, these new electric aids relied on battery-operated carbon transmitters and ear phones. They were far more advanced than the mechanical hearing trumpets, conversation tubes, and acoustic fans of the past. For people with hearing loss, especially those with progressive hearing loss and the late-deafened—and even, to some extent, those born deaf or who lost hearing at a young age—these technologies promised opportunities for integration into the (hearing) social world.

But the devices were far from discreet. Large, bulky, and requiring heavy batteries that had to be charged frequently, they were frustrating, if not obnoxious, for users. The historian Mara Mills has argued that the history of hearing aids is a history of the miniaturization of technology, a cavalcade of progress towards better hearing. Individuals who were hard-of-hearing led demands for technological improvement. Yet even when the vacuum tube was introduced in the 1920s, making it possible to increasingly amplify sound while reducing the size of aids, many hearing-impaired people refused to wear their devices. By 1950, hearing aid companies were strategizing about how to sell their products to resistant consumers who not only complained about the discomfort and high cost, but candidly expressed their embarrassment over exposing their impairment. For instance, Irving Schachtel, president of the hearing-aid industry leader Sonotone Corporation, expressed an obvious truth: “that nobody wants to put on a hearing aid, and that hearing aids are most difficult to sell.”

Deafness is highly stigmatized, perhaps because its technology and modes of communication make this invisible impairment visible. Last year, Victorian Hearing, an Australian company, came under fire for deaf-shaming when it published ads with the tagline “HEARING AIDS can be UGLY” next to a photo of a woman wearing a shrimp behind her ear. The ads expressed a level of derision virtually identical to early 20th-century patent medicine ads that boldly proclaimed, “DEAFNESS IS MISERY, GOOD HEARING A JOY.”

Aids to hearing have always been designed to be hidden: concealed within the skin or the body, or disguised as furniture and ordinary objects. In the 19th century, the wealthy had the option of purchasing mechanical aids to hearing that could “disappear” when not in use: fans, urns, thrones, headbands, and even walking canes were all masked as assistive devices. Even ordinary ear trumpets could be refashioned for specific purposes, such as mourning, with lace and ruffles intended to be hidden in a widow’s dress. By the 1950s, hearing-aid companies like Sonotone sent out free mail-order pamphlets advising women how to fashionably style their hearing aids, including disguising wires in a jeweled pin.

To treat hearing loss (whether temporary or progressive), people turned to faithful family remedies: decongestants such as tobacco smoke to clear out the head, filling ears with fluids, wearing tight caps, plugging ears with cotton, or medicinal recipes including purgatives. Patent medicines and restorative tonics appeared, all promising miraculous results for hearing loss. These were characteristic of the time. The late 19th and early 20th centuries were considered the golden age of American patent medicine, when distrust and frustration over contemporary medical therapeutics encouraged people to look for alternative treatments. Where medical practitioners failed to deliver on a deafness treatment—or in some cases, made the impairment worse—these entrepreneurs offered hope. They promised to quickly, painlessly, and discreetly alleviate deafness. Some even boasted guarantees of relief.

No entrepreneurial product for deafness was more notorious than artificial eardrums: small acoustic aids inserted into the ear canal to resonate sound to the eardrum. Nearly 400 years ago, a German physician first came up with the idea of an artificial eardrum by wrapping a small tube made of elk hoof with a pig’s bladder and inserting it into the ear. Over the centuries, other variations appeared, suggesting better materials for resonating sound: lint, fish skin, egg membranes, or paper. By 1850, British surgeons attempted to regulate the use of the device strictly as a surgical prosthetic, and only for cases of eardrum perforation. Their attempts, however, were in vain; increasing stories of miraculous restoration of hearing led to demands for wider availability of the device. For 20th century medical entrepreneurs, artificial eardrums held tremendous potential for profitability, and newer designs proclaiming superior sound amplification entered the market.

Artificial eardrums are not mechanical hearing aids. Rather, they’re vexed devices, straddling the line between a cure and prosthetic, offering complete restoration of hearing loss only when in use. Yet they were perceived as powerful technological interventions for integrating deaf people into hearing society, most notably because they were invisible. Once inserted inside the ear canal, they were hidden from the observer, and, as some companies boasted, even to the wearer themselves. While early electric hearing aids were bulky and expensive, and medical “cures” were useless, artificial eardrums presented the tools for personal autonomy and greater social inclusion.

And why not? Artificial eardrums were, after all, connected to the wonders of electricity and communication technologies, branded as the greatest scientific developments of the time. They were “telephones for the ear,” “sound discs,” “earphones,” or even “tiny megaphones.” The Murray Company, one of the earliest manufacturers of an artificial eardrum they called “Sound Discs,” asserted that thanks to their product “Deaf Persons need no longer despair.” They could discreetly hide their defect, mask their deafness, and pass themselves off as hearing people.

These devices embodied features that would later become popular selling points for hearing aids and even cochlear implants. Advertisements invoked the American notions of progress and innovation, with the heroic innovator—sometimes hard of hearing himself—striving to provide the deaf with an opportunity to become hearing citizens. Through scientific ingenuity and invention, the genius entrepreneur could finally give the deaf and deafened hope that their lives would no longer be isolated and morose. And with new industrialized materials, such as compressed cotton and rubber, the science of acoustics could comfortably enhance sounds, but without wires, gizmos, or other contraptions. They “restored” hearing while masking obvious indicators of deafness, therefore enabling consumers to discreetly become “normal.” “Why be Deaf?” these advertisements chimed incessantly.

Yet many of the claims of artificial eardrum vendors were grossly exaggerated, if not completely fabricated. Throughout the 1910s, these companies came under fire by medical practitioners, who accused vendors of duping a vulnerable public by selling exorbitantly priced devices that were basically useless. Companies were accused of deceiving consumers by using dubious testimonial letters to claim successful cases. Wilson Ear Drum Company, for instance, placed ads in national newspapers as well as notable magazines such as Popular Mechanics, Harper’s Bazaar, and Collier’s. The ads boasted that over 350,000 deaf persons had been cured using the Wilson Ear Drums. But there was no solid medical proof that artificial eardrums worked, either in restoring or aiding hearing; indeed, there were a growing number of cases of people seeking medical assistance after the device got trapped in the ear canal or caused an assortment of other aural problems.

As medical practitioners and journalists began to expose artificial eardrum companies as fakes, the American Medical Association launched an investigation. Beginning in 1913, the AMA crusaded to combat medical quackery at all social levels, including advertisements in regional and national newspapers. Artificial eardrums were heavily targeted. They were highly profitable, despite accumulated evidence that the devices were “trivial, worthless, and often dangerous.” Investigations into several highly advertised companies, including A.O. Leonard’s Invisible Antiseptic Ear Drums, the Morley Ear Phone, and the Way Ear Drum, reproached them outright for making false and misleading claims. The New York Department of Health went so far as to lodge a formal complaint against Leonard for fraud; he was arraigned before a Court of Special Sessions, found guilty, and sentenced to thirty days in jail or to pay a fine of $250. (He paid the fine.)

Even as the AMA cracked down on the sale of artificial eardrums and advertisements for the device declined, hearing-impaired people continued to purchase them until the end of the 1930s. The AMA archives in Chicago contain hundreds of letters from customers all across America inquiring about the benefits of artificial eardrums. These letters also reveal some reasons why the devices were purchased: to be self-sufficient and financially independent, to gain employment, to overcome frustration with a physician’s diagnosis and costs of care, or simply to self-treat their own progressive hearing loss. Even customers otherwise wary of fake artificial eardrums considered the device a last resort for a cure. If there was any glimmer of hope that hearing could be restored, then it was worth the chance—even better if the technology rendered deafness less visible.

That the hard of hearing should feel compelled to disguise their impairment with an invisible technology says a lot about how hearing loss is stigmatized. Invisibility is a popular selling point for hearing aids. At all costs, it seems, the technology must be contoured and fitted into the intricate parts of the ear rather than exposed for the world to see. The shame of mishearing, the embarrassment when the hearing aid “whistles,” the listening but not communicating—all of this threatens vanity, because deafness is still confused with understanding. “What are you, deaf?” dismisses hearing-impaired people as dumb, when we are only deaf. So we mask our hearing aids, and pass as hearing, believing we can magically eliminate our hearing loss. And this is a problem, because deafness is a difference, not an impairment.

Years after I finally accepted my hearing aids as part of my identity, accustomed myself to their bulk, and dealt with what they did to my ears, my audiologist told me I had to purchase new ones. I had no choice: Analog hearing aids, like the ones I spent nearly 25 years wearing, were relics of a technological past. Digital hearing aids were the only ones on offer, and if my analog ones broke, it would be extremely difficult for me to get them repaired. When I sat down to select my new digital aids, the audiologist laid out several options in front of me.

I raised my eyebrows when she told me the new designs were so indiscernible that it would be difficult for a person to tell I was wearing hearing aids until they took a close look. Moreover, I had the option to select the colors of my aids to match my “skin-tone” or my “hair.” Invisibility was no longer an aspiration, nor even a choice. Now the only question is how hearing aids might accessorize the newly mended body.

This article appears courtesy of Object Lessons.