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Listening to Herbs
by NANCY J. RENNERT, MD

      I detected a flash of movement through my kitchen window. The gardeners unloaded a lawn mower, a leaf blower and about a dozen bags of dark brown mulch. As they started to work, excruciating, loud, mechanical noises hammered in the middle of my head. I couldn’t tell which sound belonged to what. There was no way to judge how far away the sounds were, though a quick visual scan did not detect any other activity nearby, so it had to be the gardeners. I ran outside, with the Google translate app open on my iPhone, since I knew the gardeners preferred Spanish. I was so relieved when they did not turn off their machines. We were sort of equal now; they couldn’t hear either.

 

      When I woke up deaf four years prior, my world shattered. I was a suddenly deaf wife and mother of two toddlers and another baby on the way. I was also a newly deaf doctor. Autoimmune inner ear disease had stolen my hearing overnight and uprooted my life.

 

      Steroid medications and hearing aids helped until they didn’t. Losing my hearing severed my connections to my family, friends and colleagues. I was exhausted from trying to understand when I only heard a few words and filled in the rest with context and by observing facial expressions and body language. For safety, I slept with a bed shaker device under my mattress. Connected to the baby monitor and fire alarm, my bed vibrated to awaken me in an emergency. I left my medical practice and hoped someday to return to my calling as a physician. I attempted a sign language class, but that felt too different to me; my life was fully in the hearing world.

 

      After struggling with fluctuating severe to profound hearing loss for four years, I had cochlear implant surgery. A thin electrode in my inner ear transmitted electrical signals to my brain. Powered by a battery-operated speech processor which I wore behind my ear like a hearing aid, it connected to an internal device placed in my skull.

 

      One month after surgery, when the cochlear implant was activated and the external speech processor programmed, I heard static noises and high-pitched squeals when people talked. Nothing like real hearing. My brain had to learn to decode the electrical signals from the cochlear implant and interpret them as meaningful sounds and speech. Like learning a new language, it was a gradual process.

 

      In the space between silence and sound, “What’s that?” was my mantra. I asked this every time I felt something on the right side of my head where my speech processor attached with a magnet to the internal device or when I thought I heard something. My husband and children told me what the noise was - an airplane, a siren, a truck - and pointed at it so I could see it too. I focused intensely and tried to link each noise with my memory of what it used to sound like.

 

      Water was the first addition to my new brain database that I could identify. I turned on the spigot and saw the gushing flow splash on my plants. A static noise was there but definitely not the sound of water. This is the new sound of water, I told myself and mentally connected the noise when the water flowed to my auditory memory of water. On and off with the hose and by the third time, holy crap... the whoosh was exactly like rushing water always sounded. Big win!

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      Two months after my surgery and the day before the gardeners arrived, I heard, yes, actually heard a TV news announcer say “sunny with a 30% chance of rain.” Right out of nowhere. Hope.

 

      As the gardeners worked, I went outside to speak with them. I approached the man with the leaf blower, his face creased with premature wrinkles from sun overexposure, his eyes tired. He wore large blue headphones to protect his hearing. I waved to get his attention, and he turned off the leaf blower. I logged its whirring in my mind so when he turned it on again, I could try to add that sound to my auditory bank of remodeled neural connections. I showed him my phone transcription: “Por favor, recorte las plantas, elimine las malas hierbas y aplique el mantillo.” Please trim the plants, remove the weeds and apply the mulch. I raised my eyebrows to indicate I wanted him to confirm understanding. He gave me a thumbs up. When the leaf blower started again, damn if that wasn’t how a leaf blower always sounded! I smiled, my shoulders relaxed and I went back inside.

 

      After the gardeners left, I walked around our house, viewing the trimmed bushes and inhaling the pungent smell of freshly laid mulch. I looked toward my herb garden and my jaw dropped. “They killed my herbs!” I shouted in disbelief to no one. I surveyed the newly excavated dirt, formerly brimming with chives, rosemary, mint, and thyme, now eviscerated. The evergreen plastic do-it-yourself picket fence about six inches high, the kind sold in two-foot sections at Home Depot, was now dismembered and pointed in random directions.

 

      I dropped to my knees and groped a matted stump of chives as dirt stuck under my fingernails. Wrenched out of the earth, did the plants feel their leaves and stems ripped from their roots? Or was it so sudden that there wasn’t time to feel anything?

 

      I looked toward where my rosemary had grown for years. I loved the way my hands smelled after touching the pointed leaves, earthy with a hint of pine and the way the essential oils made that smell linger. Rosemary was strong, persisting through cold, winter storms, always standing up straight to grow again in the spring. I scattered it over roasted vegetables for visual appeal and added that unique flavor to my signature salmon dish, served on holidays with family and friends. Surrounded by my community crammed into my kitchen, everyone talked over each other while I set up the buffet. I missed that. Being able to hear people clearly and not live in a constant state of exhaustion from trying to figure out what they were saying.

 

      Cilantro was not supposed to be perennial, but it regrew each year in my herb garden, though it bolted much too early in July to take full advantage of guacamole season. Cilantro was polarizing; some people hated it, saying it tasted like soap, and others appreciated its bright, citrusy flavor. When the plant’s delicate leaves withered and pebble- like coriander seeds arrived, some people discarded it, while others valued the transformed spice. When my kids were young, they loved harvesting herbs and helping in the kitchen. One time, we made salsa, heavy with cilantro, and I overheard by lipreading, “Mommy can’t hear secrets.” My whole body sagged. Although I did not always understand what was said, I always knew how the speaker felt. I figured it out by observing body language, facial expressions and voice tone, even if I didn’t understand most of the words.

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      "Mommy has a magical way to hear secrets," I proposed. “Look at me and say your words without any sound coming out, quieter than a whisper.” This was our special new way to share secrets.

 

      How would I renew my herb garden? My fingers tilled the pillaged soil searching for roots. I could feel them, clinging to the disrupted dirt and I took care not to disturb them further. Too much trauma and they might not recover. I embraced the roots, repositioned them and gently packed the moist soil for support. I hoped they would thrive. A red-brown earthworm slithered over my skin as it laboriously propelled itself in segments over my wrist. If you cut an earthworm in half, it regenerates. Human inner ear hair cells do not. Lucky earthworms.

 

      Learning to listen with a cochlear implant was both tedious and exhilarating. I tried to keep my hopes high and expectations low. The sensations were overpowering and empowering. Each sound I identified intensified my motivation for more.

 

      Start over. Replant. Nurture growth. Though my herb garden would never be the same, I would find a way to make it bloom again; I was sure of it. I was learning to navigate different. To revive my garden, I chose my favorites - rosemary and cilantro - and then browsed. There were unknown opportunities ahead. I placed a marjoram seedling in my basket.

Nancy J. Rennert, MD, is Chief of Endocrinology, Norwalk Hospital and Associate Clinical Professor, Yale School of Medicine. After suddenly becoming deaf and now as a bilateral cochlear implant user, she mentors healthcare professionals and students with hearing loss/ D(d)deafness and regularly speaks and publishes on stethoscope use and strategies to improve patient-physician communication. She also advocates for accessible telehealth, clear masks and assistive listening technology for both patients and healthcare providers. Dr Rennert recently served on the Board of Directors of the Association of Medical Professionals with Hearing Loss (AMPHL). In 2024, she co-founded the nonprofit Stethoscope Equity Project (SEP) https://www.amphl.org/stethoscope-equity-project to help healthcare students and professionals find their optimal stethoscope. She currently serves as SEP Co-Chair. Dr Rennert is grateful to the hearing healthcare professionals, AMPHL members, and especially to her family for their unwavering support, which powers and sustains this adventure.

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