For one of my classes about a week ago, we read and discussed a series of articles on cochlear implants. I realized that despite a week of ENT during third year, I knew next to nothing about these devices (prosthetics?) so in true medical student fashion, I went a-hunting in the New England Journal.
Now, I have no doubt that the pathophys is correct here. Hair cells, basilar membrane, cortical circuitry…. But check out this choice phrase on neural encoding of stimuli: “aberrant developmental steps in synaptic counts, plasticity, and network properties have taken place without hearing.”
Aberrant? Really, now?
The article is peppered with instances like these, where the authors have chosen a negative word where a neutral one would have served as well. The authors’ disdain for deafness and Deafness is palpable. As a matter of fact, this journal article explains to me far better why Deaf culture is so antagonistic to the idea of cochlear implants. (And it’s hardly a surprise that the authors both receive money from makers of cochlear implants.)
This, my friends, is why narrative medicine matters. If I’d read this article last year, I would likely have simply absorbed it without further reflection. It is attention to the word choices — which comes from a weekend of writing poetry for a different class — that helps me see the subtext of this article, and make me question why the editor of the NEJM (generally a very strong publication) let this slide.
Drs. Kral and O’Donoghue should listen to Joshua Bennett, a spoken word poet I had the great privilege of meeting in September, as he tells of his own struggle and realization of Deaf culture.
(In the news this morning: Cochlear Implants Recalled)