Behind the Face Mask 

Image by Gabriele Lässer from Pixabay

The Spanish government has started to relax lockdown restrictions aimed at curbing the spread of coronavirus. In Madrid, we spent two months inside our homes, under strict measures, only being allowed outside for a few distinct purposes such as to go to the supermarket. On Saturday 2nd May, we were finally able to go for a walk and to exercise outdoors. 

With many people currently wearing face masks in public places to help reduce COVID-19 transmissions, I have realised that this poses a challenge for people with hearing loss.

I have single-sided deafness (SSD), the result of a sudden hearing loss in 2016. I have a profound hearing loss in my left ear and functional hearing in my right ear. Although I am thankful for my remaining hearing, having only one working ear comes with unique challenges. 

Sound localisation is a skill enabled by having two working ears; the mind registers which ear has heard the sound first, to determine where the sound is coming from. With only one hearing ear, the audio always enters my right ear. This means that all sound seems to be coming from my right side. 

The other main difficulty that comes with SSD, is the inability to hear speech clearly amongst background noise. With one working ear, there is difficulty in filtering out unimportant sounds when trying to understand speech in noisy environments, such as cafes or restaurants.

Now, there is the added challenge of the face mask.

Muffled Sounds and Lipreading

In attempting to communicate with people wearing face masks, namely the local greengrocer, it has only recently occurred to me how much I rely on lipreading. 

When speech is unclear, I often guess the general theme or significance, using the tone of voice as a guide. I instinctively look towards the speaker’s mouth and watch the shapes and movement of their lips to give me clues about the content. The muffled sound that comes through a face mask, is never clear. Now, with the majority of people wearing face masks, lips and faces are no longer visible to read and I am completely unaided. I am guessing without a hint.

Concealed Expressions 

In addition to concentrating on the sound of speech in conversation, I also focus on the reactions of the speaker. For example, if someone is telling a story and smiling, I know that a smile is an appropriate response, regardless of how much of the dialogue I am able to hear. Expressions are not visible through face masks. 

Customers of a local shop were being permitted to enter one-at-a-time, every time someone exited. Whilst at the front of the queue, the sound of a loud cough startled me and my automatic reaction was to quickly turn around. I made eye contact with a woman who was standing behind me in the queue. Without the ability to identify the location of a sound source, I didn’t know if the woman behind me had been the one who had coughed. I hadn’t turned around in judgement. Loud sounds startle me. As our eyes met, I smiled a friendly smile but it suddenly struck me that this had gone unseen, concealed by my face mask. I quickly turned around. I didn’t want to make the woman feel uncomfortable. 

Whatever our hearing capacity, we rely so much on expressions to understand how others are feeling. 

Developing Communication Strategies

Whilst paying for my shopping, the greengrocer uttered something from behind his face mask. I didn’t hear him clearly. I looked at him and was about to ask him to repeat himself. He quickly acknowledged my pause and spoke again in a clearer voice. 

Unfortunately, I didn’t hear the second time either. Again, he acknowledged my pause and this time endeavoured to help me understand by using hand gestures. He pointed to the top of the card reader. Ah! Do I want a receipt? 

I wonder if everyone is finding it difficult to communicate through face masks. Perhaps people are becoming accustomed to speaking more clearly. Maybe we are unwittingly developing strategies to break down barriers and make communication clearer and more accessible.  Perhaps the impact of face masks on communication will ultimately be a positive one. 

 

The Loneliness of a Busy Restaurant

What I have realised is that I appreciate the hearing I have left. And, I pay extra attention to my other senses, as I now rely more on these to interact with the world.

Sitting at the bar in a busy Mexican restaurant in Madrid, I realised just how lonely I was feeling.

Madrid is a great place to live and is a city full of people who enjoy eating out in the evenings. It can be difficult to get a table in a restaurant without making a booking, even on a weekday. This is how we came to be sitting at the bar. I had positioned myself so that my two friends were situated to the right of me – my ‘hearing’ side – so I had the best possibility of hearing them in this situation.

I don’t often go out during the evenings anymore, as I find restaurant noise difficult to be around, sometimes even painful. For three years I have been living with single-sided deafness and I am conscious of my hearing limitations. I knew that I was going to find it difficult to follow conversation amongst the background noise of music and people chatting. Still, I was feeling excited to be spending an evening in a nice restaurant with such a lively atmosphere and surrounded by the delicious rich aroma of Mexican food, which had enveloped us as we’d entered. We had ordered food to share, and it was going to be brought out to us slowly, one dish at a time. I was eager to start eating.

Both the restaurant and bar area were part of the same small space. As the customers consumed more food and drinks, the energy in the restaurant increased and people began to talk with exuberance; the noise levels steadily started to rise. I soon realised the extent of the communication difficulties I was going to have during this evening when, after speaking with me for a while, my friend next to me turned her body to face the other member of our group, during the course of conversation. I had been grasping at fragments of her words and sentences with determination, trying to make sense of them. I had been studying the shapes her lips were making to help give me some indication of what was being said. Now, looking at the side of her face and with no audible vocal clues, I was alone, and no longer part of the discussion.

I didn’t feel annoyed or even upset; I just felt resigned acceptance. Both members of the group were aware of my hearing difficulties. Of course, my friend was always going to need to turn her head away from me at some point. In fact, the conversation had started with her facing me. She was making sure both her companions were being addressed. But, this usually inclusive method of conversation had been complicated by my hearing loss, meaning that it was only possible for me to be involved in broken elements of the dialogue. If I had been with just one person, communication would have been much easier as I would have had the full advantage of always seeing my conversation partner’s face. Or, if we had been able to sit at a table, I could have sat opposite the third member of our group, enabling me to watch his reactions. I would have been able to study his facial expressions and follow the movement of his lips, and maybe, might even have caught some of the letter sounds and words he was saying.

In accepting my situation and realising my inability to successfully follow the conversation, my experience in the restaurant became one based on sights, smells and tastes. I concentrated on these senses which helped to divert my attention from the noise of raised voices. I noticed the decoration of the restaurant. I focussed on the black circular dish behind the bar, full of rock salt, with a peak in the middle, specially designed for coating salt to the rim of a margarita glass. I became lost in my observations. I watched as the bartender meticulously prepared drinks with concentration and care, rubbing lime around the rim of the glass and dipping it elegantly into the salt, so as to form an even rim of crystals. I observed the way he mixed cocktails, vigorously shaking a cocktail shaker, and then bending down to examine each drink carefully before sending them to customers. I noticed the small group of people working in the kitchen at the end of the bar, milling around continuously, some wearing white chef hats. I turned around to look at the groups of people sitting at the tables; I observed them talk animatedly to each other. The atmosphere in this small space was intimate, yet lively. Peoples’ faces looked happy and relaxed. I focused on the taste of the food. I really tasted it, trying to figure out the main ingredients.

When you lose a sense or part of one, there is a theory that your other senses are heightened. I’m not sure if this is the case. What I have realised is that I appreciate the hearing I have left. And, I pay extra attention to my other senses, as I now rely more on these to interact with the world.

I was happy to be out having a meal in a fantastic restaurant. Following my hearing loss, it had originally taken time for me to get to a stage of dealing with noise sensitivity issues to even be able to enter a busy place like this. Yet, this experience, for me, wasn’t one centred around social interaction and conversation, as it seemed to be for the other diners. It was an evening of observation, of noticing delicious aromas of freshly prepared cuisine, and of moments really appreciating the taste of the dishes. I enjoyed the atmosphere and the food, yet without the ability to converse effectively, I felt like I had experienced a lot of it alone.

This article was recently published by Hearing link.

Donations

Please help to fuel my writing by buying me a cup of tea 🙂

$5.00

How to Talk to People with Hearing Loss

I was recently contacted by Julia Florentine who has just published a book with her mum and her colleague. The book is for friends and family of people with hearing loss on how to communicate effectively and is entitled “How to Talk to People with Hearing Loss“.

The purpose of the book is to explain what people with hearing loss find useful from their communication partners so that the reader can learn to be a better communicator. It aims at helping people to understand the communication difficulties people with hearing loss (in particular, age-related) may have, so that they are equipped with the tools to speak more effectively with someone without full hearing.

Although my hearing loss isn’t age-related, I can still identify with the information in this book and think the tips would be relevant to communicating with someone with any form of hearing loss.

Among other things the book outlines ‘Two Major Myths About Hearing Loss’, ‘Five Most Common Questions Answered’ and ‘Ten Tips for Effective Communication’.

The section I found most relevant to my needs was ‘Ten Tips for Effective Communication’.

I’m sure with different types of hearing loss, the weight of importance will be concentrated on different areas, yet all points carry significance. The main tips that I would like people to know are 6, 7, 8 and 10:

6. If I do not hear you the first time, repeat with different words. Don’t say the same word I did not hear over and over again.

7. Try to limit or avoid background noise. I do not hear well in noisy environments.

8. Talk to me on the side of my better ear.

10. Hearing under adverse conditions can be exhausting. Sometimes, I need a break.

The book doesn’t just provide the tips, it also examines them; suggesting and explaining helpful actions.

I’ve been thinking about the information highlighted in number 10 regarding listening fatigue and realised that this is something I haven’t really talked about to anybody, apart from those who are close to me. I think the reason for this is because there are many other points that I feel others need to know. In particular, I inform people of my hearing side and the fact that I may need to sit close to them to hear them and to watch their lips for clues. I try to make sure I tell these two pieces of information to anyone who I will be having a prolonged or regular communication with. These details are conveyed for practical reasons. The fact that I am tired, doesn’t seem essential to explain.  It seems more like a personal detail.

Yet, the effort involved in listening can be very demanding. Even just meeting with a friend for a coffee can leave me feeling exhausted, and I often have to go home afterwards to lie down and rest my ears and brain. A great amount of concentration is needed to hear the main aspects of a conversation, to process this information, whilst trying to focus on keywords over background noise. It can be tiring attempting to keep up with the change in context, at the same time as endeavouring to hear questions; striving to give appropriate answers. During any conversation, I continually urge my tinnitus not to steal my attention, I deal with sound sensitivity issues, and all the while trying to look at ease with the situation. And so, it is not surprising that trying to follow a conversation, let alone joining in with it, can be quite a mission for someone with hearing loss.

I am aware that people with hearing aids may turn them off when they get home after work or being in a noisy environment, and this allows them to rest their ears and takes away the pressure of trying to listen or respond to conversation. I am quite envious of this. It must be a relief to be able to tune out after being around noise all day. Similarly, I often wear an earplug in my hearing ear when carrying out noisy tasks, such as washing dishes – this gives my ears a rest from noise.

I found it interesting that the point about listening fatigue had been included in the book, as it is not really a tip, but rather an insight into life for someone with hearing loss. It is a point that I would like others to know about me, but one which I rarely voice. I would like people to know that it is an effort to converse. Unlike some issues related to hearing loss, everyone can relate to feeling tired. Perhaps this understanding and awareness could promote empathy.

If you would like more information about the book, it can be found on Amazon, through the following links:

UK: http://bit.ly/hearinglossbook

US: https://amzn.to/2HzgBXd

Spain: https://amzn.to/2w6Yp1W

I hope Julia’s book will help enable more effective communication between those with hearing loss and their communication partners.