Sound of Metal: An Audiologist’s Perspective

https://www.youtube.com/watch?v=VFOrGkAvjAE

Directed by Darius Marder, ‘Sound of Metal’ portrays the experience of Ruben, a career punk drummer and recovering addict whose hearing suddenly and rapidly deteriorates over the course of a few days.  Ruben’s world begins to crumble after the diagnosis. Raging frustration from the sudden, emotional loss starts to affect him and his relationships, as he struggles to come to terms with the new realities of his life. Without giving too much away, the film depicts Ruben’s experience as he investigates the possibilities of committing to a dignified life in a communal Deaf co-op, or re-entering the hearing world through cochlear implants. Overall, as an Audiologist, I felt that the film provided an accurate representation of how both hearing loss and cochlear implants can sound, as well as the spectrum of emotion that an individual can experience with permanent hearing loss in the search for answers and self-acceptance. 

On the other hand, as an Audiologist, there were some details in the film that I think should be clarified for accuracy. First, although consistent noise exposure is very dangerous and can be detrimental to one’s hearing, it generally does not cause a sudden profound hearing loss to occur overnight. In addition, if an individual does experience a sudden hearing loss, it is imperative that they are seen by an Ear Nose & Throat physician as soon as possible, a detail that was not included in the film. If evaluated early enough, steroid treatment can cause some or all of one’s hearing to recover. Ruben’s appointment with an Audiologist had a lot of accurate points, although I thought the portrayal of counseling was flat, emotionless, and lacking a lot of important detail and support. In addition, Audiologists do not quantify severity of hearing loss through percentage. Moreover, a significant plot point of the film was hinged on the cost of cochlear implants (tens of thousands of dollars) and that they are “not covered by insurance”. This is simply not true. The large majority of insurance plans cover the costs associated with cochlear implantation, unlike hearing aids. 

Finally, and most importantly, I found it largely inaccurate that the personal choice of becoming a member of the Deaf community or choosing to pursue cochlear implants were presented as mutually exclusive. It is absolutely true that Deaf individuals can live a full, dignified life without cochlear implants. In addition, I do not want to discredit the concern for loss of Deaf culture associated with increased cochlear implantation after birth. On the contrary, the film seemed to portray that you have to choose one or the other. While there are some Deaf communities that are completely against cochlear implants, there are also many communities with individuals who identify as Deaf that also utilize cochlear implants or hearing aids for safety reasons. In total, I think that in many cases there is an acceptance for both, which was not depicted in this film; moreover, no individual should be shamed for choosing one or the other, or wanting both.