Friday, September 23, 2011


The voice of early 80s David Byrne filled my head as I stood in the Heartland Inn in Coralville, IA a few weeks ago. You may find yourself.....How did I get here, indeed? What was I doing in Iowa?

I was attending a conference on tinnitus, defined as those often annoying sound perceptions 1 out of every 100 persons in the United States experiences. Richard Tyler, Ph.D., a renowned expert on tinnitus management (don't ever use the word "cure", please) was hosting an annual conference at the University of Iowa in Iowa City. Audiologists, ENTs, neurosurgeons, hearing aid reps, and others presented a very impressing program of research and potential solutions to this often debilitating condition, coined by someone as "the malady of the 21st century".

The clinic trial/research studies were mind blowing. Many addressed the problem of defining what tinnitus is: a by-product of hearing loss, a psychological manifest, both? Several presentations discussed use of functional imaging studies to examine what happens in the cortices in tinnitus patients. One study used rodents as subjects, curiously stating that these rats had tinnitus. You may ask yourself, how did they know this? There is no objective tool to measure tinnitus, in humans or otherwise. Obviously, a reliable case history cannot be obtained from a rat. The clinicians subjected the poor animals to several minutes of very loud stimuli, to provoke tinnitus. If you've been to a loud concert, you've been a test subject yourself.

One presenter stated that a conditioned response with food (akin to Pavlovian) was another measure to determine which rats had tinnitus and which didn't (control group). There are more details about this that I will spare you. The crux of the study involved the permanent ablation of a certain part of the rat's brain. Following the surgery, a statistically sigificant amount of rat subjects with alleged tinnitus "reported" by their carefully monitored responses that the sounds had ceased. Human subjects later? How can we do such an invasive trial?

Other studies documented the implementation of the anaesthetic Lidocaine into parts of the (human) brain to temporarily stop the tinnitus. Yet others used electrical stimulation with a similiar result, however, hearing loss and even deafness also occurred in some cases. I see that perhaps a future Your Audiology Tutorial entry will be necessary to explain these models in more comprehensive detail for the interested.

But there I was in Iowa, my first time. Though my excitement for travel has dimmed a bit over the years, I still light up like a kid in certain moments. The very different landscape of Iowa City was a catalyst. Not a palm tree to be found. A much different feel than South Florida, that Midwestern vibe I've written about here before. Just to be somewhere else still gets me mildly buzzed.

The U of Iowa was much larger than I would've expected. We had lunch on campus both days, the first of which was in the student cafeteria. It was similiar to a mall food court, with stations for nearly every cuisine you can name. The student body was mostly lily white and blonde, as I did expect. The group attending the conference, however, was very ethnically diverse.

The highlight of this trip was surely just outside of the very rural Downey, IA, about 10-15 miles outside of Iowa City, in an historic barn owned by Dr. Tyler. 150 years old, to be exact. Tyler gave us a mini-tour, explaining the network of ropes seen bordering the octagonal ceilings. It was/is part of an efficient hay bailing system. Above that is an impressive collection of wood planks forming rafters that reminded me of the attic at my father in law's chateau in France. Pitchforks and other ancient tools were hung on the walls. Silos for grain sat in various spots. I loved it. The barn was just this side of a cornfield (but of course), not the sweet corn for human consumption, but the kind thrown to cattle and pigs.

An actor came and performed a 15 minute monologue. He played a man suffering from hyperacusis, an abnormal sensitivity to loud or even moderately loud sounds. The charcter was based on the actor's girlfriend's friend, or someone, as they were diagnosed with superior canal dehiscence, which, to simplify, is an erosion of bone over the inner ear which allows another portal for sound to travel through. The monologue was intense and fascinating.

Afterward, we enjoyed a barbeque. Then an older gentleman clad entirely in white brought in a record player and a microphone. Yup, it was time to square dance! Something I had not done since junior high school in P.E. class on those few Florida days it was too chilly to "dress out". I was dreading this, but had a whale of a time, even sweating a bit. I also enjoyed watching doctors and audiologists from Brazil and Singapore try to make sense of this very American custom. But I stopped and thought more than once, I'm square dancing in a barn in Iowa! It was funny. I spoke with the caller afterward, listening as he explained that VCRs killed square dancing back in the 80s, as folks decided to stay home instead of coming out to do-se-do and allemande. He remarked that the Internet really did it all in.

The final night a few of us, including one attendee's niece, hung out in the charming downtown Iowa City area, perusing a great old bookstore called The Haunted Bookstore (complete with sleeping cats) that had me salivating at their selection of used volumes. We all mentioned that we could've spent the entire night there. One of my colleagues bought a few writings of Dorothy Parker and Somerset Maugham. Nice to see an audiologist with good taste! When she found out that I like to write creatively she suggested I collaborate with her on a project she's been considering: profiles of why audiologists chose the profession. It is a fascination of hers, and she quizzed nearly everyone at the symposium, including a woman from British Columbia who does house calls, often driving hundreds of miles.

We dined at a slightly upscale hipster place called Motley Cow. There was no bovine on the menu. My polenta was quite good. We ate ice cream at Whitey's afterward. Most of the downtown strollers were Cucasian, though there were a few Asian and Middle-Eastern folks. I expected to see more of them, but what do I know of Iowa.

So we're back at the Heartland Inn, a slightly rundown hotel ala Days Inn with not too smelly carpets and suspicious bedspreads (the staff there was excellent, though). I looked at my room and thought of all the previous ones I'd stayed in for other syposiums and hearing aid trainings. It was like I looked up, and ten years had flashed by. What a long journey since graduate school. There were times during that I didn't think I would make it, but here I was. Very hard to explain, but Talking Heads' "Once in a Lifetime", for the myriad of meaning and relevance to middle age it has, really resonated those few days in Iowa, though I wasn't thinking things like "this is not my beautiful hotel room"! I've stayed in swanky places. No, it was more of one of those moments where you truly have time to stop and assess. As the guy in the breakfast room explained to me why he pours the batter for the waffle irons (fire marshall mandate), and the physician articulated neural activity to a late afternoon audience, I thought, once in a lifetime, indeed.
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