The epigraph to Rebuilt, Michael Chorost’s 2005 memoir of learning to hear through a cochlear implant (CI), is taken from the voice-over to the opening sequence of The Six Million Dollar Man: “Gentlemen, we can rebuild him.” The 1970s television series, based on the novel Cyborg by Martin Caidin, introduced bionic implants to the general public. Although Air Force surgeon Jack Steele had coined “bionics” in 1958 to describe the engineering of machines based on biological principles, the term soon connoted superhuman, cybernetic prosthesis. With remarkable circularity between fact and fiction, early cochlear implants were marketed as “bionic ears” (Blume 1997). Chorost’s own device was built by Advanced Bionics, one of the first companies to trademark the term. Yet after decades of research in speech processing and electroacoustics, enhancement to—rather than beyond—perceptual norms continues to seem like an extraordinary feat. Today, the six million dollar man can be found pitching the Lee Majors Bionic Rechargeable Hearing Aid: “With my bionic ear you’ll know when the phone’s ringing.”¹

Enhancement logic has tended to limit biological electronics to the “extension” of normative bodily and media continua. Taking a different approach, Chorost understands his cochlear implant to be a new medium, “a kind of relationship with technology that has not existed before. Mediating a person’s perception of reality by computationally controlling nerve endings inside the body is most definitely new. Glasses don’t do that; cell phones don’t do that; even pacemakers and artificial hips don’t do that. But a cochlear implant does” (2005:43). Chorost calls himself a cyborg, yet he trades the biomedical rhetorics of rehabilitation and enhancement for what might be described as a media-theoretical stance on altered, always partial, perceptual experience. With the development of cochlear implants—the first neural prostheses—in the 1950s and (p. 262) 1960s, electrical machines began to communicate directly with the nervous system, bypassing certain aspects of the human sense organ and, sometimes, even the medium of air or external generators of mechanical vibration.² Cochlear implants afford novel forms of auditory perception. They increasingly simulate as well as stimulate hearing—these electroacoustic devices replicate particular functions of the inner ear (transduction, filtering), but at the same time they “process” or reshape incoming sounds. Implants also produce their own electronic tones—detectable only by the user—for control-setting.

If this “new medium” is defined broadly as electrical hearing—or even more broadly as electrical-neural communication—its technical infrastructure is continuously changing.³ Most cochlear implants presently consist of a fully implanted receiver and electrode array; an external microphone and speech processor, worn at the ear; and an external transmitter, which attaches magnetically to the receiver beneath the skin. Cochlear implant systems are generally programmable and amenable to upgrades. Extracting and coding speech—especially in noisy environments—remains a research priority, however substantial work is also being done to expand these “speech processors” to handle music and other sounds. I have argued elsewhere that implant hardware and software embody cultural values related to communication: the privileging of speech over music, direct speech over telecommunication, non-tonal over tonal languages, phoneme over emotional prosody recognition, quiet over noisy environments, single rather than multiple software options (for reasons of economy, namely lack of clinical time for installation and training), and black-boxed over user-customizable technology (software settings must be set in the clinic; users can adjust volume and microphone sensitivity, and select among a few preset programs based on generic “listening situations”).⁴ If traditional hearing aids can be considered the first mobile communication technologies, implants raise additional questions about media wearability and the contraction of hearing and communication to the neural realm (Mills 2009:140–46).

Cochlear implants have exhibited a prolonged period of “interpretive flexibility”—the multiple and often divergent perspectives on design and use that proliferate during the development of an artifact, before its eventual “stabilization.”⁵ Fervent debate surrounding the significance of implants suggests that they remain new media even after fifty years. At one extreme, Ray Kurzweil has described cochlear implants as a first step toward “the singularity,” when synthetic biology and intelligent machines meet each other in the culmination of universal communication (2005:195). He projects, in The Age of Spiritual Machines: When Computers Exceed Human Intelligence, that by 2029 “cochlear implants, originally used just for the hearing impaired, are now ubiquitous. These implants provide auditory communication in both directions between the human user and the worldwide computing network” (1999:221).⁶ Others have speculated from these trends in sensory prosthesis and signal transmission to possibilities for an expanded range of human audition, or an impending era of “synthetic telepathy,” “downloadable intelligence,” and automatic language translation. In such predictions, the cochlear implant is often figured as the endpoint of body-machine fusion—the mobile medium that will end the need for human mobility.

(p. 263) At the other extreme, first-hand accounts from cochlear implant users overwhelmingly emphasize constrained psychotechnical experience and ongoing negotiations with body-machine compatibility. One of the first implant test subjects, Charles Graser, was described by friends and observers as “the bionic man” in the 1970s (Figure 12.1). Graser’s use of experimental and often provisional devices resulted in singular acoustic experiences. “It really is like dealing with a new medium,” he noted in the fall of 1973. “It is difficult to compare what you hear one time with what you heard one month or a year ago. It’s sure too bad that what I hear can’t be recorded.”

Click to view larger

Figure 12.1 Charles Graser (left) at Urban Engineering, c. 1972.

Image courtesy of Charles Graser.

Even so, as the primary test subject at the House Ear Institute in the 1970s, Graser’s individual physiology and psychology contributed directly to the design of the single-channel 3M/House device—the first cochlear implant to receive FDA approval (in 1984). From a medical engineering perspective, Graser and other early users were essential for establishing surgical technique, number and placement of electrodes, biocompatibility of implant materials, design of external hardware, and strategies for signal modulation. As Graser reflected in his journal from 1973, self-reports of perceptual experience by implant users were the imprecise but unavoidable independent variables for processor assembly: “There are no standard or objective evaluation points or standards in this experiment. The patient merely attempts to describe what he hears and the engineers design equipment or adjust it accordingly.” Graser was an ideal subject for these trials: he was an expert listener—a saxophonist and singer—and he had an uncommon lay expertise in electroacoustics through prior military radio work.

(p. 264) He recorded hundreds of pages of field notes and diaries during the 1970s. From a sound studies perspective, this writing documents the first moments of reckoning with a new electroacoustic medium and, in turn, with the re-definition of human hearing. It indicates: a range of hardware and software possibilities for cochlear implants, before economic and cultural imperatives began to assert themselves; a definition of hearing that exceeds ear and event, and necessarily encompasses mind and media; an understanding of hearing (and not just “listening”) as communicative and directional—yet marked by technical, bodily, and commercial filtering; a sensitivity to the exchanges and interferences that occur between electrical technologies in an increasingly dense media ecology. Most important, Graser’s notes denaturalize the finished products of ergonomics and design, revealing the trials and errors by which implant technology became mobile, wearable, and “personal.”

Graser’s involvement with the House Ear Institute in the 1970s occurred in the midst of a shift in the long history of experimentation with electrical stimulation of the ear—a turn away from the traditions of auto-experiment by individual scientists, and isolated treatments or tests of patients in clinical and pseudo-clinical (i.e., “quack”) settings. In the postwar period, “medical electronics” emerged as a field alongside the development of transistors, integrated circuits, and miniaturized devices. This variety of interdisciplinary work was institutionalized through new biomedical engineering departments at universities. At the same time, university-industry collaborations (legally formalized by the Bayh-Doyle Act of 1980, which allowed academics to patent the results of research that had received government funding) led to increasingly large-scale medical and engineering collaborations. Beginning in the 1960s, Graser volunteered to test cochlear implants in the relatively informal clinical setting of the House Ear Institute, which had partnered with a small, private engineering firm owned by Jack Urban.

This was simultaneously a pivotal moment in terms of human subjects research, occurring just before the 1975 revision to the Declaration of Helsinki, and its instantiation in US law (1981), requiring Institutional Review Board (IRB) evaluation and approval of such research on ethical grounds. Graser’s experiments preceded “informed consent” as well as health information privacy laws (i.e., Health Insurance Portability and Accountability Act, or HIPAA, of 1996). For this reason, his “voice” as an experimental subject was not formally suppressed—physicians at the House Institute often publicly cited his field notes. Graser further testified in lectures and on film about his experiences; these testimonies initiated a final turn—the slow clinical acceptance of cochlear implants, which had otherwise been greeted with intense criticism in the medical, pedagogical, and popular spheres.

Long History of a New Medium

Even internal histories of the cochlear implant, such as the often-cited 1966 literature review by Blair Simmons of Stanford (an early CI innovator), place the technology in the (p. 265) long tradition of electrical stimulation of the ear. Most of these histories begin with the experiments of Alessandro Volta, who in 1790 directed a current into his own ear canals and heard something:

I introduced, deep into my two ears, two types of probes or metallic rods, with round tips; and I made them communicate directly to the two extremities of the device. Just as the circle was thus completed, I received a shock in my head; and, a few moments later, (the communication continuing without any interruption,) I began to sense a sound, or rather a noise, in my ears, that I could not easily define; it was a type of jarring crackle, or sizzling, as if some dough or tenacious material was bubbling. This noise continued without diminishing or increasing, the whole time the circle was complete, &c. The disagreeable sensation—which I believed to be dangerous—of the shock in my brain ensured that I have not often repeated this experiment. (1800:427; translation by author)

Johann Wilhelm Ritter and Guillaume-Benjamin Duchenne, among others, eventually attempted the same auto-experiment. Duchenne likened his sensation, in 1855, to “a little dry parchment-like sound, a crackling…when the intermissions were very rapid the sound resembled a crepitation, or the noise produced by the wings of a fly flying between a window-pane and the blind” (1883:370).⁷ The unprecedented sounds seemed either to derive from the shaking of the ossicles and the auditory nerve (the result of electrical vibration); or it was argued that the noises were produced by the electrical equipment itself.

Duchenne subsequently turned to what he called a “gratuitous” population—deaf patients—to continue his research:

My own ears and those of my friends not being sufficient for my experiments, I borrowed the ears of deaf gratuitous patients, to whom I held out the inducement of possible improvement. By chance many of these patients were cured or bettered. This is how I was led to be a curer through my physiological curiosity. These cures were quickly known, and then deaf and deaf-mutes were sent to me in numbers, and whether I would or no, I was obliged to continue these empirical experiments. (369)

Click to view larger

Figure 12.2 One approach to Electro-otiatrics, an understandably suspect field for many Deaf people. Reprinted from Kyle 1903:134. In the public domain.

Rudolf Brenner of Leipzig later undertook the first systematic studies of this therapeutic phenomenon, applying electricity to the tympanic membranes of numerous individuals and establishing a diagnostic “formula for the reaction in the normal ear” (Roosa 1874:492). He took the perception of “hissing, roaring, ringing” to indicate an auditory nerve that might be accessed via electricity, despite other otological impairments. Hearing began to be defined according to nervous function, without reference to what had previously been thought of as “the ear itself.” These experiments were part of the emerging field of “electro-otiatrics,” which has understandably been the subject of much critique within Deaf studies (Figure 12.2). In the nineteenth century, electrical therapies were offered by lay aurists as often as by licensed physicians; these treatments were not only provided to deafened therapy-seekers in clinical settings, they were sometimes forced upon children in deaf oral schools (Scheppegrell 1898:318).⁸ In 1898, allergist (p. 266) and otolaryngologist William Scheppegrell published one of the first monographs on the application of electricity for the diagnosis and treatment of ear diseases. In terms of therapy, Scheppegrell analogized electricity to a pharmaceutical agent; he noted that it could be “applied” to a patient’s ear for several different purposes: to relieve pain, increase absorption, stimulate muscular action, staunch hemorrhages, destroy tumors, or heal ulcerations. Although the sensation of sound might be a side effect of electrical stimulation, nowhere was it suggested that electricity could be used to transmit complex messages into the ear or brain.

Gordon Flottorp, formerly of the Harvard Psycho-Acoustic Laboratory, dates the “modern” period of electrical hearing to 1925: in several countries that year, “radio enthusiasts” reported hearing sounds when they held electrodes near their ears. What was “new” about these experiments, Flottorp explains, was their use of alternating current through the relatively precise source of vacuum tubes (1953:236). Unlike Scheppegrell’s (galvanic) electro-therapy, in which a direct current of electricity was used to provide vibratory massage or cauterization to the middle ear, in these cases an electrical waveform carried audio information (via variations in frequency and amplitude) through the skull to the auditory nerve. This generation of experimenters described electrical stimulation as “a new medium” or “a new mode of hearing,” situating it alongside other “new” communication technologies, like radio itself.

One of these radio enthusiasts, Gustav Eichhorn, obtained patents in Switzerland and the United States in 1926 and 1927 for his “radiophone,” in which “an exciting element…is held against the head or near the ear, so that…the skin or supple part of the face in the immediate neighborhood of the ear are forced by an electrostatic effect to set up oscillations which are not transferred to the ear drum but direct to the inner organs of hearing.” Eichhorn pitched his invention to people with impaired ear drums, and to radio listeners interested in a “physiological and acoustic” mode of perception—one in which “the body of the user is included in the anode circuit” of the radio system (1927: 1–2).

Another enthusiast was Hugo Gernsback, the founder of Modern Electronics, Electrical Experimenter, and Radio News magazines, as well as Amazing Stories, the first (p. 267) science fiction journal. Gernsback, who purportedly coined the phrase “science fiction” and the word “television," is now known in the electronic music world for constructing some of the first electrical keyboards—the staccatone in 1923 and the pianorad in 1926. Among his 80 patents is one from 1923 for an Osophone or “acoustic appliance,” which employed a portable microphone to amplify and transmit speech vibrations to a listener’s teeth. The March 1934 cover of Radio-Craft, edited by Gernsback, featured his Phonosone, a bone-conduction radio-listening device “for the near deaf.” Like Eichhorn’s radiophone, the Osophone and Phonosone were similar in principle to nonelectric bone conduction hearing aids. These new inventions showed that electrically-generated vibrations could carry speech information indirectly to the auditory nerve, although there was much debate about how this occurred.

By the 1930s, physicians and physiologists began to collaborate on these experiments with radio and telephone engineers. In one widely-reported case, Stephan Jellinek (a Viennese doctor) and Theodore Scheiber (an engineer) used a telephone transmitter connected to an electrode to send an electrical current into a patient’s ear. They claimed that the patient experienced “a new method of hearing,” “not dependent on the functions of the outer or middle ear.” In a notice titled “Earless Hearing,” Time Magazine reported in April 1930 that “should the Jellinek device succeed, humans could hear an infinite range, would not have their orchestra limits the piccolo flute and the double bass” (1930:40).

The auditory nerve began to be directly incorporated within electroacoustic circuits around the same time. By the end of the 1920s, Robert Wegel and Charles Lane of Bell Laboratories had loaned Princeton psychologist Ernest Glen Wever, upon his request, an audiometer, a loudspeaker, an oscillator, and other electrical devices from Bell Laboratories (Vernon 1997). Wever and Charles Bray—both former students of Edwin Boring—set out to test his “Telephone Theory” of hearing (Boring 1926). According to this theory, the inner ear behaved like a (contemporary) telephone transmitter, converting sound waves into analogical electric currents, which were carried to the brain rather than being manipulated or reordered in the cochlea.⁹

Wever and Bray decerebrated a cat and attached an electrode to its exposed auditory nerve. The cat became the transmitting end of a modified telephone system; electrical signals from the nerve were conducted to a receiver in a separate, soundproof room.¹⁰ Bray listened at the end of this telephone as Wever made noises into the cat’s ear. Whispers, whistles, tones from organ pipes, room noises—these all could be easily identified. (Transmission declined as the cat slowly died; the system continued to function for up to twenty minutes after death.) The telephone theory thus seemed valid—in fact, Wever and Bray compared the cat-transmitter favorably to that of an “actual” telephone, set up in the same laboratory rooms (Wever and Bray 1930b:377–78).

Within the next two years, Harvard physiologist Hallowell Davis and his former mentor, Edgar Adrian, independently replicated the procedure, demonstrating that the Wever-Bray effect was actually the result of a second electrical impulse produced by the ear (Adrian 1931; Davis 1935, 1991:17–18).¹¹ When Davis tried placing an electrode near a cat’s brainstem, the circuit ceased functioning. Only electrodes placed near the hair (p. 268) cells transmitted intelligible speech. There, what turned out to be a small, analog electrical response—the “cochlear microphonic”—amplified entering sound waves. Speech transmitted through electrode pickups near the hair cells had “a characteristic metallic quality, suggestive of a telephone or radio broadcast” (Davis et al. 1934:313). The ear thus transduced mechanical input in more than one way: filtering sound waves at the cochlea to trigger a response from the auditory nerve; generating electrical analogs at the outer hair cells.

The questions raised by the Wever-Bray experiment galvanized an enormous amount of ear research. Otologists quickly appreciated that this technique provided an opportunity to hear through someone else’s ears. With the assistance of Harvey Fletcher and Robert Wegel of Bell Laboratories, Samuel Crowe and Walter Hughson began to study ear pathology at Johns Hopkins (Crowe and Hughson 1932).¹² In 1931, they imposed various artificial lesions on cats—damaging their ossicles, puncturing eardrums, initiating infections. Using an audiogram chart, they then plotted their own reception of sounds through the cats’ ears.¹³ Some “defects” seemed in fact to improve hearing.

In 1940, S. S. Stevens—a psychologist at Harvard and a colleague of Flottorp and Davis—wired an electrode to a radio set and placed it in the middle ears of graduate student test subjects, who described hearing “tin-pan” music and “occasional words.” Stevens concluded, at first, that electrical stimulation “does not promise much as an alternative means of hearing as long as so much distortion is present” (1937:194).¹⁴ Collaborating with physics graduate student Robert Clark Jones (who went on to work at Bell Labs), Stevens was eventually able to correct some of this distortion; he tried the experiment on himself in 1940 and reported, “a reasonably pleasant half-hour was spent listening to Fred Allen’s program.” (Stevens and Jones 1939:264). He named this mode of electrically stimulated acoustic perception “electrophonic hearing.”¹⁵

Later that year, working with Jones and otologist Moses Lurie, Stevens tested a set of patients without eardrums at the Massachusetts Eye and Ear Infirmary. Believing the middle ear to play an essential role in electromechanical transduction, Stevens predicted that these individuals would not respond to stimulation. Yet of twenty ears, sixteen perceived sounds like buzzes and “cricket chirps.” And although the side effects were uncomfortable—dizziness, nausea, facial twitching—Lurie reported an (unwanted) eruption of public interest:

Human beings are very peculiar people. If you promise them or you even hint that you might help their hearing, they will let you do anything in the world. I remember when Dr. Davis and I gave the first demonstration at the International meeting of the Physiologists. The newspapers obtained a report of the presentation. The first thing I knew I received letters from individuals all over the world asking when could they come and have their hearing restored and that is the great danger of this work appearing in the newspapers and the ensuing publicity. (1973:515–16)¹⁶

Direct electrical stimulation of the human auditory nerve was first attempted in 1957, when Drs. Charles Eyriès and André Djourno implanted wire electrodes (connected to (p. 269) induction coils) at the 8th nerves of two deafened patients in Paris. These individuals were able to perceive sounds of various frequencies, delivered through a microphone and external coil in the laboratory. Both experiments, however, lasted no more than several months. In one case, the device ceased working; in the other, the patient strongly disliked the experiment and ceased participation.¹⁷

Dr. William House of the House Ear Institute in Los Angeles made a few similar—and similarly brief—tests in 1961 after a patient brought him a French news clipping about Djourno and Eyriès. According to Marc Eisen, “The work of Djourno and Eyriès was published only in French and never gained momentum in further pursuing human implants. Their work would likely have remained in obscurity for many years if a patient of William House had not brought the work to his attention” (2009:91). With the help of a neurosurgeon and an electrical engineer, House began by temporarily stimulating the auditory nerve of a patient during surgery. Soon thereafter, he placed an implant at the man’s cochlea, followed by a similar trial with a female patient; he was forced to remove their devices almost immediately due to the instability of the materials. Only at the end of the decade, with improvements to transistor technology and surgical plastics—aided by the precedent of artificial pacemakers—would House resume such surgeries.

Robin Michelson, a physician in private practice in Northern California, also began to investigate cochlear implantation in the 1960s. He was first motivated by T. I. Moseley, a patient with tinnitus who was the founder of Dalmo-Victor, a firm that built radar antennae and other signaling apparatus for the military. One of Moseley’s engineers constructed a device for Michelson that amplified the inner ear’s electricity, so he could listen to the cochlear microphonic in patients with tinnitus. Through experiments with this device, it occurred to Michelson that the inner ear might also be stimulated with electricity. In the mid-1960s, he began conducting laboratory trials on cats in collaboration with an engineer from Zenith Radio. This research was funded by Department of Defense, which was interested in the possibility of implanting microphones in the heads of cats and sending them into the field as roving acoustic spies.¹⁸

Michelson eventually moved to the University of California–San Francisco (UCSF), and in 1970 he implanted four adults with single-channel devices designed by an engineer from Beckman Instruments.¹⁹ Although he had initially believed that cochlear implants would only be able to transmit simple sound cues, by this point he held the “primary goal of usable speech recognition” (Michelson 1971:323). Working with neuroscientist Michael Merzenich and otolaryngologist Robert Schindler—grandson of the founder of Jensen Radio (now Jensen Mobile Electronics)—he began to focus on the development of a multichannel device. This research, which led to the Storz and later Clarion implants, was anchored in animal studies conducted throughout the 1970s to establish the safety of electrical stimulation, especially over the long term.²⁰ In collaboration with the Research Triangle Institute, the UCSF team began in the mid-1980s to focus on the problem of signal processing for speech, based on feedback from human implant users. At Stanford, F. Blair Simmons had implanted a patient with a multiple electrode device in 1964, with discouraging results. He, too, turned to animal research, (p. 270) partnering with Robert White of the electrical engineering department to investigate multichannel cochlear stimulation into the 1980s.²¹

Working in a clinical as opposed to academic context, House did not carry out basic research. In 1968, he performed an exploratory surgery to test electrical stimulation of the auditory nerve on Charles Graser, a patient at the House Ear Institute who had been deafened by high doses of streptomycin prescribed after an accident in 1959. In 1970, he gave Graser a percutaneous multielectrode “button” implant. With electronics engineer Jack Urban, they spent the next two years testing numerous modulation schemes in the laboratory before Graser was released for equally exploratory “field tests” with an early portable speech processor.²² House compared Graser to Charles Lindbergh, “who flew over the Atlantic at great risk to open this possibility for others. Mr. Graser also faced unknown risks and has made great and lasting progress” (House 1974). Graser’s physical experiences contributed to surgical procedure and knowledge about the effects of long-term stimulation. According to Marc Eisen, his perceptual experiences also set the standards for signal modulation in the first commercial implants:

Postimplantation, he worked intensely as a research subject, and continued to do so enthusiastically for many years. Many of the observations and modifications that House and Urban reported in the 1960s were based on testing only of Graser. For instance, one of the surprising findings from work with Graser was that a 16,000-Hz carrier signal helped him appreciate higher frequencies, and amplitude-modulating the carrier with the acoustic signal generally sounded the best. This signal processor strategy became standard on the House/3M (St. Paul, MN) cochlear implant. Reporting of these early results was primarily by testimonial experiences of the individual subjects rather than systematic study. Another important outcome of these early studies was abandoning the multiple electrode systems for the single-wire electrode. (2006:6)²³

Stuart Blume, a sociologist of science, further suggests that Graser’s performance helped recruit other researchers internationally: “For the implant pioneers, in the 1970s, conviction grew out of personal experience. It was not aggregate data, which did not yet exist, that convinced them of the promise of the implant. It was their work with one or two experimental subjects that convinced them, or the visits they paid to William House in Los Angeles” (2010:175).

Click to view larger

Figure 12.3 The 3M/House Cochlear Implant.

Photo Courtesy of Charles Graser.

In 1984, the FDA approved the 3M/House single-channel cochlear implant for adults (Figure 12.3).²⁴ The next year, approval followed for the Australian (Nucleus) twenty-two-channel implant designed by Graeme Clark. With the approval in 1990 of cochlear implant use by children, the longstanding conflict between mainstream medicine and the Deaf community was exacerbated—because pediatric implantation potentially decreases the population of native signers.²⁵ Less well known, cochlear implants remained an intense medical controversy throughout the 1970s, even when applied to deafened adults. William House, in particular, was criticized by many university otologists for proceeding without animal research, an ethics review board, or valid clinical trials. Dr. Nelson Kiang of the Massachusetts Institute of Technology cautioned, (p. 271) “Enthusiastic testimonials from patients cannot take the place of objective measures of performance capabilities” (1973:512).²⁶ A 3M employee recalled that criticism of pediatric implantation was nearly ubiquitous in the 1970s and 1980s, coming from “every conceivable quarter: New York League of Hearing, Central Institute for the Deaf, the public press, academic institutions.”²⁷

Nevertheless, the testimonials of individuals like Charles Graser succeeded in establishing the credibility of cochlear implants—even as those individuals labored with makeshift technology to shape the design of commercial devices. In the 1970s, Graser’s “personal evidence” appeared in various formats: short marketing films produced at the House Ear Institute; live demonstrations before other physicians; positive excerpts from his field notes, published in scientific articles; even a single-run comic strip. Graser’s statements were often selected for evidence of speech recognition, although the field notes describe his engagement with a much wider range of environmental “audio clues”—and, in fact, the earliest implants were not generally successful at transmitting the complex waves of speech.

In the interview and journal entries that follow—half a century after the first implant, and forty years after his own—Graser’s disappointments as well as his enthusiasms become evident. Despite the “bypassing” of his ear, he details the myriad ways that living (p. 272) with a prosthesis is an embodied experience. These notes rupture the seamless conjunction of biological-electronics presumed by “bionics.” Graser discusses his ongoing difficulties with the neural-machine interface: trials of various metals and coatings for the electrodes; the transition from a percutaneous (Figure 12.5) to a transcutaneous implant; experiments with glasses, magnets, and adhesive means for attaching the external transmitter. He details his efforts to domesticate this new technology through his own altered habits of sleeping, showering, and self-care, as well as by technical adjustments to facilitate walking, bicycling and other “mobile activities.”

In part due to the total and prolonged nature of hearing through cochlear implants, Graser’s field notes represent an unusually extensive pilot analysis of an audio technology. He documents the transformation of his everyday soundscape, meticulously attempting to correlate the novel sounds from the device to objects and people in his environment. He marvels over hearing electronic sounds, some of which never existed as airborne waves but were delivered from laboratory equipment directly to his auditory nerve. If sound conventionally indicates motion (of vocal tracts, musical instruments, loudspeaker diaphragms, other objects in the environment), electrical hearing is here also produced by interference: in these notes, Graser deciphers sonic experiences of energy from television sets, electrical wires, and radar traps.²⁸ His journals are thus a record of introducing a new technology into an existing media ecology; his cochlear implants become actors in a network of electronic devices—blocking some, while allowing Graser to interact with others in novel ways. In a related manner, he reflects upon the suddenly apparent presumptions and protocols of modern orality, as well as his alternative points of entry into audition.

Click to view larger

Click to view larger

Figures 12.4 Guides to two of Graser’s early processors.

Courtesy of Charles Graser.

With Graser’s assistance and approval, I have chosen the following selections from his field notes from a sound studies perspective, as opposed to a marketing or therapeutic one. Graser writes as an exceptional listener and, at once, a person with an audiological impairment. In the fifty years since the first implant surgery—and the two centuries since the first experiments with electrically stimulated hearing—200,000 people have adopted cochlear implants. The devices themselves now tend to be multichannel, with computerized processors and the capacity for software upgrades, to accommodate ongoing research into the processing of speech (and, to a lesser extent, music and other sounds). Through this technology, hearing has increasingly been defined as communication: the calculated detection of speech and environmental sounds, the machinic segregation of desired sounds from “background” noise, the possibility for on/off control (or “earlids”). Whether this new medium will gravitate toward more normative models of hearing or toward radical forms of communication—and whether its use will become common or rather remain always minor—are part of the technology’s continued interpretive flexibility.²⁹ Although the “experimental future” of implantable audio electronics has indeed materialized incrementally, many of the emergent socialities and acoustic phenomena predicted by Graser’s field notes have proven to be short-lived. Indeed, after decades of implant use—with the risks of neural damage inherent to his work as a test subject—Graser can no longer hear through these devices (Figures 12.4). (p. 273)

(p. 274) “Customizing My Own Sound”

Mills conducted this interview with Graser via email between February 2010 and April 2011:

How did you lose your hearing?

While I was a high school teacher with a young family in Colton, California, I also worked part-time as a tank truck driver for Richfield. We appreciated the extra income, and I enjoyed a job where I got instant results, compared to social studies teaching.

While I was working one Sunday in June 1959, fuel spilled and ignited on me. I managed to put out the fire by using an industrial wheeled fire extinguisher before I collapsed. This was in a Tank Farm where a great deal of fuel was stored. Then, 17 pieces of emergency equipment arrived, and I was rushed to the hospital for a 3 1/2 month stay. I was so seriously burned on my legs and body that I wasn’t expected to live, but my good physical condition, wife, private nurse, and medical personnel barely kept me alive. Due to infection from the burns, I was given streptomycin, an anti-bacterial medicine. This was a very painful period. At first, it appeared that I was dying, but then the doctors realized that I had lost my hearing and sight. It was still touch and go to survive, but my sight returned, and I learned to walk again before I was released from the hospital to convalesce at home. After a few months, I was fortunate to be able to return to school and do some class scheduling and other tasks. Finally, the school offered me the job of school librarian to replace the retiring librarian. So, the following year, I was a deaf, busy new librarian in the high school of approximately 2,000 students.

How did deafness affect your daily activities?

Before the fire, I taught social studies to junior and senior high school students. I also had a busy social and part-time work life. After losing my hearing, I resigned my position on the city planning commission, quit singing in the church choir, driving the tank truck, square dancing, and many other things. It was a real blow to not hear our three children’s young voices, and have people communicate by writing to me. People are not very eager to do that and you begin to lose contact. You don’t get into many bull sessions and so forth after you lose your hearing.

I always enjoyed our family dinners and parties, but I started feeling lonely when I was not in the conversation. The same held true for get-togethers with friends. You always feel somewhat of a dunce when everyone laughs, and you don’t even know what was funny. Watching most TV programs was also useless until captioning began.

(p. 275) Before long, I had an appointment at the House Ear Clinic, and I began using two powerful hearing aids that gave me some feeling of sound. I also began to study speech reading. Fortunately, my wife managed to help me understand her, and she became my “interpreter.” I managed to get along, but deafness is an extremely difficult situation, and maybe even more so for a person who is very verbal and musically inclined. I had been playing the sax, singing, and listening since I was very young, and I had taken courses in speech. When I was a part-time tank truck driver, I rigged radios so that I could listen to music in those long hours.

Fairly soon, I began to communicate with Dr. William House, and he mentioned that research was being done on an artificial hearing system using electrical energy to stimulate the cochlea and hearing nerve. Deafness can also cause desperation, and I felt cochlear implant development was sort of a Calling.

Why did you decide to participate in the early trials at the House Ear Institute? What outcomes did you expect?

As I look back on it, I was really naïve about agreeing to participate in the cochlear implant development, but I was desperate to hear again. In fact, I began to communicate with Dr. William House about progress in research. We traded letters every six months. This correspondence lasted for 10 years. Then, Dr. Bill introduced me to Jack Urban at his Burbank engineering business. Jack had worked in the space program and the Lincoln exhibit at Disneyland in Anaheim, California. Jack was so enthusiastic and supportive that you wanted to join the team. Within a short time I entered St. Vincent’s Hospital in Los Angeles for an experiment attaching electrodes in my inner ear.

The first surgery via my left eardrum was not too painful, but before anesthesia [had] improved, you had to sort of fight to regain complete consciousness. The object was to find out if I could hear sound from electrical stimulation. I was really sedated, but I wanted to hear the words, “Dr. Watson, do you hear me?” I didn’t hear words, but I said that it sounded like someone tapping on a microphone with a pencil. I was disappointed, but the next time that I saw Jack, he was excited because I did hear him tap the microphone. This led him to develop an electrical “box” with controls for changing various sound components. The electronics were in a metal case about the size of a normal book. It reminded me somewhat of my radio shack duty with the 11th Airborne Division in Japan after World War II.

Tell me about the field tests you performed in the 1970s and 1980s.

I enjoyed the chance to “play around” with the switches and dials to create better sound. Jack Urban then attached the mike to the device, and I watched TV, and my wife read to me to find out how much help I was getting from the sound. This was encouraging (p. 276) enough for Jack to build a single channel portable device that I could use outside his lab.³⁰ This instrument was approximately the size of a Blackberry, two cell phones thick, small enough to wear in a shirt pocket or holster that I wore around my neck. At first I was slightly disappointed about the sound, but when my wife and I reached our home, I held the device in my hand, and the sound drastically improved. I just wanted to keep talking, but my wife was tired and went on to bed. My young son and I stayed up much longer talking, and the sound kept improving as the moisture on my hand improved the electrical system’s ground. This quickly led Urban to attach a wire and a silver piece that I wore at my waist.

Not long after this, I was asked to demonstrate my sound comprehension to a number of visiting doctors in Los Angeles who seemed to think I was using mental telepathy, or cheating. The most skeptical doctor asked me to take a simple verbal test. He said, “Close your eyes and repeat to me a number from one to ten that I say.” When I said “two,” I noticed doctors around me smiling. I was then told to try it again, and I told the doctor twenty-two. The doctors almost applauded, and the doubting doctor left without further comment. So, I didn’t get fooled after all. This was one of many interesting experiences I had during development times.

I started doing my own adjustments to the instruments because we lived 60 miles away from Jack Urban’s lab in Burbank. Sometimes, he would telephone and tell my wife what I should do. All of this was very informal. It was also fun to customize my own sound, and I even carried a small screwdriver with me to fine tune the “box” to provide the best sound for various circumstances. I tried changing Modulation, Symmetry, Carrier Wave strength, Microphone Sensitivity and other sound values.³¹ This resulted in modification of the portable instrument. Jack Urban would sometimes ask me why I made changes, and I would just reply that sound fidelity was better. He was disturbed because his oscilloscope showed sort of a “dog leg” on the sine wave. I was afraid that if he corrected it, I would lose some fidelity. As changes were later made to design an instrument that could be produced for multiple people, both my wife and I were aware that the sound of a commercial device might not work as well for me. It also bothered me when more advanced devices were simplified, and I couldn’t customize sound. My concern was that the more the processor was changed, the less noise and fidelity it would produce.

Click to view larger

Figure 12.5 Graser’s Early Percutaneous Implant.

Images Courtesy of Charles Graser.

All of this development was done on a part-time basis. I would leave my school librarian job as soon as school let out and head for Urban’s lab in Burbank, more than an hour’s drive from school. Dr. House was at the House Ear Institute or other pursuits all day, and Jack Urban had ongoing, busy engineering design and production work to do. Virtually the whole early development relied on verbal input. I would twist the dials and change the switch positions as I counted. I tried to give examples of what speech sounded like (p. 277) by sort of mumbling words with my hand covering my mouth. I was always optimistic about improvement.

Almost all of this experimentation was done with a single channel. When we experimented with multiple channels, no improvement was noticed, so Dr. House decided to stick with the single channel. The early testing and use was through a hard-wired 6-electrode array. I had an exterior connection on the left side of my head. The whole experience was so exciting that I didn’t mind looking a little odd. Friends even kidded me by calling me the Bionic Man. People seemed more interested in the new technology than bothered by a really wired person.

All of this was done without signing a lot of legal documents or anything comparable to current requirements. It involved just trusting each other, or ignoring the dangers involved. Dr. House even commented that he checked up on me by phoning my wife daily until many hours of successful stimulation had occurred. By that time, I was using the implant sound [during] all my waking hours with no negative experience or (p. 278) weakening of the stimulation. One of the things that made this interesting was what it did to my self-confidence and ego. I enjoyed the attention and was invited to give speeches about the development. It was fun to be in a leading-edge design to help deaf people hear.

I remember a conversation that I had with a deaf person I encountered after I started using the CI. He said he wasn’t interested in the CI. At that time I didn’t understand his attitude, but I do now. Changing communication cultures is not easy, and you can end up with none. I knew one CI recipient who learned sign language, and his total communication became worse.

Tell me about your experience of sound with the implant.

The implant initiated remarkable experiences with various sounds. I was eager to use the telephone, so my wife and I decided that I could just ask her a question, and she would say the one word, yes, or no-no to reply, sort of a code to tell me if I was correct or not. When I phoned her from work and asked what we were having for dinner, she said “spaghetti,” and I repeated it back to her after she said it several times to me. We started “playing word games.” She would say the name of a city that would be familiar to me, and I would repeat it back to her. I really enjoyed hearing the city, Albuquerque, and other interesting names.

Even though this was a single-channel cochlear implant device, I was amazed at all I could hear. Hearing the school bells and other environmental sounds was really helpful. People’s voices were the best of all. Conversations became more enjoyable because of the improvement in my lip reading. My wife and I had dinner at a noisy restaurant, and she told me it was too noisy for me to use the cochlear implant. However, I told her I could hear the voices of the people nearest to us. I wanted to hear music, but the fidelity wasn’t very good. When I joined the church congregation singing a hymn, I was told that I was OK but somewhat tone deaf. In fact, my wife, who was a good singer, said that there were plenty of other singers who seem to be tone deaf. Hearing the turn indicator sound was helpful, as well as hearing other car noises. I even sorted out a squeak in the car’s steering and applied some lubricant to stop the annoying sound. I avoided a collision one day, because I heard the sound of loud acceleration behind me. Riding my bike under high tension electrical lines produced an uncomfortable buzz, but Jack Urban was able to eliminate that problem.

My wife could get tired of me asking her to say the name of States, Presidents, and practice words, even when we were out for an evening walk. She would tire of this, but I was persistent. She also got accustomed to me asking her what a sound was that I heard. On a family camping trip, the noise of a nearby stream, pans being moved, voices of my family, and even a squirrel stealing peanuts out of a bag near me were exciting moments. Ocean waves crashing, helicopter blades beating, or small planes were easy to identify. (p. 279) I even began to listen to tapes of familiar music, which was interesting but much more difficult to comprehend.

The development team soon began to make changes in the system that required me to have additional surgeries. The crustaceous connection on the left side of my head was just temporary, and it had begun to deteriorate and needed to be removed. So, an induction coil was implanted on the right side. Electrical energy passed through the skin to this implanted induction coil. However, the problem with the exterior coil was that it needed to be held correctly against the head. Attachment to eyeglasses didn’t work very well, so adhesive was tried.³² This led to the next surgery, where a magnet and coil replaced the older induction coil. This system was later replaced by a ring-magnet coil system that was much better.

Other events occurred which caused additional surgeries. At one point, the CI electrode broke, requiring a re-designed wire. The electrode break was quite a surprise. We were on a camping trip in Canada, and when I ducked my head to exit the tent in the morning, the implant stopped working. Another time, the insulation on the electrode leaked, so a better coating was developed. As time went on, revised sound processors appeared. All of these systems required a cable from the transmitter to the head coil.

The implant I liked best came later. It was small, and the magnet was part of the instrument, so a cable was no longer needed—it fit right on your head above your ear. It was small enough that it used a regular small hearing aid battery. This on-the-head single-channel device was developed years before more advanced systems were improved enough so that they didn’t need be carried on the body with a cable to the head coil.

How many different implant systems have you tried?

All in all, I have had nineteen cochlear implant surgeries. The first implant had a plug in my skull where exterior electrodes could be connected. All the additional implants were single channel with Dr. House, until the 1990s. Later, multi-electrode implants were done at UCSF.³³ After the initial implant, the experiment involved both my ears so that I could use an existing implant while an “upgrade” was done on the other side. The original plug was just pulled out of my head in the office…

[Regarding the need for these upgrades:] It took a while before the magnet attachment system was devised, and later there were changes in the type of magnet. As I have noted, earlier implant electrodes broke, and then moisture seepage ruined another.

When the CI quit working [entirely], I received an auditory brainstem implant. The ABI had some promise, but it didn’t work out.³⁴

(p. 280) Passages from Charles Graser’s Cochlear Implant Field Test Notes, 1972–1978