I’m taking a short break this week.  But before I go: last week, I re-posted the first blog in a two-parter about navigating the health system.  Last week’s was about waiting to see the doctor.  This week’s follow up, first published November 1, 2011, is what happens when your name is finally called. 


Having escaped from the waiting room zoo, I am  sitting in an examining room waiting to see my new ENT specialist. And hallelujah, it’s a real room, with a door. My previous ENT believed in the open office concept, a nightmare for patients with hearing loss.

Suddenly, the doctor strides into the room, white coat and a medical intern flapping behind him. Doc plops onto the stool in front of me and looks me in the eye.

(Good communication skills, hooray! But he’s an ear, nose and throat specialist; he should know how to talk with his hard of hearing patients. On the other hand, I’ve been giving my family doctor some basic patient communication training, which she has now, after eight years, almost completed. She’s proud of the fact that she no longer talks to my feet or other body parts during a check-up.)

So, what can I do for you today, uh, (looking at my papers), Mrs. Hannan?”

“Well, I haven’t seen a specialist in a million years, and my audiologist thought maybe it was time I should. A lot of my friends have acoustic neuromas or other interesting stuff, and when I was a child a doctor did radiation on my ear, but I’ve never had an MRI, and I’m thinking maybe I should?” (My babbling trails off.)

“Mumble, mumble,” he says into my chart.

Doc doesn’t respond to my little attention-getting wave, so I lean sideways, downwards and forward to make eye contact. “Sorry, doctor, I’m hard of hearing, could you face me please?”

He gives me a blank look, then a little laugh-snort, “Yes you are, aren’t you? Sorry about that.” (We all laugh a bit, but I’m not sure if he’s sorry for my hearing loss or because he didn’t face me.)

“Ok, fine, an MRI it is. I’m-sure-there’s-nothing-wrong-you’re coping-well-so-come-and-see-me-afterwards-probably-in-a-few-months”. Doc stands, nods and sweeps out of the office, the intern catching his wake. 45 minutes of waiting, 2 ½ minutes of consultation. I’m not complaining; I know there’s a shortage of doctors, with hundreds and thousands of people who need help. I’m lucky to have access to good medical care. It’s just that during this short meeting, I had to spend more energy on my communication challenges than on discussing my medical issues.

Two months later, I’m at the hospital for my MRI. After I change into one of those attractive hospital gowns, the technician hands me earplugs to wear during the noisy procedure.

“I’m hard of hearing,” I tell her. “Are there any instructions I need to know before this starts?”

“We’ll tell you what to do during the test; you’ll hear my voice telling you when to breathe in, hold, and let it out.”

“No I won’t. My hearing aids will be out, and I will be functionally deaf.”

A blank look. “I’ll speak loudly, you’ll hear me.”

“No. I. Won’t. What do you do for other people who can’t hear?” I ask.

A blanker look.

“Hmmm, well, we’ll do our best, I’m sure it will be fine.”

“Hmmm, well, unless you have a little captioned TV screen in there, I will not understand what you are saying.”

She frowns, but asks me to put my things away and have a seat.

Grumpy, I put my hearing aids and other valuables into a locker and sit down in a tiny ante-room. I feel vulnerable, deaf and half-naked. The technician seats two other patients, whom she has clearly told that I  don’t hear, because they both smile at me, nodding, as if I were one step up from the village idiot. They talk about me ….poor thing, my aunt is the same way….and I don’t bother to tell them I can read every word their lips make.

The technician reappears with a huge length of clear tubing coiled around her arm, and motions to me. I think, not on your life, woman! I’m here for an MRI, not an enema!

My face must show my shock, because she cracks a smile. She mouths, no it’s ok, please come with me.

In the large MRI room, she says, “None of us have ever done an MRI on a deaf person. I’m embarrassed that we didn’t have something in place. But let’s try this.  We’ll tie the tubing around your wrist; when we yank it, you breathe in and hold it until the next yank, when you let it out.”

“What if you forget to yank the second time?” Her smile explodes into a laugh.

They slide me in, feet first, and throughout the procedure I can feel the MRI’s loudness.  I dutifully respond to the jerking of my wrist and thankfully, the tubing doesn’t break.   That was my second worst fear, just after having the power go out while I’m entombed in MRI hell.

The happy ending? Nothing showed up on the MRI.   But while I am pleased at the technician’s practical solution, I’m surprised at the lack of MRI protocol for patients with hearing loss – has no other hard of hearing or deaf person ever had an MRI in this major city hospital? Who would bluff through an MRI or other important medical procedures?

This weekend is Canadian Thanksgiving. I plowed through the delights of turkey, stuffing, veggies and pie, just two days after a visit to the dentist. His advice to “enjoy your feast, but chew very carefully”, made me nervous eating anything thicker than gravy.  And since it was a holiday, I decided to repost an article, slightly updated, but which still  resonates today: navigating the health system with a hearing loss.


OK, people with hearing loss, think quickly now. What’s the most challenging aspect of going to the hospital, doctor, or dentist?

The eye exam where you can’t see the technician’s lips (or any face-part) because of the lights are inyour eyes?

The masked dentist who’s clearly trying to ask you something but you can’t say ‘pardon’ with a mouth bolted open by metal bars?dentist

The doctor in a rush who doesn’t make eye contact? 

These situations are the tip of the ‘healthcare communication barriers’ iceberg. You’d think that doctors and other health professionals would know, instinctively, or at least have been taught, how to communicate with us. The truth is, they are just as likely to break our rules of engagement as any random, untrained person. What’s more, the average healthcare environment is usually not an accommodating one.

But we should never, ever, have our health compromised because of hearing loss!

While many health issues are beyond our control, we do have a say– and a responsibility – in creating effective communication. We can take the lead by identifying the problem (this examining area is too noisy for me to hear you well) and some solutions (speak up, Doc, and/or write it down!).

But as for the question about the most challenging medical situation – my vote goes to the nightmare of “Waiting for Your Name to be Called.”

Like most people, I have spent many life-hours waiting to see the doctor or dentist, at the ER for a child’s broken collarbone, or for medical procedures like x-rays and MRIs. It’s not the mind-numbing wait time that stresses me, but the sheer difficulties of hearing someone call my name. I live in fear of missing my turn, and finding myself the last person in the waiting room, just before they turn out the lights.

I always let the receptionist know about my hearing loss, but I still worry. Clinics and emergency rooms are chaotic, and listening for my name is an aerobic workout.

Please, Ms. Hannan, have a seat. We’ll call you when we’re ready.

Thank you, but I have hearing loss and I might not hear my name called. Could I sit here, beside you? Help with the filing, maybe?

No. Please join the others in the waiting room; we’ll find you.

Well, could you do a little wave, so that I know it’s me you’re calling? I’ve been missed before.

Sure, yes, we’ll try, whatever, siddown!

I shuffle away, hoping to find a seat close to the doorway where the nurse will appear, so I can read my name on her lips. The crowded waiting room has rows of seats; some face the important doorway, but others face the back of the room.

Guess where the only empty seat is. Sitting down, I immediately adopt the upper-half-twist, a manoeuvre unique to hard of hearing people who are trying to see/hear something behind them. The lower half of the body faces forward, and the upper half is cranked completely backwards, in this case towards the doorway.

Variations include the simple ‘neck twist’ – full-body forward and neck turned to the back, like an owl – and the more common ‘neck thrust’, in which all body parts face forward, and the neck thrusts really forward, to put the ear closer to the source of sound. Please note that all of these positions are painful if held for any length of time.

If I do manage to cop a seat facing the door, every time the nurse appears, file in hand to call out a name, I jump forward in my seat and do the ‘neck thrust’. If someone else gets up, I shift back. But if not, I rush the nurse saying, “Hey, hi, it’s me, did you call my name, didja?” And please god, she did, otherwise I slink back to my seat, embarrassed at having 200 people witness my pathetic pleading.

I relax for a moment and look out the window, admiring the pretty flowers. Then I feel eyes on me – lots of eyes. A kind soul taps my arm and directs my attention to the nurse, who wouldn’t dream of wading through the mass of humanity to where I sit, and who is calling me impatiently.

My turn at last, now the real fun starts. I’m anxious, with an elevated heart rate and clammy hands, and I haven’t even seen the doctor yet. When stress levels rise, my residual hearing plummets and my well-honed coping skills go into reverse.

Pull yourself together, Hannan, you’re here about an important medical issue. Once you get out of this waiting room zoo, it will just be you and the doctor, one on one. The perfect listening environment….

To Be Continued.