This series of posts at looks at Hitler’s hearing impairment. This is the third posting in the series and it is certainly not a tribute to Hitler, but an interesting discussion of a hearing loss that was accumulated over a lifetime by an historical figure. This series is a re-visit of a topic that was first discussed at Hearing International August 27-September 10, 2013. While much of the content will be taken from the originals, components have been added in this visitation of Hitler’s Hearing Loss. At the end of this 3-week series, there will be an estimate of his likely hearing impairment.
While history will never know the extent of this impairment, there is evidence that can be compared with what we know today that gives us clues as to the extent of his hearing impairment. Did this have any effect on behavior? Did this cause miscommunication among trusted generals and others? Other issues? At the end of our discussion …you decide….RMT
Our discussion of the bombing last week brings Hearing International to the question of how Hitler could have survived a blast from a kilogram of plastic explosive when he was only 6-12 feet from the bomb? This question has baffled those who have studied the July 20, 1944 plot for over 70 years. While there has been a great deal of speculation as to how he survived the blast, Hitler felt he was simply being protected by providence, as this was only one of many attempts on his life. There is even speculation that Hitler actually died in the July 20, 1944 attack and that he was impersonated by his body guards or doubles during the last months of the war. Although probable, it is highly unlikely that in the past 70 years someone would not have come forward with the truth, especially during the Nuremberg Trials,in an effort to save their skin.
Deep in the forests of Rastenberg, Germany (now Poland), Hitler’s new Rastenberg or Wolf’s Lair Headquarters (see map below) on the Eastern Front consisting of intensely guarded buildings and bunkers, Hitler rescheduled his July 20 staff meeting for 12:15pm as he was supposed to meet Mussolini that afternoon.
The meeting was normally held in a bunker without windows and built with very thick walls called the Führerbunker but, as indicated last week, the meeting was unexpectedly changed from the subterranean Führerbunker to Albert Speer’s wooden barrack-hut because of the hot weather. This drastically changed the blast intensity as the wooden barrack had open windows of much less rigid construction than the Führerbunker. The diagram below presents the positions of various individuals and the bomb (in red). While Stauffenberg originally placed the bomb to the left of the table leg, another officer moved it to the right of the table leg; that, and the fact that Hitler had a habit of almost laying on the map while looking at troop movements, probably sheltered him from the major portion of the blast.
When the blast happened, the four officers on Hitler’s right, positions 2,3,4,5 were killed, while Hitler, position 1, and two officers to his left, positions 23 and 24, were virtually unhurt, and two officers to their left, positions 22 and 21 were wounded. One look at the room (photograph above) suggests that if the bunker had been used, all of the people in the room would have died from the blast. While Hitler’s private physician removed 150 splinters from Hitler, there was also blood coming from his ears. Reports from the scene and Hitler’s personal physician suggest that he probably suffered an acoustic trauma created by the blast.
The July 20, 1944 Explosion
When a bomb detonates, the energy released from the explosion radiates outward in all directions at once at speeds between 3 and 9 km per second. As this sphere of energy expands, it compresses and accelerates the surrounding air molecules into a supersonic blast wave. This overpressure only exists for a few milliseconds, but it is the primary cause of explosive injuries and property damage. The closer to the source of the blast, the more severe the compression. Hitler was only 6-12 feet away from the blast.In an explosion, the initial concussive force of a blast wave is immediately followed by high-velocity shock waves that impart more energy into whatever they’re passing through, be it a concrete wall, one’s vital organs, or a wooden table containing maps during a staff meeting. As a blast wave passes over an area, it leaves literally nothing behind. The supersonic wall of air leaves a near-perfect vacuum in its wake. So, a split second after the body is severely compressed, it is subjected to an equally massive opposing depressurization force. Unfortunately, the explosion isn’t over yet, as air immediately rushes in to fill the atmospheric void left behind by the blast wave, pulling debris, objects, and people back towards the source of the explosion. This blast wind is strong enough to hurl a human body several meters. Those caught by the blast wind while standing up are the most vulnerable to being carried away. But it isn’t this blast wind itself that injures—it’s the blunt-force trauma resulting from face-planting into the side of a Buick at freeway speeds. This barotrauma wreaks havoc on the innards, especially air-filled organs like lungs, ears, and stomach, as well as joints and ligaments where tissues of differing densities meet. This often causes hemorrhaging, and it may even result in organ rupture. The lungs are especially at risk of hemorrhage as well as edema (swelling brought on by fluid buildup). The brain is not much better off. Recently military physicians studying the effects of barotrauma on US Armed Forces have compared the effects of an explosive blast on the human body to the act of squeezing a tube of toothpaste—blood and bodily fluids are forced into the brain and skull, resulting in edema. The Picture at right is the staff briefing room at Wolf Lair after the July 20, 1944 assassination attempt. (Click on the “Hitler Bomb Plot” picture for a short video of the devastation created by Stauffenberg’s bomb).
Hearing Loss from Explosions
According to Otolaryngologists at the US Army Surgical Institute at Ft. Sam Houston, tympanic membrane perforation is the most common primary blast injury based upon a retrospective study of US service members injured in combat explosions in Afghanistan or Iraq and treated at Ft. Sam Houston between March 2003 and July 2006. Their results in the evaluation of 463 wounded patients indicated that 15% of the patients had a tympanic membrane perforation. A total of 97 tympanic membrane perforations occurred among 65 patients (see left). The average surface area involved was 41% and more than one third of the perforations were central or anterior-inferior. Most (83%) patients reported symptoms, most commonly diminished hearing (77%) and tinnitus (50%). Outcome data were available for 77% of perforations with 77% spontaneous healing occurred in 48%. The remainder (52%) had surgical intervention. The most common audiogram abnormality was mild high frequency hearing loss. Tympanic membrane perforation occurs in 16% of explosion injured patients. Most patients are symptomatic and many have large perforations requiring operative intervention. An explosion causes a large amount of energy to be displaced, creating a shock wave and a very loud sound. This loud sound may be powerful enough to destroy a person’s ability to hear, either temporarily or permanently. A 2012 effort to review noise induced hearing loss from blasts by Dr. John Oghalai, Associate Professor of Otolaryngology, Stanford University suggested that when we looked inside the cochlea, we saw the hair-cell loss and auditory-nerve-cell loss,” Oghalai said. “With one loud blast, you lose a huge number of these cells. What’s nice is that the hair cells and nerve cells are not immediately gone. The theory now (2012) is that if the ear could be treated with certain medications right after the blast, that might limit the damage.” This, however, was certainly not available in 1944.
Hitler’s Hearing Loss
Hitler was very close to the blast. His physician noted blood from his ears right after the blast and for some time afterwards, suggesting tympanic perforation (described as shattered eardrums in the literature) and he was treated by Dr. Erwin Geising, an ENT whom Hitler had seen for a reoccurring furuncle over the years; however, he did not record much other information about the specifics of the impairment and the residual impairment created by the perforations. Most audiologists realize, however, that a tympanic perforation can create no hearing loss or a maximum conductive loss of 40-60 dBHTL depending upon the frequency and the extent of the damage. If one considers that the Fuhrer may have had some sensori-neural hearing loss from noise exposure in the trenches during WWI, then combining that with the blast perforations and possible acoustic truma, there is a real possibility that an existing sensori-neural impairment was significantly exacerbated.
It is also well known that Hitler was given no less that 73 different medications, some routinely during the years 1941-45, by his personal physician, Dr. Theodor Morell (Pictured left). Morell kept a medical diary of the drugs, tonics, vitamins and other substances he administered to Hitler, usually by injection (up to 20 times per day) or in pill form. Some of them were Morell’s own mixes. His experiments sometimes contained toxic and addictive compounds such as heroin. Later, historians speculated that Morell played a big role in Hitler’s deteriorating health. Some of the compounds given to Hitler and written in Morell’s diary were: atropine, caffeine, cocaine, adrenaline, morphine, testosterone, lipids derived from animal tissues and fats and many others.
While it is sheer speculation, based upon his noise exposure history and what we know of blast injury, it is possible to estimate Hitler’s hearing loss with a 75% chance of accuracy at 35-40 dB loss for the lows, and an 50+ dB loss for the highs in the left ear. For the right ear there would have to be some residual impairment due to Stauffenberg’s bomb on top of his noise induced hearing loss. Thus, his impairment would have been much worse for the right ear, probably in the 70-80 dB level for the lows and 90 + for the highs.
As audiologists we also know that hearing loss reduces a person’s interactions and social capabilities, which could be a partial explanation for why the Fuhrer was very antisocial and was seen in public very little from the time of the July 20, 1944 plot and the end of the war. What ever the specifics of Hitler’s hearing loss, he probably had a significant hearing impairment at the time of his death, or if he did escape to South America as some suggest, for the rest of his life.
Robert M. Traynor, Ed.D., MBA is the CEO and practicing audiologist at Audiology Associates, Inc., in Greeley, Colorado with particular emphasis in amplification and operative monitoring, offering all general audiological services to patients of all ages. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was Senior International Audiology Consultant to a major hearing instrument manufacturer traveling all over the world providing academic audiological and product orientation for distributors and staff. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of the field of Audiology in over 40 countries. Dr. Traynor is the current President of the Colorado Academy of Audiology and co-author of Strategic Practice Management a text used in most universities to train audiologists in practice management, now being updated to a 2nd edition.