Why are Audiologists Afraid of Musicians – Part 4

This is the fourth in a series of blogs about why audiologists are hesitant to see musicians or others in the performing arts.  The blogs are actually quite tongue in cheek but have some truth in them.  I routinely receive phone calls from musicians who have been referred to me for a “second opinion” when the issue is really that the other referring audiologist didn’t really understand what they had already learned in school.  Audiologists do learn everything, and more, about working with even the most demanding person, but for some strange reason, we don’t always recognize this.

Today’s topic is about perfect pitch.  This can be a nightmare for audiologists.  It is the single one thing that causes all audiologists to run away and pull their hair out – see my picture at top of blog.

These are the musicians that can quickly (and correctly) identify a note, a chord, the “pitch” of a rogue noise, or even a made-up mishmash of notes on the piano.  In psycholinguistics we might say that this person has categorical perception of music rather than continuous perception.  For the rest of us, we just cringe as the musicians tell us that our audiometers are tuned slightly flat and that 250 Hz is not even near middle C and that we should get it fixed.

If you type “perfect pitch” or “absolute pitch” into any search engine, it will give you a nice over-view of this phenomenon along with a rather long list of musicians and other famous people (I am not on the list) of people who have, or claim to have had, perfect pitch.  My interest is how a hearing health care professional can clinically provide service to such a person.

Of course I am blowing this all out of proportion.  Musicians are wonderfully accomplished people who, like all of our other clients, expect the same level of dedication to our field as they have given to their field.

Let’s look at it from their perspective.  Musicians with perfect pitch may not be as enviable as you might think.  I recently attended a Baroque concert with one of my business partners and he has perfect pitch.  I enjoyed it thoroughly while he sat there and cringed.    Baroque musical instruments tend to be old and therefore, as a rule, are tuned slightly lower in pitch than what would normally be the case.  The second space in the treble clef (A at 440 Hz) may be played at 420 Hz- what sounded flat to my partner, sounded quite nice to my (relatively) untrained ears.  And of course, when musicians with perfect pitch come in to my audiology office, they may snidely comment that my audiometer sounds flat, but that’s really the end of it.

Musicians who have perfect pitch (and even those that have wonderful relative pitch) do not have superhuman hearing in other ways – they cannot hear 25,000 Hz,  they cannot discern just noticeable differences in frequency or intensity any better than anyone else, and they are just as prone to hearing loss as you or me.

In short, other than musicians with perfect pitch being unable to appreciate Baroque music, and being able to show off at parties, and instantly know the key that a piece of music is written in, and…they are just like the rest of us.

Having a client with perfect pitch is no reason to run screaming from the room (and end up referring to me).  Audiologists are well-trained to handle every question and every concern a musician may have.  We may have learned about 440 Hz and 466 Hz, rather than about A and B flat, but this is just jargon.  We know about decibels and can easily convert to terminology such as mezzo forte without having to know Italian.  And we know significantly more about the normal and pathological auditory system than virtually anyone else on the planet, so why are we afraid of working with musicians?

Hopefully this series of blogs has helped to reassure us that audiologists have received amazing training that can be applied to a wide range of situations outside of our normal clinical population.

About Marshall Chasin

Marshall Chasin, AuD, is a clinical and research audiologist who has a special interest in the prevention of hearing loss for musicians, as well as the treatment of those who have hearing loss. I have other special interests such as clarinet and karate, but those may come out in the blog over time.


  1. Regarding audiologist and hearing impaired, due to the way the NHS is funded in the UK. Audiologists seem to to be limited to what they can provide for a profoundly deaf person such as myself. So I’m finding it extremely difficult to work with the Seimens Reflex aids I wear. So most of the time I have to practice and play without them in because of the sound distortion and the difficulty I have differentiating between pitch and tone.

    1. Regardless of which hearing aid is available to you, there is no hearing aid in the world that will bring back pitch discrimination. This is one area that modern hearing aids just cannot fix.

      The traditional strategies in a case like this is “less is more”. The audiologist needs to avoid undue amplification in the region of your hearing where there is pitch distortion.

      This can be done by filtering out this region, or using some form of frequency transposition that moves sound from a damaged frequency region to a healthier one. And there are many hearing aids available in the UK market that can accomplish this task.

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