The Giants of Audiology: Interview with Richard Tyler, Ph.D.

Welcome to this week in Hearing.

Hello, I’m your host,

Bob Traynor for our special series called Giants in

Audiology. This week, my special guest is Dr.

Rich Tyler from the University of Iowa.

Let me take a couple of minutes and read Dr.

Tyler’s bio.

Rich Tyler was trained at the University of Western

Ontario and the University of Iowa,

and then became a scientist in charge of clinical outstation at

the Institute for Hearing Research in Nottingham, England.

He’s a full professor of communication sciences and

disorders and in Otolaryncology at the University of Iowa,

he’s hosted international hearing aid and cochlear implant

conferences and his 30th international conference on the

management of tinnitus and hyperacusis patients.

This will be held August 10 and 11th of this year.

He states how he appreciates being able to help people

with hearing loss, tinnitus, and hyperacusis.

Welcome to Giants in Hearing, Rich,

and thanks so much for being with us today.

Thank you. An honor to be here.

So

I understand that you grew up in Windsor, Ontario, Canada,

and that’s someplace south of Detroit where a lot

of us don’t understand and things like that.

Right, just south of Detroit,

which most Americans can’t understand,

but it’s actually true. Okay.

And sports at that time was quite a part of your life?

Yes,

I played basketball and football and baseball sports was my life.

I actually had a scholarship to play college football

in Ontario, but I decided to turn it down.

Football is kind of dangerous, actually.

It can be.

As you’re growing up,

my understanding is your worst job was being a baseball umpire.

But I don’t think there’s a lot of people that would have

expected Rich Tyler to be a good humor man.

Well, baseball umpire,

no matter what you call half the people don’t like it.

But the best job I ever had in my life

was selling ice cream from a truck.

I drove around the neighborhood same time every day.

All the children were waiting for me and everybody liked me.

It was the best job I ever had.

Was fun selling.

And how much were ice cream cones at that time?

Well,

I think you could buy an ice cream cone for $0.15 or $0.25.

It was.

Be. And that was Canadian, of course.

Yes, Canadian. Okay.

But my understanding is that as you were growing up,

you were a stutterer,

and that had a major factor in shaping your career choices.

Yes, absolutely.

I was a stutterer and had some therapy and had the deal

with this in both elementary school and in high school.

So it was part of my life, being a stutterer.

But by the time you hit 17,

you hiked all around Europe for four months or so,

and that’s an experience that many of us would

never have had the opportunity to do.

Yeah, it was a long time ago.

I think I might have been 19 years old, but right there,

it was quite common in those days.

But I hitchhiked around Europe for four months.

I slept in youth hostels and I often slept outside.

Some people actually took me into their homes.

It was again,

it was quite common for people to be hitchhiking and a great

opportunity to meet people and see

different countries and cultures.

I actually walked through Checkpoint Charlie

in Berlin into East Berlin at the time.

Norway, Greece, Spain, the United Kingdom.

It was a very important part of my life, four months on my own,

exploring the world. Sure.

Now, for your undergraduate experience,

my understanding is you started at the University of Windsor

for the first year and then moved on to other areas.

Right.

The University of Western Ontario were just starting

their Speech Pathology and Audiology program,

and I had applied and did not get accepted.

And then one week into class,

I got a phone call saying someone has dropped out and were

I still interested in coming to University of Western Ontario

in the Speech Pathology Audiology program.

And I said I’ll be there on Monday.

So I changed my directions and went up to London,

Ontario and started with the program there.

That’s a pretty good mentor there at the time,

from what I understand as well.

Yes, I did indeed. There was Jim Stover, John Booth,

Bill Yovitich,

who had been trained and worked with

Wendell Johnson from Iowa. And he actually helped me,

bill Yovitz, with my stuttering.

In fact, when I got through the program,

my stuttering was less important in my life and had been

impressed with the teachers I had in the science of audiology.

And so it changed my perspective on what I wanted my career

to be as my stuttering became less important in my life.

And so your bachelor’s degree and your

master’s degree are from Western then

and then moved on to looking for a PhD program.

Right. So, as I said,

I was interested now in psycho acoustics,

and I think one of the top people in the

time was David Green from Harvard.

I applied to work with David Green

and got accepted at Harvard.

A few weeks before school started,

they sent me a list of names and asked me

if I knew any of these names on this list,

and I didn’t know any of them and let them know that.

And then about a week before class started,

I got another letter from them saying that I did not have

enough classes in psychology to be accepted

into the psychology course.

So they declined my position to go to Harvard and

work with David Green and psychoacoustics.

But then you discovered the University of Iowa.

Right. Well, I had already been accepted,

also been accepted at the University of Iowa.

Again,

Bill Yovitich had told me what Iowa City was a

nice place to live, and so I just decided, okay.

So I drove to Iowa City.

First day of classes,

I walked in the front door of the building and went into

Ken Mall’s office,

and he was shocked to see me because I had forgotten.

I didn’t realize I was supposed to acknowledge that

I accepted their offer to work there as a student.

But in any event, he was very helpful and accommodating.

And so I started off in the PhD program

at the University of Iowa.

You had some pretty interesting people who’ve done very well

that were your colleagues there in the PhD program as well.

Yeah, it was a wonderful program.

We had lots of interactions and lots of enjoyment together,

working together.

George Haskell, Michael Gorga, Pat Stomachowitz, Paul Colaney,

Larry Dezell, and many others.

It was really a wonderful opportunity to interact with

the fellow students and learn from them as well.

That was a good time to be at Iowa, from what I understand,

because you had some fabulous mentors that

all of you were working with at that point.

Yeah, it worked out quite well.

I was very impressed with the scholarship and the

classes that we had. Arnold Small David Lily.

Jim Curtis.

Ah. Paul Abbas. Just lots of very, very bright people.

The classes.

Were very enlightening and very helpful

in my career and probably

used a lot of your time as well to study,

because they weren’t just the everyday hearing

science course or the everyday kind of course.

Those were pretty highly detailed and very

kind of innovative courses at the time.

Yes, they were very you know,

we had a whole course on psychoacoustics, for example.

And you were involved with the journal club there,

from what I gather, as well.

Right.

So

one of the journal clubs we had was working with

we had every two weeks we had a would discuss a journal from

JASA or American Speech and Hearing Association

or some journal we look at.

And we’d anyways,

it was my turn to bring the beer one evening,

and Conrad Lundine and I drove over to the house.

We got

talking about the article. We disagreed.

We were kind of arguing in a nice way and knocked on Abbas’s

door and walked in with a case of beer, arguing.

And it turns out it was the wrong house.

It was the neighborhouse,

and the family was sitting there eating dinner,

and here we walked in arguing with a case of beer.

So that wasn’t well, that’s doc students you know,

you’re learning and interacting with each other and so on.

But I understand that there was quite a quandry at the

University of Iowa because you were

also becoming a potter at the time.

Yeah, that’s true.

So

they had

given me some money to pay tuition,

and in the end of the second year,

beginning of the third year,

I had taken all the courses I had to take,

but I had to register as a full time

student and spend the money.

So I looked around and decided I would take a pottery class.

So it was kind of fun and interesting.

And it turns out one of the professors somehow found

out that this PhD student was taking a pottery class,

and they actually had a special meeting,

a faculty meeting to determine what was going on and if this

was appropriate or not and what they should do about me.

It turns out I was an A student at that time,

and they decided to let me go.

So I took two pottery classes.

I’m not the best potter,

but it certainly was an interesting experience,

and we had lots of fun.

Well,

one of the things that we have as a shot here is of some

of your pottery and, of course, any of you who wants.

To contact Dr. Tyler.

I’m sure that he has a few pots around there

and they will be famous one day.

So after the PhD program,

you ended up in England,

and how did you get to the Institute of Research,

which at that time was part of the University of Nottingham?

Right. So it was just starting,

and my parents were from Great Britain,

so I was hoping to go and experience something.

And there was a job open there,

and I received the job to work at the Institute of

Hearing Research when it was first starting.

So that was quite a thrill for me and a lot of very bright

people at the time just getting started Quentin Summerfield,

Adrian Davis, Mark Haggard, and many more.

So they were very hardworking people.

They didn’t have backgrounds in audiology or in psychoacoustics,

which kind of surprised me,

but they were well trained in other areas and

focused on hearing and hearing loss.

And I learned a lot from them and benefited

from being able to work with them.

It’s really interesting to see the colleagues that we all work

with over the years because many of them end up doing some very

interesting things. And one of your good friends, Adrian Davis,

I think

had a pretty significant award at that time.

Yes, he received the British Empire Award,

the Order of the British Empire Award,

because he basically nurtured newborn

hearing screening worldwide.

And I think that

success of newborn hearing screening,

how it’s done worldwide can largely be attributed to the

work of Adrian Davis. So that’s a wonderful thing.

Now,

the

the other thing that was going on about that same time is,

tell me about the Trip to Jerusalem.

And I understand you met Robin Hood

and Maid Marion in this Jerusalem.

Right.

So

my first office was right downtown Nottingham,

and Nottingham Castle is on a cliff right downtown.

And the Nottingham Castle had been redone.

But at the base of the foot of the cliff,

there was the oldest pub in England

called the Trip to Jerusalem,

where the soldiers would start off there and

they would have a pint before they went off to war.

In any event,

I decided to go down for a pint before this official

opening ceremony at the Castle and.

Sure enough, in the Trip to Jerusalem in this old pub,

I’m sitting down there having a pint and in walks Robin

Hood and Maid Marion and sits down across from me.

I was overwhelmed and overjoyed.

It turns out that they had been hired to show up at the

reception later on that evening on the castle of the opening

ceremonies. But I didn’t know that at the time,

so it was quite a thrill for me to have applied

across from Maid Marion and Robin Hood.

Wow.

So during that same time you did some study

with Gunarfonte up in Stockholm as well?

Yes,

I also had applied for grants when I was looking to work

in Europe to work with Gunner Font in Stockholm,

and that was awarded and Mark Haggard

allowed me to go there for two months.

Gunner Font basically invented speech synthesis and

I think should have received the Nobel Prize.

He wrote the equations.

He had a wall full of racks where

you could generate an /e/ or an

different speech sounds.

And that was the very first time anybody had ever designed

speech synthesis. So it was very amazing place.

And my favorite story about that is that we had a lunch meeting

every day and people from all around Europe were there.

And one lunch period someone stood up and said that he

thought that it was very important about when people are

thinking and talking and some people scratch their forehead

and some people scratch their chin and some people scratch

the back of their head and that has

to do with their thought processes.

And Gunner Font listened patiently and when he was

finished, Gunner Font stood up and said, well,

that’s interesting because when I think about something,

I usually scratch my rear end.

And he stood up and scratched his rear end as he was.

That was a big enough for the lunch period.

Even some of the best of the researchers worldwide

are still people just like the rest of us.

It’s a really interesting kind of thing to see how many

individuals are just guides and or ladies that have grown up

and they still have a life in addition to

what they do for their profession.

I can say. He actually also took me out to his home,

which is a small home,

for dinner one evening and it was a real treat.

There was no road nearby at all.

It had to walk through the forest to get to the home.

Wow. Very special.

Kind of like Hansel and Gretel looking for things.

So now,

I understand your first interest in Tinnitus came

from a 1981 Siba conference on Tinnitus.

Right. So when I was working in Nottingham,

there was a group

interested in Tinnitus,

and that’s when things were first starting

to get interesting, I think,

in terms of the research efforts and clinical service.

And Ross Coles, who worked closely with me,

and I learned quite a bit,

invited me to participate in what I believe

was the very first conference on tennis

conference.

So that was a real thrill for me to meet with all these people,

David Kemp and Charles Berlin and many,

many others that were all involved in studying Tinnitus.

And it was just fascinating to hear the different perspectives

and the different theories and the potential treatment.

So it was a motivating factor to get me involved in tinnitus.

We all have someplace where we kind of do some kind of a

critical thing that gets us into a particular area

for some reason. But also during that time,

I understand you even met with a Member of Parliament,

which had to be pretty good for a Canadian

guy from British parents. Right.

So

one of the members of parliament that actually helped get

the Institute of Hearing Research

started was Jack Ashley.

He was an MP, as they refer to them,

and I had some interactions with him and

basically invited me to come down to London and

meet with him at the House of Parliament.

And I was thrilled to do that.

Took the train down from Nottingham and actually ended up

having tea in the gardens on the bank of the Thames River

with Jack Ashley. And it was a real thrill, again,

given my parents were British and from East London,

it was a real treat for me to be there at

the Houses of Parliament, having tea,

looking over the Thames.

And so it was a real thrill for me to be able to talk with

Jack Ashley about his tennis and hearing loss.

And he eventually wrote a book on his experience as well,

so that was important for me.

Now comes the interest in cochlear implants Rich

and brought you kind of back to Iowa in the early 80s.

Right.

So I was looking forward to coming back to either

Canada or the US and looked around for a job,

and there was a job in Iowa,

and it turns out that I was hired by Brian McCabe,

a physician.

Who was the head of the Department

of Otolaryngology in Iowa City.

So I knew Iowa City was a good place to live and

got the job.

So I worked with Bruce Gantz and he and I were co principal

investigators and a series of P 50

NIH grants on cochlear implants.

So it was a very exciting time for me to come back to Iowa to

get involved in cochlear implants and

was very fun to be in Iowa City and

get involved in cochlear implants.

Well, but at that time,

cochlear implants were still single channel devices.

Yeah,

some of them I had actually had some grants when I was still

in the UK and studied some of the single channel implants.

And some of them were actually just being used to help

people lip read to vibrate.

And I sometimes say,

I thought my job

was to prove that cochlear implants did not work,

because they was quite controversial at the time.

And if they were just helping people lip breed,

maybe you could do that just as easily

with the vibrations on your skin.

It was also interesting because they were quite controversial at

the time in the sense that a lot of the people from the

deaf culture were opposed to cochlear implants.

And we had some meetings.

I remember one in Paris where a cochlear implant meeting,

and there were picket lines outside

from people from the deaf culture.

So it actually motivated me,

and I wrote an article on cochlear implants in the deaf

culture to try and help both sides understand the other side

because it’s changed their life.

Many, of course, deaf children are born with hearing parents.

A lot of times,

as we enter into the field of audiology and

people start with cochlear implants,

it’s difficult for hearing people

to understand why there is

an issue with the with the deaf community.

But they referred to cochlear implants,

particularly at that time, as the medicalization of the death.

And it was one of those things that

for a while,

I couldn’t understand why anybody wouldn’t

want to have their child be able to hear.

But culturally, it’s quite a different world.

Yeah. And again,

there were sort of two groups of people,

the parents of deaf children are hearing people,

generally speaking, not always, but generally.

Speaking.

And they want to be able to communicate

with their young children, of course.

And

adults that are deaf want to be able to

show that they’re okay with their sign language.

They can communicate, they’re smart people,

they’re productive, and they can be friendly, and that’s fine.

So that’s okay.

But I think it was true that less of an issue now

that for hearing parents to want to have

children that here with cochlear implants is acceptable.

And that worked out in the long run.

And as part of that position and you’re

interested in cochlear implants,

you started the International conference

in Iowa on cochlear implants.

Yes,

we had the first international conference on cochlear implants.

It was wonderful. And again,

the field has evolved in such an impressive

way with the different

companies involved and the progress and how much better

patients here with cochlear implants

now than they did initially.

So it’s amazing how the whole field

has evolved in the right direction.

Well,

and even worked with Bill House a little bit from what

we’ve discussed as well. Yeah, I was quite thrilled.

Bill House, who developed cochlear implant,

I was quite thrilled.

One of the number one Otologists maybe in the world,

he called me, and we had a few interactions,

and I actually was invited to go out to visit him,

and he made dinner for me on his yacht just south of Los Angeles.

And I had another meeting north of Los Angeles

four or five days later,

and Adrian Davis was coming over from Europe to attend

that meeting with me. And so I thought, well,

maybe we can camp for three or four days in Los Angeles.

I grew up camping with my parents,

and it was an inexpensive way to spend the three or four days

in Los Angeles. Yeah, but not in Los Angeles, though, right?

Yeah,

of course.

There’s quite a few people camping

in Los Angeles these days.

At the time,

there was

no national campgrounds in Los Angeles,

but there was one on Catalina Island off of Los Angeles.

And so I convinced Adrian Davis we would

camp there for three or four days.

We flew out

from south of LA. Onto the island.

I had

my suit and tie on.

And we had clothes in one suitcase and in the other

suitcase I brought a little small tent and sleeping

bags for Adrian and I and some food and

got picked up in the airport and drove to the other

side of the island into the campground.

This guy dropped us off and we were sort of out in the

wilderness. There was no picnic tables or numbers on campsites,

but looked like a beautiful area.

And

this park ranger came over in a jeep eventually and said hey,

you’re not supposed to be here.

And I said well we’re here to camp.

And he said no, this is a campground.

And we were there with our suit and ties and suitcases

and he didn’t believe that we were going to camp.

And so eventually he said okay, you can camp.

And I said well where’s our campsite?

And he said well you camp anywhere you want.

And then as he left he said just watch out for the wild boars.

I didn’t know what a wild boar was,

but Adrian and I had a nice day.

We set up the pup tent that night.

In the middle of the night

we’re sound asleep and I hear

looked outside the little pup tent and there were three or

four wild boars that were actually larger than our tent.

And I didn’t know what to do.

Adrian was fast asleep and the wild boars got closer and

closer. Finally I shouted get out of here, get out of here.

And the wild boars took off and Adrian Davis

stood up and took our tent down.

So it was an interesting experience

dealing with the wild boars and with Adrian,

and I understand that that’s about the same time,

maybe a little bit later,

you began to move toward the International

Hearing Aid Conference

in the early ninety s, I think if I remember right.

Yes.

So

we were doing hearing aid work as well as our cochlear implant

work and had the world’s first international

Hearing Aid Conference in Iowa City.

And I invited Dennis Byrn and that was established.

Quite a nice working relationship with Dennis.

I went back to Sydney to visit him a few times and on one of

the first times I had gave a talk at the National Acoustics

Laboratory suggesting that you might not want to fit hearing

aids based on thresholds Dennis’s approach.

You should consider fitting hearing aids based

on loudness levels so that you’re equating

loudness of speech frequency.

To the individual’s loudness perception and hearing

impaired people. And I published an article on that,

but nobody’s paid attention. That’s okay.

That was a time when Dennis was the world’s guru in fitting

hearing aids So against the grain is kind of good sometimes,

for sure. Yeah. Well,

he

was able to accept me as a friend and colleague,

and we had several wine tasting parties both in

Australia and actually in Iowa.

Came to Iowa a couple of times and worked out with took me on

a wine tour in north of Sydney and introduced me to Bill Noble.

And so Bill Noble was a visiting professor here,

and I was able to do some great work with Bill Noble as well,

in the hearing and cochlear implant areas.

This begins kind of a time when you began to focus on tinnitus

and understand that it even started

at the source of the tinnitus movement, which was Dr.

Jack Vernon.

Yeah, jack was doing physiological research,

and one patient contacted him and

took Jack to a fountain in Portland

and told Jack,

this is the only place where I don’t hear my Tinnitus.

And that’s what gave Jack the idea

to create a tinnitus masker.

So this was the world’s first strategy to have a wearable

device that sounded like the fountain waterfalls that

would mask or partially mask your tinnitus,

and that’s what got maskers going.

So I had a wonderful time working

with Jack over the years.

Had dinner on his boat once with he and Mary,

and it was quite a treat for me.

And you also became the scientific advisory committee

director for the American Tinnitus Association,

from what I understand. Also.

And as I gather,

that was about the same time as the Blues

Brothers were really pretty hot.

And you kind of amplified that at Jack’s retirement party.

Right.

So I was invited to participate in Jack’s retirement party

and gave a little speech, but they was a formal event,

and I didn’t own a tuxedo.

I was generally a pretty informal guy in general, so.

I dressed up in my costume that I had with dark sunglasses

and a hat as one of the Blues Brothers.

And

it was quite a treat at the reception and the dance

following the retirement party, I think well appreciated.

Well,

to watch Rich Tyler do somersaults and sing in the

microphone, I think I’d pay quite a lot to see that.

Now,

this was about the same time that you opened

the tinnitus Clinic at the University of Iowa?

Yeah,

as I said,

I learned a lot from Jack and it was clearly a need that

this tinnitus patients weren’t not being helped,

generally speaking.

And so we decided to get things moving and

opened up a tinnitus clinic in Iowa City

and I really enjoyed that.

And part of the problem was quite interesting.

I had

several people help me over the years,

including Shelly Witt and

others,

but it was really important to see that we

could actually help these patients.

But in the hospital setting it was also interesting because

getting paid for the services was not always clear.

And I joined several different committees on trying to resolve

this and see how it would work for several different

audiology organizations. And it’s still a challenge,

I think we can certainly help these patients,

but it can be a challenge in making it work

and getting reimbursed for our services.

And this is the time too,

that the conference changed its focus to the International

Tinnitus Conference again now when it’s 30th year this year.

Yeah.

So

we’ve had this conference for many, many years,

tried to focus on initially and particularly tried

to focus on getting other professionals,

including audiologists and psychologists,

interested in helping tennis’patients

and letting them know what to do.

And indeed that also included getting companies

motivated to produce sound therapy devices.

And so we always had interactions with

companies and with professionals.

I tried to get people that were well versed in helping

distressed patients in general, not just about Tinnitus,

but just about things in their life in general,

because some of the Tinnitus patients are indeed

quite distressed and need our support.

And so it was very helpful to get help from people

like psychologist Anna Met Moore in Denmark,

who has taught me a lot about connecting with patients

and being helpful to distressed patients.

Well,

I think that’s one of the main things in tenants’treatment is

just letting tinnitus ‘patients know that someone’s listening,

that it is a real kind of an issue,

and the kinds of things that all of us have learned

in our tinnitus treatment over the years.

I think one of the highlights of my attendance at the Tinnitus and

Hyperacusis Conference has to be the Round Barn at Rich’s House.

Yeah, well, I’m sorry to hear you say that.

Well, no, it was the social highlight.

I’m kidding. It’s okay.

So

many years ago,

I acquired a Round barn just outside of Iowa City that’s

referred to as the seacrest 1883 octagonal barn.

And I’ve had several grants to help with the restoration.

I met many volunteers, artists, photographers.

It’s been a real treat for me to be able to restore this and

to meet lots of different people and helping do this.

So we always have a barbecue and a square dance in

the Round Barn for all of our meetings in Iowa City.

And the sad thing is,

when I go and give some paper in Europe or China,

people don’t ask me how’s my research,

they ask me how’s the Round barn,

which is terrible.

We all become famous for some things these days.

I have people ask me how’s the old studio baker doing?

That kind of thing.

Well,

the the American Speech Language Hearing Association awarded

the 2008 Editors Award for the article for article of the

highest merit to you and colleagues

that put together a volume there.

Yes. Claudia Colio, Pantel Helena and Gerringer,

Stephanie Goggle and William Noble.

And I published an article on identifying tentative subgroups.

I think that

one of the problems in solving the issues with tinnitus is that

there are likely different mechanisms and therefore likely

different strategies for helping these patients.

So in clinical trials,

we need to focus on different subgroups and be able to measure

those differences accurately. And, for example,

a drug might help some tentative subgroup but not others.

So we can find out.

What that subgroup is,

based on the history and based on psychoacoustical

measures of the tinnitus, will be in a better shape,

better position to find the subgroups and to be

helpful in treating these tinnitus patients.

And then you’ve received

at least a couple of inventor,

recognition Awards from the University of Iowa as well.

Yeah, I’ve been helped by many people,

including one example is Jay Rubenstein

in looking at the potential of electrical stimulation to help

tinnitus patients. So we did work on cochlear implants.

Some people who get cochlear implants say that, oh,

they can hear better, but even better than that,

their Tinnitus is gone.

So we did some preliminary trials to use both intracochlear

and extra cochlear stimulation in Teddis patients and looked at

different stimulation rates and different stimulation locations

to try and suppress tinnitus with electrical stimulation.

And I think there’s still great potential from that.

And I think that will eventually may even be a device focused

primarily on tinnitus with electrical stimulation

to be able to help some patients.

Now, there’s an award that’s called the Lasker Award.

And I didn’t know what the Lasker Award

was until we began discussing it.

And my understanding is it’s kind of an

equivalent to an American Nobel Prize.

Yeah. So this is perhaps the highlight of my career.

I didn’t know what it was either,

but Blake Wilson contacted me and invited me.

I think everybody they awarded this to graeme clark,

Ingelborg Hoekmeyer, and Blake Wilson,

and everybody got to invite I forget exactly six

or seven people. So Blake Wilson invited me.

So

the game,

this is the equivalent of the Nobel

Prize from the United States,

and this was awarded

in 2013 to these three individuals for their

contributions to the cochlear implant field.

So they had a special dinner,

and I was asked to provide toast

to the awardees.

So I

gave a toast host and awarded

my contract.

Kind wishes and provided some background for graeme clark,

Ingelborg Holkmeyer and Blake Wilson.

And in addition to that,

I gave some stories about key people that had helped them

in the fields, and that included Erwin Holkmeyer,

Mike Dorman and Jim Patrick.

So I gave this speech and

was thrilled to be able to be part of this award because

I had been involved in knowing these people

clearly and following their careers and interacting with

them over the years to see how cochlear implants had

involved and become accepted and worthwhile

my speech.

My welcoming address at this last

awards was actually recorded

and is available on YouTube.

We have that, I think,

as something that they can click on and review too Rich if we

need to. That’s wonderful. I hope people have a look at that.

It’s a thrill of my career.

Yeah.

The quality isn’t good of the video,

but the quality of the audio is really exceptional.

But more than that, I gather you’re a Diggery do player,

right? Well,

I guess this is sort of a problem.

That

a later date. I was invited to go to Sydney, Australia,

and I was awarded at this ceremony,

a Diggery doo by graeme clark.

Now, I failed music in grade two,

so I’m not really up on things in terms of music.

But it was quite a thrill to be awarded this.

And I’ve tried a little bit here and there from graeme clark.

So that was one of the thrills of my careers.

Well,

I understand that just blowing one

of those things is a little bit tough,

so just being able to make some sounds is quite a feat.

How has audiology changed from your first

trip abroad to maybe your last trip abroad?

I know a lot of us who have had some international experience

in the there wasn’t much going on in our profession,

but by the time we we get into the 2000s,

things have changed quite a lot.

Yeah, it’s interesting.

I guess

I can say in my first some of the the first trips that I had,

there just wasn’t a lot even.

People were just starting to measure hearing in some places.

My memorable trip was I went to China, Beijing in 1988.

There were traffic jams everywhere with bicycles.

There was no cars.

All the buildings in downtown Beijing were two stories

or one story,

and they were blocked toilets.

So it was a total different life.

But I was there to help them with

their first cochlear implant,

and they had some

sites to test hearing, but it was pretty minimal.

And

in those early days,

people were getting more interested in not just pure tone

thresholds, measuring pure tone threshold loss,

but also speech perception,

and not just repeating individual words,

but hearing

words with background words,

hearing

background sounds coming from different directions,

and not just hearing words,

but also localizing where sounds were coming from.

So at least in the research field,

it was becoming more in those cochlear implant days,

more realistic, I’ll say.

And of course,

today

there’s so much available on your smartphone,

and it’s affecting the healthcare field in general,

among other things.

And in some ways this is very helpful because people can

get some tests and some ideas and things remotely.

But it’s also a challenge in some ways because

not all of the things available online are valid.

There may very well be inaccuracies,

and sometimes it may prevent somebody from going and

getting their hearing tested properly and getting fit with

hearing AIDS or cochlear implants or getting appropriate

tennis counseling that would benefit from them.

So there are some clear benefits from the high technology

and interacting that is available now,

but there are also some shortcomings.

So it’ll be interesting to see how things move.

But I think that

in the long run,

it’s still going to be beneficial for individuals that

are distressed about their hearing

loss or their tinnitus or that

need special fittings of cochlear implants or hearing

AIDS to see professionals in their offices

and not do things remotely.

So it’ll be interesting to see how things evolve,

I think. If I remember correctly, Rich, you.

You kind of refused to take a ride in an ambulance

during that China trip as well,

right? So when I was in Beijing,

I was

asked by the physician in the local hospital if I would

go out to the number one school for the deaf.

And I said, I’d be happy to do that.

He said, Well,

I’ll come around in a car and pick you up in the morning.

And as I said, there were all bicycles everywhere.

I hadn’t seen a car in Beijing.

And so I said, where’s the car come from?

He said, well, it’s used as the ambulance for the hospital.

And I said, well,

how do you get to the number one school for the deaf?

And he says, Well, I go by bicycle.

And I said, well, get me a bicycle.

So I think I rented a bicycle for a dollar for the week.

And we rode by bicycle for 45 minutes out

to the number one school for the deaf.

The principal said she was pleased to meet me.

I was not the first Westerner to come to the

number one school for the deaf in Beijing,

but I was the first one to arrive on bicycle.

Maybe that was kind of a thrill.

Well,

many of us have had some fabulous

experiences abroad and so on,

but I can say that there’s very few of us that

ever got to take Miss America to dinner.

Right?

So

Heather Whitestone came to Iowa city

many years ago.

She was the Miss America 1995 and had a profound

hearing loss and received a cochlear implant.

So she eventually wrote a book listening with My Heart.

But I was fortunate and privileged to be

able to take her to dinner in Iowa City.

That was a very pleasant experience.

Well, that’s something that not many guys get to do, for sure.

But I want to call our colleagues attention to the fact

that you are the 2023 recipient of the Jerger Career Award in

Research in Audiology by the American Academy of Audiology.

And very well deserved.

And you’ve led us all into the area of tinnitus,

cochlear implants and many other areas as well.

Rich.

And so congratulations from not only myself this

week in hearing, but audiologists in general.

Thank you.

I was quite thrilled and quite surprised to receive this

Jerger Career award. And as I said, I have worked with many,

many different people around the world all together

and with them, with their help and with their input.

And learn from many other people the importance of hearing,

the importance of helping people with distressed

situations because of their tinnitus and hyperacusis.

And it’s really been a major factor in my career to have been

able to work with so many clever people from around the world.

So I’m quite thrilled to be able to received

the Jerger Research Career Award.

Well, one of the things that we’ve observed recently,

I’d say relatively recently,

is that many audiology clinics are now moving toward becoming

not just a hearing center, but a hearing antennatus center.

How do you see that changing the profession

for the future for tinnitus patients?

Well, I think it’s a great thing.

I think there is no cure at this point.

Again,

I think there might be some cures with particular subgroups

of tinnitus patients, but at this point there is no cure.

And of course,

we’ve known for decades that the pure tone thresholds

are not the only way of measuring hearing loss.

And so I think that

there’s a great potential here for interacting with patients,

not just

in the clinic, but as we said, also through smartphones.

And I think it’s a wonderful thing that there are more and

more professionals getting involved

in helping these patients.

And I think that with a focus not just on helping them

with their hearing, but also with the counseling,

I think that there’s opportunities

now and as we said,

some advantages and some complications

with things online,

but I think there’s wonderful opportunities

now for helping these needy patients.

And the profession is opening up and

now connecting with more tennis patients that they ever did.

And there’s a lot more options in helping patients with tennis

and with hyperocuses and with hearing difficulties.

So I think that there’s training programs and more

detailed personalized counseling programs.

Professionals are being trained better and professionals

are now working with smartphone apps and things.

So it’s going to be complicated.

As I mentioned,

there will be some apps and things that are not

helpful and some people that will be put off.

But I think that in general,

there’s great potential here for helping patients

and the profession is expanding its horizon.

To include tennis and to include hyperacrusis.

And I think we’ll be able to help more patients and be able

to do a better job helping them based

on the expansion of our training.

I think I would be remiss in our discussion, Rich,

if I didn’t say something about the fact

that during my time as chair of ATA,

we were trying to find

some sort of a certification

for people that were interested in treating Tinnitus patients.

When we first started talking about that,

people were saying things like,

how do you get a group of people that are treating

Tinnitus all to agree on anything?

I mean,

it’s like putting cats in a bag and watching them fight.

And you were able to take that group

as one of the leaders there

and put a cohesive group of 20 people together

to come up with a Tinnitus certificate,

which is now

the certificate holder.

Tinnitus management certificate from

the American Board of Audiology.

Yeah. Well, I think that obviously, we’re all different.

We come back from different training procedures

and different experiences in life,

and I think we all have to appreciate that

these different perspectives need to be listened to.

And

although we trained in one particular way,

there might be some other training.

And as I said,

I’ve learned a lot from psychologists

and also other audiologists,

and my opinions on helping people

have changed over the years.

And I think that we just have to be a good listener and realize

that we’re not always right and that there’s different

perspectives and all the patients are different

and might need different approaches.

And so it’s useful to have an open mind and to be

a good listener and to try and work together.

And it may very well be that useful for us if we try

something new every now and again and see where that goes.

So I think it’s important to realize that we’re different

people and we come from different backgrounds,

but it’s good to be a good listener sometimes too.

Absolutely.

Well, Rich,

in addition to the tinnitus management certificate,

I understand that subsequently you’ve introduced some

questionnaires and so on that can be of assistance in

tinnitus management as well as in the response

search that goes on in the tinnitus area.

Yes, absolutely. I think there’s.

This is very important.

We developed the Tinnitus primary functions

questionnaire and that helps direct

counseling. First of all,

because patients are different and they can be

affected by their tinnitus in different ways.

So, for example,

they can be affected by their thoughts and I’m motions.

The tinnitus can affect their hearing,

the tinnitus can affect their sleep or the tinnitus

can affect their concentration.

And so the tinnitus’s primary functions questionnaire can

help direct which areas they need treatment in or not.

And also in terms of research,

the tinnitus primary function questionnaire has been

translated worldwide and it’s very sensitive

to different treatments. For example,

if someone does not have any problems sleeping,

then those questionnaires on sleep can be ignored

before and after the treatment scheduled.

So that makes the questionnaire very sensitive.

So thoughts and emotions, hearing,

sleep and concentration, the four areas affected by tinnitus,

different and different people.

So the questionnaire can be used to direct counseling and the

questionnaire can be also used to focus on the effectiveness

in clinical trials. In addition to that,

in our studies I’ve seen that different quality of life

scales hardly even touch on the topic of hearing.

So these quality of life scales are used by many

health care systems around the world,

putting out allocations for funding

for different treatments and so on.

And they hardly even mention the aspects

and the importance of hearing.

So we developed a new questionnaire called the Meaning

of Life questionnaire and this has been published a couple of

years ago that helps people and helps researchers

and helps healthcare communities,

I hope worldwide appreciate the importance

of hearing in our lives.

And the previous quality of life scales

do not magnify that importance of communicating.

So it’s the Meaning of Life questionnaire that

we just published a couple of years ago.

Now we can just kind of Google those and they

should probably pop up, wouldn’t you think?

Yeah, I can send you the information that you want.

I can send you the articles.

Well, that’s good. So either Google these or contact Dr.

Tyler. I help you find these particular questionnaires.

Well, this kind of concludes our discussion today, Rich.

But certainly I want to thank Dr.

Tyler for his time,

energy and effort that went into our discussion today.

Thank you for being with us at Giants in Audiology.

What an example for all of us to follow

in a career development

in a successful career.

On behalf of Audiologists Worldwide,

thank you for your contributions to our profession

as well as the development of audiology

in the world environment.

And I hope that all of you,

as listeners to Giants in Hearing will join me in Seattle

at the American Academy of Audiology Honors Ceremony

banquet, where my good friend and colleague Dr.

Rich Tyler will receive the 2023 Jerger

Career Award in Research Audiology.

So thank you for being with us today at this Week in Hearing.

Thank you. I’m honored.