The Giants of Audiology: Interview with Robert Sweetow, PhD

Welcome to this Week in Hearing and our special series Giants in Audiology. Hello, I’m Bob Traynor, your host for this episode, and today my guest is is the Dr. Robert Sweetow Professor Emeritus, Department of Otolaryngology, University of California, San Francisco, California, who is best known for his work in hearing rehabilitation and tinnitus. Thanks for being with us today, Robert, and we really appreciate your participation in the Giants in Audiology series. Wow. I have to tell you, first of all, I’m honored that you would include me in this, but I must say that I was a bit taken aback because when I first got your invitation to be on this series about Giants, I thought we were talking about the San Francisco Giants. And so I got all prepared and I got all my Giants gear together and all that. And then a later email come you said, no, this isn’t about the San Francisco Giants. Then I thought maybe you were confused, thinking that I was a lot taller than I am. But at any rate, whatever it is, I clearly am very honored that you asked me to do this. Thanks, Robert. I appreciate that kind of analogy because it’s very important to know where we’re going with these Giants in audiology discussions. Before we get going, though, I’d like to read your biographical sketch for the group. So some of those who didn’t get the pleasure of listening to some of your great presentations and working with you on projects, I want them to realize who we are actually working with today. Dr. Robert Sweetow is Emeritus professor and former director of audiology at the University of San Francisco in San Francisco, California. He received his PhD from Northwestern University, an MA from the University of Southern California, and a bachelor’s degree from the University of Iowa. Dr. Sweetow has written 25 book chapters and over 113 scientific articles. He’s the reviewer for several journals, the author of Counseling for Hearing Aid Fittings, and I’ll interrupt here saying that was one of my best presentations, was being chosen to be an author of a chapter in your book. That was the first presentation, really, of personal style in the use of hearing aid fittings. Now we’ll continue. As a former member of the board of directors of the American Academy of Audiology, he was the. Co developer of the LACE Auditory training program, Dr. Sweetow has been an invited lecturer at more than 300 meetings worldwide and is a highly sought after speaker for his informative, and I tend to agree, an entertaining style. His research interests include amplification, counseling, rehabilitation, neuroscience, and tinnitus. Dr. Sweetow was the recipient of the prestigious 2008 Distinguished Achievement Award from the American Academy of Audiology. Again, thanks for being with us, Robert. And where we’re going to go with this is to, I think you started off in the city of Chicago. That’s true. I was born in the hospital called Lying in hospital that nobody believes that name. It was affiliated with University of Chicago. I actually looked it up recently because nobody believed that that was the name of a hospital and it’s now gone. Any record of me being born, I think, is long gone. So it’s not lying around anywhere. Yeah, that’s right. I’m lying around a lot now. After lying around in the hospital, then you kind of grew up in another part of I actually. So I was born in Chicago. And when I was, I think in third grade or something like that, I moved to a suburb Scopey. And I was there for really until I went to college. Dad was a sales guy. And mom, as I understand you mentioned, she was a beautiful blonde domestic engineer. Yes, that’s right. My dad was a carpet salesman who worked until he was like 95 years old. Just the opposite of me. I retired in my 60s. He worked into his 90s. And my mother usually didn’t work. She worked really hard at makeup and stuff like that. And she was absolutely a beauty wherever we went. People thought she was a movie star, wanted her autograph and things like that. But I hear she was a pretty terrible driver as well. Yes, that’s right. Actually, she made a big article in the Skokie News because she was driving up to the police station to file some papers or something about her license or something. And she managed to bump into a row of police motorcycles and it went down like dominoes. All these police motorcycles went down. So she made the news. It’s too bad we. Don’t have any pictures of that one. That would be a very good one to kind of correlate a lot of this stuff together. So, high school, you were kind of a football player. I guess for a while. I was, actually. That goes to show what a bad football team we had was. There I was at the time about five foot 5, 135 pound running back. And so, you know, that our team couldn’t be very good if a guy that size was starting as the running back. Well, but those low level guys with, as they say these days, a lower center of gravity can kind of crawl right up underneath some of those guys. That’s true. Yeah, that’s true. I was able to get right underneath everybody’s legs, and I was real fast, actually. But I don’t know where my lower center of gravity was, if it was somewhere. Well, I understand there were some things, maybe that you had some friends that had some deaf parents and things of that nature that were kind of some inspiration, maybe, or maybe not in moving into audiology. Yeah, one of my closest friends had Deaf parents. But honestly, people ask me that all the time. Did that have anything to do with me going into audiology? And the answer is, it really doesn’t. It really didn’t. I got into audiology because I just fiddling around in college, I really just couldn’t decide what I wanted to major in or anything like that, and took a course and actually got an A in it, which was the only a that I got other than in physical education. So I thought, oh, maybe I want to stay in this area. And so there it was. Did somebody say something about Dumbo Pinna to you at one time or another? That’s what I heard somewhere. Yes. As you could tell from my side view here, I have fairly good sized auricles or Pinnas. Pinnae, I guess. And when I was a kid, I would ask my older brother, who’s five years older than me, I would ask him to drive me to school, and he would say to me, well, why don’t you just fly to school? What can I tell? Well, now, I think this is about the time, and I was, like, not surprised by this at all. I think this is about the time you told me about that part of high school. You were a carnival barker at one time or another. So I haven’t had very many jobs in my life recently, really. But at one point, when we were in college, not in high school, but when I was in college, a good friend of mine was running a carnival. Stand in rural Iowa. And I went to school at University of Iowa. And so he asked me one summer to work with him and another guy, and we had a stand at the carnival going from Little town to Little town. And my job was I was the guy who would call people into our stand and say, ‘Hey, come on over here’. I’ll guess your name, I’ll guess your weight. I’ll guess anything you want me to guess about you. I know it all. And then come over. We would look at their hands and do just crazy things. If I looked at, say, a farmer’s hand that had, his fingernails were dark from working in the land, I would look at his hands and I would say, I know what you do for a living. You’re a brain surgeon. It was a really fun gig. Again, it was especially fun because we would walk around to the back of the tent and do a little swig of Jack Daniels and then come back out and guess people’s names, weights, and occupations. I see. And that was probably because you couldn’t really work at McDonald’s anymore, right? I got fired from McDonald’s when I was at Iowa because all my friends would come in and none of us had any money. And they would come in and ask, they’d order a hamburger and fries and a milkshake, and I would bring out a package of like, ten hamburgers, twelve milkshakes, eight orders of fries, and hand it to them. And finally my supervisor saw that what I was doing and said, bye bye. That in and building a lava lamps. I think, too, that was another great job that I had. My high school girlfriend’s father was really, I think he was actually the inventor of lava lamps. And so he had a big factory in Chicago, and one summer I needed a job, and so I went to him and I asked if he could give me a job in his factory. He said, OK, show up on Monday. I showed up on Monday and walked right over to the assembly line thinking that that was what was going to be my job, working on the assembly line. And instead the foreman said, oh, no. Yeah, the boss told us where you’re supposed to be located. He takes me downstairs into the basement where there’s a gigantic furnace. And my job was to shovel garbage into the furnace. This is in the middle of the summer in Chicago. It must have been 130 degrees in that room. So I managed to last like a full day, and then I quit, which is another reason why my girlfriend’s father and never was too keen on me. Well, that shows a brilliant. Individual, I think, that would quit a job like that. Now, as high school began to wane, I understand that, like many of us, some of us just weren’t the highest level people at school. But I understand you were the valedictorian for a certain component of your course of your class. Well, yes, sort of. I was actually, in high school, the valedictorian of the second half of my class. I think there was like 500 kids in my year and I was like, ranked 251st. Okay, so the valedictorian of the second half, I guess there was some interesting things that led to your matriculation at know, a lot of us would think, oh, Iowa, Iowa is well known for our audiology and speech and hearing and so on. And of course we would think that Robert Sweetow went there for all of that fabulous kind of orientation to the world. But I understand there’s a different way in which you ended up at Iowa. Yes. First of all, my grades weren’t good enough for me to get into Illinois, which was my first preference. And then the Iowa track coach had contacted me, had seen some of my times as a sprinter in high school and talked to me about a scholarship. But then I was invited to a party in Iowa City by one of my friends brothers who was part of this fraternity, which was basically animal house. So I went to this party, fell in love with Iowa and said, that’s where I’m going. And that’s where I wound up. Well, I don’t think there’s anything better than going to a toga tromp to choose the school that you want to go to in some respects. That’s right. At the University of Iowa. My understanding is you had some pretty good mentors there that you were interacting with at Iowa through the undergraduate kind of thing. Yeah. So I didn’t move into speech pathology I think I took in my junior year. I started off in pre dentistry, I remember. And at the time, if you recall, when you went to the dentist, now they put a thing in your mouth that sucks up the saliva in your mouth. At the time when you went to the dentist, you were told, okay, turn your head with spit into that little bowl. But I am left handed. Figured, well, if I am a dentist with my left hand and I tell him to turn around, Down and spit. Everybody’s going to spit on me. So I was a little concerned about that. So that, honestly, I think my junior year, I took intro to speech path and audiology. And then, you’re right, Iowa had some great people there at the time, and I did pretty well in that class. I think it was one of my few good grades and then decided to stay with it and then didn’t really transfer over into audiology from speech pathology until I was going for my PhD at Northwestern. No, I’m sorry. When I was going for my master’s at USC, that’s when I switched over. So what got you to move back to California or out to California to go to USC rather than staying in Iowa? So, first of all, I don’t know that I would have gotten into Iowa’s grad program. Secondly, I got a scholarship from, my parents had moved from Chicago out to Los Angeles. So I thought that, know, be nice to be around them. And I got a scholarship offer from USC, which absolutely shocked me that I actually was getting a scholarship. But then, of course, once I accepted and once I got there, I realized that the reason I got a scholarship from them was I was the only male in a class of like 20 females. So they obviously needed a token male in there. Wow. So some mentors or things, people that were of interest, that kind of moved you toward audiology at USC? There was one guy, this guy, Nick Pappas, who had actually gotten his PhD some years earlier at Northwestern. I’m not really sure what ever happened to Nick, but, yeah, I was in the speech path program there, and I just didn’t like the way they were doing things. They were doing too much child therapy with people, with kids that I didn’t really think needed a psychological approach. And so I just decided, this isn’t for me. And I was actually going to leave the program. And this guy Nick said to me, why don’t you just try audiology and see what you think? And sure enough, I did, and I liked it. So, Robert, I understand that you did your PhD at Northwestern. How did you end up at Northwestern? Was that something Dr. Pappas recommended or was that just something that you heard, that it was a good school? How did you get to. Well, yeah, Nick Pappas did say, oh, you’re going to go on. Northwestern would be great. And of know, having taken courses in audiology, I knew Northwestern, certainly at the time, was the Mecca of audiology. Everyone with a big name practically was coming out. Over there or going in there or currently there. So I applied to Northwestern not at all certain that I would get in, and I would. I remember taking my know. Remember you had to take the exams. And again, I was like an idiot in mathematics. In high school, I think I got an F in geometry and a D in algebra. So math was not my subject. And I remember taking the GREs, and when the GREs came back, my scores on them were, like, in the 98th percentile in math and about the 90th percentile in the other areas. So I think Northwestern looked at that and said, oh, this guy is really smart. And they came back and did it. And some years later, I remember having a discussion with Dr. Carhart. Of all people Because I failed during my qualifying exams, I failed on the electronics section, the electronics portion, because they asked a question that required a lot of mathematics. And so I said I couldn’t do it. Then old Carhart called me in afterwards and said to me, what happened there? And I said, to tell you the truth, I’m an idiot in math. And he said, well, how can you be an idiot in math? We’re looking at your GRE scores, and we see what you got. And I said, to know, I got to be honest with you, Dr. Carhart, I think that they must have mixed up my scores with somebody else. That’s how I got in with Northwestern, I think. Well, but at the time, Northwestern indeed was Mecca. And not only Carhart, you had a number of other fabulous mentors there as well. Yeah, Carhart. It was Carhart. Hartford, Noel Matten, Doug Knopsinger, Tom Tillman, Fred Waltman. Let’s see, who am I? Forget Peter Dalos. I mean, it was an amazing. It was just an amazing array of people there. So, yeah, I was really lucky. And to this day, I still say Carhart was the greatest professor ever. And understand you and Carhart had kind of an encounter at one time. Yes. This was. Let’s see, when did I get my PhD? Around 1976 or something like that. So I was a guy with, I know I look grody right now, but, I mean, I had a longer, grodier, dark beard and long brown hair. And at the time, one day I was in the bathroom, and I’m standing at the urinal, and all of a sudden, guy walks up next to me at the next journal, and it’s Ray Carhart. And he looks at me and goes, Why did you shave your beard? I had just shaved my beard like the day before. He said, why did you shave your beard? And I said, I don’t know. I thought you might want me to look cleaner here as a PhD student. So he actually termed me a deciduous hairsuit, which of course I smiled at and then had to run back to my dictionary to look up to see what it meant. And what did it mean? Deciduous means it’s changing and hairsuit means hair. So it was somebody who changes their facial hair or their head hair quite a bit. Well, I just didn’t want the audience to have to go to the Internet and look that up to find out what that was. Well, and the first position was at the San Francisco Hearing and Speech center from what gather? Yes. Yeah. So right out of Northwestern I got this job and I had been to San Francisco on vacation once and loved it. And so I got this job offer as the director of audiology there, which just of course lured me because I was 26 years old, or 27 years old at the time. And when I finally got to work there I was younger than everybody else on the staff. Now I’m put in as the boss, which was a little intimidating. But fortunately I had a really nice group and the staff and they accepted and every once in a while did what I asked. Wow. As part of that, while you were there, you kind of moved into some adjunct professor positions. San Francisco State and University of SF, of a lot of us that started some of those positions, kind of used those to develop our teaching skills, if I remember correctly. Yeah. And actually there was a lady, there were two professors at San Francisco State that I remember. You might recognize their name, Stan Lamb and Diane Berger. And they had done some publications back in their sixty s, 70s. Anyway, at different times they went on sabbatical and so they called me and they said, hey, would you just cover our courses for those semesters? So I said, yeah, it’d be fun. I think that I did develop some of my teaching skills there because it was very relaxed, very loose. I could joke around. I could be myself. So those were kind of fun gigs for sure. And then in the 90s, it looks like that’s when you became the director at the University of Colorado. San Francisco Medical Center, University of California. Oh, I’m sorry. I have Colorado on my mind. Yeah, I got working. I was very happy at the hear what Speech center, and one day I got a call from the head of Otolaryngology there. A guy by the name of Bob Schindler. And Schindler just said, ed, like to take you out to lunch. And he offered me the position. And I went out there, and I interviewed their staff, their otologists, and their laryngologists, everybody in the otolaryngology staff, to see if I would get along well with the rest of the faculty. And it turned out great. And when I started there, it was a very small program. I kind of followed the years of Elmer Owens and Dick Flowers. So there was like a period after those guys left and before I got there that the audiology program really shrunk down a lot. And so when I got there, there were three audiologists on the staff. I had a secretary who, we had no computers. Everything was done by paper. I had a secretary who was wonderful older lady, not relative to my age now, but relative to my age then. And she was dyslexic. So she would take down messages for me. I would call them back, and there’d be wrong number. It was quite a challenge in the beginning, but then it turned out to be great for me. During your time there, there were a lot of projects that you took on. One of them that you and I worked on, I worked on, one of your projects was for InSound, which became the Phonak Lyric device. And we were working on some clinical trials there that had to be kind of, here’s a new device. It goes in the ear and stays there forever. And to put that in perspective, that had to be kind of an interesting project to kind of direct that project. Yeah, it was really fun. Bob Schindler my otolaryngology boss, he was actually one of the inventors of that particular project, of that particular product. And so, yeah, we got involved right away. It was really my first experience using a microscope from the department, and I was terrible at it. I remember, you know, how you had to turn the knobs to depth of focus. I would turn the knobs and smack myself in the nose, or hit patient in the head. Um, so it was really interesting. And at the time, the. Insound, which became the Lyric, was much bigger than it came in later days. So it was interesting trying to get this in and out. And one of the big things that I remember that I’m actually really proud of is at first the FDA wanted only otolaryngologists to be able to. Yeah, I remember that. Yeah. And so I had to really, really do a whole pitch about why, if they limit this, otolaryngologists doing it, the access to getting this device is going to be very limited because otolaryngologists, most of them, don’t want to deal with anything having to do with hearing aids. I was really able to pitch that successfully. Particularly then the ENTs weren’t interested in doing much with hearing aids. Of course, a lot of that’s changed now. But also, that was a time when you began working with the LACE project as well, which is a huge auditory training program these days. Yeah, I wish it was even huge-er because unfortunately, the guy. Well, let me step back and say this. So with the LACE program, this group of guys came to me, and the reason I knew them, this was another part of my professional career, I guess, was at one point, I was the audiologist for the Grateful Dead, of all people. Okay, so now you have a very good selection of Jerry Garcia ties. Yeah. That you never wear. I actually did, but. So this group of engineers came to me one day at UCSF, and they said, we’re working on a project. They were looking for new capital projects to do. And they were working on a project that they heard about, a tinnitus approach, which basically was phase inversion. And so they came to me and they talked to me about how did I think that would work? And I said, I’ll tell you how I think it would work. It won’t work. Tinnitus is not a real sound, and so inverting it is not going to do anything. And so I said, but I’ve been starting to work on something else that I think might be good. And by the way, just to finish that connection. So these guys were engineers for the Grateful Dead, and that’s how they knew of me. That’s why they came. Okay. And I can go into some other Grateful Dead stories later, probably off camera. Anyway, so that’s what I pitched to them. The whole idea of LACE, which at the time, I didn’t even have a name for it. It was an auditory training program. The name LACE, which was an. Acronym for Listening and Communication Enhancement, came to me, actually, one day when I was in the bathroom. I was just sitting there letting my mind wander, and there it came. These guys said, oh, that sounds interesting. And they were terrific at developing software and doing telecommunications and stuff like that. So if it weren’t for them, I don’t know that the LACE project ever would have gotten off the ground, because I definitely didn’t have the technical skills to develop it the way they did. Wow. Well, but during your time at the University of California, San Francisco, you also saw a lot of celebrities, from what I understand, and I know you can’t say anything about them, but that has to be. I know every once in a while I’ll be having talks with other colleagues, and they saw famous politicians, and they saw this one and that one and all these other people. And can you tell us a little about the experience and the special kinds of TLC you need to do when you’re working with those kinds of. I mean, without mentioning names? Being out in the Bay Area, I had a lot of the very well known winery owners. Yes. Some of them were really nice. Some of them were just so nasty and felt like everything was owed to them. One guy, actually, in particular, used to come into my office, pull up in his limo, and then he’d come into my office with a physician with him at all times. He had a physician with him 100% of the time, and he treated this physician horribly. And so one day, my patient went to the bathroom, and I started talking to the physician, and I looked at him, and I said, I apologize for asking this, but how is it that you put up with the behavior that you’re giving to you? And he just said to me, money, and that was that. And probably free wine as well. That was one tremendous benefit, even from whether it was a nice wine owner or a not so nice wine owner. They all seemed to send wine to my house. They would ask, yeah. And so I would go home at the end of the day, and there would be a case of wine in front of my. That was. That was always fun. It was always fun, yeah. And I’ve heard a couple of things in the Old Bay Area society that there’s some stories running around about Robert working with patients in their wine caves and places like that as well. So that has to be an interesting experience as well, also, And then I had a couple of very famous sports guys, which that was the most fun for me. Of course, one guy in particular won’t mention his name, but he called and I answered the phone, and he goes, Dr. Sweetow this is blah, blah, blah. And I thought it was my brother just putting a fast one on me. And so I said, oh, yeah, sure it is. And then he said, oh, really? And then as I listened, I recognized his voice from hearing him on TV and on the radio. And so seeing him was a real thrill. And I had some other musicians and stuff like that, so it was always fun. I mean, I would get up in the morning, look at my schedule, and either be elated about who I was going to see or totally depressed, knowing I’m going to have to deal with this guy, and it is not going to be fun. The only real advantage on some of these celebrities was when they purchased hearing aids. They were so, I don’t know, mixed up or whatever you want to say, that they would order, like, six hearing aids at a time. And I would say, oh, well, you know, that if you lose the hearing aids, they’ll be replaced. And they would say, well, not immediately. So they would order, like, three sets of hearing aids, which, of course, made the university very happy. Of course it did. But when you look at your schedule in a practice, it doesn’t make any difference if they’re famous celebrities, politicians, and sports people or if they’re just routine patients. You have the same reaction. Oh, I’m glad to see Margaret this week. Oh, I don’t want to see know that kind of. Absolutely. And then actually, a couple of the well known people I saw, I was able to get them to come to AAA for to be a keynote speaker at conventions. Whoa. How cool is that? I know I was there, but I don’t remember. I guess I can mention those names because I knew them primarily for some other reasons. But one year I brought Huey Lewis. Oh, that’s right. I remember that one. And then one year I brought Amy Tan, the author, to the convention. Yeah. So that was a lot of fun. And they both did a great job. And it’s been well known in the press about Huey Lewis is really having a lot of trouble, and I’m not going to knew. It’s been all over the press, but he’s gotten in years and in a mess for, well, you know, and I understand during the previous positions, as well as in the position at the University of California, you had a number of grants and some kinds of things that, that led into some other projects that you were pretty. Famous for these. Really? My point there, Robert, is I think a lot of the grants and the work that you were doing there led into some of the tinnitus research as well as tinnitus kinds of treatment, things that all of us have known you for, and at least I’d say, in the last half of your career in, well, you know, the tinnitus stuff. I was interested in tinnitus even when I was going for my PhD. And I remember talking to Dr. Carhart about that, and he said, what do you want to do your dissertation on? And I said, I’d like to do it on something with tinnitus. And he looked at me and he said, oh, would you like to be staying at Northwestern for the next six to eight? He said, he said, then that’s not the area you want to try to do a dissertation on. There’s too many variables. Of course, he was right. But what I think really helped me with tinnitus is I wrote one day I was sitting at home and I was reading something about chronic pain and how chronic pain was being treated with cognitive behavioral therapy. And it dawned on me that tinnitus is so similar to chronic pain in terms of it being subjective and invisible and sometimes incurable and things like that. And I saw that cognitive behavioral therapy was really helping a lot of these chronic pain patients. It dawned on me that that would be a logical approach for tinnitus patients. So I wrote a paper, I think, in 1976. It was the first paper that really talked about cognitive behavioral therapy as it might apply to tinnitus. And so that was very useful for me. I got an early grant from the ATA, the American Tinnitus association, which helped me develop one of the first tinnitus scales. It was called the tinnitus Severity scale. No one ever has used it. And it was like, of everything I’ve ever written, well, there have been a few others, I’m sure, but the statistics on it were. I just didn’t have a very good grasp of statistics in those days. And so it was kind of a clever scale, but it was one that has been replaced by much better researched handicap inventories and functional index and stuff, TFIs and so on But you were also a board member and the Scientific Advisory Committee director for the ATA as well. Yeah. And it was interesting those days, because if you remember, those were the days when. Way of dealing with tinnitus patients was masking. And I remember when I came out with the whole concept that cognitive behavioral therapy might be the way to go instead of masking. I got a lot of pushback from pioneers in Tinnitus like Jack Vernon, who said, well, my concern is that if cognitive behavioral therapy is the approach then that’s going to move, that audiologists might be taken out of the tinnitus picture. And if the funding organizations like NIH believe that Tinnitus is more psychological than real, it’s going to hurt funding. And so he had some points there. And I have tremendous respect for Jack Vernon, but I argued that, no, that I think that really there’s room for all kinds of approaches on it because there’s no one single approach that’s going to work well and it’s the true thinkers. However the thinking came about, as you’ve mentioned earlier, however that thinking came about, I would say it is a routine procedure for very bothersome tinnitus and persistent tinnitus for patients to use cognitive behavioral therapy. So that’s an innovation, I think, and I suspect that your paper inspired a lot of that and the thinking that came after that. I hope so. Even today there’s still arguments about what’s in the audiologist scope of practice and is that too psychological for an audiologist? But my approach was cognitive behavioral therapy encompasses a lot of procedures. And I said no, certain of those procedures are within only the realm of a trained psychologist or psychiatrist. But there’s so much common sense involved in cognitive behavioral therapy that that was kind of the approach that I was advocating audiologists can take. Even if they weren’t cognitive behavioral therapy experts, I would advocate that they take some training in it, but if they just understand the basics, that should help them with their counseling. Well now I think there’s even some work that’s being done with an audiology approach supported by psychology people that will be available in clinics probably the next year or so. Quite a beginning for a treatment program that has been fabulously beneficial to many patients. It. But you were also an FDA consultant for hearing tests and ENT devices and things of that nature for quite a mean. That was. That was fun. I don’t know exactly how much I really contributed to all of that stuff, but, yeah, I did have that as a physician. And I think because the person I replaced retired, or actually, I think that might have gone to work in the hearing aid industry, and so they needed a replacement for that person because they didn’t want to have some kind of a conflict of interest. So that’s how I was brought in on that. Okay, well, to just take a minute. I want to discuss one of your better publications. You told me this is the best publication you ever did, and it was published in something called how to Eat, like an audiologist. And if you look very closely, you’ll see Dr. Sweetow here with his Cheetos and something else to facilitate things. And this was quite a heavy publication. The American Academy published that. You were on the front cover along with some other colleagues as well. Incredibly fun project. So my contribution, we were all supposed to say how we cook one of our own recipes. So my recipe was for Sweetows, Cheetos – Cheetos Burrito. Sweetows. Cheetos. Burritos. That was it. And so the picture has me with my sombrero on and a bottle of tequila and a bag of Cheetos and of course, my Sweetows. Cheetos. Burritos. And so that was really a fun project trying to. Well, but your work with the American Academy has been long term. And as an editor large for tinnitus today as an assistant editor for the Journal of the American Academy of Audiology since 2005, I think it is Trends in Amplification is another publication, Seminars in Hearing another one, and lots of various publication kinds of appointments that you have taken, done well and served on a long term basis. Yeah, I was fortunate. Just like you, once you have somewhat of a name in the field, people ask you to do those things. And certainly being a journal editor is fun. Most of the time is fun. As we’ve talked about in the past, some times, peer reviewing certain articles can be very challenging. Because some brilliant scientists are not brilliant. So there’s always that confusion in there when you’re trying to peer review mean. It’s been. It was fun for me to be on the board at AA and to be on these various boards. I just met a bunch of brilliant people and always had a good time. Well, and part of that good time, I remember sitting in the audience one time, I can’t remember the name of the talk, but I sure remember favorite coming in and putting a cheese head on your head because you had lost a bet somewhere along the line. Yes. Dave Fabry is a very close friend of mine and we are big rivals in betting things because I’m a 49ers fan and he’s a Green Bay Packer fan. So one of our early bets was the loser had to wear a cheese head while giving a speech and not telling the audience why they were wearing this cheese head. So I lost that one. David talked there with the cheesehead on. I’ve also lost bets to him that cost me a tattoo on my arm that I got. I lost a bet with him that the bet was, this was at one of the student academy meetings that was at AAA. The loser had to get a pierced ear. So I was up there giving the speech and Alan French, who’s an ENT he was. This was all arranged. He was sitting in the front row and in the middle of my speech he just stood up, walked onto the stage with his little black bag and took a needle and thread and belling Dave he pierced my ear and I was pretending like I didn’t know what the hell was going on. So he pierced my ear, pulled the thread through and there I had a little earring in. And then he very quietly turned around, walked off the stage and sat down. And then afterwards, the students of course were shocked. But then afterwards after him to see my new gold stud in my ear and lo and behold, they had put like a little teddy bear in my ear lobe rather than a gold stud with a gold stud. Yeah. And I think that we have some photos to kind of go along with some of these interesting situations in which you found yourself in your bio where it says entertaining presentation. That one in the cheesehead one seemed to be kind of highlight of some of those, although more serious ones have. Really been informative and clinically very appropriate to the times and those kinds of things, but it’s always in an entertaining orientation to the world. I never thought when I was a kid that I would be a public speaker. I’m sure I can’t remember clearly, it was like 90 years, years ago. But I remember know to my class was difficult. And my first speaking gig I got. You remember a guy named Cy Libby who was. Oh, yeah, stuff like that. So Cy Libby was a regular speaker at Bob Sandlin’s International Hearing Aid Seminar. And one day I get a call from Sandlin and he said, Cy is sick and he can’t come. This was just like a week before the seminar. He said he can’t come out, and he recommended you as a substitute. And I said, really? I said, fantastic. So that was my first real know and came about by accident. And at that, I realized I can really go out there and have fun speaking and try to be as goofy and entertaining as possible. Because I have to be honest with you, I never considered myself the intellectual peer of some of the Giants in audiology, but I knew that I could give an entertaining speech, and it would always be fun, because when I would be at the podium or after giving a speech with a group of people, I would say, hey, I’m really honored. And it’s intimidating to speak after you because you’ve got such perfect data and just so much to give to the audience. And they would look at me and they would go, can you imagine having to speak after you because you had just had the audience laughing and having a great time? So I was very fortunate that I was able to be in that position to get out there and have fun and entertain and try to educate at the same time. Well, on one side they’d see the very entertaining kind of a speech, and the other side is lines and data, and then they’d just eaten, usually. And then it begins to kind of eyes begin to close and so on. You can tell that there’s a problem by the guy in the back that’s snoring sometimes in some of those other kinds of talks. Of course, we’ve all been on both sides of those talks. Of course, I don’t remember what the bad joke was. I’m sure it was a bad joke, and I was giving it that talk in San Francisco. And in the middle of my talk, all of a sudden, there. Was all this commotion in the back of the room, and a guy had had a seizure. And so I stopped the talk, obviously, and everybody ran over and called 911. In fact, that I remember one of the guys called 911 and was put on hold, which was. But at any rate, it turned out that the guy who had the seizure was fine, and he actually came to the conference the next day, which I was shocked. But then about a week later, I was giving a talk at a state conference, and I used the same joke that this guy got the seizure from. I used the same joke and there was somebody, a woman sitting in the front row, and all of a sudden she started choking and somebody had to run up and do a heimlick on her. I’m never doing that joke again. That was, I think that’s in our best health interest for you to stay away from that. And you’ve kind of led me to believe that one of the biggest honors was the distinguished chief of award from the American Academy of Audiology. Tell a little bit about how that transpired. Robert yeah. Gyl Kasewurm, who was on the board, AAA, with me at the time she nominated me, which I was just amazed. And then a lot of other people had to write in letters of support for that. And again, I never really looked at myself in the same regard as some of the other people who were getting that award. So I was just flabbergasted. And I think a lot of the people that wrote letters of support for me, who were very prominent in the field, were also good friends of mine. So maybe they felt, I can’t say something terrible about this guy. But, yeah, so it was a tremendous, tremendous honor, I think the biggest honor of my life. And although I remember when I went to give the acceptance speech at the convention at the time, AAA was doing it as a dinner. It was a dinner thing. And while I was giving my speech, which I really worked on to make it fun and thanking everybody who was involved, as I was giving my speech, the waiters and waitresses came out and started cleaning dishes and handing out the dinner while I’m speaking. And so there was so much noise that I think nobody actually heard what I had to say. Well, hopefully we maybe should have given the audience a QuickSIN test or something like that before we started. So we’ve both had some experience in international markets and international kinds of things, and I know that we shared some of the same translators, like the. De Russo in Brazil and a few others around the world here and there. What are some of your perils? What are some of your highs and lows of some of those international presentations? Because we’ve all had them. And you said the wrong thing at one time and thought you were saying one thing and you really said something that really was totally gross or totally off base somehow. Yep. Well, I can remember. I can think of a couple of them. Right. So some you may want to mention, some you may not want to know, and some you might want to edit out at your. In Brazil. And I got up there, and as I was standing there, it was after a break. So the audiovisual guys in the back know, just setting up the sound and seeing if everything was quite right. And so I was at the podium just before giving the speech, just as I was about to give the speech and the audio visual guy kind of waved to me to see if I was happy with how everything was sounding. And I went, oh, yeah, it’s perfect like this. And there was like a gasp from the audience. And I’m thinking, what’s the problem here? I didn’t say anything at the end of the speech. I said to somebody, I said, why did everybody get so crazy when I went like this? And they said, because this meant this in our country. So I essentially flipped off about 1000 people that were in the audience, which I didn’t know. And then I remember another big highlight, not that I screwed this one up, but was actually with you in Switzerland. We took a. Yeah, yeah. And the performer at this dinner was the fastest piano player in the world. I forget his name. Nico something or other. I actually got one of his CDs. I have one of those laying around someplace. Also amazing. He was less. Yeah, so that was a bad one. I also used the wrong term. I remember at a speech in either Australia or England I used a term that I just thought was fairly mild. And apparently it was very specific to their culture that somebody said to me, you know what you just said? I’d said, whoops, we’ve all done those from that trip to Switzerland. I vaguely remember. Not vaguely. I actually quite well remember the fact that the president of the company at that time told me, you need to go meet Dr. Sweetow at the station in Zurich. And I’m thinking, okay, hanging out for a whole day in Zurich with Robert Sweetow. That has to be a pretty good day. And it was. A beautiful day in the neighborhood, but it was really a lot of fun. One of my memories from that, and I know neither one of us still have the picture, but taking your picture in front of a place in Zurich, Switzerland, called the Hotel California, which was a pretty big deal at the time. Well, so now that we’ve kind of hit a lot of the high spots and low spots and so on. Robert, where do you see the profession going? And how have you seen the development of tinnitus treatment and some of those kinds of innovative treatment programs that have actually kind of, some of them have become pretty routine in audiology clinics. But the future of the profession, I think, would be a nice way to begin to wrap up our discussion this morning. I was asked a few years ago to give a talk to the incoming students at one of the local universities here. And at first I said, well, let me think about it, because at the time I was thinking the future is a little cloudy for audiology because of over the counter hearing aids and because of stem cell advances and online Internet hearing testing and all of that. That, I think, creates a challenge for audiologists. But I sat down and started writing down where audiologists can go, how they can evolve and things like that, and realized that as long as audiologists are willing to evolve and are not, like, in the mood that, well, hey, there are no more typewriter salesmen, but there are computer salespeople. Right? And audiologists have got to be thinking along the same lines that automation is taking care of a lot of things right now. And the whole dispensing of hearing aids, the whole advances on hair cell growth, things like that. While they create a challenge, there’s still going to be the need for face to face communication in terms of aural rehabilitation, in terms of tinnitus, definitely the counseling, just, it’s essential. And so then forensics, I think, is a tremendous field for audiologists to get involved in. So there are a lot of different. Interoperative monitoring is another one. I mean, there’s just so many things that audiologists can do that go beyond diagnostic testing and hearing aid fittings. Vestibular is another example that audiologists really need to branch into something that I’d never branched into, because at the time, I don’t even know what. Just were considering vestibular work back when I was, well, Rich Gans probably was has turned that into a multi million dollar worldwide operation, of course. Yeah. Well, Robert, this has been a truly enlightening and truly fun Giants in audiology. Be the host for and I want to thank you on behalf of not only the profession, but many of the kinds of things that we would all like to see in the profession. We would all like to see some more entertaining speeches one day, maybe when you get tired of walking the dog, and various other things that a guy does to relax a little bit when you aren’t quite as active as you were. A new entertaining speech would be very nice. So again, I just want to thank you for your fabulous career, your insight and hilarious talks occasionally. That had a point, and they had very good academic kind of basis. But we all learned so much from you and your orientation to the profession. So today my guest has been Dr. Robert Sweetow, Professor Emeritus, Department of otolaryngology, University of California, San Francisco, and a true giant in audiology. Thanks again for being with us, Robert, and we look forward to maybe hearing another one of those high level, entertaining presentations. Thanks so much for asking me. I appreciate it.