The Giants of Audiology: Interview with Michael Valente, 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 and today my guest is Dr. Michael Valente, professor emeritus, Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri. Dr. Valente is best known for his work in the whole field of audiology. But specifically in hearing, hearing rehabilitation. And one of my interests, practice management. Thanks for being with us today, Mike. We really appreciate getting to know you better and your unique and truly inspirational journey to a highly successful career in our profession. Well, thank you so much, Bob. It’s an honor to do this. as I said to you before, I don’t consider myself a giant in audiology, but it’s nice that you recognize mee as such, some people. You know, I’m only 5′ 6″, so how can I be a giant in know? But anyway, thanks for being with us. And I always like to read the professional biographical sketch for each and every giant that appears with us. so here we go with Mike’s biographical orientation. Michael Valente is professor emeritus of clinical audiology. At Washington University School of Medicine in St. Louis University. And was there for 34 years directing the division of adult audiology. In that position, Mike was active in the clinic and directed the hearing aid research laboratory. Taught graduate courses in amplification and a very important, innovative area called business component of audiology. He received his PhD from the University of Illinois at Urbana champagne in 1975. His interests include spending time with his beautiful wife, Maureen. Daughters Anne and Michelle. And some grandkids by the name of Noah, Salem and Lumen. And again, thanks so much for being with us, Mike. And I understand you kind of started off in the New York City area like Brooklyn. Or know, one of those places that people from the west never know. That’s almost like another country to us. So here we are. Anyway, you can tell us a little bit about growing up in Brooklyn. and some of the other things that went along with that. Sure. Well, I was born almost 76 years ago on February 1, 1948 at Kings county hospital, which is in the eastern part of Brooklyn. And at that moment I had two older brothers and an older sister. All of which, luckily, are still alive. So I must have some relatively good genes as you’ll find out in a few minutes. My background is a little bit different. And some of my memories of my youth are really stories told through my siblings. And also some research I’ve done online. And I also had another sibling who passed away at nine months from pneumonia. And then I had another sibling who passed away, stillborn. So it was a rather large family. my mother was a native american living in Brooklyn, and my father had immigrated from Portugal. And what makes that interesting is he never spoke English, and so he spoke in at three, I was removed from the family and placed in an orphanage. So for my first three years of life, we lived in a rather poor section in an apartment on Alabama Avenue in Brooklyn. And I remember it only because it was a dark hallway and the entrance to the apartment was in the bottom of a staircase. And I even remember the sense of the smell of urine in the hallway. So it wasn’t exactly living in the life of luxury. And I spent three years there, never realizing that I never actually spoke to my father because he spoke Portuguese. And obviously at zero to three I didn’t speak Portuguese. And the only person who learned to speak Portuguese was my older brother. So my communication with my father was through my brother. I never had a direct communication. And so my mother was a housewife. My father was slightly disabled. He worked in a bakery doing some kind of job. And then something happened and I never quite understood what. But at the age of three, my sister and I were removed from our home and placed in an orphanage in far Rockaway. And we spent five years there from the age of three to eight, for myself. And when people hear that you spend time in an orphanage, the immediate reaction usually is, oh, my God, horrible. And those kinds of connotations. But actually, it was really five excellent years of living. the staff was wonderful. I had a million and one other friends, both male and female. we were fed well. it was a large complex. I remember we walked in the front door and it were like little dormitories on a single level. And you’d walk in and the kitchen was over there right as soon as you walked in. And then there was a wall, and then on the back of the wall were just rows and rows and rows and rows and rows of beds in several columns, if you will. So each one of the kids got a bed and a nightstand, and then behind that, in another wall on the other end, was where you had the showers and the bathroom and all that lovely stuff. And I spent five years there from the ages of three to eight, obviously. I went to elementary school in for a rockaway. it was probably at that point of my life, the best part of my life because it was warm, the staff was welcoming. We had an in ground swimming pool and all those other lovely things. And then at the age of eight, my sister and I were removed from the orphanage and we were placed in a foster home on Long island. And we both spent five years there. Unfortunately, this is in Hicksville which is on long island. It’s towards the eastern, the midsection of Long island. And unfortunately that experience was not nearly as pleasant as the experience that we had in the orphanage. the family was obviously a mother and a father and two kids who were our age. And you’ve heard stories of foster kids being mistreated by foster families. Well, this was it. it was a violent home. there was a lot of physical abuse, there was some sexual abuse. There was a lot of tormenting because we were foster kids and not real kids, we wouldn’t grow up to be anything. And all those stories you hear, I remember they had money for us to go to the movie theater and to get ice cream sodas. And we never saw it. It was kept by the parents. I remember having haircuts with a bowl put around my head rather than sending me to a barbershop to get my hair cut. The bottom line was it wasn’t a healthy environment. And after five years of that, at the age of eight, there was an episode that ended up being quite violent. And my sister and I were removed. My sister went to a foster home in Brooklyn. It was an older couple and they didn’t want to take siblings. So I was placed in another foster home, also in Brooklyn, in the brownsville section of Brooklyn. And I spent know the rest of my life with that wonderful family. It was the exact opposite of the family in Hicksville. The family was wonderful. They had two kids. We moved to Brooklyn. I spent high school years at Samuel J. Tilden high school for reasons that if you know, the Bedford stiff section of Brooklyn is not exactly the most safe section in the world. And so we moved from that back to long island into Levittown. And that’s where I spent the rest of my years. My claim to fame in Hicksville was that I went to the same high school as Billy Joel. Didn’t meet him, but I remembered that you heard about him. I had no claim. Did any of that piano stuff kind of come through osmosis by any chance? I don’t think so. he never finished high school. He got his GED later on in life. I didn’t know him. He didn’t know me. But that’s my only claim to fame in Hicksville. and then at Tilden high school, didn’t know anybody. and then I graduated high school. My claim to fame there was. I was the youngest one to graduate in my senior year. I was turned 17. the only award I got was the best attendance through high school. And that was about it. I didn’t particularly care for high school. I didn’t like the idea of people telling me where to go, what to do, what not to do, be it this class at this hour, that class at this hour. And that’s just my personality. I did well. I was told that I was bright, but I can’t say that I performed well in high school. So when high school was over, you got to make a decision on what do you want to do with your life. A lot of my friends went to college because of my performance and lack of confidence. I decided maybe college is not for me. So I decided to enroll in a junior college, a Nassau community college a two year degree. But because I had no money I paid for it myself. And in those days it was $5 a credit. So every course took $15. And I stretched it out to three years by working full time during the day and then going to school at night and doing that. It took me three years to finish that degree. And the jobs that I held were delivering parts for a dodge. And I did that. I sold men’s and women’s shoes. And my interesting thing about selling men’s shoes, it was at a really exclusive men’s clothing store on Long island. And it was right next to or near where they had a place called the Westbury Music Festival, where they had different rock groups come in. And my first concert actually was Sonny and Cher way back when. But what’s interesting there is one night I was selling shoes, and in walks the five members of the temptations, because they were giving a concert, and somehow their shoes got lost in the shuffle. So I sold each one of the temptations a pair of black leather patent leather shoes to go with their tuxedos. I also sold shoes to telly Savallis, who is known for Kojak. And I also sold shoes to Engelbert Humpadinkle which I was not a big fan of. And then other jobs I had was selling women’s shoes. And the other thing I did is I sold clothing to men who were extra large, so to speak. And in that role, I ended up fitting a large number of the New York Jets who practiced their football on long island. And I saw Joe Namath quite a few times and the offensive line of the New York jets. And then I finished my associate’s degree, did very, very well. And I was fortunate enough to land a full time scholarship to Adelphi University, which is on long island. It’s a private college, a liberal laws college on Long island. Because my goal was I wanted to teach history in high school. And I spent two years there, did rather well, graduated, and there were no jobs for history in high school. And then I also had to face the draft because it was back in that day when you were dealing with Vietnam and you were dealing with the draft. And Bob, you know this well the first year of the draft, it was announced on national tv, on radio, and you were selected based upon your birth date in a random fashion. And I remember that night, listening to the birthdays, going and going and going. And the general feeling was if your number was greater than 150, the chance of you being drafted was low. So the goal, I’m sure every kid in the United States my age was listening to this, hoping that they were higher than 150. Well, as luck would have it, I was number 86. And it didn’t take them two weeks to get me down to get my draft physical. Fortunate or unfortunate, depending on how you look at it. I failed, and I became 4f. And so I had no job. I graduated college. I couldn’t get a job teaching. And then what do I do? So I continued to working full time so I can earn money and pay for my life. And then I was literally in a bar one night, the salty dog on Long island. And I was just sitting there and I shook up a conversation with this gentleman and he said, what do you do? And I kind of explained, well, I don’t know, because I don’t have a job. I couldn’t get a job teaching. And he happened to be the director of a speech pathology, audiology program on Long island at Nassau county hospital. And he explained what it was, and he said, why don’t you just come on down and see what we do? And maybe it might interest you. And I did. I went literally the next day and I observed for the full day. And it really was exciting. And so I did a little research and found out the same university that I graduated with my bachelor’s degree, had a master’s degree in audiology and speech pathology. I applied lucky enough to get a scholarship, but interestingly, it was in speech pathology, and it was with an emphasis in aphasiology. And so I got into the program as a speech pathologist. And like a lot of guys and women who went into audiology, who started in speech pathology, speech pathology didn’t exactly do it. And so it didn’t take me but a half a semester to figure out speech pathology and particularly aphasiology, where the goal was not to improve, but to maintain was not where I wanted to go. And I was really fortunate in that one of the faculty members was Roy Sullivan, who was the senior faculty member in audiology. And we took a liking to each other. He took me under his wing. I did an internship at his hospital, Long Island College hospital, did well. And then I was talking to I really, really like audiology. I enjoy education. I really don’t want to work. What would you suggest? And he, you know, you should think about going on for a PhD. And it never really entered my mind until that point. And I did a little research, and I asked him, well, where should I go? What would be the best programs? And he said, mike, the best programs currently are the big ten in the midwest. Now, Bob, when you grow up in New York, you think the world begin and ends with New York City. I’ve understood that from people that have been there. I might just interject here, Mike. Dr. Sullivan was, for those of you out there listening to us Dr. Sullivan is the person that set up the American Academy of Audiology for their URL, which is audiology.org. So that’s another one of the many legacies of Dr. Leroy Sullivan. and it appears to me that you are one of those legacies as well, Mike. So here we go. I did some research, and he said, the big ten. Well, first of all, I didn’t even know what the big ten was, so I had to do research on that. And back in those days, you didn’t have a computer, and the only way you found out is you went to the library, you did some research. And so what I did is I applied to all of the big ten universities, and I don’t even remember why. I think it was because John O’Neill was at the University of Illinois and Willard Zemlin, and those were two gentlemen that I read their text while I was doing a master’s degree. And I was accepted, and I went there, and my family went out with me. And again, as a New Yorker, you don’t know where Illinois is. And I remember distinctly thinking it was on the west coast. And during a break I’ll go to the then. So we’re driving out there, you’ll appreciate this. And we’re looking for seagulls, and there are no seagulls in Illinois. And then it kind of dawns, know we’re not on the west coast here. And so I went to University of Illinois. I did not have a scholarship in the first semester. So what I did was I sold my car, I worked from midnight to eight o’clock in the morning, dispensing gas at a gas station, and then went to the beach during the day and accumulated enough money to pay for that first semester at the University of Illinois. And then I was fortunate enough to have John O’Neill take me under his wing and I got a scholarship for the rest of my time, two and a half more years at the University of Illinois. I truly loved the University of Illinois. I had a great time there, learned quite a bit. I defended my dissertation, completed the dissertation on time, had a wonderful committee, did a dissertation on masking levels differences. And then, as you know, when you graduate from your doctoral degree, you have to look for a job. So I went back and I looked and I did research. And again, I’m from New York and one of the jobs I was offered was at Columbia University. But interestingly enough, I also had a job at central Missouri State University, which is just east of Kansas city. And the salary at that place was higher than the salary at Columbia. So I turned down the offer from Columbia and accepted the job at central Missouri State, which again is a state university just east of Kansas city. And I just want to backtrack one little moment. In my years at Illinois aside from all my experiences academically, I met my wife Maureen there. And we ended up, as, you know, getting married later on. And Maureen grew up in the St. Louis area in Alton, Illinois. So I knew sometime along the line I would have to get a job that’s close to St. Louis and Kansas City fit the bill. So I got the job at central Missouri State. it was a master’s degree program in audiology and speech pathology. Taught six different courses over the six years I was there. Supervised the clinic two days a week and did committee work and all those lovely things. Had a great faculty, great students, modern new clinic at that time. And then in my 6th year, I was up for promotion to an associate level. And you’ve been in academia. You know, this story I’m about to tell you may very well be approved for it or in consideration for it, but there are other people who are there before you and there’s a certain allotment on who gets and who doesn’t get. And unfortunately, the year that I went up, I was not in that allotment, although the, you know, Mike, you really deserve it, but this is the reality. We only have so many available slots and you were not in the queue. Well, that kind of got me a little upset because I thought it should be based upon what you’ve earned over those years and not based upon some queue. And so I got a little ticked off and I looked at other positions and I accepted a position at the veterans Administration hospital in Omaha, Nebraska. Loved the VA, but absolutely despised Omaha, Nebraska. I don’t mind cold, but when it’s negative 80 degrees, the wind chill, that’s a little bit past my upper limit of comfort. And then doing that for two other three years we were there. It didn’t take long for Maureen and I to say, you know, and Maureen had a great job. She was working at Boystown in the vestibular lab with Dave Sear. And so she had a wonderful job there in Omaha and I was at the VA. we enjoyed the camaraderie that we had with Boystown and the VA, but living in negative 80 degrees just was not going to last very long. And it was further away from St. Louis. So I looked for a job that was in a warmer climate and ended up in Atlanta, Georgia, through the VA. Loved Atlanta, loved the VA. But again, I’m getting further away from St. Louis. And I was there one year and a job opened up at the University of Missouri in Columbia. Took that job knowing that it was going to be temporary, because while I was there, I was fortunate enough to be approached by Margot Skinner, who, as you know, is internationally known for her work on hearing aids and later on in cochlear implants. And there was an opening at children’s Hospital to direct the children’s hospital audiology program. And I was invited by Margot to interview. I got there, I interviewed, and Margot was a very wise young lady. And she said, mike, pediatric audiology is not for you. I mean, it’s just not going to work out. And I knew it, but I was hoping to get closer to St. Louis. And she said, however, there is going to be a job opening in a year for my position. She was director of audiology in the adult section because we’re going to be opening up a brand new program in cochlear implants. And when that becomes available, I will contact you. So I was at the University of Missouri, and true to her word, Margot contacted me if I would be interested in coming in to interview for the position of director of audiology at Washington University. And I accepted the invitation. I went for the interview. It was only two people, Margot and John Fredrickson, who was the chair of the department. And John relied almost exclusively on the recommendation of Margot. But I do remember sitting in his office and him saying to me, mike, I think you’re well qualified for this position, but in order for you to maintain your position, you’re going to have to demonstrate two things. One is you’re going to have to develop much greater research than what you currently have. And up to that point, I only had one article in a peer reviewed journal, and that was way back when. And you’re going to have to demonstrate that you’ll manage the program so that it’s profitable. Can you do that? And I said, oh, sure. And mind you, at that point, I had absolutely no training in administration, no training in anything related to business. I didn’t even know what black and red meant. I didn’t know what profit. I knew nothing about business at all, but I knew that I wanted to be in St. Louis, and I knew that I could be successful at this job. So I went back to Columbia, told Maureen about this. It took me three months to accept the position, and Margot was incredibly patient about that. And the reason I had questions about it, because I was in Columbia in a academic environment that required me to do nothing but show up each day and teach a class and to do the clinic. And I could have done that for the rest of my life and been happy as a frog on a lily pad, as opposed to Washington University, with now this thing hanging over my head of publishing, which, again, I only had one article at that point, and running a successful department financially and administering nine people, and I had none of those experiences, but yet I accepted the position. Long story short, was there for 34 years, learned the business part along the way. And in all the years that I was there, our department was in the black every single year except for 2008, when everything crashed, and then 2020, when, of course, we had the pandemic. So the message I would like to give somebody who might be watching this is here I was in a situation where the prospect was daunting in terms of, could you actually physically do this? And what would happen to you if you failed? Do you just take the easy step and stay where you are, that you knew you were going to be successful for the rest of your life, or do you take the challenge and do it? And I decided to take the fork towards the challenge and do it. And it was the best decision I ever made. Not to say that along the way, I didn’t stumble, because Lord knows I stumbled. But I was fortunate enough to have people who supported me when I stumbled. And I was smart enough not to make the same mistake twice. It’s one of those things that if you’re always challenged to some degree it tends to really change the way you look at the profession and the way you look at yourself, as well as colleagues and all kinds of things doing the same thing all the time. people find as audiology is a great profession, but at that time, and we were practicing about the same time to do exactly the same thing every day and talk about the same courses that you all do every day, that gets just a little bit boring over a period of time. But the challenges are what always interested a lot of us to kind of rise to another occasion or do something we don’t know anything about and try to find something about it. I totally think that this was not only for you, but for our profession. It was a great move on your part. Yeah. And there were so many wonderful things that came making that move. And was 34 years of working with incredibly talented audiologists that I hired along the way, building new clinics. I actually built two brand new clinics. The plans for the clinic, the booze, new equipment, new staff, new procedures, working with an incredibly talented group of physicians and a large variety of professional areas, meeting people around the world, doing research, meeting people at AAA, working on the meetings, working on task force. It really just expanded the challenges, and each challenge was better than the one. well, and you also were involved with the Central Institute for the Deaf as well during that time. Yeah. And now CID literally was across the street. And when I got there, it was a master’s degree program in audiology. And my role there was to teach the amplification courses to the master’s degree students, and then also to supervise the students that want the clinical practice from CID. And then, as you know, the field went to the AuD. And at that point, CID was headed by Brad Stach. And Brad was wonderful in that the initial reaction on the part of the people at CID was not to pursue the AuD shut down and program completely. And Brad saw the history of CID. The AuD and he literally built the entire program from scratch. And I was invited to be part of the committee to develop it, but Brad really was the person who did it. And I continued my teaching of the amplification course in the AOD program almost to the time that I retired. And we continued to take interns and externs from the AOD program. We supervised Capstone projects. we did everything where I taught a course one semester on the business aspects of audiology. We arranged for the students to observe surgery. There was just an enormous amount of interaction between the medical school, where I was, and CID, which was across the street. Well, and you had a huge hearing aid research laboratory there at Washington University, from what I understand and from some of the papers I’ve seen and so on. Yeah we were fortunate. My initial contact on that was really through Starkey Jerry Rusitsko, who was the head of research at Starkey. And he literally helped me build a research laboratory and also hire a full time audiologist to be an associate in the research lab. And as time went on, the projects got bigger and bigger and bigger and more. Number of projects. We were the first in the country to install in our space, as you know, which is an eight loudspeaker array, through the help of Larry Revitt. And I did research with a large number of hearing aid manufacturers battery manufacturers, ear mold labs. I mean, everything and anything. And what was important about that to me was, number one, how do you go about doing that and then being successful at it and then doing irbs and all those things that are associated with research projects. But the thing that was critically important to me when I created these protocols and I created these budgets in combination with the sponsor, one thing became absolutely clear on both sides of the discussion was if we were to engage in research with your product, and we find that the results are not favorable to your product or shows no significant difference from the control that will be published. And if we can come to that agreement, we cannot engage in a clinical study. So for the 34 years that I was at Wash U, creating a little under a million dollars worth of income to do these studies, I always maintained the independence from the sponsoring manufacturer that we set the protocol, we negotiated the protocol, we agreed upon the protocol, but we always agreed that we were going to do a project that was going to be publishable. And when it was published, it will stand on its own regardless of the outcome, in favor or not in favor of your particular product. And just to emphasize that .1 of the projects we did was the first version, one of the first versions of digital signal processing, where everybody thought this was it. This was going to solve all the problems related to sound quality and speech intelligibility and quiet and noise and all these other issues. And we found out that the performance of the linear version of the hearing aid and the digital version of the hearing, there were no significant differences. there was an improvement in sound quality, but there was no improvement in performance. And we published it. And Widex at that point made no attempt to stop us from publishing it, because we had this agreement. The results are the results are the results. That’s why Macintosh still survives very well, making analog amplifiers that sell for 30 grand or so. and the other thing is, this was at a time when ethical practice things or research, were only kind of figments of the minds like yourself and research colleagues. it wasn’t cast in stone, as it is currently, both in the ASHA code as well as in the AAA code. And also we call it some bearing on ADA code. So this was an innovative kind of a thing for manufacturers. They all expected that their stuff was going to be better than everybody else’s. And of course, none of us wanted to hear that as clinicians, we wanted to know what was going to work and what wasn’t going to work. In working with manufacturers. And I understand this, some of them want to kind of manipulate the protocol so that the results will favor their product. And it gets to be a tussle to negotiate this, saying, no, we can’t do that, this is what we have to do. And there was more than one project I had to say, no, thank you, because the suggestion for the protocol clearly was designed to enhance whatever product we were investigating at the time. The other thing that was nice about all of this research, it involved the staff in the research, and that led to, not every audiologist is interested in research. And when I hired audiologists, I would say, if you’re interested in research, we do it. If you’re not interested, that’s okay, because you’ll have the ability to teach and you’ll have the ability to practice best practice. But I had at least six audiologists who worked with me, and you know this, you’re working with them, and you’re saying, you know, you’re a wonderful audiologist, but you need to consider going beyond this. You need to consider pursuing a PhD so that you can add to the base of knowledge in the field, because being a clinician is wonderful, but you should be beyond that. And I had six audiologists who were wonderful audiologists who, I’m proud to say, went on and successfully pursued their PhD, and that I could not have done if I stayed at Central Missouri State University or at University of Missouri. And that was one of the other nice things that was, know, being at Washington University. And as you know, because you’ve done this, when you’re doing research that you’re doing, you get invited to speak at a lot of different national and international meetings. And I had the pleasure of going to almost every state in the United States and a lot of countries abroad and presenting some of the ideas. I also was invited by AAA to create, to be the chair, if you will, of two task force to create two national best practice guidelines dealing with, one, dispensing hearing aids to the adult population. And the second one was dispensing bone anchor devices to patients with unilateral hearing loss. And I also did a task force with Asha on dispensing hearing aids to the adult population. But the one that I did with AAA was wonderful in the sense, when you do a task force, you have to select people to be on the task force. That’s one of your charges. I recruited a lot of who I thought were wonderful people. Tod Ricketts, Darcy Benson, Dave Citron. And you go on and on. But the best one for me was Harvey Abrams from Florida, because he’s the one who taught me evidence based practice. And he said, you know, mike, you did this other one for ASHA. It’s okay. But if you want me on your task force, rather than making recommendations like you did for ASHA, every recommendation we make has to be based upon the evidence, not just because you think it’s the right thing to do. And then if you go through that process, you’ll find the things that we don’t have evidence for. And that will be part of the task force, is to highlight. We have these recommendations. It’s anecdotal. We think it’s going to the right thing to do, but we have no evidence to really support that recommendation. And it was just an absolutely wonderful experience. And I believe it was the first best practice guideline that made recommendations, not because it seemed to be the right thing to do clinically, like, really, or measures, but there was evidence to support what it is you were recommending, and then opened up areas that we think this is the right thing to do. But there’s really no evidence to support that, though. Here’s a guy who started off with one peer reviewed article. now, by now, you had 44 peer reviewed articles out of 102 total or so. we’re not sure how many have come since that time, but there’s a number of those. and the other thing, when you talk about national and international presentations, it isn’t just one or two or one here and one there. It’s 345 national and international presentations combined. you speak very humbly about those things, Mike, but honestly, as one of our Giants, 345 national international presentations are quite a few, as well as the publication. And in addition to that you have like 29 book chapters. Hopefully there may be another one in your future here soon. Anyway. but also a number of textbooks as well that you were involved with. And I don’t know, I think I count about ten or so or more. And if you’re like me, you remember every single one of those and all the headaches that went with it. but fabulous publication record and educated a whole lot of us in a lot of areas where we needed that extra little push of best practice and some of those kinds of things. were there some of those books that were harder than others to put together? They’re all hard, as you know, you’ve done this before. They’re all hard, as you know, you’re approached by a publisher are you interested in doing a book? And who says no? I mean, that’s like a wonderful thing to do. And then you’ve got to figure out, okay, now, what’s the timeline for this? What’s the timeline? And then you have to kind of break it down into chapters, and then you do it linearly, like on the book, on audiology, patient history, audiometric exam masking, speech pathology, speech audiometry, immittance, and so on and so on and so on. So you think about the organization in a linear fashion, and then you select, okay, who are you going to invite to see if they’re interested in doing this? And that, as you know, is a challenge in itself. And then once you have somebody who agrees to do it, or more than one author to do it, you have to be sure that they understand the guidelines, the author guidelines. And you know this. How many authors say, yeah, we’re going to write this for you? They don’t pay attention to the guidelines. It’s like they never receive the guideline. It’s kind of like, okay, it’s due in March 15. March 15, comes and goes. You have nothing. You contact the person, oh, yeah, this came up. That came up, it’ll be June. And you’ve done this. I’ve done this. you can cite an example where you got a chapter where you had to basically write it because it would take too much time to get somebody else to do it, or you had, thank God that didn’t happen very often. It was so poorly written that you just simply had to say, this is just not going to work. And then you just cut it out. And that’s how you make enemies who never talk to you again. and then the thing about it is you do all this work and you know this, and I keep saying, you know this because you’ve done this before. Your financial reward is like next to nothing. But you get so much satisfaction in producing this from scratch, working with these marvelous people in the United States and around the world, and then publishing it, and then it now becomes a body of evidence for your field. And then you leave that behind when you’re pushing daisies. it’s a wonderful experience. And I was fortunate enough to do, I think it was 14 or 16 of these things. And each one is, as you do more and more and more, you get better at it. but it’s a lot of work. And if you’re doing it for money, this is not the field in which to do it, but it’s just a wonderful experience. One of the few things that sometimes happens with publications is that you may end up with a couple of extra gigs because of it. And sometimes you can almost make those don’t pay big bucks either. But a lot of times you make more on that than you do off the textbook as well. anyway, but the other thing too is you’ve been quite a journal editor also, Mike. trends and amplification from 96 to 2000, the Journal of the American Academy of Audiology still an editor for that publication International Journal of Audiology, seminars in hearing and actually a contributor to the canadian hearing Report. A lot of us know Marshall relatively well, who’s the editor of that and recruits heavily from a lot of other things that all of us do here in the United States. But again, there’s a lot of those experiences. are there some of those that stand out more than others or less than others? Those kinds of things. Now, the transient amplification was interesting because this was from team a medical published, and they asked me to create a brand new journal, and it became transient amplification. And then I did that for, I don’t know, five or eight years. And then I passed along to Todd rickets, and he became editor for a while. And that was a wonderful experience because each edition was a specific topic, and then recruiting people for that topic. And again, anytime you do that kind of editing thing, you get to meet people from around the world that you never would ordinarily have met. And you get to know different writing styles and different personalities. It just adds more to your life than you could possibly imagine than just saying, yes, I’ll start a new journal and begin that process. But the other thing that was interesting to me when I was the associate editor in amplification for the JAAA, Jim Jerger was the editor, and he was a wonderful person to work with. And I remember when I was reviewing articles, not always, but many, many times, my length of my review was bigger than the actual volume of the article because I really believed in getting into the depth. Did they answer the question? Was statistical analysis correct? Was the formatting correct? And I spent a lot of time on that. And I remember one time Jim Jurges said to me, mike, when you edit, your goal is not to protect the author. Your goal is to protect the reader. And that was a valuable lesson for me in that what ends up in publication is, for lack of a better word, the truth. And as you know now back in those days, you had to have at least three reviewers for each submitted article. And later on in my career it ended up being sometimes two reviewers. And as you know, you’ve been a reviewer sometimes the reviews are wonderful, a lot of suggestions, and others. A simple sentence looks fine to me, and you sit back and you say, how did that happen? So the goal is to get reviewers who take it seriously, with the goal being that whatever ends up in print is the best possible version of that particular manuscript. Yeah. The hard part I will never forget. Of course, you never forget the first time you submit an article and it comes back with more red ink on it than it has black ink. and talk about a learning experience for a young person trying to get something published. that was a rude awakening, but a very good one. Oh, yeah, I remember that very well. Getting back my first submitted article with three reviews, just like, oh, my God, it was horrible. I thought this was like a masterpiece. I thought this was a Picasso. And then it comes back with all of these things. And then I was taught early on, when you get that review and you’re shocked by it, put it down, don’t look at it for a week, go back to it, reread the comments, and it’s not going to be nearly as stabbing as the original reaction to it. And I learned that. But all along my career in submitting these articles and getting reviews, even I can remember my last article that I submitted a few years ago, also had a lot of negative comments. I have never, in all of my years in submitting manuscripts for publication, ever got anything that said, except as is I never came even close to that as the best I ever had was. Except. But with minor revisions. But most of them were except with major revisions or out and out reject. Well, there’s too many egos involved, I think, with some of that. But there are some serious editors, and those are the ones that probably gave you the review except with minor revisions. but there’s a whole lot of egos involved, and there are a whole lot of different things going on, different ways of looking at topics and all these things. And the nice thing about that is all of that, as you know from all your experience as an editor, you take all of those things and put them together, and as you say, that comes out a lot better for the profession, a lot better of science and so on. And then the other thing I learned is, if you’re going to be a researcher, develop a thick skin. Same with forensic audiology. about the time you sit for a cross examination and you’re fried you walk out all burned up, and then you come back and your skin is a little thicker, and they don’t fry you quite as bad. And that’s the same, I’m sure, with the journal situation. But you’ve had editors, awards audiologists of the year awards a lot of number of things. Like know, you mentioned your research with the battery manufacturers. It sounds like you almost were one of their original energizer bunnies for a period of time, too. But I think where we want to move our discussion, Mike, is to a couple of things. You’ve been the 2014 distinguished achievement award at the American Academy of Audiology. That had to be quite an honor for a guy who had that kind of an inspirational start as well as the presidential award from the American Academy of And I’m sure you have some things to say about those. yeah. What’s interesting about the presidential award, I knew absolutely nothing about that. And Maureen and Robert Sweeto were involved. Robert Sweetow approached Maureen about doing this, and Maureen kept it quiet. And I was at the general assembly, didn’t have any idea what was going on. And then it was announced that I got up there. I mean, I was flabbergasted. it took me a second or two to recover and then walk up and accept the award. And then on the award that I got later on in my life from the AA that was spearheaded by Francis Kuk, that one I knew about in advance. And I had to present like a little speech, an acceptance speech for the award. And that was really hard at that point. I’ve done hundreds of presentations to small audiences and very large audiences, and that one was really hard because it was about me and I’m very uncomfortable talking about me. So I tried to keep it less than two minutes, but that was a wonderful, wonderful evening at a dinner. And the thing is this big, it weighs a ton and they mail it to you later on. I don’t know if you can see it, but it’s right behind my back here. I have one of those from being the chair. Those things are, you don’t want hit anybody with it. Could you? Well, I think from your perspective, Mike where would you see the future of audiology with all your vast experience, publications, honors and research experience and all these different things, where would you see the future of our profession here at the end of 2023? Thank you for asking that question, because I’ve given that a considerable amount of thought. As you do know, from the time you started in audiology until now, there have been numerous occasions of disruptive technology that at the time everybody thought this was end of audiology as we knew it. And did I get into the right field? And every one of those things ended up being no big deal. And then recently you’ve had OTC, and the initial reaction to that was, this is the end of audiology as we know it. And I did some research, and almost instantaneously I figured out this was going to have no significant negative impact on audiology. In fact, it’s going to be a positive thing. And I’ve done presentations about that. And then there was the pandemic where everything just shut down and people lost their jobs and so on and so forth. And healthcare was one of the professions that flourished and actually did just fine. So for somebody who’s watching this and considering getting into audiology as a profession, I think the golden years are ahead. As you know, there’s a shortage of audiologists. As you know, there’s a high attrition of audiologists, so there always will be employment of audiologists. And as me as an example, getting into the door is just the beginning, and you do with it what you want, you do with it what you can. You accept the challenges along the way, or you take the easy way, if you will, and you’ll have a very fine career. it’s a wonderful career. Salaries are improving. The doctoral degree has improved the standing of audiologists. So I think the future of the career is bright. I have no qualms about that. I see the day in the not too distant future where audiologists will be more autonomous with third party reimbursers than they are right now. you won’t need a referral from a physician to get an audiometric exam. You can go directly to an audiologist to get the exam. I’m hoping that, in time, audiologists will be better managers of third party reimbursement to make it more lucrative, more profitable, more easy to navigate than what they seem to be doing right now in many, many areas. I think artificial intelligence has to have some kind of impact on diagnostics and some kind of impact on amplification. And it already is being instituted in a large number of amplification schemes going forward in terms of noise reduction and decision making. I can see the day when there may very well be a pharmaceutical answer to curing deafness. And I know that there are several drug manufacturers working on that right now, where it is conceivable I’ll be pushing daisies by the time this happens, where you could find a cure for deafness and hair cell regrowth. I could see an issue with that. And then there are other things that audiologists can get into that’s just beyond diagnostics and amplification and cochlear implants. Because think about it. When you and I first got in the field, we did diagnostics and we did hearing aids. And in the time that we’ve been in this field, we’ve added cochlear implants, we’ve added electrophysiology, we’ve added vestibular evaluation. We’ve added bone anchored devices. And new avenues of treatment will open up to audiologists going forward that you and I will not be aware of, because we were not aware of that when we entered the field many, many years ago. So audiology is always going to be a profession that’s going to evolve. And then the question is, as an individual, how are you acceptance to change? How do you modify yourself to that change? And let me give you an example. When OTC came around two years ago, I decided I needed to incorporate it into my practice and not make believe it didn’t happen. And there are a lot of different steps that went in that direction, and I just didn’t say, well, we’re not going to do that. And how do you incorporate cochlear implants into your practice? How do you incorporate vestibular into your practice? So it’s all these new things that are coming at you is how adaptable are you to accept that change? And how willing are you to work to make that change successful? Or are you just going to say, no, I’m not going to get into this. It’s just too much work. And it gets down to the individual personality, much like my personality when I was offered the job at Washington University. Do I take the cushy path or do I take the challenging path? You have 100 audiologists, 90 might have, might have taken the cushy patch, and ten might have taken the challenging part. It’s taking the challenging part that separates you from the group. Yes. and one of the things that is one of those biggest factors, Mike, is the idea that you need to have that thick skin we talked about just a little while ago where in case something doesn’t work, well, then you go back and you regroup and you try it again, or you go back and regroup and do it just a different before we, before we kind of terminate our discussion here, Mike, it’s just been fabulous. I always ask the giants, what’s your coolest moment to date, relative to your profession and those kinds of things? I think we all have some of those things that you’ll just never forget. That was the coolest moment. But I always say to date, because most of us, I think I’ve retired from three different audiology jobs in my career, and I know that many of my colleagues have done the same thing or something similar. So there’s going to be things that will come later than now, of course, but what’s the coolest thing that has been part of your career today? Well, I actually come to think of three things. three. One was the biggest was meeting my future wife at the University of Illinois. That was the most coolest thing of my entire life, was that. And then that, of course, led to a wonderful marriage two daughters and three grandchildren. And there’s nothing cooler than mean. That is like the height of coolness. The second one, not nearly as important, was winning or not winning, but getting the award from aa of my lifetime of work I didn’t expect that. I got it. It was just a wonderful. Because that’s kind of like the eruption of the volcano, and it doesn’t get any better than that. You can’t go any better than that. And then the third one gets back to how I started at Washington University. It’s kind of like the train going up the hill. You can do it, you can’t do it. You can’t do it. You can’t do it. Going into a position that knowingly I did not have the background, but saying, I think I can do it, and I’m willing to take the chance. And being there for 34 years and in the 34 years building a nationally and internationally recognized program and then fulfilling the number one thing that John Frederickson said to me when I was hired, be profitable. And in the 34 years that I was there, again, coming from somebody who had no idea, I didn’t know anything about business, doing that and learning things along the way and being profitable for 32 out of the 34 years, that’s the other cool thing that I did along with. I mean, if you’re profitable and you got a horrible program and you’re miserable, that’s not a big deal. But to be profitable, be happy in your job, have a wonderful staff. As you and I both know, you can be a giant in audiology and I can be a giant in audiology. But we’re not giants if we don’t have a root system of people helping us along the way. I was really fortunate to have a lot of people along the way that if I didn’t have their support in a lot of multitude of ways, you and I wouldn’t be talking today. Well I hope that our group out there has learned from our discussion today, Mike that no matter where a person starts in their career it’s a lot of hard work to get to a certain place. And then you continue to do hard work because it’s just like that football player that starts off in the peewee group, well, then he graduates to the next level, and he got to show himself all over again. Then you go to the next level maybe high school, then you go to the college. And every time you have to prove yourself, and if you continue to prove yourself, then you go on into the NFL, which is where most of our giants find themselves. I think these So today my guest has been Dr. Michael Valente, professor emeritus, department of Oligology, Washington University School of Medicine from St. Louis, Missouri, a true inspirational giant in audiology. Thank you for tuning in this week to this week in hearing. And thanks, Mike, for all your comments and sharing this unique experience in becoming a true giant in audiology. Bob, thank you so much. Invitation. This has been a wonderful hour or so in just shooting the breeze and talking about. The breeze has us quite a professional. And thanks again for being with us. Thank you again.