You Have My Full Attention...Really

The case easily fits in the palm of your hand

I received a pair of AirPods Pro 2 for Father's Day. They emit good-to-great sound, have noise cancellation features, and function well as an accessory for hands-free telephone calls. But their greatest utility to me is as backup hearing aids. The AirPods amplify all sounds and serve adequately for those who, like me. have moderate hearing loss. Were it not for social offensiveness, I would feel comfortable wearing them all the time.

Hi. Excuse me. Hey. Do I have your attention?

I can’t tell because your AirPods are in.

Human communication was awkward enough before AirPods and their non-Apple brethren became so ubiquitous, but at least some pockets of life seemed off-limits. Not anymore...

Joseph Montes, a 55-year-old information-security manager who lives near Boca Raton, Fla., keeps his AirPods in all day. “They’re always off, but if someone calls, I can answer,” he said.

The devices are such a constant that when he visited the doctor recently, Montes didn’t understand why the nurse was giving him “dagger eyes.” He finally got the hint when the doctor came in. Montes sheepishly pulled one AirPod out of his ear. “I’m a man, I’m stupid,” he said.

IMHO, there are easy solutions for users to defuse disapproval. For example, a blinking LED could signal that the AirPods wearer is listening to a signal from his iPhone, and if the light is off he can give you his full attention. Or he could wear his hair long to cover the offending ear buds.

Finally, retirees like myself can accentuate our age. People give us a lot more leeway because elders are not expected to observe niceties; younger folk are just grateful that we appear to understand what they are saying and can carry on a conversation. To my fellow boomers, just practice giving others a blank look and wear those AirPods proudly.

Muddled TV Dialogue: More Solutions

The sound customization menu (right) on our Sony Bravia

As we noted last month, television viewers who are not hearing-impaired are turning on closed-captioning:

But your TV is just one of the culprits. The rest of the problem lies within virtually every other step of the audio process, from a studio’s production choices to the device used to watch the content.

In addition to closed captioning and turning up the volume on all sound, newer TVs can amplify speech. On the Sony purchased this year I adjusted the "Voice zoom" from 0 to 4 (picture top).

Go to Settings > Display & Sound > Sound > Sound mode > Dialogue. On the company’s Bravia TVs, there is also Voice Zoom, which lets you adjust how much you would like the dialogue to stand out. Open Settings > Display & Sound > Sound > Sound customization > Voice Zoom.

The WSJ lists buying headphones, investing in speakers, and/or the aforementioned boosting dialogue feature as solutions to unclear speech. As in many aspects of life, tech caused the problem and is providing the solution.

The Audio Doesn't Equal the Video.

The hearing aids that I got in 2018 have been very helpful.

Every day speech with real people is comfortably decipherable--by the way, have you noticed that old people frequently mumble? that's a subject for another day--but for television I often still must turn on closed captioning. More people with normal hearing are also using the feature.

“If you have people talking or shouting during the adventure scenes, the explode-y sounds are way higher than the dialogue,” said Melanie Brooks, a 43-year-old professional musician in Boston. Catching some of the lines in her favorite fantasy and adventure TV series is hard without captions, she added.

People tend to blame their flat-screen TVs for bad sound. The tube TVs of decades past had front-facing speakers that sent audio toward you, while new, super-thin models have speakers that are behind the screen or point downward, bouncing sound away from you. But your TV is just one of the culprits.

The rest of the problem lies within virtually every other step of the audio process, from a studio’s production choices to the device used to watch the content, said Richard Nevens, senior director of audio-hardware product management at Avid Technology, which specializes in audio- and video-editing tools.

Movie sound technology has outstripped the capabilities of the speakers on home devices, including TV's.

It's a relief that I don't have to upgrade my hearing equipment.

Meanwhile, I'll be setting closed captioning to "on."

Acoustic Epidemiology

(WSJ Illustration)

Like my pediatrician nearly 70 years ago, the 21st century doctor still places a stethoscope in several spots on the chest and back, asks me to breathe deeply then normally, and pronounces everything to be fine.

It's familiarly reassuring, yet a little disturbing, that almost everything has changed in medicine except the ritual of interpreting the sounds of respiration through a stethoscope...until now. [bold added]

Researchers around the world are trying to turn the humble cough into an inexpensive tool to diagnose and stop respiratory-disease killers like tuberculosis and Covid-19. They’re collecting recordings of millions of the explosive sounds from patients and consumers on smartphones and other devices. And they’re training artificial intelligence to find patterns to try to identify the type and severity of disease from the cough itself.

“We call it acoustic epidemiology,” says Peter Small, a tuberculosis expert and chief medical officer of Hyfe Inc., a Delaware-based company with two free smartphone apps—one for consumers, another for researchers—that use AI to detect and track how often someone coughs.

The sound and frequency of coughs are rich with medical information, he says. Different diseases have some audible differences: crackling in parts of the lung for pneumonia, a wheezing sound for asthma. Makers of these apps say there are sounds and patterns that AI can detect, but the human ear can’t hear.

The smartphone revolution has allowed researchers to amass databases of respiratory sounds and correlate them with various medical conditions.

ResApp Health Ltd. is using an explosion in telehealth services, particularly during the pandemic, to expand use of an app-based test for cough sounds that helps doctors diagnose diseases including COPD, pneumonia, asthma and bronchitis, says Tony Keating, the Brisbane, Australia-based company’s chief executive. A telehealth provider asks a patient to hold a smartphone at arm’s length and record five coughs. The app analyzes the coughs, then sends the results to the doctor.

Using technology developed by researchers at the University of Queensland, the company built the diagnostic tool by training an algorithm on recordings of 6,000 coughs, along with clinical data from those patients in the U.S. and Australia, Mr. Keating says.

Acoustic epidemiology is in its early stages. No expert would posit that a smartphone app has risen to the level of a medical-grade diagnostic tool, but its value as an initial screening device seems undisputable.

Your humble blogger believes that cough-analysis would be a logical next step for Apple's expansion into health care, but at first blush implementation seems tricky: coughing regularly into one's watch or phone is socially dubious, and putting on a sensing device like a smart bra or undershirt every morning seems like too much trouble. Maybe a famous-designer T-shirt? I'm sure they'll think of something.

Got the Pods But Waiting for the Card

I went to the nearby Apple Store to buy a set of AirPods, Apple's wireless earbuds. At $159--the wireless-charger version is $199--they're an indulgence, especially since the new hearing aids perform a similar function.

I mentioned to the Apple salesperson that I was keenly interested in using the Apple Card, the new credit card that Tim Cook announced 11 days ago, to buy Apple products.

Unfortunately--and I hope this isn't a trend---we'll have to wait at least 3 months to get it. (We're used to the new stuff being available within a month after an Apple announcement.)

While the Apple Card will allow users to make purchases anywhere MasterCard is accepted, it’s also quite unlike many other cards available today.

Apple Card doesn’t have late fees, annual fees, international fees, or over-limit fees. And although users will be encouraged to pay their monthly statements, technically, if you want to skip a month, you can. Just be ready to pay extra interest.

I like the price--no annual fees--and better security--no credit card number or CVV imprinted on the surface.

I also like it as an Apple shareholder. [bold added]

[Wedbush analyst Dan] Ives went on to say that Apple’s clear opportunity is “tapping into its 1.4 billion active iOS devices and monetizing the financial vertical.”

BTW, I miss working full-time in the financial world; impressing people with phrases like "monetizing the financial vertical" is what made my day.

Sounds Like a Racket

I've been wearing hearing aids for a week. I'd like to say that it's been a revelation, because I can listen to the sounds of nature again, or an orchestra's full range. And I don't have to turn up the TV volume and irritate others in the household.

But it's been a modest let-down. I can hear the seatbelt rubbing against the upholstery and the crackling of cellophane, prevalent this time of year. Water flowing through the pipes and heated air forced through the ducts are much louder. At commercial establishments the decibel level of the Muzak is sometimes painful, and I have to turn off the equipment.

I am remembering a childhood that wasn't so great, when I had to cover my ears at the airport or when a marching band passed by.

The technology is more advanced than I had expected. The inserts are small, light, and pick up the frequencies that I cannot hear. The 36-hour battery life is impressive. The remote control doubles as a bluetooth intermediary between the hearing aids and the iPhone, obviating the need for the AirPods (Apple's wireless earbuds).

The cost of $3,000--most of which is not reimbursable by insurance--is quite steep in the world of consumer electronics, though I understand it's about half the cost that people paid a few years ago for old technology.

Well, hearing aids are preserving neural cells, except that no one told me that they are not in the brain's pleasure centers.

Hearing Footsteps

2013: below the 20db line is bad.

In 2013 an audiologist said that I had mild hearing loss.

Five years later the members of the household have tired of asking me to turn the volume down on the television set.

Also, they are weary of my ignoring requests that I don't remember because I never heard them in the first place 😉

It was time to get my ears checked again.

2018: the deterioration continues

Sure enough, the test showed a worsening, especially at the higher frequencies.

Hearing aids can cost thousands of dollars; most insurance plans cover only a little of the cost.

Saving money might be tempting, but untreated mild-to-moderate deafness has other consequences.

Hearing Loss [is] Linked to Accelerated Brain Tissue Loss [bold added]

Although the brain becomes smaller with age, the shrinkage seems to be fast-tracked in older adults with hearing loss, according to the results of a study by researchers from Johns Hopkins and the National Institute on Aging. The findings add to a growing list of health consequences associated with hearing loss, including increased risk of dementia, falls, hospitalizations, and diminished physical and mental health overall.

I'm placing my order this month.

Don't Correct, Sympathize

(Clipart image)

There's a word for that condition:

Misophonia, a disorder which means sufferers have a hatred of sounds such as eating, chewing, loud breathing or even repeated pen-clicking, was first named as a condition in 2001.

So, people who tell others to stop slurping their soup aren't necessarily etiquette-obsessed, they may have a brain abnormality:

scientists said scans of misophobia [sic: misophobia is the fear of germs] sufferers found changes in brain activity when a 'trigger' sound was heard. Brain imaging revealed that people with the condition have an abnormality in their emotional control mechanism which causes their brains to go into overdrive on hearing trigger sounds. The researchers also found that trigger sounds could evoke a heightened physiological response, with increased heart rate and sweating.

In recent years anti-social, unusual, and even criminal behaviors have been found to have a physiological basis. Institutions are already having a tough time adjusting to the notion that the environment determines life's outcomes. If one's genes determine the rest, what role is there for free will, motivation, and character? (Those questions are way above your humble blogger's pay grade.)

Meanwhile, when your kid covers his ears because certain sounds bother him, don't correct, sympathize.

It Goes Quickly

(Image from Annamated Adventures)

The science of aging confirms what we all know: deterioration is inescapable.

Every function of the human body declines 5% every 10 years,” says Michael Roizen, chairman of the Wellness Institute at the Cleveland Clinic. “That’s brain function, heart function, liver function."

The mind: "Speed of processing and working memory peak in the 20s and gradually start declining...Learning new information after 40 can be harder."

The eyes' afflictions: presbyopia, cataracts, glaucoma, and macular degeneration.

Hearing loss: "There’s no way to restore such hearing loss, since it’s caused by both genetics and environmental factors, such as exposure to loud noises and chemicals, as well as your diet and medications."

Muscle and bone loss: “When you lose core strength, you start having more and more trouble with balance...The combination of muscle and bone loss becomes a real problem when people reach their 60s and 70s."

We are fortunate to have more than a few friends and relatives who are in their 80's and 90's, but every one is a shadow of their mid-70's selves. It goes quickly, doesn't it?

Old age is like everything else. To make a success of it, you've got to start young - Theodore Roosevelt

We've been making regular visits to a relative at Brookdale in San Jose.
Very nice, but even the cheapest level of service is $5,000 per month.

The Chirp of Crickets

There's no advantage to being a "fly on the wall" unless the fly can hear. Researchers have mimicked the hearing mechanism of the Ormia ochracea, a fly that is able to isolate the chirp of its prey, male crickets, with remarkable accuracy:

A tiny structure similar to a playground see-saw connects the fly's two sound sensors, and vibration on one side drives the other in the opposite direction. The net motion of the see-saw permits the fly to determine what is known as the "phase" of the sound wave—in other words, the extent to which the peaks and troughs of the sound waves detected by its sound sensors line up with each other. This allows for fantastically precise determination of its direction of origin.

Sensitive hearing aids that are able to ignore unwanted sounds will be the result of studying Ormia. That will be a boon to us aging, hard-of-hearing snoops who not only want to listen to gossip but help originate it.

Photos and diagrams from Washington University in St. Louis

The Hearing Test

First the eyes, then the teeth, and now the ears. This summer I'm having my head examined.

Not so pristine: above the 20db line
is good, below it is bad.

The otolaryngologist (now there's a mouthful) inspected the ear canals and pronounced them "pristine," a word never before associated with my physical self. I was ready for the hearing test.

The audiologist shouted, "Hello! How are you! I'm Dr. Morgan!" Unlike other people, audiologists show politeness by yelling. As he saw that I understood, he lowered the volume.

The doctor ran a series of tests, including press-the-button-when-you-hear-the-tone and repeat-the-word-that-I'm-whispering (audiologists use more scientific-sounding terms). The findings: I have mild-to-moderate hearing loss, worse at the higher frequencies. The advice: hearing aids should be considered if my hearing worsens. The prognosis: further deterioration is a possibility, but a trend can't be drawn from a single measurement. Come back in a year and do it again.

One more thought: using context and experience the brain is always racing to fill in the video and audio blank spots in the sensory world. These blank spots crop up more frequently as we age, and we are often unaware that we are compensating. I'm not going to take action now because everything seems to be okay......what could go wrong? © 2013 Stephen Yuen

Through the glass silently.