What? My blood pressure was not audible? Certainly, there are always “firsts” in life, but the young assistant at the doctor’s office had me perplexed. Blood pressure is another little issue that I am working on, and throughout the years it has always been quite detectable. Could I claim success and say that whatever I did ─ cutting salt and exercising consistently ─ had paid off? Although the pressure could not be heard on either side, I had a strong, steady, palpable pulse! This did not sound right at all. I suspected that my attendant belonged to the group of young people with a possible noise-induced hearing loss.
As I sat waiting for the physician to arrive, I began to wonder. In medicine there are so many tell-tale yet subtle noises that can hint at potential problems: heart murmurs; heart valve wooshes; swooshing of a narrowing carotid artery; odd bowel sounds; wheezes, crackles, rhonchi and rales in the lungs… The stethoscope is a most important instrument indeed.
When Jane’s physician left the practice of medicine behind, her new doctor warned her that she would have to take prophylactic antibiotics before going for dental work. Why would that be? The answer: because she had a “noisy” heart valve. Although such things often did not cause any trouble, she would not want to risk bacterial endocarditis. How long had this been going on?
Hearing loss often progresses so slowly that people do not even perceive the gradual decline, and health care workers are no different. I suppose that they might also suffer from hearing-loss denial, just like most everybody else. But where does that leave the patient? Should “hearing” practitioners involved with diagnostics and vital sign monitoring have their hearing evaluated as part of their license renewal?
Although digital blood pressure monitors, amplified stethoscopes and graphic auscultation systems are available to lend a diagnostic hand, they do not do much good if professionals fail to realize that they should be using them. Deaf doctors and health workers do not have that issue. They know that they need special assistance.
In an interesting article that appeared in 2006 in the American Journal of Otolaryngology, authors took a look at the issue of “Physician hearing loss.” In a survey that combined questionnaires and hearing tests, 46% of physicians with hearing loss described their hearing as good.
So, how do we know that our health professionals actually hear what they are supposed to be listening for? We don’t. I guess, in the end it all comes down to trust. Trust that physicians and health practitioners appreciate that good hearing is a most valuable diagnostic tool. In the interest of patient safety and quality of care, getting periodic hearing tests is simply the ethical, Hippocratic thing to do.