A Letter to 'Dr. Payne,' the Audiologist Who Made My Hyperacusis Worse


Dear Audiologist:

I know you think the squeaky door in your office is no big deal. I would have thought so too, until the rock concert that wrecked my ears and caused my hyperacusis. I don’t know how to make you understand the ear pain that comes from a high-pitched squeak.

I thought audiologists knew about ears. I learned, too late, that they know about hearing loss. And hearing loss is the opposite of what I have.

To me, noise is not too soft. It’s too loud. It’s painfully loud. It feels like a knife stabbing my ear. And when the noise stops, the pain doesn’t stop. It lingers. Often it worsens. So does the ringing in my ears.

I felt uneasy when I arrived at your office, already exhausted and in pain from the traffic noise, and you laughed at my industrial earmuffs, the ones that make me look like an airplane mechanic.

You raised your eyebrows when I said your shoes clip-clopping on the tile floor caused knife-like pain in my ears.

Then came testing, which used beeping noises that made me grimace with pain, causing you to say accusingly, “That’s barely a whisper.”

I told you how I desperately wanted to get better, to live again like a normal person, to go to the grocery store, sit at the dinner table and make a phone call without enduring excruciating ear pain because these activities are all too loud for me.

I wanted to believe so badly that you could help me. So I tried to follow your instructions — that I must stop protecting my ears so much because noise could not possibly harm me.

I tried. But in the parking lot, I was hit by the surprise of a honking horn, and I worsened further. When I played pink noise in the background, which you said was helpful and soothing, my tinnitus reacted with more piercing tones, and my ears ached.

When I stopped following your advice, I stopped getting worse. I even marginally improved.

On my most forgiving days, I don’t blame you. I think you did your best. I know you don’t have the expertise to know better. I know you rarely — maybe never — see patients like me, so severely injured by noise.

But on my less forgiving days, which is most of them — when my ears are on fire and roaring like a jet engine, when my head feels like it is about to explode, when I can’t be anywhere but in a quiet room, when I look at my future and know I will have a severe disability forever, made yet more severe due to my visit to your office — I do blame you.

I blame you for failing to use those three little words, “I don’t know.”

Sincerely,
Your former patient

Hyperacusis is most often caused by noise overexposure or a head injury. Sounds are perceived as loud and painful. In an informal poll, half of hyperacusis patients said a medical practitioner has made them worse, either through loud testing or bad medical advice. 

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Illustration by Emma Fifield

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