This control experiment shows that the hearing organ must be intact for sound to produce pain-related behavior. This may seem obvious, but it’s important to understand that the pain you experience does not come only from your eardrum or outer ear.

Partial silence/Hours in thought and talk/My dog listened and understood/Time in hours on the old back porch/I was in my own safe, social world.

Patients who started with low wear time and increased it by six months did just as well at one year as those who wore their processor consistently from the start. Patients whose use declined did measurably worse. A slow start is not a verdict.

What changed things was a program almost nobody talks about: state vocational rehabilitation. Every state has a version of this department, just under a different name. The idea behind all of them is the same: If a disability is standing between you and a job, the state will help remove it. Hearing loss counts. Hearing aids count.