By Alexander Chern, M.D.
Last summer’s blockbuster film “A Star Is Born” brought hearing loss into mainstream media. What has the entertainment industry done since?
Friend: This is my friend Ally.
Ally: Oh, my God! Hi.
Jackson: Hi. Hey.
Ally: I thought that might be you.
Jackson: What’d you say?
Ally: I thought that might be you.
Jackson: That’s me.
Ally: So why are you in here hon?
Ally: What brings you here?
Jackson: Oh I was playing right around here tonight. I’m a musician.
This exchange stood out to me while watching “A Star Is Born,” the blockbuster film from the summer of 2018 about a hard-drinking, seasoned rock star, Jackson (played by Bradley Cooper), who discovers and falls in love with a struggling artist, Ally (Lady Gaga).
This scenario is familiar to most people (with or without hearing loss)—sometimes we miss a few words here and there when having a conversation in a noisy environment, such as a loud concert or a cocktail party. But something felt strange about this scene; this type of situation rarely happens in a movie, let alone twice in one scene, because movies are scripted.
In most movies, any imperfections of daily life are often erased from movie dialogue so that everyone seems perfect—and this includes the ability to hear. As a resident physician in otolaryngology–head and neck surgery (also known as ear, nose, and throat surgery, or ENT) and as a person with hearing loss, I suspected there was something more to this than meets the eye. Several scenes later, my hunch was proven correct when we learn that Jackson suffers from hearing loss and tinnitus.
When Jackson visits a hearing specialist (a cameo by William Slattery III, M.D., an otolaryngologist from the House Ear Clinic in Los Angeles, and Cooper’s actual ear doctor), they discuss Jackson’s hearing loss and the importance of using in-ear monitors to protect his hearing while performing. In the next scene, Jackson adamantly refuses to use hearing protection when performing at loud rock concerts, and he later explains that his struggles with hearing and tinnitus began when he was younger. His hearing worsened throughout his career as a musician, suggesting he likely has noise-induced hearing loss from exposure to loud sounds, a common occupational hazard in the music industry.
Hearing loss is both underrepresented and misrepresented in the media, which frustrates many of us who actually have hearing loss. When hearing loss is represented in the media, it is often in connection with aging—individuals who are hard of hearing have typically been depicted as elderly, isolated, and disabled individuals who are dependent on others. Other media representations of hearing loss focus on Deaf culture; television shows like “Switched at Birth” and “The Society” and movies like “A Quiet Place” and “Wonderstruck” represent individuals with deafness, but are not necessarily relatable for all individuals across a wide spectrum of hearing loss.
In contrast, Cooper’s character in “A Star Is Born” is a famous, still-young music celebrity who does not meet the typical stereotype of someone with a hearing loss. As the movie progresses, we watch Jackson struggle with his hearing loss and its impact on his self-image as he continually refuses to have his hearing treated or protected while exposed to loud music onstage.
Though Jackson’s struggles with his hearing are not the main focus of the movie, this subplot also reminds the public that this condition not only affects the elderly—young people can have hearing loss, too. One in five young adults ages 20 to 29 reportedly has trouble hearing. And fewer than 16 percent of individuals ages 20 to 69 who could benefit from wearing hearing aids have actually used them.
I can relate to Jackson’s struggle to reconcile his image with his hearing loss. Even though I am currently an ENT physician-in-training, pursuing a career that helps treat people with hearing loss, I spent almost 10 years of my life while in college and medical school refusing to wear my hearing aids when I certainly could have benefited from them. As a young person with a hearing loss (I am 29), I made life harder for myself for no good reason other than what I felt was society’s perception of people with hearing loss.
The media is the fastest and most cost-effective way to raise awareness and eliminate stereotypes, promote inclusion of individuals with hearing loss, and reduce the perceived stigma that is still ingrained in our society. Doing so will also help us fight the hidden epidemic of hearing loss, which is both highly prevalent and severely undertreated.
Not so long ago, people persisted in using terms such as “deaf and dumb,” “deaf-mute,” and “hearing impaired” to refer to these individuals. Such terms reflect the unconscious biases people have against such individuals who struggle with hearing, which, in part, prevents them from seeking treatment. I believe those who work in entertainment—writers, producers, and directors—should take the artistic responsibility to portray individuals with hearing loss in an accurate, authentic, and diverse way.
In addition, the frequency of individuals with hearing loss portrayed in the mainstream media needs to more accurately reflect its real-life prevalence. According to the National Institute on Deafness and Other Communication Disorders, about 20 percent or 48 million Americans report some degree of hearing loss. Normalizing hearing loss and fighting stereotypes will also require the entertainment industry to show us more characters with hearing loss wearing modern, digital hearing technology. We also need more character development, storylines, and subplots about hearing loss, not to mention actors, directors, and writers affected by this condition who are best able to tell such stories. Diverse media representation will be crucial in raising awareness and educating the public about hearing loss.
I recently saw “Toy Story 4,” the latest installment of Pixar’s iconic “Toy Story” series that began decades ago, in 1994. I was thrilled to see the creators of the movie took a big step toward inclusivity when they featured a young child wearing a cochlear implant with a bright green processor. (It’s in an early scene when Bonnie goes to kindergarten for the first time and meets her classmates.)
I remember, as I am sure many of us do, what it felt like to be made fun of for wearing hearing aids as a child—it was embarrassing. For many, this perceived stigma is often a barrier to obtaining treatment for their hearing loss. Wearing hearing aids makes us feel different, and not in a positive way. Glasses, a medical device seen as part of everyday life for many people, used to be stereotyped as being worn by nerdy kids without any friends. However, glasses are now considered fashionable and stylish—many individuals wear glasses even if they do not have vision loss.
There is no reason why having hearing loss treated with hearing aids or cochlear implants should be perceived any differently than having vision loss treated with glasses, especially nowadays when wearing name-brand headphones or earbuds or other accessories on the ear is commonplace. Though there is still a long way to go in raising awareness, breaking stereotypes, and making hearing loss hardly anything different in the media, that little boy in “Toy Story 4” rocking his bright green processor marks an important first step.
Alexander Chern is a second-year ENT resident physician at NewYork Presbyterian Hospital, Columbia/Cornell.