Is the situation in Sound of Metal real

Sound of Metal is a critically acclaimed film released by Amazon Prime starring Riz Ahmed as Ruben and Oliva Cooke as Lou, Ruben’s girlfriend and heavy metal bandmate. (Warning spoilers ahead!) 

Ruben, the drummer for the band, starts losing his hearing quickly and begins to break down, possibly jeopardizing his hard earned sobriety. A doctor suggests cochlear implants which are expensive and not covered by insurance. Via his addiction sponsor, Ruben enters a community of other people that are addicts and have lost their hearing who are trying to transition to a new way of life. Lou is not able to stay but convinces Ruben to. 

The community leader, Joe, a Vietnam veteran who lost his hearing during the war, takes a liking to Ruben and after a while offers him employment within the community. However, Ruben sells all of his belongings including his RV and music equipment to get the cochlear implant surgery and to pursue Lou. When Joe learns of this, he asks Ruben to leave, since the community is founded on the premise that deafness is not a handicap. 

Ruben flies to Paris where Lou and her father Richard sing together at a party. While Ruben can hear via the implants, the sound is distorted and the next morning he takes his things and leaves. He sits in the square listening to the distorted church bells and removes his implants to sit in silence.

Is the situation real? 

From many audiologists online, the situation is fairly accurate. Hearing loss can cause muffled sounds and cochlear implants can sound tinny and robotic. Emotionally, many have the roller coaster of emotions and experiences that Ruben was depicted with while searching for answers and a new way of living. His struggle to understand, to realize that it was happening, and his nervousness is described as completely accurate. Additionally, many reported dizziness, tinnitus, and vertigo (due to inner ear damage).

However, many found that the suddenness of the situation may not be completely accurate. Ruben lost his hearing nearly overnight with no prior warning. While not impossible to lose hearing in both ears, it is more likely that one ear loses hearing at a time. Sometimes steroid treatment can help prevent permanent damage if evaluated early enough.

Finally cochlear implants are covered under most insurance plans unlike hearing aids.

What are Cochlear implants

Instead of simply making sounds louder (as with a conventional hearing aid), a cochlear implant provides a sensation of hearing by bypassing the damaged hair cells in the cochlea and directly stimulating the auditory nerves by using electrical signals.

The microphone of the cochlear implant picks up the sound and the speech processor converts the sound waves into a digital code which is then sent to the transmitter coil. 

The transmitter coil sends the coded signal through the skin to the implanted receiver which is located just under the skin. The receiver converts the digital code to an electrical signal. This signal is then sent from the implanted receiver via a wire to the electrodes in the cochlea.

The electrodes stimulate the cochlear nerve fibers and they send the signal to the brain.

The brain interprets these signals so the wearer can understand what was heard.

The sound perceived through a cochlear implant is not the same as the sound heard with normal hearing. Cochlear implant wearers who have previously heard naturally often describe the sound as being robotic or tinny, as illustrated in the film. However, with time the brain adjusts to the new signals and what is heard becomes more natural.

We can’t know exactly what the world sounds like to someone using a cochlear implant, and it will of course vary between people, but there are some simulations available. The University of Southampton Auditory Implant Service offers simulations of different voices and music, and a link to the University of Granada, Spain where you can download a program to make your own simulations of sound perception through a cochlear implant.

Living with hearing loss

In the film, Joe forces Ruben to make a decision between the community and the cochlear implants. However, many in the Deaf community do not believe it to be a mutually exclusive choice. Many Deaf individuals can live a full and complete life without the implants. On the other hand, for safety reasons many choose to utilize them. There are also now many smartphone apps that help the hearing impaired through amplification. Many felt that the kind of support that Joe provided at the halfway house was also unrealistic because actual resources like this are lacking, especially in the United States. There are few resources that emphasize that Deafness is not a handicap

Societal Issues

The casting of the film was a major issue, with full hearing actors Paul Raci and Riz Ahmed taking the roles of a Deaf actor. Despite this, many in the community were elated that the film brought about real issues that they faced. From the emotional rollercoaster to Joe’s community, many could relate to the film. They were also happy that their hearing friends could finally understand their perspective. 

The situation in the film is unfortunate and while many can protect their hearing with various types of devices, sometimes strange things happen. Through the Sound of Metal, we should all realize that  Deafness isn’t a tragedy or a handicap and while implants may provide a solution, we should remember that silence can be golden .