I needed hearing aids, and because I needed them, I didn’t want them.

“According to this chart your loss is considered moderate.”

“But it goes away,” I said, convinced this expert wouldn’t believe me. “Sometimes I can hear just fine.”

“Okay, yes, I’m seeing that here too. Wow, you test all over the chart.”

I liked Melinda — the first audiologist I’d met in my 35 years on earth — but I’d been tricked into meeting her. Specialists and pharmacists and support staff were blurring together. because for months I’d been visiting doctors of all kinds — neurologists, otologists — to try to piece together what was going wrong with my head, why my hearing cut out and returned, and why my ears would suddenly fill with startling noises, hisses and thrums that made it impossible for me to teach my classes, impossible to navigate the world. Sometimes the room tilted away and I felt like I was falling. Sometimes my hearing and balance came back, remaining stable for days. But they were tense and uncertain days, because I knew they would not last.

“I think I do have something that can help you,” a new phy­sician in Denver had told me, after ten minutes of pleading and bitching on my part. With a glint in his eye, he packaged me off to Melinda’s examination room without explaining who she was. To my alarm, Melinda wasn’t a diagnostician after all. An audi­ologist was someone who prescribed machines you had to buy. They didn’t cure you, just made things louder.

“You can choose from in-the-ear and behind-the-ear models. Behind-the-ears are going to offer more options.”

“What would that cost me?”

She paused.

“There’s a variety of price ranges. So there are op­tions. For someone with fluctuating loss like yours — the more expensive models, again — I’m thinking about a six- thousand- dollar pair from Widex that might be able to offer more flexibility and, given the nature of your loss, might wind up being the best fit for you.”

“Are they covered by insurance?”

They were not. But I was tired. I had been in too many examination rooms, filled out too much paperwork. Here, face-to-face with Melinda, I opened my mouth to object to any testing, any fitting, but I found, to my surprise, that I lacked the will. So she rose and I rose, and I let her lead me away to the sound-treated room.

The room had gray walls and a bolted-down chair at its center, draped with audio cords. The sound treating removed any voices or footfalls or equipment humming from wires or pipes, leaving me nothing to listen to but the roar in my head. I nearly said, “It’s loud in here.”

“Let me know if this is uncomfortable.” Melinda pushed flexible earphones into my ears, placing them in far enough they’d avoid any errors from diffraction — no sound hitting obstacles on its way to me and changing as it bent around them. Sound passes through some obsta­cles, of course, but those sounds can weaken and change as a result. When such obstacles become so intrusive as to obscure the sound completely, I’d learned, they’re known as sound shadows: a wall too thick to hear behind, a wind to take your words away. A physical shadow seemed like a good metaphor for whatever was going on inside my ears: sound was darker on this side of it, the warmth of human noises muted or void.

Melinda disappeared from the room and into the ad­jacent booth. There was a window between us, but my chair was turned away from it. If I couldn’t see Melinda’s face when she spoke into the microphone, I’d find it harder to know what she said, and in fact that was the point. According to Dr. Jess Dancer, a professor of audi­ology quoted in Katherine Bouton’s Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You, “It’s not unusual for speech intelligibility to increase from 20 percent when listening in noise without vision, to 80 percent or more when the speaker is seen as well as heard.” We hear with all our senses at once.

“Can you hear me now?” Melinda asked.

“Yes but you’re way too loud.”

“How about now?”

I tried to distract myself by picturing the sound-starved neurons misfiring in my ears, creating the feed­back signals I misread as noise. As I tried to imagine the auditory centers of my own brain, the neural networks of fibers far thinner than spider’s silk, constellations and ligatures pulsing off and on all night and day, I thought too of the shapes sounds make in the air, the way we come up against them.

Air molecules are always moving, colliding and wan­dering back, but we can lend them direction by widening and narrowing the vocal folds in our throats as we force more air out of our chests. At the speed of sound, 343 meters per second, those molecules we’ve agitated strike the eardrums of our listeners. In turn, those eardrums agitate the three small bones of the ear, which clack out patterns on the cochlea, the coiled snail in its bony cham­ber, where the force of the sound converts to electrical signals, carried straight to our brain on cranial nerves; their destinations are the specialized regions of our tem­poral lobes that relate electrical patterns to sounds we’ve heard in the past.

Along with auditory centers, visual and language cen­ters too can be found in the temporal lobe, just above your ears, straight behind your eyes. It’s a region of the brain that’s especially important to memory, particularly long-term memory. The ability to translate noises into linguistic meaning is inextricable from how the hearing see the world, and how we hold on to what we’ve seen and heard.

As I listened to the noise in my own head, I felt something nudging those very neurons. Or did I? It came from my ear, through the wires snaking back to the audiometer. I wasn’t sure, but I thought it was a tone. Or just the intimation of a tone: a hum I couldn’t pin. Then it became clearer. A high sound. I thumbed the button. Melinda saw I’d responded and selected the next frequency in the test. I clicked. Then the next.

Sounds are pressure waves. When they appear closer together, that means we’ll hear a given tone as a high one: trumpets and piccolos. When the pressure waves move farther apart, the tones drop lower: cellos down to kick drums. Melinda was an old hand at this kind of work, alternating the sounds to create a map, one that showed her exactly what my ears could perceive and what they missed. I found myself anxious to catch even faint sounds. Sometimes I clicked at what could only have been ghosts.

I wanted to pass this test, leave the office without permanent electronics of my own. But there were long stretches of what felt to me like silence. Except that it wasn’t silence. It was a series of sound waves that, if you drew them, might resemble the ocean on a nearly still day: low, infrequent ripples. I just didn’t know they were there.

Pure tones — not metaphorically pure, actually pure — is the proper term for the sounds Melinda sent through my head. A pure tone is a tone that plays at one frequency at a time, one set level of volume kept steady for each. Real sounds out in the world aren’t pure, metaphorically or otherwise. Life noises — wind, cars, doors, rustling fabric — exist as complex waves of any number of fre­quencies at once, both loud and soft sounds emerging in a single breath. When you speak words such as “fix” or “shut,” they surface with a hiss of air, grow louder and more resonant, close with a click and a whisper, proceed­ing as a single, constantly changing string of frequencies, each phoneme a collection of measurably distinct pres­sure patterns, striking a listener’s ear with varying force.

But tuning forks can make pure tones. So can syn­thesizers. Audiologists have equipment to make them too, and that’s what Melinda sent through my ears from the booth: lone waves of pressurized air. There were no obstacles, no sound shadows, for the waves to diffract against, no interfering noise, no change in the velocity of sound from earphone to eardrum. I clicked the button in my hand to indicate the sounds I heard, and I clicked again for phantom sounds. I didn’t know which sounds were real.

The news arrived as expected: I heard most of the sounds she played, but only just. I heard high sounds bet­ter than low ones. If this condition was progressive, I would prob­ably lose them all. Meanwhile, sound would come and go.

This put me at a disadvantage among those who come to deafness late. Most late-deafened people suffer pres­bycusis, an age-related loss of hearing. In presbycusis, the hair cells in the inner ear start to die from the outside in. This could happen to me too, of course — it happens to most people if they live long enough — but that wasn’t my trouble now. People with age-related hearing loss lose high sounds and I was losing low ones. My ears were dying from the inside out.

In the years before my partner Elisa and I moved to Colorado, I’d grown surprisingly healthy after my lazy 20s, exercising and finally giving up on what was left of a smoking habit I’d kept through college and grad school. The Boston neighborhood where we lived back then, Jamaica Plain, swelled with hills and bordered on a park full of trails through second-growth forest, falling-apart stone walls, abandoned cages from the Franklin Park Zoo. I’d leave the house on summer evenings, jog seven blocks to the park, drift down one path and then another, up rocky rises and through clearings I’d never seen before.

I experienced my first vertigo attack after one of those jogs; two or three years after that my hearing had begun to slip, then return, slip and return. On my bad days, Elisa would have to shout to be heard. I shouted back loud enough to distinguish my own voice. Shout back-and-forth long enough and you’ll either dissolve in laughter or wind up fighting. I wasn’t in the mood for laughter.

Outside Melinda’s office, I called Elisa on the lanyard they’d given me, one with a tiny microphone that was designed to pair up with the aids thorough a magnetic coil and synch with my phone.

When I heard her voice answer — or a voice — it sounded unrecognizable. I caught the electronic squeaks of words, muffled and robotic.

“Hang on,” I said, fussing with the volume. “Hang on, maybe it’s where I’m standing. Can I call you back to try again?”

I was nearly at the bus stop by then, so I walked back to­ward the clinic. I’d had a signal there when I called Elisa on the way in. “Hey, I’m trying again. Is this any better? Say a line or two more so I can tell if I hear you. Okay. Okay, this isn’t working. I’m going to hang up. I’m sorry, I just can’t hear you. I’m going to go.”

It’s no coincidence that being fitted with mechanical devices coincided with the sharpest pricks of self-consciousness I’d felt since the sickness began. Shame, after all, is built into the way such devices evolved: toward camouflage, deni­ability. As though I could fool everyone. As though I should want to.

Electronics were only the latest solution I’d tried. Before it occurred to anyone to fit me with hearing aids, I was in the habit of cupping my hand to my ear to in­crease the loudness of sounds around me. This is a good, if basic, technique: it can raise environmental sound by six decibels, or enough to lift a conversation from the background to the foreground, or to transform a whis­per into speech. But it doesn’t inspire self-regard. And over time it grew less effective: the deafer you are, to a point, the louder the world needs to be. If you want to lift the sound of a waterfall by twenty or thirty decibels — transform it from the far-off sound of a babbling creek into something monstrous — you can’t rely on your hand alone.

We’re familiar with ear trumpets from old-time pic­tures and cartoons. The daft uncle who still can’t hear even with one (“What’s that, sonny?”). Most scholars trace these back to the seventeenth century, but it would be haughty to assume our ancestors couldn’t have rolled leaves into cones, or hollowed out auroch horns, or gone looking on a nearby beach for shells. Among the acoustical artifacts of which we’re certain, the oldest was made a bit over three hundred years ago. It’s two feet of blown glass with a flare at the end — a sparkling coronet, hardly concealable or subtle. This wouldn’t do. Swiftly, makers emerged, some of them, like Frederick Rein, exploring a new commercial market, rich with fattened bourgeoisie desirous of staying in the game. Rein made his ear trumpets of brass and painted nearly all of them black—the easier to blend into pre-electric murk. The richer you were, the more concealable they could be made. The poor, like now, made do with what they could. They made do with cupped hands.

When I tell someone, in my smooth, trained voice, that I’m going deaf, they think, at first, that I’m joking. Ask a new friend, one chancing for the first time to trust you with a whispered confidence, to repeat that secret but louder. Misunderstand the volume of your own voice in public, because what’s normal to you is obnoxious to others. I have one of those voices that carry. There is no hiding, only learning how to get more comfortable being obvious, resorting what I take to be appropriate public conduct: the repeated request, the slow exchange, the new gestures.

In the decade that followed, I grew less shy. I stopped thinking twice about asking restaurants for a seat against the wall, or asking others at dinner to switch so I can take sound in from one direction alone. Every place I go in the evenings — bars, coffee shops, friends’ houses — I ask if we can sit outside. Often, indoor echoes are too much. Often I nod and pretend. It’s necessary to pretend.

Less comfortable teaching large classes, I teach small workshops, take on freelance editing work, a little ghostwriting. It’s not enough, but since I can work nearly anywhere I work at coffee shops. I try to find shops with multiple rooms, where I can put a solid wall between myself and the espresso noise, the amplified hiss and grind. If the music isn’t loud, I can make friends among the regulars, feel like my old self. Or rather, I can feel like a new self, but one that’s comfortable in his body — or trying to be.

In the bad days of adjusting to the hearing aids’ new sounds, Elisa imposed a limit, for her own sanity, on how often I could mention my ears. When they’re bad now, meaning I can hardly hear at all, I tell her about it as a by-the-way, an incidental. What at first struck me as lonely-making now feels like good instinct, good training: I’m acting as if. I complain less to myself now too.

Most frustrations I feel now aren’t with Elisa but with strangers. And it’s not the strangers I blame. To create a bond of intimacy, we lower our voice. In a room full of shouting kids, their mother will sotto voce the adult stuff in my ear — she’s establishing intimacy, wry mutuality — but precisely because the kids are shouting, whatever she tells me is lost. I say what and miss it a second time. I never do find out. Incidentals, the definition of low stakes, but still.

My favorite barista confides in me out of habit; we like each other, we joke, so when I walk in he comes up to the counter to confess out of range of his boss’s hearing, out of mind of the other patrons; he lowers his voice, even moves his lips as little as he can get away with. Each time, I remind myself it’s the opposite of unfriendly — I’m in­vited to the conspiracy. But like a narc I say I’m sorry? What? I tell him again that I’m hard of hearing and he nods and says, “Me too.” Lots of people do that. So you amp it to “I’m deaf,” and their fellow feeling diminishes not at all. “Oh, totally, I’m deaf too.” The word has no meaning. The world remains an arm’s length off. Loud bars are bad until they’re really loud, almost un­bearably loud, at which point they become good: if ev­eryone’s shouting at the top of their lungs, I can take off my hearing aids and join the democracy. You can shout the kinds of things in a loud bar you could never say in the quiet. You can shout like no one hears.

Gossip, caveats — you get used to missing them. A wave of the hand. “It’s not important,” “It doesn’t matter.” Texture. In a masked world, even lip reading becomes impossible.

My life in whispers: James Bond films when I was a kid (the mystery woman who warns him you’re in danger here). My mother, hushed, about what was wrong with Peg (“it’s cancer.”) My mom and dad on Christmas Eve, murmurs drifting upstairs (I remember the rustle of boxes in paper being set beneath the tree, my father’s low voice, “There’s a lot this year,” and the way that thrilled me.)

As time passes, as the hearing aids become insepara­ble from my sense of self, I’m coming to view the hearing world with not resentment but confusion. How can it be so easy? Hearing people laugh at a joke when I didn’t know words were spoken. They adjust themselves in space without looking. It’s exotic to watch them.

My sense of empathy misfires. I see a woman exit a 7/11 in the rain. She’ll get her hearing aids wet, I think, before catching myself. No, she doesn’t wear them. She’s an able-bodied forty-something. Watching a movie, I’ll follow along as the main character tails the villain onto a subway car. Now he won’t be able to hear for the back­ground noise. Worse: Finally, he’ll understand what it’s like for me. But no; subways are loud, but they permit raised speech, some understanding. They don’t blot noise out completely, not for everybody.

Hearing aids work only up to a certain point. After that, they’re useless. One day my ears will malfunction so badly I won’t be able to make use of them. After that, I’ll get cochlear implants installed. Implants aren’t like organic sound — for the vast majority of users, they’re far worse than real sound — so I can’t help but dread the day.

When I could hear well, one of the sounds I most loved was a cat drinking water. A simple need was being satisfied for the cat, and the sound affirming that was satisfying for me. Similarly, there’s a sound Elisa makes when she tastes something especially toothsome, a kind of satisfied smack of her lips. I missed hearing that when my ears went bad, but — before it happened — I didn’t know it was a sound I’d miss.