The following is an excerpt of  Volume Control: Hearing in a Deafening World by David Owen. Listen to a radio interview with David Owen about how our everyday lives present hearing challenges to us.

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Volume Control: Hearing in a Deafening World

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When my mother’s mother was in her early twenties, a century ago, a suitor took her duck hunting in a rowboat on a lake near Austin, Texas, where she grew up. He steadied his shotgun by resting the barrel on her right shoulder—she was sitting in the bow—and when he fired he not only missed the duck but also permanently damaged her hearing, especially on that side. The loss became more severe as she got older, and by the time I was in college she was having serious trouble with telephones. (“I’m glad it’s not raining!” I shouted, for the third or fourth time, while my roommates snickered.) Her deafness probably contributed to one of her many eccentricities: ending phone conversations by suddenly hanging up.

I’m a grandparent myself now, and I know lots of people with hearing problems. A guy I sometimes play golf with came close to making a hole in one, then complained that no one in our foursome had complimented him on his shot—even though, a moment before, all three of us had complimented him on his shot. (We were walking behind him.) My parents-in-law, like many older people, have a hard time ignoring a ringing telephone but also a hard time hearing what callers are saying; they have turned up the volume on their kitchen telephone so high that even if you’re in another room you can’t help but eavesdrop. The man who cuts my wife’s hair has begun wearing two hearing aids, to compensate for damage that he attributes to years of exposure to professional-quality blow-dryers. My sister has hearing aids, too. She traces her problem to repeatedly listening at maximum volume to Anne’s Angry and Bitter Breakup Song Playlist, which she created while going through a divorce. I know several people who seem to be hard of hearing but could probably be described more accurately as hard of listening—a condition that often coexists with deafness, or transitions into it, and makes it worse. One of my wife’s grandfathers lost most of his hearing in old age, and another relative said of him, “He never did listen, and now he can’t hear.”

My own ears ring all the time—a condition called tinnitus. I blame the Chinese, because the ringing started, in 2006, at around the time I was recovering from a monthlong cold that I’d contracted while breathing the filthy air in Beijing, and whose symptoms were made worse by changes in cabin pressure during the long flight home. Tinnitus is usually accompanied by hearing loss. It’s said to affect forty-five million Americans, including a surprising number of people in their teens and twenties and thirties—although so many of the people I talked to while working on this book told me they have it that I wouldn’t be surprised if the real number is higher. The ringing in my ears is constant, high-pitched, and fairly loud, but I’m usually able to ignore it unless I’m lying awake in bed or, as I discovered recently, writing about tinnitus.

The National Center for Health Statistics has estimated that thirty-seven million Americans have lost some hearing. According to the National Academy of Sciences, hearing loss is, worldwide, the fifth leading cause of years lived with disability. The World Health Organization has estimated that by 2050 there will be a billion people with a disabling hearing loss. Two-thirds of Americans who are seventy or older have lost some hearing, according to various estimates. Hearing loss is also the second leading cause of service-connected disability claims made by military veterans (tinnitus is first). All this bad news is made worse by the fact that the ears you’re born with are the only ears you get: a newborn’s inner ears are fully developed and are the same size as an adult’s, and, unlike taste buds and olfactory receptors, which the body constantly replenishes, the most fragile elements don’t regenerate.

Hearing problems are often aggravated by the human tendency to do nothing and hope for the best, usually while pretending that everything is fine. This is the way we treat many health problems, although it’s not the way we typically treat threats to our other senses. People who need glasses almost always get them, and, as Lauren Dragan wrote on the website Wirecutter in 2018, “If someone told you that wearing certain jeans too often might trigger permanent leg numbness, or overuse of a hot sauce would cause you to lose your ability to taste sweets, you’d pay attention.” Yet people who notice trouble with their ears wait more than ten years, on average, before doing anything other than saying “Huh?,” turning up the TV, and asking other people to speak up. I heard a joke about a man who was worried his wife was going deaf. He told his doctor, who suggested a simple test. When the man got home, he stood at the door of the kitchen, where his wife was at the stove, and asked, “Honey, what’s for dinner?” She didn’t respond, so he moved closer and asked again. She still didn’t respond, so he stood directly behind her and asked one more time. She turned around and snapped, “For the third time, chicken!”

One day when I was seven or eight, I drove myself halfway crazy by staring at the house across the street and trying to figure out what seeing is. It leaves no trace; you can’t feel or taste it; it does something to you but you can’t put into words what that something is; how do you know for sure that you are doing it? Hearing is at least as hard to comprehend. For a previous book of mine, I interviewed engineers and scientists who’d been involved in the development of the Xerox machine. One of them, a physicist who’d received 155 patents during his years at the company, beginning in 1952, said, “The more you understand about xerography, the more you are amazed that it works.” Scientists who study hearing often feel the same way. One of them told me, “If you stop and think about how hearing works, it seems insane.” The principal components of the auditory system are coiled inside a spiraling fluid-filled chamber about the size of a pea, yet a person whose ears are fully functional can hear vibrations so faint that they displace the air molecules inside their ear canals by distances measured in trillionths of a meter. I had a couple of long conversations with a prominent hearing researcher, and, at one point, while he was using a diagram on the wall of his office to explain the still somewhat puzzling functions of two different kinds of auditory nerve fibers, the whole thing suddenly seemed so fantastic that I worried that if I learned more I might cause my own ears to stop working—like the tightrope walker who falls the moment he looks down.

Yet those of us who can hear are often extraordinarily reckless with this extraordinary gift. The greatest modern threat to hearing is excessively loud sound. Ears evolved in an acoustic environment that was nothing like the one we live in today. Thunderstorms, gales, waterfalls, ocean waves, erupting volcanoes, howling animals, screaming enemies: during most of human history, few of the world’s noises would have been either loud enough or sustained enough to cause permanent hearing problems. Deafness was by no means unknown, since the pre-noise era was also the pre-antibiotics era, and infections of many kinds left eardrums inflamed or in tatters, or filled middle ears with pus, or destroyed the delicate sensors deep within the inner ear. Ears have also always been vulnerable to mischief and accidents and fighting and warfare and genetic glitches. But our ability to deafen ourselves with ordinary daily activities has never been greater than it is now. Grown-ups often assume that the population segment in the most danger is teenagers who listen to loud music through earbuds, but almost all of us routinely expose ourselves to sound levels that are potentially damaging. Although we are generally more aware of the dangers of noise than people were in the past, and are therefore more likely to take steps to protect ourselves, the world is louder as well—so much so that, for virtually everyone, completely avoiding damage is impossible. Hardly anyone makes it to retirement age with their ears in anything like their original condition.

During most of human history, few of the world’s noises would have been either loud enough or sustained enough to cause permanent hearing problems.

One reason for our recklessness is that most of us underestimate the importance of hearing to our well-being. An occasional activity for my friends and me, when we were lads, was to consider whether we’d prefer to be frozen to death or burned, hanged or guillotined, shot by a firing squad or drowned—a classic sleepover thought problem. We also debated whether we’d rather be deaf or blind, although that debate seldom lasted very long, because, like most people who are able to do both, we assumed that not being able to hear would be a minor infirmity compared with not being able to see. My grandmother got deafer and deafer but still lived what appeared to me to be a mostly normal grandmother life. (Eyesight eventually became an issue for her, too—although, when she was in her late eighties and had to renew her driver’s license, “the nice man at the triple-A” helped her identify the symbols in the eye test, which she couldn’t make out on her own.) But my friends and I didn’t actually know enough about either blindness or deafness to make an intelligent choice.

When Helen Keller was nineteen months old, in 1882, she contracted what her doctor called “an acute congestion of the stomach and the brain”—a disease that’s now believed to have been either bacterial meningitis or scarlet fever—and the infection destroyed both her eyesight and her hearing. When she was twenty, and had therefore lived with both disabilities for almost two decades, she didn’t hesitate in her own choice. “The problems of deafness are deeper and more complex, if not more important, than those of blindness,” she wrote in a letter to James Kerr Love, a pioneering Scottish physician who worked with the deaf and was a friend. “Deafness is a much worse misfortune. For it means the loss of the most vital stimulus: the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of men.” The quotation most frequently attributed to Keller—“Blindness separates people from things; deafness separates people from people”—is one she probably never made, at least in those words. (It’s often quoted, never sourced.) But she clearly believed essentially that. In 1955, when she was in her seventies and was asked The Question for what must have been the millionth time, she replied that, “after a lifetime in silence and darkness,” she knew that “to be deaf is a greater affliction than to be blind,” and added, “Hearing is the soul of knowledge and information of a high order. To be cut off from hearing is to be isolated indeed.”

One evening not long ago, my wife and I went to a local lake for a picnic dinner with a dozen friends, and, because I’d been working on this book and therefore thinking obsessively about my ears, the old sleepover question came into my mind. I realized that if I were blind I wouldn’t be able to see the children splashing in the water, or the sun going down over the far end of the lake, or the people sitting at our long picnic table, or the emails and text messages that I’d been checking surreptitiously under the table. But after I’d thought about it for a while I realized that, if I were deaf, I wouldn’t be even a tangential participant in the evening—which had far less to do with watching the sunset than with engaging verbally with friends. I’d have been a silent lump at one end of a bench, trying to seem interested and present but having no idea what anyone was laughing about, and worrying that everyone was feeling sorry for me, if they were thinking about me at all. You can interact with a blind person for quite a while without realizing that they’re blind; the same doesn’t happen with someone who’s deaf. I have a retired friend who, at social gatherings, almost always sits in silence and scowls at everyone else. He has a reputation for being sullen and ill-tempered, but his real problem, I now understand, is that he’s both hard of hearing and too stubborn to wear hearing aids. So, now, with confidence, I make my final selections: frozen, guillotined, firing squad, and blind.

From the book Volume Control: Hearing in a Deafening World by David Owen. Copyright © 2019 by David Owen. Reprinted by permission of Riverhead Books, an imprint of Penguin Random House LLC