It Takes Courage to Be Vulnerable

It Takes Courage to Be Vulnerable

For this audiologist, a hearing loss created an interest in the field, and then provided essential tools for understanding patients—and himself. By Trent Westrick, Au.D.

millions of people have read brené Brown, Ph.D.’s bestselling books and have viewed her inspiring motivational talks. For those unfamiliar with Brown, she has spent her career researching courage, vulnerability, and empathy, among other complex topics. While the tenets she researches and discusses are applicable to many facets of everyday life, they are particularly relevant to me, an audiologist with a hearing loss.

When most people think of audiology, terms like courage, vulnerability, and empathy do not immediately come to mind. Even some experienced audiologists do not regularly use these descriptors. But when more closely considering the relationship between a patient, their family, and the audiologist, courage, vulnerability, and empathy play a significant role.

My journey to becoming an audiologist began after I was diagnosed with sensorineural hearing loss at age 8. Since I was born before the advent of technology

used in newborn hearing screenings, my hearing loss was not identified until I was older. I believe my mother suspected I had a hearing loss based on my behavior and reliance on visual cues, and then my performance in school began to decline when we started having spelling tests. I also had chronic middle ear infections, so whenever my mom mentioned her concerns about my hearing to doctors, they would just discover another ear infection and assume that was the cause of my behavior. But the diagnosis of sensorineural hearing loss at age 8 ended up being completely unrelated to the middle ear infections.

The day I was fitted with my first hearing aids was memorable and overwhelming as I became aware of a world filled with new sounds. My mom still tells the story of how I walked out of the audiologist’s office and turned around to see whose footsteps I was hearing, not realizing they were my own. As exciting as wearing the hearing aids was, they made me feel vulnerable. I was not

ready to let others know I had a hearing loss. Wearing hearing aids at school took courage, with support from my parents and audiologist.

As I experienced the technological advancements in hearing aids firsthand, I became more interested in the possibility of a career in audiology. I was, however, acutely aware of a major obstacle. Talking about my own hearing loss was incredibly difficult. Even with my family, teachers, and especially my friends, even mentioning my hearing loss made me feel vulnerable.

I continued exploring a career in hearing healthcare in college, and quickly came to understand that if I felt uncomfortable talking about my hearing loss and its associated challenges, so too would my patients. As I started graduate school working toward my doctorate in audiology, I slowly overcame this reluctance to discuss my hearing loss. While gaining clinical experience, I also earned a better understanding of the roles that empathy and vulnerability play in the patient-audiologist relationship.

Although I have become more comfortable talking about my hearing loss, there is still a sense of vulnerability when discussing my progressive vision loss, a result of having Usher syndrome. Usher is the most common genetic cause of combined hearing and vision loss.

I started experiencing vision changes around age 14, such as difficulty seeing in low light in movie theaters or while walking in the woods at night. I began losing peripheral vision a few years later, which caused me to bump into things. I complained to my optometrist for several

years before I learned about Usher in an undergrad class and essentially self-diagnosed my condition. A few years later I had my first genetic workup and the diagnosis of Usher (type 2A) was confirmed.

That was in 2005. At about the same time, my younger sister was also diagnosed with a sensorineural hearing loss and with Usher. Our older brother is unaffected.

I initially had trouble processing the diagnosis, but after a few years I was fine with knowing I had Usher. That said, I kept it to myself because it was easier than talking about it. And now that my peripheral vision loss has continued to progress and has started interfering with daily life more noticeably, the time has come for me to tell people about it and stop hiding it. I still struggle with sharing the diagnosis, and accepting my worsening vision is also a work in progress. I feel some of the same vulnerabilities familiar from my hearing loss; likewise, I recognize that some of my patients are likely experiencing similar feelings of vulnerability.

I do not feel the need to discuss the details of my own hearing loss with every patient I see, but I am able to reflect on my own experiences in an effort to better understand how each patient is dealing with their own unique challenges related to hearing loss. While my hearing loss might not be the same degree and configuration as that of my patient, I have more than likely experienced some of their same emotions, including frustration, embarrassment, and vulnerability. My understanding of what patients are experiencing creates space for empathy. Empathy builds trust.

Since I too struggle with disclosing my own hearing and vision issues, I understand the hesitancy patients experience when pursuing assistance for their hearing loss. I recognize the emotions patients feel when I encourage them to disclose their hearing loss to others and to advocate for their communication needs.

When a patient seeks the services of an audiologist, they are putting themselves in a vulnerable position. Not every audiologist has hearing loss, and having a hearing loss is not what makes an audiologist competent. Audiologists, regardless of their own hearing status, are trained to give their patients the courage to succeed, to help patients advocate for themselves, and to empathize with patients as they describe the emotional and psychosocial challenges of having a hearing loss.

I share my story in this context to shed light on the roles courage, vulnerability, and empathy play in the patient-audiologist relationship. I advise that individuals with hearing loss seek and work with an audiologist who not only understands these complex emotions, but also creates space for their patients to discuss them. As Brené Brown says, it takes courage to be vulnerable.

Trent Westrick, Au.D., is an assistant professor and the externship coordinator at Pacific University’s School of Audiology, College of Health Professions, in Oregon.

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