Music Performance with a Cochlear Implant

A professional musician in New York City for two decades, Jonathon Taylor retired early due to progressive hearing loss that could not be helped with hearing aids. After receiving a cochlear implant 17 years later, Taylor participated in a week-long adult band camp at Michigan’s Interlochen Center for the Arts in August 2021, an experience he related in the winter 2022 issue of Hearing Life magazine. Last summer, he returned to camp with significantly improved results, as he shares here in honor of Better Hearing and Speech Month.

When I returned to Interlochen’s band camp in 2022, the conductor was using a microphone to address the assembled musicians—likely a result of the Hearing Life article where I mentioned my difficulty understanding him. This announcement was greeted by applause from the entire band, many of whom apparently also had trouble hearing him. This is an important lesson for self-advocacy as encouraged by HLAA—don’t be shy about requesting accommodations! When you need them, you probably are not the only one.

So how am I hearing today? Since implantation, my hearing has dramatically improved, though at a somewhat slower rate in the second year. Before surgery, my sentence comprehension score was 62% in quiet. Within four months it was up to 85%, and at seven months I was able to correctly repeat an astonishing 97% of sentences in quiet.

During the year after my implant, while in the country with my wife, I told her that I had heard a bird, which in and of itself was not surprising. But the fact that I knew it was a bird meant that I was recognizing more sounds, in addition to better understanding speech. Although hearing tests check your ability to hear pure tones, most sounds in the real world, including music, are not pure tones, but a combination of harmonics above the fundamental pitch.

Since I am not a neuroscientist or audiologist, I cannot vouch for the scientific accuracy of my observations. But I believe that my problems with pitch arise from having different degrees of hearing loss at different pitches, making those harmonics off-kilter—not balanced as I was accustomed to before my hearing loss. What distinguishes a bird song from a trumpet, or a trumpet from an oboe playing the same note is timbre, which I think is related to the balance of harmonics. Timbre is “the character or quality of a musical sound or voice as distinct from its pitch and intensity” (Oxford Languages). Essentially, my brain has relearned the pattern of harmonics of birds, oboes and trumpets.

Nina Kraus, a neuroscientist at Northwestern University, has written a wonderful book, Of Sound Mind, about the role of the brain in hearing. She gives an example of a ferret, which has a neuron that responds to a preferred frequency of 8000 hertz (Hz). However, when a pitch of 6000 Hz is paired with a reward, the ferret’s brain shifts its preference to 6000 Hz.

Initially, I had assumed that the tuning of the electrodes in my cochlear implant imposed very strict limits on the ability to perceive pitch and timbre—but the plasticity of the human brain, like the ferret’s, is amazing. Although I still believe there are limits on pitch perception with a CI, they are not as rigid as I had thought. I can now enjoy listening to music more than I could at first, and even more than I could with hearing aids alone.

Prior to my implant, an orchestra concert was just a big wash of sound because I could not separate out different instruments. That has improved gradually in the nearly two years living with my CI. I am now able to enjoy live performances at the Metropolitan Opera, New York City Ballet and Broadway musicals. I would recommend that anyone with an implant who wishes to listen to music start by listening to small ensembles before attempting larger ones.

It’s difficult to know why I was able to improve so much more than I would have without doing anything special. I suspect that exposure to speech and sounds enabled my brain to process these stimuli and learn to sort them out. Post-activation, I did receive auditory training, which helped me focus on differences between similar speech sounds. This included listening to podcasts and doing homework exercises with my wife.

As for music, I believe that using the Angel Sound^TM app, along with slowly playing scales on a keyboard may have helped somewhat. I would also surmise that starting to practice my instrument and playing in the ensemble at camp may have made even more of a difference than the auditory training. I personally believe that active performance might be more beneficial than passive listening.

Will I ever hear music the way I did in my youth? Probably not. Even if I completely recover my physical instrumental skills, I’ve accepted that I would never be able to resume my professional career. However, with a different set of expectations, I can once again enjoy playing alone and occasionally performing in an ensemble, which gives me a sense of accomplishment. And, of course, I am grateful to be able to resume listening to and appreciating music.

Read more about music and hearing loss in a past issue of Hearing Life magazine.

Want to take a deeper dive into this topic? Attend the HLAA 2023 Convention Research Symposium on Friday, June 30, for an in-depth look at the science behind music and hearing loss. The “Joy of Music/Loving Your Ears” panel will feature four prominent experts in the fields of audiology, science and music performance.

REGISTER HERE for the convention by May 26. Admission to the Research Symposium only is also available for just $20/person.

If you or someone you know has a hearing loss, visit hearingloss.org for resources and to find a local chapter, or a Walk4Hearing near you.

For questions, contact HLAA at inquiries@hearingloss.org.

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