"Does God Have a Cochlear Implant?"  

(to be published in Journal of Deaf Studies and Deaf Education)

Michael A. Harvey, Ph.D., A.B.P.P. 

    Abstract

This article describes some psychological and ethical considerations when providing family therapy for parents who are considering cochlear implantation for their deaf/hard-of-hearing child.  Common couples' dynamics, multi-level criteria of informed consent, therapist bias and intervention strategies are illustrated.  The clinical vignette of 8-year old Tommy and his family is largely factual with enough changes to disguise the participants' identities.  I took more creative liberties narrating my daydream in order to best illustrate the relevant impacts of the pathological and culturally affirmative models.  


"Does God Have a Cochlear Implant?"
Michael A. Harvey, Ph.D., A.B.P.P.

 

"What do you think?" came my knee-jerk response.  A well-known face-saving device among therapists when we don't know the answer. 

"I don't think so," replied 8 year old Tommy.  "God doesn't need a cochlear implant because he's not deaf." 

"How do you know that?  Suppose God is deaf?" I asked. 

"Well, he could make himself hearing anytime he wants without getting an implant," Tommy responded confidently. 

"And why would he wanna do that?"  (Admittedly on a defensive note, let me beg the often-cited debate of whether God is a "he," "she," "it," etc.  Here, I was simply matching Tommy   Here, I was simply matching Tommy's masculine gender assignment.)

"So he can be like everyone else." 

"We're trying the best we can, dear," interjected Shirley, Tommy's mother.  "That's what we've been talking about with all those doctors."  

Still looking at Tommy, I said, "If God was the same as everyone else, he wouldn't be God, now would he?"  A brilliant intervention, I thought.  I wanted to introduce the concept of cultural heterogeneity. 

"Yes, he would," Tommy immediately retorted.  "He would be God and be the same as everyone else.  Like mom and dad; they can both hear but they're still different from each other, right?"

"I know that, dad.  But remember when mom got that new toaster oven?  She asked Aunt Doris how she liked hers before she bought one for us.  Remember?" 

"Yes, but what does -" 

"It's easy, dad," Tommy interrupted.  "If God likes his cochlear implant, humans like me will probably like it, too." 

"If it's good enough for God, it's good enough for you?" I mused. 

"Yeah," Tommy replied. "Look what I drew!"  He proudly displayed a drawing he had made.  It looked like Casper the Friendly Ghost with wires coming out of his head.  However, it was none other than the Supreme Being with an implant!  Although Tommy put up a fuss every Sunday morning when it was time to go to Church (Southern Baptist), God was an important part of his life.  An endorsement from Aunt Doris would do for toaster ovens, but nothing less than God's endorsement would suffice for important decisions like getting an implant.  Only problem was God's presentation of his endorsement was unclear and was subject to debate.  If only he would use PowerPoint, I thought. 

Tommy had incurred a profound hearing loss shortly after his sixth birthday as a result of a rare kind of auto-immune deficiency.  His parents were devastated.  They were an upper middle class, interracial couple (Leo was African-American, Shirley was White) who worked hard to reap the "American Dream."  Their dream did not include having a deaf child.  After undergoing extensive medical and audiological evaluations, Tommy had recently been approved for cochlear implantation surgery.    

As a well-established University Professor in Sociology, Leo had recruited/coerced his grad students to collect relevant medical and sociological articles from libraries and the Internet.  Shirley, a housewife, visited several clinics and consumer groups and had been reading reams of testimonial reports from implant users.   We scheduled another meeting with just the two of them - "adults only" - as it would not be helpful at this stage for Tommy to hear what I sensed would be his parents' ambivalence or fears.  I had an inkling of what was to come.  

A week later we adults met.  "So who wants to start and where?" came my typical open-ended beginning.

"I'll start," Leo immediately announced.  He was obviously sitting on a lot of feelings and was eager to release them.  "I've been going back and forth about the surgery ever since the doctors told us a month ago that it was possible.  They talked about the benefits of cochlear implants: that Tommy would have greater access to sounds and conversation; that he'll have a richer life with expanded options; but that we shouldn't expect miracles or for him to have completely normal hearing.  Their position makes sense.  But then I read about the position of the Deaf community.  They say that to be implanted is a cultural stigma and that we would be trying to fix something that isn't broken; that we should accept Tommy as Deaf.  Their position makes sense, too.  But if he'll have a better life as -" 

"Tommy's hearing disability is not a difference, honey.  It's not like being Black or White."  Shirley's voice was soft and sweet but I wondered how long that would last. 

"Do you think Tommy will have a better life with or without an implant?" I asked Leo.

Well, that's just it, I don't know.  As Tommy's dad, I'll answer >Yes, of course!'  But that may be because I'm too involved, too close.  The readings I've done as a Sociologist [he produces a copy of Harlan Lane's Mask of Benevolence] is compelling.  Would I have a better life as a White man?  I don't know.  Would I have a better life as a Latino?  I don't know.  Would I have a better life as a piece of broccoli?  I don't know that either."  Leo became philosophical and humorous, as if he was giving an oration to his students.  I bet he was a good teacher. 

"I'm glad you're not a piece of broccoli, dear, although you should eat it more regularly," Shirley joked.  We all laughed.   

"My mother used to force all that green stuff on me," came my contribution.  But then I realized that I had inadvertently been co-opted to distract Leo from making his point which ran counter to Shirley.  To get him back on track, I asked him to say more.  

He responded immediately: "If I wasn't Black, I wouldn't have to fight discrimination.  I wouldn't have been called a Nigger by other White kids throughout my childhood in an almost all White neighborhood.  I wouldn't have been accused of shoplifting more times than I care to remember.  Part of me wishes I were White.  But I'm Black, and I'm proud of being Black!  I wouldn't know me as White."  He paused, apparently in search of words to describe his White "virtual reality."  

"Do you see any advantages to being Black?" I asked. 

"Yeah, of course I do!" came his immediate response.  "It's made me who I am.  It's given me strength, a backbone, the will to fight; it's given me soul; it's given me compassion; it's given me a deep commitment to help change the world and rid it of evil!"  He ended his oration by quoting W.E.B. DuBois, the famed Black activist in the early 1900's.  "I'll never forget how DuBois described the >spiritual strivings' of Black people as >the dogged determination to survive and subsist, the tenacious will to persevere, persist, and maybe even prevail.'" The words and soul of Leo and DuBois permeated the room. 

Positive strivings, however, are not the full story.  As Leo noted, a host of liabilities and challenges are also part of the collective memory of the Black community.  In the words of Cornel West, a contemporary Black professor and protege of DuBois, "These >strivings' occur within the whirlwind of white supremacy - that is, as responses to the vicious attacks on black beauty, black intelligence, black moral character, black capability, and black possibility.  This unrelenting assault on black humanity produced the fundamental condition of black culture - that of black invisibility and namelessness (Gates & West,1996).

For Leo - as a Black man and sociologist - the spiritual strivings, threatened invisibility and namelessness of the Deaf community were inextricably involved in his struggle to decide whether or not to implant his deaf son.   

Not so for Shirley.  "You can quote DuBois, but I can quote some our great inventors, like Alexander Graham Bell.  If he hadn't tried so hard to make a hearing aid for his deaf wife, he wouldn't have invented the telephone!  There have been incredible advances in surgical techniques for the hearing impaired, assistive listening devices, digital hearing aids, cochlear and auditory brain
stem implants."  Her voice, no longer soft, revealed her strength and determination.. 

"All I want to do is give him a better chance to get the same benefits as others who have normal hearing," she exclaimed.  "He can be proud of being deaf if he wants, but he doesn't have to be deprived of important opportunities!  He can have the best of both worlds!  That's the difference between you and him!  You can't make yourself white and be proud of being black.  Well Tommy can.  He's never going to be completely hearing, even with a cochlear implant.  But he'll have a better chance to succeed in this racist world of ours.  That'