Ann Otol 88 :1979




Some of my otological friends sug- tory and his interaction with another gested that I look back to the early grand old man, Harvey Fletcher. Hardays of my association with the Ameri- vey is now 94 years old, the second oldcan Otological Society and tell you est living member of the National Acadsomething about how it was and who emy of Sciences. Harvey Fletcher meawas who in the roaring twenties. I shall sured human hearing as part of the Bell follow this direction, and shall center my Telephone Company's effort to improve remarks on one of the Grand Old Men telephones. Somehow Harvey Fletcher of the Society whom I admired greatly: and Edmund Fowler got together. FowDr. Edmund Prince Fowler, Sr. He will ler was very instrumental in developing be the starting point for several free as- the audiogram as a display of hearing sociations. Pardon me if I telescope loss that would be easily appreciated some dates and am satisfied with less by otologists, and then in persuading than complete accuracy of detail. I will otologists to use the bulky and expentell you what my memories are: not sive 2A audiometer in addition to their time-honored tuning forks. He persuadnecessarily exactly how it really was. My association with the American ed Fletcher to give up the confusing Otological Society began in 1930 or 31 term "sensitivity unit" in favor of "deciwhen, as a neurophysiologist at Harvard bel." (Was that really simpler?) I don't Medical School, I was trying to assemble need to remind you of Fowler's discovup-to-date electronic and acoustic ery and naming of recruitment of loudequipment to study the electrophysi- ness. Fletcher and Fowler respectively deology of the ear. I think it was Dr. D. H. Walker, another grand old man, who veloped and implemented speech audilearned of my project and persuaded the ometry (the 4C audiometer) for screenAmerican Otological Society to give me ing school children for hearing loss. Out a substantial grant. This, combined with of a survery in New York City came a help from medical school research spectacular statistic that figured rather funds, "put me in business." I think Ed- prominently in an advertising contromund Fowler conspired with Dr. Walk- versy many years later. This was "3,000,er in securing this grant from the sacro- 000 hard-of-hearing children in the sanct Otosclerosis Research Fund, which United States." Remember that one? was sitting very idle at the time. This The total was estimated by applying to was in the Great Depression, and long the U. S. population of children the perbefore Uncle Sam learned to care about centage that failed the 4C screening test. medical research. The help was critical, No one seemed to know or care that the and I gave thanks again to the Society percentage of failures was built into the for it, and also for the contact that it scoring system. It was the percentage provided me with top-level otology. that fell outside the two-standard-deviaTop-level otology of the kind that I tions limit of the scores of the group. best understood was personified by Ed- But perhaps this bit of statistical legermund P. Fowler. He was interested in demain actually helped the cause of hearing. I became aware of his early hearing conservation in children. The American Otological Society inwork with the electric audiometer developed by the Bell Telephone Labora- vestment in my equipment began to pay From the Central Institute for the Deaf, St. Louis, Missouri. Presented at the meeting of the American Otological Society, Iric., Los Angeles, California, March 31-April 1, 1979.


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off in 1932. Word got around the Harvard Medical School that "something was going on about hearing" in the Department of Physiology. The chairman of the ENT Department, Harris P. Mosher, sent one of his brightest young men around to see what was up. He was Moses H. Lurie. Moe and I had met in 1917 on board the S. S. Chicago on our way to France to serve as doctor and ambulance driver respectively. We had not seen each other since, but we became firm buddies again on the spot. I never had done any histology, but Moe knew how. I needed help, and Moe joined the team, WOC (without compensation). I practiced the old business maneuver of taking in a partner to provide an essential asset. Bill Derbyshire, and later S. S. Stevens, (my students) and I had all the fun in the laboratory doing the experiments and Moe did the laborious anatomical follow-up afterwards. (It's a fine system and I have used it ever since.) Fully as important, we were invited to present our results at an American Otological Society meeting. We shot the works and set up a live demonstration in a hotel dining room (in Philadelphia, I think). Bill Derbyshire anesthetized the cat, performed craniotomy, excised part of the cerebellum to expose the eighth nerve, and put an electrode on the round window - all in a serving pantry during dessert. How we dared try this with portable electronics and primitive acoustics I don't know, except that we were young and foolish: but it worked. We demonstrated the difference between cochlear microphonics and action potentials. I may have condensed two episodes into one, but my memory of the sight of that eighth nerve in the hotel pantry is as vivid as any I possess. This performance earned us a place year after year on the programs of the American Otological Society along with other scientists such as Barry Anson, Theodore Bast, Stacy Guild, and Walter Hughson. Dr. Edmund Fowler was one of our strongest and most appreciative supporters, but I don't think he ever knew what some of us called ourselves. Moe and Bill and I and perhaps others referred to ourselves as "the trained seals." We did our acts regularly, and published papers and were very well


fed. The more fortunate trained seals were made Associate Members. Dr. Fowler was one of our trainers, and Moe Lurie and I got quite chummy with him. One year - about 1936 - at the cocktail party before the American Otological Society dinner Moe Lurie, Dr. Fowler and I' were chatting together. Dr. Fowler raised his glass and proposed a surprising toast: "To the quick immediate and total destruction of the entire human race." For many years thereafter we three drank to the same toast at our second martini. There was, however, a lapse of about five years with no toast after the nuclear bombs were dropped on Japan. Somehow it didn't seem funny then, even at a third martini - but we resumed it later as a reminder of the good old days when it was funny. After the War I became deeply involved in problems of design and distribution of audiometers and hearing aids, and was made chairman of the AMA Committee that dealt with such problems. Sure enough, there were E. P. Fowler, Sr., Moe Lurie and several other grand old men. I soon found that the otologists and the hearing aid dealers considered themselves natural enemies. The otologists were the champions of defenseless senior citizens against the hard sell of unscrupulous dealers. Hearing aids were all right for the conductive impairment of otosclerosis or chronic otitis media, but the otologists' conventional wisdom for the elderly was: "You have nerve deafness, and a hearin~ aid won't help you. Save your money!' Unfortunately at that time "nerve deafness" was any hearing loss that showed up by bone conduction, including presbycusis. Otologists were slow to learn that with a soft sell and realistic expectations a hearing aid does help a great many people with old-fashioned nerve deafness. Ot~erwise there woud be no hearing aid busmess now - especially since some of our grand old men with their stapes surgery have taken so much of otosclerosis out of the hearing aid market. .In the same evangelistic spirit we tned to control the advertising claims of the manufacturers. Our committee met with representatives of the manufacturers annually, and carried on a useful dia-

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logue. Horns and tails ceased to be so age of hearing loss from audiometric visible, and most manufacturers re- thresholds. The basic idea had been duced their advertising puff. We were, Fletcher's, and his very simple "point so to speak, the referees of their com- eight" rule had been elaborated by petition. But one company president whom else but E. P. Fowler Sr. (in colrefused to modify his advertising in ac- laboration with a physicist, Paul E. Sacord with our criticisms. Among other bine ). Fowler and Sabine went into things he exploited deceptively the 3,- great detail, but this made the rule too 000,000 hard-of-hearing children that complicated and it never got off the Fletcher and Fowler had "discovered." ground. All we did later was to draw a When we made noises about going pub- straight line through Fowler's beautiful lic with our opinions he countered with ogive and leave out the second-order noises of his own about a lawsuit against corrections. Unfortunately Fowler's the AMA. I think he knew very well name is no longer associated with it. that the AMA had already been conIn closing I note that the efforts victed once under the Sherman Act for of physiologists and psychoacousunlawful restraint of trade. The penalty ticians to understand and explain was nominal and very mild for a first of- hearing have continued to be a proper fense but for a second offense it was although secondary interest of the Amerferocious, and would have been disas- ican Otological Society. You have entrous, both politically and financially. I couraged us and helped to develop our had a couple of hasty conferences with sense of proportion. I recall an immortal an AMA vice-president and a legal ad- put-down that I heard Stacy Guild, an viser and we executed a safety play. I anatomist, use more than once to end the say "executed" advisedly. It was the discussion of a presentation by an enquick, immediate and total destruction thusiastic physiological "trained seal" of the entire AMA committee. such as myself. He would lower his voice Of course we regrouped and were about a major third and intone: "Gentlesoon back in business under the auspices men: we still don't know how we hear." of the AAOO, but we were very circum- To this I say "Amen." The more we spect about our "listing" of "acceptable" know, the worse do our time-honored audiometers and hearing aids. We also simple models serve us. We don't even devoted much attention to Conservation know how the ear works, let alone the of Hearing, first in children and then in brain. industry. Same grand old men and some There will always be a place for others not so old but just as grand. One Grand Old Men such as Stacy Guild job that I was involved in was to revise and Edmund Prince Fowler, Sr. - and the AMA rules for calculating percent- I hope for their "trained seals" as well. REPRINTS -

Hallowell Davis, MD, Central Institute for the Deaf, 818 South Euclid, St.

Louis, MO 63110.

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Reminiscences: March 31, 1979.

Ann Otol 88 :1979 REMINISCENCES MARCH 31, 1979 HALLOWELL DAVIS, MD ST. LOUIS, MISSOUlU Some of my otological friends sug- tory and his interaction...
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