:: Article

Vestibular Disturbance

By Elise Blackwell.

The release forms at the audiologist’s office include lines not just about privacy but about third-party marketing. If you fail to read carefully, your inbox fills with hearing-aid spam and, perhaps, burial insurance. I am the youngest person there.

The room I am led to reminds me of the booth where I spend several hundred college nights, headphones on, carefully blending the end of one song into the beginning of the next. But no walls of alphabetized vinyl surround me here. I don the headphones and hold the buzzer like a Jeopardy contestant, clicking with my thumb whenever I hear a sound as well as several times when I do not. Normally calm, I am panicked by silences that feel too long.


The first time I read Teju Cole’s essay on the mysterious loss of his eyesight I burned with subject envy. In my defense, his blindness was incomplete as well as temporary and my envy of his talent is as general as the snow over Joyce’s Ireland. Also this: his affliction was immediately preceded by the reading of Virginia Woolf’s diaries.

When I returned so my senses, or summoned them, I realized the horror of blindness to a reader, to a writer. I would rather lose any sense other than sight if I had to choose. Not even music is worth that.


I am a professional eavesdropper. I write because I am curious about people and am more likely to be listening to the people at the table behind me than the person I am dining with. An example: a man behind me at a restaurant whose menu includes boiled celery emerges from a long silence to say, “I’m starting to have a problem with death”. His companion answers: “As a concept or a process?”

Once, in a basement, I heard Jolie Holland sing a song composed of found lines, each collected in the bars of New Orleans. The song was called “I was a real Tina Turner in my day”.


In my fourth novel, the main character has sex with a famous older man as a blindfolded violinist plays in their hotel room. It sounds cheesy when I write it down like that, but one critic told me that it disgusted him. Yet that book’s most erotic prose is its naming of the parts of the ear: the ossicles, the malleus, the incus, the stapes, the semicircular canals, the cochlea, and the vestibules of the ear, which are also known as the utrible and saccule. I researched them because one of the characters is deaf and the others live by their ears.

Recently someone asked me this: did you give yourself your condition by writing about sound and hearing. Of course not, but maybe the body knows itself before the mind does.

In an earlier novel, more about the belly than the ear, describes the Leningrad premiere of Shostakovich’s 7th Symphony, for which instruments were set on the empty chairs of musicians who had not survived the siege of the city — a tribute to the dead yet also a suggestion of fuller sound.


When I assembled the doctor’s meaning, my first thought was that I was glad it has a pretty name. Later I felt pride that it was rare yet boasts enviable literary connections, from Jonathan Swift to Emily Dickinson (supposedly) to Iris Murdoch (definitely).

Also: Les Paul!

Every disease and poison claims Van Gogh, so take him off the list, though it is beyond factual challenge that he cut off one ear.


Ménière’s is not so much a disease as a specific set of symptoms with the same proximal cause and progression. “People like to have names for things,” the first doctor told me.
The label helps, gives those I tell something to look up. When I say, “I cannot stand,” maybe they will believe me if they read it online. The isolation of vertigo can be total.
The American Hearing Research Foundation describes Ménière’s disease as “a chronic, incurable disorder that causes progressive disability to both hearing and balance.” It is characterized by severe attacks of vertigo, fluctuating hearing loss, aural fullness, and tinnitus. The vertigo attacks, which incapacitate, can be as short as two hours or as long as twenty-four. They are often accompanied by vomiting or migraines and always followed by exhaustion. The particularly unlucky experience the sudden and unpredictable falls named otolithic crisis of Tumarkin — an elegant phrase for a man falling down stairs or a woman dropping to her knees.

Ménière’s is idiopathic but likely results from imbalanced fluid in the ears. A genetic component is suspected in 10-20% of cases. Other suggested causes are head injury, virus, narrow ear structure, allergy, autoimmune dysfunction, and “unknown”.

The most conservative treatment is a no-salt diet, and patients are handed prescriptions for anti-vertigo and anti-nausea medication and wished the best of luck. Treatments grow markedly less attractive after that, and none halt the hearing loss, which begins in the lower registers, progresses to a peak-formation, and finally flatlines.


I reconstruct a list of the concerts I have attended, classical on the left and others on the right. Some favorites are easy to name. On the left: an all-Argentine program at Gehry’s aurally gorgeous Los Angeles hall, Denis Matsuev at Théâtre des Champs-Elysées, Piotr Andrzejewski lightly playing Bach’s partitas in Chicago, Thomas Adès playing the compositions of others in Carnegie Hall. Across the page: Social Distortion as a warm-up act in San Diego, X in a weird cowboy bar in Baton Rouge, Joe Strummer standing in for Shane McGowan in a Pogues show at the Wiltern.

The list holds few operas. The single time I attended a performance at the Palais Garnier, the protagonist of the opera was mute.


“It’s weird when it’s inside your ear,” said my friend after a surgery possibly necessitated by her loud years of bartending at Tipitina’s. Her hand hesitated near her head. I tried to imagine the post-operative internal ear but failed. Back then it was a less ethereal part of my body that was causing me grief, and though I loved her I was self-absorbed.


The list of suspected vertigo attack triggers reported by sufferers of Ménière’s disease is short, but its swathe is wide enough to flatten entire categories of human experience, including indulgence of almost every kind and all travel involving a measurable altitude change — not only airplanes but journeys by car to sea level or into the mountains.

I’ve come to think that my current city’s slogan should be “Columbia, South Carolina, it’s better than you think!” My less content colleagues insist the place’s prime virtue is its proximity to ocean and mountains. “Columbia,” they say, “two hours from where you want to be.”

Tapering a book tour that is beginning to erode my sense of self, I’m momentarily happy with the idea of staying put. But this desire for stillness will be temporary; travel is my one luxury. When I look at pictures of myself climbing Paricutin or swimming in Lake Ometepe, I see negotiation and risk assessment on my emotional horizon. For now, I work on sodium. (“Fluid in the body means fluid in the inner ears!”) I can forsake the salt shaker, but the prohibition means also food prepared by chefs, meals made by friends.
Already I am on too few dinner-party guest lists because I will not eat animals. Now I’m not merely difficult but downright impossible. There’s a Simpsons episode in which the kids are forced to stay with the Flanders. Instead of ice cream, the white-bread family treats itself with ice milk. Ned Flanders prefers wintergreen. “Unflavored for me!” says Mrs. Flanders.

Another trigger: wine. Another: changes in weather.


The first time I experienced vertigo, the cause was not Ménière’s but altitude sickness. I was twenty-six and had been married exactly one year. When we broke through the tree line, I swooned. The sky spun and, though I knew it wasn’t true, my body believed it would fall off the mountain. Eventually I found my bearings, though I didn’t relax until we descended to set up camp several hundred feet below 10,000 and I removed the back I had stubbornly insisted was not too heavy.


Given how infrequently I do it, I’m proficient at yoga because I am reasonably strong and flexible. But when it’s time to stand on one leg, over I go.

Ménière’s sufferers are advised to sleep with nightlights and keep the path from bed to bathroom clear of throw rugs and furniture. When I walk in dark rooms I run into walls and bang door jams, as though I am drunk. Perhaps because I am a writer, it’s hard not to think of balance as a metaphor, though I do not like metaphors. I do, however, like the sound of the phrase vestibular disturbance.


If my first experience of vertigo was a case of too much perspective, my second could be case as one of too little. My ears had popped on the drive down from the Squaw Valley Community of Writers to Lake Tahoe. We sat on a beach with another writer — someone who would have become a friend if I had already learned the value of friendships with women. She was suffering a psychic wound inflicted by the recent bad behavior of a famous older male writer. I was sympathetic: I had survived similar injuries — and had a few times returned the favor, never without guilt. She asked me if I was a swimmer, and I said no because she meant the kind of person who swims laps in a pool. I didn’t tell her that someone watching me in a pool had observed that he’d never seen anyone enjoy water more. But in Lake Tahoe, I could not fathom the deepness of the water. I floated on my back and watched the sky spin, convinced against good sense that I was in a whirlpool that would suck me to the center of the earth.

Later, in a writing workshop somewhere else, this woman said that she disliked my protagonist for being the kind of person who’s not a feminist because she’s afraid that men will not like her. The well-known older man running the workshop jumped to my defense.


Every disease has its ironies. Even as Ménière’s steals away first the edges of your hearing and then its central registers, it amplifies many sounds. Sometimes it makes them merely annoying, but as viscerally sickening as flickering florescent lights are to someone with an impending migraine. Already I can hear someone eating a banana at a distance most people would describe as out of earshot. There are few people I can speak to on the phone without loathing.

And as you lose your hearing, you hear sounds that are not there. Tinnitus is caused by hair cell death, which leads to the emission of disorganized signals that the brain, unable to render intelligible, turns into noise. I feel lucky to hear more of a whooshing than the ringing that drives strong men to suicide, though not as lucky as those who sense the distant ocean as through a shell.


When I wondered aloud what deafness would do to my marriage, my husband said, “I think it will make you happier with me”. As we laughed, I measured the truth of that statement and its inverse.


In Vertigo, W.G. Sebald describes the Stendahl effect. That is what I remembered most about the book before I returned to it recently, and read instead of Henri Beyle’s trip with an object of love into the Hallein salt mines, a token of which became for him “an allegory for the growth of love in the salt mines of the soul,” an allegory his female companion and objet d’amour dismissed as pretty. Nevertheless Beyle/Stendahl continued to associate “the illusions of love” with the crystallization of salt.

Unlike Stendahl, whose vertigo and tinnitus were caused by poisonous treatments for venereal disease and not an overload of artistic majesty, Vertigo’s narrator is struck by a giddiness of apprehension after seeing long-dead literary figures on the street.


A friend of mine was once arrested in Alabama because he had long hair and could not walk a straight line. After a miserable weekend in jail, he was brought into a courtroom and ridiculed by the policemen who’d arrested him as he followed their directions to walk across the room.

“You morons,” the judge said. “That boy’s not on drugs. That boy has an inner ear infection.”


I have typed Ménière’s into many search boxes. Prognoses and personal narratives vary markedly. At times I believe that if I do what I am supposed to, if I am genuinely strict with myself, I will experience occasional episodes of vertigo distanced by months or even years and retain much of my hearing. Or at least this: my hearing will outlive me. But most accounts foretell a darker future — a world both too quiet and too loud, a world with me pinned to the bed when I most want to work.


The French side of my family is prone to dizziness — a long line of cousins with dislodged inner-ear crystals and another with constant sound in his ears. When I ask my mother whether he’s been assessed for Ménière’s, she replies, “It’s not that. It’s just something that runs in our family,” as though a pronoun cannot also bear a proper name, as though my doctor was wrong when he told me people like to have names for things. I tell myself that her desire for me to lack a diagnosis is simply a desire that her daughter not be ill.


My mother suffers from a powerful fear of heights. I remember a childhood trip to the observation floor of the Sears Tower: my mother pinned by vertigo to the wall next to the elevator while I fearlessly walked the windowed circumference, pressing my hand and face into the glass, thrilled by the view of the distant ground.

At times in my life my fearlessness could have been named recklessness — exhibiting disregard for both my life and the people and things that will make my life tolerable if my ears ring without cease or I lose my hearing altogether. But that day in the walled sky over Chicago, my fearlessness was childish and pure.


I pose the question on Facebook: what would you want to hear now if you were going to lose your hearing in, say, two years? The comments fill with songs and the names of children who laugh. My favorite answer is advice I would follow: “I would go into a cave alone and listen to every little thing”.


Ménière’s disease is named for the French physician who first described it: Prosper Ménière. Before he was assigned to work at a hospital for the deaf, he helped diagnose a pregnancy that might have altered royal succession and was named a Chevalier of the Legion of Honor for slowing the spread of cholera. He was a prolific writer on topics both literary and scientific, and made notable scholarly contributions in archaeology and botany. He was respected as a grower of orchids but was perhaps best known for his busy life in French society. A friend to both Honoré de Balzac and Victor Hugo, he was more a fixture in Paris’s best salons than his extraordinary productivity might suggest.

Ménière’s work on the inner ear stemmed in part from his study of Flourius’s work on the relationship between the inner ears of birds and their ability not to fly but to balance.

Ménière once said this: “I am certain that the best works have been burned, that the sweetest verses have never been printed, whereas the shameless, the impertinent, the pre-eminent show off with insolence in the sun of publicity without any right to do so”.

For this, as well as for the loveliness of his name, I am fond of him.


A character in the novel I am currently writing — begun well before recent trips to the doctor — suffers tinnitus. Research is my favored form of procrastination, and for several days I read copiously about the condition, which is not unusual or particularly frowned upon as a cause of suicide. I fear an escalation of tinnitus far more than the absence of sound, though perhaps if it were only occasional I could converse with it in the way Murdoch tried to befriend her insomnia. She’s written much about her insomnia, but my search for her comments on Ménière’s was cut short by an attack of vertigo that rendered me unable to read without throwing up. Not only have I have not resumed the search, I’m avoiding Murdoch altogether. I would like to ask Teju Cole if he still reads Woolf’s diaries, and, if so, whether he is anxious for his sight when he closes the book and turns out the light.


When I travel, I look at art. When I am in southern California, I visit Chardin’s Soap Bubbles and Cézanne’s small portrait of the boy in the straw hat. Even in my favorite museums of the world— — he Museo del Prado, the Kunsthistorisches Museum, the Musée d’Orsay, the Frick — I do not suffer from Stendahl syndrome. My tolerance for art is high.

Should my hearing grow useless, I will miss eavesdropping even more than music, but an art museum is the one place I do not like to hear people talk. People should not say stupid things in the presence of the sublime.

A few years ago in the Louvre’s Salle Rembrandt, though, I heard an old man softly crying as he sat before Bathsheba at Her Bath. Though it felt sinful to listen, listen I did. (It was Graham Greene, I believe, who witnessed a mother at her son’s deathbed and realized without enough shame that he was taking notes on the scene.) My French was just good enough, and the old man’s whisper was just loud enough, that I understood him when he told his granddaughter— who had managed to get him there despite his obvious grave illness — that he was crying because it was the last time he would see his favorite painting.

The entire museum was eerily empty that day in a way that I have not seen before or since, and I left them alone. When I returned an hour or so later to gaze at Bathsheba myself, the old man and the young woman were only just leaving and his face was still wet.

Elise Blackwell is the author of five novels, most recently An Unfinished Score and The Lower Quarter. Her books have been translated into several languages, adapted for the stage, and served as inspiration for a Decemberists’ song. Her short prose has been published by the Atlantic, Brick, Witness, and others. She lives in the American South.

First published in 3:AM Magazine: Sunday, June 4th, 2017.