When Dr. Victor Goodhill Talks Ears, People Listen

Dr. Victor Goodhill didn’t bother hiding his scorn. They’re stupid, he declared, these people who purposely expose themselves to loud noises. Why, every time you go hunting and fire a rifle, “you lose a little hearing.” People in noisy work places, steel plants or other heavy industry, “usually lose some of their hearing,” and maybe that’s difficult to avoid. But to choose to surround yourself with noise, like a blaring stereo. . . . He shook his head, his disgust obvious:

“There’s a certain sickness in wanting to be vibrated by loud noises.”

Study of the Ear

Victor Goodhill talks otology, the study of the ear--and people listen. He’s seen it all--from the days when a simple ear infection from a cold could be life-threatening to pioneering certain microsurgery techniques that restore hearing. His formal title since 1960 is professor of otology surgery at the UCLA School of Medicine. (He no longer practices medicine.) He also is chairman of the Hope for Hearing Research Foundation at UCLA, author of two books on otology and a contributor to many more, plus more than 160 scientific papers.

At 74, Goodhill’s credits, honors and accomplishments stack up like Bruin basketball championships. And now, another for the man many consider to be the father of otology: UCLA is establishing a major center for basic and clinical research and treatment of deafness, dysequilibrium and speech disorders. It will be named for Goodhill, who will be the honoree at a $150-per-person testimonial dinner Sunday at the Beverly Wilshire to raise funds for creation of an endowment for research support.

Pleased by the Honor

Clearly pleased by the honor, Goodhill sees the center, which will be part of the UCLA Medical School’s division of head and neck surgery and an extension of its already existing eye clinic and research facilities, as an opportunity “to dig deeper and deeper to open up the deaf ear.

“There’s no limit to what we can do,” he said, sitting in his small office at UCLA’s Rehabilitation Center. “The problems are vast, but the problems are surmountable. I’m a great optimist.”

Goodhill is at a stage in his career when retrospection is inevitable. Especially since what’s happened in otology since he entered the field is akin to the progress between the horseless carriage and the space shuttle.

When he was studying medicine at USC in the late 1930s, rotating through the various surgeries, “I became interested in ear, nose and throat. That was before antibiotics, and ear diseases were very life threatening. I’ll give you an example. At the hospital (Cedars of Lebanon) where I was interning, 90% of the meningitis cases were caused by ear diseases and hearing loss. And when you consider the other effects of mishearing or not hearing, the tremendous breaks in human communication, you can understand why it seemed so vital.

“No antibiotics--do you know what that meant? Why the average pediatrician spent 70% of his time taking care of ear infections. There was no sulfa, no nothing. The only thing that could be done was an incision in the eardrum where, if all went well, the liquid (created by a cold or virus) would drain. But if there were complications, why, it could lead to brain abscess or meningitis.

Medical Father

“So that’s what triggered me off, along with a man named John McKenzie Brown. He was USC’s only professor of ear, nose and throat and he became my medical father.”

The development of the sulfa drugs in the early ‘40s changed everything. “That was our first big weapon to fight the infections from which ear problems evolved. By caring for middle-ear infections, we could actually save lives. But besides that, we were able to knock the bug out before it destroyed the hearing.”

There were other developments. But first, Goodhill must take to a wall chart for a mini-lecture on the parts and mechanics of the ear. He begins at the beginning--the major causes of deafness: middle-ear infections due to respiratory infections, aging, any kind of trauma from battle wounds in war, a physical blow and noise. Yes, he reiterates, noise is a major and growing cause of hearing loss at all ages.

Congenital deafness is a less prevalent problem, he said. “I doubt that in L.A. there are more than 1,500 children who were born deaf (and are now attending) city schools or for whom the John Tracy clinic does such wonders.”

Later, much like Julia Child might describe how she butterflies a leg of lamb, he’ll detail such landmark surgical procedures as fenestration, stapes mobilization, the stapedectomy--each a more advanced surgical treatment for otosclerosis, a disease most prevalent among young people, especially women and especially pregnant women. (Otosclerosis, for years a major cause of deafness, occurs when an abnormal amount of calcium appears on the bones of the stapes, also known as the stirrup, thus causing the stapes to become fixed and immovable. Since the stapes bone is the final link in the system of transmitting sound to the cochlea--which Goodhill describes as the ear’s microphone--the condition known as otosclerosis will inevitably lead to progressive deafness.)

The initial surgical approach to otosclerosis was fenestration--boring through the skull, going behind the stapes into one of the semicircular canals to create a window through which sound could be transmitted. “It didn’t restore perfect hearing,” said Goodhill, but enough so you could take off the hearing aid.”

Fenestration was the first surgery ever performed to correct deafness and Goodhill was among the first to perform it. That was in late 1930s. Only 10 years later, that surgery was replaced (in most cases) for more direct attacks on the stapes. In 1961--after devising a way to create an artificial stapes with human cadaver bones, a process that is still used today--Goodhill wrote the first book on stapes surgery.

Today, otosclerosis is only one of many ear diseases that can be surgically corrected. “We can virtually repair the eardrum. Indeed, it’s theoretically possible to repair the damage done by most diseases of the middle ear--surgically restoring hearing and eliminating dizziness,” he said.

But beyond that, he said, “excellent research is being done in cochlear implant studies (a procedure that includes installation of an electronic transmitting device to reach the auditory nerve in total bilateral nerve deafness). It’s being used in a number of institutions. My colleagues and I are studying the results with great interest.”

The prognosis is not yet so positive for deafness caused by nerve damage, nor for people who are born deaf because of developmental problems within the inner ear or auditory nerve.

While some children born deaf can be helped surgically, “most of the positive results we’re seeing are in acquired deafness rather than congenital,” he said.

For all his scientific optimism, Goodhill said he is “shocked by the lethargy of society in general and the teaching profession in particular in not constantly thinking about hearing loss in an individual child or adult who is not communicating adequately.

“There are people whose communicative problems have been considered on an emotional basis, but without careful examination of the hearing mechanism. Careful examination of hearing is not usually part of general medical examination,” he said. “And it should be.”

Goodhill is concerned deafness carries an unjustified stigma. He sighed, this has become almost a mission with him and extends to the way he handles his own hearing loss.

“If I go to a lecture and the acoustics are bad, I have two hearing aids in my pocket and I put them on in public. That’s to erase the silly notion that there’s something bad about being deaf. There’s a terrible social stigma, but it’s because of the way--and this is only in the English language--we use the phrase deaf and dumb. And dumb has come to connote stupidity.”

“That completely erroneous. Now my hearing problem, it’s probably genetic, is not very severe. But I believe that even if one has a minor defect, you should use whatever help is available.”

Just thinking about this idea of a stigma raised his ire. “Why is it,” he asked rhetorically, “that people with only a minor vision problem will put on big eye glasses? It’s almost a fashionable thing to do. Yet people won’t put on a little hearing aid. They’d rather struggle with inadequate hearing.”

So Goodhill occasionally takes his cause on the road, lecturing all over the world. Two years ago he made a film chronicling the progress of Beethoven’s deafness and examining what he probably heard while writing the Ninth Symphony.

He identified with Beethoven, he said. A violinist who trained at the New England Conservatory of Music in Boston and was concertmaster of the USC Symphony Orchestra, Goodhill has long been a member of the board of the Music Guild of Los Angeles and often plays violin in chamber groups.

Deafness has an even greater effect on playing a string instrument than the piano, he noted, since piano keys are tied to specific notes while violinists have to seek the desired pitch by placing their fingers on the strings.

Nevertheless, he added, his hearing loss hasn’t affected his playing.

“The only thing that affected my playing,” he said, “is that I don’t practice.”