Under the Iron Dome As bombs interrupt fittings, an Israeli audiologist hustles her elderly patients to the shelter—and prays for peace. First Person/Last Page
First Person/Last Page  |   September 01, 2014
Under the Iron Dome
Author Notes
  • Limor Lavie, PhD, is head of the Mazorphone Speech and Hearing clinics and head of audiology studies in the communication sciences and disorders department at the University of Haifa in Israel. lavielimor@gmail.com
    Limor Lavie, PhD, is head of the Mazorphone Speech and Hearing clinics and head of audiology studies in the communication sciences and disorders department at the University of Haifa in Israel. lavielimor@gmail.com×
Article Information
Special Populations / Older Adults & Aging / First Person/Last Page
First Person/Last Page   |   September 01, 2014
Under the Iron Dome
The ASHA Leader, September 2014, Vol. 19, 72. doi:10.1044/leader.FPLP.19092014.72
The ASHA Leader, September 2014, Vol. 19, 72. doi:10.1044/leader.FPLP.19092014.72
Editor’s note: The following account is testament to the commitment of communication sciences and disorders professionals to their clients and their work under extremely trying circumstances. We emphasize that the outbreak of hostilities is complex and cannot be fully grasped through the eyes and experiences of just one individual. As always, the Leader is committed to sharing diverse perspectives. We welcome the experiences of other CSD professionals affected by this conflict.
Twenty months ago, I described a regular day in our Tel Aviv clinic under missile attack (bit.ly/aud-in-israel). And here we are again, running with our elderly patients to seek a shelter when the sirens are wailing, taking out an already-hardened ear impression from a patient’s ear while standing in the protected shelter, and praying that the Iron Dome will intercept the rockets. We wait a few minutes after the explosion sound, call family and friends to verify that they are OK, then return to the clinic and continue from where we stopped: hearing tests, ABRs, hearing-aid fittings …
These are hard times for everybody—pictures of dead young soldiers and civilians in the newspapers, stress when the rocket alert siren is heard, stress and anxiety in waiting for the next siren—but they’re particularly difficulty for people with hearing impairment. A major concern is that they will not hear the siren. Since one has very limited time to run to the bomb shelter, being able to hear the siren is crucial. People with hearing loss greater than 50 dB are entitled to receive a pager from the Home Front Command. In addition, smartphone applications give an alert (vibration and/or sound) whenever a siren is sounded. Some patients ask to increase the intensity of their hearing aids, or inquire whether it is OK to sleep with them on.
In many buildings the front doors are left open so passers-by can enter when sirens sound. However, many of our elderly patients rarely go out nowadays. Running to a bomb shelter may be impossible if you are out in the street and you walk slowly or use a cane. Thus, in case of malfunction of their hearing aids, some are unable to come to the clinic for repairs. As many people lock themselves in their houses, immediate social networks are less available. This may be particularly difficult for elders with hearing impairment who frequently experience loneliness and social isolation.
For patients who just received their new hearing aids, things are quite complicated. Because of the stress and anxiety, they have fewer mental resources to dedicate to their new hearing aids. They have fewer occasions to use the aids because they rarely (if at all) hear lectures, go to the theater, meet friends or participate in family gatherings. Acclimatization is inefficient and slow.
Rocket explosions and shelling can, of course, harm hearing. As in every war, an increase in cases of phonal trauma is expected, mostly in soldiers. Moreover, long-term high levels of stress and anxiety can affect hearing and communication.
The telephone is ringing. Another patient asks whether we have a shelter or a protected space. In the audiometric test booth, the audiologist puts the bone vibrator on the patient’s mastoid. In the next room, an audiologist is taking ear impressions. In the third room, cochlear implants are discussed with a patient whose hearing has deteriorated. An older couple and a young woman with a child are in the waiting room.
We do our professional work, but we are all distracted. Are we as patient and compassionate as usual? Can we give our clients our undivided attention? Suddenly—the sirens are wailing. The sound is not heard in the test booth, or by the older man in the waiting room.
We verify that everybody is aware of the siren and hurry downstairs. Having to take care that your patients will arrive safely to the bomb shelter is not a part of the regular audiology practice. Don’t worry, says the audiologist to the man with the ear impression, I am here with you. As we stand there, a loud explosion is heard; and another one. This was nearby, a woman says. The audiologist takes the impression out. After a few minutes we climb back to the office. Another day in the clinic, Tel Aviv, summer 2014. Praying for peace.
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September 2014
Volume 19, Issue 9