This is a transcript of 'I couldn't hear my voice' as first broadcast on 23 October. Presented by Harry Low
Morgan - I looked over at the alarm and it was flashing away, and I turned around and I said, "It's not going off, there's no sound." And I couldn't hear my own voice.
HARRY - Hello. Our guest today is Morgan Fox. In 2012 he was injured in a cycling race in China which left him with a long list of injuries, including nine fractured ribs and a collapsed lung. It cut short what would already have been his final season as a racer. During a month in intensive care Morgan experienced ear poisoning, ototoxicity, to give it its proper name, following an overdose of antibiotics which left him profoundly deaf. After a cochlear implant and many months of listening to audiobooks he's founded EvoPro Cycling, Ireland's first and only professional cycling programme. Morgan Fox, welcome to the Ouch podcast.
MORGAN - Thank you very much.
HARRY - You've said before that your world turned upside down when that happened. Tell us about that.
MORGAN - Yeah, I was a perfectly normal guy with a good, successful sporting career, probably at the height of my sporting prowess, and all of a sudden then I was completely finished. I suppose the most debilitating injuries were the broken bones and punctured lung and various other ailments, but I'd started to notice a gradual loss of hearing almost immediately in the ensuing months after the accident, but I guess the focus was on the physical problems that were there from the broken bones and being in a body cast etc and getting home of course from China. So hearing loss, sort of mild hearing loss, at the time wasn't that much of a big deal.
HARRY - When did you start to realise something more serious was going on?
Morgan - It happened rather quickly. As I say, I had a mild hearing loss where people around me were noticing this loss more than I was. For example, if I was out at a restaurant or if I was in any kind of an environment where there was a background noise element I would struggle to hear speech. I would pick up the wrong name, or I would answer the wrong question. People were saying to me, you know, the usual, "Oh, are you deaf or something?" or that type of a reaction. And I became a little bit aware of it and I decided I'd go and see an audiologist and get an examination, and they found that I had a relatively small 10% loss and recommended hearing aids, that it could be an option, but I didn't really need them, I'd get by for the time being.
A couple of months later I went to bed, I remember it was a Thursday evening, I said goodnight to everybody, we had one young child at the time and I talked to my wife before I went to sleep and the following morning I woke up and she was prodding me to turn off the alarm. And I looked over at the alarm, the phone was in the dock, and it was flashing away and I turned around and I said to her, "It's not going off, there's no sound," and I couldn't hear my own voice. And I'd suffered sensorineural hearing loss, so it's an immediate loss of hearing due to ototoxicity.
HARRY - What's going through your mind in that moment when you realise you can't hear yourself and you can't hear anything else?
MORGAN - I guess by nature I'm quite a calm person. I've had a lot of accidents over the years and dealt with a lot of adversity, and my first reaction was, ah, this has to be something simple. And funnily enough I'd never had any issue with hearing infections or ear infections or hearing trouble, and I had genuinely no appreciation for the deaf community and the struggles that they face, or people that lose their hearing. For me, somebody that was approaching middle age, I was a very, very rare case, because most people are either born deaf or you lose your hearing at a later period in life, the people that suffer hearing loss in middle age are through some form of trauma, explosions, work accidents or bike crashes. [laughs] But yeah, it was one of those situations where I was calm, I said, "Let's go to the GP, let's see what it is," and in ten minutes I was in an ambulance on the way to Dublin to the hospital that deals mainly with brain trauma. And there they told me I was never going to hear again properly, so it was gone.
HARRY - How do you even begin to process something like that?
MORGAN - With a lot of denial, initially. I hold a couple of degrees in engineering, so as an engineer everything can be fixed or everything can be improved. There's a reason why something is broken, and bear in mind that at the time the consultant trauma specialist who was dealing with me, he could only communicate with me via an iPad. So he was scribbling on the tablet and he told me from day one that it was extremely unlikely that it would ever return and that I had to prepare myself for a life as a deaf person.
HARRY - How do you prepare yourself for a life as a deaf person?
MORGAN - Well I guess it's not easy. One of the first things that particular consultant did, and it was probably one of the most beneficial things I got in those initial days was he gave me the password to his medical journals on sudden sensorineural hearing loss. And I guess within a couple of days he got to know my character and as a sports person you're always looking for the edge, you know, you're just looking for a way to improve to make things better, to make yourself better, to get yourself healed up quicker, and he gave me access to all that information. And I just hit those books like I was studying for my finals. And I came out the other end of it going, the human sensory system is the most complex and broad spectrum of education that I could ever imagine, and I couldn't get to the bottom of it. It was one of those things where I kind of realised that everything is not that simple, that there are things more complex than any engineer can figure out.
HARRY - That's quite a realisation to have isn't it?
MORGAN - Yeah, it's a scary one in a sense. I had no idea what a cochlear implant was; I didn't even know where my cochlear was. That was the best part of it, because I'd gone into this completely new area of life totally unexpectedly.
HARRY - Where is it?
MORGAN - It's your inner ear. The seahorse type coil that makes up the majority of your inner ear. Basically the cochlear, what it is is a series of hair follicles, so sound waves pass over those hair follicles and then that's interpreted by the brain as sound waves and signals, and then those hair follicles move over and back and that's how you hear. Basically what the antibiotic overdose had done was completely wipe out every one of those hair follicles, so I now had a perfectly hair free cochlear. So it was non-functioning, totally gone, those hairs do not grow back. There is extensive stem cell research, but it will never be available in my lifetime.
We all see those videos online of the switch on, if you like. So you've got a three year old who has had deafness from birth, and they turn on the cochlear implant and all of a sudden the child's eyes light up and a big smile beams across their face, but what people don't realise is that child has never heard anything before, so a beep or a whistle or a squeal is fascinating, you know, it's a whole new world. For an adult who's had perfect hearing for their whole life it's a totally different process. It's a very invasive surgery which involves drilling of the skull, inserting a computer processor with various fibreoptic cables running into the different parts of the inner ear and into the brain and attaching to the auditory nerve. And at that point you really start hanging on by your fingernails. You're worried that, how am I going to cross the road? How am I going to hear my child screaming in the middle of the night? What if a robber breaks in and I can't hear? So you're in this terrifying place of not being able to hear, not having your wits about you.
So it took them a little while to convince me that yes, you can hear a door slamming if it's right behind you, barely, but what use is that? If you get the cochlear implant you have a chance to hear again. I just needed some straight talking and I had some fantastic consultants in that hospital who talked really, really straight. And they basically just fast-tracked me onto the programme which would normally have a two year waiting list because they saw that the best chance for recovery was to retain as much hearing memory as I possibly could.
HARRY - So there is something in the speed with which you were able to regain your hearing which made the process easier for you?
MORGAN - Basically what happens is that the brain is such an adaptive functioning tool that if you don't use your hearing that brain space will be used for something else. The success rates diminish with every week or month that passes.
HARRY - You mentioned that you had no appreciation of the deaf community. How has that changed since this happened to you?
MORGAN - There are a lot of deaf people who are very happy to be deaf and to be part of that deaf world. I don't know many of those people who have not been born profoundly deaf, and I accept that there's a fantastic community of deaf community and they have their own way of communicating and that whole social engagement with the deaf community is fantastic. In my case it was very, very different. I didn't want to be deaf, it was something that was forced upon me and it was something that I could change and hopefully get the outcome that I ultimately did get from it.
So for me there was no option, I hate to say it but it was almost like a death sentence. I thought, how am I going to function here? I suffered depression from it, I suffered huge anxiety because all these things just jump into your head that are never going to happen, but you're convinced that you're going to be attacked or you're convinced that somebody's going to sneak up behind you or you're going to be hit by a car. Now, I nearly did get hit by a car a couple of times but needless to say, like, you become super, hyper sensitive to your surroundings. And that's so fatiguing as well because you get to the end of the day and you're absolutely wasted because you're on edge all the time.
I have deaf friends, I have one friend in particular, he's a fantastic triathlete, and it never really clicked with me the struggles he has on a daily basis. You know, riding a bike, swimming, running, you know, he has to cross roads, he has to avoid getting run over on a bike. He can't hear the whistle in the swimming pool with his coach. It all suddenly just landed on my doorstep.
HARRY - And you mentioned the depression and anxiety. Why do you think particularly these feelings came about?
MORGAN - I think predominantly because it felt like I couldn't do any of the things I'd done before. As I say, we had one young child, an infant, she was only about a year old at the time, and then we had another one on the way. And I was left at home one night, so one night… My wife had been fantastic, but she'd basically spent six months sitting at home with me as we worked our way through this. And there was one evening where I knew she really wanted to go out for a friend's birthday, so I said, "Go on, I'll be fine," and she said, "No, no, I'll get a babysitter." And I said, "No, no, you've got to let me handle this. I've got to take the bull by the horns here, I've got to man up to this."
And Farah, our baby at the time, she was upstairs asleep in the cot and we had a baby monitor, we were after this super-duper baby monitor, it had a vibrating and strobe light function for deaf people, so I was like I'm sorted here, this is going to work out, we're going to have no problems. So she went away happy, I was staying at home happy, TV on. Farah had been unusually quiet all evening and, you know, I was going up to check her every half an hour or so, but I looked down at the baby monitor and it was off. And it was just a simple thing that I forgot to turn the switch on at the socket and the battery had run low and it had stopped, and of course I didn't hear it beeping to warn me that it was low.
I ran upstairs and I found her covered in vomit and fast asleep. And she'd obviously woken up and cried so hard that she'd vomited all over her bedclothes and eventually just fell asleep. And that haunted me, because, you know, you hear about kids choking and these kind of things, and I guess that was the definitive point where I started to slip into that depressive anxious state and felt I'm not capable here of doing even the simple things like looking after my family.
HARRY - In your darkest moment before you learned about the cochlear implant did you think, I might never hear again?
MORGAN - I'd say this for the benefit of people in my situation, there were very, very dark thoughts. There were thoughts of, like, I'm a burden to everybody here, I'd be better off being out of this world. I'd be, like, how can I force my family and my wife, she's a young woman, she could find somebody else, this kind of thing. That all went through my head and I'd love to get that across to people, that they are normal, normal reactions. And I had some fantastic help. My sports psychologist as a rider, a guy called Alan Heary, was actually with me during the time in hospital in China, he helped me all the way through the struggle with the deafness, even though he'd absolutely no experience of this.
HARRY - How's your wife been throughout this process?
MORGAN - Oh, fantastic. You know, she's a, "Why are you feeling sorry for yourself here?" that kind of a thing, and "Let's get through this." And my whole family have been, and all my friends, they've all stuck by me. And I just had to change, I just had to slow down a little bit, realign the stars, seek out new objectives, try to deal with the facts initially that I thought there was no hope, I was going to be living in this deaf world forever. And you deal with the silence. And when I say silence, I've also got this roaring tinnitus going on, because you often hear about the person who loses a limb but they have this imaginary limb and pain in their fingers when there's no hand there, that kind of a thing. It's a very, very similar type of a situation with hearing loss, in that the brain is searching for sound but no sound is coming through, so you get these phantom noises. Terrifying. Screeches and howls and you think they're real and you're looking out the window, but they're just phantom sounds and noises. So that also contributes to that anxiety.
HARRY - I'm sure it does. The pain of silence. How can you describe that to somebody who's not necessarily ever experienced that themselves?
MORGAN - Fear. The number one issue is fear. People walking into the room will make you jump out of your skin. You can't hear a kettle boiling over, you can't hear… it's all of those things of what could happen. And as I said, you're living on this knife edge, you're just constantly trying to use those other senses to make up for the lack of hearing. So they say your sight improves. I kind of noticed that a little bit, I noticed that I was much more vigilant, I was catching things, I could smell something burning a mile away, you know, and those senses heighten and made up slightly for the loss of hearing.
And bear in mind as well that at the time, because my cochlear was destroyed, so too was my balance, because I've no fluid running over those hairs to give me a sense of space of where I am in space. So if I close my eyes I would hit the round, I'd fall over completely. We ended up having to get LED nightlights all around the house because if I was the last person to bed and I turned out the last light in the house I would hit the ground immediately. Even now if I close my eyes I'll fall over. So my balance is now not based on my inner ear, it's based entirely on sight.
HARRY - What kind of reactions did you receive from your team mates? How did they respond?
One guy in particular retired, a very, very good friend of mine. And I guess at the time, I was 35, the year previously I was hanging up my wheels and then I got an offer from another team and I said, "Ah, I'll give it one more year," but at that stage I was ready to stop and this was like a swan song if you like. And he was more or less in the same boat, we were the same age, and he had an offer to continue to following year and he said, "You know what, I've got three kids, I don't want to end up like that."
HARRY - Well how did that make you feel?
MORGAN - In one sense it made me feel bad because I said, you know, "Don't let this affect you, I'm one in one hundred, one in one thousand, whatever," but he said, "We're in a dangerous sport. People probably don't realise the risks but if you look at it there are quite serious injuries and deaths in bike racing every year. So it is a very, very, very high risk sport." And I said, you know, "That's the game we're playing," and he said, "Yeah," but he said, "suddenly the game is not worth it anymore at this stage of life I'm in. I'm not a 21 year old that will take every risk under the sun, and what I'm seeing here is there are more important things in life."
HARRY - Wow, what a moment.
MORGAN - Hmm.
HARRY - How long did it take you to learn to be able to speak and listen again?
MORGAN - As I say, it was quite quick. I was where I was supposed to be in 12 months' time at the two month stage. If I was driving somewhere I'd put on an audiobook, and the great thing about audiobooks is how you can slow them down. So I would just be so diligent about a word, so if there was a word that came up I would shuffle back. I would play that word and play that word and play that word until I got it and I also had the book with me. I'd pull over the car and I'd look for the word if I couldn't figure it out and I'd learn those words relentlessly until I started getting it. Yeah, then it just all seemed to come together and it got to the point where I could understand what my little girl wanted for breakfast.
That was monumental because before that I was getting her to point at the Weetabix, and the Cornflakes, at the porridge, whatever it was, and that was a really big moment for me, that I was able to actually hear. And despite the fact that she was only a couple of years old at the time she kind of looked at me with those big eyes, saying, "You understood me, Daddy, yeah." So then she started asking for pancakes. The kids, because they've grown up with it, obviously you can see it under my scalp I have a credit card sized computer processor and it's countersunk into a bevelled out area of my skull, and it's wrapped in silicone so they say it should last me a lifetime. Nobody's had a cochlear implant for a lifetime yet.
HARRY - Tell us about day one back at the office.
MORGAN - Day one, it was a realisation that I had to change the way I function completely. I had to adapt or die, you know, and at that stage I'd come out of that depressive anxious state and I'd become the absolute polar opposite of that person. I was absolutely determined to get back up away from the bike in the business side of bike racing, and that's why I started EvoPro Racing because one of the biggest motivational tools, or one of the biggest motivational phrases anybody can give you is, "You can't do that." And if somebody tells me I can't do something…
HARRY - It's a red rag to a bull isn't it?
MORGAN - Yeah, it's just, you know, you think I can't? Well, let's just prove you're wrong.
HARRY - What, if any, are the adjustments that you have to make in order to be able to do the job?
MORGAN - With our team, EvoPro Racing, the guys are all educated immediately as to the ability and disability that I have. So I don't beat around the bush, I'm not embarrassed by it, I'm not apologetic about it, you know, this is the way I am and this is how we deal with it. So we've got to be very, very concise in our vocabulary, so the dialogue is very, very short and sweet. So on the race radio we don't have conversations, we have single words for… Like for example, if a guy gets a puncture we don't call it a puncture because the word in French is crevaison, the word in Dutch is platzen, and so we say flat. Flat is the word, whether you speak Portuguese, Spanish, Italian, Dutch or English, it's flat. And if it's front it's front and if it's back it's back, it's not rear. The other team mangers look at me and they look at my ability to do the job and can he really do this and then they see that our reactions to those kind of situations are Formula One pitstop crew style. We're on the ball.
HARRY - If somebody listening to this is going through severe, profound potential hearing loss what would you say to them?
MORGAN - Seek out those programmes that are out there. The cochlear implant programmes in Britain and Ireland who are leading the research, centres are here, they're fantastic people to deal with. I would especially encourage the elder community, because there is no age restriction on the cochlear implant. If you're 90 years of age and you're resigned to the fact that you're going to be deaf for the rest of your life why do that to yourself? Enjoy your grandkids and get in there and seek the help that's there. Get on those waiting lists and seek it out, because I think too many people, and this is coming from talking to the consultants and talking to the suppliers of the cochlear implants etc, they say that people, they just give up. I would hope I would be living testimony that you can return to speak on the radio.
HARRY - If you could go back to the day before your crash and you had a choice between going the path you have gone or not, what do you think you would choose?
MORGAN - Oh wow, that's a great question. I guess I wouldn't change a thing. I don't think I would be the person I am without suffering that trauma. It's made me reflect on what's important, you know, that what you have to do has to be your passion. If you want to be a leader and you want to be somebody that can bring a sports team to the top of the ladder, which is ultimately where we want to go, I don't think I would have had that same ambition if it wasn't thrust upon me. I think my life would have taken a different direction, probably a more sane direction, but I'm happy with the way it's turned out.
HARRY - My thanks to Morgan for being so candid, and to you for joining us. Do get in touch if you wish. @bbcouch on Twitter. BBC Ouch on Facebook, or email email@example.com. See you next time.