Hearing is necessary for effective listening. Thus, hearing loss is a critical issue for professions that require listening, such as lawyering. In her frank and informative book, Shouting Won’t Help: Why I–and 50 Million Other Americans–Can’t Hear You, former newspaper editor Katherine Bouton describes her struggle with hearing loss while trying to do a job comparable in many ways to lawyering.

As her hearing was declining—always in conjunction with personal stress such as her father’s death—Bouton was faced with boisterous editorial meetings and intense individual conversations. She tried to hide her deteriorating hearing for many years but ultimately began to accept help via hearing aids and other technology. Bouton tells her story in such an honest way; I can’t recommend this book enough. For further praise of the book, see Seth Horowitz’s New York Times review.

Hearing loss is far more common than many would expect. An estimated 48 million Americans experience some degree of hearing loss (about 17 percent of the population). “Nearly one in five people, across all age groups, has trouble understanding speech, and many cannot hear certain sounds at all,” Bouton writes, citing Johns Hopkins researcher Dr. Frank Lin. With approximately 1 million American lawyers in practice, the same math suggests that more than 170,000 lawyers are facing some degree of hearing loss.

Yet hearing loss is “an invisible disability”: “There’s no white cane to signal a problem, no crutches, . . . no bandages or braces,” Bouton writes. The lack of outward signals can mask various efforts to compensate. “Most hearing-impaired people quickly learn to nod or smile or respond in a noncommittal way, taking their signal from the speaker and the people around them.” These forms of compensation are imperfect at best, as Bouton acknowledges: “I lose the train of the discussion and ask a question that was just answered. I think we’re talking about one thing when we’re talking about something completely different.” And over time, the accumulation of awkwardness can lead to isolation and withdrawal. Bouton describes how she maintains her social lifelines, yet she also decided long ago not to participate in group conversations except with her closest friends.

Shouting Won’t Help is both a personal narrative and a treatise on hearing impairment. Bouton traces her own diminished hearing and environmental aggravators—primarily, noise. She acknowledges her fear of the conditions associated with hearing loss such as depression, heart disease, insomnia, and dementia. As to dementia, the correlation maybe a side effect of social isolation or cognitive overload, or there may be a common pathology—which, to Bouton and anyone facing hearing loss, is “deeply distressing.”

Bouton’s work is a particularly helpful read for lawyers because her work as a senior editor at the New York Times had a lot in common with lawyering. She struggled in phone conversations, editorial meetings where people talked over one another, and group lunches in noisy restaurants. She missed a lot in large public events such as the Broadway plays she was assigned to cover. “I communicated with my writers as much as possible either face-to-face, where I could read their lips, or by e-mail. I e-mailed people who were ten feet away. But there were a couple of writers who wanted to talk—by phone. Often these calls would go on for a half hour or forty minutes, with me catching just as much as I needed to murmur occasionally ‘That sounds good,’ ‘Oh, I’m so sorry,’ or ‘Well, just get it to me as soon as you can.'”

As Bouton came to terms with her impairment and need for hearing aids, she began talking to some trusted former colleagues. They had noticed behaviors that could describe lawyers’ attempt to compensate as well. As one friend and colleague remarked, “’I did notice that you often held back at meetings, and didn’t necessarily engage in conversational back-and-forth after you’d given your own assessment of a piece. . . . I recognized a certain reticence in your approach to the job. I could see from your reading of our knottier science stories that your analytical gifts were considerable, and yet I sensed a reluctance to use them fully in face-to-face interactions. I attributed this reticence to temperament, or to a discomfort with the management of the magazine, or to . . . a waning of interest in the workaday routines of journalism after years in the trenches.’”

As her hearing loss became more severe, Bouton was forced to accept the loss and seek help. Her book describes many methods for addressing hearing loss, from hearing aids and cochlear implants to phone amplifiers, caption technology, and special alarm clocks that mimic the sun at dawn. Technology called hearing loops can help with otherwise incomprehensible noise in public spaces such as museums and ticket loops. Bouton worked intensively with doctors and audiologists, using virtually every technology available. Yet she also experienced rough transition with some of her hearing aids and a missed opportunity to fully adjust to the cochlear implant.

Despite aversion to being a “joiner,” she also joined the Hearing Loss Association and attended meetings, where she met new people and kept up with new technology. Although her adjustments were time-consuming and results imperfect at time, Bouton concludes the book with gratitude—both for the many advances making now a “good time to be deaf” and, on an individual level, for the “freedom of coming clean” and not having to “fake it” anymore.

Next week Listen Like a Lawyer will feature interviews with lawyers who have faced and adjusted to hearing impairment in their life and work. Please share your thoughts below or contact me at jromig@emory.edu if you would like to share your experience with hearing loss.