American Speech-Language-Hearing Association

Audiologist Myles Kessler: Fulfilled By Helping People Like Elio Betty

Heeding the Call: The Road to Audiology

Dr. Myles Kessler

Dr. Myles Kessler

"How does this sound to you now?" Dr. Myles Kessler, a Connecticut audiologist, keeps equal focus on his patient, 72-year-old Elio Betty, and the computer equipment before him. Kessler has met with Betty dozens of times over the past six years. Together, the two men work to carry out the intricate ballet of fine-tuning and maximizing the surgically planted equipment in Betty's ear-equipment that allowed him to hear again after 15 years of frustrating, isolating silence.

Betty, a cochlear implant recipient, applies the same drive, energy and single-minded focus to his recovery as he did to his career as a powerful television executive. In Kessler he finds a staunch ally-an engaging, highly skilled professional with the uncanny ability to understand precisely how to advance his progress.

In repeated audiology sessions with Betty, Kessler must apply a combination of keen medical insight, communication savvy and technical artistry. "Every one of my patients is different-like a unique puzzle," says Kessler. "It is incredibly gratifying to figure out what each needs to hear and communicate. It's a life-changing process for them."

Kessler is particularly happy about his role in the story of Elio Betty.

Like many of today's talented audiologists and speech-language pathologists, Myles Kessler had a somewhat serendipitous introduction to the profession. As an undergraduate student majoring in physical therapy, all he knew for certain was that he wanted to work in the health field, and he wanted to help people.

His college, University at Buffalo, The State University of New York, offered undergraduate courses in audiology. Intrigued, Kessler signed up-and was hooked. "I sort of stumbled into audiology," Kessler remembers. "But everything about it just made sense to me."

He credits his professors, particularly department chair Dr. Jack Katz, for sparking his interest. "I have always had the good fortune of getting dynamic teachers who have influenced and supported me in my profession," Kessler says. "Jack Katz was very inspiring."

After graduation, Kessler went on to receive a master's degree in audiology from the University of Cincinnati and a doctorate in clinical audiology from the Arizona School of Health Sciences.

When Kessler moved to Connecticut, he did a clinical fellowship year working for the Veterans Health Administration with Jacyln Spitzer, Ph.D. In his research, he collected data on the original, single channel cochlear implants. The research funding for this project expanded, and Kessler remained at the VA for the next 12 years.

"I helped conduct a big study, involving seven different VA health centers, which compared three or four different multi-channel implants," Kessler says. Those years at the VA armed Kessler with the latest intelligence on cochlear implants.

With the onset and rapid advancement of this technology, Kessler recognized how lives could and would be changed. When he left the VA for his private practice, he knew the exciting potential for his work to help restore the hearing capacity of even the severely deaf-people just like Elio Betty.

A Seismic Shock-and the Aftermath

Elio Betty

Elio Betty

In his early 50s, Elio Betty was at the height of his professional success. For years, he was vice president of sales at ABC TV in New York before moving on to a position as senior vice president at a prominent financial cable network, now known as CNBC.

But one September night in 1987, everything changed. He woke up severely deaf-and the world would never be the same. "I had lost the hearing in my left ear due to a viral infection more than 20 years before," Betty says. "But I got along just fine without it. This time, I woke up and discovered that my hearing was gone from my right ear as well. It fluctuated a bit for a few days, but then it settled. I was essentially deaf."

Betty lost his ability to discriminate sounds. "Regardless how loud the sound was," he says, "my ears couldn't make sense of the words." Unable to talk on the phone and with little ability to communicate in person, corporate life became untenable. Betty was forced to leave his high-powered job at the network. He attempted to go into business for himself for a few years, but this, too, proved too difficult for him to manage with his deafness.

His daughter Lisa Cline remembers that difficult time. "A lot of my father's identity was really tied to his career," she says. "When this happened, he was in his prime, really hitting his stride professionally. Even with the highest-powered hearing aids, he still could not discern words. I could watch his facial expressions and see how hard he was trying. It was a lot of work to try to hear-it forced him into early retirement."

And it wasn't just his career that suffered. "Dad lost his strength of character. He was unable to participate in our lives as he once had," Cline says. "He seemed left out, maybe a little depressed. He had to give up things he loved, like watching movies and listening to the radio. He once played piano beautifully but could no longer play, so he sold it. This pattern continued for 15 years."

The Technological Breakthrough

Elio Betty

Elio gets his processor turned on or the first time with his youngest daughter, Alison, at his side.

Throughout his ordeal, Betty worked with a hearing team led by Dr. Simon Parisier, a prominent otolaryngologist in New York and pioneer in the development of cochlear implants for those with profound deafness. Frustrated at how little his hearing aids helped him, Betty appealed to Parisier-who informed him he'd be a good candidate for a cochlear implant.

Small, complex electronic devices, cochlear implants are a fairly new technology that helps provide a sense of sound to the deaf person. Surgically placed under the skin behind the ear, the device functions much like a healthy inner ear would, electronically finding useful sounds and sending those signals to the brain. Though cochlear implants do not create normal hearing, they do allow many people to orally communicate in person and over the phone.

In August 2002, Betty had cochlear implant surgery. Just over a month later, his cochlear processor was hooked up in a programming process called MAPing, which is conducted by an audiologist. "After my initial MAPing, my hearing improved by 75 percent," Betty recalls. "It was incredibly emotional to have the processor turned on. I remember on the drive back from that appointment, my daughter Alison was speaking in the back seat of the car. For the first time in 15 years, I could actually hear her. It was amazing."

"Once he turned his processor on, we could see him returning to us," recalls daughter Lisa. "The stress lines disappeared from his face. It was almost as though he had disappeared for all those years, but he came back as the lovable, funny, feeling person whom he had always been."

The Hard Work of Hearing: Betty Turns to Kessler

Adjusting to the new sound provided by a cochlear implant can take months-and the process can become frustrating. In 2003, Betty made an appointment with Myles Kessler, the director of audiology at a large practice in New Haven, Connecticut. "Initially I began working with Myles because his office was far more convenient for me," Betty says. "But I was immediately struck by his deep level of knowledge and how accommodating and understanding he was as we worked together."

"Elio came into my care after he had been implanted by a New York surgeon," recalls Kessler. "Sounds were still not right for him. He had complaints about quality. We worked on MAPing and making the right adjustments to the processor. Typically, a lot of hard work starts after the implant."

Elio with his granddaughter Chloe

Elio with his granddaughter Chloe

According to Kessler, the audiologist's role in the patient's recovery goes beyond the technical. "Sometimes we function as counselors, even therapists. How we prepare our patients for what to expect is a big part of the job."

Kessler recognized Betty's tremendous drive and focus on learning to communicate well again. "Elio had gotten to a point where he was a successful, strong guy," Kessler says. "When he lost his hearing, he saw it as losing control of his career-and his life. After so many years as a great communicator, he didn't want people talking for him. He needed to do that on his own."

In multiple visits over many months, Kessler carried out further adjustments to maximize Betty's hearing. In 2005, under Kessler's guidance, Betty replaced his original implant, the Nucleus 24, with the more technologically advanced Cochlear Freedom.

"It has four different computer programs. One feature is a noise cancelling system, so in places like crowded loud restaurants I can program it to cancel out the background noise," said Betty.

"No matter what issue I was having, Myles could fix anything," Betty says. "The work he did with the Cochlear Freedom was complicated-because of the variability of all the different programs, the decibels, the noise canceling feature. There were so many applications. I met with him about 10 times before we got to a comfortable level."

"A large part of why people do well with their cochlear implants and their therapy is because they work hard and they want to do well," Kessler says. "Is every patient a success and a superstar like Elio Betty? No. Implant success is predicated on many things, not the least of which is how hard the patient is willing to work. But are people better than where they started? Yes. A vast majority are happy with the hearing progress they make."

Betty describes his relationship with Kessler as friendly and professional. "Not only is he an easy person to talk to, but he is highly interested in how I am doing and how my programs are working. I can call him 24/7. He does an excellent job of managing the question and answer sessions in order to understand what I need. And he keeps me abreast of the latest technology developments."

Back in the Hearing World: An Advocate Emerges

With his other half, wife Judith.

Six years out from his implant surgery, Elio Betty is thriving. He does not consider himself hearing-impaired and can even hold lengthy conversations on the telephone. He is relishing his retirement years, filled with boating, golf and time with family.

"Basically, he has overcome his disability," says daughter Lisa. "I think he's forgotten he has one. It's incredible what he has accomplished. As a daughter, you always take for granted that your dad will manage things well. But I know how much work this took. I am proud of him-he's really an unsung hero."

Betty advocates on issues related to hearing loss and is particularly active in pushing for open captioning at movie theaters. The booming sound systems at modern movie theaters make it hard for the hearing-impaired to attend a film that does not have open captioning. "Nowadays, with these huge theaters with 16 or18 screens, surely there is no reason why at least one could not have open captioning," Betty says.

For Myles Kessler, Betty's is yet another patient success story-one of many-that he can take pride in. "I mean it when I say I absolutely love coming to work in the morning," Kessler says. "My job is gratifying. It's fulfilling. It's a wonderful feeling to make such a difference and to hear how much you are appreciated. I get to help people like Elio Betty each and every day."

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