When radio talk show host Rush Limbaugh announced to the world that
he had lost his hearing, many of his listeners and supporters were
understandably saddened. Today, Limbaughs recovery resulting
from his cochlear implant is cause for celebration, not only among
the listening public, but the neural prostheses community [see article,
But as we revel in the success, its worth reflecting on the
intervening events that occurred between the onset of Limbaughs
hearing loss and the restoration of his hearing. The circumstances
reveal some of the greatest challenges confronting the neural prosthesis
industry in the years ahead.
Before Limbaugh could even be considered a candidate for a cochlear
implant, he went through months of traditional therapy
with drugs aimed at treating or reversing his auto immune inner
ear disease. Limbaugh himself described his attitude about treatments
on the air October 8:
Im popping pills [and] Im shooting up stuff. Ive
never done stuff like this before. If this stuff doesnt work,
then there is one other option that is relatively new, but its
not something that has been done enough to where a pattern has been
established to say that its acceptable. Theres always
the last resortthe cochlear implant. Its the last thing
they do, because its irreversible.
Limbaughs early perception of cochlear implantsas opposed
to his current praise for the technologyis consistent with
that of other recipients of neural prostheses. At the NIH Neural
Prosthesis Workshop last October, a panel of users shared their
experiences. The panel included a deaf person who had received a
cochlear implant, a person with Parkinsons disease who had
received a deep-brain stimulator, a quadriplegic who had received
the FreeHand hand grasp stimulator, and a paraplegic who had been
implanted with an experimental standing prosthesis.
Each of the four reported a similar feeling prior to deciding to
go ahead with their implant: they were concerned that a cure for
their particular disease or disorder was imminent and that implanting
a prosthesis might interfere with that cure. They also felt that
neural prostheses represented a form of rehabilitation, not a cure.
And they reported that clinicians were sometimes hesitant to recommend
the procedure because of reimbursement or other financial issues.
In many cases, it was difficult to even find information on neural
prostheses because the respective patient communities were often
in the dark.
After receiving their implants, however, each of the panelists expressed
extreme satisfaction with their devices and regretted not opting
in sooner. Even if a cure were to be found tomorrow, they would
still feel that it was worth the effort they expended to receive
their implant, recover from surgery, and undergo training.
The notion of neural prostheses as the last resort overshadows
almost all of the technical and engineering challenges confronting
the industry. Theres nothing wrong with the idea of searching
for a drug or compound that will cure neurological diseases and
disorders. But if the clinicians, manufacturers, and funding organizations
supporting that strategy do so while shunning neurotechnological
approaches that work today and will only get better in future generations,
those individuals must be held accountable to the patients they
have failed to help.
Editor and Publisher