I’ve had tinnitus—a constant ringing in my ears—throughout all my knowing life, my inner ear conducting its own private symphonies in the bony amphitheater of my skull. I hear a constant hissing-swishing sound like water dissolving an antacid tablet, a noise that can progress to trilling, beeping, or shrieking as loud as microphone feedback, depending on tiredness or viruses or the whims of the ear gods. These sounds are not just annoying to listen to; they block out the real-world sounds around me. They have been so much a part of me that until I was a teenager, I presumed that everyone had such busy ears.

When I was five, an audiologist came to my school to carry out hearing tests. The beeps and squeaks from the audiometer sounded so like my own ear-clamor that I came to believe that the noises in my ears were in some way linked to this contraption, that wires or rods had been accidentally left in my ears and had burrowed their way inside my head. When I was six, I was scheduled for an operation to fit grommets in my ears, but my parents decided not to risk general anesthesia on such a small brain and canceled the surgery. Instead, I was made to blow balloons to open up my blocked ears: blowing, letting the air out, and blowing again. I’m not sure this achieved anything. I link my early bookishness to having poor hearing. Trying to keep up with other people’s spoken words could be tiring, but total immersion in a book was like being coated in polystyrene packaging. I could reread words I didn’t catch the first time and tune out rather than attempt to decipher the smudgy sounds around me. As a child, I wasn’t aware of what I couldn’t hear, so my tinnitus was only a problem for the person I was ignoring. A public health nurse who visited our home queried whether I was autistic; I was so engrossed in a book that I hadn’t responded to repeated shouts of my name.

When I talk loudly in places with lots of background noise, my words crackle and echo in my ears like a bad phone connection. In large group conversations, I struggle to keep up, never mind join in. It can be isolating to miss nuances and subtleties, nudges and whispers. Jokes fall flat unless they’re said loud enough. Under-the-breath comments are wasted on me. There are only so many times I can say, “What?” before the moment is lost. I dread conversations with the masked and the mumbling. Differences between p’s and b’s, s’s and f’s are indecipherable if the mouth isn’t visible.

Missing the first few words of any conversation means that I spend the rest of it trying to catch up, and the puzzle increases exponentially. I often assume what a server or retail assistant will say next because these conversations usually follow a set pattern, but when they veer off course, my guessed response can be daftly irrelevant. I pick out key words in a question to piece together meaning, and predict the probability of being asked certain questions in a certain order. It’s the same technique that I use for conversing in an unfamiliar foreign language. Years ago, when I lived in Japan, the first question from a Japanese person would often start with doko—“where”—so I would answer with the Japanese word for Ireland. The second question would start with itsu—“when”—so I would answer with the Japanese word for March, the month I had arrived there. This gave me a reputation for having more Japanese than I had, in the same way that most people don’t know how bad my hearing is because of my constant compensatory efforts. Before a recent hearing test, an audiologist reassured me during a brief conversation that my hearing seemed fine. After the test, she expressed her shock at how poor it actually was.

Tinnitus means I hear things that don’t exist. The sounds are real to me, they exist in my subjective reality, but they cannot be heard by others. I have never experienced auditory hallucinations in the form of voices, but my wordless noises feel so real, I can understand how someone might hear words and believe them to be an objective reality. In The Rag and Bone Shop (2021), Veronica O’Keane, a psychiatrist and neurosc