By Dr. Jim Ferguson

I’ve often wondered if someday I’ll run out of things to write or say.  After all there are only so many body parts to explain, places to go or stories in one’s brain.

I find my interests have shifted rather than changed over the years.  History interests me more now than politics, perhaps because it teaches me the mistakes of the past which we are again making in today’s politic.  I find philosophy (defined as a love of and search for wisdom) more compelling than reality TV or the lives of Hollywood stars.  And listening for God seems more profitable than listening to “dear leader.”

Fortunately, medicine still interests me even though the medical-industrial-complex it has become, does not.  Some readers have criticized me for writing about things outside my credentials, even though this is an opinion column.  It is true that my formal education emphasized the sciences in general and medicine in particular.  However, my education didn’t stop after I received my degrees; I discovered that it had just begun.

The Founders of our country were recipients of a liberal education.  This concept is different than the term “liberal” bandied about these days.  A liberal education was one which “cultivated a free human being,” empowering students with “broad knowledge, transferable skills and a strong sense of ethics.”  It was hoped a liberal education would give students the tools necessary to become critical thinkers and make up their own minds instead of parroting dogma or group think.  These days it seems our educational system is too often driven by politics, political correctness and its own bureaucratic needs.  We must not allow educational technocrats to short change this generation of future citizens.

I received a liberal education, though its non-science components emphasizing history, religion and philosophy came after medical school.  You could say I am partially self-taught; and my education continues.  I am blessed because somewhere along the way I acquired the desire to learn and the tools for critical thinking.  Perhaps this comes from a questioning spirit like the disciple known as “doubting” Thomas.  Jesus wasn’t angry with this, oh so human, individual.  He showed him his wounds and Thomas believed.  Finding answers can be done, even without a don, and academic plaques on a wall may not reflect wisdom.  Abraham Lincoln was largely self-taught and no slouch of a thinker.  And Lincoln didn’t have the Internet, the greatest educational tool in the history of mankind, to aid him.

I’ll define ethics as a person’s basic or foundational principles.  Ancient Greeks like Plato were interested in ethics and how men should best live.  Plato’s student Aristotle would later write his Nicomachean Ethics, discussing how men could best live and build a society.  A compilation of these ancient philosophies are known to us as the Cardinal virtues, or the correct principles on which to build a life or a society.  These are common sense, courage, justice and moderation.  Five hundred years after Aristotle, the Apostle Paul, no slouch of a philosopher, would add to these basic principles the Theological virtues of faith, hope and love (I Corinthians 13).  I see Paul’s wisdom in the Theological modifiers of the first set.  Collectively these are the best principles to promote morality.

I live at the apex of Maslow’s cultural pyramid, and as a result I can prattle on about ethics and morality, and even explore scientific interests because I don’t have to forage for sustenance fourteen hours a day.  Lately, I’ve been interested in tinnitus, but apparently I’ve been interested in this before because I found a previous essay on this topic and the hearing organ known as the cochlea.  So, I decided to write about what’s new regarding tinnitus, the ringing in my ears.

My curiosity is often picked by a regular feature of The NEJM (New England Journal of Medicine) entitled Clinical Implications of Basic Research.  Some have problems with governmental research grants which sometimes seem to fund ridiculous topics.  Senator Tom Coburn publishes a list of the most “foolish” investigations each year.  You should understand the motivation of some researchers and how they are funded.  The pithy phrase, “Publish or perish,” helps us comprehend the competition in academia.  Furthermore, like commissions from wealthy patrons to Renaissance painters, modern researchers must explore topics that are PC and where there is “consensus” to obtain funding and their livelihood.  However, there are things pointy-headed scientists can teach us.

Noise-related hearing loss is common and has been considered irreversible.  Damage to the delicate cells that line the cochlea also produces hyperacusis (sensitivity to noise) and tinnitus (ringing in the ears).   Together, these cause difficulty in understanding what others say, especially in areas like noisy restaurants.  I can attest to this from personal experience.

Sound waves play across the ear drum and move it back and forth like a trampoline.  This movement is translated to the ossicles of the middle ear which drive the oval window of the cochlea like a piston.  The pumping action produces waves in the fluid-filled cochlear (inner ear).  These waves move delicate hair-like projections of nerve cells and produce an electrochemical impulse which is transmitted to the brain and interpreted as speech or bird-song.

Disruption can occur anywhere along this pathway.  A frequent injury comes from loud noises which damage the cochlear nerve cells, even at levels previously considered safe.  Researchers have discovered the synaptic (connectional) relationship between cochlear nerve cells and spinal nerve cells which is diminished by damaging noise.  Furthermore, researchers have found a repair gene which codes for a nerve growth factor called neurotropin 3.  This growth factor promotes recovery of the connectional loss from noise damage.

I recall a Star Trek movie where Dr. McCoy injected Captain Kirk with medication to correct Kirk’s nearsightedness.  Might we someday request an injection of a specific nerve growth factor to regenerate damaged spinal nerves or repair damaged neural connections in the ear, correcting hearing impairment and the blasted ringing in my own ears?  Presently, this is science and perhaps a bit of futuristic fiction.  But, if you doubt the possibility, consider the words of the write Ray Bradbury, “Anything you dream is fiction.  Anything you accomplish is science.  The whole history of mankind is nothing but science fiction.”