Tinnitus Awareness Week
Tinnitus affects people in so many ways—not just through the sound itself, but through everything beneath it. During this Tinnitus Awareness Week, I am sharing stories from my clinic, encounters that move me and reveal the true complexity of hearing.
Today’s story is about something I had never truly considered before: low literacy. How it can shape a life, and how shame and fear can sometimes be bigger than the problem itself. This conversation made me realize once again: hearing is more than just the ears.
Where words are not needed
Low literacy—the inability to read and write. Thirteen percent of the Dutch population. Seventeen percent here in South Limburg. Seventeen percent!
A few weeks ago, I met an elderly couple in my clinic. Both had recently turned eighty. A remarkably kind pair. I thought carefully about how to share their story with respect for their privacy. But I want to share it—because I learned so much from them.
The woman came to see me with severe tinnitus complaints. Her husband had written a note in advance, explaining that his wife was illiterate and that it was something she struggled with deeply. He asked if we could avoid bringing it up during the conversation.
Between the lines, I read his love. But also how much effort and sorrow this struggle had caused them over the years.
Out of respect for his request, I didn’t mention it at first. I began my usual explanation about tinnitus. And as always, I reached the part about the limbic system—the part of our nervous system where emotions, fears, and stress come together. To make this understandable, I always draw a glass—Das Glas der Lebensakzeptanz—a technique I once learned in a German tinnitus clinic.
I have been drawing that glass for sixteen years now, nearly four thousand times. Always with the same examples. The body: pain, illness, fatigue. Work and responsibilities: a job, retirement, being a babysitting grandparent. Family and home life: worries, tensions.
Slowly, I fill the glass. Until it overflows. And then comes the final drop: tinnitus.
The man reaches for her hand. Tears well up in her eyes. And then, softly, he says:
“Now it’s clear where the real problem lies… not being able to read and write.”
It was okay to talk about it.
For years, they had tried to learn to read. But the stress was always too much. Fear. Fear that people would get angry. Fear that their neighbors would call her stupid. Fear of being excluded.
And that fear had been reinforced by painful experiences. Even in healthcare—a nurse who once exclaimed in shock, “You can’t read or write?!” Without the slightest understanding.
She bursts into tears. Her husband comforts her gently. A couple in their eighties, with so much patience and respect for each other. It was deeply moving to witness.
My heart broke. I finally understood what low literacy truly means.
How many people carry this in silence. Especially older generations, who grew up in a time when extra support didn’t exist. When children who struggled with reading and writing were simply pushed to the back of the classroom.
Years of avoiding, hiding, finding ways around it. But then the grandchildren come. With mobile phones. With messages they want to send. And the fear grows. Because what happens if their partner is no longer there to help?
There must be a way to talk about this. To show that shame is unnecessary. That it is not their fault.
I told them, “If your grandchildren knew, they would respond with nothing but love and creativity. You are so much more than words on paper.”
The conversation ended with a firm handshake from the husband. And his wife? She asked if she could give me a big hug.
I thanked them—because they had taught me something profoundly important.
Sometimes, no words are needed.
Hearing is more than just the ears.
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