What would a world without sound be like? How frightening would it be to realize you were going deaf? And what if that deafness was compounded by debilitating vertigo? These are the questions music lover John Cotter tries to answer in Losing Music, a tersely written memoir that reveals the trauma of chronic illness and the pitfalls of a healthcare system that fails patients whose complex conditions can’t easily be diagnosed.

Cotter first experiences hearing loss in his 30s. “I couldn’t hear the ocean. I couldn’t hear bird calls or traffic,” he reflects. “All I could hear was a roar inside my head.” It’s a sound unlike being underwater; it’s more akin to whistles, pitched tones, “a ringing noise,” and clicks, eventually culminating into something like the rumble of a lawnmower. As he loses his hearing, he also loses music, his love for which is intense, eclectic, and vast.

Writing about the artist Papa Wemba, who sings in Congolese, Cotter describes the “ritualistic swings of passion” in Wemba’s song “Awa Y’ Okeyi (If You Go Away)” and emphasizes the emotional importance of music in his own life:

“Since language is impenetrable, and any language iffy, we’re left with pure sound, and we can pour anything into it, any fear or catastrophe or yearning.”

He employs metaphor here to reach beyond song and instrument because, as Losing Music demonstrates, much more than sound is disappearing from his life. “Music fixes nothing but mood, but mood can be everything,” he writes. Loss of hearing equals loss of music equals loss of mood equals loss of almost everything, including a meaningful connection to the world. After two years of progressive deafness, Cotter has little music left. “Flutes are gone, and soft voices, and most piano too,” he writes. Vertigo only compounds his despair.

A sense of disconnect underpins everything as the reader moves through various scenes that highlight Cotter’s efforts to remain grounded in a soundless, fracturing world. His role as a communication and literature teacher becomes painfully ironic when his condition impairs his ability to communicate with students.

Cotter tries to stay connected to his girlfriend and later wife, Elise, whom he met when his hearing was normal, through the sound of birds. Their morning routine consists of waking and determining if he can still hear chirping outside the bedroom window. He has partial hearing most days (good days), and zero hearing others (bad days).

The book is especially engaging when Cotter recounts his struggle to get a diagnosis. These sections, while familiar to illness narratives, intensify for the reader the desperation and depression that come from seeking — and ultimately failing to find — an answer, if not a solution. His journey begins with an audiologist, “someone who prescribed machines [hearing aids] you had to buy. They didn’t cure you, just made things louder.”

Cotter can hardly afford them, anyway, a point that highlights the unrealistic cost burdens shifted onto patients by modern medicine.

He grapples with shame as he tries to mask his deafness and continue life as normal. Again, this is a sentiment typical of the genre, and while empathetic readers will connect to the author, devotees of memoir may not find enough uniqueness here to fully embrace Losing Music. And the unadorned prose may disappoint anyone looking for literary flourishes in these pages.

When Cotter begins consulting a plethora of ENTs, otologists, and other specialists, a debate oscillates between whether or not the cause of his condition is Ménière’s disease — an untreatable inner-ear disorder — or something entirely different. Even a visit to the renowned Mayo Clinic is an utter failure. “I didn’t leave Mayo Clinic with either a cure or a reliable prognosis,” he writes.

These draining experiences lead Cotter to thoughts of suicide. “Acquire a chronic condition and you’ll feel like you’re falling…as if from a high cliff,” he begins. Later, as his mind and soul “feel sick,” he considers killing himself “as a kindness” to others. Relatives and friends, he reasons, “wouldn’t have to watch someone they loved fall apart.” His loneliness intensifies as his condition worsens. As sound fails him, his tether to the world frays. His suicidal thoughts rise to a crescendo as he imagines ways of ending his life. Unlike memoirs where suicide lurks in the shadows, Cotter brings it vividly to the fore here. It is startling, unsettling, and raw.

While Cotter’s journey follows a predictable illness/disability storyline — sickness, treatment, recovery (of some sort) — Losing Music also lays bare the defects in American medicine. Pointedly, modern science doesn’t save him; he is as uncured at the end of the book as at the beginning. But he does discover an important coping strategy: Words become his new music. Through them, he deepens our understanding of sound, human connection, and what it means to be (and remain) alive.

Shelby Smoak is a writer and musician. His memoir, Bleeder, received praise from sources as diverse as the Minneapolis Star Tribune, Library Journal, and Glamour, and has won several awards, including “Best of the Best” by the American Library Association. He was also featured on local TV and radio, including NPR. Shelby has been touring as a musician since the 1990s. He recently appeared on NPR with his band Bleeder. Awarded a Pen/American grant for writers living with HIV, Smoak holds a Ph.D. in literature and an M.A. in English. He works as an advocate and education specialist for BioMatrix Specialty Pharmacy. He lives, writes, and plays music in the Shenandoah Mountains of Virginia.

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