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====Cochlear Implant==== | ====Cochlear Implant==== | ||
<blockquote>To admissions board, Starfleet academy:<br> | |||
<br> | |||
I am writing this letter on behalf of my former patient, Ms. Mackenzie Ingram. It is meant to provide detailed and accurate information regarding her hearing deficit and cochlear implant so that you may make an informed decision on whether it will affect her duty to perform as a Starfleet officer.<br> | |||
<br> | |||
Mackenzie was born with a congenital hearing deficit. Specifically, she has a mutation that prevented a specific protein from being expressed during development. Without this gene, the many afferent nerves that innervate the cochlear nerve did not develop. In layman's terms, her ears developed normally, except that the nerves needed to transmit the actual signals to the brain did not form. This means that she has a 100% hearing deficit: she is completely deaf in both ears. Today, we would have detected this lack of nerve development and used specific treatments in order to ensure proper development. However, when Mackenzie was born, we had no treatments to restore her hearing, and so we were forced to install a cochlear implant.<br> | |||
<br> | |||
The implant is two pieces. The first is the device that I surgically installed inside of the right ear when Mackenzie was only a few days old. It uses a then-experimental neural fiber interface to transmit signals to the cochlear nerve, which then signals directly to the auditory cortex of the brain. The second piece of the implant is external. It consists of five microphones that are splayed around Mackenzie's right ear and picks up all ambient sounds and noises. It then uses advanced filtering algorithms to determine what to transmit to the internal structure of the implant. The two pieces are separable and connect through a physical port that is visible behind Mackenzie's right ear. This was chosen because we did not want any kind of electromagnetic interference to disrupt a wireless signal. The internal device is powered by the external, which uses a battery that typically lasts three to four months and is easily replaceable.<br> | |||
<br> | |||
In the time since the device was installed, there have been many advances in microphone and neural fiber interface technologies. However, any attempts to adjust the device has been futile because it results in a change in the form of signal that is transmitted to Mackenzie's brain. The human brain is very receptive to change and transformation during development, which is why the implant stuck. However, once that time of plasticity (or ability to change) has passed, any change in the form of the signal transmitted to the brain results in dire side effects. When we tried to upgrade Mackenzie's external implant device, for example, she experienced severe headaches and nausea, and even passed out. For this reason, it is unlikely that until there are significant developments in neurotransformational medicine, Mackenzie will be unable to improve or replace her implant, nor have one installed in the left ear. In a similar fashion, I will be unable to build a superhearing capable bionic ear for Starfleet.<br> | |||
<br> | |||
All that remains it the obvious question: what is Mackenzie's hearing capability with the implant? This is difficult to ascertain because the implant is the only form of hearing that Mackenzie has ever had, so she is unable to make comparisons or contrasts to what you or I may experience when we hear. It is clear that Mackenzie is able to clearly hear and understand verbal communication, but she has difficulty discerning between two people's voices. She can hear notes from a piano, but has trouble distinguishing between close tones. She can even recognize, with practice, a specific chord progression, but can never tell you whether it makes her '''feel''' something. These limitations are both hard to discern and to quantify, however, and I would urge you to be reluctant to dismiss her application due to them. <br> | |||
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I hope this letter has helped shed some light on my very charming patient, and please feel free to contact me at my office if you have any further questions.<br> | |||
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Sincerely,<br> | |||
<br> | |||
Dr Xien Cao, Director of Pediatric Otolaryngology, University of Washington Medicine and Seattle Children's Hospital</blockquote> | |||
<h2 style="margin:0; background:#8B6508; font-size:120%; font-weight:bold; border:1px solid #F0E68C; text-align:center; color:#ffffff; padding:0.2em 0.4em;">Mission Logs</h2> | <h2 style="margin:0; background:#8B6508; font-size:120%; font-weight:bold; border:1px solid #F0E68C; text-align:center; color:#ffffff; padding:0.2em 0.4em;">Mission Logs</h2> | ||
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