We wish we had a videotape of these three distinguished gents pulling theirs out. But if it were an audiotape, Limbaugh wouldn’t understand what was being said. As he told his nationwide startled radio audience on Monday, he is going deaf, very quickly. He suffers from autoimmune inner-ear disease (AIED), which affects only about 20,000 of the estimated 30 million Americans with significant hearing loss. This aural ordeal carries a special poignancy, or irony, for a man who loves nothing more than the sound of his own resonant, irrefutable voice. Rush’s job, his very vocation, is talking talking nonstop for 15-1/2 radio hours a week and, occasionally, listening to calls from his audience. The Mouth That Roared has lost its ears.
Since he went national in 1988, Limbaugh has created a sizable industry in right-wing radio rant. For the past decade you haven’t been able to slide the dial without hearing the spawn of Rush: harrumphing haranguers who kvetch about the Clintons (when they were in power) or the media (when the GOP galloped in). Conserva-talk conquered radio including sports-talk radio, especially in times when the jocks cool off and the politics heat and spread to TV, with Fox News and most of the prime-time natterers and Sunday solons.
Not many of these have Limbaugh’s gifts. He can slip the stiletto with a smile; he leavens his diatribes with goofy sound effects; he knows that the primary goal of a radio man is not to indoctrinate but to entertain. Sometimes, he does both, and confects great radio. This talent has kept him at the head of the wolf pack: his is the most dominant voice in radio, with 20 million listeners weekly. And now, it appears, he will have trouble hearing himself.
Starting in the spring, Limbaugh experienced steady decline in hearing in his left ear, to the point of deafness; this was shortly followed by a loss of hearing in his right ear. Listeners said he sounded different (though this may have been from his recent significant weight loss), and Rush thought so too. As early as February or March, he said on last Thursday’s show, "my own voice sounded bordering on chimpanzee." Kraig T. Kitchin, president and Chief Operating Officer of Premiere Radio Networks, which this year signed its star to a $31 million contract, noticed that Rush had started wearing a small hearing aid, but says, "To me it was a non-event. In the radio business, many broadcasters who have been on the air for 25 or 30 years use hearing aids. It’s like watching a great basketball player who has a bandage around his knee."
Over the summer, Limbaugh consulted specialists who could not offer an accurate diagnosis. Was it genetic? Limbaugh’s father, a World War II vet, had experienced hearing loss, as had his grandparents. Was it traumatic? Since the hearing loss occurred suddenly, doctors thought a virus might be responsible. Within a month, Rush was wearing hearing aids, and when those devices no longer helped, he came to Dr. Jennifer Derebery, an ear specialist at the House Ear Clinic and Institute in Los Angeles. That’s where his condition was diagnosed as AIED.
Wanted: Really good Rogaine
AIED is essentially an arthritis of the inner ear, explains Dereberry. Like arthritis, AIED is the result of the body’s own immune system attacking normal, healthy tissue in this case, the sensitive hair cells that ferry sound waves into the electrical impulses that the brain reads as sound. The cause may be genetic; some people may just have the misfortune of containing sufficient sequences of DNA in common with bacteria or viruses. These are then seen by vigilant immune cells as foreign, and the immune system launches an attack on the normal body tissues that it perceives to be invading microbes. In AIED, antibodies start swarming in on a specific protein that serves as the bed on which the hair cells grow. As their foundation falls apart, the hair cells start to die. As Limbaugh said on his radio show Thursday, what he needs is a Rogaine that really works.
Of all sensory neural hearing losses, AIED is the most treatable. First line therapy includes steroid drugs, most commonly prednisone. As effective as it is, however, prednisone does have troubling side effects: osteoporosis, weight gain, mood changes, skin rashes. Some patients may become tolerant to the drug, peaking at their maximum benefit in hearing within a few months. "It’s a nasty drug long term," says Derebery. So doctors have begun switching to methotrexate, another anti-inflammatory that was initially used to treat cancer patients. The combination of the two often packs the most punch.
The only problem with methotrexate is that it takes up to two months before patients see any benefit in hearing. In Rush’s case, says Derebery, that was too long. "We didn’t think we had that much time with Rush, so we’re doing a full court press on him." She was concerned that if Rush’s hearing loss progressed any further, that the nerve damage would be too great and no longer reversible.
Dereberry believes "there is a significant chance that we can improve his inner ear with medicine. He is not that old, he came in pretty soon after his hearing loss occurred, and his nerve pathway may still have good integrity." As added insurance, she tossed a third drug into the cocktail: Enbrel, a drug prescribed for rheumatoid arthritis, which blocks the activity of a protein essential to the body’s inflammatory response. By clamping down on the immune response, she is hoping that more of Rush’s inner ear nerves will be spared.
If after two months on the medications Limbaugh’s hearing does not improve, Dereberry’s next option will be surgical. She will implant a cochlear device that will essentially replace the hair cells and do their job, picking up sound waves, translating them into digital form, and sending the information to a radio receiver implanted in the inner ear. The receiver then transmits the appropriate electrical signals to the brain. With these devices, says Dr. Thomas Balkany, chairman of the department of otolaryngology at University of Miami, many AIED patients can hear well enough to conduct a telephone conversation. Derebery says the implant will only be considered if the medications fail: "If we put the implant in today, we destroy any chance that the inner will come back."
Kitchin says Limbaugh faced the news "with a great deal of resolve, an absolute get-after-it attitude. He’s not feeling sad for himself. He’s not mad at himself. He is resolved to continue to find a way to live up to his own expectations and the expectations of his listeners." For now, Rush "does have a hearing aid in his right ear, and is capable of hearing very well in his right ear. In addition, we are employing technology that allows his producers to share the name of the caller, the mood of the caller, the approach of the caller, so that he has a sense about him of where the conversation is starting."
Back at the golden EIB microphone
Though the message is poignant, not everyone is ready to forgive the messenger. "I still don’t like what he says and I don’t like how he says it," declares Al Franken, author of the 1996 best-seller "Rush Limbaugh Is a Big Fat Idiot." "I have a lot of friends who are conservatives, so it’s not about his politics. It’s just that he plays unfair and is very hypocritical and a demagogue." Franken wants it known he sympathizes with Limbaugh in what must be a difficult time for the big fat idiot. "Obviously, it’s a terrible thing that he’s lost his hearing. You don’t wish that on anyone, even people whose work you don’t like. And it’s a bad thing for a guy in radio to lose. But he didn’t die. And he’s got health insurance. If some lazy, unemployed piglet, as he calls the poor, had this happen to him, Rush wouldn’t be sympathetic to this person getting the medical help that he’s getting. But I hope he’s okay."
So, with no reservations, does his consulting physician. "It is a devastating disease," says Dereberry. "Imagine having normal hearing today and, between now and New Year’s, you’re deaf. He is understandably saddened, but resolved to move on, and his attitude is ‘What can I do to get better.’ We’re all impressed with how he’s dealt with this."
Remember that Limbaugh is more than, as a TIME headline once called him, "Conservative Provocateur or Big Blowhard" (choose one or both); he is the centerpiece of the dominant form of commercial radio. "We not only have made a lot of money with the Rush Limbaugh Show," says Kitchin, "we’ve built a lot of great radio stations for Clear Channel, our parent company, and for a lot of our affiliate companies that we do business with. He has been the stanchion on which AM radio was rebuilt, and he believes that his work is not done." Rush certainly agrees that he has a sacred mission. "The word ‘retire’ is not in my vocabulary," he told his Thursday audience, adding, "I’m not going to quit until every American agrees with me." (That rumble you just felt under your feet was the seismic shudder of America’s last 17 liberals, aghast that Limbaugh will be kicking them around for another decade or two.)
So, three hours each day, El Rushbo is still calling the conservative cavalry charge, still assaulting the microphone by rattling papers with his formerly nicotine-stained fingers, still motoring down The Turnpike of Truth, still accepting "megadittos" from the call-in faithful, still picking on Bill Clinton and preserving, if not his hearing, his sense of humor about that Beacon of Freedom, that immense figure of political fun, himself. The first caller on Thursday began a familiar complaint by saying, "Listening to the media..." Limbaugh broke in: "I’m fortunate that I don’t have to any more."
Perhaps he is comforted to know that many people have continued contributing to the world’s entertainment long after they lost their hearing. Why, Rush could be the Beethoven of bombast.
Reported by Andrea Sachs and Alice Park/New York