Daniel Coelho (left) and Sean Kastetter Photo by Sarah Walor
Daniel Coelho: The beauty about a cochlear implant is that the technology — although the human component is what makes it all so rewarding — the technology is for the most part so profoundly successful, that patients will have literally a life-changing experience. I have a patient that I just saw yesterday — a 70-something-year-old woman — who had not heard a blessed thing in 15 years, and the day that she had her cochlear implant activated, she was able to talk on the cell phone to her great-grandchildren, hear them for the first time in her life. This is a story that we hear every single day. We have a lot of tissues in our office, because patients will cry a lot. It never gets old. I can go back and watch the video [of the moment the patient hears clearly for the first time], I still get goosebumps — it could be the hundredth time I've seen it. Sean Kastetter: The interesting part is [this kind of emotional response] happens just as much with the adults, if not more with the adults, than it does with the kids. It opens up their world for them, because most of the time, by the time they get to us and are talking about a cochlear implant, they're fairly isolated. DC: Depression is setting in. [But] just in the past week, I've had two patients who've told me, "You've given my life back." It's very exciting. SK: What we do as audiologists for the cochlear implant patient, we see them relatively frequently over the course of the first few months, and then over their lifetimes, we'll probably see them a couple of times a year, just to make sure that the programming and the implants that Dr. Coelho put in are working properly. DC: Sean has an enormous wealth of knowledge. But it's not only the technical aspects of programming and cochlear implants; he has the historical perspective, of having seen how the rapidly evolving field has changed over the past 20 years. It's a very complementary, synergistic relationship. Just from a diagnostic point of view, it's very important to help quantify hearing loss. And for those of us who can't speak — little children, that you can't get a subjective assessment of their hearing, there's a whole host of testing that audiologists can perform. SK: I have the advantage of having worked with a number of surgeons who do cochlear implants over my career, [and] there's a lot to be said for not only his surgical technique but also his bedside manner, and making sure patients understand what it is that's going on, and the follow-up. I think that's the part that I enjoy the most about working with him. DC: I would say definitely our relationship has evolved. SK: I would agree with that. You know, ultimately what we want is what's best for the patient. And we want them to have a great outcome, and I don't think they can have a great outcome without all of us on the cochlear implant team and Dr. Coelho all kind of getting together and feeling free to say, "I think this is a good idea, I think this is a bad idea," and everybody kind of putting their heads together. It's evolved over time, and it's still evolving. DC: And if I may, there are so many other professionals who are involved in the care of these patients. We have a speech and language pathology team here, which is really top-notch, not to mention everybody else — the nurses, the people in the operating room and the administrative staff and everybody like that.