In the hit film A Star Is Born, Bradley Cooper's character is a country-rock musician who suffers from hearing loss and a condition called tinnitus — defined as ringing, buzzing, or other chronic sensation of noise in the ear without an external cause.
Tinnitus affects 25 million to 40 million people in the United States, by various estimates, and is more common in older people. Many consider the symptoms a minor nuisance, but patients with extreme symptoms can be miserable.
We spoke to Dennis C. Fitzgerald, an assistant professor of otolaryngology/head and neck surgery at Thomas Jefferson University, about how people cope with the condition, and what the movie got right. (A lot — perhaps because Cooper, who also directed the film, sought advice from his own ear doctor.)
Can one exposure to loud noise cause tinnitus, as Cooper’s character claims in the film?
Absolutely, if it is loud enough. Tinnitus can be caused by a short, intense burst of noise, such as an explosion, or by a physical blow to the ear, Fitzgerald said. In both cases, the damage is the result of intense pressure — harming sensory cells in the inner ear or the circuitry that travels from those cells to the brain.
The condition also can be caused by long-term exposure to noise, and it seems to have a hereditary component. In some cases, it can result from ear infections or as a side effect of taking certain drugs.
Cooper's character suspects he caused the problem by putting his head inside his father's Victrola, a type of vintage record player. Fitzgerald was skeptical.
"Probably years of playing rock music is more believable," he said.
A common misconception among tinnitus patients is that they will hear better if they can just get rid of the ringing in their ears, he said. Unlikely, especially if the condition was caused by exposure to noise. In such cases, tinnitus is generally accompanied by hearing loss. Even if the ringing could be eliminated, the patient still would have trouble hearing.
And, alas, there is no way to get rid of the ringing and other phantom noises, contrary to what is promised on the labels of certain supplements. But some patients can mask the effect with wearable devices that generate a soft shhhh sound, according to the National Institute on Deafness and Other Communication Disorders. Other types of sound generators can train the brain to ignore the ringing — a process called habituation. Some patients may find relief through cognitive therapy.
What were those things that Cooper’s character was given to wear in his ears?
At one point in the movie, the singer's brother urges him to insert some type of protective earplugs designed for musicians.
Generally, such devices block the loudest sounds while allowing certain frequencies to pass through at a lower volume. Some, called in-ear monitors, have an added electrical component — wirelessly piping in the sounds from a performer's fellow musicians while blocking the roar of the crowd and other background noise.
But Jackson Maine, Cooper's character, is reluctant to wear the plugs, claiming they will distance him from his fans. Bad idea, Fitzgerald said.
"He was the tough guy," he said.
Yet he said he was encouraged by real-life stars who have gone public with their struggles. Ozzy Osbourne, Eric Clapton, Neil Young, and The Who's Pete Townshend all have spoken openly about noise-induced damage to their hearing. Fitzgerald hopes younger performers pay attention.
"I think the word is getting around to musicians these days," he said. "They want to be able to hear something when they're 60 years old."
Cooper cast his own ear doctor in the movie. Why does he even have one?
Cooper told the Cut he consulted William Slattery III, a specialist at the House Clinic in Los Angeles, to make sure the movie was medically accurate.
"The next thing you know, he calls me up and says: 'Hey, can you help me? We were thinking about having a part where we have a doctor testing my hearing,' " Slattery told the media outlet.
Within a week, he was on the set in Palm Springs, his lines memorized — though Cooper ended up telling him to ad lib when the cameras began rolling.
No word from Cooper's representatives as to why he has an ear doctor. It would be unusual for him, at 43, to have noticeable hearing loss, though he could be experiencing some other type of ear issue.
The most common form of hearing loss is related to age — affecting one in three people between the ages of 65 and 74, the National Institute on Deafness and Other Communication Disorders says. Among those 75 and older, nearly half have trouble hearing.