Medicalization is Not Care
Echoes of Care: Deafness in Modern Britain, Jaipreet Virdi. McGill-Queen’s University Press, 2025.
Historian Jaipreet Virdi’s second book, Echoes of Care: Deafness in Modern Britain, based on her PhD thesis, describes the history of deafness in Britain from the mid-1700s to the 1920s. The chronological structure offers a firm grounding in how deafness was perceived in modern British history and, by extension, colonial Canada. The book covers the questionable beginnings of the specialization that would become ear, nose, and throat (ENT) medicine. Originally, ENTs were called “aurists,” but by the late 1800s — in an effort to shake off public scandals and accusations of quackery — they began to bill themselves as “otologists” and partnered with other specialists.
Virdi’s first book about the history of deafness, Hearing Happiness: Deafness Cures in History, focused on the U.S. and has become well-known in disability spaces. Understandably, Echoes of Care is more academic in tone and language and holds less of Virdi’s personal story as a hearing-aid user with severe-to-profound hearing loss. Hearing Happiness helped fill some gaps for me as a reader: I learned more about Virdi’s personal story and was rewarded with definitions of some terms, like “tympanic cavity” being the eardrum.
Diagnosed with mild hearing loss when I was sixteen, I didn’t know I needed to see an ENT doctor until last year. By that time, I’d developed moderate-to-severe hearing loss, chronic tinnitus, and hearing sensitivity. I finally got a diagnosis to explain two decades of pressure in my right ear: Eustachian tube dysfunction. My ENT prescribed a steroid spray and promised I’d be cured in months. Over a year later, my ear-pressure pain still comes and goes, far from cured. This brought to mind Virdi’s description of how nascent ENT professionals were derided as fakes because of “cures” that mostly didn’t work. I’d hoped to get answers, but my ENT said there were no treatments for my hearing sensitivity or worsening tinnitus. Leaving his office — which shared space with a private hearing-aid clinic, what Virdi calls “salesmen” — I wondered if his main job was to prescribe hearing aids.
Echoes of Care describes how, around the turn of the 19th Century, in an effort to establish legitimacy for their new profession, aurists created medical devices intended to cure deafness. In 1839, aurist Alexander Turnbull embraced one such instrument as a cure-all; it pushed air or water through the Eustachian tube’s tiny channel connecting the ear to the mouth to clear blockages but was deadly if misused. Virdi details the investigation that ensued after two of his patients died in his office. The outcome of the trial was inconclusive and the British public’s skepticism of the profession remained high.
I admit I read Virdi’s descriptions of the air-blowing devices with great interest and wondered if there might be a safe equivalent today, which shows the impact of this chronic pain on my daily life.
Virdi concludes by discussing modern-day Britain in a way that echoes modern-day Canada, identifying “a pattern of services reduction . . . that is evident in cultural expectations for deaf [people] to ‘become hearing’ or pass as such, as well as the general capitalistic forces underlying medical services, even within a country that offers national health services.”
Echoes of Care describes how, back in 1700s Britain (and so also in colonial Canada), deafness was not seen as a medical “problem” but as a social difference. Aurists tried making inroads into deaf residential schools, arguing many cases of deafness were preventable if caught at an early age. Educators resisted this, as did the wider British public, due to the “popular prejudice,” which saw deafness as an auditory difference and anyone promising a cure as quacks. This changed in the late 1800s when eugenic ideas of social control helped aurists gain access to spaces with deaf children, where they measured, took statistics, and studied the “diseases of the ear” to help substantiate their claim that otology was a legitimate profession.
The advent of statistics led to a widely accepted idea of “normal,” which meant anything considered “abnormal” began to be even more stigmatized and controlled. In my reading of this and other disability texts, challenging this concept is a key aim that could hopefully lead to a society where deafness is respected as an auditory difference rather than seen as a medical problem to be fixed.
Echoes of Care describes a process of medicalization that prioritized the career advancement of practitioners over patient needs:
Disability is viewed solely through the lens of impairment, under a “restitution narrative” that crafts all conditions as treatable, or at least to be corrected toward “normalcy.” Under this framework all sufferers are expected, if not required, to adapt their health and behaviour in response to medical innovations, even though what tends to be defined as “illness” or as a “condition” (or even “disability”) is socially constructed and a product of social factors.
I was surprised to learn that in Britain the term “hard of hearing” began to be used in the early 1900s when eugenicists argued that “slightly deaf” children should be moved to oral schools to save the state money. At times Virdi’s descriptions of ableism were hard to read, but I appreciated being a witness to a history that helps to explain much of today’s hostile world.
This book is timely as DEIA initiatives get scrapped even by Canadian organizations and fewer “accommodations” are made for those of us raised to accommodate the hearing world while (in my case) not being able to afford the results of the historical medical efforts that Virdi studies with such a critical eye, such as $10,000 hearing aids that don’t restore full sensory function. What would the experience of people with diminished or absent hearing be like today if medical professionals and others had spent the past 200 years ameliorating conditions such as Eustachian tube dysfunction and focusing on patient comfort rather than amassing techno-capitalist wealth?
After reading Echoes of Care, I won’t look at my ENT doctor in the same way again. An echo is a hollow substitute for deeply thoughtful, patient-centered support and care.
— Yolande House holds a Master’s in History from Queen’s University and a Canada Council for the Arts project grant to complete her memoir-in-essays about being hard of hearing.
Read this review and many others in Issue 308 (Summer 2026) Disability: The Revolution. Order the issue now:
Order Issue 308 (Summer 2026) Disability: The Revolution (Canadian Addresses)
Order Issue 308 (Summer 2026) Disability: The Revolution (International Addresses)
