The Cochlear Implant at the End of the World

Staging disability in an apocalyptic future, the film A Quiet Place insists that we think beyond a logic of functionality if we want to survive environmental crisis

A Quiet Place, 2018

Disabled people don’t make it through the apocalypse. At least that’s the conventional wisdom of both speculative fiction and our own world: If the biomedical industrial complex collapses, so do all the people who rely on its products. Corporations need us to believe this, yes, but it’s hard to deny the truth of it. If pharmaceutical companies like Eli Lilly, Novo Nordisk, and Sanofi were unable to continue manufacturing insulin, or if it became so scarce as to be affordable only to the investors and technocrats packing their bags for Mars, I’d be done for in a matter of weeks. It’d be nice to think some miracle collective of anarchist scientists could pop up to take their place, but that’s not how we tend to imagine the end of the world going down. So, while people with disabilities have historically populated film and literature more regularly than any other minority group—frequently as “narrative prostheses” where their bodies become plot-driving problems—they disappear from our postcapitalist futures. That is, unless they’ve been mutilated or mutated by the same catastrophe that caused the world to collapse or they’ve gained some kind of supercrip cyborg body in the chaos. (Think of the double-entendre-ish firearm worn by Furiosa in Mad Max.) Those of us with the kinds of everyday illnesses, dependencies, and access issues that more typically define disability can’t hope to make it into the fast-paced, social-Darwinist worlds of apocalypse movies.

Disability politics have always had their own utopias and dystopias that have more to do with issues of ableism and access in the present than they do with the apocalyptic future. Today’s landscape of genomics and prenatal testing threatens to eliminate congenital disabilities entirely, not unlike the openly eugenicist “utopias” of the early 20th century novelist Charlotte Perkins Gilman. In her 1911 novel Moving the Mountain, one of the pioneers of Gilman’s ideal society brags that, through intensive biological screening of each potential citizen, “We have better children than ever were born on earth before,” and “Idiots, hopeless ones, we don’t keep anymore.” It didn't take long for this explicit genetic manipulation to become dystopian in the popular imagination, as the 1932 publication of Aldous Huxley’s Brave New World attests. Although the field of genetic testing aims to distance itself from the rhetoric of eugenics proper and from popular anxieties about “designer babies,” medical professionals insist in quite similar terms to Gilman and her contemporaries that universal screening can eliminate undesired bodily anomalies. Last year, when the news broke that Iceland had all but eliminated Down syndrome as a result of prenatal testing, the head of the prenatal diagnosis unit at Iceland’s central hospital told a CBS reporter, “Babies with Down syndrome are still being born in Iceland. Some of them were low-risk in our screening test, so we didn’t find them.” Implied, here, is an ideal world very close to the past and present, in which just slightly better screening technologies could fully eradicate a category of humans based on the assumption that disabled lives are not worth living. Not all that much seems new when it comes to neo-eugenics.

The ideal disability society, however, is the one envisioned by universal design, a contemporary architectural and educational movement aimed at making social environments accessible to all kinds of bodies and minds. One of the foremost promises of universal design is that disability accommodations never only benefit the people for whom they are intended, but benefit all people by giving them more possibilities for maneuvering through their environments. For example, while the intended function of curb cuts was to allow wheelchair users to cross the street, they also made life much easier for mothers pushing strollers or workers pushing dollies stacked with heavy boxes. Accommodating the few benefits the many, the logic goes. Like today’s dystopian neo-eugenics, universal design is a utopian concept based more in our present world than any radically altered future. Who will have time to worry about accessibility when they’re scavenging for food in the bombed-out remnants of their former lives?

The obvious answer—disabled people—has just gotten its first mainstream representation in A Quiet Place, this summer’s surprise blockbuster. The thriller introduces its thoroughly apocalyptic future with a scavenging scene in a desolate pharmacy, where Lee and Evelyn Abbott (played by director/lead actor John Krasinski and his real-life spouse Emily Blunt) creep around in tense silence, trying not to attract the seemingly omnipresent, predatory aliens with ultra-sensitive hearing that now reign over the food chain. While searching for meds for their sick older son, they communicate with their family using American Sign Language, which they had all learned before the invasion because one of the children, a preteen girl named Regan, is deaf. The family’s ability to communicate without spoken language is undoubtedly what’s kept them alive for as long as they have been, given how few traces of other humans emerge throughout the film. Though Krasinski’s character is seen toiling obsessively to repair Regan’s broken cochlear implant on a regular basis, the movie’s presiding gambit is nevertheless that Regan’s deafness is hardly an impairment, but actually the family’s saving grace. While a glut of movies structured by narrative prosthesis has conditioned viewers to expect a storyline in which Regan’s deafness is ultimately cured and thus the family is made whole through homogenous sensory capacities, any desire for this type of shallow resolution is quickly rendered irrelevant by the many gains that deafness grants to this family in their struggle for survival.

From a disability perspective, then, the nightmarish world of the film takes on a utopian sheen: In a world where humans struggle to survive by means of silence and sign language, auditory normalcy is no longer prized, commodified, or even useful. Because a community (in this case, a family) has accommodated one person’s needs in the preapocalypse world, they all are equipped with the tools to survive beyond it. This is the promise of universal design in its most extreme application, and an answer to the questions most of its proponents don’t dare ask: How do we even think about disability, a category defined by access to one's environment, as we face radical ecological change that may render those environments unrecognizable?

The only possible answer, the film insists, is to think beyond capitalism’s logic of functionality. No one learns ASL thinking they’ll need it to evade bloodthirsty aliens, but that doesn’t mean they won’t wind up using ASL for exactly that purpose. Unintended utility and useful dysfunction are the main enablers of survival in A Quiet Place. Most crucially, Regan’s broken cochlear implant has been utterly nonfunctional as a hearing device since the fall of humans’ dominion over their natural world. But its dysfunction is what keeps her family alive: When the monsters get too close to her, the implant responds with a glitchy, high-pitched feedback sound that they cannot tolerate and must flee. It is even implied, in the end, that the implant’s lifesaving malfunction might result in all of the surviving family members becoming deaf or hearing impaired, as they repel encroaching predators by subjecting both the monsters and their own ears (including those of a newborn infant) to the screech of Regan’s implant, painfully amplified many times over through speakers. This is all a far cry from the supposed function of cochlear implants—perhaps the most controversial prosthetic device available today—which aim to grant a kind of access to the hearing world that many in Deaf communities find troublingly assimilationist. Among Deaf and disability activists, cochlear implants are often figured as an enemy of ASL, with ASL fostering Deaf culture and implants threatening to destroy it. This is a long-running debate with roots much older than cochlear implants themselves, echoing concerns over the early 20th century imposition of “oralism” in Deaf schools, which mandated that Deaf students be taught to lip read and speak in verbal English rather than learn ASL. Though, over the years, Deaf communities have become more accepting of the implants as one among many available communicative choices, the National Association of the Deaf’s official statement on the matter still emphasizes that the device is a “tool for some forms of communication, not a cure for deafness” and encourages “parallel visual language and literacy development” for those who do use it. What’s fascinating about A Quiet Place is that Regan and her family need both of these purportedly oppositional technologies to survive, though neither of them operate in the contexts they were intended for. The film’s Deaf politics are neither separationist nor assimilationist but something messier and technologically omnivorous that, perhaps, only makes sense for a disability-inclusive worldview that wants a chance at surviving the anthropocene.

After all, though this particular film’s super-hearing aliens may be the stuff of fantasy, the possibility of human bodily and communicative norms being altered by ecological turbulence is not. Just ask the educators in Flint, Michigan, whose students’ third-grade reading proficiency has dropped 30 percent since their water has been contaminated with lead. We would do well to remember that our world is already apocalyptically debilitating, to borrow Jasbir Puar’s useful term. In her 2017 book The Right to Maim: Debility Capacity, Disability, Puar points to environmental toxicities as one of many producers of debility, a population-level condition she proposes as “a needed disruption” to the individualized concept of disability. Amid increasingly stark environmental disparities among racial and economic groups, inadequate infrastructure in natural-disaster-plagued areas, and fears of ice-bound viruses being unleashed from polar ice caps due to climate change, it can be stupefying to recognize how ill-prepared humans are for whatever environmental change holds in store for our bodies and minds. What we perceive as “normal” embodiment today may be altered with our environments, such that disability politics would have to look very different as well. The debates over assimilation into the hearing world necessarily dissipate once everyone is living in silence.

Still, there are dangers to getting carried away with panic over the uncertain relationships between our bodies and our unstable ecologies—particularly in terms of how easily the rhetorics of disability and disaster slip into one another. Just recently, Barbara Ehrenreich’s controversial new book Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer has taken a more explicitly doomsday approach to the biomedical industry. Armed with a litany of health studies and the wherewithal to question her doctors’ standard protocol, Ehrenreich makes a detailed case for why, as a person self-proclaimedly “old enough to die,” she advocates forgoing preventative medicine like mammograms and colonoscopies. She argues persuasively that there is a lack of evidence supporting the frequency with which these procedures are recommended, and it’s surely no matter of controversy that people should be able to opt out of them if they wish. All the same, Ehrenreich’s fundamental conflation of medicine with dystopian body politics is hard to swallow. “Not only do I reject the torment of a medicalized death,” she writes, “but I refuse to accept a medicalized life.” “Must be nice,” a disabled friend of mine remarked on Facebook when the book came out. “Some of us never had a choice.” And, I might add, some of our medicalized lives are pretty damn OK.

Ehrenreich goes on to critique the apocalyptic anxiety surrounding what she sees as overmedicalization, making a rather large leap to tie preventative medicine to more indulgent transhumanist technologies like computerized minds and Google cofounder Sergey Brin’s ambition to “cure death.” She pokes fun at CrossFit for its (yes, silly) promise to keep people alive at the end of the world, boasting that its program will prepare customers “‘for any physical contingency,’ . . . ‘not only for the unknown, but for the unknowable,’ and the latter category includes the zombie apocalypse.” These technologies are available only to a hyperprivileged set that feels entitled to an escape from mortality, and are fair targets for mockery. But it is disingenuous to compare them with mundane preventative exams that are covered by Medicaid and Medicare, like breast and prostate exams. It doesn’t seem to occur to Ehrenreich that maybe poor and disabled people would like to extend our lives not because our pharmaceutical overlords tell us we should, but because we weren’t supposed to survive in the first place. Whether because of race or disability or poverty or nation, or some combination of these, it’s quite common to be marked “old enough to die” from birth.

I see in Ehrenreich’s thinking, and in many other smart people’s thinking like hers, an all-too-readiness to equate medicalization with the normalization of corporate control. In other words, there is a real paranoia on the anti-capitalist Left that if the medical establishment claims that something will increase your chances of surviving (say, flu season, cancer, or old age), it is always and only a cynical profit grab. By no means do I want to defend the pharmaceutical corpocracy’s right to unfettered growth, here—medical treatment is diabolically expensive, and the advertisement of addictive drugs and unnecessary procedures is one of society’s great evils. There is no denying that companies attempt to normalize their most expensive products so people will continue consuming them. But as I watched A Quiet Place, I found myself wondering: What happens when our normal environments change drastically but our technology does not? What if our medical resources have capacities that even their profiteers don’t plan on? The truth is, modern medicine didn’t destroy the world; capital did. One of the great challenges of our time will be to figure out how the former can outlive the latter. For years now, diabetics have been hacking our insulin pumps to add functions that manufacturers can’t or won’t program them with. Maybe the fantasy of the anarchist scientists isn’t so fantastical after all.

We have little certainty about what our bodies will need as our planet changes. This may mean that tools once considered niche develop more generally useful applications, like Regan’s cochlear implant does. It may mean that already widespread technologies develop new urgencies, such as mammograms in a more intensely carcinogenic world. It may mean some tools become useless; it’s hard to imagine in vitro fertilization (IVF) having much of a life in a society defined by extreme scarcity, though, as A Quiet Place’s pregnancy storyline makes excruciatingly clear, there may be an increasingly critical need for contraception. As humans grapple with irreparable environmental change, we have to face the fact that none of us—neither biotech nor its critics—knows what future bodies will need. Our best chance at survival may be to open our social and spatial worlds up to as many accommodations as possible for the bodily differences we have now. For all we know, we could end up with a world where neither ASL nor cochlear implants are enough on their own, and we’ll be glad we have them both.

This is why I pause over what I see as too frequent slippages between anti-capitalism and naturalism—the kind of politicized hostility to biotechnology that posits that any one way to survive or die is more natural, and thus less beholden to capital, than any other. I pause over the idea that, without access to medicine, a large minority of bodies will be light-years less likely than others to survive the kinds of “natural” disasters ushered in by climate change. It does make some kind of sense, in an era of human-wrought environmental crisis, to turn a skeptical eye toward our impulses to intervene in what we understand to be nature’s course, even or especially when it comes to our own bodies. But we must be careful not to succumb to some primitivist fantasy of returning to a natural world or way of living that never existed in the first place. This is where—because 2018 refuses to make any sense at all—John Krasinski has more of a radical imagination than Barbara Ehrenreich. His crowd-pleasing, at times macho survivalist and painfully heteronormative horror flick nonetheless knows what so much of the environmentalist Left doesn’t: that whatever kind of future we end up with, disabled people and sick people, with our medicine and dependencies and devices, will be in it, too. And all of us will be better off for it.