Methought I heard a voice cry Sleep No More.

 

I have always had a healthy respect for fire. I suppose this is not unusual, although nowadays fire is not a regular component of our daily lives, so its presence awakens something that alternates between fascination and fear. Something atavistic. Fire –especially unexpected fire- can produce panic; smoke –also if unexpected, or inexplicable- can have the same effect. Both are worthy of our attention, both should command our respect, our search for the source.

That’s why smoke detectors are so valuable. The two commonest detection systems would seem to be either ionization and/or photoelectric –the former, ionization, grew from an attempt in the late 1930ies to detect poison gas, but the advance of the technology did not make it widely available –or affordable- until the 1970ies. The optical variety matured around the same time.

The purpose of both smoke and heat detectors, as we all know, is to alert us to the presence of the potential danger by activating some form of alarm –something that either by sheer volume or unpleasant pitch will demand action. It should arouse us if we are asleep, or get us out of our chairs if we are not. It should be audible over whatever other sounds are present in the environment, and sufficiently different from them to concern us. Usually, smoke alarms have a frequency of around 3000-3200 Hz and need to reach 85 decibels at 3 metres.

Anybody who has ever heard their smoke alarm sounding when the toast burns in the kitchen can attest to the discomfort this incites. It is piercing and –at least for the hearing population- impossible to ignore. Enough to wake the dead, as my mother used to say -but apparently not the child: http://www.bbc.com/news/health-38918056  As the BBC article reports, ‘Researchers at Dundee say there are several theories they were exploring as to why standard smoke alarms may not wake children.’ One, however, has led to an interesting innovation. ‘Rodney Mountain, from the University’s School of Medicine, said: “Children’s hearing ability, brain function, sleep patterns and stage of brain development is very different to adults. We are programmed to respond to human voices warning of danger, such as a mother’s voice shouting to warn a child. Children are not born pre-programmed for our modern world of danger warning sounds from digital beeps and sirens -they have to learn, recognise and interpret these sounds.”’

So, the researchers wondered whether the sound of a woman’s voice –a mother surrogate, essentially- might trigger a child’s arousal more effectively. ‘Research by Dundee University and Derbyshire Fire and Rescue found that of 34 children tested, 27 repeatedly slept through smoke detector alarms. They have developed an alarm with a lower pitch and a woman’s voice, which issues a warning: “Wake up, the house is on fire.”’ And, instead of the terrifyingly strident, ear-piercing pitch, ‘the prototype has a lower pitch of 520Hz, to which young children are more likely to respond.’

Of course, this approach is still in its experimental phase and ‘The researchers said it was important the study did not undermine the need for every home to be fitted with smoke alarms, as these will wake adults and had a proven record in saving lives.’

Several weeks after reading this article, I happened to be over for dinner at the house of an old friend. We were sitting in the living room enjoying a glass of wine before eating when the smoke alarm suddenly activated. Apparently some grease on the stove had started to smoke.

“Well, the alarm did its job, didn’t it?” she said, laughing and filling up my glass again when she returned. “It’s amazing how annoying they are. You can’t ignore the alarm –you just can’t!”

I chuckled and told her about the BBC article I’d read about the alarm failing to rouse children.

The smile never left her face even when she had another a sip of her wine, but I could tell she was still thinking about what I’d said. “You know, that reminds me of something that happened when my son Jeremy was still around two years old…” She closed her eyes for a moment, savouring the memory. “We were over at my father’s cabin at the lake. Jeremy loved it there…” Her smile grew even larger and transformed her face. “It was so different from the city where we lived. Everything was new to him –the birds, the trees, the lake with Grampa’s little wooden rowing boat… He was usually so tired, it was no trouble getting him to go to bed at night. He slept in a little crib in my room, and rarely stirred even when I eventually came in to go to bed at night.

“Anyway one morning dad and I were sitting in the kitchen enjoying a cup of coffee while Jeremy was still asleep. He’d just installed a new smoke alarm because he used the fireplace a lot at night and I told him I was worried about the dangers of fire in a wooden cabin. I suppose he’d put it too close to the counter, or something, because when our toast began to burn, suddenly the alarm went off. The noise was so loud and high pitched it was painful and I had to cover my ears. I remember my heart started pounding and I actually felt faint.

“’The man at the store told me it’d wake me from a coma,’ dad said once he’d turned it off. ‘I’m surprised Jeremy isn’t crying.’

“Or out here,” I said. “Your crib is so low to the ground, I took the side off it so he could get out if he wanted.

“I went in to check on him right away; I’d left the bedroom door partially open when I’d gone into the kitchen, but he was still lying motionless in the crib like he does when he’s really asleep. I even remember standing at the door and watching him for a while –he was so adorable when he was sleeping…” She sighed and had another sip of her wine.

“I could see the gentle rising of his chest as he slept, so I knew he was okay. Dad started calling me from the kitchen to tell me my burnt toast was getting cold, and I can recall speaking Jeremy’s name in a normal tone of voice, telling him to wake up. Suddenly his eyes flickered then opened and a big warm smile filled his face…”

Martha turned her head to look at me, her eyes little sparrows flitting from cheek to nose and hovering over my face trying to decide where to land. “Do you think that’s what they were describing in the article?”

I smiled and added a tiny shrug. “A mother’s voice is so important, isn’t it?” I said, but realized as soon as the words emerged that it wasn’t a particularly profound observation.

She nodded her head and laughed. “Curious how my voice could wake him as a child but not as a teenager.”

“Who starves the ears she feeds and makes them hungry, the more she gives them speech…”

“Pardon me?” she said, giggling with the wine.

I enlarged the shrug. “Just a fragment of Shakespeare,” I said. “It means that noise isn’t as valuable as words… I’ve always wanted to use that quote.” I glanced at my own wine and smiled.

 

 

 

FHR: Fetal Heart Rap

When I was a child, I was fascinated with noise. Well, perhaps sounds would better describe what interested me. What were theyI mean really? And what happened to them after I heard them? When I was finished listening and if there was nobody else around to use them, what occurred then? Sounds told us stuff –information- and I didn’t think Nature would just throw them away. So were they like the wind and simply moved on after touching my ears, or did the data get stored somewhere? Collected and saved –someplace chock-a-block with noise bouncing off every wall, or stacked neatly in little, labelled piles? Maybe there was a sound library somewhere. And when I discovered echoes, I thought I was getting close: recycled sound. It was like taking a book out of that library.

As I grew older –I was going to say matured, but that never really happens, does it?- the riddle of the information contained in sound only intensified for me. I mean, where is it? I even wrote a novel to explore my fascination with it (Sound Bites) that’s published somewhere Googleable online, but that didn’t quell the itch… I began to wonder if I was haunted by something –an idée fixe.

When we are enchanted by something, does that make it more likely we will find it? Or just more likely that we will look for it..? Seek, and ye shall find. But even more mysteriously, does it find us?

 

FHR. Every obstetrician –every nascent parent- knows what that stands for: Fetal Heart Rate. Along with uterine contractions, it’s what we measure on our monitors in delivery rooms around the world. More importantly, it’s the sound that connects us to that inner intrauterine environment. The hidden world. It’s the baby talking to us, giving us a weather report directly from that moist, warm space where we all once lived.

And it’s not a one-off either. Midwives, doctors -and increasingly, parents- are regularly tapping into it for news. Information. Meaning. It’s a sound fraught with emotion and expectation –the unopened present.

But I recently got to unwrap the present in an unexpected venue, in an unforeseen medium: music.

 

“Would it be okay if my uncle came to one of my appointments?” Cynthia was a tiny little woman from the Caribbean that was seeing me for her first pregnancy. She spoke with a delightful accent and every sentence was embedded in an almost musical rhythm. It was as if she was singing to me… She was certainly one of my favourite patients and I looked forward to her visits.

With the notable exception of her husband –another small person who usually sat quietly at her side with an embarrassed smile on his face- I hadn’t met any of her family. “Of course he can come with you, Cynthia,” I said. “Your aunt, too, if you want…”

She shook her head, and ringlets of rich, shiny hair escaped from her headband like children at recess. “No, my aunt is no longer with us…” She blinked and then a huge smile invaded her face and her eyes twinkled like crumpled foil in the overhead lights. “Uncle Ed raised me pretty well by himself…” She seemed to hesitate for a moment before continuing. “But now he says he’s curious.”

“Curious?” Now I was curious.

She nodded her head, and her hair came out to play again. “About the sound.”

“The sound? I don’t…”

“You know, doctor. The sound!”

My face must have galvanized her husband because he realized he finally had a role to play: the interpreter. “She means the sound you play from the baby each time we come, doctor.”

“The baby’s heart rate?” I tried not to make it sound like a question. More like an acknowledgment of a point made. They both nodded their heads in a sort of random unity, and smiled. The doctor had understood.

“Well, I’ll try to put on a good show for him, then.”

Cynthia glanced at her husband and a surprised expression flitted briefly over her face; she suppressed it as she turned back to look at me. “Do you know my uncle?” she said, this time unable to disguise her curiosity at my seeming prescience.

I shrugged politely and smiled. “I don’t think so… Should I?”

They exchanged looks again; secrets crept from eye to eye. “Well…” –her husband started to say something, but Cythia reached out and squeezed his hand.

“It’ll be a surpise… Okay?” she said, the last word asking for my permission.

“Okay. I’ll look forward to meeting him.” I really was looking forward to it.

She was fairly far along in her pregnancy so I saw her again in a couple of weeks. It was, however, just long enough for me to forget the surprise. An office is busy, even chaotic at times. There are many surprises…

Cynthia was already in the examination room when I walked in and I noticed the uncle immediately. A tall, thin man with a patchy white beard, sat comfortably beside her –lounged might describe it more accurately. He looked entirely at ease in his rumpled brown fedora and clean but wrinkled blue suit, and his face lit up and immediately cracked into a thousand crevices when he noticed me and smiled. He stood up and extended his hand. “Thanks for letting me come,” he said, his voice sonorous with a hint of gravel. “Cynthia’s been bragging about you for some time now,” he added, and his eyes locked on me like talons from under the brim of his hat.

He glanced at an expensive looking recording device he’d placed on the table by the sink and his smile widened. “Thought I’d record the baby –if that’s okay with you…” He was asking permission, but his eyes knew my answer and relaxed their grip, caressing my face briefly as they returned to the recorder.

“Of course, of course,” I found myself repeating, strangely nervous that my performance might not be up to the machine –or the uncle’s- standards. Cynthia got onto the table and I proceeded to take her blood pressure and assess the size of the baby in her abdomen with my measuring tape. It was an old tape, the numbers worn thin by the years of use, and for some reason I felt embarrassed with it. Like I should have used the new one I had in another room…

And then came the time to listen to the heart. I positioned the doptone over the region of her abdomen I hoped would give the best sound and turned it on. Nervously again. With stage fright, almost. I got the area right and the sounds pounded out in their usual steady cadence –fast at first (I had disturbed the baby by measuring the abdomen) and then settled down into a steady, industrial rhythm. A horse galloping. One hundred and forty hooves per minute -I almost said that, I was so anxious.

Uncle Ed, for his part was entranced, and his eyes were focussed elsewhere –inside his head, if I had to guess. Then he closed them -closed the private door- and his whole body began to sway in sync with the beating heart. Even his feet began to tap. I almost thought he was going to get up and dance…

Finally he raised his head and opened his eyes, sated. Exhilarated. Then, like an orchestral conductor he nodded for me to stop the sounds as he reached for the machine to turn it off in tandem. The performance was over; I almost expected applause, but except for the delight, bordering on exaltation I could feel around me, that was it.

He shook my hand warmly, gathered up his instrument, and sidled out of the room as relaxed and in control as ever. He left Cynthia beaming and her husband wide-eyed. But she winked at me as she left –a show of silent appreciation of the concert.

The whole episode left me puzzled however. Why had I felt so nervous? It was like I’d been onstage the whole visit. I walked down the short corridor that led to the reception desk and discovered both my secretaries huddled together and whispering loudly. They both looked up in unison when I turned the corner, their eyes sparkling, their expressions, well, rapt I suppose. Another puzzle.

“Interesting chap that uncle, eh?” I said, to break the spell.

“Interesting?” one of them managed to gasp as they saw my entirely benign expression.

I felt naïve, for some reason. “Yeah, he was really into the fetal heart stuff. He even recorded it,” I said, trying not to expose how strangely anxious his taping of it had made me, but I must have said it too loudly.

A patient I didn’t recognize was sitting nearby in the waiting room and she rolled her eyes when she heard me. “Well, I guess so, eh?” she said, and exchanged glances with one of my secretaries. They both laughed.

“Do you even know who that was?” the patient said.

I shook my head slowly. But just then, my colleague, the other doctor in the office, called for the patient, and she disappeared through a door after winking at my secretaries with an enigmatic smile on her face.

“Well,” I said to the now empty waiting room, trying to pretend I wasn’t as curious as I must have looked. “Who was the uncle..?”

Another set of eye-rolls –this time from behind the counter. “Come on,” one of them said when she finally found the strength to close her mouth. “Don’t you ever listen to rap?” She pronounced it like an accusation, but I know she didn’t mean it like that.

I am appreciated in the office –admired, maybe- but not for my musical insight. I am loved for other things… I hope.