When the winner of the 1995 Miss America was announced, Heather Whitestone McCallum turned to her fellow finalist to see if she cried, knowing that it is almost always the winner who bursts into tears.
The fellow finalist was dry-eyed and smiling, and this was the first non-verbal cue that allowed Whitestone, who is deaf, to realize that the tiara was hers. Since then McCallum, now 29, has become a wife and a mother of two little boys.
And just yesterday she became something else — a hearing person.
With what's called a cochlear implant, a device that can restore some level of hearing for those with profound hearing loss, she has already heard a variety of low- and high-pitched sounds, including the sound of hairspray coming out of the bottle, a van door opening, and the jiggling of makeup in her cosmetics case.
It could be anywhere from three to five years, however, before she is able to hear and understand more complex sounds like voices.
After hearing water moving through the faucet and into the bathroom sink as she brushed her teeth Thursday night, McCallum became very emotional.
"In a way, God said to me, be patient. You will hear your boys' voice at the right time. Each day, I will bless you with a new gift," she said on ABCNEWS' Good Morning America.
Deaf Since She Was a Toddler
McCallum, an Alabama native, lost her hearing as a toddler. Despite her deafness, she pursued her dreams, and even made history as the first Miss America with a disability. She may not have heard heard the pageant announcer say, "… And the new Miss America 1995 is Miss Alabama Heather Whitestone," but McCallum was happy in her silent world.
But then McCallum became a mother and realized there were sounds she really ached to hear, particularly on the day that her older son, John, who is 2 years old, fell in the backyard. She couldn't hear his cries for help.
The desire to hear the voices of her two young boys is what inspired Whitestone to pursue the cochlear implant.
A Breakthrough of Tears
Heather received her cochlear implant on Aug. 6, in a surgical procedure that lasted one hour and 20 minutes. The implant picks up sound through a tiny microphone connected by a cord to a small box outside the ear. The box turns sound into a signal — transmitting it through the skin, straight into the skull. After the procedure, it takes six weeks for the patient to heal before the device can be turned on.
On Thursday, an audiologist at the Johns Hopkins Medical Center in Baltimore activated McCallum's implant by sending different tones to the device in Heather's ear.
The tones are like individual notes of music that will eventually become the symphony of sound that McCallum will hear.
"I can hear a little more," she said after the device was activated.
The first real sound was the audiologist clapping. The next was her son banging a drum.
It was the breakthrough that McCallum and her loved ones had waited for. She could hear. Everyone in the room, McCallum included, burst into tears.
Strengthening Brain Connections
Even though McCallum can technically "hear," it will still take a long time, maybe a few years, for her to be able to really interpret what is being said, according to Dr. John Niparko, an ear, nose and throat doctor, who is the director of the Listening Center at the Johns Hopkins Medical Center in Baltimore.
"In the setting of deafness, there's competition for space in the brain that normally would have been occupied by hearing," Niparko said. "Since she lost her hearing, that space has been occupied by other senses: touch, pain, motion."
McCallum heard "perceptive burst sounds," but over time she will need to learn how to hear more complex sounds like speech and music, and to sharpen her ability to decipher those.
"It's like an English speaker being plopped in the middle of Red Square; you hear the noise, but you don't know what they're saying at first," Niparko said. "It's a process that involves establishing and strengthening brain connections. And could take anywhere from some small steps in months, to three to five years."
Part of the therapy is just everyday listening, and McCallum will need encouragement to do just that. But another important part of her "rehab" will be structured exercises to work on sound and reproduction.
Over time, she will develop a better sense for the higher frequency of speech, and will learn how to voice the whispery sounds that do not come from the voice box, but rather the teeth. It is that nuance that will make her voice sound more natural, Niparko said.
Getting Message Out
Meanwhile, McCallum wasted no time getting her message out about cochlear implants. She went lobbying on Capitol Hill Thursday, meeting with legislators to help advocate on behalf of the deaf, and to raise awareness among deaf people about the opportunities available for improving speech.
About 70,000 cochlear implants are in use around the world, with 21,000 of them in use in the United States. The cost, about $50,000 including post-operative treatment, is prohibitive for many, and is usually only partly covered by health insurance.
Of 28 million Americans who are profoundly deaf or have a significant hearing loss, at least 700,000 can benefit from a cochlear implant. That figure includes 200,000 who are children younger than 5 years old. Because more than 80 percent of deaf children are born to hearing parents, doctors believe the earlier the baby gets an implant, the better.