Can You Hear Me Now?

Winter 2016

Can you hear me now?Those best positioned to do research to help the deaf are the deaf themselves, contends Tilak Ratnanather. As a role model and mentor, he’s made it his mission to bring more deaf and hard-of-hearing students into STEM fields— giving voice to a new generation of young scientists.

By Joe Sugarman Photos by Chris Hartlove

Like all freshman, Stephen Tang '07 was anxious about the upcoming year when he arrived in the Fall of 2003. As the Whiting School's first deaf student to major in Biomedical Engineering, he realizes now that he was also a little naive.“In retrospect, I did not have a very good understanding of the challenges my hearing loss would present me after high school,” he says. “I didn’t appreciate the importance of always looking for solutions to issues and concerns that came up regarding my hearing loss in order to function in the real world. These were foreign concepts to me coming out of high school, as I never really had to deal with such challenges with my parents around.”

Tang had an inkling that he’d someday like to pursue a career in medicine—a dream he’d often dismiss due to his deafness. How would he even do routine procedures, like listening to a patient’s heart through a stethoscope?

But during orientation week, he met Tilak Ratnanather, an associate research professor in the department. Like Tang, Ratnanather was born with sensorineural hearing loss and wore hearing aids. He was also the first deaf professor Tang had ever encountered.

“Growing up, I really didn’t know any other deaf people,” Tang says. “So meeting Dr. Ratnanather was a bit of an honor for me. He was a professor at a big research university. He showed me by example that if he could get this far into his career with the same challenges that I grew up with, I could do the same.”

During his years as an undergrad, Tang worked in Ratnanather’s lab. He watched how his professor successfully interacted with colleagues and conducted research just as fluidly as his hearing collaborators. Ratnanather wrote letters of recommendation for Tang and explained how he could overcome obstacles real or perceived. (There are now digital stethoscopes that greatly amplify the sound of a beating heart, for example.) After graduating from the Whiting School, Tang attended the University of Wisconsin School of Medicine and Public Health. He is currently in his first year of a residency in radiology at the university’s hospital.

Tang’s story is not unique. Since arriving at Johns Hopkins in 1991, Ratnanather has mentored dozens of students, many of them deaf or hard of hearing. His mentees have gone on to pursue careers as engineers, researchers, and physicians around the globe. Eight of them are doctors or in medical school. Three are working at research universities. NASA employs one.

For his achievements, Ratnanather was one of 14 educators nationwide selected to receive a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring last summer. In a ceremony at the White House, President Barack Obama said: “These educators … open new worlds to their students and give them the encouragement they need to learn, discover, and innovate. That’s transforming those students’ futures, and our nation’s future too.”

Ratnanather displays the handsome sculpted glass award he received in his office, but he’s clearly modest about the honor. He’s earned a reputation around the department for his warmth and congeniality, as well as his love of travel and rugby—a holdover from his days growing up in England.

An expert lip reader, Ratnanather answers questions thoughtfully, including those about what motivates him to mentor others. “Deaf students face a unique problem,” he says. “A hearing impairment, for the most part, is invisible. Sometimes they think they’re the only person in the lab or the community that has hearing loss. It’s important for deaf people to look up to someone and think, ‘If that person can do it, then I can do it too.’”

But Ratnanather, who sees himself as a matchmaker of sorts—pairing students up with researchers for internships, or making mutually beneficial introductions at conferences and symposiums—has a broader plan in mind. Deaf and hard-of-hearing students have traditionally been underrepresented in STEM fields at the undergraduate and graduate levels. Historically, surprisingly few pursue careers in auditory research. Ratnanather thinks this is simply bad for science. He believes that those who might be the most effective at doing the research to help the deaf are the deaf themselves.

Tilak with students
Ratnanather regularly collaborates on research projects with his students.

At 52 years old, Ratnanather, has come a long way from his beginnings in Sri Lanka to shaking the hand of the president of the United States. He was born in 1963 in what was then known as Ceylon, but his family moved to London for its superior system of education for the deaf. Born with probable damage to his inner ear, Ratnanather was fitted with hearing aids at an early age and attended schools for the deaf through high school. (Even in profoundly deaf individuals, there remains residual hearing that can be amplified via hearing aids.) In his mind, there was never any question but that he’d attend a mainstream college. When he matriculated at University College London, he became its first congenitally profoundly deaf student to pursue an undergraduate degree in mathematics.

This was in the days before real-time captioning of lectures, interpreters, or cochlear implants made higher learning more accessible for hearing-impaired students. Ratnanather’s instructors used a special microphone that transmitted FM signals to an amplified receiver attached to his hearing aid. The system, which is still used in classroom settings, worked well—as long as the professors remembered to turn on their microphones. Relying on the transmitter and doing extra reading, he was able to graduate near the top of his class.

It was an achievement that earned him a spot in the DPhil mathematics program at the University of Oxford, where, in 1989, he completed his doctoral research in numerical analysis of fluid flows. That was another first: At the time, Ratnanather was the only congenitally profoundly deaf individual in the world to graduate with a doctorate in mathematics.

It was at an AG Bell convention the following year when he met Bill Brownell, then a professor in the Department of Otolaryngology–Head and Neck Surgery at the Johns Hopkins University School of Medicine. (The Alexander Graham Bell Association for the Deaf and Hard of Hearing is an international advocacy, research, and education organization, well-known for its work in awarding college scholarships to hearing-impaired students.)

Ratnanather says it was a meeting that changed his life. Brownell recruited him to cross the Atlantic to do postdoctoral studies in his department and in biomedical engineering under Aleksander Popel, also at the School of Medicine. Both men were to become his mentors.

“Tilak joined my lab with little knowledge of biology but with a huge motivation and drive to work in the area of hearing biomechanics,” recalls Popel. “With a lot of reading and exposure to the hearing sciences community, he became an expert and a major contributor, especially in the area of mathematical modeling of electromechanical transduction by outer hair cells in the cochlea. He has also become internationally known for his tireless dissemination of knowledge on modern technologies for the hearing-impaired.”

Over the years and with developments in neuroimaging, Ratnanather’s research moved beyond focusing on the inner ear and into the brain. Since 1998, he’s been an integral part of the Whiting School’s Center for Imaging Science, performing an acrobatic mix of geometry, advanced computations, and data analysis necessary to map the intricacies of the human brain.

“He’s an expert in mechanics and understanding complex geometric systems,” says Michael Miller, MS ’79 , PhD ’84, the Herschel L. and Ruth A. Seder Professor of Biomedical Engineering and director of the center. “Many of our algorithms are very computational, in that we try to simulate actual neural connections and projections that occur in the brain. That’s associated with very complicated and complex codes. Tilak is an expert in numerical analysis and convergence of various computing approaches, which is very important to what we do.”

Using computational anatomy, Ratnanather and his colleagues have been probing the specific structural differences—or biomarkers—between healthy brains and those afflicted with maladies from ADHD to mental illness. Recently, the team was able to pinpoint structural differences in the amygdala, hippocampus, and entorhinal cortex—the region responsible for memory—in subjects with preclinical Alzheimer’s.

“The idea is that if you pinpoint the location where the damage is happening, a drug could one day be developed to stop atrophy in that region of the brain,” says Ratnanather. “Imaging is becoming a very powerful tool for developing biomarkers. That research could be carried over to other diseases, such as Huntington’s, Parkinson’s, depression, schizophrenia, and even to issues of speech and language.”

Ratnanather also has collaborated on research with his students, including developing an iPad app called Speech Banana (, which helps recipients of cochlear implants adapt to their new method of “hearing.” It has been downloaded nearly 1,000 times since its launch last year, and the app is currently being developed in Korean and British English versions.

In 2012, Ratnanather himself received a cochlear implant at the Johns Hopkins Hospital, and while he says the device has significantly helped increase his hearing ability, the learning curve is steep. “You basically have to retrain the brain,” he says of the electronic device. “The neural pathways are already in place thanks to early diagnosis and early intervention via hearing aids, but the stimulus is much different. Still, you can notice improvements on a near daily basis.”

In 1991, there were just two deaf or hard-of-hearing individuals pursuing graduate degrees in auditory sciences worldwide. At the undergraduate level, the percentage of deaf students majoring in the sciences versus other fields has always been much lower than the percentage of hearing students who aspire to a scientific career.

Deaf students can face a variety of challenges in the classroom and adapting to college life. The Americans with Disabilities Act mandates that deaf or hard-of-hearing students have access to interpreters or assistive devices, like closed captioning or FM transmitters, during lectures. For classroom discussions, the FM-transmitting microphone, usually worn by a professor around his or her neck, can be replaced by a speakerphone that picks up speech from all directions. Instructors typically receive advice from the university’s Office of Student Disability Services on the best ways to accommodate a deaf student, as each impairment—and preferred strategies for dealing with it—is different. Ratnanather says all of the students he has mentored have relied upon FM transmitters, captioning, or lip reading in class. Still, many students can miss comments spoken by classmates, and even the best lip readers can miss significant parts of a discussion if a lecturer’s face is turned or the room isn’t bright enough. These difficulties make it that much harder for students to succeed in demanding STEM fields.

And then there are the social challenges. “You always feel different from others in social settings; you always feel like others have to ‘include’ you, and that can be a bit of a drag,” says Tang. “However, having a mentor who can overcome all the challenges in a university setting made more difficult by our hearing loss is a huge help.”

Ratnanather thinks the biggest hurdle deaf students must overcome is in their minds. “The first obstacle is really psychological—being the only deaf kid on the block, so to speak. So once the deaf kid knows that there is a deaf person who has beaten all odds to be part of the faculty in a mainstream college, the burden is dramatically lifted.”

Lina Reiss ’05 became Ratnanather’s first mentee when, in 1995, he encouraged the Princeton undergrad to spend a summer as a research assistant in the Center for Hearing Science under Eric Young, a professor of biomedical engineering. Reiss went on to pursue a graduate degree in biomedical engineering at Johns Hopkins, becoming the first congenitally deaf person in the world to receive a PhD in the field.

Now Reiss is an assistant professor of otolaryngology at Oregon Health & Science University (OHSU), where she conducts research in audiology and cochlear implants. She says she never dreamed about heading up her own lab until she met Ratnanather, who introduced her to other deaf scholars. “I previously thought I would end up working for a company as part of a team, not be a team leader or professor with my own lab,” she says. Through Tilak’s example and people he introduced me to—Tilak somehow knows everyone!—he showed me that I could indeed run my own lab and be a leader, even with hearing loss.”

Reiss has gone on to become a mentor herself—something Ratnanather emphasizes to his mentees in order to broaden their impact. “The idea of having more and more deaf people doing hearing research is important. Someone with a cochlear implant knows from experience what it is like to live with one. And in the past few years, there are more and more people with cochlear implants who want to do STEM work as a way to ‘pay it back.’”

Ratnanather honored at the White House
Ratnanather was among those honored at the White House last summer with a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring.

Reiss and his other students say that once Ratnanather becomes your mentor, he’s your mentor for life. “We have kept in close touch ever since I graduated in 2010,” says Joseph Heng ’10, who studied biomedical engineering as an undergrad at the Whiting School and recently became the first congenitally profoundly deaf resident in internal medicine at the Johns Hopkins Hospital. “He still doesn’t hesitate to put me in touch with anybody he knows who he thinks can help me achieve what I would like to do. His mentoring doesn’t end in the classroom or laboratory.”

Another way Ratnanather is increasing the ranks of hearing-impaired STEM students, particularly at Johns Hopkins, is by his work on the AG Bell College Financial Aid Committee, which awards thousands of dollars in scholarships to deaf and hard-of-hearing high school students every year. Ratnanather has served on the committee since the mid-1990s and has chaired it since 2005. (“And probably will for life,” he quips.) The opportunity has meant that he can funnel the best and brightest who express interest in STEM majors to Johns Hopkins and other places. Tang was one such student, as was Dominic Pisano ’06, the first deaf student to major in neurosciences at the university.

In the coming years, Ratnanather hopes to develop a multisite mentoring program, involving research labs at the University of Southern California, OHSU, Rice University, and Baylor College of Medicine, home to his former mentor, Brownell. “The idea is that if a student enters a STEM program and wants to pursue studies in auditory sciences, biomedical engineering, or work on cochlear implants, he or she could work in labs at any of these schools for the summer,” says Ratnanather, whose team is planning to write a grant proposal to the National Science Foundation to make the program a reality. “The plan is to expand the mentoring program and increase the pipeline.”

Since Ratnanather and others have started their mentoring movement, the number of deaf researchers in the auditory sciences has expanded significantly. In 2015, there were 10 hearing-impaired faculty members in the auditory sciences nationwide, with another 15 pursuing graduate programs in the field. It’s no coincidence that Ratnanather knows them all.

“Deaf people don’t have to go to special universities. They can come to Hopkins and similar places and find success,” he says. “There are many imaginary obstacles placed by their own concerns about being deaf. If we remove those barriers, they can get over the hump.”

Making Their Voices Heard

When Tilak Ratnanather attended his first meeting of the Association for Research in Otolaryngology (ARO) in 1992, he was just one of three hearing-impaired researchers out of the hundreds attending the conference. Bothered that organizers didn’t provide closed captioning for the myriad lectures and events, he and the two other researchers decided to meet for dinner to brainstorm ways to help the conference become friendlier to its deaf and hard-of-hearing attendees.

From that dinner sprang a new subgroup called the Hearing Impaired Association of Research in Otolaryngology (HI-ARO), which has continued to meet for dinner at every ARO conference since, and has expanded to include some 50 international scholars and students who stay connected throughout the year via email. The group discusses issues related to succeeding as hearing-impaired researchers, as well as opportunities for networking. Ratnanather’s mentee, Lina Reiss, says a connection she made at one of the dinners led to her current position as a researcher at Oregon Health & Science University and also helped convince her that she could succeed at it.

“The experience left quite an impression because it was at this gathering that I had the chance to see other deaf individuals who had succeeded in not only securing faculty positions, but also in successfully running their laboratories despite their hearing impairment,” she says.

And the upstart group has had an impact on the larger conference as well. The 2015 ARO gathering was held in Baltimore last February and, as Ratnanather notes, every one of its podium talks offered closed captioning.