This chapter is special... and I have many I need to acknowledge.

The cochlear implant issue has long been a controversial one - it has helped many people, but it's invasive and what independent research I've done leads me to think that I'd never want one.

Those I have talked to among the Deaf/HOH community in our midst have given me a lot of information and personal insights - RK, CB,KS - thank you very much, guys. It has made this issue come to life in my story...

The alternative treatrment we'll touch on is real, and all the specific information I will give is based on my own research. All the sources will be cited. It's an exciting prospect, I must admit, though some may still choose to stay as they are.

I haven't decided yet if we will be audience to Rachel's decision... we'll see...

This is a very good point to re-state that this story takes place 13 YEARS IN THE FUTURE. The research I cite is just now coming to the fore... and I chose to not make up a ream of it for the ensuing decade. So, I have chosen to keep the "tide turning," without going into detail. From the research I did, it's very VERY likely that what is portrayed here will be accurate in 13 years...

TY so much toCB andRK for both info and personal insight - we talked a lot about these two treatments and what they meant to not only the Deaf community, but to both my betas personally... lol, in fact, Sue's answer to Myles' question at the end is verbatim what I got from RK... It seemed to fit perfectly...

Chapter 8: A Fork in the Road

Leland Residence

Tuesday, 7 pm

"Liz, that was incredible." Brian leaned back from his third helping of pot roast and rubbed his stomach, then leaned over to Rachel and signed ME BIG BROTHER, YOU WANT?

The eight-year-old smiled a little. DAD NOT A-D-O-P-T YOU, she replied. VERY OLD MAKE HIM FEEL.

Sarah laughed. "Besides," she said in a loud whisper, signing as she spoke, "we already asked. Dad said feeding you alone would eat up his pension in a year."

Myles watched the exchange with a smile; Brian had indeed become almost a sibling to Rachel. Their cultural connection was something that had affected the whole family, and Myles was grateful that there had been a solid "bridge" for them all.

Though his hearing aids made him virtually "hearing," Brian's parents were Deaf, as were most of his siblings. So, unlike Sue, he'd grown up immersed in Deaf culture. He'd also provided a perspective for Myles that Sue never could – a gender viewpoint as well as a cultural one. It had been an interesting journey.

Now, as Brian shot him a mock glare, he laughed as well. "Don't look at me like that, bambino," he warned, using Earl's version of the nickname. "I used to hear Jack say you were the only person he'd ever met who could keep up with Bobby at Miller's Buffet."

"Leave him alone, Myles." Elizabeth smiled as she cleared the last of the dishes. "It's a high complement to the chef when a guest leaves nothing for sandwiches the next day."

"But those sandwiches are generally my lunch," the Harvard grad mourned. "I guess I know who's springing for the midday meal tomorrow, then."

Brian's good-natured retort was drowned out by the doorbell ringing, the light above the dining room doorway flashing at the same time. Sarah and Rachel raced to answer it, and squeals of "Uncle Sam! Uncle Sam!" were heard.

Elizabeth glanced at Myles, a surprised expression on her face. He brought his hand to his head. "Oh no… I forgot I'd invited him and Tara over tonight. He just got back from Wyoming."

Her green eyes clouded with concern. "Ordinarily, that wouldn't be a problem, but I called Sue when I got home. She and Jack should be here any minute with Zachary."

Now she looked at Rachel dragging Tara into the living room, chattering delightedly about something, signing again as soon as her hands were free. "We can't overload her, Myles. She's already terrified that Dr. Billings is going to drill a hole in her head whether she wants it or not."

Brian leaned over and touched his teammate's arm. "Hey, why don't the adults go talk a bit first? That way, you can decide how much information she needs before she has to face a whole crowd. Or, if she even should face a whole crowd."

"That's a good idea, Brian." Myles stood and walked into the living room, where both girls were glued to Sam's side, their eyes like saucers as he dug into a large shopping bag. Each girl was already sporting a beautiful cowboy hat; not a tourist-shop knock-off, but a 6 beaver Stetson.

"Daddy! Daddy, look!" Rachel was to him in a flash, pulling him over to the sofa. "Uncle Sam got a hat for you, too! And for Mommy!"

Myles was already shaking his head. "What'd you do, buy up the whole state?"

Sam Leland glanced at his wife, grinning, then entertained his twin with a bewildered look. "Well… it's not like there was a whole lot there, dude. I mean, it is Wyoming. I guess it could have been worse – I could have ended up in Montana." Now he smiled at the girls again. "Which means I wouldn't have found these to go with your hats."

He pulled two pair of hand-tooled leather boots out of the bag, custom-made with "Rachel" and "Sarah" twining down the outside in a beautiful script. Both girls squealed so loudly that Brian winced and promptly adjusted his hearing aids down several notches.

Myles couldn't resist; he elbowed Brian to get his attention and signed ADJUST YOU AFTER TIME.

The doorbell rang again, though Myles only realized it from the flashing light, since the girls were still at about a hundred decibels. He stepped away to answer it.

"Looks like you needed us after all, or Liz did," Jack teased loudly as he and Sue stepped in, their 9-year-old son Zachary in tow. "You didn't mention you were opening a Deaf Club." He grunted as Sue poked him in the ribs.

FUNNY, Myles signed in reply. S-A-M HERE. BACK FROM W-Y TODAY.

Sue smiled. EXPLAIN A LOT. She managed to pull Zach's coat off before he ran to the living room to join the fray. PARTY YOU HAVE, VERY LOUD, ME THINK SMALL NOISE I HEAR ALSO. Myles looked a little confused, so she tried to feel her throat push to talk louder. "From the look of it, I could probably hear them as well."

He nodded now. ME NOT SURPRISE. Blue-grey eyes rolled to the ceiling in mock-exasperation. WELCOME, PLEASE ENTER MAYBE DANGER. They laughed together at the horrified expression on his face.

:
MOM! Zachary Hudson ran over as Sue sat down, his dark eyes wide and excited as he held up a pair of hand-tooled boots, minus the fancy writing. WAY COOL!

Sam grinned at her. "I thought about getting a six-shooter holster for him, then decided I wanted you still speaking to me." He laughed as she signed GOOD THINKING, wrinkling her nose at him.

"Hey, pardner," Jack drawled, ruffling his son's blond hair as Zach plopped down on the floor and promptly shed his sneakers. "Those are some fancy spurs."

The boy's face split into a huge grin. "Yeah, and Uncle Sam said he's got a horse for me out on the ranch, too!"

"A what?" Several sets of eyes nailed Sam, including Elizabeth, who had just come in from the kitchen with a tray of coffee and cake.

Sam looked at the lot of them as if they were daft, then very slowly brought a "closed 3" hand to his right temple and waved the index and middle fingers a couple of times. He spoke very slowly. "A horse. Big, four legs, eats a lot of hay? I just set up a foundation for a couple thousand wild mustangs. Three tame pintos didn't seem to mess up the numbers that much."

Tara was laughing. "Don't argue. You all know better by now." She stood and turned around once, modeling a full skirt and a matching vest over a blue shirt. "If he got me into suede fringe, you all are goners."

"When school lets out, we'll just take a little trip," Sam shrugged, smiling as the kids went into hysterics again.

Elizabeth held up a hand for quiet; it took a minute. "Well, before y'all head out to the north forty, there's a kitchen full of dishes waiting." A chorus of "aww" was the response. "Go on, girls."

Sue got the hint. "Zach, go help them, please."

He turned, betrayal etched into the fine features of his face as he spoke and signed. "Mom! I didn't eat here tonight!"

"Zachary." Jack drew the namesign out slowly, a "z" signed at the side of his chin.

"Besides," Sue said, smiling now, "the more you help, the faster you and the girls can go play."

The 9-year-old sighed dramatically. "Okay, okay. But I'm sending them a bill." The quip might have gotten him in big trouble if he hadn't been grinning the whole time.

Myles chuckled. "I am so glad my kids aren't the only ones who've been corrupted by my twin."

Tara glanced around at the group as the clunk-clunk of cowboy boots faded across the hardwood floor. "So what's going on? This looks like a serious pow-wow."

It only took a few minutes to fill them in on Rachel's appointment, and the doctor's suggestion. When they'd finished, Sam was scowling. "There's nothing wrong with Rachel. He makes it sound like she's broken. You're not seriously considering this?"

"We're not considering anything yet, Sam," Myles reassured him. "This is up to Rachel. There are some other options available, and we wanted to hear about them before we talk to her about any of it. It's her choice."

Tara looked at Elizabeth. "Lot of people for an 8-year-old with a tough choice to make. Would it be better if we clear out for awhile? Sam was hoping you'd let us take the girls tonight for a sleepover, and we'd take them to school tomorrow, but if you think it's too much…"

The psychologist thought for a minute. "Actually, that might be a very good idea. It would give Rachel a break, and give us time to figure out how much information she needs. We're still processing, too."

"Okay," Sam was already on his feet. "We'll go supervise the cleanup and then get a game or something going. That way, they won't think it's weird if we vanish and then show up later."

"Thanks, Sam," Myles replied. "And by the way; are you sure those professional cowboys are going to let you back into the state to take the kids riding?"

:
Elizabeth sat down next to her husband after serving everyone's coffee. Jack, Sue and Brian were all on the sofa, and Myles had taken one of the side-by-side armchairs opposite. He squeezed her hand once, then leaned forward. "All right," he started. "Obviously, Rachel isn't very keen on the idea of a very invasive surgery. But I don't know a whole lot about what other options there are, or if there are any. I assume that you know more than I do."

Jack chuckled. "That's a first." He waved a hand as Myles gave him a sideways glance. "Sorry; couldn't resist. I'll be quiet now." He made a show of being very interested in his carrot cake.

Sue swatted him with a smile, then turned back to Myles. "Well, cochlear implants have been around since the mid-1980's. In all honesty, there hasn't been a lot of advancement in the technology, even after nearly forty years. It's a simple enough design: a small electronic device is implanted under the skin behind the ear, then electrodes are connected to the non-working parts of the ear and to the receptors which lead to the brain. It doesn't restore or create normal hearing. Instead, under the right conditions, it can give a deaf person a useful auditory grasp of the environment, and help him or her to understand speech."

"Yeah," Brian added cynically, "only what most audiologists don't tell you is that it's not guaranteed, and if it doesn't work you're out of luck." He caught the glance exchanged between the Lelands and softened his tone. "Sorry. Because the process bypasses the ear canal totally, it destroys all of the normal hearing. What little was there, isn't anymore."

Sue nodded and continued. "What they also don't tell you up front is that even now, most insurance won't cover it because it's still considered 'cosmetic' – and that in 2000, the surgery was $65,000. Today, that figure is at about $90,000. And you also have a month's recovery time, then an activation and fifteen to twenty 'mapping sessions.' That's training for re-recognition of sounds."

"And it's possible that a hearing aid would still be necessary," Brian piped in again. "They still only do it in one ear. If it didn't work, then Rachel would still be deaf. And she'd be worse off than before, because they only implant your 'better' ear, to ensure the best hearing. Also, CI's don't last forever; most of them burn out after five to ten years and have to be replaced. And some people I know who've had them tell me the sound is really tinny – even after thirty-plus years of research."

"CIs have helped many people," Sue finished, "but I personally think that the researchers jumped at a 'Deaf cure' a little too fast. There are still just too many uncertainties, and too many risks."

"Okay," Elizabeth said, crossing her legs and rubbing her temples as she leaned back against the soft leather chair. "This all matches what little reading I've done. I think it's safe to say that if there's no other alternative, Rachel would be better off as she is, since she really has adjusted quite well. The idea of a cochlear implant terrifies her right now."

"What do you know about a technique called HCR?" Myles asked. "I saw an article about it recently on the bulletin board where our support group meets, but I haven't had time to look into it."

Brian chuckled. "If you've only seen one article, then you're way behind. HCR has been around since the turn of the millennium, but they've worked much more slowly and cautiously, mainly because of the nature of what we're talking about."

Sue was nodding. "HCR stands for Hair Cell Regeneration, and it's a gene therapy. Since we've finally realized that we're not always ready to play God, they've taken their time. But it's very promising. It won't work for all cases of deafness, because not all cases are caused by hair cell destruction. In Rachel's case, though, it might well be worth waiting for."

Myles took a sip of his coffee. "I don't want it to sound like I'm ready to have my daughter 'repaired.' I hope you don't think that…"

"Of course not, Myles," Sue replied easily. "I know that you've done everything you can for Rachel, and that you haven't really begrudged a minute of it. You had me surprised, as completely as you dove into the culture. It says a lot about your bond with her."

"Well, I could comment about a golf hustler you introduced me to," he smiled, signing it at the same time, "but I think I'd rather hear more about this research."

Brian picked up the discussion, signing as he spoke to give Sue a break. "Well, you know that until the last fifteen years or so, it was commonly believed that all species of animals except mammals could regenerate hair cells spontaneously."

"Yes," Elizabeth responded, "but let me make sure I understand. Hair cells are essentially sound receptors, catching auditory waves that translate to sound, yes?"

"Right," Brian replied. "And most hearing loss, especially in late-deafened adults, is caused by the destruction of hair cells due to illness, drug interaction, or excessive exposure to loud noise. In Rachel's case, it was the meningitis."

"Research into whether the same procedure scientists observed in other species could be copied in mammals started clear back in 2000, in Great Britain," Sue said, "and it began to work, in mice at least. By introducing a gene, they were able to stimulate regeneration of hair cells. They also had some success in a hair cell transplant, where they were able to grow mice hair cells in a test tube."

"Within three years, a patent had been issued to a European pharmaceutical company," Brian continued. "But it still wasn't widely available. People were starting to realize that you don't mess around with genes without having a very good idea of what you're going to tweak in the process. But the idea had started, and it showed promise. More people got involved…"

"Now, after fifteen years, it's becoming more and more of a 'when' than an 'if,'" Sue added. "From what I've read, it's really nearing the point where HCR will be a viable option."

"Then why didn't the audiologist offer it as a possible option?" Elizabeth's voice mirrored her frustration from earlier.

"Because technically it's still experimental, and there are always 'old school' types who want to stay with the 'proven' methods. And it won't be cheap either, though it may be covered by insurance in time," Brian replied. "Look, you need too understand; HCR isn't a 'next week' thing. It's still several years, perhaps as much as a decade if you're really cautious, down the road. But, it's close enough that Rachel may not want to risk a CI and ruin any chance she could have later with HCR. That's if she decides she wants to do anything at all."

"Let me ask you both something." Myles sat forward in his chair, resting his arms on his knees and folding his hands together. "If HCR were offered to the public tomorrow as a viable, all-but-guaranteed treatment for your hearing loss – would you do it?"

They both looked at him, and Myles noticed that Jack's attention was peaked as well. "I'm just curious," he clarified. "I'm sure Rachel will ask you both as well."

Brian leaned back, resting his arm on the sofa and tapping at his chin. "As an all-but-guaranteed? Honestly, I might consider it. But I've lived with my hearing aids all my life; in terms of most Deaf, I'm only culturally Deaf, not medically. HCR wouldn't change my life that much necessarily, except in the fact that I'd save a bundle on batteries."

Myles nodded, chuckling, then looked over at his former teammate. "Sue? I suspect your answer might differ."

Sue glanced at Jack for a moment. He reached over and took her hand. "Sweetheart, I'm curious, too, but I would never push you to do something you didn't want to. If you ever decided to do it, I'd be there to help. If not, I still love you. You know that, right?"

She nodded, smiling. "Yes, I do know that." Then she turned to Myles. "I think if I'd had a few more years of being able to hear, I might entertain the idea. But so much of my life has been… in silence, you would say. I suspect I would have a much harder time learning sounds again than either Brian or Rachel." Her smile got wry. "Besides, at my age I'm used to asking 'what?' and having folks repeat things fifty times if needed. Though Levi might like to retire."

There was soft laughter all around at that, and Myles teased her a little, surprised again at how far they'd come from the adversaries of fifteen years ago. L-E-V-I HAPPY HIM NOT IN BIG MESS EVERYDAY NOW.

"Yes, but he's disappointed, too; he never gets Tea Room scones anymore."

:
The girls were off to Sam and Tara's, the others had gone home, and the house was silent. Only a single light was still on.

"You're quiet." Elizabeth was standing in front of the dresser in her nightgown, a white silk one like he'd given her the night before their wedding, brushing out her waist-length hair. She glanced in the mirror at her husband, who was stretched out on the bed, his hands clasped behind his head, contemplating the ceiling. "Still processing?"

"It's going to take awhile," Myles replied absently, bending each leg up in turn to untie his shoes, then kicking them onto the floor, unbuttoning his shirt at the same time. "They gave us quite a ream of information."

"That they did." She turned. "What are your first thoughts?"

"That I have no idea what I would do if it were me." He got up, dropped the dress shirt in the hamper, and walked over to her, taking the brush from her hand and running it over the back of her hair, loving the feel of ebony silk in his hands. "Or if we should subject Rachel to any more chaos right now. What about you?"

The psychologist sighed softly, closing her eyes at his touch. "I think a cochlear implant is a very bad idea for her right now. It's been four years; she's finally adjusted enough to where her life has some semblance of normality about it again. An invasive surgery, recovery, and mapping sessions would throw her into chaos again."

Now she turned again and slipped her arms around his waist, letting her hands drift under his t-shirt. "And I don't like the idea of the risk involved, and the fact that it's really a one-shot. I think the idea of looking into HCR and seeing what sort of options are there would be better for her, if she decides to do anything at all."

"I agree. It certainly sounded like a much gentler way to do things." He set the brush on the dresser and ran his hands through her hair. "But we're still going to let her make the decision, right?"

Elizabeth nodded. "I think it would be best. I don't agree with the audiologist that we're under the gun. Rachel is highly articulate, her reading is above her age level, and she's adjusted very well socially. She has a circle of friends that includes both Deaf and hearing, and she handles social situations with more grace than I thought possible. More so than I do at times."

"Maybe it's time to get a new audiologist," Myles suggested. "I'll ask Brian tomorrow if he has a recommendation."

"May I ask you something?" His wife leaned into his embrace, her cheek on his chest.

"Mmm-hmm."

"If Rachel were to decide to do something, and it worked, would we still stay involved in the Deaf community?"

Myles looked at her in surprise. "What do you mean?"

Elizabeth led him over to the bed and sat them both down, taking his hand. "It's not just the medical aspects of this we need to consider, Myles. And Rachel will need some information along these lines as well. A great deal of her support network right now is ingrained in the Deaf community here. Helga, her friends at Chesterfield, the plays she's involved in, her volunteering as a storyteller at the library… if she decides to try one of these treatments, we need to make sure that her support doesn't get knocked out from under her at the same time."

He pulled her into his arms and leaned back, stretching out again as she snuggled next to him. "Is this some subtle way of asking if I'm going to back out?"

"Well, you wouldn't have to endure another golf tournament." Elizabeth laughed as he poked her in the ribs, tickling her; then her face grew serious. "I don't know," she answered honestly. "It just occurred to me while we were talking tonight. It's not just Rachel; I know you have some wonderful friends in the community as well. So do I. We have become an integral part of it, and I don't want to feel like we're abandoning them just because Rachel can hear again."

"Fine line to walk, isn't it?" He dropped a kiss into her hair. "But then, we've walked a fine line through all this anyway. But my answer is no. I can't see turning my back on Ron, or Helga, or any of our friends in the Deaf community. Rachel's medical status has nothing to do with that."

She smiled up at him. "Do you have any idea, truly, how far you've come? The man I met fifteen years ago wouldn't have said that with such conviction. In fact, I doubt he'd have said it at all." Now she pushed up on one elbow and ran her finger down his chest.

A fine blond brow popped up, over mischievous blue-grey eyes. "I take it you find that particular fact… intriguing?"

Her soft, throaty laugh jolted every facet of his being. "Why don't you finish getting ready for bed, and I'll show you exactly how intriguing."