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We had just finished watching a mystery thriller on TV. It was somewhat disturbing, but not memorable. What was memorable was my husband's reaction.

Bob was crying, his shoulders shaking.

"What, what?" I asked, surprised and alarmed. The movie wasn't that moving. He said, "It hurts. My hearing, my not hearing. The way you treat me." This movie had no subtitles for the hearing-impaired, and Bob frequently interrupted our viewing with "What?" when he missed some dialogue. I had reacted with angry impatience because answering him meant missing more dialogue. As if it mattered so much.

I had let him down big time.

We've known each other for 10 years, married five. Bob is 78 and I'm 73. When we met I hadn't noticed his hearing loss. It became more obvious when we'd go biking and he'd be unaware of cyclists or cars behind us. I joked about getting him a T-shirt with a giant ear on the back, a red slash through it to warn others that he was "Unsafe at any speed." When Bob couldn't hear an owl at night or the spring peepers in daytime we knew his world was growing more silent. After some searching he found hearing aids that substantially improved life for him and for us. But they aren't entirely reliable.

I suggested that we learn some basic American Sign Language for our everyday exchanges. Bob gave me the finger.

Aware that our relationship was being tested, we agreed on some new rules for communication. "Speak up, I can't hear you" is a demand: I feel blamed and resentful. "Speak up, I want to hear you" is an invitation; I'm open and more likely to respond graciously. No "Huh?" or "What?" No gum chewing or talking with backs turned or from another room. If Bob didn't understand me, he'd repeat as much of what I'd said as he could, so I wouldn't have to, and I'd fill in the blanks. I would be his hearing-ear girl and he'd be my seeing-eye guy.

Before my own cataract surgery a few years ago, I had been fearful at night when Bob was driving — certain that he was as night blind as I was — and that he would hit a deer, common in Minnesota. After my surgery, I realized it was just me who saw only darkness ahead. It's so easy to assume others perceive the same as we do.

Bob relies a lot on lip-reading. This, with my thin "chicken lips," is quite a skill. I must remember to make eye contact, speak low and slow, and mind my s's, f's, l's, p's, the beginnings and endings of words and everything in between. Sometimes Bob squints at me, bunching up his eyebrows, which means "I can't hear you." But the face he makes says to me, "What the hell's wrong with you?"

Bob doesn't always know that I've heard him if I'm not loud and clear. An irritating pingpong of pardons ensues. We fill in the blanks, believing we heard what was said, and that what was said was what we heard. In the book "Shouting Won't Help" by Katherine Bouton, her hearing husband asks her "When are we eating?" and she answers, "Chicken."

I prided myself on my ability to listen. I was licensed as a psychologist in 1987. On some of the worst days of my life, I could attend to clients and escape the racket in my own mind, the crashing in my heart, the complaint in my neck from leaning in to hear. I read body language — contemptuous eye-rolls and disgusted sighs speak much louder than words.

Bob is an experienced therapist too, and teaches communication skills to engaged couples. "The greatest gift we can give another," it has been said, "is the gift of our attention." He coaches his students to avoid misunderstandings with "What I hear you saying is …" We like the advice of Brent Atkinson in his article "Why Do Intimate Relationships Succeed or Fail?": Stand up for yourself without putting the other down.

I grew up in a family where everyone could hear but the adults were listening-impaired. A loud voice meant anger; now whenever I raise mine I feel annoyed. Enunciating each word distinctly signaled that limits of patience had been reached. "I. Am. Not. Going. To. Tell. You. Again." Must I weigh my words? What is worth saying, and worth saying again? And maybe again? Communicating with the hearing-impaired is a little like communicating with the memory impaired. It is too easy to think "Oh, the hell with it" and just give up.

I don't remember confiding in my parents. They were raised strict Catholics; their generation revered stoicism. Children should be seen, not heard. Grief was not shared. My mother did like to tell me stories of her growing up. I loved the attention but eventually realized she didn't listen to me. I learned to express myself in diaries. Sam the Clam was my nickname. Silence was my refuge, but silence from another felt like exile.

I dreamed of the perfect partner who would listen to me, even in the middle of a nightmare. I knew that one way to attract him was to be a good listener. When I met my sons' father we thought we had so much in common. He was Catholic, a Marine officer with a medal-bedecked uniform. He pretended to like to dance and I pretended to like football. We were eager to please each other, in a hurry to settle down and marry, to reproduce and separate from our parents. He had red hair and attitude: "Don't tread on me." I wanted to be like him. We drank together, for in vino there is veritas. Our initial soul mate confessions later became ammunition for arguments. "But you said …" I stopped feeling safe with him. He read my journal without asking, and was angry to learn of my unhappiness. After eighteen years, we divorced, our two sons then young teens.

In time I've seen my own part in that relationship; I still have the journal tracing its disintegration. By the end of the marriage, I was as distant and disinvolved with my husband as I was my parents. Single again, I looked for the partner who would be there for me, though I wouldn't be "nurse or purse." My mantra was "Marry someone whose wheelchair you're willing to push. Or who you want pushing yours." Dependency can be cruel, either way.

When Bob and I met, we immediately liked each other. Our lives were enriched with shared interests and families. Within five years we knew we were in it for the not-much-longer long haul and we wed. Silence with Bob, because we know, love and trust each other, can be golden. Peaceful, not punishing.

Our challenge to stay connected despite hearing loss is common. Many people don't realize they aren't hearing well. They may assume others are mumbling. The loss is a handicap that can be invisible to both speaker and listener. Hearing problems have been increasing in degree and in the numbers affected, with estimates varying wildly, from 31 million to 48 million people of all ages. Shame, denial and stigma contribute to the conflicting numbers. Damaging decibels from exposure to armed conflict, loud music, jet planes and jackhammers hurt everyone's auditory systems. Sometimes it's hard to tell who can't hear and who is simply tuned out — or tuned in to their too loud iPods.

Losing one's hearing is humbling. It shouldn't be humiliating. Physical limitations may mean dependency on others or on things, such as a walker or a wheelchair or hearing aids. Without the ability to hear, it is more difficult to be with others and easier to feel excluded. For the hearing-impaired, dialogue and interactions are missed in public and private places. There's little awareness of the sounds of nature — crickets, birdsong, the wind in the trees, water dripping.

When I become irritated at Bob because I must work to be heard as hard as he must work to hear me, I try to remember my friend RuthAnn, who died two years ago from a terrible ALS-like disease (progressive supranuclear palsy and corticobasal degeneration). After diagnosis, her physical abilities diminished rapidly, and soon she could hardly move her body, even her eyelids. With effort she was able to speak, and she could hear. Despite her paralysis, she always showed great interest in others, remembering many details of their lives. When visiting I had to make an effort to hear her. I watched her lips closely, repeated some of her words for clarification, and was patient with her and myself, not giving up and pretending to understand if I had not. It was hard work — and worth it. With her, I briefly experienced the challenge Bob has with me.

RuthAnn taught me how I'd like to be with my limitations and my husband's, and with anyone who experiences disabilities that slow down responses and understanding. She kept her sense of humor and she connected with others to the end. Just a week before she died her hospice nurse asked her what she would do on April Fools' Day. She whispered, "Play dead!"

I want to be present like that. Mornings, Bob and I have a coffee ritual, sharing our dreams, reactions to the news, the weather, the day ahead. Sometimes this conversation is slow or brief, sometimes I am animated and full of myself, and after a minute or two Bob will say, "Wait, let me get my hearing aids." Then I know he is present.

It makes me sad to see couples sitting in restaurants silently staring away from each other or at their cellphones. Maybe they can't hear each other? Maybe they stay in touch by holding hands, or even texting? I hope so. There are so many ways to hear each other, and so many ways to listen.

Sherry Machen and her husband Bob are retired and divide their time between Plymouth, Minn., and Green Valley, Ariz.