On August 29, 2019, the narrator of Eliza Barry Callahan’s The Hearing Test wakes up with a deep droning sound in her ears. At the doctor’s, she is diagnosed with Sudden Deafness, and is told she has lost low-end hearing. This is a strange, unnerving disease — the cause is a mystery, and the disease could worsen over time, eventually possibly leading to total deafness. The narrator, an artist and musician, finds herself unrooted from normal life, thrust into a new experiential reality. She begins to write down her year: the way her hearing devolves, her interactions with people she meets, and her changing perception of the world. The Hearing Test is her effort of mapping out a year of living with illness — a way of “keeping score.”

The Hearing Test draws from Eliza Barry Callahan’s real-life diagnosis of Sudden Deafness, just before the onset of the Covid-19 pandemic, and the novel developed from what was initially an essay about her experience. Callahan fictionalizes her experience through The Hearing Test’s narrator, who we follow on a contemplative journey toward silence. She visits doctors and takes hearing tests, attends regular video-call sessions with a hypnotherapist, and contemplates the nature of silence. In the early days of her hearing loss, she is struck by the absence of some sounds and by the increased intensity of others. She is newly aware of the sound of her own heartbeat and the thud of her eyelids meeting in a blink. “I could hear my voice more clearly now,” she says. “I had become nearer to myself.” But the narrator’s forced proximity to herself is a simultaneous journey away from herself, or from the version of herself she once was, an idea emphasized by the fact that she remains unnamed for most of the novel (the only time she is named is on the very last page). As her hearing changes, so too does her sense of self and the things around her that she becomes attuned to.

Despite its introspective quality and the narrator’s narrowing focus on herself, The Hearing Test is a novel full of other people. It takes the form of anecdotal interactions with people who cross her path — the doctors and hypnotherapist, friends and acquaintances she meets or talks to on the phone, online forums she browses. Conversations range from the quotidian to the unusual, and are mostly recounted in reported speech, filtered through the narrator’s perspective. Emerging naturally from these conversations is a constellation of artistic, literary, and cultural references — to movies, artwork, events, and figures from history. A frozen frame on a video call makes her think of a Francis Bacon painting, and something he once said: “We nearly always live through screens—a screened existence.” A patient at a hospital tells her a story about Ingrid Bergman, which leads her to recall a scene from Journey To Italy. A sense of curiosity runs through The Hearing Test, as the narrator draws connections between things she hears and sees, as if building a vast network of interconnected ideas.

This sense of interconnectedness is a throughline in The Hearing Test. As the year progresses, slow coincidences begin to appear to the narrator, echoes in the conversations she has, the things she observes, and the art she engages with. The day of her diagnosis — August 29 — is a date that recurs: “This date seemed to follow me.” Her doctor’s name, Robert Walther, reminds her of a book she was reading at the time, responses to the works of artist Robert Walser. Coincidences and juxtapositions like these are scattered across the book, gently leading us from anecdote to anecdote, observation to observation. The narrator notices these patterns — which she terms “co-occurrences” — and makes note of them, “keeping score.” But strikingly, she doesn’t seem to put much stock in them. Instead, she treats these coincidences as a matter of course, observing and recording them.

She is remarkably aware of her own cognitive biases, the way her thoughts may be influencing the things she sees around her. The most obvious of these is her attraction to the idea of silence: “I had started to find that the word silence ran to me out of pages and spoken sentences. It wanted my attention—a desperate sort of flirtation.” She begins to ruminate on the nature of silence and to see versions of it everywhere — a rip in a woman’s outfit is “a small silence”; stars are “little silences or shrapnel from the halos of angels.” These references don’t feel forced; rather, they feel like a natural anchor for her to cling to, to examine rips, lacunae, and gaps that are ever-present in the external world and our internal selves. She is aware of how her illness affects her perception — “I had begun to understand my own life by misinterpreting things I was reading and experiencing with only half of my attention. And I thought that our misinterpretations are perhaps the most individual and specific things we have.”

Fictionalizing from her real-life experience allows Callahan to impose structure on her narrator’s year through the coincidences that mark her conversations and the cultural histories she engages with. Patterns also emerge in sentence-level wordplay, and in subtle juxtapositions. Callahan writes of a bell: “the ringing, the bell wringing itself out.” Many of these moments are dryly funny: in a conversation with her hypnotherapist, she writes: “I explained my sense that the clock was intensely ticking. And he told me to stop imposing my own feelings onto the clock’s ticks. And just like that, we were out of time.” Callahan even fictionalizes a short film she directed, Bay of Cadiz: “I had made a score…for a film about a girl who becomes a fish after eating a piece of fish…” There is a playfulness with reality, form, and intention that point towards the book as both a deliberate and carefully structured work of fiction, but also a deeply personal experiential record of illness. The patterns in The Hearing Test that might make sense in fiction, in real life are strange, unexplainable — but are they stranger than having woken up one morning with a sudden loss of hearing?

This changing nature of perception and the self is at the heart of The Hearing Test. This novel is a highly individualized story of illness, but it also reminds us that our individual perceptions of the world are precisely how we find meaning, in our communities, in our relationships, and our daily lives. In the same way that a musical score builds on recurring motifs and emotional cues to offer viewers a directive to experience, The Hearing Test is an effort of “keeping score” by recording a year out of carefully balanced building blocks, with recurrences that anchor the narrator as the year unfolds. The hypnotherapist suggests that “Music is the architecture of sound.” The Hearing Test feels like the architecture of experience — Callahan’s expertly structured narrative of a deeply destabilizing year, and an illuminating record of how we seek meaning and connection despite, or perhaps because of, our disordered existences.

Nirica Srinivasan is a writer and illustrator from India. She likes stories with ambiguous endings and unreliable narrators.