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Three years later, Isailo bought the restaurant from the owner, who moved her husband to Santa Fe, New Mexico, in hopes that the heat and the dry air might better suit his physical needs.

“After that, my mother quit cleaning houses, and the three of us spent most of our time there, at the diner. Most of my memories are of time spent in the restaurant, in the kitchen sitting on a worktable, or on the floor behind the counter. It was called the Olympia Diner, after the woman who owned it, and my father never changed the name. He never changed the menu, either, and when he painted the dining room walls or retiled the kitchen floor, he kept the same colors and the same pattern, the same tile, the same everything. One year, the owner — this was after her husband died — came back to visit her family, and she stopped by the restaurant to see what my father had done to it, and when she saw that it was almost exactly the same, she started to cry. She didn’t sob or gush or anything like that, but there were tears in her eyes that sometimes slipped down her cheek and made her face wet. She didn’t know what to say. She ordered a cup of coffee and a piece of pecan pie, and when my father wouldn’t let her pay for either, she just stood up from the counter and left. That was the last we saw of her.”

Just before their son’s eighth birthday, Abbasonov’s parents sold the Olympia, and the three of them moved to Dallas, Texas, where they used the money from the sale of the restaurant and the money that Fabia had saved to buy a house, a piano, and to pay for piano lessons for Karl, who had been begging his parents for music lessons since the age of four.

III.

The 1693 edition of Blancard’s Physical Dictionary contained the first written record or mention of tinnitus aurium, defining it as “a certain Buzzing or tingling in the Ears.” The American Tinnitus Association (founded in 1971) further defines tinnitus as “the perception of ringing, hissing, or other sound in the ears or head when no external sound is present.” According to statistics collected by the ATA, an estimated 50 million Americans suffer from some varying degree of tinnitus, and over 16 million Americans suffer from tinnitus to such a degree that normal, day-to-day living becomes impossible.

The human ear is divided into three main regions: the sound-collecting outer ear, the sound-transmitting middle ear, and the sensory inner ear. The outer ear is separated from the middle ear by the tympanic membrane, and the middle ear is, in turn, separated from the inner ear by membranous fenestrae. The sound-collecting compartment of the outer ear is conical and called the pinna. This cone functions poorly for most people, which is why the elderly may cup their hands to their ears when they want to improve their hearing. The middle ear specializes in transmitting the sound from the outer ear to the oval window opening of the inner ear through the vibration of movable bones called ossicles. The inner ear then conducts this information to the receptor neurons.

The inner ear serves a second function (through the intricate vestibular system), which is to tell the rest of your body where your head is and what it is doing at all times. The vestibular system satisfies this function through two main processes: angular acceleration, necessary for shaking or nodding your head, and linear acceleration, necessary for detecting motion along a line, such as when an elevator drops beneath you.

The auditory and vestibular systems are intimately connected; the receptors for both are located in the temporal bone in the inner ear, in a convoluted chamber called the bony labyrinth. A continuous membrane is suspended within the bony labyrinth, which creates a second chamber within the first, called the membranous labyrinth. The inner ear has two membrane-covered outlets into the middle ear — the oval window and the round window. The inner ear and the middle ear are connected through the oval window by a small bone, the stapes, which vibrates in response to vibrations of the eardrum, and which then sets the fluid of the inner ear, called perilymph, sloshing back and forth, which in turn causes the round window to vibrate in a complementary rhythm. The membranous labyrinth, caught between the oval window and the round window, bounces up and down in all the sloshing.

Located within this sloshing mess is the organ of Corti, which rests on the part of the membranous labyrinth called the basilar membrane, and it is here, finally, where the transduction of sound into neural signals occurs. Auditory hair cells sit within the organ of Corti — inner hair cells, which are the auditory receptors, and outer hair cells, which help to “fine-tune” the pulses of sound. The sensitive stereocilia (sensory hairs) of the inner hair cells are embedded in a membrane called the tectorial membrane. As the membranous labyrinth bounces up and down, the basilar membrane bounces up and down, and the fine stereocilia are sheared back and forth. When the stereocilia are pulled in the right direction, the hair cell depolarizes and releases a signal. This signal is transmitted to a nerve process lying under the organ of Corti, and is then transmitted back along the auditory nerve to the brainstem, where it is read, finally, as understandable sound — car horns, voices, jet engines, or music.

But why should any of this matter?

Bear with me for just a moment longer.

The outer hair cells of the organ of Corti help to “sharpen the tuning” of the frequencies of sounds we hear. Outer hair cells can change length in response to nerve stimulation. By pushing the basilar membrane up and down, the outer hair cells can amplify or dampen vibrations, making the inner hair cells more responsive or less responsive. The theory, then, is that if the outer hair cells can move the basilar membrane (and it has been proven that they can), then they can, in special cases, also move the oval window, and then, possibly, the eardrum. And in severe cases, by shifting the eardrum, the outer hair cells can make the ear work in reverse so that the ear acts, in essence, not like a receiver, but, rather, a speaker. Even before Abbasonov, there have been many cases in the history of medicine of a patient complaining of persistent whispering in her ear, dismissed as crazy until an obliging doctor finally places his stethoscope to her ear and listens, only to discover that he can hear the whispering, too. It is this phenomenon, of the ear reversing roles, that most doctors use to account for the constant ringing or roaring that plagues sufferers of tinnitus.

What I have just presented here is almost word for word the same anatomical lesson I was given by Dr. Larry Franklin, a tall, emaciated, and young professor at the Washington University School of Medicine, who was, according to most experts, the first doctor to understand and then explain how it is that Karl Abbasonov can not only speak, but speak well, even though every muscle in his body is contorted in such a way that even the simple act of breathing is, for him, performed by a machine. At the end of the lesson I was, to be honest, almost afraid to ask the next logical question: