By Phil Cromer, PhD

I remember the day the sound started very clearly and very unfortunately. It was early 2021. The pandemic was still tightening its grip on the world, and my own life was unraveling in quieter, more personal ways.

I was going through a divorce while still living under the same roof as my spouse. We owned and ran a business together, and I was carrying much of the operational responsibility while everything around us felt uncertain. At the same time, I joined the Mental Health Association in Indian River County as chief clinical officer, and not long after was asked to step into the role of chief executive officer as the organization navigated an unprecedented public health crisis.

By day, I was focused on expanding access to mental healthcare for children, families, and adults. By evening, I was trying to hold both a business and a personal life together while the world felt increasingly unstable.

I was sleeping in a spare room as part of a temporary arrangement that was never meant to last. It was a period marked by disrupted sleep and emotional strain, and I remember thinking at the time that the lack of rest and stability were likely adding to my already high stress level. Looking back, my nervous system rarely felt settled during that time.

One evening, as I lay down, a high-pitched, piercing sound suddenly appeared in my left ear. At first, it flickered on and off, like an old radio searching for a station. The sound crackled, then vanished, then returned. Each time it came back, it stayed a little longer. I had no frame of reference for what was happening, and I was worried.

I did not know what it was. I wondered whether it was stress related, caused by the divorce, work demands, the pandemic, or lack of sleep. I did what many people do when something frightening happens and searched online for answers. That only made things worse.

That night, I called my brother and then my father. I asked if either of

them had ever experienced anything like this, such as ringing, buzzing, or hearing sounds that were not there. Neither had. I asked other relatives in the days that followed. No one had a history of anything similar.

The next morning after that first night, the sound was gone. I was flooded with relief. I told myself it had been stress and that my nervous system had simply misfired under too much pressure. I felt hopeful, almost euphoric. But the following evening, it returned. The same flicker. The same switch-like quality. On. Off. Then fully on. After that second night, it never went away.

It is the first thing I hear when I wake up and the last thing I hear when I lay my head on the pillow. It is constant and unforgiving. Silence, true silence, has not existed for me since. I have faced challenges in my life, but this has been one of the most difficult. Tinnitus is not just a sound. It is an intrusion that does not allow rest.

Around that same period, I had COVID-19 and received the Pfizer vaccination. I was hesitant at the time, but like many people, I made the decision in the context of uncertainty and practical concerns around work and travel. I cannot say with certainty what caused my tinnitus. There is no family history of auditory or neurological conditions, and my physician has noted the timing of onset as potentially relevant, though no definitive cause can be established. What I do know is that the onset followed shortly after this, during a time when my nervous system was already under extraordinary strain.

I have learned that dwelling too long on what might have been avoided can be emotionally dangerous. It invites regret without offering resolution. I acknowledge the timing, accept the

uncertainty, and focus instead on how I live with what is here now.

I describe my tinnitus using a scale of 1 to 10. One is barely noticeable. Ten is unbearable. I do not remember the last time I experienced a 1. On good days, the tinnitus settles into a 4 or 5. On stressful days, especially during meetings when I must track multiple conversations or make highstakes decisions, it can spike to a 7 or 8. There have been moments when it has reached a 10, moments when the sound felt so overwhelming that my body reacted before my mind could catch up.

In those moments, I rely heavily on what I teach to my patients. I am a licensed psychologist, and my work is grounded in evidence-based treatment, particularly cognitive behavioral therapy. When the thought is this is unbearable, the suffering increases. When I can reframe it to something more accurate, such as this is awful but survivable, my emotional response begins to shift. Not instantly and not completely, but enough to create space.

Over time, living with tinnitus has reshaped not only how I cope personally, but also how I understand resilience, meaning, and hope in the face of chronic health conditions.

What makes tinnitus particularly cruel is that it steals something deeply personal. For me, that loss was silence. I used to cherish it. I needed it. In graduate school, I spent countless hours in quiet libraries. I could not study with music playing or write with background noise. Even the smallest sound disrupted my concentration. Silence was my refuge. It was where I did my best thinking and my most demanding academic work. Now, I have had to learn how to live without it.

Ironically, the very thing I once avoided, noise, has become part of my coping. Music helps. Art helps. Laughter helps. Being with friends and family helps. And movement helps.

Endurance sports have always been part of my life. Over the years, I have run marathons in cities like New York, Palm Beach, and Chicago, and eventually qualified for and ran the Boston Marathon, a milestone I still hold close. As time went on, the distances I undertook grew longer. I ran a 50-mile ultramarathon in the Florida Keys, followed by a 100-mile race also in the Keys, and in 2025 I trained for and completed Ironman Florida, despite never having been much of a swimmer or cyclist. Next year I am aiming for 200 miles.

Running and ultra-endurance events have now become more than personal challenges for me. They are a way I can stay grounded in my body, and they provide a platform for mental health awareness and education. Endurance teaches you how to stay present in discomfort, how to negotiate with pain, and how to keep moving forward when the finish line feels far away. Those lessons have translated directly into how I live with tinnitus.

At 54, I found myself wondering what comes next. I have considered running another ultramarathon but feel drawn toward creating something of my own, a long-distance run that would extend beyond competition. When I shared the idea with my girlfriend, an accomplished endurance athlete, she asked a simple question: What is the purpose?

That question stayed with me and worked quietly in the background for months. Over time, the answer became clear.

The run would be about tinnitus. Not curing it and not fixing it but bringing awareness to what it is liketo live with a chronic condition that never turns off. It would be about helping others feel less alone and supporting research, education, and understanding.

In my professional life, I work with people who live with chronic pain, psychosis, and long-term mental health conditions. People who are hurting in ways that are often invisible. Tinnitus belongs in that same world.

The story of this run is also the beginning of a larger project. I am writing a book that weaves together life with tinnitus, mental health, and the long, quiet hours of training for my 200-mile tinnitus awareness run. It explores how endurance, structure, and movement are tools for managing the noise and for making sense of suffering as it reshapes my identity, values, and purpose.

This is my first real attempt at journaling. I often recommend journaling to others, but this practice is new for me. Writing, like running, has become another way of moving through the noise rather than away from it.

I still miss silence. I miss its simplicity and its emptiness. I am not trying to be poetic when I say that. Silence was once my anchor. Now, I anchor myself differently. I have learned slowly and imperfectly that the human brain is remarkably adaptable. I reframe. I adapt. I keep moving. I hope that by telling my story, someone else who lives with tinnitus, or any relentless condition, might find a measure of comfort in knowing they are not alone.