In the first few minutes of Pedro Almodóvar’s Pain and Glory (Dolor y Gloria, 2019), the film’s protagonist Salvador Mallo (Antonio Banderas) lists for the audience the various diseases, ailments and diagnoses that he has come to find himself blighted with. A film about reconnecting with the past, Pain and Glory tells, via various recollections, the life story of a sixty-something auteur in bodily and artistic decline. Where in his younger years he was a precocious child and acclaimed filmmaker, Mallo’s poor health now prohibits from him from engaging in creative work and the wider social world outside his flat: he repeatedly asserts that he is neither mentally nor physically in a position to do so. The filmmaker’s routine headaches, meanwhile, result in self-medicating through heroin: a habit that he breaks after an emotional re-union with a former lover.

Among Mallo’s various prohibitive ailments is tinnitus. Indeed, the condition is one of numerous narrative components that serve to connect the film’s protagonist to Almodóvar, leading audiences to question the extent to which Mallo is an autobiographical figuration. Various internet sources speak of Almodóvar’s tinnitus diagnosis from 2007, which he describes as ‘diabolical, loud noise existing only for me.’ Tinnitus is, for Almodóvar, ‘a nightmare. The volume shoots up and you can’t do anything about it. Also, it provokes distortions, I hear Peggy Lee out of tune.’

When Mallo informs the audience that he is suffering from tinnitus—alongside insomnia, migraines panic attacks, joint pain, back pain and bone calcifications—the statement is accompanied by a prolonged high-pitched sine tone. There are echoes of this tone heard in the film’s musical score. A recurring motif opens with a similar but quieter high-pitched tone: it is the first sound that is heard in the film. In aurally representing the condition in this way, Pain and Glory coheres with other cinematic depictions of the condition. Mack Hagood has traced the evolution of the ‘tinnitus effect’ in film sound, a trope that has proliferated in narrative film since the early 2000s. The tinnitus effect names a high-pitched ‘ringing’ tone that acts as a signifier of acoustic trauma, often sounding after an explosion or acts of violence. This high-pitched tone is often accompanied with the ‘muffling’ of diegetic sound, emulating hearing loss. In Almodóvar’s film, however, it is not a bomb or gunshot that tinnitus is associated with, but the depletion of an aging body and the pain of familial bereavement: Mallo’s present state of malaise is partly attributed to the death of his mother, four years prior.

The sine tone acts as a proxy for Mallo’s tinnitus, enabling audiences to ‘hear’ it. Of course, this sounding is contradictory: with the (rare) exception of objective tinnitus, tinnitus is not audible to others. Yet, at the same time, film as a medium has often made audible purportedly ‘interior’ sounds: from the voiceover that details a character’s intimate thoughts to the thudding heartbeat that communicates fear or desire. This aural proxy for tinnitus is accompanied by a visual one. The high-pitched sine tone is coupled with an illustration of the inner ear, reminiscent of a medical diagram, which appears behind a moving waveform. Both the waveform and the illustration present sound and the ear as general, objective and standard.

The ‘standard’ ear, like the ‘standard’ body, has typically been predicated on white, Western masculinity, insofar as it is ‘unmarked’ by identity and social context. Disability and impairment, meanwhile, are often ‘feminized’ through their proximity to care, the home and dependency. Yet tinnitus has been presented as a particularly and explicitly masculine affliction. Hagood’s tinnitus effect, for example, tends to soundtrack men during scenes of combat or violence. In Pain and Glory, tinnitus is attached to an alternative form of masculinity: that of the bourgeois, creative ‘genius’, whose intellectual labour is at particular risk of disturbance by this noisy condition. Caring for his current physical, intellectual and administrative needs is outsourced to various ‘mothering’ figures: namely, his personal assistant, Mercedes and his housekeeper, Maya. The two women worry between themselves about Mallo’s wellbeing; providing him with food, reminding him to get dressed, accompanying him to medical appointments and organising his mail. While there are moments of tenderness, their labour passes largely unacknowledged by Mallo.

In the end, the crisis is resolved. Emotional and physical debility are overcome. An operation removes a calcified lump in Mallo’s throat, which has been causing him to have distressing coughing fits. The film concludes with the filmmaker back at work, shooting a scene depicting a young version of himself and his mother. His creativity is no longer held back by his bodily afflictions. His solipsism wanes. Tinnitus, we can assume, is something that can be lived with and worked around. This resolution might be interpreted as reproducing a narrative of ‘overcoming’, so common to depictions of debility and disability. Yet such a reading is complicated by Pain and Glory’s relation to time and memory. Throughout the film, Mallo returns to scenes of his past, while his past (former lovers, a picture of him as a child, previous feuds) revisits him in the present. The cinematic work-in-progress that is being shot by Mallo at the end, likewise, concerns working with and through the past, rather than simply leaving it behind.

The appearance of tinnitus in Pain and Glory is brief: it is by no means a central component of the film’s narrative. Nonetheless, its association of tinnitus with the (masculine) ear and the sine tone is illustrative of popular understandings about the condition. This depiction and tropes that ground it are not without their complexities. Tinnitus becomes a type of sound rather than a subjective sensation, the experience of which might be heightened or diminished in different situations and auditory environments. As such, tinnitus extends beyond the ear and the sine wave. Almodóvar’s description of his own tinnitus suggests this: for him, tinnitus results in distortions and detunings – specifically of the voice of Peggy Lee. The making ‘audible’ of tinnitus thus risks silencing other aspects of the condition.