What’s the secret to keeping your balance? The ear does more than hear: it helps us stay stable by perceiving movements and gravity. Elegant sensors deep within the skull detect every twist, turn, and tumble, powering swift reflexes that keep vision and balance steady. This is the vestibular system. It’s primordial and ubiquitous: every animal has one, and even plants have a rudimentary version. It works so well that we take it for granted—until it fails. How does this remarkable system function? What happens when it goes haywire? How can modern medicine treat vestibular disease?

The Great Balancing Act tells the story of the vestibular system, from T. rex hearing organs to cochlear implants, and from the unsung power of hair cells to inner-ear problems in outer space. Combining neuroscience, history, and medicine, Jeffrey D. Sharon—a vestibular doctor and researcher—explains the sense of balance using accessible language and wry humor. He recounts how pioneering scientists solved the mysteries of the vestibular system and shows why it is necessary for spatial reasoning and abstract thought. Sharon explores the devastating consequences of vestibular problems such as vertigo, dizziness, and imbalance, offering an expert, patient-friendly look at emerging and future treatments. Engaging and entertaining, this book invites readers to discover a little-known yet vital part of ourselves.

Jeffrey D. Sharon is the director of the Balance and Falls Center and an associate professor in the Otology, Neurotology, and Skull Base Surgery Division at the University of California, San Francisco.