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To Donna and Johnny
INTRODUCTION PERSONALLY SPEAKING
Some years ago, I was invited by my then-boss, Jann Wenner, the owner of Rolling Stone, to be the lead singer in a band he was putting together from the magazine’s staff. I had just turned forty-one and I jumped at the opportunity to sustain the delusion that I was not getting old. “Sign me up!” I said. My chief attributes as a singer included impressive volume and an ability to stay more or less in tune, but I was strictly a self-taught amateur. I had, for instance, never done a proper voice warm-up and had certainly never been informed that the delicate layers of vibratory tissue, muscle, and mucus membrane that make up the vocal cords are as prone to injury as a middle-aged knee joint. So, on practice days, I simply rose from my desk (I was finishing a book on deadline and spent eight hours a day writing, in complete silence), rode the subway to our rehearsal space in downtown Manhattan, took my place behind the microphone, jolted my vocal cords from zero to sixty and started wailing over my bandmates’ cranked-up guitars and drums.
The folly of this approach became clear to me a few weeks into rehearsals when J. Geils Band front man Peter Wolf, whom Jann had enlisted to perform a song, pulled me aside. “You don’t have to sing full out in rehearsal, man,” he said. “Save something for the show.” I followed his advice, but by then my voice had taken on a pronounced rasp. I wasn’t concerned. I had suffered hoarseness in the past and it had cleared up. Plus, a little vocal raggedness is never out of place in rock ’n’ roll. Also, and perhaps most importantly, I felt no discomfort—so how could I have hurt my throat? I now know that an invidious feature of voice injuries is that, when they happen, you feel nothing. The vocal cords have no pain receptors.
I continued attending twice-weekly rehearsals and soon reverted to my old ways—actually singing harder, trying to put some of the old volume back into my voice, which was sounding weirdly dampened. I was also finding it difficult suddenly to hit high notes, like the F above middle C in the Stones’ song “Miss You” (“Ohhhhhh, why’d you have to wait so long?”). Reaching for it, my voice would break up into a toneless rattle, or vanish altogether. This began to concern me as the days ticked down to our gig—a holiday party at a downtown dance club to which Jann had invited two thousand of his closest friends, including a constellation of celebrities (Yoko Ono, Paul Shaffer, Val Kilmer), and hired Cher’s soundman to work the mixing board. Singing is as psychological as it is physical. Stress attacks the vocal apparatus, tightening muscles that should remain loose and pliable, restricting breathing, closing off the throat, paralyzing the tongue and lips. I was experiencing all of these symptoms as I took my place, center stage, in the glare of the lights, and began our opening number, the Beatles’ song “I’ll Cry Instead,” originally sung by John Lennon. It would seem a little on the nose to suggest that Yoko and her and John’s son, Sean, were looking up at me from the front row, except they were.
Today, I can barely bring myself to listen to the CD of that concert which Jann later presented to each band member as a memento. I wince at the tentative way I sing that Ohhhhh in “Miss You,” sneaking up on the note from below, sliding into it gingerly. I get there, sort of. But at what cost? By the end of the night, I was growling the lyrics to “White Room” like it was a Tom Waits number.
A three-day bout of laryngitis followed. Then I began speaking in a parched whisper. This eventually “improved” to a torn-sounding rumble. Three months after the gig, I was still speaking as if my words were being stirred through gravel. But I was determined to believe the problem would clear up—until an alarming encounter in the building into which I had just moved with my wife and infant son. Holding open the elevator door for one of my new neighbors, a smiling blond woman, I pointed at the buttons and asked, “What floor?” Her smile vanished.
“You’ve got a serious voice injury,” she said.
I demurred, but she cut me off, saying that she was a voice coach who worked with Broadway singers and actors. Only much later did I learn that Andrea wasn’t just any voice coach. She was first deputy to Kristin Linklater, founder of a worldwide network of experts who teach a method of vocal production first described in Linklater’s 1976 book, Freeing the Natural Voice. Along with Stanislavsky’s Method, Linklater’s system is renowned for having helped liberate actors from the stagey, stilted vocal mannerisms of old-school theatrical acting. And Andrea was having none of my disavowals of serious injury. She said that she could see, in my neck, the compensatory muscle movements I was making as I spoke. I was, she told me, straining the tendons, pressing them in against my voice box (or, in the jargon of voice science, larynx), in a bid to compress my vocal cords and help them create sound. “I bet your neck gets pretty sore,” she said.
In fact, for weeks I’d been enduring a peculiar sensation in my neck, as if I had scalded the skin.
“You’re no doubt straining other muscles, too,” she went on. “We use our whole body to sing, and also to talk. Abdominals. Hip flexors. Shoulders. Back. With an injury like yours, you’re working harder with all of them. You must be pretty tired by the end of the day.” I had been attributing the strange, bone-deep exhaustion that afflicted me every evening to the stresses of new parenthood and finishing my book. Not the muscular effort of speaking.
She invited me to drop by her apartment, anytime. She could show me some simple relaxation exercises that would help with the immediate symptoms. I hate presuming on neighbors and knew that I would never avail myself of this kind offer. Andrea shrugged and said: “At the very least, you ought to see a laryngologist, just in case it’s… something else.”
This caught my attention. I grew up in a medical family and was familiar with the euphemism “something else.” She meant a growth. A malignancy. This had never occurred to me. My rasp was so clearly the result of singing with Jann’s band—or was it?
* * *
The next day, I arrived at Mount Sinai Hospital. I had an appointment with Dr. Peak Woo, chief of laryngology, a subspecialty of otolaryngology (or ear, nose, and throat medicine) that focuses on the vocal cords. Dr. Woo was a soft-spoken man in his late forties with a kindly bedside manner—the kind of doctor who can grasp the tip of your tongue and pull it slightly from your mouth without it seeming unnatural. With his other hand, he guided down my throat a laryngoscope, a tool that looked like the curved spray attachment on a garden hose, a small light affixed to the end. On a nearby computer screen, the live image of my throat was broadcast, a wet red tunnel at the bottom of which sat my vocal cords: two symmetrical, fleshy, pearly-pink membranes stretched like a pair of lips across the opening of my trachea (or windpipe). Through my open vocal cords I could see the rings of tracheal cartilage descending toward the dark abyss of my lungs. Dr. Woo told me to say “Ahhh.” I did so, the membranes swinging together like a pair of drapes across the opening of my windpipe. They furiously vibrated as I produced the sound. They popped open the instant I fell silent. He removed the scope.
It was not, he said, a malignancy.
He pointed to the screen, which held a photo of my vocal cords in the open position. The edge of the left cord was ruler straight. On the margin of the right cord was a small bump. A tumor would be lumpy, asymmetrical. My vocal mass was smooth and regular, as if a tin
y pea had been inserted under the semitransparent mucus membrane: a textbook polyp, wholly consistent with my history of over-singing in Jann’s band. I had broken a blood vessel in that vocal cord and the unchecked bleeding had created the bump of scar tissue that was interfering with the vocal cord’s normal, fluid, rippling action. Sweet pure singing voices are partly the result of vocal cords with clean straight edges that meet flush across the opening of the windpipe as they vibrate. Mine did not, and this is what produced the rasps and rattles and rumbles in my voice.
I asked if he might just snip the offending polyp off in a quick outpatient procedure. Hardly. To have the thing removed I would need to check into the hospital for several days to undergo surgery, which would require not only a general anesthetic but a special paralyzing agent to render me completely immobile—a crucial consideration given the extreme fragility of the vocal cords and the permanent injury to the voice that can result from removing even a micrometer too much healthy tissue. Peering through a high-powered stereo-vision microscope, Dr. Woo would, he explained, reach down my throat with a miniature scalpel mounted on a long, knitting-needle-like extension, slit open the mucus membrane, and use a tiny spoon-shaped tool to “shell out” the mass. Given the outer membrane’s gossamer fragility it could not be stitched closed and would have to heal on its own. This would require six weeks of strict postoperative vocal silence.
I left his office with a prescription for a medication to take in the days before the operation. Scheduling the procedure was up to me. He told me to call when I was ready.
I never called.
* * *
Why? The usual excuses—no time, too expensive, too risky, and who could afford to stop talking for six weeks?—positions easier to maintain with a vocal injury than with almost any other medical emergency. Especially if you don’t make your living as a singer, actor, audiobook narrator, news anchor, podcaster, voice-over artist. Like most people who are not voice professionals, I took for granted the sounds that emerged from between my lips, thinking: As long as I’m getting the words out and being understood, my voice is fine. Which is not to say that I wasn’t self-conscious about my rasp. I would often worry, when meeting someone new, that my growling speech might, erroneously, suggest that I was a two-pack-a-day smoker or a Bukowski-esque barfly. (Fine when I was working for Rolling Stone where such behavior was virtually expected; less so when, in 2005, I moved to The New Yorker.)
Speaking on the phone, which always heightened my awareness of my damaged voice (probably because my speech was being isolated, broadcast back to me through the phone’s earpiece), I often worried that I was conjuring in the brain of my invisible interlocutor the image of a thuggish underworld heavy—a particular concern if I was trying to get a potentially delicate journalistic source to trust me. And it was certainly annoying to pick up the phone and say what sounded to me like a perfectly normal “Hello,” and have the person on the other end mistake my crackling, static-riddled voice for my answering machine. There was also the inconvenience of disabusing friends who mistook my rattle as a symptom of the flu. But for all these annoyances and discomforts, I was not (I told myself) disabled. I could converse. I could work. By these lights, the surgery was not necessary.
I did, however, take certain measures to preserve what remained of my voice. I tried, for instance, to apply the knowledge Andrea had imparted to me in the elevator; I concentrated on relaxing my neck, stopped pushing my voice out with an extra effort of my abdominals. This tended to reduce my volume—or “projection”—but it also eliminated the scalding neck pain and overall exhaustion. I also learned, by unconscious trial and error, to lower my pitch, which seemed to smooth my tone a little. Over time, I was even able to convince myself that the problem had cleared up—a state of denial I sustained for over a decade, until a day in late 2012, when I embarked on a new story for The New Yorker.1
* * *
It was about Dr. Steven Zeitels, a vocal surgeon at Massachusetts General Hospital in Boston. Since the mid-nineties, Zeitels had ministered to an array of popular singers—Steven Tyler, Cher, James Taylor—as well as famous TV and radio broadcasters, opera stars, Broadway belters and actors. A few months earlier, he had successfully operated on the British singer-songwriter Adele, removing a vocal polyp that had threatened to end her career. She had thanked him from the stage when collecting several Grammy awards. I had spotted Zeitels’s name on The New Yorker’s in-house “Master Ideas List”—and while I’m certain that my own vocal malady must have played a subconscious role in my pouncing on an idea that my fellow writers had allowed to languish, my own polyp was far from my mind when I called Zeitels to ask if he might be willing to cooperate with a story. I hadn’t even finished my pitch before he interrupted me, saying: “It sounds like you’re dealing with a pretty significant vocal issue yourself.”
Brought up short, I stammered something about having experienced “a little vocal strain” some time ago, and changed the subject. But I could not staunch his clinical curiosity. When I visited Zeitels in Boston for our first set of interviews, he insisted on “looking at” my throat. I hesitated, leery of violating the unwritten ethics of journalism (receiving treatment from a physician could be perceived as a quid pro quo for a favorable story). On the other hand, he was proposing not treatment, merely a quick peek, which might be justified on reportorial grounds: it would afford me as intimate a look as possible into Zeitels’s methods and manner as a physician—which was, after all, why I was there, shadowing him through his workdays. To say nothing of the fact that, at that stage, I hadn’t ruled out writing about my own vocal injury in the piece; Zeitels scoping my throat might make a nice scene. Finally, there was Zeitels’s urgent fascination with all aspects of voice injuries. He wanted to see my vocal cords.
In short, I had the exam.
Like Dr. Woo, Zeitels peered into my throat with a laryngoscope; he, too, left an image of my vocal cords up on his computer screen. Even to my untrained eye, the mass looked far bigger than in the photo taken more than a decade earlier by Dr. Woo. Zeitels was certainly impressed. “It’s like Adele’s,” he said. “But yours is magnitudes bigger. You couldn’t possibly sing with something this big. It’s mechanically impossible.”
He was right about that. The few times I’d tried, my voice shut down, went off-pitch—and the extra exertion of driving air past my burdened vocal cord would force me to reload my lungs at an abnormally fast rate, making my phrasing choppy (good singers time their intakes of breath around natural pauses in a song’s lyrics), causing me to hyperventilate and grow light-headed. Little wonder that I had not sung publicly since Jann’s party and no longer sang even in private, around the house. Too exhausting. Too depressing.
I missed it, and this gave me some emotional insight during the interviews I conducted with Zeitels’s patients, many of them professional performers whose singing voices had been silenced. The most renowned, and notorious, was Julie Andrews, who, in 1997, while performing in a Broadway production of Victor/Victoria, suffered hoarseness, was diagnosed with a polyp, and underwent surgery at New York’s Mount Sinai (this was some years before Dr. Woo’s tenure there). She emerged from the operation not only bereft of the preternaturally pellucid tone that had made her famous, but unable to sing at all without experiencing the rattling, pitch shifts, drop-outs, and dizziness that I knew all about. She successfully sued the hospital—but never got her singing voice back. In 2000, she turned, in desperation, to Zeitels, who tried, in four separate operations, to repair the damage, but in vain. “She’d lost too much vocal cord tissue in the earlier operation,” he said, “and much of what remained was stiffened with scar tissue.”
For Andrews, who had been performing professionally since age ten, and for whom singing formed an essential part of her identity and livelihood, the loss was devastating. “To feel that that would never come my way again!” she told me with feeling. “The huge joy—apart from singing itself—is the wonder of singing with a very big
symphony orchestra. It’s ecstasy.” Another of Zeitels’s patients, a former New York City Opera tenor scheduled to undergo surgery to remove some vocal cord scarring that had ended his singing career, told me why he was hoping to return to professional performing at the unlikely age of forty-nine. He had been working as a singing teacher, but “I’ve grown a little tired of just talking about it,” he said. “I mean, when you sing, you’re giving voice to your soul.” I related to these testimonials, and admitted as much to Zeitels—although I hastened to add that, of course, for me, singing had always been a mere hobby, a pleasant pastime, and that I had no right to compare my meager loss to that of real vocal artists.
“Why not?” he said. “Singing meant something to you. Gave you pleasure. Expressed something inside. It’s mysterious. People who do it, at any level, report that it has a profound effect on them psychologically, emotionally, spiritually.”
He let me know, however, that my singing was not the primary issue. There was also the question of my speaking voice. Yes, I could still talk, he said, but my altered voice was affecting my life in ways that I was not acknowledging. “Here’s the way to understand your speaking voice,” he said. “You’re grossly hoarse. People might say, ‘Well, his voice isn’t that bad.’ No. Your voice is actually pretty bad. Your right vocal cord—the one with the polyp—has a severely impaired elastic dynamic capability. You’re working at three or four percent of normal.”
Consequently, he said, I had done what many people with my injury do: I had developed strategies for, as he put it, “speaking around the problem”—retraining my recurrent laryngeal nerve (the nerve that, among other things, controls the tension on the vocal cords) to drop the pitch of my voice, slackening my freighted vocal membrane so that the 3 or 4 percent that was still pliable would vibrate. This reduced the rattle in my voice, but at a cost. It was robbing me of the natural variation in pitch and volume that people use to give color, animation, expression, and personality to their utterances—what linguists call prosody, the melody of everyday speech. Through prosody, we bolster the messages carried by the words we speak—or create meanings directly opposed to them. The sentence, “Those look great,” is formed very differently by the vocal organs of a middle-aged man praising his friend’s new khakis—and those of the khaki owner’s teenaged son. One is a carefully articulated effusion of genuine praise, the other an artful act of deadpan sarcasm.
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