Twenty years of Classical Singer! I still remember, in the early 1980s, when Carla Wood first walked into my New Jersey office. That chance patient-doctor encounter led to an interview in CS’s predecessor, The New York Opera Newsletter, which was then a modest publication put out by Carla and David in Maplewood, N.J.—and the beginning of my second career, as a medical columnist.
For this 20th anniversary issue, I wanted to look at how singers have rightly assumed greater and greater control over their health—physical, vocal, and psychological—over recent years. This trend is nothing less than a quiet revolution, and is the result of an empowerment that comes from increased interest, knowledge, and an open sharing of information between singers, voice teachers, therapists, and physicians.
A brief historic overview of how we got here will put things into context.
Interestingly, the first person to actually see the vocal folds was not a doctor or a scientist but a voice teacher. More than 120 years ago, Manual Garcia (1805-1906), a renowned Frenchman of Spanish extraction who lived in London, figured out that by holding two mirrors he could reflect sunlight down his pharynx, and see his larynx. The medical profession quickly took up the concept, which led to a famous and bitter fight for the honor of making this discovery, between the Austrian Turck and the Hungarian Czermak. The point of this well-known story is that the discovery, and its practical application, belongs to neither of these scientists, but to a singer and voice teacher.
Laryngologists remained beholden to Garcia for decades, and even in the 1930s much of medical laryngology depended on using light indirectly reflected through a mirror. Using the mirror, physicians would diagnose, biopsy, and treat laryngeal problems. Tiny, curved, long-handled brushes made from the softest camel hair were used to apply astringents and other solutions directly to the larynx. Indeed, the last camel-hair laryngeal brush I saw (thankfully, no longer in active use) was in the office of my friend and mentor, Dr. Eugen Grabscheid, in New York in the mid 1980s.
Today, thanks to advances in fiberoptic and video technology, looking at vocal folds is no longer a mystery to singers. Pictures are available in most laryngologists’ offices, and many singers keep a folder of photographs of their vocal folds. Through professional magazines, websites, and lectures, images of those two little white bands have become almost commonplace, and imagination has been supplanted by anatomic reality.
Voice therapy also has a long and honorable history. One of its modern giants, the Viennese phoniatrist Dr. Emil Froeschels (1885-1972), was a pioneer in recognizing (among other things) the deleterious role of muscle tension, and the need for relaxation, in producing a good voice. His technique for jaw relaxation (“the chewing method”) was applied primarily to the treatment of stuttering and other forms of dysarthria, but the implications for general muscle tension in voice production are clearly there. Fellow Viennese Dr. Sigmund Freud also influenced Froeschels, so the psychological aspects of voice pathology also figured in Froeschels’ work.
Froeschel’s many students included Dr. Friedrich Brodnitz, a New York phoniatrist from Berlin whose practice included many famous performers, most notably Leontyne Price. I well remember Dr. Brodnitz, a dapper, white-haired little man who smoked a big cigar and was the (German-accented) voice of reason, mediating between the imagerists and the surgeons at our national meetings. When I asked him (as a resident, about 30 years ago) what “the secret” of working with the operatic voice was, he said: “Know the roles!”
The concept of relaxation in singing is, of course, not the invention of one man. It is a fundamental tenet of voice pedagogy. Singers today, however, have been able to incorporate the science into the art of doing this. Many of the old methods (“forget everything you’ve learned so far”) have been replaced, or more properly, have converged, through sharing the cumulate scientific evidence of anatomy and physiology.
Yet another stream of knowledge has come from advances in general health care, diet, and exercise. The vocal performer is no longer just about the voice. Self-awareness of general fitness beyond “the instrument” is driven by many factors, of course: the need to stay young and attractive, the shorter ramping-up period before singers take large and physically demanding roles (for comparison, read Rudolph Bing’s reminiscences of the grooming apprenticeships for singers in the typical smaller German opera houses before WWII), and most currently, Met General Manager Peter Gelb’s highly lauded philosophy to re-emphasize the theatrical in opera.
Singers have always been interested in alternative medical care. In previous generations, however, this had a magical quality, and was little more than anecdotal bits about the Dame Nellie Melba Spray and special concoctions (often containing egg whites) to be swallowed at a specific hour. Ritual beliefs and placebos ruled the green room.
In my own area of specific interest, acupuncture, I remember only one Western physician with any scientific interest, the German-born London physician Dr. Felix Mann. In 1958, Dr. Mann studied acupuncture. This was a time when almost no information existed outside China. In fact, Dr. Mann had to spend 10 years teaching himself medical Chinese before he could read the appropriate texts! These modest beginnings have grown into a widespread interest in acupuncture and other forms of alternative and complementary therapy. Many Western physicians are learning these treatments, and a recent exodus of physicians from China is making Chinese practitioners available to singers with pain, tension, and other singing-related problems.
The credit for all that is new in taking care of the voice, however, ultimately goes to singers. Laryngologists have written a great deal for singers. (A prime example is Dr. Bob Sataloff, who has been a tireless promulgator of useful medical information, both as an author and as director of the Voice Foundation.) Many of us continue to write columns and books, but it is the new generation of singers and teachers who have embraced and internalized this knowledge. This interest has even led to a new word, and a new specialty, “vocology.”
More and more, voice teachers are taking the time to learn about anatomy, physiology, and treatment by working with voice therapists and physicians. An organized curriculum has evolved, embraced by singers’ professional organizations, with important results. These results include a shared common body of knowledge, more effective vocal training, and a common language spoken by all of us who take care of the voice. Foremost in this group are the singers themselves, who read, ask questions, and share information.
