It was spring and I was in the last term of my Master’s program in vocal performance when my phonation became inconsistent in my middle voice. The [a] on the “A” above middle C was hiss-like, my voice became easily tired, and I was consistently going flat. The high E-flats that had been so common were gone. I could sing no higher than the B-flat below that.
My voice teacher at the time assured me that individuals who have pathologies cannot sing high B-flats. She concluded that my problem was technical, not physical, so I continued preparing for the final requirement for graduation: my Master’s recital. As I subjected my voice to continuous use and technical practice, my phonation worsened. By the end of the semester, when I should have been walking down the aisle with diploma in hand, I was hastily canceling engagements and scheduling a visit with a reputable voice clinic.
“Your right vocal fold has hemorrhaged,” said the speech therapist. “Take voice rest for three weeks, at which time we’ll scope you again and begin speech therapy.”
Every feeling you can imagine, from self-pity to anger, went through me, along with every existential question: How had this happened? What was I going to do with the rest of my life if I couldn’t sing again? Why was this happening to me?
Silence. For three weeks, I communicated with scrap paper and a Sharpie. I had a lot of time to think, heal, and forgive. I found myself with loads of time. I couldn’t work, and my husband made just enough to pay for our rent and food. During my silence, I found people’s reactions fascinating. At summer barbecues, my friends would ask me questions in loud, well-articulated tones, punctuated by ridiculous hand signals. Often I’d write, “I’m mute, not deaf!”
After the three-week rest, my speech pathologist scoped me again.
“Looking good. But the fold is still swollen and all the blood has not been absorbed.”
Each week we’d work on speaking. Each visit began with a scope. At first, my hemorrhage was healing quite well, but as the months went by a tiny blood blister formed.
“You’ll have to get that zapped,” said the therapist. She began to recommend surgeons at various costly institutions across the East Coast. “I want you to go to someone who has worked with professional singers before,” she advised. “I want you to go soon.”
The pressure was on—and I was hesitant. I had a short list of the finest Ear, Nose, and Throat doctors on the East Coast, but I didn’t have the $5,000-$10,000 it would cost to have the surgery. Most of the ENTs had waiting lists of up to six months. Moreover, I just didn’t feel compelled to be seen by any of them. I wanted to sing again, but each time I prayed about going to a surgeon the answer was always the same: “Wait.”
“Wait for what?” I thought. My speech therapist was telling me that the little blood blister appeared to be getting larger; I didn’t have a degree; and although I had found a job, I wasn’t fulfilled—because I could not sing.
I sought outside counsel from my pastor.
“Follow that small, irrational voice and wait,” she said.
As I waited, my employer’s healthcare provider changed to a plan that would cover the procedure anywhere in the country. My mom called to recommend that I find a surgeon at Loyola Medical Center in Chicago, so I could stay with her during my recovery; and unexpectedly, my undergraduate voice teacher contacted me to see how I was doing after graduate school. I told her about my hemorrhage and about my hesitation. She responded that several years earlier her husband sought treatment from a wonderful ENT by the name of Robert Bastian at Loyola University in Chicago. Instantly, that small “wait” changed to a loud “go.” So I went.
Within two weeks, I was in Dr. Bastian’s office in the Civic Opera building, which houses the Lyric Opera of Chicago. Dr. Bastian’s demeanor was kind and confident. He diagnosed me with a capillary ectasia on my right, true vocal fold, with a blood blister on the superior surface. He recommended vocal fold microsurgery and gave me an excellent prognosis.
As to how this injury occurred, Dr. Bastian surmised that I was a vocal overdoer, not necessarily in singing, but in all my activities. He explained that if an individual is a professional voice user, like a singer or lecturer, and a naturally social individual (as most singers are), there is a great likelihood of vocal overuse.
That may be only part of the answer to how this injury occurred, however. My vocal difficulties began shortly after I had begun taking a prescription-strength, non-steroid, anti-inflammatory drug to treat sciatica. I cannot say for sure what actually caused the hemorrhage, but all athletic activity is risky, even fine singing.
The outpatient surgery took only 45 minutes, and after insurance, I paid about $400. Dr. Bastian told me to resume vocal rest for a period of four days, at which time I could begin speech therapy and limited singing.
“I ask that you don’t sing in public for at least two weeks.”
“Two weeks?” I thought. “My gosh, I haven’t sung in public for more than seven months!”
It has been a little more than three years since my surgery, and as predicted, my vocal folds recovered beautifully, with no scarring or rigidity. I have since made my professional debut, and this year I will be performing my first Madama Butterfly. Still, when I run into old classmates from graduate school they seem surprised that I am able to sing after voice surgery.
I suppose there was a time in the not-too-distant past when a vocal injury was the kiss of death for one’s singing career—but now I know it doesn’t have to be anymore.
