The Games People Play With Their Voices

De-Mystify and De-MedicalizePerhaps it is appropriate at this time to de-mystify and de-medicalize as well as de-glamourize voice care. Perhaps it is time to empower voice patients to secure informed consent about options and alternatives to medical intervention. Some doctors may be misleading their patients by seeing a one-sided picture of the voice problem. By not having a larger view or understanding of not only the functional or non-organic voice problem itself, but also how to deal with it non-surgically, some medical doctors don't know what to do - and that includes some of the big names, the so-called hierarchy. But many of these doctors have had no real training in voice. When the problem is not organic, they often prescribe medications. These doctors may be actually contributing to the medicating of America.This point was brought home clearly by one of my patients, Jim, an executive in the banking field. His problem started in late 1988. Jim had left his hometown for New York City to take a job that kept him on the phone from eight to 10 hours a day. It was a high pressure job and he soon developed chronic, recurrent laryngitis by day's end. As his voice grew weaker, his throat and neck areas became very painful by the end of the work day.As Jim remembers, he saw four or five doctors and two speech therapists, including Dr. X., a leading ENT doctor, who concluded that Jim's problem was not organic. "When Dr. X. said to me, 'You're straining it somehow, ' without any further explanation. I walked out.From Doctor To Doctor...To DoctorJim next visited the office of Dr. Y., where an esophageal wrap procedure was among the potential procedures that was discussed, though only as a last resort. Jim's condition was diagnosed as dysphonia and acid reflux. (Th e laryngological medical literature increasingly look to reflux GERD or Gastroesophageal Refl ux Disease] as the likely source of chronic laryngitis and hoarseness, with voice misuse usually not given appropriate or adequate attention.) Jim was given a number of acid reflux medicines and accompanying speech therapy to no avail."I ran through money very quickly taking tranquilizers, pain pills and anti-reflux medications," he says. Throughout most of 1989 Jim stayed on that program without improvement, although Dr. Y. insisted Jim was "getting better."Another 15 doctors, masseurs, acupuncturists, and psychiatrists followed. Dr. Y.'s thesis was that Jim's condition was improving. It wasn't. "They had me doing speech therapy, which turned out to be very Rube Goldberg. A psychiatrist told me that I hated my grandmother. My feelings toward, he said, made me cynical, and that was causing me to lose my voice. I couldn't believe that one "Ready To Give UpAlthough not a quitter by nature, Jim began to think no one could help him. He had spent more than $30,000 on what he now calls "shrinks, speech therapists, masseurs, tea leaf readers and total wildness."Jim visited Dr. Cooper in L.A. in August of 1990. "I saw a 50 percent improvement in my voice within three days. But I wanted more. With Dr. Cooper in California, I began searching for a doctor in my area who used his method of Direct Voice Rehabilitation. That became a problem. There was nobody. In my search, however, I met a patient who has had a paralyzed vocal cord and had been told his career was over. He had gotten his voice back with Dr. Cooper. I worked with that gentleman between semi-annual trips to L.A. "Dr. Cooper originally diagnosed my problem, myasthenia laryngis, in half an hour. With Dr. Cooper's help, I'm in the right pitch. I've had no problems at all since Christmas 1992, and I'm doing more talking than ever. My voice has become a tool rather than a liability, and now have regular public speaking engagements in addition to my job-related telephone work."