“Preemptive” Voice Surgery?

Lisa Paglin
Aug 28, 2017 · 6 min read

This is the article that I wrote soon after Adele’s first vocal surgery. It was published in the Intermezzo Musician’s Magazine on February 2012.
ps://www.cfm10208.com/images/intermezzo/88_20120126044723.pdf

Bernhard Warner refers to this in his article in the Guardian about vocal injury and our work to, as he says “push for a revolution in the way that almost every modern performer has been taught to use their voice.“
https://www.theguardian.com/news/2017/aug/10/adele-vocal-cord-surgery-why-stars-keep-losing-their-voices
Thursday 10 August 2017.

“…After Adele’s 2011 surgery, Zeitels became something of a celebrity. Occasionally, a reporter asked him if Adele was cured for good. He made no assurances, but told Channel 4’s Jon Snow that her surgically repaired voice “sounds smoother now than before”.

While the media was celebrating this miracle surgery, one woman in the music industry raised a dissenting voice. According to Lisa Paglin, a former opera singer turned voice coach, Zeitels had simply found a temporary fix; in the not too distant future, Adele would once again be forced off the stage and back into the operating theatre. It was a prediction that Paglin and Marianna Brilla, her coaching partner, were willing to stake their reputations on. The rash of vocal injuries silencing our most promising young talents, they argued, is too big a problem to be solved by microsurgery…”

“Preemptive” Voice Surgery?

In 2011, Mr. JAMES C. McKINLEY wrote an article entitled “Advances in Medicine Lead Singers to Surgery” — New York Times, November 18, 2011 http://www.nytimes.com/2011/11/19/arts/music/why- voices-of-singers-like-adele-and-john-mayer-are-stilled.html?_r=1&emc=eta1.

The article is about professional singers who suffer from vocal cord abuse and about Dr. Steven M. Zeitels, the Eugene B. Casey Professor of Laryngeal Surgery at Harvard Medical School and the Director of Massachusetts General Hospital (MGH) Center for Laryngeal Surgery and Voice Rehabilitation (MGH Voice Center). Since that article came out, Dr. Zeitels became known as a doctor of celebrities, and for practicing new diagnostic tools and surgical techniques for the voice.
Some people may feel that this sounds like it could be good news for those singers who build their careers on unhealthy vocal practices. They might have half a chance, with the intervention of surgeons like Dr. Zeitels, of spotting and repairing that hemorrhaging vocal cord (!) before the problem “gets out of hand”.
Then they can go back to singing. Until the next injury.

McKinley’s previous article of 11/7/2011, “Adele Undergoes Surgery on Her Vocal Cords”, tells us that British singer Adele’s surgeon was Dr. Zeitels, who

“operated on Adele to fix bleeding in her larynx”.
“After the surgery, Dr. Zeitels predicted that Adele, 23, will make a full recovery and return to performing(…). No timetable was given.” According McKinley’s article, Adele has had “health issues related to her voice, which she pushes hard and strains in her emotional, gospel-infused performances”.

Adele presumably hopes to have a long career, and her surgery was successful, but speaking of timetables, how long before the next round of surgery?

In McKINLEY’s article, Dr. Zeitels, says that: “over the last 15 years the use of fiber-optic cameras that can scan the vocal cords for minuscule injuries and abnormalities has become common. It is now possible to spot problems like bleeding, nodules and cysts earlier and to take swift action to fix them”.

So: surgery as preventive measure?

Dr. Natasha Mirza, director of the Penn Center for Voice and Swallowing at the University of Pennsylvania, says: “Done properly, they are actually pretty safe, these procedures” [emphasis added].

How many surgeries would Dr. Zeitels consider performing on Adele? Or on anyone?
After surgery, unless a singer makes major changes, “return to performing” often means a return to the same vocal abuse that put her/him on the operating table in the first place.

Concerts — injury — surgery — rest — concerts — injury — surgery, etc.
Is this the life of a professional singer? Is it inevitable?

Surgery for a problem resulting from vocal misuse is certainly not a “cure”. It is a temporary fix.

Why do many singers harm their voices while singing? Dr. Mirza says that pop/rock singers get hurt because they have not had classical training.

This is false.

Much “Classical” training today concentrates on generating a bogus “big sound” associated erroneously with “opera”, and while this may not always cause injury, it certainly does not prevent it.

Many opera singers graduate from conservatories and universities with vocal cords already damaged, even before beginning their careers.

McKinley says that physicians believe that:

“The strain of singing (professional rock/pop) full- voiced for an hour and a half is intense — as hard on the larynx as a professional football game is on a lineman’s body — and the vocal cords need time to recover after each performance.”

Years ago, this statement would have caused gasps of horror.
Now, doctors, infected by the prevailing mindset of today, believe that singing is and “always has been” detrimental to the voice.

I would like to repeat that:

Now, doctors, infected by the prevailing mindset of today, believe that singing is and “always has been” detrimental to the voice.

On the one hand, it figures, considering what physicians see in their daily practice and what they are told, often by “famous” people, about “singing technique.” On the other hand, doesn’t anyone believe that injury can be prevented?

Prevention does not mean “lots of rest”. A singer with bad vocal habits will certainly feel better if he or she is NOT SINGING. Actual prevention means helping singers in difficulty to regain their balance through proper vocal technique.
Dr Zeitels says: “Is there some epidemic? No. The only thing different happening is the singers know better how to take care of themselves, the doctors know better how to take care of them, and what has been happening always is just getting noticed.”

We beg to differ.
THERE IS INDEED AN EPIDEMIC.
Today we witness great advances in the medical treatments of the vocal organ, but there is a great deal of dangerous miscomprehension and misrepresentation about the voice when it comes to singing. Bad training and lack of criteria abound.
It is preposterous and irrational that many medical professionals view singing in the same league with rock climbing or football. Singing is an art based on a balanced, healthy, well-working vocal instrument that needs no “recovery time” after a performance.
Gary Bongiovanni of Pollstar, says, “There is a whole industry built around maintaining vocal health.” What irony. There is an industry built around singers who harm themselves while singing, and there is another one built around fixing them up.
Accepting vocal injury because doctors will be waiting in the wings is inane. Expecting and allowing it is insane.

We would define the general approach to singing today, no matter what the style, with one word: chaos.

As singers and as specialists in vocal education, re-education and repair, we have worked with many singers who have been injured as the result of bad vocal training. We have been able to observe directly how singers who finish appropriate re-education studies, even those who had been suffering from acute voice abuse due to previous vocal practices, can acquire permanent stability and autonomy and never again suffer from confusion, vocal difficulty, vocal dysfunction or injury.

Once the cause of vocal abuse is permanently removed through re-education, vocal health is reinstated.

Medical intervention, no matter how technically advanced, will never take the place of healthy, balanced use of the voice. Even if “swift action” is taken, surgery does not correct faulty technique.

Is surgery now considered preventive medicine? Is this the medical version of the military’s “preemptive strike”?

To avoid injury and illness, singers must achieve the same high level of technical proficiency as any instrumentalist. Singers have to learn to respect their vocal instruments. They have to learn to sing.

Lisa Paglin, director, of New Voice Studio Italia in Osimo, ITALY.
http://www.newvoicestudioitalia.com

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Lisa Paglin

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