No more hiding: Videostroboscopy of my imperfect vocal folds

A few weeks ago, one of the voice-specialty speech-language pathologists (SLP) I currently work with wanted to see my vocal folds. The professor in my voice disorders class, who is also an SLP, had taken videostroboscopies of the students in class so that we got practice seeing them and seeing what a rigid videostroboscope feels like. So, this other SLP pulled up my file from class in spring of 2014.

Prior to this video being taken, I was enjoying thinking of my voice as functional and healthy. Seeing the paresis in action again, however, brought back the emotional memory of the first time I saw it. All the "how can I sing opera without an intact voice?" came flooding back into my head. Thus, I put the video away in a file on my computer and never looked at it past that spring semester in 2014. Until that SLP wanted to see it.

A few caveats: I wasn't tolerating the rigid scope very well (the one that goes in the mouth). I have a pretty hyper gag-reflex and I was certain I would gag the whole time, so the video is choppy and the SLP taking it never quite got a full shot of my vocal folds. I just want to say that the SLP who took this video is an amazing voice therapist and very skilled with the stroboscope. The fact that she never got a good look was entirely due to my hyper-reactivity. I just never managed to calm myself down! (The one at the ENT's office back in 2009 went through my nose.) The second caveat is that I wasn't singing regularly much at all at this point in time and I had a round of reflux that week so my vocal folds are a little swollen, but you can see the paresis still there.

When the other SLP wanted to see the video a few weeks ago, I realized that I had been avoiding it because I'm much happier thinking about my voice as healthy and functional for me. I've been practicing again and taking voice lessons again and my voice felt great! Why would I want to see it still being an issue? Then I realized that avoiding the video is silly. If I want to stick to my own philosophy of a balanced voice being the whole goal of technique, then I should learn to accept my whole voice--flaws and all. It still is functional for me right now. I am still able to express myself musically through my singing, so I should not be afraid of looking at my full voice for what it is at this moment.

With all that said, here's a little guide to interpreting this video. The front of the throat is at the bottom of the video and the back of the throat is at the top. You can see the epiglottis in full view at the bottom and you can see the root of the tongue where it meets the epiglottis there in most of the video as well. The opening to the esophagus is at the top of the video and is closed whenever you are not swallowing. (The muscle that closes the esophagus functions such that it's tonically closed during it's resting-state.) The right side of the screen is the left side of my larynx and vice versa. The vocal folds are the white strips of tissue you'll see in the middle of the screen--the posterior portion of the vocal folds are first visible around 00:20. There is a bit of redness there as well thanks to the reflux I was dealing with around that time. (I was having an issue getting my PPI prescription renewed with my doctor's office.)  The arytenoids are visible near the top of the video. These are the guys you want to keep your eyes on to see the paresis in action. The posterior glottic gap (i.e., the place where my vocal folds don't completely meet during phonation) extends further for me due to the paresis. This is where I "leak air" when I'm singing.

At 0:31:  You might need to stop and start the video in short bursts from here, but this is where you can see the left arytenoid doesn't go as far to midline as the right.  If you stop and start a few times, you can see the right arytenoid adduct smoothly and quickly. The speed with which the right arytenoid adducts makes it pretty clear the left arytenoid isn't traveling as far. It stops moving before the right arytenoid does.

At 0:48:  You can see the left arytenoid "crap out" (very technical term right there). It stayed in an adducted position, or as close as it gets to midline during adduction, so what you can briefly see is my right arytenoid adducting to meet it.

If you think you're seeing any bumps on my vocal folds that look like nodules or polyps, it's actually mucus. This is determined during stroboscopy by the very scientific method of having the patient clear their throat and swallow. If the bump moves off or moves to a different location, it's mucus.

So, those are my vocal folds as they are now (minus the swelling and redness from reflux). Yes, I can still sing with these folds and my voice doesn't fatigue during the day as long as I don't strain when I speak. Essentially, the biggest "enemy" to my being able to sing is tension, since it's still easy to want to "fight" with my voice, particularly on long phrases. But, I think if I stop hiding from my vocal flaws and learn to accept them, I'll start to sing better just by feeling more free to express myself flaws and all!

Edit to add:  Also, when I start to glide up the pitch, I start to shift my epilaryngeal area in the manner referred to as "covering" in the pedagogical literature. This is all great and good in the singing world, but it obscures the view of the vocal folds when using rigid stroboscopy. I should have tried for a more "choral sound" during my glide to maintain the laryngeal position. But, gliding is a check for the superior laryngeal nerve (that handles the action of the cricothyroid), and as you can hear, mine is pretty well-intact. Just the recurrent nerve (the one that handles the muscles of adduction and abduction) is a little impaired.

The deception of talent and genius

"You have such a talent!"    
"Wow!  You must be so smart to be in engineering/physics/math!"

How often in our society do we hear and/or say these same phrases?  These phrases seem like such harmless compliments, don't they?  I mean, what else do you say to someone to point out how special they are?  Heck, maybe they're even true.  I don't know.  But I think these phrases belie a fatal assumption our society feeds us (in the US, at least) and I think this assumption can severely undermine an individual's capabilities.

I occasionally get students that only come to one lesson and never returns. Why?  Because they show up to know one thing: Are they talented enough to be a star?  Usually, they have aspirations to go on some talent-based TV show to become famous, and they just want to know if they're good enough to do that.  My usual tactic with this student is to emphasize how much work it takes to really be a polished professional vs. an amateur in any singing genre. I state that the difference between a profession and an amateur is that the professional will sound consistently good no matter if their tired or their throat is dry, etc.  Professionals don't have to make excuses about why their high notes aren't there today because their high notes are always there, unless they have strep throat or laryngitis or something. And in those cases, a professional often knows when to cancel (even though they often go on when they feel they shouldn't, but that is another topic for another day.)  Professionals spend years training and practicing their technique so that they are able to do the expect job day in and day out. For the student only seeking fame, I'll end up saying they have a lot of potential to be an exceptional singer and that I would love to help them become outstanding if they're ready to work for it.  Of course I'm not surprised they don't come back. They didn't come to me wanting to hear about how much work they need to put into their singing--they came to me for a gold sticker that says they're a star and I don't give out stickers. Period. They'll need to find another teacher if they just want their ego fed.

And that's the inherent issue with this "talent" culture, it undermines the training, focusing on the innate talent of the individual in lieu of the amount of work spent honing technique and artistry. In theatrical fields, the "gift" that audience members are in awe of often came from years of work and financial investment for all the professionals out there. (Granted, there are always a handful of singers who happen to fall into the career without a lot of training needed, but they are, on the whole, an incredible rarity. And those who fall into it and also attain career longevity are even more rare. So no beginner should ever bank on being one of those people.)

This "talent" attitude is also present in intellectual fields, where the world "talent" is often replaced with "genius" or "smart." I can't count how many times people have said to me, "your husband must be so smart!" when I tell them what math-intensive, STEM field he's working in. Granted, I think he's pretty darn smart, but he always tells me how annoying it is when he hears someone say that because he feels he just had to work really hard to attain the necessary knowledge for his field. I was once a math tutor for a local community college. How often did I hear students say I "just get math" because I was smarter than them? It seems like, as a society, we have this gauge for how smart a person is, and it is usually related to the subject matter they are studying.  When I was in music, I very rarely heard anyone call me smart. In that world, I was either talented or not. Now that I'm in an applied-science field, I hear a lot of talk about how smart a person is verses how well they're doing in class.  It seems like to most people, intelligence is just another form of talent. But I don't agree--it's the work ethic and motivation to improve that makes the real difference.

Thus, we often find ourselves saying things like, "I would love to seek that career, but I would need such-and-such degree, and I could never do that.  I'm not smart enough." Or "I know I need to work on my acting, but that's just not my talent. My voice is what I work on; singing is where my talent lies." See where I'm going with this?  How toxic is this attitude?  How are we okay with just limiting ourselves or giving excuses for ignoring a vital part of our craft just cause we find it hard?

A better way to look at things, in my opinion, is to consider the amount of time and effort needed to become good at the thing you are interested in and/or need for your profession. I could've been a physicist or an electrical engineer. I have the intellectual capability to do those fields, but I don't have a desire to spend 4+ years of study on them. That undergrad voice major in your music school who's just not as "talented" as you might just happen to develop a work ethic that carries them into the highest opera houses or the biggest hits on Broadway.

When people focus on the amount of work, time, and planning that go into reaching a certain level of success in a challenging field, they often find there is very little they can't accomplish. So next time you hear about the "instant" success of that amazing new performer or meet a "genius" mathematician, just take one moment on consider the focus and effort this person put into their field and complement them on that--and maybe congratulate them on finding a true passion in life that makes all that work worth it.

Getting back into the game, again (or Look, Ma, I can sing!...I think)

A few years ago, I posted on singing after a break.  Well, I took another long, inadvertent break when I went through the master's program for SLP.  The good news is, I finally found a good teacher in my current town and I'm hoping to plan a recital for sometime this year.  I still haven't seen a vocal coach in about six years, I've only had about three lessons with my new teacher thus far, and I usually only practice about four times a week since I'm still quite busy in the PhD program, but it still feels good to be singing again.  I feel a little more like a normal person when I say I do singing as a hobby, but it's also a little weird to go from someone who trained for the professional operatic track and then downgrade to an avocational singer.  It's like, I want to have all the abilities I used to have, and I have the knowledge of what makes something professional vs. student vs. avocational, but I don't have the time to focus on music and singing as much as would be needed if I were to go out for professional gigs again.

That said, a dear friend of mine recommended that I record my singing and "share it with the world" as he said, so I've decided to do just that.  I've uploaded a couple of my personal practice sessions here where I made it my goal to just to focus on the text and emotional journey and to not obsess over every little thing that went wrong.  Basically, I'm working on letting go and just singing/making music.  For me, this means always thinking about one or two measures ahead in my mind, which I figured out works for me because as a person because I'm usually thinking a few phrases ahead when I'm telling a story to friends--so it's a good way for me to focus on the expression of the piece.  These recordings are not perfect (made only on my iPhone 4s microphone in a small practice room) and I can tell a few spots where I got off here and there (like when I shorted a phrase by a whole beat near the end of the Mozart aria), but overall, I think I managed to make a little music that day rather than just be a singing-technician.  Progress!

P.S. Another big plus of being avocational is that a little snap-shot of my singing doesn't have to be professional quality or flawless since I'm not trying to attract any gigs through my web presence, so that gives me a bit of courage to share it with you guys. Feel free to leave constructive criticism or feedback in the messages below, though, as I still appreciate hearing about how I can still improve as a singer.

The discussion begins!

I've had a great comment over on my other blog, Balanced Voice, that I would love to open up to a discussion in the comments.  If anyone has the time or inclination to give their two cents, I think it's an interesting topic that needs more exploration in the pedagogical world.
Check it out:  Technique vs. expression

Another semester, another workload

I'm getting pretty burnt out of school right now.  I'm tired of taking classes, studying for exams, and having homework of any kind (even if it's just reading articles).  I suppose this is reasonable for someone in their second year of their PhD program of a new round of degrees after a career change, but I'm just tired.  The fall semester is about to begin and I'm dreading the work load that comes with it.

That said, I'm very happy that I decided to continue for the PhD in Speech, Language, and Hearing Sciences.  I'm really enjoying getting to dig really deep into the research literature, learning how to design scientific studies (there's a lot of planning to do!), and getting to guest-lecture in courses.  The mentoring I'm getting from the faculty at my university is really amazing!  I'm at one of the top schools for SLP for my PhD.  I say that not to brag, but because I want to say learning how to think critically from some of the best researchers in the field is incredibly exciting!  It's also cool to see these top researchers day-in and day-out and then to see other people at other schools get all "fan girl" or "fan boy" over these people I get to work with everyday.  Maybe this is what it feels like to be a young artist at the Met!

I'm also doing my clinical fellowship on a part-time basis in voice, with some other clients with things like traumatic brain injury and Parkinson disease to round out my hours.  In the US, everyone who wants to be an SLP has to do a clinical fellowship after they finish the clinical master's degree. The governing body for SLP, ASHA, dictates a certain number of hours for the CF, so mine should be completed in two years (hopefully) at my current part-time hourly rate.  Usually, this clinical fellowship is called the "CFY" for "clinical fellowship year," since it's usually completed after 9 months of full-time clinical work (so that those SLPs who work in the school districts still complete it after their first year of work).  But, since mine is part time and will take me a little longer than a year to complete, I'm calling it my "CF"--minus the "year" part.

This semester, I will be completing my PhD minor in neuroscience (which involved taking all the first-year PhD required courses for neuroscience at my university) by taking a biological computer modeling course.  For this, I need to brush up on my calculus.  This is the course that I'm worried might be a heavy course load. (Last year, I took a cellular and molecular neuroscience course and a systems neuroscience course for my minor.  The cellular one was not quite up my alley--good to know, but not the most exciting material for me--but the systems one was fantastic!  Exactly what I wanted from my minor!  And the cellular course made a good foundation for the systems one, so I'm glad I took both.)  I'm also taking a grant writing class where we'll compose a draft for a grant called an F31.  This is the research-dissertation (for PhD students) grant from the National Institutes of Health (NIH) in the US.  It's a very competitive grant, but my department has a very good record of their students being awarded F31s...possibly due to this really good class I'll be taking.  I'm excited about this class because I have a cool project to write on and being forced to plan every aspect of your study, including possible limitations to completing your study, from the very beginning is a BIG skill that all good researchers need.  And it's daunting at first!  But I'll have good guidance from the professor for this course, so that will be great.

And last but not least, I finally found a good voice teacher where I live, so I'm back taking lessons (sporadically at the moment--once a month or so) and practicing regularly on campus.  I'm hoping to get up a program for a recital in town just for fun, but I'm not putting any pressure on myself to make that recital happen anytime soon.  I'd rather get my coursework mostly done before I schedule something like that.  But it really feels good to be singing regularly again!

And I must say I'm loving the "singing as a hobby" compared to professional work right now.  There's something satisfying about not worrying about catching a cold or if I had a little reflux the night before.  I can just take a break from singing that day.  No big deal!  --I guess I kinda feel like just a regular person in that way.

Anyway, if I don't blog as regularly during semesters, blame the calculus! jk.  But seriously, I'll try to stay on it a little more now.

New blog, new topics

Hello all!  Once again, I let this blog lag quite a bit.  Sorry for my absence.

I've been wanting to get back into blogging a great deal, but I've been stuck as to which direction to go in.  I wanted to share the things I've learned about the most effective ways people learn complex motor tasks, like riding a bike or, well, singing, but I also wanted to open up a place where voice teachers, singers, and voice scientists could comment and discuss the best ways to go about that.  So, I recently decided to make a new blog for that purpose.  This blog is going to be more narrowly focused than this one, and I'm hoping it will develop into a great place for any pedagogical questions or issues that arise for any of you.  I'm also hoping it can be a resource for new teachers to ask experienced teachers for advice if you're dealing with a tricky voice for the first time.

The current plan is to keep this blog going, but to keep the focus of this blog my own personal and academic journey.  The new blog will be where I discuss the scientific evidence from physiological and behavioral studies that I think is often missed in pedagogy coursework.  As such, I'm starting off this new one as if folks already have some basic, general knowledge of how the voice works physiologically.  I hope you'll check out this new blog and feel free to begin the discussion there on any questions or issues you're currently having, either with your own voice/singing training or as a voice teacher, any questions you have about what science can offer vocal pedagogy.

I hope to "see" you there!  http://balancedvoice.com