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Mi Mi Mi ME: Our Voice is Our Identity

by Tim Deenihan

Even if you’re not a professional singer, your voice is a delicate instrument

Professor Ciara Leydon works with one of her students.

Ciara Leydon is working to protect your identity.

Not your digital identity, or the paper trail you leave through the banks and schools and job and life. Her work goes much deeper than that: under the skin, you might say. Deeper than fingerprints and, in many ways, more personal even than your DNA.

“Our voices are so fundamental to our concept of who we are,” Leydon says, sitting in her office in the Department of Speech-Language Pathology. “Voice is intrinsically linked to how we see ourselves and consider our roles in the world.”

Indeed, vocalizing our inner thoughts, feelings and emotions is such an essential part of being human that we almost can’t express what it means to be alive without employing the act of expression itself. We voice our opinions and our opposition. We speak up, speak out, speak our minds and speak truth to power. We call it like we see it when we tell it like it is. Make a bad call, and we are met with a chorus of disapproval.

If the act of breathing thought and feeling into sound is universal, then how special must be that unique sound, that specific tenor or pitch or quality that identifies any one voice as different from all the rest? A favorite singer releases a new song, and fans don’t need to wait for the DJ to identify the artist; they recognize who it is from the first note sung. Our loved ones’ voices ignite emotion with a single word. Our children’s voices grow and chang alongside their own quest to find a place in the world. Even Stephen Hawking, whose voice is not his own, can hardly be imagined without the sound of that computer orally conveying the journey of his mind.

To a massive extent, voice equals identity — in both its quality and its content.

Yet a person’s voice is woefully unprotected, with heartbreaking effects across the spectrum of speakers, which, of course, is essentially all of us. Consider Dame Julie Andrews, whose legendary voice was grounded when it never fully recovered from surgery to remove growths from her vocal chords. Now unable to hold notes or proper pitch, she no longer sings professionally. This is a tremendous loss not only to her but to her audiences, who were essentially the “end-users” of her once magnificent voice.

“But it’s not just the professional voice users,” Leydon is quick to point out. “We have a patient, a grandmother, who won’t sing to her grandchildren because she’s lost the control and quality of her voice that she used to know as her own.”

The problem is that the epithelium — the skin-like protective barrier covering the vocal folds — seems to have been largely overlooked by scientists and evolution alike. “Given how important the human voice has always been,” Leydon says, looking at humanity’s penchant for expressing ideas and emotions all the way back to that first primal scream, “you’d think they would be well protected. But they’re not.”

Quite the opposite, in fact. After initial injury, the epithelium does a very odd thing. Unlike actual skin, which rebuilds its barrier with the same pre-injury integrity, the epithelium rebuilds itself to look just like it used to, but it behaves quite differently. Post-injury, the rebuilt epithelium is strangely porous.

To understand the problem a little better, imagine a brick house that suffers some damage. When the builders reconstruct the broken wall, however, they use red, rectangular sponges. The result is something that looks the same and is just good enough to protect the inhabitants’ privacy, but will be useless against wind and rain and any intruder.

For the vocal folds, the result is that any and all irritants, such as cigarette smoke, acid reflux, surgery or even simple overuse at a particularly exciting basketball game, directly affect their structure, sound and integrity, opening the way for lasting damage to the voice.

Typically, scientists have been looking for a solution below the epithelium, trying to determine how to strengthen or improve the resilience of the vocal chords themselves. Leydon believes this approach misses the point. The epithelium is the barrier. Returning to the house analogy, the current approach is like trying to storm-proof a living room while ignoring the fact that the windows are all blown out.

Leydon studies the cell structure of the epithelium that grows after injury, trying to determine what makes pre- and post-injury epithelial cells look identical but behave so differently. She’s working on the theory that, if we can restore the epithelium’s basic function — that of serving as an effective barrier — then we can step back and allow the vocal folds to take care of themselves.

Her approach has attracted some impressive attention. She is currently funded through grants from the National Institutes of Health which, in addition to her own work, are assisting four of her students to continue their studies to become speech-language pathologists. Two of them traveled to the National Convention of the American Speech-Language-Hearing Association recently to present their research.

Getting to the next level won’t be cheap, however. Leydon’s previous position at the state-funded University of Wisconsin-Madison meant she had access to resources currently out of reach at Sacred Heart. To get a better understanding of the many variables that affect the epithelium from within and without, she needs to get a better look at the vocal folds and their fickle guardian from all angles. She needs a spirometer and a pneumotachograph to study the functions of both the lungs and the vocal folds and their relationship, as well as machinery to improve visualization of vocal fold structure and function and a diffusion kit to assess vocal fold anatomy.

The importance of the mission keeps Leydon focused. Certainly some are at greater risk than others. Teachers typically have little-to-no professional vocal training, yet are expected to speak — and speak loudly — nearly all day, every day. So it should come as no surprise that 60 percent of teachers report voice disorders resulting in pain, lost work days and even short-term disability. But even the general population is at significant risk with as much as 9 percent of us experiencing some form of vocal fold disorder.

For Leydon, finding a means to help the voice heal properly appears to be a biological challenge, but the reward for success is potentially much greater. “It is such an amazing gift to be able to produce voice,” she says. “From a shout to a whisper, a healthy voice can express the entire spectrum of human experience.

“It’s who we are.”