The voice is the seat of the soul, according to a classic maxim. It reveals when we're stressed, nervous, excited, angry, or have been fast asleep.
Marilyn Monroe and James Earl Jones -- the quintessential feminine voice and masculine voice, respectively Ð made millions with their voices.
Many of the rest of us depend on our voices for our daily livelihoods. That includes teachers, politicians, car salesmen, radio dispatchers, football coaches, telemarketers, receptionists, ministers, performers, talk show hosts -- the list goes on and on.
Experts say that about six percent of the population is affected by voice disorders, with 70 percent of the population over age 48 developing voice problems related to the normal aging process.
Clint Eastwood's breathiness, Jackie Gleason's roughness, and Demi Moore's raspiness are really not normal voice qualities, but they certainly don't qualify as voice disorders, says University of Arizona speech-language pathologist Julie Barkmeier.
But Julie Andrews' traumatic experience with surgery for vocal nodules Ð calluses that commonly form on singers' vocal cords Ð did result from a pathology. As Parkinson's Disease takes its progressive toll on Billy Graham and Michael J. Fox, their speech will become softer and mumbled, Barkmeier added. And a rare neurologic disorder called spasmodic dysphonia almost cost National Public Radio talk show host Diane Rehm her career.
"A voice is considered a voice disorder when a person is self-conscious about the quality of his or her voice, when others react negatively to the quality of the voice, or when it impairs a person's ability to perform normal daily functions," Barkmeier said.
Barkmeier, who teaches a vocal disorders class at the UA this semester, focuses her research on learning the neurological causes of voice disorders, new therapies for treating voice disorders, and how good "vocal hygiene" can affect the voices of young and old alike.
Barkmeier recently won a 4-year, $500,000 grant from the National Institutes of Deafness and Other Communication Disorders to study tissues that protect the nerve supply to the human voice box, or larynx. She and project co-investigator Nathaniel McMullen of the Arizona Health Sciences Center also will study blood supply to the laryngeal nerves. It is research that will help scientists and health professionals understand certain kinds of nerve injuries that paralyze vocal folds, resulting in abnormal voice breathiness.
Normally, vocal folds in the larynx (LAR-inks) close like a valve when a person exhales. The folds vibrate as air passes gently between them, producing voice.
Voice problems arise from abusive voice habits, physical injury, disease, and some not-yet-identified causes.
Performers are one special population at risk for voice problems thatBarkmeier investigates. Singers and actors are prone to developing voice nodules because of the demands they put on their vocal cords. Vocal tissue is built to adapt to those demands, Barkmeier said, so that tissue under frequent intense force and friction thickens and hardens into a callus. Voice nodules can be a nightmare for singers, who must change their voice patterns and sometimes face surgery to get their voices back.
The conventional advice for singers with voice nodules is complete voice rest Ð just stop performing. Not always the easiest thing to do, if that's how you earn your living.
"Interestingly, I've developed a hypothesis. I think that many singers who are properly instructed but who still develop nodules may be developing them not because of their singing, but because of their offstage speaking," Barkmeier said.
That proved to be the case with a UA voice student who was referred toBarkmeier for help. "It really was his speaking voice that was the problem. I had to convince him with the concept that he is a vocal athlete, and like any athlete, you don't train all out, 100 percent of the time, every day. You have to have days off."
Rock and blues singers are especially prone to developing voice problems. A raspy voice can be an asset in singing rock and blues, until it becomes "the stress that overwhelms" and artists find they can no longer last an entire performance.
"And this is the sad part Ð local rock and blues artists are the ones who don't get the help when they need it most. Truly their careers are many times on the line because of voice issues they face. But they can't get help because they can't afford it."
Local artists need a fund to spot them money when they need professional voice help, Barkmeier said, and they need educational forums or workshops that coach them on how to prevent voice problems.
New studies suggest that for people who use their voices a lot, HOW a person sings or speaks is far more important than HOW MUCH a person sings or speaks, she noted.
A 1998 study found that auctioneers were merely warmed up after an hour of auction calling Ð they showed no signs of fatigue or other voice problems. An auctioneer takes a big breath, chooses a pitch, and chants one or two tones around that pitch, a performance Barkmeier described as close to "sing-talking."
By contrast, Barkmeier helped on a study conducted by the Walter ReedMedical Center in Washington, D.C. The scientists studied army sergeants who attended drill-sergeant training camp, where soldiers literally yell for hours on end.
"We took pictures of their larynges, both before and after camp. Amazing pathology happened to their larynges in only one week's time," Barkmeier marveled.
Barkmeier and UA graduate students are involved in several projects designed to identify what people do that causes them to develop voice problems, and how those problems can be prevented. They work with people of all ages Ð from pre-schoolers in the UA's Wings on Words program to the elderly. They are recruiting volunteers for some of these studies.
Barkmeier offers a few basic tips that will help keep the voice healthy:
* Try not to yell and scream. Be careful about trying to talk loudly over background noise.* If you're a teacher, use a microphone to project your voice in the classroom. Not only will this save the teacher's voice, it will help students with hearing problems.* Drink lots of water to maintain proper hydration. "Your vocal cords are like two bags of water, and without a lot of water, they don't vibrate very well," Barkmeier said. She recommends a dozen 8-ounce glasses of water a day, or more if you exercise.* Make sure you get a proper breath before you launch into a sentence. Trying to talk when you're running out of air causes a lot of strain.* Speak at a comfortable pitch and loudness.* Don't smoke. "Your tissues react to smoke and other irritants byswelling and turning red. After repeated exposure, tissue starts to adapt to the chemical irritants by changing color and by changing in other ways. Eventually smoke can disrupt cell replication, that is, become cancerous."* Reduce caffeine intake. "More than two cups of coffee a day offsets your rehydration."
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