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A French doctor explained what happened to some of his patients

Sound is a human instrument. It is composed of vibrating elements, resonant cavity and energy to generate vibration. Energy comes from breathing from the lungs. Vibration occurs in the sound box or the two vocal cords in the lower part of the throat. The vocal cords are arranged in a "V" shape, perpendicular to the trachea. Finally, the resonance cavity is composed of multiple structures located above the vocal cords: the upper part of the larynx, the pharynx, the nasal cavity, and the oral cavity.

Our voice is the only instrument that is both a string and a wind instrument-because breathing causes the vocal cords to vibrate. It is almost an orchestra in itself. All of this gives each of us a unique voice mark; there are seven billion people, seven billion different voices. The French sister journal of Scientific American, "Cerveau & Psycho", told Jean Abitbol, ​​an otolaryngologist, otologist, and craniofacial surgeon living in Paris, about the wonders of sound.

[The following is an edited interview transcript. ]

How important is voice to one's self-identification?

It is indeed an essential component. When we perform surgery on patients to change their voices, we see this very clearly; their self-identity is severely damaged. For example, I met a lawyer who had vocal cord edema due to smoking, and her voice was very deep and masculine. (She smokes two packs of cigarettes a day.) Her profession has great charm and authority, and she deals with criminals every day. ("My world is a prison; I defend all thugs," she told me.) But she wanted to change her voice, and her fiance didn't like it and asked me to perform surgery on her. I suggest she change her fiance! She laughed and asked a colleague to perform an operation on her.

When I saw her again, her voice was very sharp, telling me something terrible: "My voice has schizophrenia." When she spoke, she couldn't recognize herself. She was "not her" but someone else. Occupied by the impression of speaking. The consequences are terrible: her fiance left her, she can no longer work, she has lost all the lawsuits, she has no power, and she never dared to speak anymore in jail...not because her voice has grown louder, but because she and There is a break in her harmony, a conflict with herself, a feeling of losing her identity, which makes her unstable. She started smoking again, regained her voice in two or three years, and gradually regained her career influence.

I think the change in your voice will also make people around you feel uneasy.

Imagine that, from one day to the next, your spouse or your child sounds different. This is what happened to one of my patients, a 36 year old woman. She has been suffering from vocal cord paralysis since the age of 9 or 10 due to a virus infection of the vagus nerve that controls the vocal cords. This made her voice sound like a whisper, without power. She had to use a bell to call her husband or child!

I injected her with a substance that could make her vocal cords flexible again, and she recovered in two weeks. But she couldn't recognize herself: "Doctor, I have a woman's voice!" She never knew this voice before, because her paralysis can be traced back to before puberty. This experience is still very positive for her. She no longer felt like a strange beast. But her family felt uneasy. After the operation, her husband asked me a question in a somewhat irritated tone: "What did you do to her? She is no longer my wife." The same goes for her children: "She is no longer a mother. !" Two months later, they were used to this change. They came to apologize and tell me that they thought it was great; but their first reaction was to feel usurped, as if something had been stolen.

All of this shows that you must be very cautious before making changes to your voice equipment. This is emotional surgery. When you have appendicitis, you will have surgery, but if you find a growth on the vocal cords, if it is not cancerous and will not bother the patient, why touch it? I know the ENT specialist who treated Louis Armstrong. Armstrong's voice has two huge bumps, which may have given him a hoarse voice and unparalleled arousal power. Imagine if they were removed.

You mentioned "emotional surgery". Can you tell us more about the relationship between sound and emotion?

Our emotions are like conductors of our voice. If you smile, if you feel uncomfortable, if you are anxious, all of this can be heard because it has a very specific effect on your vocal organs. When you feel good, the lubrication of the vocal cords is very good, but when you are anxious, stressed or have stage fright, the lubrication is much less. In the latter case, the blood supply also deteriorates, especially due to vasoconstriction. Then the vocal cords turn white and lose their elasticity, which translates into dryness of the sound. In addition, frequent and strong pressure can cause vocal cord gastric reflux, which dries out due to acidity and is covered by lumps (keratosis). As a result, the sound is interrupted and becomes hoarse. Emotional expression also changes the structure of the sound resonance chamber, especially by mobilizing the mouth and cheeks.

For these reasons, we cannot synthesize sound accurately. Even though the projects carried out at the National Academy of Arts and Crafts (Conservatoire National des Arts et Métiers) achieved excellent technical performance, they lacked the emotional aspect. On the contrary, great opera actors, such as Luciano Pavarotti or Maria Callas, have an extraordinary talent for conveying emotions.

What other aspects of our identity are expressed in the voice?

For example, our social identity. Lawyers or doctors do not speak like politicians. This is of course expressed through language, but it can also be expressed through components of speech, such as the rhythm of speech. Perhaps the person who illustrates this most vividly is Charlie Chaplin in his movie "The Great Dictator": When this character imitating Hitler speaks to the crowd on the balcony, even if he does not actually speak a word of German, his The speech immediately evoked political tirades and authoritarian leaders. This voice also betrays our gender, because it is clearly different between males and females. It is no coincidence that many transgender people want to change their voices.

Why are the voices of men and women so different?

Mainly due to the influx of puberty hormones, testosterone causes the vocal cords to become longer and thicker (males are about 24 mm long and 4 to 5 mm wide, women are about 18 mm long and 3 to 4 mm thick), such as those of the throat resonance box expand. This is why eunuchs who have been singing in operas for a long time must undergo surgery before puberty. This is not the voice of a woman, but the voice of a child, even higher than the voice of a woman. If their voices are so distinctive and powerful, it is because the growth hormone and thyroid hormone produced by glands other than the testicles are affected by the Y chromosome, giving them morphological size. And the intensity of a person's breathing.

Except for this special situation, the male voice is usually bass-based, and female voices are primarily high-pitched. Bass and treble always coexist and reinforce each other in both sexes, just like a diamond and its case. Because the beauty of sound lies in its depth.

Are there many people who are uncomfortable with their voice and want to change it?

No, not really. Few people make such a request to me. In 95% of cases, I will send them to the psychologist because it shows that they have a problem. For example, recently a 40-year-old woman had a thin and hoarse voice and asked me to perform an operation on her. But when I checked her, I found a magnificent sound generator. Then she revealed to me that her problem can be traced back to the day after she lost her mother. She said her voice was very special. I can not do anything. Intervention by a psychologist.

In most cases, the desire to change one's voice in a profound way exposes underlying psychological problems. Many people don't want to change it completely, but want their voices to be more convincing and have a certain amount of power. The importance of voice in communication has long been known, but with the advent of COVID-19 and telecommuting and virtual meetings, the desire to control its power has increased tenfold. Voice coaches can help. After all, what these people want to change is not their voice itself, but the way they use it.

This article originally appeared on Cerveau & Psycho and is reprinted with permission.

Guillaume Jacquemont is the editor of Cerveau & Psycho and the author of La Science des Reves (Science of Dreams), Framarion, 2020.

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© 2021 Scientific American, a division of Springer Nature America, Inc.

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