As we enter the 21st Century and the third millennium, we should reflect on a minor miracle: Opera has survived, intact, to the end of the 20th Century. Opera has successfully withstood the onslaught of movies, recordings, electronics, computer-generated virtual reality – and even musical theater! And this is not due to the plots, sets or costumes, however fine these may be. It is due primarily to the voice and its impact on the listener.
When I think about the future of the operatic voice, I think about what lies ahead in the treatment of vocal problems, and the preservation of the voice, with an emphasis on the prevention of damage. In laryngology, we have learned a great deal about how the voice works: the sciences of anatomy, physiology and modern techniques of stroboscopy, ultra-high speed photography and other forms of analysis have taught us much. Many of these tools, once used for research, are now part of routine clinical evaluation. While there will always be need for “a doctor in the house” (I still happily spend a great deal of time backstage), the old-fashioned cure-alls in an atomizer have yielded ground to scientific knowledge. In fact, the imagery and mythology of the voice has, by some physicians, been completely banished from the medical toolbox. As myth has yielded to science, I believe we are now entering the third phase of voice medicine. This is a synthesis of our recently acquired (and growing) knowledge of anatomy, physiology of muscles, nerves and mucous membranes with the psychology of singing.
Singing is not merely two slips of tissue rubbing together; the entire mental and physical output of body and mind come together in the voice. The placebo effect should not be the object of scientific derision: it is a powerful healing force, the mind-body connection. The physician must incorporate the singer’s mental attitude, insight and heightened self-awareness in the treatment equation, and do so in a predictable and scientific way. This is not an oxymoron. The vast majority of voice problems I see in singers are self-induced. I believe that newer techniques of biofeedback will be developed to help the singer achieve conscious control over the vocal mechanism and prevent injury. Surgical treatment of vocal problems continues to advance, riding the back of technology. Lasers and microsurgical instruments all play a role. I hope, however, that our tendency towards tinkering and gadgeteering will be counterbalanced by an increasing synthesis of the physical and psychological. For example, there already exist rudimentary surgical procedures for changing the pitch of the voice. They are unreliable, and have been used mostly to raise the pitch of the speaking voice in transsexuals. At the present, this is rather crude and unpredictable. Will this ever have an application for the operatic voice? I don’t know, but I would propose that the singing community should not be on the cutting edge of the newest surgical technology when applied to the larynx. Whatever advances in treatment the future holds, I hope that greater emphasis will be placed on the prevention of voice deterioration. As anti-aging medical research continues to roll back the definition of “old,” there should in this also be a benefit to the singing voice. I’m not referring to cosmetic surgery, but the cell biology of aging, of maintaining muscle strength, tissue turgor, respiratory function and neurologic control, and the avoidance (or at least delay) of chronic degenerative diseases. People will not only live longer, but will also live younger.
In my personal opinion, one of the greatest preventive advances, however, will not be medical, but political: I’m referring to the routine introduction of amplification in the opera house. This is not in the future, but already reality. Many opera houses (most recently City Opera), have come out of the closet, to admit that they use amplification. This is not a shortcoming, but rather something essential, if we are to preserve more voices. The arguments are not new. Most opera was never meant to be sung in huge theaters, over a full symphonic orchestra. It is as if baseball were transferred to a field where the distance around the bases has been doubled. Except in notable exceptions, the vocal mechanism simply cannot sustain this amount of trauma without damage. The result may be vocal fold nodules, dilated blood vessels or hemorrhage. In the long term, the muscles wear out, resulting in the uncontrolled wobble, the pushed wide vibrato with no center. Obviously, some voices survive longer than others. But we are losing the opportunity to hear beautiful smaller voices which never make “the cut”, and also voices that do, but burn out after a too-brief career. The change will come only if the audience no longer thinks of opera as an athletic event, but a musical one, where richness, subtlety and agility do not have to take a back seat to loudness. With the current level of sophistication in amplification, I think the time has come to preserve voices by allowing them to function safely within their normal physiologic dimensions. And let’s look forward to another millennium of singing.
