I had bouts of laryngitis in the past: a few days when I sounded like one of Marge Simpson’s sisters and pantomimed smoking cigarettes with both hands to entertain friends. But my voice had been uncharacteristically unreliable in recent months. Before a gig in Seattle last October, it got so raspy that I had trouble holding a tune. For a singer and rapper performing her own material, there is no understudy. (If you live in the continental United States, I’ve probably played a city near you, and you probably didn’t hear about it. Lots of independent musicians operate under the mainstream radar — itinerant bards sharing rooms at the Ramada.) Hoping to save the show, I found a service online that dispatched a nurse to my hotel room to administer an IV drip marketed as a restorative cocktail of B vitamins. I felt pretty sure this was nonsense, but panic dissolves your commitment to empiricism. I also got a prescription for prednisone, a steroid that tamps down inflammation quickly, sometimes within hours, allowing irritated throat tissue to function smoothly. Neither the prednisone nor the infusion saved the day, and I had to call off the performance, a decision that sent shock waves of disappointment in all directions. Band members, bartenders, sound techs, openers and the merch seller had all been expecting a night of work. Fans already had tickets and babysitters. The venue had already spent promotional dollars. I’ve only canceled a handful of times in nearly two decades onstage. It feels awful.
Christmas morning my voice was worse than at any time I could remember — as if it had been lit on fire and left to burn down to powder-fine ash. My next tour was scheduled to begin in three weeks: an important run along the West Coast to support my most recent record, “Bury the Lede.” Scrapping a whole tour would mean losing tens of thousands of dollars in earnings, much of which was already spent on flights and hotel rooms or promised to other people. At my level, a serious hit.
I committed to strict vocal rest: no talking, no singing, no whispering (which is hard on the voice), no vocalization at all. I was eager to observe it dutifully — desperate to recover and perform — and would have been hard-pressed not to: I could generate very little sound at all. I drank lakes of tea and swallowed a few tablets of leftover prednisone, hoping every morning to wake up healed.
Healthy, my singing voice is lower than most women’s. Fiona Apple used to be a go-to at karaoke. It has dropped in register further as I’ve aged. I like the way my voice has seasoned; a little more texture has made for better handling, like tread for tight corners. At 43, I sing better than I did at 25, I think. My voice has become more nuanced; I let it drift into speaking tones in the service of an intimate moment, let it catch in my throat before sending it into breathy background harmonies. I haven’t had more than a few hours of formal vocal instruction, but I’ve trained for years in the way that most pop performers do: We mimic along with the radio; practice in our bedrooms; write to our strengths; and — maybe most important — we were born with good voices. A lot of people insist that anyone can learn to sing, and I don’t argue otherwise. But I think having a genuinely impressive voice is a lot like having impressive cheekbones — you can’t rehearse your way into the asset.
I tried to resist the temptation to test my voice, like looking beneath a Band-Aid. But when I did it remained ragged. Big anxiety was seeping in. Voices don’t last forever. What if it never fully came back? As we get old, vocal cords stiffen, muscles begin to waste and the voice gets less flexible, less agile. Listening to my grandmother sing used to scare me because I was told she had a beautiful voice in her youth, but to me, her singing sounded like any of the old church ladies: wavering, thin, not particularly musical.
The sound of our voices is born of our anatomy, the way we’re shaped inside — not just a skill but part of the physical self. The prospect of not being able to sing anymore felt like contemplating an amputation. Plus, the sensation inside my throat felt scary: raw, abraded. I pictured pink, mangled tissue. I decided to fly to Minneapolis, where my label was based and where I still had health insurance, to see an ear, nose and throat specialist and find out exactly what was wrong.
The worst-case scenarios were almost too frightening to consider. Vocal cords can hemorrhage. Their blood vessels can rupture. They can form cysts or polyps or callus-like growths called nodules that limit range and damage tone. Just over a decade ago, Frank Ocean tore a vocal cord, canceling a string of sold-out shows in Australia at the last minute. To treat a lesion, John Mayer had surgery, took a two-year hiatus and still reported that his voice returned altered — even his laugh changed. One of the most horrific stories is Julie Andrews’s. She sued the doctors who performed a procedure to remove nodules from her vocal cords, asserting it destroyed her four-octave range. Many singers have undergone vocal operations and returned to top-of-game performance — Miley Cyrus and Justin Timberlake among them — though long periods of postoperative vocal rest are obviously more financially tolerable for people who spent their junior-high years on Disney’s payroll.
The best way to keep a voice healthy is to care for the whole organism: rest, eat well, stay hydrated. The mandate is simple, but it’s also the opposite of the reality of touring, when sleep is interrupted by late nights and long day drives, meals are sourced during fuel stops and even drinking too much water can delay the van’s progress with frequent bathroom breaks. Vocal experts advise against singing too much or straining to talk in loud environments — precisely what is asked of a touring musician doing preshow interviews, nightly sets and post-show conversations with fans at the merch table. It’s easy to suspect that the best way to care for your voice is to secure any job other than vocalist.
Without a foolproof regimen to maintain vocal health on the road, singers become superstitious — about particular warm-up routines and types of tea. We are sensitive to haze, temperature and bad vibes from the monitor tech. On a band’s hospitality rider, you’ll see booze, chips, maybe lunch meat and a fruit tray, then hit something like “1 bulb ginger root, 1 jar minced garlic (organic), 1 bottle single-source local honey, 9 ripe lemons.” Anybody in the band can make a sandwich before the show, but only singers make potions.
As a vocalist, heading in to see an ear, nose and throat specialist for a busted voice feels a lot like heading into the community clinic for an S.T.D. test. The news might be real bad. And if it is, it might be my fault. (I’ve probably been pushing too hard lately. And I shouldn’t be drinking late, holding court at loud parties. I know better, just get careless in the heat of the moment.)
In the exam room, a physician assistant pushed a thin tube mounted with a camera up my nostril then snaked it down my throat, scanning for any visible causes of my symptoms. When it was pulled out a minute later, I shuddered — improbably, the sensation was like having a piece of myself removed, a shrimp being deveined.
Immediately, the physician assistant reported that there were no nodules. My shoulders dropped with relief. The vocal cords themselves looked healthy, but the surrounding tissue was acutely inflamed. My laryngitis was possibly the product of a sinus infection, which was probably still active. I was prescribed a course of treatment that began with 13 pills a day. There were antibiotics to knock out the sinusitis, a high-dose course of prednisone, an expectorant to help drain the mush out of my face and famotidine to prevent any reflux from further irritating the vocal anatomy.
There were only four days until the first show. I got the green light to try performing, presuming I felt capable. Offstage I was to remain totally silent. I was privately anxious that I didn’t know exactly where the line was: How healthy should my voice feel before I could stop worrying about causing a bleed or damaging it permanently onstage?
Heading home, I noted that the physician assistant had not seemed particularly charmed by me. On mute, I was just less likable. I had made being the center of attention my life’s work; relegation to a nonspeaking role was isolating, almost punitive. Words are how I connect to the world and the people in it. Without the ability to voice them, I started to sense a partition descending between me and the scenes of my life, as if they were unfolding at a remove.
Thirty-nine hours before I was supposed to leave for tour, the meds seemed to be kicking in. High notes were unsustainable, pitch was iffy, but I had recovered some usable midrange to rap with. When I sang, however, air sometimes came out where music should be, like writing with a spent ballpoint pen. I recorded a clip of my voice to send to Becky, my manager. We had seven club gigs and several sold-out meet-and-greets. I wasn’t sure what to do. Becky replied that we should get on planes and go — we could cancel shows last-minute if we had to. I cut my set from 75 minutes to 55 and packed my bag.
The first show in Portland, Ore., sold out in advance.
Standing behind a microphone to soundcheck in my condition felt ridiculous. The voice that came out didn’t handle like mine — it was a rental bucking around the parking lot while I fumbled with the clutch. The sound tech turned my volume as high as it would go.
The audience arrived. After our first song, I explained the situation, and my obvious hoarseness. They were forgiving, rallied in the way that crowds do behind an underdog. When I couldn’t hit the high notes, they sang them for me, and my heart bobbed inside my chest, rafted by gratitude. At the end of the set, they clapped me offstage to return to my silence.
We made it through our show in Seattle, went on to California. My voice gained strength each day, and I would spend down a bit of it performing at night. The stress and the side effects of the medication were mounting, though. I was losing weight in a way that was not beautiful; turning sideways I could see my ribs in the hotel mirror. Prednisone made sleeping difficult; the fatigue made me lightheaded. When I finished the prescription, I broke out in full-body hives.
Our last night, we played the Independent in San Francisco. As had become routine, I explained to the crowd that I hadn’t spoken since Christmas and that this next hour would be my parole from silence. I reached for some high notes and hit them, sweated in my show clothes, left it all onstage. At the end of the last song, I zipped my mouth shut before walking out of the spotlight.
Right after tour, I got sick again. Follow-up medical visits involved a CT scan, more meds and the suggestion that I speak with a surgeon. My sinuses, which serve as resonating chambers for the voice, were still a mess. On the phone, the surgeon, who has operated on opera singers with symptoms like mine, described a possible course of treatment: a procedure to punch small holes in the paper-thin bones of my sinuses to widen the passageways. I didn’t even know I had paper-thin bones in my face — the thought of punching holes in them sounded terrifying. The doctor assured me that the surgery only rarely changes the timbre of the voice in a perceptible way.
The shows go on, however: In May I traveled with my bandmates Aviva and Joshua to play three concerts in Europe. I can hear a lingering vocal fry, an imprecision when my voice starts to tire, but so far I don’t think the audience is docking points; in both London and Prague we were encored twice.
Before our show at the Pink Room in Manchester, I stood in the back of the crowd to catch a few songs from the opener, a singer called Begonia. Her voice was incredible, and by the second song everyone in attendance recognized as much. She leaned back from the mic, belting, and still easily filled the room with sound. Her voice was textured, like Yebba’s or Adele’s, which added emotional heft; a little roughness mimics the way all our voices behave when we’re overwhelmed by big feelings. And Begonia’s was enviably nimble. She could flip from booming chest voice to delicate, hovering flutters, close her eyes to rise higher still and then descend again on time and in key. It was like watching someone play a Stradivarius — no, it was like watching someone be a Stradivarius. I looked back at Aviva, who has trained other vocalists, and shared a knowing nod.
During my finest moments as a singer, the distance between my imagination and the outside world is foreshortened. The music in my head becomes audible to others, just as I intend it. I am the composer and the instrument — I am even the closest listener, as the vibrations of my voice are conducted by my jawbone to the inner ear. There’s no telling how many of those moments you get in a career, in a life. The promoter, who was standing near me watching Begonia, turned to whisper that she had goose flesh. Aviva excused herself to go backstage, “Let me not cry before the show.” And I knew exactly what she meant. A voice will do that to you.
