Even if you are willing to faithfully believe in your surgeon’s technical skills (based on his description to you of his own technical prowess), how can you assess his diagnostic skills and his error rate, when even he cannot?
Faith N. Metsan felt something begin to change in her throat one autumn afternoon. Over the next few hours, her voice just seemed to disappear. She didn’t have any other symptoms. By evening, when she tried to speak, her voice was nothing more than a whisper. Thinking this was just the beginning of laryngitis, and because work was busy, she waited for a week. When she didn’t seem to be getting better she called her primary care physician, Dr. Marcus Goodew, and made an appointment.
Faith N. Metsan showed up at Dr. Goodew’s office saying she was hoarse. Like Faith, most of us have a general idea about hoarseness, though perhaps without really knowing what it is in any detail. A performer often knows when her voice is not working well because the change is sudden. She has thousands of hours hearing her own voice for comparison. Yet, singers and performers stake their entire careers on their voice and many have never seen nor had any concrete visual concept of what was transpiring inside their necks.
Mr. Heim Stillear, at 70-years-old, seems older and less intelligent to his family, since he was hospitalized for a stroke about two months ago. They come to the appointment with him and help him into the exam chair. When I ask Heim what is going on with him, the long pause before his strained answer begins makes his family uncomfortable. His daughter interjects, “We are having a very difficult time understanding him.”
If you are hoarse, almost certainly you will benefit from a video recording of your vocal cords. Most vocal events happen too fast for you to perceive, without some capability to slow and review the images of a video recording. Even video needs some help from a stroboscope or high-speed recording to catch events well.
Physicians who specialize in voice are known around the world by various names: laryngologist, phonosurgeon, voice doctor, phoniatrist and there are probably others. Essentially these words mean that the person has a special interest in the voice beyond what a general doctor has; beyond even what a typical ear, nose and throat physician has. They are focused to some degree on the voice. There is not a formal degree for a laryngologist and anyone may use the name. Quite likely, over time the training for this subspecialty will become more formalized.
When something goes wrong with your voice, you might simply say, “I am hoarse.” Your funny best friend might ask with a smile, “Got a frog in your throat?” Then what? Do you rest your voice? Do you gargle? Do you eat chicken soup? Do you see a doctor? Do you pick up a pill at the pharmacy? Which doctor do you see? What if you are a doctor? Is it simple or difficult to discover the cause of a hoarse voice? What do you need to do to make a diagnosis? Do you look in the mouth? Do you guess? Do you write a prescription for a pill?
20th World Congress IFOS - Seoul, Korea The international Federation of Otolaryngology Societies (IFOS) met in Seoul, Korea this spring. The scientific program for laryngology was broad-based and excellent. I particularly enjoyed meeting my colleagues across the world who are working on gender voice surgery techniques. Participating in the energy of Gangnam with an evening dance in the conference hall was one way to sample the flavors of Korea. They have selected Paris as their next meeting location in 2017.
The 10th biennial PEVOC is being held in Prague, Czech Republic. The opening ceremony with the Prague youth choir in the Rudolfinum was spectacular and a great time to catch up with colleagues. Jan Svec, conference organizer, opening up the conference. Opening night gala Young performers from the Czech Youth Opera and their director. Tassos Hantzakos joins in a traditional Czech dance. Party on the waterfront.
2nd Meeting of European Academy of ORL-HNS & CE ORN-HNS - European Academy of ORL and Head & Neck Surgery (EAORL-HNS) The European Academy of otolaryngology hosted a lovely spring meeting in Nice, France. The laryngology sessions were excellent with an outstanding faculty dinner at Hotel Negresco. I enjoyed all of the new ideas discussed both in the lectures and in the hallways. I also enjoyed exploring the views from the hills of Nice, France. http://www.eaorlhnsnice2013.com/en/