Thoughts on Oesophageal Speech

One of the standard ways of regaining some form of speech following laryngectomy is the use of 'oesophageal speech'. This might well be described as glorified burping with attitude.

I find that the only response to any sort of artificial speech at all is a comment on the lines of: 'Oh - that's what happened to Jack Hawkins isn't it?' He seems to have been the only publicist of those of us without a voice-box in the last generation. Yet there have been all sorts of advances quite apart from energetic burping.

I have to confess to having tried this in the distant past. Usually after several beers and a curry, when a good belch could easily provide a whole sentence-worth of speech. The more musical amongst my colleagues could even provide a reasonable rendering of the national anthem... One indeed could render at least the first line in two part harmony using vocal cords and oesophagus respectively. I'll leave to the imagination of the reader his attempts at three part harmony...

But following my laryngo-pharyngo-oesophagectomy, the mechanics of the process leave rather a lot to be desired. To start with, obviously, there is no oesophagus: the stomach has been dragged up through the diaphragm and anastomosed to the base of the tongue. And there is little in the way of any sort of musculature remaining in the pharynx whose walls might be persuaded to vibrate in the manner of anything even approaching a decent burp.

Enter upon the scene the wonders of Speech Therapists. Now I have to confess here, after almost 30 years as a G.P., to having entertained uncharitable thoughts about speech therapists in the past, not entirely unadjacent in degree to my thoughts about social workers. I've received, and tried desperately to stuff into records envelopes, long multi-page screes outlining reasons why little Wayne, born and bred in Essex, can't recite Wordsworth without dropping his aitches and getting almost suffocated by his glottal stops; and rather obvious comments on the difficulties of Grandad after his stroke.

However, I've now met two of the species in person. Each of them has entirely dismissed the deficiencies of my remaining anatomy and declared that I'll be an accomplished orator in six weeks. Well, almost. Quite uncannily, each of them prodded the front of my neck with an experienced finger and said: "say 'car'." And I did. Just like that. Albeit with voice production that would shame a rather hoarse gorilla, but nevertheless a recognisable word. "Say 'cat'." That worked too. So I said 'Kathryn' and my goode wyfe almost burst into tears. These speech therapists really do know what they're doing...

For the next week, at least once an hour, I sit here saying "Car, car, car: cat, cat, cat: key, key, key." Sometimes it works rather well. Most of the time, at present, it sounds rather like our dishwasher emptying itself round the S-bend. But every now and then it actually sounds quite reasonable. I've started recording my efforts for comparison with future progress. I have a series of recordings (the wonders of digital mini-disc technology) starting with many hours of readings in my original voice. These days a complete digital recording studio fits in the pocket. Before the Big Operation I walked along a deserted north Cornish beach reading from Ecclesiastes, from Rupert Brooke and from Khalil Gibran. The effect, with the sea in the background is dramatic to say the least. It's not immediately obvious how attached one is to one's voice. Everybody takes it for granted. Quick 'one-liners' interjected into the middle of conversations now tend to be a bit of a major production with the artificial larynx: everyone has to stop and listen, which rather takes the wind out of one's sails. When you are obliged to concentrate, these bon mots are frequently not so bon after all... But there are advantages here: occasionally a brilliant interjection commands attention and works rather well.

After the operation I practised with increasing success with my 'Servox' buzzer-gadget, and now, I'm building up a compendium of these rather gurgling attempts of trying to use what remains of my own anatomy. It's really quite interesting. I 'tuned up' the Servox to approximate to my original bass-baritone voice frequency, (I'm an inveterate fiddler with any gadget... and used to be a quite successful singer...) and suddenly my vowel sounds sounded like me again. Sort of early 60s Cambridge if you'll pardon the expression... So far my 16-bit digital burps are not very impressive, but I anticipate improvement as I master the art. As long as it doesn't end up by mimicking late 90s Essex, I'll be able to show my head in local society without people thinking I'm trying for an audition for East Enders... In any case, glottal (or should I say 'glo-ll') stops are a little difficult without a glottis, and I really do not think I could ever manage to strangle vowel sounds into as many complicated diphthongs, trithongs and multi-thongs as the average denizen of the Queen Vic.

Or is that Coronation Street?

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Dr Alan G. Gray