For a singer like Julie Andrews, famous for her light, clear soprano in The Sound of Music and Mary Poppins and in the stage production of My Fair Lady, vocal troubles proved devastating. Andrews began having difficulties with her voice in 1997, and shortly afterward underwent an operation that left her unable to sing at all. Andrews said that “It felt like I’d lost my identity” and that she “went into a deep depression.” In her case, the damage really was permanent: she has never sung in public since.

Our voices are not easily separable from our humanity. Even before we learn to speak, our voices are a bridge between our private wants and the older and larger people who can satisfy them; they connect us on a level that comes prior to speech and language, and even people who never acquire strong language abilities still make use of their voices. A fully silent person is extraordinarily rare, and our memories of people are deeply interwoven with the sensory impression of their voices.

But when one’s identity is so closely tied to one’s voice, that voice will inevitably disappoint. I was what’s known as a late bloomer. For many adolescents this causes concern, but I had been a devoted choral singer since I was eight years old, and being slow to grow meant that I kept my high treble voice – a voice that, as I was proud to demonstrate, could go all the way up to high C – through the end of middle school. In ninth grade my voice began to slide downward, and by tenth grade it had “broken,” which is to say, my usable singing range was both lower than it had been and smaller than it would eventually become. I was horrified at first, and I begged my parents to let me have voice lessons so that I could “get my voice back,” as I put it. They graciously agreed, and my voice would eventually settle into a high tenor.

Almost every boy experiences the “breaking” voice. What I went through was a natural process, not a problem or an injury in need of a fix. That’s why the use of that term is now strongly discouraged among people who work with child and adolescent singers. But it has proven extremely difficult to eradicate, according to Ben Liberatore, a doctoral candidate in anthropology at Columbia University who studies choristers in the English cathedral tradition. “The adults in these spaces will say ‘We don’t say break, we don’t say break,’ and then they’ll turn around and say ‘break.’” Since the English tradition emphasizes the unchanged treble voices, especially boy trebles, the choristers, Liberatore notes, know perfectly well that their time in the choir is limited, and are frequently terrified by that fact. “There are choirs that really support [choristers whose voices have changed] and there are those that don’t,” and in the latter “these children are standing on the edge of the abyss” because “when your director says ‘Well I think that was it,’ you know that it’s over.” The boy choristers have been valued for their high voices, and the entire culture of cathedral singing communicates to them that once those voices have begun to change, their voices become less valuable. They, the choristers, become less valuable.

This is perhaps the most central and most persistent difficulty that vocal musicians face: the instrument they use is a part of their own body, and whatever eccentricities or distinctions it might have are built in by nature. Criticism of that instrument is going to feel personal, and any change has phenomenological force: it’s a change to you, to the way you relate to the world and to the way you sound to yourself. A dramatic change in the voice can feel like alienation from one’s entire body, and when one’s sense of identity is centered on singing or speaking, the psychological toll can compound enormously.

James Smidt, a voice teacher based in New York City, deals with people for whom the stakes could hardly be any higher: aspiring or already-practicing professional opera singers. Many students are not dealing only with vocal difficulties. “The voice is extremely personal,” Smidt told me in an interview. “It’s people’s primary means of expressing themselves in the world.” Any kind of training involves critical feedback, but since a singer’s instrument is an extension of their own body, this feedback needs to be given with care, and often isn’t. “Students are denigrated, laughed at, shamed,” Smidt says. “The result is that they are incredibly afraid of making the ‘wrong’ sound.”

Smidt doesn’t mince words about who is to blame here: conservatories and major opera companies that “are turning opera into a commodity and are trying to turn young artists into these interchangeable commodities. It’s all about profit and consumption.” Being judged based on one’s ability to conform to a marketable “type” takes a serious toll on singers, and those young singers supposedly at the top institutions are suffering the most. “The most traumatized students I have are students from major conservatories. They are always watching themselves, always trying not to fail, and it’s ruined their relationships to their voices.”

A fully silent person is extraordinarily rare, and our memories of people are deeply interwoven with the sensory impression of their voices.

That relationship does not recover overnight, and Smidt emphasizes that this takes more than just a voice teacher. If students have emotional and psychological issues, Smidt will suggest they find a therapist. The role of the voice teacher is to be a professional collaborator offering nonjudgmental technical advice. “I tell people is that this is a space where they can make mistakes. They don’t owe me anything: they’ve already paid me for this lesson. I’m here to collaborate with them and to try to help them become a little better than they were when they walked in.” All this is in the service of recovering a healthy separation between the voice as one’s personal quality or personal instrument and one’s vocal technique, which can always be improved. “Hopefully they can come to see that, ‘oh, it’s not me that’s wrong, it’s not my voice that’s wrong, it’s just a technical issue that we can work on and fix.’”

Smidt’s students are recovering in an emotional sense, but they are also often recovering from poor teaching, the consequences of which should not be overlooked. Poor singing technique shortens a singer’s career by inducing unnecessary strain in the voice. It’s much like lifting weights: anyone coaching the barbell lifts will tell a trainee that approaching them with proper technique is paramount. This seems unimportant when someone is starting out with light weights, and likewise, the breathy and intimate singing that most of us do for ourselves and in church isn’t going to strain us. But add a few plates to the barbell and good technique becomes the line between success and injury; sing to fill a theater and only a solid technique will carry the voice without unnecessary and harmful effort. Years of such singing can damage a person’s ability to produce theatrical sound at all, and singers who continue to sing with serious technical problems run an increased risk of long-term or permanent vocal injury.

What happens to people who suffer injuries that affect their voices is in some ways clear and in others quite mysterious. We have detailed medical knowledge of the lungs, the larynx, and the entire apparatus of voice production, and our ability to treat these injuries has advanced tremendously during the past century and continues to do so. But on the other hand, the centrality of speech to a singer’s sense of self and sense of connection to other people means that these injuries affect a person emotionally and psychologically in ways that are difficult to predict. Dr. Patrick Kiessling knows a great deal about this: in fact, the importance of the voice and its role in person-to-person connection was what drew him to his work. Kiessling is a resident physician and postdoctoral fellow in the otolaryngology (popularly called ENT for ears, nose, and throat) department at Stanford Medicine, and he also has a degree in voice performance and is a singer himself.

“I think these conversations with patients, when their ears or voice are affected, definitely need to be approached with a certain amount of sensitivity,” he says. “There’s so much going on in this small region of the body that’s really personal for people.” His reminder about both the proximity and involvement of the ears is a reminder about human communication in general: it is always and everywhere a two-way process. We learn first by reception; the speech of others is the prior condition of our own.

Medically, surgical intervention can sometimes help restore healthy functioning. But surgery is merely the first step, as Kiessling readily admits. The work done by physicians and by rehabilitative therapy are steps in a process over which we have shockingly little control. Surgeons rebuild a joint, reconnect a muscle, or excise a malignant body; they can repair a body but not heal it. After the operation comes healing; the body itself must reintegrate into “wholeness and health,” two words sprung from one. We can create better environments for the outcome of this healing process – indeed, this is the primary goal of medical intervention – but it will always remain outside our direct control.

Humans are not amenable to quick fixes, and the human voice is no different. We should also be skeptical of any desire to “fix” something human. In this respect the Anglican choral tradition has a great deal of self-searching to do: Liberatore’s work has documented many ways in which the demands of the treble chorus tradition instrumentalize the young singers, making their sense of belonging to the choir community and even to a school community contingent on their ability to sing high notes, knowing that ability will not persist: most boys’ voices will drop, and most girls’ voices will acquire strength and resonance that make them unable to blend easily with young trebles. These are not problems with the singers: natural maturation is not a defect, but support for this ordinary maturation is highly variable, as Liberatore emphasizes. “There are choirs and schools that provide excellent support, and there are others that don’t.” Much of the best support, he told me, comes from the institution making ample provision for changing voices: even when the singers have phased out of the main choir, there is another choir ready to take them in where they can get used to the changes in their voices and continue their musical education. This is one way of building an institution at human scale.

When one’s identity is closely tied to one’s voice, that voice will inevitably disappoint.

Professional opera, too, needs to ask some hard questions about the ways in which singers are taught and the expectations placed on them. The commodification of singers described by Smidt is dehumanizing, and undermines the entire artistic endeavor. We go to live theatre to see individual human artistry: the unique choices of artists and their unique voices make every performance a singular event.

We might think, too, about the technological forces that have contributed to the devaluation of live singing: widespread use of the microphone is only about eighty years old, but it has completely transformed our experience of the human voice, and not necessarily for the better. Granted, it has greatly eased the demands that can lead to vocal injury. Yet training singers to compete under the terms set by microphone and recording technology is not, Smidt thinks, the way to go: there is no substitute for the emotional power of a live human voice moving directly from the body of another person to our own ears. “What so many people, including younger voice students, don’t quite understand is the incredible, visceral thrill that real theatrical singing can give you.” It is clear that efforts to compete with the recording industry are failing: opera companies continue to close every year. Relying on the humanity of the enterprise, rather than on the ability to shape individual voices into marketable niches of performance, may be the only viable way forward.

Above all, institutions for singing and for vocal care need to remember the imperfect human beings at the heart of their work. Smidt reminds students of this: “You don’t make a career on perfect sound. Your career is built on a consistent 70 percent of your best.” It is all too easy to think of people in terms of production capabilities. But the long-term harm of this is readily apparent, and we do not honor the human voice by rendering it “manageable” in an industry. Throats and larynxes do not sing; people sing. We might better honor this gift by not structuring our institutions to harm the people who choose to share it with us.