Prelude - The Voice of the Canadian Opera Company
Spring 2002

Dr. Brian Hands has had a long association with COC as a specialist frequently used when singers need assistance. "In my practice I see all professional voice types, primarily singers - professional, students, classical, pop and rock. I also see those who use their voice to earn a living in other ways - actors, CEO's, lawyers, teachers, clergy, and TV and radio broadcasters."

Dr. Hands is also the force behind VOX CURA (launched in 1995) - the only free-standing voice center of its kind in Canada. By using a technique called videostroboscopy, the shape, the movement, vibration and timing of the vocal cords can be closely viewed and recorded. Dr. Hands explains, "A strobe light illuminates and slows down the vibration of the vocal cords so one can study them. This helps me determine why a singer is missing one or two notes in their range - why their 'low' is not good, why their mid-range break does not float the way it used to. By being able to see more precisely, I can make a very accurate assessment as to the cause of the problem.

"99% or professional singers have never seen their vocal cords," says Dr. Hands. "When they actually see this instrument - where it is located, positioned, what it does, and what its relationship to the various parts of the voice production mechanism is - they are astounded.

"We try and put it in proper perspective and show the four parts of this vocal production mechanism. The generator - the diaphragm - is the source of power blowing out air over the vocal cords, which are set into motion by virtue of that exhaled air. When people realize that the size of the larynx is the size of a thumbnail and the white of the nail is the size of each vocal cord they're overwhelmed. So we have a generator, a vibrator (the larynx), and the articulator (which is the jaw, tongue and palate). Singers have to relax, open up and let the sound come through the fourth component - the resonator (the head, mouth and nose)."

Dr. Hands' mantra is "the breath." "It's the hardest thing to learn because you have an innate sense that singing usually comes from the throat. No one focuses on the diaphragm which is "the center of the universe" for the voice.

"The majority of singers come in to make sure their 'pipes' are clear. Some may come with colds: others come if they have to sing that evening and they want to make sure they're not in any danger. Often the company wants to know if the singer is well enough to perform. I make the determination if they're safe to sing with no risk of damaging the vocal cords. A haemorrhage on the vocal cords is perhaps the sole, absolute indication when I would advise a singer not to perform. It's my judgment in conjunction with the singer because singers know their body better than I do. I can say, 'Your cords look healthy and you're safe to sing.' However, if they feel they can't go on stage and give a performance that makes them happy, then it's their decision whether to cancel or not. I always respect the singer's wishes.

"Most professionals really do very little damage to their cords. Usually it's just that they are singing when they shouldn't be and need rest. Some are singing eight shows a week so they start compensating and end up with difficulties.

"Performers are usually extroverted and they can become social animals after a show. That's when the most damage is done. They go to a restaurant or bar, the music is loud, usually someone is smoking and there is a din that they have to speak above. It creates problems worse than singing two to three hours on stage. When they go to bed, there is a risk that the alcohol will reflux back up from their stomach causing a burn to the vocal cords."

Dr. Hands' best advice? "Don't eat or drink three hours prior to bedtime. Reduce the amount of coffee, chocolate and tea (very dehydrating). Always warm up before vocalizing. Use steam inhalation. NEVER whisper. It hurts the vocal cords the most because it forces the cords into complete apposition. The rubbing will abrade the surface of the cords and may lead to nodules. You can yell, but never whisper."

Dr. Hands first became involved with singers when he joined the ENT (Ear, Nose and Throat) Department at Central Hospital in 1975. "The Chief of Staff, Dr. Paul Rekai sat on the Board of the COC with Herman Geiger-Torel back in the 60's and 70's. Dr. Rekai came to me and said 'I want you to take care of the opera singers. You will be the doctor for the opera.' One's training in the professional voice is quite limited as a resident, so I started reading and attending courses. That's when all the touring musicals were starting to come to Toronto - Cats, Phantom of the Opera - and those companies would contact the COC to see what doctor they used. In the 1970's singers occupied 5% to 10% of my practice. Now it's 65%."

Singers are often accused of being overly sensitive about their voice. "So many things affect the voice," Dr. Hands says. "I tell my singing students that voice production involves the entire body. Anything that goes wrong with the body affects the voice."

"Singers have great creativity and emotional attachment to what they do. You couldn't get the musical expression if there wasn't that soul, that spirit, that sensitivity that allows them to express themselves. So it's not just the fact that the cords don't look right or they're red or they're inflamed - it's the whole body. When the instrument is not working they worry that it either means the end of that performance or the end of their career. There's a reassurance needed. The singer has to feel that you understand them, respect them and have their best interests at heart.

"The greatest high I get is seeing a patient that I have treated, perform on stage and know that I played some small role in allowing them to sing that night. That gives me great pleasure. I have met some truly wonderful people."

Did Dr. Hands ever want to sing? "In grade 5 the major even for boys and girls was the formation of the glee club. If you didn't make it in you were ostracized. Twenty-nine of us arrived for the audition, and the singing teacher recognized that rejection would affect our lives forever! So not wanting to ruin our social careers he let us all join. The opening song was 'My Grandfather's Clock' and I had a particular role - my job was to make tick-tock noises with my tongue - that was all I was allowed to do! I still see that singing teacher - he's a patient of mine and we laugh about it now. He tells me, 'I knew you would be successful in your career, but I never thought it would be anything related to music."