“A pop and a hiss,” like when you crack open a can of soda. This is the sound a voice can make when it breaks.
That’s how American singer Joanna Newsom described what happened to her in early 2009, when she discovered that she had developed vocal cord nodules due to excessive concerts and a lack of vocal technique. Instead of opting for surgery, her decision was to remain silent. She spent two months without speaking or singing. And, when she reappeared in 2010 with her third album, Have One on Me, the change in her vocal register was evident in the songs. She went from singing “wildly” to doing the complete opposite.
Although Newsom could have gotten over her fear of surgery, certain precedents explain her decision not to go under the knife. A vocalist’s greatest fear is losing their voice. And, for a multitude of artists, for decades, this nightmare has come true countless times. The case of Julie Andrews is particularly noteworthy, as she was renowned for her pure and crystalline voice.
In 1997, an operation to remove polyps (benign growths) from her vocal chords left Andrews unable to sing. The actress sued the doctors who operated on her for negligence, claiming they had unnecessarily operated on both sides of her throat and that she had never suffered from nodules, but rather from muscle striations caused by overuse of her voice. Andrews had been forced to withdraw from the musical Victor/Victoria and admitted to prioritizing “bright, happy” songs in her repertoire, which led her to overuse her high register.
Although the lawsuit against Mount Sinai Hospital in New York was settled in 2000 for an undisclosed sum, there were far greater repercussions than solely monetary ones: Andrews had to abandon music and focus instead on acting and writing children’s books. She managed to reinvent her career, to the point that many who saw her, for example, in The Princess Diaries (2001), are unaware of this sad episode in her professional life. Her case highlights the psychological consequences that arise when a vocalist loses their instrument and livelihood, consequences that are often subtle.
Andrews fell into a deep depression. She said that she felt like she had lost her identity. Other vocalists have compared this feeling to the experience of an athlete who loses a limb. The link between the voice and self-identity is even evident in the figurative sense associated with the word “voice”: when someone says they have their own voice or that they want their voice to be heard, they are implying that they want to be seen, appreciated and taken into account. But the voice is also a muscular tool. And, when it tears, identity is also broken or disfigured.
Some go further, pointing out that the voice as identity represents an “epistemological conundrum,” since it is “conceptually, impossible to ‘locate,’” as Canadian journalist John Colapinto noted in The Guardian. “[The voice] is ‘in’ the speaker’s body as an act of breathing and articulation, but doesn’t exist until it is manifest in the air as a sound wave. Arguably, the voice comes into existence, as voice, only when someone is around to process that sound wave in the brain’s auditory cortex.”
So intrinsic is the voice to an artist’s identity that some admit to having lost it for strictly psychological reasons. For instance, The Weeknd lost his voice during a concert in Los Angeles. And the show’s cancellation was traumatic for him, to the point that it’s been documented on his latest album, Hurry Up Tomorrow (2025), in the interlude: “I can’t fucking sing.” In that line, Abel Tesfaye (known professionally as The Weeknd) expresses his frustration at not being able to perform. Tesfaye attributed the loss to having played the role of Tedros on the TV series The Idol (2023). He commented that his voice became psychologically linked to the character, who couldn’t sing. Hence, reassuming his identity as The Weeknd was more difficult than expected.
The identity component of the voice is also evident in opera singers, who undergo a remarkable vocal transformation during their training. For most opera singers, a 2015 academic study points out, “voice type will determine future roles, the music they perform and potential career trajectory,” meaning that “voice type becomes a facet of identity and position within the operatic world.”
This makes stories like that of the celebrated British baritone George London, whose operatic career was cut short, particularly tragic. London developed unilateral vocal cord paralysis that impaired his voice. Despite several medical attempts to restore it —including silicone and Teflon injections into the affected vocal cord — the doctors were unable to return him to the vocal quality that he demanded of himself.
Using your voice carries inherent risks, due to the physical nature of the activity. The vocal cords are muscles that, in the case of singers, must be trained and cared for, as they’re vulnerable to injury, fatigue and other problems. Sometimes, artists themselves neglect their vocal health, by abusing drugs and alcohol. But record labels also encourage overexertion, by subjecting artists to grueling tours and almost daily flights. “Recovery days are the most important days,” Miley Cyrus said on a podcast.
Cyrus suffers from Reinke’s edema and a polyp on her vocal cords. She underwent throat surgery in 2019. The singer explained that she didn’t have rest days because “the off days are the days that money’s not coming in,” recalling that her record label tended to prioritize financial productivity over vocal care. “I definitely didn’t get the training that I needed to say, ‘Hey, I don’t want to do this until I’m 15; I want to do this until I’m 80.”
A video of a 2001 interview with Björk frequently goes viral on social media. In it, the Icelandic singer explains that she traveled from Hamburg to Cologne by train, in order to preserve her voice. This surprises the interviewer, who can’t understand why a star of her caliber doesn’t travel by plane. The singer’s response (“air pressure forces the molecules to go tiny”) is often perceived as an unintentionally comical example of her eccentric personality… but her explanation is logical. The intensity of touring and frequent flights causes vocal problems when one sings excessively for many years. The first step toward severe vocal cord damage is inflammation, which can be caused by various factors.
“One of the big risks for performers these days is that this inflammation, which you get from having to use your voice more than the average person, can also be caused by the dryness of airplanes, the dryness of hotel rooms, the smoke that’s on the stage, etc.,” vocal coach Dane Chalfin explained in an interview. “It’s not just the hour a performer’s on stage. It’s the press they do in the morning; it’s their soundcheck; it’s their meet and greet afterward. Eventually, the inflammation in their vocal cords will reach a critical mass, where it becomes unmanageable.”
“If a performer keeps performing while their larynx is already inflamed,” he continues, “they start running the risk of developing hemorrhages, where they burst blood vessels. And they also run the risk of creating other problems, like nodules and polyps.”
Chalfin adds practical tips for preserving your voice while touring: avoid performing immediately after long flights, rest at least 24 hours between a flight and a performance, stay hydrated, use steam inhalations to protect the larynx, and keep caffeine and alcohol intake to moderate levels.
It’s ironic that the music industry itself encourages the misuse of the voice. This occurs whether through overuse in concerts, or because of bad habits being encouraged, since the timbre resulting from such excessive effort, like that which led Björk to have vocal cord nodule surgery in 2012, or from alcohol and drug use can be commercially appealing. For instance, Jazz singer Julie London was famous for her smoky, sensual voice, but the reality is that she achieved that timbre by smoking three packs of cigarettes a day. Her voice deteriorated prematurely and she spent her final days ill. The acclaim for an album like Marianne Faithfull’s Broken English (1979), on the other hand, demonstrates that audiences are fascinated by imperfect and worn voices, since timbre is paramount: it’s interesting. Faithfull recorded her masterpiece after years of a troubled life, with that experience reflected in the songs through her voice.
However, singers whose careers rely on vocal power and polished technique cannot afford to market their voices from the perspective of esthetic deterioration. Modern vocalists like Adele and Sam Smith, fearing the permanent loss of their instrument, have undergone vocal surgery at the hands of Dr. Steven Zeitels. Numerous artists have placed their trust in the renowned surgeon. Zeitels performs delicate and successful operations, but some experts question whether resorting to his expertise always addresses the underlying problem.
“How many surgeries would Dr Zeitels consider performing on Adele? Or on anyone?” asks voice coach Lisa Paglin. A former opera singer, she describes Zeitels’ operations as temporary fixes. “After surgery, unless a singer makes major changes, [a] ‘return to performing’ means a return to the vocal abuse that put [them] on the operating table in the first place.”
Although the voice can be retrained after a period of decline as Joanna Newsom did, even improving her technique in the process, the esthetic result of that effort doesn’t always convince the public. Pop and soul icons renowned for their voices, such as Aretha Franklin, Frank Sinatra and Whitney Houston, left behind albums and live performances before their deaths that revealed the serious deterioration of their voices, making them seem like mere shadows of their former selves.
However, there’s something profoundly poetic in great vocalists not only continuing to take the stage with deteriorating voices, but choosing to display that decline openly. Mariah Carey is firmly established as one of the greats of music, but a few days ago, videos of an event in New York went viral on social media, showing her voice no longer possessing its former virtuosity. But, with time, we’ll remember that her latest album, Here for It All (2025), also offered something valuable: a seasoned, authentic voice, present in the moment and unfiltered. After years of experimenting with vocal editing, works like this one by Carey demonstrate that the voice continues to define an artist’s identity, even when time wears it down to the point of being practically unrecognizable. The alternative isn’t always to withdraw or hide; sometimes, the most honest act is for a singer to show themselves as they truly are… even if it confronts the public with their own inevitable decline.
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