Speechless

Judy McGuire

An MRI of Judy McGuire’s brain

Word Count 1769

I’d been in crippling, ever-worsening pain for a couple of years when it became clear that if I didn’t want to end up immobile, I’d need hip replacement surgery. I knew a few people who’d had the procedure, and they’d deemed it life-changing. I chose mobility. The operation, performed at the #1 orthopedics hospital in the country, went swimmingly. No complications or infections, and I was up and walking immediately. Of course, there was some pain and unsteadiness, but I was prepared for that. What I didn’t expect was waking up a few days later, suddenly unable to speak.

I wasn’t totally mute. I could push the air out, but the words that followed were so raspy, and at such a low volume it was nearly impossible for me to discern them, let alone anyone else. The results ranged from annoying to potentially catastrophic– the deli guy couldn’t hear my sandwich order, but also, if I were walking down a dark street in an unfamiliar neighborhood, and someone came after me, I’d be done for because I’m not exactly built for speed, and I could no longer scream. It was weird because I wasn’t sick—aside from normal post-surgical pain, I felt fine.

Once I was able to leave the house, I hobbled over to an ENT a friend had recommended. I needed to fix this immediately. Coinciding with this commitment to movement, was another bold move I had recently made: I’d been a writer for decades, but I wanted to do something more meaningful, so I applied to and was accepted into an MSW program. I scheduled my hospital stay so I’d be healed by the time the semester started.

The doctor threaded a scope up my nose and down my throat and gave me his take: “You’re not imagining it—you really can’t talk!”

That the default for doctors treating women is that we’re hysterical morons is well documented, but that was the first time anyone had ever been so blatant with me. It would not be the last.

Turns out, I couldn’t speak because my left laryngeal nerve was dead. This meant that my left vocal cord just lay there, while my right vocal cord jumped around doing all the heavy lifting. This ENT advised that while he wasn’t completely sure what was causing it, it seemed likely that I had a mass in my chest or neck. I needed to get a CT scan ASAP.

I’d had melanoma a decade earlier, and my mom had died of kidney cancer at around the age I was then. The idea of cancer making a comeback scared the crap out of me.

I hobbled out of his office, crying, and called my pal Lance—who, despite her career as an entertainment executive—was my most science-y friend. “You do not have cancer,” she insisted. (PS, that’s what everyone says when you think you have cancer. Sometimes they are right, sometimes they’re not.)

Lance went into deep research mode, and by the time I landed back in Queens, she’d sent three different journal articles detailing how vocal cord paralysis is sometimes (albeit rarely) caused by epidural anesthesia. They cited a woman who’d lost her voice a few days after giving birth, a man who’d lost his after a knee replacement surgery, and there were more... . I was starting to feel more positive and forwarded the articles to my ENT. I thought he’d be happy to hear this news—after all, I’d had an epidural. It made sense!

To say he was dismissive might suggest that he’d actually read the articles or even scanned the abstracts. (He did not.) So I went ahead and booked the CT scan, which thankfully turned up clear.

Back at his office, after he’d looked at the scans, I pushed him about the articles I’d sent. “That was a very small study, it proves nothing,” he announced. (Note: none of these were studies.) Despite his dismissal, he didn’t have a better answer except to say that nerves often regenerate, and mine probably would. I should check back in a few months.

Meanwhile, school was about to start, and I was still mostly voiceless. In addition to coursework, social work students are required to put in a certain number of fieldwork hours every week. My plan to work with the elderly wasn’t going to cut it—my own dad couldn’t hear me. The school allowed me to attend classes and defer fieldwork until my second semester.

I loved being back in school. Sure, I was a geezer amongst gazelles, but I was inspired by the kids and their commitment to making the world a better place. I loved reading and writing papers. Gradually, my voice sounded a little stronger. Maybe my nerve was healing!

Nope. Another scope showed that my overworked right vocal cord was just getting stronger and picking up the slack.

I hadn’t had both hips replaced at the same time because it seemed like too much, so my second surgery was scheduled for Winter break. My voice was still weak and raspy, but it had transformed from sounding like Marge Simpson’s sisters trapped under a stack of pillows to more of a Brenda Vacarro/five-pack-a-day smoker sound. I could live with it, but as I was waiting to be wheeled into surgery, I explained what had happened last time to the anesthesiologist.

“That didn’t happen,” was his reply.

“No, it really did! Look at these articles,” I wheezed, pulling up the journals on my phone and showing him that these weren’t Daily Mail clickbait craziness—these were journals written for doctors by doctors.

He feigned looking at my phone and smiled indulgently, as though dealing with a very slow toddler. “So if I can’t use an epidural, what should I use?” he asked the simpleton on the stretcher.

Obviously, I had no fucking idea and said as much. Off to the OR we rolled. A few days later, my voice disappeared nearly completely again. It turns out, that one of the hallmarks of this rare condition is that when it happens once, it’s more likely to happen again if you ever get another epidural.

So when a text from the anesthesiology department of the oldest orthopedic hospital in the country popped up, asking me to fill out a survey on my experience with the anesthesiology department at this top-rated hospital (#1 in orthopedics!), I was delighted to share every single one of my thoughts. None of them complimentary.

To my surprise, they responded quickly and had me meet with one of their neurologists. This person determined that I probably either had brain cancer or lupus. Awesome! MRIs were scheduled, gallons of blood were drawn. Their conclusion? Dunno, but it sure wasn’t a well-documented freak accident caused by the know-it-all anesthesiologist who dismissed my concerns, that’s for sure.

In the pantheon of disabilities, losing your voice is pretty minor. But trying to live your life when nobody can hear you blows. On a flight to the UK, the man seated next to me began to twitch and sweat—he was obviously having a seizure. I tried telling my husband what was happening, but he couldn’t hear me over the roar of the plane. I gestured frantically, and when he caught on that the guy was suffering, he was up like a shot, his full tray of foul-smelling airplane food flying across the aisle, as he bellowed for an attendant. HE’S CHOKING, he yelled.

I tried to correct him; the man was having a seizure, he hadn’t eaten anything. It was no use. Nobody could hear me. The flight attendants had come running, and this poor man looked so sad as he received a wholly unnecessary Heimlich maneuver.

Since my voice was now worse than ever, I wouldn’t be able to do fieldwork this next semester either. Disheartened, I took a leave of absence from school. It all just seemed so hopeless. And then the pandemic hit.

Behind a mask, I was even less audible, but I couldn’t bitch about croaking when so many were dying. There were refrigerator trucks full of Covid casualties housed just a few blocks away. I put aside thoughts of fixing my voice and concentrated on finding a job. A few months later, I officially dropped out of school.

Once I found a job and got my bearings and the pandemic started to ease up a little, I restarted my quest for speech. I met a surgeon who treated me like a human being. He suggested a surgical fix—they would stitch an implant onto my vocal cord. The downside: I would have to be awake during part of the surgery, so they could gauge my ability to speak. But they assured me that I’d be so drugged up I wouldn’t remember that bit.

Well, apparently, I’m not a good candidate for any kind of anesthesia, because I sprang wide awake during surgery, and attempted to jump off the table, while they had knives and fingers and whatnot inside my throat. I hyperventilated and struggled and recall the word “fentanyl” being bandied about as they pushed more sedatives into my veins. So much for not remembering.

That really, really sucked, but at least I’d been warned it might happen and was treated with respect. Recovery was brutal—ask Shania Twain; she had the same surgery—but my voice is better now. While it still isn’t 100%, at least my husband can hear me when I yell at him.

To celebrate, I bought myself a karaoke mic, but decided that what I really needed to officially close this shitty chapter was to have the #1 ranked hospital in the U.S. for orthopedics pay the out-of-pocket expenses for this grisly operation. After all, two grand was nothing to them. I’m sure they spent more (and to their credit, didn’t charge me) trying to get their anesthesiologist off the hook by unsuccessfully proving it was brain cancer, not an error borne out of arrogance, to blame.

But no. The response to my request was a masterclass in medical gaslighting. They had made no error, their doctors were blameless, and despite what several medical journals and all the evidence might suggest, I was simply mistaken.

They say a memoir should be written from the scar, but the scab on my neck is still healing, so trying to wrap up this very long essay with a valuable life lesson is a challenge. So sure; I lost my voice for three-plus years and wound up getting my throat sliced open while I was awake; but what I gained in credit card debt and deep mistrust for the medical community is priceless. How’s that?

Judy is a writer/recruiter/recovering advice columnist who currently lives in Jackson Heights, Queens, with three cats and a man. She’s authored two books—How NOT to Date and The Official Book of Sex, Drugs, and Rock ‘n’ Roll Lists— and ghosted a few too—including a Hardy Boys mystery and one by Rihanna’s tattoo artist.