High Notes & Declan Costello

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Hi Helena. Hi Adam. And hi to all of our listeners.
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We've got a fantastic episode for you today, but before we introduce our first
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guest, Helena, why don't you tell us all about yourself?
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My name is Helena Dix, aka Queen of the High Notes, but my mother also calls me other things.
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I am an international opera singer who loves globetrotting around the world
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and singing high notes and causing mischief.
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When I'm not on the stage, I love to cook, to laugh, walking my dog.
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Hanging out with all my wonderful friends.
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And my name is Adam Miller. I am a former opera singer turned producer, writer and director.
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And Helena, you and I have had the great pleasure of working together in all
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sorts of capacities over the years.
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Now, why don't you tell us who our guest is today? Today on the podcast,
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we are joined by Declan Costello, one of the UK's leading ENT surgeons and a
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true authority on the human voice.
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Unusually, he started out not in medicine, but as a choral scholar at Cambridge,
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studying music before going on to train as a doctor.
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So he understands the voice from both sides of the stage.
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He's become something of a legend in our operatic world, trusted by elite singers
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to diagnose and treat some of the most delicate and high-stake vocal problems.
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Alongside his clinical work he's a past president
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of the british laryngological association a
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published author and even contributed to gray's anatomy put simply if your voice
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is your livelihood he's the person you want in your corner that's right and
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as we pick up the conversation with declan we begin with a chat about how to
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pronounce your name helena.
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In person, I don't think Helena, have we? Your name is pronounced Helena,
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right? It is, yeah. Helena.
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I've been called far worse, Declan, so don't worry about it. You know, it's fine.
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It's fine. It depends who you speak to. We had a couple of guests on,
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oh, God, a fair few weeks ago now, and one of them was calling Helena Helena
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the whole way, and then one of the other guests actually told the story of a
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time that people had got her name wrong and Helena called them out in front of it.
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And you can see, hear him go, oh, I might fix how I'm pronouncing that now.
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Although it's not as bad as the time that I, like when I first moved to London
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and I was at the Academy, we did a Messiah with Chan Rochford,
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Julia Riley, Robert Anderson and myself.
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And we went down and, you know, a lot of those oratorio gigs where people will
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host you in between the rehearsal and the show.
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Right. These lovely people in this like little town.
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Us we all go down we don't know each other that well we're sitting
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around and they've put on this like dinner for us before we
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got into the oratorio into the performance i should say but they
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were slightly that slight amounts of
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dementia so they were getting the names wrong but it was really funny because
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they were eyeballing us like they'd eyeball me and they'd go so chan you know
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what like it wasn't even a female versus male names like one of them eyeballed
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me and said so chan you know are you you know have you been in the country long
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and chan went to kind of answer but then realised they were eyeballing me.
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And it just became this kind of comedy of who are they speaking to versus who
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are they looking at versus, you know.
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We can imagine Declan isn't the commonest name in the world.
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I'm quite often called Declan as in the land of Dec. There you go.
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But there's an advantage to having a fairly unusual name in the sense that if
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somebody Googles you, you're one of the first hits that comes through,
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which is quite useful at times. And also you are like...
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You know, the consultant to the, like everyone I know, your name is there,
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you know, every time anyone talks about, you know, vocal stuff and,
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and aunties and laryngologists and like all the thing, it is always your name. Always.
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That's, that's really nice to hear. Yeah. I mean, there's a relatively small
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pool of us doing what I do.
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But you're a rock star. You're still a rock star in the industry. I'll take that.
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I'll take that. But I think, I think the other thing is that the people,
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singers have got much more savvy about who they go to see.
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Sure. You know, there was a time 20, 30 years ago when people would have walked
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up and down Harley Street or the equivalent of Harley Street in Sydney,
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and they would have just chosen the shiniest brass pluck they could see and go in there.
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Whereas people, I think there's word of mouth goes round.
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Sure. And people know that there's a pool of people who do quite a lot of this
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laryngology thing that I do. So, do you want to tell us then,
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actually, Declan, what you do, what this pool of people do?
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Yeah. So, I'm a laryngologist. I am an ear, nose, and throat surgeon,
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and I have a specific interest in voices. Over the years, medicine has become
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increasingly specialised and then sub-specialised and sub-sub-specialised.
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And to the extent that there are certain ear surgeons who do only about two
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or three particular operations.
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And within the world of voice, there are people who do certain aspects of voice,
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but my particular interest is in singers.
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So I do look after ear and nose problems, but I spend the vast majority of my
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time looking after throat problems.
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And within that, a lot of singers. Wow. Oh, that's amazing. We're a specialised
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beast, aren't we, to be fair?
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Yeah, you are a specialised beast. And I think, you know, we may come onto this,
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but part of the reason I'm doing what I do is because of my own background as a singer.
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So, I sort of understand it from the other side, as it were.
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Yeah. So, tell us about that. Tell us about that journey from,
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well, was it a journey from singer to surgeon or were they simultaneous?
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How did that happen? Well, at school, I was doing A-levels that looked like
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I might be going in towards a career in medicine. Both my parents are medics.
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But actually, a singing teacher took me to one side and my singing started getting
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better at that stage and it looked like I might be able to do a choral scholarship.
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And I also, at that time, a tutor sat me down and just made me think properly
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about whether I wanted to do medicine or whether I was just kind of meandering
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into it by default. And at that time, I was enjoying the music more.
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I couldn't do a choral scholarship and study medicine at the same time because
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they both take up too much time.
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So I ditched the idea of medicine at that stage. But then halfway through the
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music degree, so I completed the three years of music, but halfway through the
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music degree, decided I wanted to study medicine after all.
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So I went back and did, having done three years of music, I did five years of
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studying medicine and then worked
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through medical school. And then after medical school, did a variety of
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junior doctor, resident doctor jobs. And I did a bit of plastic surgery,
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a bit of orthopedics and this and that. And I really enjoyed ENT.
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And then within ENT, doing stuff on voices seemed like the obvious thing.
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Did you make the change because you found at all the singers' parties that when
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everyone was sitting around just talking about their voices all the time, it annoyed you?
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And actually what you'd rather do is get everyone to stick their tongues out and have a look down.
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And have a proper look yeah well i do you know as you can imagine i do get quite
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a lot of questions when i'm at sort of social things people by and large are
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quite good about not kind of nabbing me in quiet moments but and being like
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sorry i think not least not least because singers.
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And again we may talk about this in a second but singers are quite sensitive
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about the fact that they may have problems with their voices and don't,
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you know, if I'm in a rehearsal or in a social thing or whatever else,
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people don't particularly want to be that guy who comes up to me and says,
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like, I've been having problems with my passaggio for the last few months,
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because then everybody else goes, oh, right, okay, George is having problems with his passaggio.
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Right. Yeah. Past the turkey. Yeah.
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Right. Well, and that sort of taboo, I think, about vocal problems is very real.
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So, and it's something, yeah, again, we can maybe chat a bit about that.
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Well, that's right, because of course, you know, the last thing a singer wants
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is anybody, you know, whispering about to say, oh, you know,
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such and such went to see, you know, a laryngologist or they've got a bit of
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an issue that's going, you know, like that's literally the last thing.
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And it's a great shame, you know, because there's not, I mean,
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it's getting better than it was.
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I think there was a time a number of years ago when people just absolutely would
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lock this stuff down and they would never talk about it to anybody.
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But there's a number of singers who have talked about their vocal problems over the years.
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And I think if I've operated on someone and people are back on stage and they're
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happy, people will quite often post nice things on social media to say,
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look, I'm back on track. So there's much less in the way of...
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Silence and keeping a lid on things than they used to be.
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But people are still nervous. And I think there's a concern about appearing vulnerable.
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There's a concern about, you know, if this particular opera company know that
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I've had problems, will they hire me for the next contract or that sort of thing?
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So I can understand where the anxiety comes from. And it's about knowledge too, isn't it?
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Like, for instance, if you were, say, working with an opera company or you had
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a contract with them for the next year,
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I would assume I might be completely wrong um i'm
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a soprano so i often am of course but um in saying that
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the the the management for the company would probably not
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have a lot of knowledge about the voice and about you
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know the kind of physiological things so if they
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heard that such and such had a bit of a problem they wouldn't necessarily
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understand that that might be a problem that's easily to get
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over or to you know to and so assumptions
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start to be made don't they and and and yeah i
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wonder whether or not it would be helpful i mean
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i've said this actually before and we adam and
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i interviewed melissa who runs the linderman program over at
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the metropolitan opera and does all those things and she was
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talking about all the different aspects that they have for their young artists
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including vocal health and understanding of that which i think is amazing and
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actually look obviously i went to college a long time ago and i was at the royal
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academy and all that kind of stuff but it would have been would have loved them
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to get someone like you in to talk about you know various vocal health things and, you know,
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great, good things as well, not just the negative things, but,
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you know, the things to be doing in a positive.
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Yeah, I think there are programs like that. And I think some of the conservatoires are doing that now.
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I think they do have an ENT surgeon at the Royal Academy who goes in.
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I do sessions for groups like Genesis 16 and university and college choirs and
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that sort of thing. Just...
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About vocal anatomy, about vocal health, how to look after your voice.
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What to do if things aren't going so well, just taking some of the stigma out
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of it and taking some of the fear out of it as well.
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Because I think there's a worry that if you have a problem with your voice,
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then that could be a kind of career ending thing.
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And that then leads into an ongoing anxiety and a stress about going to see
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somebody like me to have your larynx examined.
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Is this going to be curtains for me? the problem then is that that leads into
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a vicious cycle of tension and stress that starts to feed into the problem.
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If people have a problem for a few weeks and think, I just need to get this
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looked at and they come and see me, have an examination of the larynx.
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And if everything's fundamentally fine, great.
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You can park that problem quite quickly and go back to the technical stuff.
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But actually, if you leave it for months and months and months,
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it festers and psychologically you get yourself in a tangle and then physically
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you get yourself in a tangle with muscular tension.
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So I think nipping these things in the bud, can be really, really helpful.
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Just while I remember, there's another thing I think about people being worried
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about the discomfort of having the larynx examined.
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It's really, having your vocal cords looked at is really not very difficult.
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Not particularly uncomfortable.
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It's a dance site better now than it was 25 years ago, because we just use a
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little endoscope that goes in the nose.
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Previously, we'd have had rigid scopes sitting on the tongue and all the rest
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of it. But now, it's very, very easy to do.
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Sorry, you were going to say, Helena? Yeah, I was just going to say,
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Adam, I think when we had a speech here on, we had Samantha Uron on, and I don't know, Adam,
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whether you recall whether it was her that said it or someone else that said
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it on the podcast recently, they said a really great idea for singers is to
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go and have a scope when you're in great health. When you're healthy. Yeah.
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And I thought, oh my God, I can't believe that I'm old. And I'd never thought
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of that, like that I'd never actually considered going and doing it because it's so interesting.
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Like, fascinating. And getting that baseline. Yeah. Yeah, very much. It's very interesting.
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It's de-stigmatizing and it takes out the fear that if ever you needed to have
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it done, you know it's actually really not so bad. It's extremely useful for
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me to be able to have something to compare with down the line.
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Actually, the Royal Opera House send all of the Yetta Parker young artists to
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me when they start for a kind of baseline examination, which is super, super helpful.
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That's amazing. And so for our listeners who wouldn't have a clue what it looks
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like, tell us what a healthy scope would look like in basic terms for people to. Yeah.
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So what we're talking about is the vocal folds, the vocal cords,
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which are two white structures that look like strips.
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As you look down, they look like sort of strips that meet in a V.
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And the vocal cords, well, so vocal cords and vocal folds are basically interchangeable terms.
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They're called vocal folds, actually, because as you look at the tube of the
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airway, they're just a sort of infolding of the airway.
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So vocal folds is probably slightly more accurate. So they should look a kind of pearly white colour.
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They should not have too much in the way of sticky mucus on them.
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They should have straight edges. So this V, the straight lines of the V should
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be absolutely dead straight, as straight as a ruler.
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And the most common thing I would see in terms of
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abnormalities would be little lumps and bumps and protrusions
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on the inner edges of those of those straight lines sometimes
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I'll see some sort of redness in this and then at the when I'm getting a patient
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to use their voice that when they're being examined I will initially just have
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them breathing very quietly and I get the scope having gone through the nose
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I get the scope to a few millimeters above the vocal cord so I can get really
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really close in and check the surfaces and then I'll come back and get them to.
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Give me a sustained e and then do some pitch glides
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and various other things just to examine the different aspects
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of how the voice works one of the key things in terms of the
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examination technique that i use and that should be
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used for any singer is called stroboscopy and stroboscopy is a technique whereby
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as the vocal cords come together when they're vibrating they're actually vibrating
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several hundred times a second but stroboscopy gives you the illusion of slow
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motion so it looks as if they're moving just one or two that it looks as if
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they're vibrating just one or two times a second.
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And that's really helpful because it gives me information about the pliability
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and the suppleness of the vocal cords.
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And for any singer needing to see an ENT surgeon, needing to see a laryngologist,
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a stroboscopy is absolutely critical.
00:14:40.001 --> 00:14:43.681
I remember having that done the first time. It was fascinating to see.
00:14:43.941 --> 00:14:45.941
Absolutely amazing. Yeah, absolutely.
00:14:46.361 --> 00:14:52.561
And singers are universally absolutely fascinated by being able to see their
00:14:52.561 --> 00:14:58.681
own larynxes, but also they're tending to hang on to, is that a musical instrument? I don't know.
00:14:59.961 --> 00:15:05.001
Or are you strangling a cat? Yeah. I'm just not sure. It's children playing
00:15:05.001 --> 00:15:07.741
outside. How dare they have fun and play outside on the streets?
00:15:07.961 --> 00:15:10.921
There's all kinds of things. Oh, you've got to go onto the porch and be like,
00:15:11.201 --> 00:15:13.281
get off my porch, get off my property.
00:15:13.641 --> 00:15:16.681
The other day I was teaching because my studio is at the front of the house
00:15:16.681 --> 00:15:21.081
and one of the kids threw his football into my front yard and I could hear them
00:15:21.081 --> 00:15:24.701
like, because I was doing my singing practice and I could hear the father go,
00:15:25.181 --> 00:15:27.501
oh, well, that's it. You've lost your ball now, mate.
00:15:27.601 --> 00:15:30.121
You're going to have to go in like, you know, because it went over the fence.
00:15:31.041 --> 00:15:33.461
And he's like, what do you mean, dad? And he's like, I saw her.
00:15:33.621 --> 00:15:37.961
She did not look impressed with us playing several times in front of the yard.
00:15:37.961 --> 00:15:40.561
So I'd opened the door and I'd given like that kind of, you know,
00:15:41.101 --> 00:15:44.321
like slightly older woman looking disapproving, like as if to say,
00:15:44.421 --> 00:15:47.701
can you stop, like, you know, because I was trying to record something at the time.
00:15:47.781 --> 00:15:51.081
I wasn't rude. I was just like letting them know I was there, you know.
00:15:51.501 --> 00:15:54.381
And the dad's like, oh, that's it. She was scowling. It's going to go now.
00:15:54.461 --> 00:15:58.461
The ball's going to go now. And he's like, okay, I'm going to go and I'm going to ask. And he's like.
00:15:58.915 --> 00:16:02.275
You know, at the door. And he's like, can I please have my ball?
00:16:02.335 --> 00:16:03.635
And I'm like, yeah, of course, no problem.
00:16:03.735 --> 00:16:06.495
And then I like toddle off and I hear the dad go, oh, that was much easier as
00:16:06.495 --> 00:16:07.855
I thought. She didn't look impressed before.
00:16:10.395 --> 00:16:14.335
Yes, you can, but I need three scales right now. I definitely think there's
00:16:14.335 --> 00:16:17.175
a clown and a hooter or something out there. For sure.
00:16:18.435 --> 00:16:22.655
Just in the sense of now that you said about what a good scan should look like
00:16:22.655 --> 00:16:25.655
and, you know, what a good scope should look like.
00:16:25.655 --> 00:16:30.235
Like when, this is maybe a silly question, but I'm interested because one of
00:16:30.235 --> 00:16:34.015
my colleagues and I were having this discussion the other day about male versus
00:16:34.015 --> 00:16:38.935
female chords and also different voice type, like the differences in voice type.
00:16:39.055 --> 00:16:42.615
So do you see a big difference for our listeners to know that in the voice types?
00:16:44.175 --> 00:16:49.395
So the simple answer is just if I were looking at scopes on mute and not able
00:16:49.395 --> 00:16:54.615
to hear the recording of the voice at all, it's very, very difficult to discern one voice from another.
00:16:54.615 --> 00:16:57.595
Okay partly because i mean vocal cords
00:16:57.595 --> 00:17:00.775
are different sizes and different configurations and
00:17:00.775 --> 00:17:03.615
different shapes and things but there's no when we look down
00:17:03.615 --> 00:17:07.015
with the endoscope there's no ruler there's no measure of
00:17:07.015 --> 00:17:09.795
how big one person's set of vocal folds
00:17:09.795 --> 00:17:13.455
is compared to another so okay it's actually really difficult
00:17:13.455 --> 00:17:16.395
to tell um i guess in general
00:17:16.395 --> 00:17:19.615
male vocal folds are thicker but
00:17:19.615 --> 00:17:22.475
in terms of the length of the vocal folds which is different between the
00:17:22.475 --> 00:17:25.235
the sexes but in terms of length of the vocal folds you can't really
00:17:25.235 --> 00:17:27.975
tell that from looking with the endoscope because there's no yeah there's no
00:17:27.975 --> 00:17:30.835
way to measure it through it okay so there's no there's
00:17:30.835 --> 00:17:33.835
no distinct difference between no and in and in
00:17:33.835 --> 00:17:37.095
terms of different voice types you know i sometimes have people contacting me
00:17:37.095 --> 00:17:40.355
to say i'd like you to let me know whether i'm you
00:17:40.355 --> 00:17:43.255
know a high baritone or a low tenor just by looking
00:17:43.255 --> 00:17:46.855
with the scope oh wow that's not
00:17:46.855 --> 00:17:50.735
going to happen you know there are certain things i can tell but that sort of
00:17:50.735 --> 00:17:54.055
minutiae is not that's not really my oh that's interesting because i certainly
00:17:54.055 --> 00:17:58.815
have heard people talk about the thickness of of the chords being relative to
00:17:58.815 --> 00:18:03.335
to voice type so that's that's interesting yeah i think i think there's a danger to.
00:18:03.983 --> 00:18:09.643
There's a danger, isn't there, of over-medicalizing and over-scientificizing,
00:18:09.783 --> 00:18:12.943
not a word, over-scientificizing the whole process. Yeah, no,
00:18:13.183 --> 00:18:13.903
we're going to keep that.
00:18:14.291 --> 00:18:17.711
People thinking i what
00:18:17.711 --> 00:18:20.651
i don't want for singers when they come to see me is
00:18:20.651 --> 00:18:23.471
to hang on to the voice as a
00:18:23.471 --> 00:18:27.651
kind of mechanical biological physical process
00:18:27.651 --> 00:18:30.471
because yes i need to look at the vocal folds
00:18:30.471 --> 00:18:33.611
and make sure that everything's okay but actually fundamentally this is an
00:18:33.611 --> 00:18:36.291
artistic endeavor a thing
00:18:36.291 --> 00:18:39.471
about engaging emotion and conveying words
00:18:39.471 --> 00:18:43.171
and meaning and if people get too fixed and
00:18:43.171 --> 00:18:46.251
hung up on the physicality of the voice and tweaking this
00:18:46.251 --> 00:18:49.231
muscle and holding that muscle and then you actually start to
00:18:49.231 --> 00:18:53.451
lose the sense of why you're doing it in the first place um there are some people
00:18:53.451 --> 00:18:56.731
who like to come to see me every six months or a year or so for checkups and
00:18:56.731 --> 00:19:01.991
i in in principle that's fine and i'm very happy to to see them but i don't
00:19:01.991 --> 00:19:06.971
want people to get hung up on the the sort of physical thing because ultimately
00:19:06.971 --> 00:19:09.011
they need to be able to speak to a singing teacher.
00:19:09.251 --> 00:19:12.451
Why did I get onto that? I got onto that because I think this thing about looking
00:19:12.451 --> 00:19:17.031
at the larynx and determining whether somebody's voice is one type or another. Gotcha.
00:19:17.231 --> 00:19:21.051
I don't think that's for me. I think that's for the ears of an experienced singing
00:19:21.051 --> 00:19:23.511
teacher and for the singer themselves to work through.
00:19:23.731 --> 00:19:25.811
And it's not for me to look and say, well, actually, no, no,
00:19:25.811 --> 00:19:27.931
no, I don't think you should be doing that. I should be doing something else.
00:19:27.931 --> 00:19:29.151
You're not a tedder. Yeah.
00:19:29.531 --> 00:19:32.531
Well, no, I know, I know. So that would really spook them, I think.
00:19:32.691 --> 00:19:36.891
So how do you kind of resolve that for yourself as a singer?
00:19:37.091 --> 00:19:40.591
Like as a singer and a mechanic? How does that play in your head?
00:19:40.731 --> 00:19:47.951
I think what I tend to say to patients is that what I can do is to establish
00:19:47.951 --> 00:19:52.731
whether there is any problem with the vocal cords. Have you caused yourself an injury?
00:19:52.971 --> 00:19:55.291
Are there any bleeds or polyps or what have you?
00:19:55.791 --> 00:19:59.951
If there are kind of mechanical obvious muscular tension issues,
00:20:00.091 --> 00:20:03.651
then we can start to address those and maybe think about vocal coaching or singing teaching.
00:20:03.991 --> 00:20:09.911
But I don't, yeah, I try to avoid people getting too stuck on the sort of physical processes.
00:20:10.211 --> 00:20:12.891
You know, I am not...
00:20:13.148 --> 00:20:18.148
Too shy to tell you, and I feel slightly ashamed in saying this,
00:20:18.468 --> 00:20:24.648
but I only went to see someone to have a scope done for the very first time
00:20:24.648 --> 00:20:26.488
ever in my career last year.
00:20:26.968 --> 00:20:29.728
And, you know, everyone was like, what? You've obviously been very lucky.
00:20:29.828 --> 00:20:31.168
That's great. What you've never been before.
00:20:31.288 --> 00:20:34.888
And I was like, oh no, I, you know, I will say that in general,
00:20:35.068 --> 00:20:39.228
I'm very fortunate to say that I'm not a singer who psychs themselves out very frequently.
00:20:39.468 --> 00:20:41.248
Yes, I've had a couple of times when I've not been able to sing,
00:20:41.348 --> 00:20:42.608
but it's, you know, been laryngitis
00:20:42.608 --> 00:20:46.368
or something like it's not you know and I pride myself on you
00:20:46.368 --> 00:20:49.528
know trying to keep quite healthy and all those things but I'm not particularly strung
00:20:49.528 --> 00:20:52.428
up on things but I went to do this big Strauss
00:20:52.428 --> 00:20:55.368
Spectacular for Scottish Opera and got up there and
00:20:55.368 --> 00:21:00.068
it was a very short rehearsal period and the last time that I'd sung for Scottish
00:21:00.068 --> 00:21:04.968
Opera I had to cancel and it's one of the only times I think there's three times
00:21:04.968 --> 00:21:08.308
in my whole career I've had to do that and so it's haunted me and again I'm
00:21:08.308 --> 00:21:11.808
not someone who gets in my own head very much but we had the first rehearsal
00:21:11.808 --> 00:21:14.868
everything was going well and towards the end of the first rehearsal I thought something.
00:21:15.368 --> 00:21:19.368
Something's not right and by that night I had nothing like I did like like I
00:21:19.368 --> 00:21:23.688
just like and I thought oh my god like this is weird like I you know and it's
00:21:23.688 --> 00:21:27.488
not it wasn't fatigue it wasn't anything and I just got my anyway so they sent
00:21:27.488 --> 00:21:31.988
me to see Scottish Opera had had their guy that that they that they sent me over to see um.
00:21:32.494 --> 00:21:36.254
And it was the first time that I'd had, you know, something like that done.
00:21:36.314 --> 00:21:38.714
So when you say about seeing us feeling a bit anxious about it,
00:21:38.834 --> 00:21:42.194
it's really funny because I would never have been nervous about seeing that before.
00:21:42.334 --> 00:21:45.534
But given psychologically the fact that I'd cancelled previously.
00:21:46.114 --> 00:21:48.954
That I only had a week while I was up there, it was a very fast turnaround.
00:21:48.994 --> 00:21:52.234
I'd spent months learning this drows because it was a bitch to learn.
00:21:52.374 --> 00:21:56.334
And I thought, oh my God, I can't have done all this work. And come on,
00:21:56.434 --> 00:21:59.034
you know, again, I was like, I'm only human, but still, this is weird.
00:21:59.154 --> 00:22:02.594
Like I didn't feel ill, like the whole thing. And when I got the scope,
00:22:02.934 --> 00:22:05.854
it was like, yeah, everything's fine.
00:22:06.114 --> 00:22:09.554
Like I can see that you've had, there has been a little bit of swelling,
00:22:09.774 --> 00:22:12.574
but nothing, you know, unusual. Your cords are actually really healthy.
00:22:12.814 --> 00:22:18.774
And part of me was just like disappointed that there wasn't anything obvious
00:22:18.774 --> 00:22:20.414
that I could fix, you know.
00:22:20.554 --> 00:22:25.514
It was like, and then you get that game of, is it in my head? Like what the hell?
00:22:25.654 --> 00:22:28.394
Like Helena, this is not normal for me. and then I
00:22:28.394 --> 00:22:31.194
like now a year later or so I look
00:22:31.194 --> 00:22:33.834
at it and I'm like Helena that was wonderful like your cords are healthy and it
00:22:33.834 --> 00:22:37.094
was a good you know and okay maybe there was something a bit
00:22:37.094 --> 00:22:41.454
that had been there but yeah I was in a way I was disappointed that there wasn't
00:22:41.454 --> 00:22:45.454
something like remarkably obvious that I could have an instant fix for you know
00:22:45.454 --> 00:22:48.954
yeah it's interesting I do I do get that reaction sometimes I mean that in the
00:22:48.954 --> 00:22:52.834
vast majority of cases when a singer has their vocal cords examined and everything's
00:22:52.834 --> 00:22:56.394
okay there's a sense of relief and people kind of skip out of the room, but occasionally,
00:22:56.694 --> 00:23:00.014
and actually it's interesting, particularly when people have had a problem with
00:23:00.014 --> 00:23:01.594
their voice for a long time,
00:23:01.914 --> 00:23:03.994
they sort of want there to be.
00:23:04.641 --> 00:23:09.001
Yeah. As you say, something fixable, a surgical solution or a medicine that's
00:23:09.001 --> 00:23:11.181
going to make it go away. Did the Strauss go okay in the end then?
00:23:11.441 --> 00:23:15.861
It did. I mean, they gave me some steroids and I said, look,
00:23:15.881 --> 00:23:18.441
I'd really prefer not to take them because I've never done it before.
00:23:18.641 --> 00:23:22.441
It's not something I've had practice with or that I know.
00:23:22.721 --> 00:23:28.101
And I'm a control freak with my voice. So I want to be in full understanding
00:23:28.101 --> 00:23:30.481
of everything. So very fortunately, I was fine.
00:23:30.581 --> 00:23:33.661
And I think you're right. I think in a way I went as well.
00:23:33.881 --> 00:23:37.261
There was a part of me that just was like, okay, I'm really glad there's nothing
00:23:37.261 --> 00:23:41.801
physiologically wrong, meaning I can go forth and sing, like, just give myself...
00:23:42.208 --> 00:23:45.548
You know, 24 hours, take it easy at the orchestral. And then,
00:23:45.648 --> 00:23:47.388
yeah, and then it was, it was a triumph, thankfully.
00:23:47.588 --> 00:23:50.508
Then I also felt a bit embarrassed that it was the first time I'd ever been
00:23:50.508 --> 00:23:52.628
to see my babies my whole life.
00:23:52.688 --> 00:23:56.848
So I definitely, it's on my hit list of things to do when I'm in good shape
00:23:56.848 --> 00:24:00.348
to go and, you know, get a scope, you know, when I'm, when I'm in a good headspace
00:24:00.348 --> 00:24:01.628
about it too, and actually seeing.
00:24:01.748 --> 00:24:04.708
Well, if there's no, you know, if there's no need to be seen,
00:24:04.808 --> 00:24:07.468
and if you aren't having specific problems, then, then that's,
00:24:07.488 --> 00:24:09.448
that's great. Carry carry on as you are.
00:24:09.628 --> 00:24:15.008
You're very fortunate to have got that far without needing it. I think so too.
00:24:15.848 --> 00:24:19.708
With that, Declan, and not specifically about your situation,
00:24:19.968 --> 00:24:23.748
Helena, but how often do you see the difference between something that's psychological
00:24:23.748 --> 00:24:27.528
and physiological when you're dealing with some vocal issues?
00:24:27.768 --> 00:24:33.548
I think, well, so the frequency with which I see a lump or a bump or a bleed
00:24:33.548 --> 00:24:38.988
or something visible on the vocal cords, I guess is maybe one time in five or
00:24:38.988 --> 00:24:40.908
something like that when I'm examining a larynx.
00:24:41.328 --> 00:24:46.408
That's not to say that all of the rest are psychological because there are often
00:24:46.408 --> 00:24:50.828
sort of technical things about posture or about demands of a particular show
00:24:50.828 --> 00:24:54.308
or about breath support or how recently have you seen a singing teacher?
00:24:54.428 --> 00:24:57.348
So there's a whole bunch of issues there. And reflux too, right?
00:24:57.468 --> 00:25:01.768
That's a bit of a... Yeah, reflux. Yeah, we can chat about reflux. Yeah, absolutely.
00:25:02.068 --> 00:25:05.388
But I think it's almost always the case that
00:25:05.388 --> 00:25:08.408
there are psychological issues for every singer you
00:25:08.408 --> 00:25:11.908
know that it's not whether you have something physical there or not
00:25:11.908 --> 00:25:14.668
everybody gets in their own head from
00:25:14.668 --> 00:25:18.268
time to time and everybody knows about particular trigger
00:25:18.268 --> 00:25:23.988
points for them with certain vocal things so as the years have gone by I've
00:25:23.988 --> 00:25:28.988
increasingly been opening up conversations with patients about how much the
00:25:28.988 --> 00:25:32.688
psychological aspects of their voice are having an impact on how they how they
00:25:32.688 --> 00:25:35.728
work physically it might not be the primary driver for why they're having a
00:25:35.728 --> 00:25:36.548
problem with their voice but.
00:25:37.086 --> 00:25:42.626
You know, just be open to the idea that the psychological aspects of this might be feeding into it.
00:25:42.786 --> 00:25:45.646
And if you were chatting to a group of, say, young artists, like you said,
00:25:45.846 --> 00:25:48.846
you go in and have a chat to people about vocal health and everything,
00:25:49.066 --> 00:25:53.226
what are the first aspects that you would say, what would be the first kind
00:25:53.226 --> 00:25:57.226
of little trigger warning that someone as a singer could maybe think,
00:25:57.346 --> 00:26:01.946
it might be something other than just an infection? What would you say? Yeah, I think the
00:26:02.355 --> 00:26:09.035
One of the things that happens when you have small swellings on the inner edges
00:26:09.035 --> 00:26:13.055
of the vocal cords is you tend initially to start losing the top end of the voice.
00:26:13.295 --> 00:26:17.735
So somebody who is having problems, particularly in their sort of floated upper
00:26:17.735 --> 00:26:22.555
registers, dropping in on a top A piano sort of thing. That's my thing.
00:26:23.115 --> 00:26:25.195
My wanky high notes. Yeah.
00:26:26.555 --> 00:26:31.715
So if that starts to cause problems, then that suggests that maybe there is
00:26:31.715 --> 00:26:34.875
something going on on the medial edge of one of the vocal cords.
00:26:35.015 --> 00:26:42.335
But I also think it's worth people just trying to work things through over the space of a week or two.
00:26:42.435 --> 00:26:44.895
I wouldn't want people to get too trigger happy and think, look,
00:26:44.895 --> 00:26:47.295
I've got two days of my top A's not working and I need to go into something.
00:26:47.295 --> 00:26:49.815
But on a long term, on a more long term. On the long term, yeah.
00:26:49.875 --> 00:26:52.255
So if there's something that's been going on for several weeks,
00:26:52.415 --> 00:26:55.455
then then it's certainly worth getting it checked out and also you know as you
00:26:55.455 --> 00:26:58.815
say with your Strauss thing if you've got a big gig coming up in a week's time
00:26:58.815 --> 00:27:01.835
and there's a problem and you need to just know what's what and whether you
00:27:01.835 --> 00:27:05.275
can go ahead then yeah that would be a good reason to come and see someone.
00:27:05.475 --> 00:27:11.535
And what about when a voice starts to get quite a lot like excess air to the
00:27:11.535 --> 00:27:16.175
sound of it and and like a like a breathy quality when it doesn't usually have
00:27:16.175 --> 00:27:17.895
what what what what could that be?
00:27:18.035 --> 00:27:22.275
That's usually a technical thing and that's usually to do with a small gap at
00:27:22.275 --> 00:27:24.575
the back of the vocal cords on phonation.
00:27:24.895 --> 00:27:28.235
And there are generally sort of technical fixes that can be worked on with that.
00:27:28.635 --> 00:27:33.435
With female larynxes, it's quite common for there to be a little bit of a gap
00:27:33.435 --> 00:27:36.495
at the back. When does that become a sort of problem?
00:27:36.635 --> 00:27:40.215
I guess it becomes a problem when the voice is excessively breathy.
00:27:40.555 --> 00:27:45.135
Yeah. And very often working the voice in different ways will give better closure.
00:27:45.335 --> 00:27:50.235
You know, different vowel sounds, different degrees of brightness will change that closure.
00:27:50.815 --> 00:27:55.915
Gosh. So tell us about reflux then, because I'm really interested in that.
00:27:56.035 --> 00:27:59.355
And I know certainly at the start of my singing career, that's actually the
00:27:59.355 --> 00:28:05.215
first reason that I went to see an ENT was because I was concerned about reflux
00:28:05.215 --> 00:28:06.795
and performing with that.
00:28:07.199 --> 00:28:09.379
And yeah, so tell us about that.
00:28:09.699 --> 00:28:15.219
Well, reflux is a fairly controversial topic, I think it's fair to say.
00:28:15.439 --> 00:28:21.259
The background of our understanding and our discussions about reflux really go back about 20 years.
00:28:21.439 --> 00:28:26.199
There was an ENT surgeon in the States called Jamie Kaufman who started linking
00:28:26.199 --> 00:28:29.519
vocal problems and throat problems with reflux.
00:28:29.699 --> 00:28:36.119
Now, that unfortunately led to a proliferation in the prescription of PPI medications.
00:28:36.119 --> 00:28:39.359
So things like lansoprazole and pantoprazole and
00:28:39.359 --> 00:28:42.619
omeprazole and esomeprazole and this whole bunch of
00:28:42.619 --> 00:28:45.419
medications and they fundamentally reduce the amount
00:28:45.419 --> 00:28:50.659
of acid that the stomach is producing and that has without question led to an
00:28:50.659 --> 00:28:56.579
over-prescription of those ppi medications now there are some people who have
00:28:56.579 --> 00:29:00.779
heartburn and have raging taste of acid in the back of the throat and you know
00:29:00.779 --> 00:29:05.299
absolutely barn door clearly got reflux and a ppi in those situations is very helpful.
00:29:05.619 --> 00:29:10.599
But I think if you're a singer who is having subtle problems with certain parts
00:29:10.599 --> 00:29:12.839
of your range, if there's a bit of excess mucus,
00:29:13.079 --> 00:29:15.959
if there's some vocal fatigue, and if there's a suggestion of maybe a little
00:29:15.959 --> 00:29:18.939
bit of redness around the back of the larynx, well, that suggests that there
00:29:18.939 --> 00:29:22.139
may be some reflux, but it might be subtle.
00:29:22.419 --> 00:29:27.399
And I'm very much of the school of thought that would try to avoid the prescription
00:29:27.399 --> 00:29:30.039
of PPI medication at the first visit.
00:29:30.179 --> 00:29:33.239
I'm open to the idea of prescribing it if things aren't
00:29:33.239 --> 00:29:36.359
settling down but in the first instance you know
00:29:36.359 --> 00:29:40.019
there are very helpful non-pharmacological ways
00:29:40.019 --> 00:29:43.139
of managing reflux cutting out certain foods yeah right
00:29:43.139 --> 00:29:46.879
exactly avoiding spicy food avoiding fizzy drink avoiding eating late at night
00:29:46.879 --> 00:29:50.319
the trouble is that all of these things all of the things i've just described
00:29:50.319 --> 00:29:52.699
are things that typically happen when you're a singer you know you have you
00:29:52.699 --> 00:29:56.059
do a show you go you go and have a beer and you go and have a beer and a curry
00:29:56.059 --> 00:29:59.579
after the show and then you go straight to bed so trying to trying to break
00:29:59.579 --> 00:30:01.699
those habits is quite difficult, but
00:30:02.095 --> 00:30:07.895
I think singers are much more alert to those issues and how to manage them than they used to be.
00:30:08.035 --> 00:30:11.615
If those sorts of things aren't working, if there's a suspicion of reflux,
00:30:11.995 --> 00:30:13.815
then I will prescribe a PPI.
00:30:14.355 --> 00:30:18.835
And then beyond that, if the PPI isn't helping, then there are reflux tests that can be done.
00:30:19.095 --> 00:30:23.415
I don't do the detailed reflux testing myself, but I work with a gastroenterologist
00:30:23.415 --> 00:30:25.655
who does dual probe pH monitoring.
00:30:25.795 --> 00:30:31.295
So he'll put a tube in the nose that sits in the stomach for 24 hours and there's
00:30:31.295 --> 00:30:36.375
an acidity monitor down just above the stomach to see if any reflux gets out of the stomach.
00:30:36.675 --> 00:30:40.255
There's an acidity probe right up at the top of the throat as well to see how
00:30:40.255 --> 00:30:42.495
much acidity gets actually up there.
00:30:42.655 --> 00:30:48.015
And then you can properly, definably quantify how much reflux there is.
00:30:48.075 --> 00:30:51.195
Because it may be that there are other reasons for the voice to be problematic
00:30:51.195 --> 00:30:54.575
that aren't reflux and then you can kind of absolutely confirm or refute that.
00:30:55.255 --> 00:31:01.815
So yeah, reflux, we've had quite a re-evaluation of reflux over the last few years. I spend...
00:31:02.131 --> 00:31:05.551
I mean, apart from the sort of singers I see, I spend quite a lot of my time
00:31:05.551 --> 00:31:11.111
seeing patients who are being referred in by their doctors with possible cancer,
00:31:11.311 --> 00:31:12.191
possible throat cancer.
00:31:12.571 --> 00:31:15.631
So I do these, we call them two-week wait clinics because we have to see them
00:31:15.631 --> 00:31:18.451
within a fortnight to establish what's going on.
00:31:18.891 --> 00:31:24.671
And quite a lot of patients in that situation have fairly sort of non-specific throat symptoms.
00:31:24.831 --> 00:31:27.031
They have a kind of feeling of a throat in the lump or they're clearing their
00:31:27.031 --> 00:31:31.791
throat a lot or a bit of discomfort and what have you. And almost always that's not cancer.
00:31:31.971 --> 00:31:35.991
But the GPs historically, over the last few years, have got into the habit of
00:31:35.991 --> 00:31:39.811
prescribing PPIs just to see if it is the reflux that's an issue.
00:31:39.991 --> 00:31:44.991
And the problem is that when you're on a PPI, it then becomes very difficult to come off the PPI.
00:31:45.191 --> 00:31:48.731
And there have been some studies recently that have said that throat symptoms,
00:31:48.891 --> 00:31:53.171
if you prescribe a PPI or if you prescribe a placebo for sort of general throat
00:31:53.171 --> 00:31:55.191
symptoms, there's no difference between the two.
00:31:55.351 --> 00:31:58.391
So we really are very much moving away from prescribing the
00:31:58.391 --> 00:32:01.571
ppis if we can avoid it my my mother is
00:32:01.571 --> 00:32:04.691
is 83 now and a couple of years ago she started
00:32:04.691 --> 00:32:08.231
this this kind of real real issue with throat and she's
00:32:08.231 --> 00:32:10.971
definitely not a singer i would like to say she's very far off it
00:32:10.971 --> 00:32:13.851
um and um i had to take her for
00:32:13.851 --> 00:32:16.611
a for a scope and uh my mother's got a wicked
00:32:16.611 --> 00:32:21.571
sense of humor she's you know she's a she's there's a lot of fun and um yeah
00:32:21.571 --> 00:32:26.111
she they said to her they were talking about reflux and there was all this kind
00:32:26.111 --> 00:32:29.291
of like clear bubbles and stuff that was coming up her throat and she feels
00:32:29.291 --> 00:32:32.211
very much like she can't breathe sometimes like it gets it gets all stuck and
00:32:32.211 --> 00:32:34.051
and she's got this horrendous like.
00:32:34.431 --> 00:32:38.691
Kind of cough thing that she does where it's just kind of this frothy stuff
00:32:38.691 --> 00:32:39.271
at the back of her throat.
00:32:39.351 --> 00:32:45.211
Anyway, they said to her, well, we've got to rule out kind of reflux and talk
00:32:45.211 --> 00:32:46.671
about your eating habits.
00:32:46.811 --> 00:32:49.991
My mother is, I don't know if there's an actual word for it,
00:32:50.011 --> 00:32:51.891
but she's addicted to tea, right?
00:32:52.411 --> 00:32:57.111
She's a tea-holic, basically, which is kind of funny. And they said to her,
00:32:57.491 --> 00:32:59.251
do you drink a lot of caffeine?
00:32:59.711 --> 00:33:04.931
And she's sitting there, she's like, no. And I just looked at her And I went, what about tea?
00:33:05.031 --> 00:33:07.271
And she's like, well, yeah, I mean, it has a little bit in it.
00:33:07.311 --> 00:33:10.411
And I was like, mum, you know, it's still caffeine.
00:33:10.431 --> 00:33:13.151
And she's like, and they're like, how much tea do you drink, Norma?
00:33:13.211 --> 00:33:16.231
And she's like, oh, you know, a few cups a day. And I'm looking at her,
00:33:16.331 --> 00:33:22.271
I'm like, like literally my mother would drink 30, 20, 20 cups to 30 cups a
00:33:22.271 --> 00:33:24.131
day and she drinks it. Oh, my God.
00:33:24.331 --> 00:33:27.091
Yeah, yeah, yeah. And she's got really bad sleeping habits. So she'll be up
00:33:27.091 --> 00:33:30.431
until two in the morning and she'll still be drinking tea and then she'll just
00:33:30.431 --> 00:33:34.451
go to bed. And so they said, do you, you know, do you drink tea like late into the night?
00:33:34.591 --> 00:33:38.331
She's like, well, and I'm like, can you stop like blatantly lying, you know?
00:33:39.791 --> 00:33:44.811
The guy said to her, I think you need to try to look at decaf tea,
00:33:45.111 --> 00:33:46.751
you know, for the evening.
00:33:46.871 --> 00:33:49.571
And she's like, no. Like just straight up, just told him no.
00:33:49.911 --> 00:33:52.791
And then he says to her, what about your eating habits?
00:33:52.951 --> 00:33:56.991
You know, do you, again, you know, it'll be like midnight, one o'clock in the
00:33:56.991 --> 00:33:59.431
morning, she'll go and get a snack or something like, you know.
00:33:59.431 --> 00:34:02.371
And you know what do you do you eat and my
00:34:02.371 --> 00:34:05.611
mom is I should tell you she used to run restaurants she's an amazing cook
00:34:05.611 --> 00:34:09.831
right like amazing that's what she's known for and he said to her so after dinner
00:34:09.831 --> 00:34:13.331
I'd like you to have some some gaviscon or something like that and she said
00:34:13.331 --> 00:34:17.031
well you can tell me that if you like but to be honest with you I'm not going
00:34:17.031 --> 00:34:21.111
to do it and the the guy was like the poor man I was so embarrassed and and
00:34:21.111 --> 00:34:25.291
I said well I was confused I said why she said do you know how good my food tastes she's like
00:34:25.411 --> 00:34:28.971
do you know how bad Gaviscon tastes? She said, I am not putting that in there
00:34:28.971 --> 00:34:30.911
after I've just had a magnificent meal.
00:34:31.071 --> 00:34:34.131
I don't want to ruin the taste of the food that I've just, like literally at
00:34:34.131 --> 00:34:36.471
every corner she was fighting them. But you know what?
00:34:36.731 --> 00:34:41.831
That's fine. And if she, I quite frequently, I quite frequently see patients like that.
00:34:41.951 --> 00:34:45.071
And I say, if you, I hear what you say.
00:34:45.331 --> 00:34:49.551
And if you're, I've given you some advice and if you don't want to take the advice, that's fine.
00:34:49.731 --> 00:34:52.371
And if all you wanted out of today, right. And
00:34:52.371 --> 00:34:55.291
if all you wanted to know from today is that you haven't got cancer
00:34:55.291 --> 00:34:58.411
then i'm very happy to give you that reassurance if you actually
00:34:58.411 --> 00:35:01.311
actively would like to try to help with this then these
00:35:01.311 --> 00:35:04.091
are my suggestions but look if you'd rather carry on carry on as
00:35:04.091 --> 00:35:07.211
you are with your current situation go for it you know knock yourself
00:35:07.211 --> 00:35:10.091
out no harm done i actually had to trick her into uh
00:35:10.091 --> 00:35:13.351
into like i got some english breakfast decaf tea and
00:35:13.351 --> 00:35:16.051
i tricked her so i'd make i'd make the tea and and give
00:35:16.051 --> 00:35:19.171
it to her later later in the night when i was staying there on a contract and
00:35:19.171 --> 00:35:22.931
for maybe three four days like she didn't say anything and then after the fourth
00:35:22.931 --> 00:35:29.791
day she went I just so you know like I know what you're doing and I was like
00:35:29.791 --> 00:35:34.051
damn it and she said to me but I have to admit Helena it wasn't quite as bad
00:35:34.051 --> 00:35:36.591
as I thought it was going to be so I will try and at least do that.
00:35:36.751 --> 00:35:39.051
She sounds like an absolute she sounds like an absolute character.
00:35:39.431 --> 00:35:42.291
She is an absolute character but it was just so funny
00:35:42.291 --> 00:35:45.791
like she was just so straight up I'm like mum this
00:35:45.791 --> 00:35:49.011
issue means that she publicly like doesn't actually
00:35:49.011 --> 00:35:51.691
feel comfortable going out sometimes you know like watching a
00:35:51.691 --> 00:35:54.491
show or something because she she actually gets quite built up
00:35:54.491 --> 00:35:57.351
and she gets quite embarrassed if she if she coughs like that and
00:35:57.351 --> 00:36:00.011
but she's just the way she just i think
00:36:00.011 --> 00:36:04.771
there is i see i know i i see quite a lot of older patients in in similar situations
00:36:04.771 --> 00:36:08.051
who have a kind of accumulation of mucus in their throat and and they're clearing
00:36:08.051 --> 00:36:13.491
their throat quite frequently i think there is a thing about um age you know
00:36:13.491 --> 00:36:17.831
your mother's 80 something i as i quite often see
00:36:18.218 --> 00:36:22.138
older patients who have weakness of their vocal cords, presbyphonia.
00:36:22.518 --> 00:36:26.118
And there is also a parallel thing of presbyphagia, you know,
00:36:26.298 --> 00:36:30.158
weakness of swallowing due to ageing and the muscles just not having as much
00:36:30.158 --> 00:36:30.718
strength as they used to. Yeah, she's got similar, it's all very.
00:36:31.198 --> 00:36:32.398
The muscle just doesn't. Right,
00:36:32.398 --> 00:36:35.938
and so she's just not clearing things as efficiently as they used to.
00:36:36.098 --> 00:36:39.318
People, I think, sometimes think that it might be that there's an accumulation
00:36:39.318 --> 00:36:42.818
or they've got too much mucus, but I actually think it's the opposite way around.
00:36:42.918 --> 00:36:46.138
I think it's just that they're not clearing it efficiently because the muscles have aged a bit.
00:36:46.218 --> 00:36:51.058
And talking about getting getting older and the changes that you see,
00:36:51.238 --> 00:36:54.438
what's the difference between looking at, say,
00:36:54.898 --> 00:36:59.498
strength versus endurance as a singer gets older and wanting to work on strength
00:36:59.498 --> 00:37:01.538
of the muscle versus, say, endurance of the muscle?
00:37:01.658 --> 00:37:05.238
I mean, have you got any recommendations for those kind of things as we age as singers?
00:37:05.578 --> 00:37:09.698
I mean, I guess already we're doing good things anyway in using everything,
00:37:09.998 --> 00:37:11.258
like, you know, continuing on.
00:37:11.398 --> 00:37:14.158
Yes, I think I was just about to say it's the use it
00:37:14.158 --> 00:37:17.138
or lose it thing i think is important i don't there aren't
00:37:17.138 --> 00:37:20.478
any sort of physical changes that i see in
00:37:20.478 --> 00:37:26.478
the larynx um it's all it's very subtle and i think the the there's a thought
00:37:26.478 --> 00:37:32.658
sometimes that i am we talked already about people thinking that maybe i will
00:37:32.658 --> 00:37:36.298
be able to determine what voice type they are based on how the vocal cords look
00:37:36.298 --> 00:37:39.278
or you know various other things and equally,
00:37:39.558 --> 00:37:43.918
the subtle changes that happen to the voice as you go through your 20s and 30s
00:37:43.918 --> 00:37:48.978
and beyond are too subtle for me to be able to see on a scope.
00:37:49.118 --> 00:37:54.878
And caused by different things too. It's not just like a physiological change here. It's hormonal.
00:37:56.358 --> 00:37:59.758
It's hormonal, yeah. It's to do with support systems.
00:37:59.958 --> 00:38:05.158
And we haven't talked about the strap muscles and the muscles that sort of Anchor the larynx as well.
00:38:05.618 --> 00:38:11.778
So seeing those changes physically on the vocal cords is generally not something that's achievable.
00:38:13.338 --> 00:38:15.998
How did we get onto that? We were talking about aging voice.
00:38:16.458 --> 00:38:19.678
Aging, yeah, yeah, yeah. Voice changes, yeah, as voices mature, yeah.
00:38:20.181 --> 00:38:24.841
I was just going to say, Declan, during COVID, I know you took quite a big kind
00:38:24.841 --> 00:38:28.921
of step, like to help people and things through COVID and coming forward.
00:38:29.101 --> 00:38:32.421
Have you seen any kind of big changes coming out of that?
00:38:32.541 --> 00:38:38.741
I mean, I got COVID quite early and I was hospitalized and told that I would never sing again.
00:38:38.741 --> 00:38:43.561
And I had a PPI that was massive and they actually said to me,
00:38:43.781 --> 00:38:47.981
my team in Royal Surrey said, they feel like if it wasn't for my singing,
00:38:47.981 --> 00:38:52.021
I probably maybe wouldn't have made it through in the sense of the size of the
00:38:52.021 --> 00:38:57.121
PPI and how I managed to actually, you know, keep on breathing. So, Helena, PPI?
00:38:57.961 --> 00:39:02.361
A clot, the clot to my lung. A PE, you mean? Oh, sorry. PE. Sorry,
00:39:02.481 --> 00:39:03.761
PE. Yeah, sorry. Pulmonary embolism.
00:39:04.061 --> 00:39:05.381
I've got a little clever then. Yeah, yeah, yeah. Obviously not.
00:39:05.381 --> 00:39:06.801
Oh, gosh, okay. I've never tried to do that.
00:39:08.621 --> 00:39:15.821
Oh, gosh, okay. It was really early and I basically had COVID and then just
00:39:15.821 --> 00:39:19.021
couldn't breathe one day and, you know, went in and the rest of it.
00:39:19.101 --> 00:39:22.281
It took quite a long time to recover and to build.
00:39:22.501 --> 00:39:27.201
And the doctors had said to my other half, you know, there's a good chance that
00:39:27.201 --> 00:39:32.421
given the size of that cloth, there's a really fantastic chance she won't be singing again.
00:39:32.621 --> 00:39:35.321
And, you know, she has to, you know, work that through.
00:39:36.141 --> 00:39:43.141
And on day one I was at the piano and looking defiantly at my husband who said, babe, remember what?
00:39:43.221 --> 00:39:47.241
And I said, no, no, no, no one tells me, no, that's just not going to happen.
00:39:47.421 --> 00:39:50.721
So, yeah, just coming out of COVID, are you seeing anything,
00:39:51.001 --> 00:39:54.201
any major changes coming out of that long term?
00:39:54.961 --> 00:39:59.021
Well, I mean, COVID was very interesting. We can chat about sort of aerosols
00:39:59.021 --> 00:40:03.681
and transmission maybe in a minute, but in terms of the long-term changes for
00:40:03.681 --> 00:40:06.541
singers, I'm seeing relatively little,
00:40:06.861 --> 00:40:10.481
thankfully, I'm seeing relatively little now. Where are we in January 2026?
00:40:10.921 --> 00:40:12.901
At the time, we were seeing...
00:40:13.916 --> 00:40:17.136
Some very weird things we saw
00:40:17.136 --> 00:40:20.496
some really quite major laryngeal pathology
00:40:20.496 --> 00:40:24.596
not just in singers but in in all comers abscesses and
00:40:24.596 --> 00:40:27.496
swelling and granulomas and bleeds and
00:40:27.496 --> 00:40:30.376
narrowings and stenosis and all sorts of really
00:40:30.376 --> 00:40:33.416
odd stuff that kind of acute that immediate
00:40:33.416 --> 00:40:36.356
phase thankfully settled down and in the
00:40:36.356 --> 00:40:39.416
and obviously singing then stopped for
00:40:39.416 --> 00:40:42.416
quite a long time there were no shows open there were very few concerts
00:40:42.416 --> 00:40:45.376
happening and people I think were practicing in a different way so
00:40:45.376 --> 00:40:48.096
when performances started up again I guess
00:40:48.096 --> 00:40:54.236
in the middle to second half of 2020 I did see quite a lot of people who just
00:40:54.236 --> 00:40:57.696
basically hadn't really done very much practice and when they got back into
00:40:57.696 --> 00:41:01.636
it were thinking hang on a minute this feels really odd I'm not sure whether
00:41:01.636 --> 00:41:05.616
there's a problem or whether actually it's just that I haven't haven't been
00:41:05.616 --> 00:41:07.856
haven't been on the bike for a while Yeah.
00:41:08.476 --> 00:41:11.016
Right, exactly. So there was quite a lot of that.
00:41:11.976 --> 00:41:17.616
We're seeing quite a lot of post-COVID patients and post-flu patients now,
00:41:17.756 --> 00:41:19.596
particularly, you know, it's winter here in the UK at the.
00:41:21.180 --> 00:41:26.340
Post-flu patients. But actually, do you know, the COVID and flu type symptoms
00:41:26.340 --> 00:41:28.140
are relatively indistinguishable.
00:41:28.260 --> 00:41:30.280
We've had a horrible wave of flu here in the UK.
00:41:30.960 --> 00:41:34.880
And I'm seeing patients, whether it's COVID or flu, I'm seeing quite a lot of
00:41:34.880 --> 00:41:41.100
people who have quite a long recovery phase after having had that sort of viral infection.
00:41:41.480 --> 00:41:45.080
And, you know, there's no magic solution for that, unfortunately,
00:41:45.300 --> 00:41:49.520
just riding it out and getting the voice to work as well as you can.
00:41:49.520 --> 00:41:54.400
But thankfully, I mean, there is obviously that really very unfortunate cohort
00:41:54.400 --> 00:41:59.700
of long COVID patients who have fatigue and respiratory issues and memory issues
00:41:59.700 --> 00:42:01.640
and all the sort of stuff that goes with that.
00:42:01.780 --> 00:42:05.080
But I am seeing fewer of those as time goes on, thankfully.
00:42:05.240 --> 00:42:08.400
And the singers, by and large, I would say, have come out of it and,
00:42:08.400 --> 00:42:10.680
you know, got back on. That's fantastic.
00:42:10.940 --> 00:42:15.800
Well, you were really, as you mentioned earlier, really involved in the research
00:42:15.800 --> 00:42:19.880
around that COVID time. and you were quite instrumental in getting a lot of
00:42:19.880 --> 00:42:22.840
the performance spaces and rehearsal spaces opened up, weren't you?
00:42:22.900 --> 00:42:23.860
Can you tell us a bit about that?
00:42:24.060 --> 00:42:27.220
Yeah, I mean, it seems like a lifetime ago now.
00:42:27.400 --> 00:42:30.520
It's nearly six years ago, but at the beginning of the pandemic,
00:42:30.700 --> 00:42:34.860
there were these clusters of COVID centred around choirs or seemingly centred
00:42:34.860 --> 00:42:36.540
around choirs. Oh yeah, of course.
00:42:37.320 --> 00:42:42.680
There was a thought, therefore, that COVID was more readily spread in people who were singing.
00:42:42.840 --> 00:42:45.620
And as a result, the knee-jerk reaction from governments was just to say,
00:42:45.700 --> 00:42:49.120
right, in that case, There's no singing, no performance, no choir rehearsals, no nothing.
00:42:49.500 --> 00:42:53.420
And I took calls from a number of friends who are choral directors and musicians
00:42:53.420 --> 00:42:55.560
saying, well, how exactly are we going to get out of this?
00:42:55.620 --> 00:42:58.160
I mean, I was just a jobbing ENT surgeon at that stage.
00:42:58.240 --> 00:43:00.580
I have absolutely no research pedigree.
00:43:00.740 --> 00:43:06.600
But it was clear that something was going to have to be done to get some data about how...
00:43:07.155 --> 00:43:11.815
Much of a problem singing was compared to other activities. And around that
00:43:11.815 --> 00:43:15.755
time, I met a professor of aerosol science from Bristol.
00:43:15.975 --> 00:43:20.795
And I met a guy who kind of does government work. And we ended up getting involved
00:43:20.795 --> 00:43:22.195
with some of the UK government projects.
00:43:22.755 --> 00:43:25.715
So a number of things kind of coalesced.
00:43:25.755 --> 00:43:30.355
And we set up this research project where we measured the amount of aerosol
00:43:30.355 --> 00:43:33.995
coming out of people's mouths when they were singing, when they were speaking,
00:43:34.155 --> 00:43:36.655
when they were coughing, when they were doing speech therapy exercises.
00:43:36.655 --> 00:43:40.115
We then went on to do woodwind and brass instruments, and we looked at children
00:43:40.115 --> 00:43:41.475
and adults and exercise.
00:43:41.655 --> 00:43:48.475
We did a whole bunch of research experiments that had never really been done before.
00:43:48.635 --> 00:43:54.155
And the upshot was that although singing produced a bit more aerosol than speaking,
00:43:54.595 --> 00:43:56.635
it didn't produce vastly more.
00:43:56.795 --> 00:44:00.355
And it's actually the phonation, it's the production of sound that causes the
00:44:00.355 --> 00:44:05.235
problem, And it's the volume, the amplitude with which you're speaking or singing
00:44:05.235 --> 00:44:06.435
that is the primary problem.
00:44:06.575 --> 00:44:09.895
It's not so much the actual fact of singing.
00:44:10.255 --> 00:44:15.015
And intuitively, we know that because singing isn't so different from speaking.
00:44:15.215 --> 00:44:17.415
You're just manipulating your vocal tract in a different way.
00:44:17.475 --> 00:44:20.315
There isn't any inherently very different thing about it.
00:44:20.415 --> 00:44:24.855
But the governments were very clear that they weren't going to allow singing
00:44:24.855 --> 00:44:28.235
to happen again until we had really got some concrete data on it.
00:44:28.235 --> 00:44:33.095
And so we were feeding through our results sort of in real time to the Department
00:44:33.095 --> 00:44:35.155
of Culture, Media and Sport here in the UK.
00:44:35.455 --> 00:44:39.975
And they were kind of almost watching the results come through in real time.
00:44:39.975 --> 00:44:45.055
And then in the middle of 2020, they decided to start opening up performance again.
00:44:45.315 --> 00:44:47.595
Amazing. God, thank you for that, G.
00:44:48.043 --> 00:44:51.043
And it was a huge team that did it.
00:44:51.523 --> 00:44:55.863
Because I had that kind of one foot in each camp of the science and the singing,
00:44:56.223 --> 00:45:00.343
I sort of ended up being the person who people were talking to about it.
00:45:00.463 --> 00:45:04.923
But there were a dozen or more people involved in the research.
00:45:04.923 --> 00:45:10.023
Is there anything in your career that you've seen, that you've been presented
00:45:10.023 --> 00:45:14.043
with, like a scope or anything, that's been incredibly unusual?
00:45:14.303 --> 00:45:17.703
Like something where you've actually had to do a double take and try and be
00:45:17.703 --> 00:45:23.223
professional and not react by either, I don't know, vomiting or skipping for joy?
00:45:24.903 --> 00:45:29.603
Well, I say that because when I went through all this stuff that I told you
00:45:29.603 --> 00:45:34.583
about, I go back into emergency the week later because I ended up developing a really bad infection.
00:45:35.123 --> 00:45:40.563
And one of the guys said to me, can I just tell you, we've got your x-ray up
00:45:40.563 --> 00:45:45.823
on the wall as a survivor, you know, because of what you went through.
00:45:46.043 --> 00:45:49.323
He said, the size of that clot. He said, oh, I'm not going to lie.
00:45:49.423 --> 00:45:52.603
He said, it made me want to vomit a little bit, but I'm like so proud of you.
00:45:52.683 --> 00:45:54.263
And I was just like, what the hell?
00:45:54.383 --> 00:45:58.383
Like, I didn't know whether to like go with the victory or be disgusted by what he'd said.
00:45:58.503 --> 00:46:02.023
So is there anything that you've ever come across that's made you have a reaction like that?
00:46:02.023 --> 00:46:07.543
I've got one or two videos of larynxes that I wheel out occasionally just to
00:46:07.543 --> 00:46:10.963
sort of interesting things. I've got a lady who came in as an emergency with
00:46:10.963 --> 00:46:13.843
a potato in her larynx. Oh my God.
00:46:14.123 --> 00:46:20.983
What? She was an older lady who was being fed her dinner and partly inhaled
00:46:20.983 --> 00:46:24.043
this potato that then sat just above the vocal cords.
00:46:24.263 --> 00:46:28.923
And it was a small enough bit of potato that she could just about get enough
00:46:28.923 --> 00:46:31.483
air around it so that she could still breathe.
00:46:31.903 --> 00:46:35.403
But it was big enough that it hadn't actually gone through the vocal cords and into the lungs.
00:46:35.503 --> 00:46:38.743
So you could see this bit of potato bobbing in and out of her larynx and she
00:46:38.743 --> 00:46:40.243
hadn't got the strength to cough it out.
00:46:40.503 --> 00:46:43.103
So that's, you know, that's quite a good one.
00:46:44.243 --> 00:46:48.243
Oh, so what happened there? What happened in the end? Yeah. I mean,
00:46:48.303 --> 00:46:51.523
basically, we, in the emergency department,
00:46:52.194 --> 00:46:56.294
gave her, not we, my anaesthetic colleagues gave her some drugs to drift her
00:46:56.294 --> 00:46:58.154
off to sleep for a minute and a half.
00:46:58.274 --> 00:47:01.974
And we tipped her head down. We got the trolley tilting right so that she was
00:47:01.974 --> 00:47:03.994
at 30, 45 degrees head down.
00:47:04.194 --> 00:47:08.094
I looked in her mouth and got a pair of forceps and just hoiked the thing out.
00:47:08.474 --> 00:47:13.254
And then we woke her up and it was fine. So that was quite fun.
00:47:13.394 --> 00:47:16.334
So the potato and then I think this is one for the trophy cabinet for sure.
00:47:17.414 --> 00:47:20.354
That is something. I'm going to feel nervous-eating potato next time.
00:47:21.154 --> 00:47:28.674
Maybe I've lost perspective on what weird or gross or excessive is.
00:47:28.974 --> 00:47:31.734
I see big tumors.
00:47:32.134 --> 00:47:36.114
I see papillomas. Papillomas are these crops of warts that sit on the vocal
00:47:36.114 --> 00:47:38.314
cords. I see quite extensive things.
00:47:38.574 --> 00:47:44.914
I think having seen so much of it over the years, I've slightly lost the oh wow fact.
00:47:45.094 --> 00:47:46.914
I mean, a potato in the larynx, I think, is quite impressive.
00:47:46.914 --> 00:47:47.714
I was going to say, that wins.
00:47:49.414 --> 00:47:53.974
But the pathology is just about sort of degrees of severity,
00:47:53.974 --> 00:47:55.534
and I lose the oh, yuck factor.
00:47:55.774 --> 00:47:59.794
But I do do, you know, in these talks I do for young singers and conservatoires
00:47:59.794 --> 00:48:03.954
and things, I do show pathology that singers develop, but I also show some of
00:48:03.954 --> 00:48:04.894
the other pathology I see.
00:48:05.034 --> 00:48:09.334
And this papilloma thing, these crops of warts, unless you have seen it a few
00:48:09.334 --> 00:48:12.094
times before, there is a slightly oh, yuck factor about it.
00:48:12.094 --> 00:48:21.354
And people cringe and hide behind their coffee cups when I get those videos out.
00:48:21.934 --> 00:48:25.554
It's just slightly weird. As I say, I think I've lost perspective on what gross is.
00:48:28.034 --> 00:48:32.174
Look, we're coming close to the end of our chat today, but I did just before
00:48:32.174 --> 00:48:36.834
we wrap up, I did want to ask, is there any general advice that you'd give for
00:48:36.834 --> 00:48:40.214
singers, young singers or even mid-stage, late-stage singers.
00:48:40.536 --> 00:48:45.796
Career singers from your perspective? Yeah, I think there are some fairly obvious
00:48:45.796 --> 00:48:50.016
basic things just in terms of looking after your voice, hydration,
00:48:50.256 --> 00:48:53.436
avoiding caffeine and managing reflux and those sorts of things that people will be doing.
00:48:53.616 --> 00:49:01.136
It surprises me still that some singers smoke because that is just as far as
00:49:01.136 --> 00:49:06.616
I can see is completely incompatible with a career in singing and if they are
00:49:06.616 --> 00:49:09.136
singing now they won't be singing in 10 years time sort of thing.
00:49:09.136 --> 00:49:12.236
The uh avoid thinking about
00:49:12.236 --> 00:49:15.196
the totality of vocal loading by which
00:49:15.196 --> 00:49:17.876
i mean you know you might be practicing for a couple
00:49:17.876 --> 00:49:20.656
of hours a day and that's a reasonable amount of pressure to
00:49:20.656 --> 00:49:23.776
be putting on your voice but if you're also going out to pubs and nightclubs four
00:49:23.776 --> 00:49:26.596
nights a week that's more of a problem than the actual
00:49:26.596 --> 00:49:29.756
singing itself so and i think that's a particular problem
00:49:29.756 --> 00:49:32.416
for young singers who are in conservatores you know they want to be able
00:49:32.416 --> 00:49:35.216
to have a good time they want to be able to go out i learned
00:49:35.216 --> 00:49:38.516
that the hard way definitely yeah because
00:49:38.516 --> 00:49:41.576
i've never been someone who's i'm a complete nerd
00:49:41.576 --> 00:49:44.536
about my voice from a very young age like always taking care
00:49:44.536 --> 00:49:47.736
i don't drink i don't smoke you know the whole the whole caboodle but
00:49:47.736 --> 00:49:51.996
i love to have a night you know like i love to have fun and i remember like
00:49:51.996 --> 00:49:56.556
i went to my first nightclub when i turned 18 and they had like a grease mega
00:49:56.556 --> 00:50:01.516
mix on the on the thing and of course i have to sing louder than everyone like
00:50:01.516 --> 00:50:05.336
when we're dancing and I was doing all the, you know, I got chills, you know.
00:50:05.896 --> 00:50:09.156
Came out the next day and I was like, you know, and I was like,
00:50:09.276 --> 00:50:11.696
okay, right. That's never happening again. So, yeah.
00:50:12.056 --> 00:50:15.036
So I hear you on the, uh. Well, and you, you learned your lesson the hard way,
00:50:15.116 --> 00:50:19.936
but you know, some, some people learn the lesson by going an even harder way
00:50:19.936 --> 00:50:23.216
and actually causing pathology and then needing to have surgery and what have
00:50:23.216 --> 00:50:24.356
you. So that's, that's not ideal.
00:50:24.536 --> 00:50:28.456
So yeah, just balancing how you're using your voice outside of the singing domain
00:50:28.456 --> 00:50:30.316
and, and whilst singing as well.
00:50:30.576 --> 00:50:34.956
And we were saying earlier on about being open to the idea of seeing an ENT surge, and if.
00:50:37.250 --> 00:50:41.050
If you are going to see an ENT, take a video of your vocal cords.
00:50:41.210 --> 00:50:44.590
It's dead easy just to use your phone to take a video of the screen so that
00:50:44.590 --> 00:50:47.270
you've got it with you at all times. I wish I'd done that now. Yeah.
00:50:48.750 --> 00:50:52.830
If you run into problems in future, then you've got that kind of baseline record.
00:50:53.230 --> 00:50:58.530
And when I'm seeing patients, in my private practice, I always include a photograph
00:50:58.530 --> 00:51:02.590
of the larynx so that the patient's got it for their own records.
00:51:02.590 --> 00:51:09.010
Be open to the sort of psychological aspects of problems that can be caused
00:51:09.010 --> 00:51:12.110
when you're getting sort of slightly in your own head.
00:51:12.410 --> 00:51:17.670
And think of working with performance coaches if you need to.
00:51:19.290 --> 00:51:23.090
Touch base with a singing teacher regularly. It's surprising how often people
00:51:23.090 --> 00:51:26.990
have careers in singing but are a little bit surprised when one of my suggestions
00:51:26.990 --> 00:51:29.670
is, and I think you should probably go back to a singing teacher because you
00:51:29.670 --> 00:51:32.270
haven't seen somebody for five years. Yeah, absolutely.
00:51:32.590 --> 00:51:34.890
Yeah, yeah, yeah. I mean, I had a vocal thing.
00:51:35.350 --> 00:51:38.590
It wasn't a vocal problem. It was just a vocal thing that I needed,
00:51:38.670 --> 00:51:41.910
you know, to do more work on. And I did that.
00:51:42.030 --> 00:51:45.310
I went back and, you know, went to a specialist in New York when I was over
00:51:45.310 --> 00:51:48.810
there. And I wasn't shy in asking my colleagues and to, you know,
00:51:48.930 --> 00:51:50.330
to get different advice.
00:51:50.530 --> 00:51:53.850
And yeah, you can learn things all the time and every day.
00:51:54.030 --> 00:51:58.550
And it must be so wonderful for all the people that come to see you.
00:51:58.550 --> 00:52:02.890
Not only are you Declan Costello, like a rock star to the singers,
00:52:02.950 --> 00:52:07.150
but also like the fact that you have this singing background and this empathy
00:52:07.150 --> 00:52:11.770
and this understanding as well is just like such a double credit to your bow.
00:52:11.850 --> 00:52:15.290
I know it's not necessary, but it is wonderful, I think. And I think singers
00:52:15.290 --> 00:52:17.330
would feel great about that too, you know? I agree.
00:52:17.470 --> 00:52:20.550
And I think it is one of the things that I feel very fortunate about is
00:52:20.550 --> 00:52:27.230
the ability to have fairly nuanced discussions about repertoire and about voice
00:52:27.230 --> 00:52:31.430
types and about rehearsal schedules and recording and those sorts of things
00:52:31.430 --> 00:52:35.390
that I think a laryngologist who hasn't got a background as a singer might not
00:52:35.390 --> 00:52:38.550
have quite such an understanding of yet. I think that's absolutely right.
00:52:39.249 --> 00:52:42.649
That's why they're lining up around the corner for you. That's it. Bless you.
00:52:42.949 --> 00:52:48.989
Well, there we go. It's been a relatively healthy winter season over here in the UK, I have to say.
00:52:49.129 --> 00:52:53.689
It's been reasonably busy, but I think people are looking after themselves.
00:52:54.009 --> 00:52:57.729
That's great. And there was some great advice there. But now we are coming to
00:52:57.729 --> 00:53:01.649
the end of our chat. And so we're going to throw you five rapid fire questions.
00:53:01.869 --> 00:53:05.749
And these are new rapid fire questions. New for 26.
00:53:06.769 --> 00:53:10.589
That's right. Yeah, 2025 questions. Should I be nervous? So are these going to be awkward?
00:53:11.049 --> 00:53:15.689
Definitely. You should definitely be nervous. Helena, do you want to kick us off? Yeah. Okay.
00:53:16.109 --> 00:53:19.669
Declan, what is your go-to karaoke song? Blue Moon.
00:53:20.169 --> 00:53:23.829
Great choice. Excellent. Oh, we like that. Bit of creaming.
00:53:24.109 --> 00:53:29.349
Excellent. Yeah. Question number two. What will the title of your autobiography be?
00:53:30.269 --> 00:53:34.369
Using My Voice. That's good. That's fantastic.
00:53:34.729 --> 00:53:37.789
Oh, I like that. Yep. That's a good autobiography title. I hadn't,
00:53:37.889 --> 00:53:41.429
I really, I should have, well, if I'd been given the opportunity,
00:53:41.429 --> 00:53:43.449
I would have thought these three and I'd have come up with something clever.
00:53:43.569 --> 00:53:46.449
But okay, using my voice. No, we don't want clever.
00:53:46.689 --> 00:53:48.149
Okay, I'll go with that for now. We just want the instant reaction.
00:53:48.209 --> 00:53:50.869
Yeah, no, that's very good. That's the whole point.
00:53:51.389 --> 00:53:54.329
All right. If you had to give a TED talk with no notice, what could you give
00:53:54.329 --> 00:53:58.369
a lecture on for 10 minutes with no preparation outside of your obvious field?
00:53:58.910 --> 00:54:05.190
What could I give a TED talk on? Raising a child with Down syndrome. Fantastic.
00:54:05.750 --> 00:54:12.030
My daughter has Downs. The thought processes and the surprises and pitfalls
00:54:12.030 --> 00:54:15.030
and issues around raising a child with Down syndrome.
00:54:15.310 --> 00:54:17.810
That would be an amazing 10 minutes. Oh, I love that.
00:54:18.470 --> 00:54:22.870
My cousin has Down syndrome and she's one of the most wonderful humans that
00:54:22.870 --> 00:54:27.330
I've ever met. And what gives me the most pleasure is that every time she sees
00:54:27.330 --> 00:54:31.570
my brother and we go up there to visit her together, she wants to marry him like every time.
00:54:31.790 --> 00:54:35.530
And it just gives me so much pleasure because she's so in love with him like
00:54:35.530 --> 00:54:38.190
every time she sees him. And it's just so gorgeous.
00:54:38.450 --> 00:54:42.330
Well, Rosie's, our daughter, Rosie's 21 and she's got a lovely boyfriend who's
00:54:42.330 --> 00:54:45.010
20 and they are very clear that he's got Down syndrome.
00:54:45.450 --> 00:54:47.930
They're very clear that they're going to get married. They've got the whole
00:54:47.930 --> 00:54:52.850
thing planned out. Bless. I love it. Yeah. No, she's a joy. She's great. That's fantastic.
00:54:53.806 --> 00:55:01.286
Okay, question number four, that's me. What is your most controversial, boring opinion?
00:55:01.626 --> 00:55:06.246
Okay, so to give you an example, my most controversial, boring opinion might
00:55:06.246 --> 00:55:11.366
be that there is no wine on earth that tastes as good as apple juice.
00:55:11.526 --> 00:55:15.886
Okay, that would be an interesting hill to die on, Adam. Yeah, this is what I'm saying.
00:55:16.066 --> 00:55:19.466
A very controversial, yet really boring opinion.
00:55:19.466 --> 00:55:26.666
Controversial and boring opinion that choosing the right running shoes is very important,
00:55:27.786 --> 00:55:31.186
see that no i see that's fantastic that's absolutely
00:55:31.186 --> 00:55:33.966
brilliant and you say that because i've started to try
00:55:33.966 --> 00:55:37.006
to run and maybe that's why i can't run i'm going
00:55:37.006 --> 00:55:41.086
to go now and try to find some proper running shoes yeah because that's that's
00:55:41.086 --> 00:55:46.126
clearly the problem it can't be the rest of me it must be the shoes i really
00:55:46.126 --> 00:55:50.766
like that that's a very good controversial boring opinion And our final question
00:55:50.766 --> 00:55:55.866
on the podcast where we've decided high notes and anecdotes is putting together a crime gang.
00:55:56.046 --> 00:55:59.826
What skill do you have that we could use to rob the Louvre?
00:56:00.086 --> 00:56:01.746
I don't know if it would be of
00:56:01.746 --> 00:56:06.606
any help, but my wife says that I have an extremely good sense of smell.
00:56:08.906 --> 00:56:09.506
Okay.
00:56:13.246 --> 00:56:18.666
I'm trying to work out whether... That's fantastic. Chuck out weather. Is that?
00:56:19.526 --> 00:56:22.986
Oh, wait. We're including it. We'll take it. I think that's it.
00:56:23.186 --> 00:56:26.886
We have to work out how to use it, but we're going to definitely use it.
00:56:26.926 --> 00:56:29.226
I like it a lot. That's brilliant.
00:56:30.146 --> 00:56:34.026
I can smell my way around in the pitch black. Done. That's it.
00:56:34.246 --> 00:56:35.426
So we knock out the lights.
00:56:35.686 --> 00:56:40.066
That's it. Perfect. You can tell which part of the building we were in by the smell of, you know.
00:56:40.646 --> 00:56:44.286
Yeah. Yeah. Yeah. Well, you know, when you walk into a music library or into
00:56:44.286 --> 00:56:47.586
a music room, it's got a very distinctive smell. You're right.
00:56:48.369 --> 00:56:51.449
So you could almost tell which room in the Louvre you're in by the smell.
00:56:51.569 --> 00:56:53.289
There you go. That's perfect. I love it.
00:56:53.609 --> 00:56:55.709
We're locking that in. We've got our first member of our gang.
00:56:55.709 --> 00:56:57.509
You are in the gang. That's brilliant. Okay.
00:56:58.129 --> 00:57:02.969
Look, Declan, thank you so much for coming and chatting with us today. This was fascinating.
00:57:03.549 --> 00:57:07.749
So, so interesting. You do amazing work. And I know so many people around the
00:57:07.749 --> 00:57:09.929
world who really appreciate it. So thanks for that.
00:57:10.109 --> 00:57:13.609
And with that, we'll say goodbye and wrap up. Thanks so much,
00:57:13.669 --> 00:57:15.349
Declan. It's been a great pleasure. Thank you very much for inviting me.
00:57:15.529 --> 00:57:19.369
And yeah, enjoy your summer. Oh, we're sort of trying to enjoy our winter.
00:57:19.409 --> 00:57:20.589
We're not going to rub that in at all.
00:57:23.549 --> 00:57:26.209
Thank you so much. We're definitely enjoying it. Thanks so much.
00:57:26.289 --> 00:57:27.629
Take care. Thank you, guys. All the best. Bye.