ADAM RUBIN, MD
Published on March 15, 2017
TVF: Where do you currently practice?
AR: Lakeshore Professional Voice Center, Lakeshore Ear, Nose & Throat. 21000 E. 12 Mile Rd. #111 St. Claire Shores, MI
TVF: Where did you complete your medical training? Laryngology?
AR: Harvard Medical School, 1997
Oto residency: U of Michigan, 2003
Laryngology Fellowship, 2003-2004, with Robert T. Sataloff, MD
TVF: How/why did you come to choose laryngology given that you are a seasoned performer yourself?
AR: Although I decided to act professionally for a few years after college, I knew I wanted to go to medical school eventually. I had not heard about laryngology until touring with my a capella group (The Yale Society of Orpheus and Bacchus). We stayed with an alumnus named Richard Stasney. He was 1 of a handful of laryngologists in the US at the time. He showed me microlaryngeal instruments and videostroboscopy and introduced me to the field. I was so excited and thought that laryngology would be a perfect way to meld my two interests. After college, I performed in a show at the Walnut Street Theater in Philadelphia. The lead singer suffered an acute vocal fold tear. He actually went to see Dr. Sataloff, with whom 13 years later I did my laryngology fellowship. After 3 years of acting/singing professionally, I went to medical school knowing that I wanted to do this particular subspecialty niche of Otolaryngology.
TVF: What comes to your mind as one of the most pressing issues in contemporary voice disorders?
AR: Two main issues:
1. Treatment of vocal fold scar. We need to find a consistent way to regenerate superficial lamina propria.
2. Restoring motion to the paralyzed vocal fold.
TVF: What is/are your research interest(s)? Would you tell us in layman’s term, what your research is about? In what ways can your research be applied in the clinical field?
AR: During residency, I was active in gene therapy and recurrent laryngeal nerve regeneration. This is difficult research to continue while in private practice. In practice, I try to ask questions that can be answered in a large volume clinical practice. For example, we looked at supraglottic hyperfunction in healthy singers, as well as the effect of emotion on vibrato. We also explored our experience with treating globus with PPI or gabapentin, and treatment of hyoid bone syndrome with Kenalog injections.
TVF: Currently, the bulk of our research is being done in collaboration with Rahul Shrivastav, Eric Hunter, and others from AR: Michigan State University Speech Pathology department. We are exploring a new outcome measure called “pitch strength”. We presented our second paper at The Voice Foundation last year. This is a wonderful collaboration between a laryngologist, voice pathologists and voice scientists.
TVF: In your opinion, what poses the greatest challenge in care of voice disorders?
AR: We need better outcome measures for objective evaluation of voice. With the changes in medicine and reimbursement, more emphasis is going to be placed on good evidence-based research and outcomes. Without improved objective measures, this is going to be difficult.
TVF: What is your vocal pet peeve?
AR: From my patients: poor compliance.
For me: Talking over loud background noise.
TVF: Which vocal myth would you like to dispel?
AR: Apple cider vinegar is good for reflux – really???!!!
TVF: Your most memorable voice case?
AR: I had a prosecutor with a huge intracordal cyst early in my career. He was about to prosecute a man who brutally murdered his wife. It was a very public case. I had to write the judge to postpone the trial, as he barely had a voice. The cyst was so large, I feared even with a technically perfect case, he would still be very dysphonic. Fortunately, he had a phenomenal result and put the suspect away for life. In addition, he gained a whole new perspective on the importance of his voice.
TVF: As a laryngologist/surgeon, what keeps you on your toes?
AR: The local performers, particularly rock and rollers and gospel singers, who are pounding the pavement to survive, cannot take off gigs as they need the cash, but have frequent voice issues. There is a delicate balance with keeping them working, while not overusing resources or medication.
TVF: In your opinion, what are some of the challenges in care of voice disorders?
AR: In addition to my answers to previous questions,
1. I think that the demands on the live performer are increasing. This is particularly true for pop and rock musicians, as well as musical theater. Educating and caring for the working performer to keep them on stage and avoid long-term serious injuries is critical.
2. Education and training for the “non-performer” voice professional (eg teachers, clergy, etc) continues to be suboptimal. Need to try to get voice training into the curriculum or training for such occupations.
3. Lack of evidence-based research and need for better objective voice measures.
TVF: What do you think the next steps are in growing the field of laryngology?
AR: Continued education and public awareness efforts about the specialty. Also, probably, stem cell therapy for SLP regeneration and improving selective reinnervation techniques.
TVF: What advice would you like to give to the general populace about voice care? How about to the professional voice users?
AR: Do not take your voice for granted. Think about what your life would be like without it. Invest in education and training.
Professional Voice User: Do not assume your voice will always be ready to go. Preserve, preserve, preserve. Do not live in fear of losing your voice, but do everything you can to make sure it is there at its best when you need it.
TVF: Who are your favorite singers?
AR: Off the cuff: Julie Andrews, Michael Buble, Freddie Mercury, Sting, Lou Gramm, Gordon Macrae, Bruce Springsteen, Bono, Frederica Von Stade, Placido Domingo
TVF: What sparks “joy” for you as a person?
AR: My wife and children, music (particularly singing), healing, loving, bringing joy to others…and a good hot fudge sundae never hurt anybody!