Laryngectomy

Laryngectomy Dhamma.
Hello again! First an update: I’m living in my own home again – just came back last week. Many thanks
to all my friends and family for helping me get this far, and especial thanks to Margaret and Pat with
whom I have been staying since I left hospital in September. For their friendship, tireless care,
encouragement and quiet, unfussy kindness, I am truly grateful.
What follows is another reflection on life since my laryngectomy (removal of the vocal chords) last July..
This time I’m going to explore my experience of living without my natural voice. I’m only scraping the
surface of this teaching. In fact this essay is my first attempt to reflect on the experience. But for what
it’s worth ... here goes.
At many levels its easier than I could have imagined. Like the way shopkeepers hardly bat an eye when I
write on the whiteboard instead of asking them verbally for what I want. Texts and emails still work
fine. And among friends, when discussions get deep, the slow pace of writing can be OK. It gives time
for relaxation and reflection by contrast to the fast pace of speech. And at times it can be great to be
able to take a back-seat and listen to conversations without any pressure to contribute. Once, when
someone came to dinner and I was exhausted by the effort before we even sat down at the table, I felt
so relieved to be able to stall the pace, writing slowly, giving myself time to take a few breaths and
recover some good humour.
I’m still using the whiteboard for many interactions – only beginning to attempt the electro-larynx in
public though using it more and more among friends and family. The electro-larynx l is basically a buzzer.
If you press it against the throat the buzz penetrates to the vocal cavity where it can be modulated into
speech sounds by moving your jaw and tongue and lips just as you would when speaking normally. A
wonderful device really ... but ... do you remember the Dalecs in Dr.Who? That’s what to expect when
we meet! The first thing Bhante asked me to say was “Exterminate them!”
Children love it – I’m a great novelty for them. And sometimes it gives me a laugh too. Those are the
good days. But it’s hard work by comparison to natural speech. My tongue and other muscles round my
neck have been damaged by the surgery, so I can only speak quite slowly and have to make a big effort
to articulate. It feels like I’m shouting. And often I have to repeat words again and again or throw in a bit
of mime in order to be understood. So it gets tiring. Writing on the whiteboard is more calming for me,
but quite cumbersome for any level of detail. I’ve experimented a bit with some speech synthesis
software, and found an Irish female voice which I was able to install on my computer. It has been useful
for telephone calls where I can prepare my questions in advance, but so far I haven’t got much use out
of it for face-to-face conversations, mainly because of my slow pace of typing.
So a lot of things get left unsaid. Sometimes it’s because I don’t have my whiteboard or whatever to
hand when I think of something I would like to say. And many things that I would ordinarily have
mentioned to others now just don’t seem worth the bother of writing down, or ‘shouting’ with the
electro-larynx. So I noticed myself more often ‘doing my own thing’ without reference to others. This is
uncharacteristic and could cause misunderstandings or hurt, and again I have to thank Pat and Margaret

for their patience and understanding here. I do have good fun in conversations on occasion but lots of
opportunities for light-hearted interaction get lost.
During the initial recovery period and the radio / chemo treatments, I hardly thought about losing my
voice at all. I had plenty of fear, anxiety and other forms of aversion, but they weren’t connected to
coherent thoughts of having lost my voice. The only thoughts that came up were mildly consoling ones.
For example, I often thought “I don’t need to talk right now” or “You don’t need to talk a lot of the
time”. But the down-side of my situation was literally unthinkable.
Then a friend gave me Colm Toibin’s book ‘The Testament of Mary’. This opened Pandora’s box and the
snakes came sliding through! I wondered why the book was making me so happy (it’s a powerful but
not at all a happy story). I found I was buzzing with the delightful thought of Jesus’s miracles! I had
never reflected much on that aspect of the Christian story before. But now ... the possibility of a miracle
.. and maybe for me ... a glimmer of hope was born! At one level, of course, I could laugh at myself. But a
moment later I was sucked in again. Miracles happened then – why not now? I could go to Lourdes,
Knock, Medjugorje! Or why not a Buddhist healing – that would be more appropriate! Bhante’s
Bodycare. The Medicine Buddha. And sure, while he was curing my throat, couldn’t he give me back my
strength and mobility in my arms and neck and shoulders as well? How about the body of a thirty-year-
old? That would be grand. Smiling happily, heart soaring, I just knew the healing was coming my way
soon. Then a wave of rationality would wash over: ‘Come on Noirin, get a grip!’
The daydreams didn’t come up in formal meditation but for days or even weeks they flared up again and
again in daily life. This was my first emotional reaction to the laryngectomy – getting high on the
thought of reversing it all! The high certainly lifted my spirits, but the effort of continually reigning in the
delusion was exhausting. Eventually I got fed up with the daydreaming mind and really wanted to stop
buying into the delusion. But ... how to do this without suppressing the hope, and the desire for well-
being? I noticed it only happened when I was in good humour. The mind would catch on to the good
humour and build a great future of health and strength. Why couldn’t I just enjoy the good humour
instead? I tried the note ‘dreaming of now, dreaming of now’ to help bring me back to the present
moment. I could feel the happiness, and on the edge of this, my painful flickering attempts to grasp at it,
to make it mine, to project it into a wonderful future. As I focused on these feelings, the other aspects
of ‘now’ sank in: no miracle, no voice box, no speech. Happiness turned to sorrow, but I preferred it to
delusion, and my heart began to open, grateful for the Dhamma lesson, glad to be touching at last on
the grief of losing my voice.
With that the heady daydreams disappeared and I was able to start thinking rationally about the reality
of my situation. I had been wondering when it would hit me. Now that I could recognize the grief I could
also see it had been lurking, unrecognised, in my earlier fear and anxiety. I had been turning away from
the obvious reality in terror, having no idea how to live without a voice. I was reminded of the opening
words of C. Day Lewis’s “A Grief Observed”: No one ever told me that grief that was so like fear. It was a
relief to be able to name it as grief. With that, compassion arose and I could acknowledge the loss. It
was as simple as saying: Yes Noirin, this is tough. But that simple recognition meant everything. I felt
more able and willing to care for a being who lives with laryngectomy.

Sometimes, when I want to talk but cannot, I feel tremendous shame. For those moments I am a failure,
a lesser being. Remember the last link the Wheel of Dependant Origination: Conditioned by birth, there
follows ageing, death , sorrow, lamentation, pain, grief and despair. I have ‘taken birth’ in the notion of
myself as someone who can talk. Someone who can say hello, contribute to a conversation, make a
point, ask questions, laugh, chant and sing (probably out of tune but still!), lead meditations, talk about
the Dhamma. I liked the sound of my own voice. Now it’s time to learn from the results of this birth.
The desire not to be manifests again and again. Not to be someone who sounds like a dalek. Not to be
someone who brings a whiteboard and marker to the shops. Not to be someone who’s rasping cough
makes heads turn all around.
When I have the time and space for deeper meditation, I am always reassured that I haven’t lost
anything of real value. The beauty of the Dhamma is still open to me. That’s all that matters ultimately.
But then, in daily life, this wisdom can desert me. Occasionally when people see I can’t speak they
assume I’m deaf too, or intellectually impaired. Sometimes they join me in writing on the white-board,
or ‘mouth’ their words silently. If I’m in good humour, this can be amusing. But if I’m not, it can trigger
rage. One time, when I was in a sulk, a nursing attendant assumed my incommunicative state meant
that I didn’t understand what he was saying (in fairness to him I wasn’t even nodding to acknowledge his
message, just glaring at him - so you could say I got what I deserved! Such is the cost of expressing anger
angrily. His response was just a reflection of what I was putting out into the world). He started speaking
loudly, one word at a time, miming and gesticulating in his efforts to communicate. I wanted to shout:
“I’m not stupid, I’m not deaf, I’m just furious can’t you see!” But of course I couldn’t (just as well or I
would have had plenty of ‘wrong speech’ to regret!), and scrawling it on the whiteboard didn’t seem like
an option. When he left I paced the room, dragging my drip-stand with me, livid with rage and
frustration. Later, I remembered the Buddha’s words: What the world finds ugly, I find beautiful.
Everything around me and within me seemed despicable and horribly ugly. And yet the Buddha would
find this beautiful? Tears of rage and self-pity flowed into the incomprehensible consolation of his
vision.
Then again, there is the temptation to find fault. Someone must be to blame for all this. Myself? For not
taking the warning signs seriously enough? My doctors? My kamma? The Buddha taught that misfortune
can occur for many reasons – e.g. heredity or environment as well as resulting from past misdeeds. So I
cannot assume that this is a fruit of ‘bad kamma’. Intellectually I accept this, and am very glad that I
don’t have to see this as punishment. But when a neighbour called and, probably troubled by my
condition, said: “I don’t know what you did in your previous life but I hope you enjoyed it at the time!” I
saw how little I understood the teaching at depth. I reacted with deep anger at her judgement but once
again I was saved by the slow pace of the whiteboard and her visit passed off cordially. Good thing too,
as it was Christmas eve! But later as I reflected on her remark and my reaction, I saw my deeper fear:
this speechless condition was a sign to all that I was being punished for my misdeeds. With that my
resentment toward the neighbour diminished. I saw that what was troubling me was not her judgement
but my own confusion, at the heart level, regarding the law of kamma.
I was shocked and depressed by that glimpse of my judgemental mind’s reaction to having a disability.
Another deep layer of dukkha needing exploration. What could give me heart for the journey? I

remembered my initial bravado in thinking I could greet this Devadutta gladly! That seemed like such
wishful thinking now. And yet I’d gone and written an essay on it, so I was going to have to try to live up
to the ideal! I tried to dredge back some enthusiasm for the path. I remembered my initial excitement
at hearing that it was possible for a human being to understand the workings of the universe. All the
hours of meditation I’d put in since, trusting that I too could come to know and understand the truth of
how things are. And now a messenger (in the form of a laryngectyomy) had been sent to show me the
way. With a rueful smile I let my guilty, shameful self be coaxed into feeling chuffed, singled out, not for
punishment, but for very rapid progress through the rounds of samsara! Ok Devadutta, I sighed, lead on!
The Devadutta has graced me with other teachings besides loss of speech, such as difficulty swallowing
and loss of flexibility and power in my upper body. In time, I’d like to reflect on these and write some
more. But for now I’ll sign off with good wishes for your own rapid progress through the rounds of
samsara. Or, as a Dalek with a yen for Nibbana might say: Exterminate those hindrances! Exterminate!
Exterminate!
Noirin Sheahan

Laryngectomy Dhamma.
Hello again! First an update: I’m living in my own home again – just came
back last week. Many thanks to all my friends and family for helping me get
this far, and especial thanks to Margaret and Pat with whom I have been
staying since I left hospital in September. For their friendship, tireless care,
encouragement and quiet, unfussy kindness, I am truly grateful.
What follows is another reflection on life since my laryngectomy (removal
of the vocal chords) last July.. This time I’m going to explore my
experience of living without my natural voice. I’m only scraping the
surface of this teaching. In fact this essay is my first attempt to reflect on
the experience. But for what it’s worth ... here goes.
At many levels its easier than I could have imagined. Like the way
shopkeepers hardly bat an eye when I write on the whiteboard instead of
asking them verbally for what I want. Texts and emails still work fine. And
among friends, when discussions get deep, the slow pace of writing can be
OK. It gives time for relaxation and reflection by contrast to the fast pace
of speech. And at times it can be great to be able to take a back-seat and
listen to conversations without any pressure to contribute. Once, when
someone came to dinner and I was exhausted by the effort before we even
sat down at the table, I felt so relieved to be able to stall the pace, writing
slowly, giving myself time to take a few breaths and recover some good
humour.
I’m still using the whiteboard for many interactions – only beginning to
attempt the electro-larynx in public though using it more and more among
friends and family. The electro-larynx l is basically a buzzer. If you press it
against the throat the buzz penetrates to the vocal cavity where it can be
modulated into speech sounds by moving your jaw and tongue and lips
just as you would when speaking normally. A wonderful device really ...
but ... do you remember the Dalecs in Dr.Who? That’s what to expect when
we meet! The first thing Bhante asked me to say was “Exterminate them!”
Children love it – I’m a great novelty for them. And sometimes it gives me a
laugh too. Those are the good days. But it’s hard work by comparison to
natural speech. My tongue and other muscles round my neck have been
damaged by the surgery, so I can only speak quite slowly and have to make
a big effort to articulate. It feels like I’m shouting. And often I have to repeat
words again and again or throw in a bit of mime in order to be understood.
So it gets tiring. Writing on the whiteboard is more calming for me, but
quite cumbersome for any level of detail. I’ve experimented a bit with some

speech synthesis software, and found an Irish female voice which I was
able to install on my computer. It has been useful for telephone calls where
I can prepare my questions in advance, but so far I haven’t got much use
out of it for face-to-face conversations, mainly because of my slow pace of
typing.
So a lot of things get left unsaid. Sometimes it’s because I don’t have my
whiteboard or whatever to hand when I think of something I would like to
say. And many things that I would ordinarily have mentioned to others now
just don’t seem worth the bother of writing down, or ‘shouting’ with the
electro-larynx. So I noticed myself more often ‘doing my own thing’
without reference to others. This is uncharacteristic and could cause
misunderstandings or hurt, and again I have to thank Pat and Margaret for
their patience and understanding here. I do have good fun in
conversations on occasion but lots of opportunities for light-hearted
interaction get lost.
During the initial recovery period and the radio / chemo treatments, I hardly
thought about losing my voice at all. I had plenty of fear, anxiety and other
forms of aversion, but they weren’t connected to coherent thoughts of
having lost my voice. The only thoughts that came up were mildly
consoling ones. For example, I often thought “I don’t need to talk right
now” or “You don’t need to talk a lot of the time”. But the down-side of my
situation was literally unthinkable.
Then a friend gave me Colm Toibin’s book ‘The Testament of Mary’. This
opened Pandora’s box and the snakes came sliding through! I wondered
why the book was making me so happy (it’s a powerful but not at all a
happy story). I found I was buzzing with the delightful thought of Jesus’s
miracles! I had never reflected much on that aspect of the Christian story
before. But now ... the possibility of a miracle .. and maybe for me ... a
glimmer of hope was born! At one level, of course, I could laugh at myself.
But a moment later I was sucked in again. Miracles happened then – why
not now? I could go to Lourdes, Knock, Medjugorje! Or why not a Buddhist
healing – that would be more appropriate! Bhante’s Bodycare. The
Medicine Buddha. And sure, while he was curing my throat, couldn’t he
give me back my strength and mobility in my arms and neck and shoulders
as well? How about the body of a thirty-year-old? That would be grand.
Smiling happily, heart soaring, I just knew the healing was coming my way
soon. Then a wave of rationality would wash over: ‘Come on Noirin, get a
grip!’
The daydreams didn’t come up in formal meditation but for days or even
weeks they flared up again and again in daily life. This was my first

emotional reaction to the laryngectomy – getting high on the thought of
reversing it all! The high certainly lifted my spirits, but the effort of
continually reigning in the delusion was exhausting. Eventually I got fed
up with the daydreaming mind and really wanted to stop buying into the
delusion. But ... how to do this without suppressing the hope, and the
desire for well-being? I noticed it only happened when I was in good
humour. The mind would catch on to the good humour and build a great
future of health and strength. Why couldn’t I just enjoy the good humour
instead? I tried the note ‘dreaming of now, dreaming of now’ to help bring
me back to the present moment. I could feel the happiness, and on the
edge of this, my painful flickering attempts to grasp at it, to make it mine, to
project it into a wonderful future. As I focused on these feelings, the other
aspects of ‘now’ sank in: no miracle, no voice box, no speech. Happiness
turned to sorrow, but I preferred it to delusion, and my heart began to open,
grateful for the Dhamma lesson, glad to be touching at last on the grief of
losing my voice.
With that the heady daydreams disappeared and I was able to start thinking
rationally about the reality of my situation. I had been wondering when it
would hit me. Now that I could recognize the grief I could also see it had
been lurking, unrecognised, in my earlier fear and anxiety. I had been
turning away from the obvious reality in terror, having no idea how to live
without a voice. I was reminded of the opening words of C. Day Lewis’s “A
Grief Observed”: No one ever told me that grief that was so like fear. It was
a relief to be able to name it as grief. With that, compassion arose and I
could acknowledge the loss. It was as simple as saying: Yes Noirin, this is
tough. But that simple recognition meant everything. I felt more able and
willing to care for a being who lives with laryngectomy.
Sometimes, when I want to talk but cannot, I feel tremendous shame. For
those moments I am a failure, a lesser being. Remember the last link the
Wheel of Dependant Origination: Conditioned by birth, there follows
ageing, death , sorrow, lamentation, pain, grief and despair. I have ‘taken
birth’ in the notion of myself as someone who can talk. Someone who can
say hello, contribute to a conversation, make a point, ask questions, laugh,
chant and sing (probably out of tune but still!), lead meditations, talk about
the Dhamma. I liked the sound of my own voice. Now it’s time to learn from
the results of this birth. The desire not to be manifests again and again.
Not to be someone who sounds like a dalek. Not to be someone who brings
a whiteboard and marker to the shops. Not to be someone who’s rasping
cough makes heads turn all around.
When I have the time and space for deeper meditation, I am always
reassured that I haven’t lost anything of real value. The beauty of the

Dhamma is still open to me. That’s all that matters ultimately. But then, in
daily life, this wisdom can desert me. Occasionally when people see I can’t
speak they assume I’m deaf too, or intellectually impaired. Sometimes they
join me in writing on the white-board, or ‘mouth’ their words silently. If I’m
in good humour, this can be amusing. But if I’m not, it can trigger rage. One
time, when I was in a sulk, a nursing attendant assumed my
incommunicative state meant that I didn’t understand what he was saying
(in fairness to him I wasn’t even nodding to acknowledge his message, just
glaring at him - so you could say I got what I deserved! Such is the cost of
expressing anger angrily. His response was just a reflection of what I was
putting out into the world). He started speaking loudly, one word at a time,
miming and gesticulating in his efforts to communicate. I wanted to
shout: “I’m not stupid, I’m not deaf, I’m just furious can’t you see!” But of
course I couldn’t (just as well or I would have had plenty of ‘wrong speech’
to regret!), and scrawling it on the whiteboard didn’t seem like an option.
When he left I paced the room, dragging my drip-stand with me, livid with
rage and frustration. Later, I remembered the Buddha’s words: What the
world finds ugly, I find beautiful. Everything around me and within me
seemed despicable and horribly ugly. And yet the Buddha would find this
beautiful? Tears of rage and self-pity flowed into the incomprehensible
consolation of his vision.
Then again, there is the temptation to find fault. Someone must be to blame
for all this. Myself? For not taking the warning signs seriously enough? My
doctors? My kamma? The Buddha taught that misfortune can occur for
many reasons – e.g. heredity or environment as well as resulting from past
misdeeds. So I cannot assume that this is a fruit of ‘bad kamma’.
Intellectually I accept this, and am very glad that I don’t have to see this as
punishment. But when a neighbour called and, probably troubled by my
condition, said: “I don’t know what you did in your previous life but I hope
you enjoyed it at the time!” I saw how little I understood the teaching at
depth. I reacted with deep anger at her judgement but once again I was
saved by the slow pace of the whiteboard and her visit passed off cordially.
Good thing too, as it was Christmas eve! But later as I reflected on her
remark and my reaction, I saw my deeper fear: this speechless condition
was a sign to all that I was being punished for my misdeeds. With that my
resentment toward the neighbour diminished. I saw that what was troubling
me was not her judgement but my own confusion, at the heart level,
regarding the law of kamma.
I was shocked and depressed by that glimpse of my judgemental mind’s
reaction to having a disability. Another deep layer of dukkha needing
exploration. What could give me heart for the journey? I remembered my

initial bravado in thinking I could greet this Devadutta gladly! That seemed
like such wishful thinking now. And yet I’d gone and written an essay on it,
so I was going to have to try to live up to the ideal! I tried to dredge back
some enthusiasm for the path. I remembered my initial excitement at
hearing that it was possible for a human being to understand the workings
of the universe. All the hours of meditation I’d put in since, trusting that I
too could come to know and understand the truth of how things are. And
now a messenger (in the form of a laryngectyomy) had been sent to show
me the way. With a rueful smile I let my guilty, shameful self be coaxed into
feeling chuffed, singled out, not for punishment, but for very rapid
progress through the rounds of samsara! Ok Devadutta, I sighed, lead on!
The Devadutta has graced me with other teachings besides loss of speech,
such as difficulty swallowing and loss of flexibility and power in my upper
body. In time, I’d like to reflect on these and write some more. But for now
I’ll sign off with good wishes for your own rapid progress through the
rounds of samsara. Or, as a Dalek with a yen for Nibbana might
say: Exterminate those hindrances! Exterminate! Exterminate!
Noirin Sheahan