Scott Adams and Spasmodic Dysphonia

Dilbert creator Scott Adams was stricken in 2005 with a rare condition called Spasmodic Dysphonia, which prevented him from speaking in a normal voice. The condition is somewhat bizarre, because sufferers can sometimes sing or speak in unusual circumstances, just not with their normal voices. The condition has struck a variety of famous people (according to Wikipedia), including Darryl McDaniels of Run DMC, and Diane Rehm from NPR.

For Adams, the condition meant he could still speak publicly, sing, or speak to himself while alone. But in normal circumstances his vocal cords would seize up and he simply couldn't speak. And to make it worse, Adams reported that no one has ever recovered from the condition. In late 2006, Adams noticed that he could speak perfectly in rhyme. So he repeated a rhyme ("Jack Be Nimble") over and over, and then...something changed. Since then, he has been able to speak semi-normally. It's not perfect, but he reported in January that he is still in a state of partial recovery.

After the jump, read Adams's report of his original recovery. I would just link to it, but his blog entries from that period have disappeared.

Good News Day

As regular readers of my blog know, I lost my voice about 18 months ago. Permanently. It's something exotic called Spasmodic Dysphonia. Essentially a part of the brain that controls speech just shuts down in some people, usually after you strain your voice during a bout with allergies (in my case) or some other sort of normal laryngitis. It happens to people in my age bracket.

I asked my doctor - a specialist for this condition - how many people have ever gotten better. Answer: zero. While there's no cure, painful Botox injections through the front of the neck and into the vocal cords can stop the spasms for a few months. That weakens the muscles that otherwise spasm, but your voice is breathy and weak.

The weirdest part of this phenomenon is that speech is processed in different parts of the brain depending on the context. So people with this problem can often sing but they can't talk. In my case I could do my normal professional speaking to large crowds but I could barely whisper and grunt off stage. And most people with this condition report they have the most trouble talking on the telephone or when there is background noise. I can speak normally alone, but not around others. That makes it sound like a social anxiety problem, but it's really just a different context, because I could easily sing to those same people.

I stopped getting the Botox shots because although they allowed me to talk for a few weeks, my voice was too weak for public speaking. So at least until the fall speaking season ended, I chose to maximize my onstage voice at the expense of being able to speak in person.

My family and friends have been great. They read my lips as best they can. They lean in to hear the whispers. They guess. They put up with my six tries to say one word. And my personality is completely altered. My normal wittiness becomes slow and deliberate. And often, when it takes effort to speak a word intelligibly, the wrong word comes out because too much of my focus is on the effort of talking instead of the thinking of what to say. So a lot of the things that came out of my mouth frankly made no sense.

To state the obvious, much of life's pleasure is diminished when you can't speak. It has been tough.

But have I mentioned I'm an optimist?

Just because no one has ever gotten better from Spasmodic Dysphonia before doesn't mean I can't be the first. So every day for months and months I tried new tricks to regain my voice. I visualized speaking correctly and repeatedly told myself I could (affirmations). I used self hypnosis. I used voice therapy exercises. I spoke in higher pitches, or changing pitches. I observed when my voice worked best and when it was worst and looked for patterns. I tried speaking in foreign accents. I tried "singing" some words that were especially hard.

My theory was that the part of my brain responsible for normal speech was still intact, but for some reason had become disconnected from the neural pathways to my vocal cords. (That's consistent with any expert's best guess of what's happening with Spasmodic Dysphonia. It's somewhat mysterious.) And so I reasoned that there was some way to remap that connection. All I needed to do was find the type of speaking or context most similar - but still different enough - from normal speech that still worked. Once I could speak in that slightly different context, I would continue to close the gap between the different-context speech and normal speech until my neural pathways remapped. Well, that was my theory. But I'm no brain surgeon.

The day before yesterday, while helping on a homework assignment, I noticed I could speak perfectly in rhyme. Rhyme was a context I hadn't considered. A poem isn't singing and it isn't regular talking. But for some reason the context is just different enough from normal speech that my brain handled it fine.

Jack be nimble, Jack be quick.

Jack jumped over the candlestick.

I repeated it dozens of times, partly because I could. It was effortless, even though it was similar to regular speech. I enjoyed repeating it, hearing the sound of my own voice working almost flawlessly. I longed for that sound, and the memory of normal speech. Perhaps the rhyme took me back to my own childhood too. Or maybe it's just plain catchy. I enjoyed repeating it more than I should have. Then something happened.

My brain remapped.

My speech returned.

Not 100%, but close, like a car starting up on a cold winter night. And so I talked that night. A lot. And all the next day. A few times I felt my voice slipping away, so I repeated the nursery rhyme and tuned it back in. By the following night my voice was almost completely normal.

When I say my brain remapped, that's the best description I have. During the worst of my voice problems, I would know in advance that I couldn't get a word out. It was if I could feel the lack of connection between my brain and my vocal cords. But suddenly, yesterday, I felt the connection again. It wasn't just being able to speak, it was KNOWING how. The knowing returned.

I still don't know if this is permanent. But I do know that for one day I got to speak normally. And this is one of the happiest days of my life.

But enough about me. Leave me a comment telling me the happiest moment of YOUR life. Keep it brief. Only good news today. I don't want to hear anything else.

SOURCE: The Dilbert Blog (link currently dead) 10/24/06.

See also: an MSBNC article on the situation.

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How Your Sleeping Position Can Help (or Harm) Your Health
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Getting a good night's sleep is key to your health, but what's the best position for maximizing those benefits? According to SciShow, the answer depends on who you are and what your body is presently doing. Do you have acid reflux? You might want to avoid sleeping on your right side, since studies have shown that can aggravate heartburn (though scientists still aren't quite sure why). Are you pregnant? Aim for the left side, since it helps blood and nutrients flow to the placenta, among other benefits. Do you snore? Maybe avoid sleeping on your back, and roll over on your side instead. The video below goes over the whole menu of possible sleeping positions, and explains which ones will help you get the most out of your 40 winks.

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Harris and Ewing, Library of Congress
14 Facts About Margaret Sanger
Harris and Ewing, Library of Congress
Harris and Ewing, Library of Congress

Born in 1879, activist Margaret Sanger sparked both revolution and controversy when she began pushing for legalized access to birth control and founded the Planned Parenthood Federation of America. Sanger remains a controversial figure even today, more than 50 years after her death.

1. SHE BLAMED HER FATHER FOR HER MOTHER'S DEATH.

Sanger was born Margaret Louise Higgins, the sixth of 11 children. Her mother, Anne Purcell Higgins, also had seven miscarriages, for a grand total of 18 pregnancies within 22 years. She suffered from poor health for much of that time, and when Anne died of tuberculosis at age 50, Margaret was just 19 years old. According to TIME Magazine, Margaret confronted her father at her mother's coffin and said, "You caused this. Mother is dead from having too many children."

2. SHE WANTED TO BE A DOCTOR.

Margaret Sanger sitting at a table.
Harris and Ewing, Library of Congress

Sadly, medical school was too expensive, so instead she entered a probationary nursing program in 1900. In early 1902, she met architect William Sanger. The two got married later that year and moved to Hastings-on-Hudson, New York, a suburb about 20 miles away from New York City. They had three children.

3. HER HOUSE CAUGHT FIRE, LEADING HER TO MOVE TO THE CITY.

After the Sangers' house in Hastings-on-Hudson caught fire, Sanger stopped enjoying life in the suburbs. By 1911 the couple had decided to start a new life in Greenwich Village, where Sanger joined the Women's Committee of the New York Socialist Party. There, she met fellow radicals and reformers—like novelist Upton Sinclair, anarchist Emma Goldman, art patron Mabel Dodge Luhan, and intellectual Max Eastman—who supported her ambitions to help working women.

In New York City, Sanger decided to jump back into her career by working as a visiting nurse in the Lower East Side tenements. She often treated women who attempted to give themselves abortions because they didn't have the money to care for another child. Dismayed by the poor health and poverty she saw among immigrants there, she developed opinions that would later lead to her advocacy for birth control.

4. SHE BELIEVED BIRTH CONTROL WAS A FREE SPEECH ISSUE.

Soon after arriving in Greenwich Village, Sanger began writing sex education columns for the New York Call, a socialist newspaper. Her frank discussion of women's sexuality and reproduction offended some readers. In 1913, politician and post office official Anthony Comstock censored her column because he considered her usage of words like syphilis and gonorrhea too vulgar.

A year after her column in the New York Call was banned, Sanger launched The Woman Rebel, an eight-page monthly newsletter advocating contraceptive use. Operating under the slogan "No gods, no masters," Sanger used the newsletter to openly defy Comstock's eponymous 1873 laws. (The Comstock laws made it illegal to use the United States Postal Service to send anything containing information about contraceptives or anything else deemed obscene.) She was indicted in August 1914, but she fled to Europe to avoid arrest. She would eventually return to the United States to face trial, but in February 1916 the prosecution dropped the charges.

5. SHE WAS AGAINST ABORTION.

Despite her advocacy for family limitation, Sanger disliked the idea of abortion. She believed proper education and legalized contraceptives would reduce the need for the procedure. In her 1938 autobiography, Sanger described her experience treating Sadie Sachs, one of the women in the East Side tenements. In 1912, Sachs's husband called for Sanger's help after he found Sachs unconscious from a self-induced abortion. After three weeks of treatment from both Sanger and a local doctor, the only advice the doctor could offer Sachs was to avoid "any more such capers" and have her husband sleep on the roof.

Three months later, Sachs became comatose from another self-induced abortion, and Sachs's husband again reached out to Sanger for help. The woman died within 10 minutes of Sanger's arrival. Frustrated by the lack of resources and information available to lower-class women, Sanger resolved to make changes. From that time forward, she wrote, she wanted to "do something to change the destiny of mothers whose miseries were as vast as the skies."

6. SHE POPULARIZED THE TERM BIRTH CONTROL.

Sanger is often credited for coining the term, but that honor actually goes to Robert Parker, a friend of hers who helped create The Woman Rebel. In her 1979 biography on Sanger, author Madeline Gray described Parker as a polio victim who studied yoga with the hopes of gaining more control over his partly paralyzed hand. Gray wrote:

"It occurred to him that control might apply to birth as well. 'Birth control,' he mused. 'Birth control … I think I like it.' They all liked it. As they put on their hats and left, they agreed that birth control was the best name for the movement."

Otto Bobsien, another of Sanger's colleagues, was the first to use the term to proclaim the start of the Birth Control League of America, a new organization he later said "never had more than a nominal existence." In 1915, when Sanger was away in Europe, Bobsien joined the National Birth Control League and offered the fledgling organization use of the movement's new name. When Sanger returned from Europe later that year, she helped popularize the term, considering it more straightforward than phrases like "family limitation."

7. SHE OPENED THE FIRST BIRTH CONTROL CLINIC IN THE U.S.

Historical image of Margaret Sanger standing on a street in New York City
Sanger outside of her trial on January 30, 1917.
Bain News Service, Library of Congress

In October 1916, Margaret Sanger opened a birth control clinic in Brooklyn with the help of her sister, Ethel Byrne, and interpreter Fania Mindell. It was the first of its kind in the U.S., and she modeled it after a Dutch clinic she had visited while evading American police. In the Netherlands, Sanger had learned about pessaries and diaphragms and became convinced they were more effective than the suppositories and douches she promoted in the United States. Sanger brought that new knowledge to her Brooklyn clinic, which served more than 100 women on its first day. For a cover charge of 10 cents, Sanger gave every woman a pamphlet of her New York Call column on "What Every Girl Should Know," a lecture on the female reproductive system, and instructions on several types of contraceptive use. The clinic closed just nine days later when Sanger was once again arrested for violating the Comstock laws. Sanger immediately attempted to reopen the clinic after being released on bail, but, as she wrote, she was promptly re-arrested and charged as a public nuisance.

8. SHE ONCE TOLD A JUDGE SHE COULDN'T RESPECT EXISTING LAWS.

Sanger and Byrne's court trials began in January 1917. Sanger's sister was tried first and sentenced to 30 days in a workhouse, but she immediately went on a hunger strike; Byrne fasted for a week before being force-fed by prison staff. When Sanger went to trial on January 29, she was supported in court by several Greenwich Village socialites and about 50 of the women she'd treated in the Brooklyn clinic. Presiding Justice John J. Freschi offered her a lenient sentence if she promised to obey the law, but Sanger responded by saying, "I cannot respect the law as it exists today." Sanger was found guilty and Freschi also sentenced her to 30 days in a prison workhouse.

In 1918, Sanger appealed the court decision and won a victory for the birth control movement. Although the court upheld Sanger's conviction and she still had to serve her 30 day sentence, Judge Frederick E. Crane of the New York Court of Appeals also ruled that doctors could prescribe contraceptives and disseminate information about birth control under certain conditions. Sanger ran with the new loophole in 1923, when she established a new clinic staffed largely by female doctors. The new clinic operated alongside the American Birth Control League. Almost two decades later, in 1939, the league and the clinic merged, forming the Birth Control Federation of America, and in 1942 this new organization officially became known as the Planned Parenthood Federation of America.

9. THE ROCKEFELLERS ANONYMOUSLY SUPPORTED HER CAUSE.

In the mid-1920s, John D. Rockefeller Jr. anonymously donated $10,000 to the American Birth Control League to fund research into contraceptives. Rockefeller's son, John D. Rockefeller III, continued his father's early support of Sanger's work, albeit more publicly. The Rockefeller Brothers Fund donated money to Planned Parenthood until 1981, when it decided to start funding agricultural research—which was decidedly less controversial—instead.

10. LIKE MANY WELL-KNOWN INTELLECTUALS OF HER DAY, SANGER SUPPORTED EUGENICS.

Many historians believe Sanger's support of eugenics was part strategic and part ideological. Sir Francis Galton, a cousin of Charles Darwin's, initiated the Western eugenics movement by suggesting that traits like "talent and character" could be passed down to children through intentional breeding. Several British and American academics latched onto the idea, including figures like Theodore Roosevelt, John D. Rockefeller Jr., and Alexander Graham Bell. Sanger's support for sterilizing the diseased and "feebleminded" legitimized the birth control movement by aligning her ideas with those of contemporary intellectuals.

Sanger's belief in eugenics was a little different from other intellectuals', though. Eugenicists, she said, believed a woman's first duty should be to the state, and that all "fit" women should bear children. Sanger, on the other hand, thought a woman's first duty should be to herself. She contended the primary reason for birth control was to prevent pregnancies among women who couldn't support a child financially. Sanger believed her ideal of economic eugenics was morally superior to the views posed by traditional eugenicists.

The modern-day Planned Parenthood doesn’t hide Sanger's controversial support of the eugenics movement, but it doesn't endorse it, either. In a document published in 2016 [PDF], the organization said, "We believe that [those ideas] are wrong. Furthermore, we hope that this acknowledgement fosters an open conversation on racism and ableism—both inside and out of our organization."

11. HER BOOKS WERE AMONG THE FIRST BURNED BY NAZIS.

In May 1933, Nazis sanctioned the burning of more than 25,000 books deemed "un-German." Sanger had published at least nine books by that point, and they were all among that number, as were titles by Jack London, Ernest Hemingway, Sigmund Freud, Albert Einstein, and dozens of others. Sanger's books, which advocated for women's choice in everything from childbirth to politics, directly contradicted everything the Third Reich believed. Adolf Hitler supported traditional gender roles and wanted to maintain high birth rates, ideas Sanger decried in her books.

12. HER NIECE WAS PART OF THE INSPIRATION FOR WONDER WOMAN.

A panel of a Wonder Woman comic from 1978.
Tom Simpson, Flickr // CC BY-NC-ND 2.0

Olive Byrne, Sanger's niece, was involved in a polyamorous relationship with Wonder Woman creator William Moulton Marston and his wife, Elizabeth Holloway Marston. Marston credited both Olive and Elizabeth as his muses, according to historian Jill Lepore. In her 2014 book The Secret History of Wonder Woman, Lepore wrote that Marston based part of Wonder Woman's costume on the silver bracelets Olive often wore. Lepore also suggested Sanger herself may have been an influence on the popular comic book character. Feminist movements in the early 1900s often symbolized female oppression with chains, and Sanger was quick to adopt such symbolism with books like Motherhood in Bondage. Wonder Woman's use of chains and ropes as weapons echoed Sanger's vision for female liberation.

13. SHE WAS NOMINATED FOR THE NOBEL PEACE PRIZE 31 TIMES.

Margaret Sanger received 31 nominations for the Nobel Peace Prize between 1953 and 1963. In 1960 alone, she received 20 nominations from 16 university professors and four members of India's parliament (Sanger took several trips to India, where she worked with people like Gandhi to discuss birth control).

14. SHE LIVED JUST LONG ENOUGH TO SEE HER LIFE'S WORK COME TO FRUITION.

Planned Parenthood's publicity director looks over a poster in 1967.
H. William Tetlow, Fox Photos/Getty Images

Two important legal milestones happened after Sanger founded the American Birth Control League in 1921. In December 1936, the 2nd U.S. Circuit Court of Appeals effectively overturned all federal restrictions on birth control, making it legal for doctors throughout the United States to provide access to contraception. On the state level, contraception was legal in some form or another everywhere except Connecticut, Mississippi, and Massachusetts. In 1965, Griswold v. Connecticut overturned the state laws preventing married women from accessing birth control. Griswold v. Connecticut later served as precedent for cases like Eisenstadt v. Baird (1972), which gave unmarried couples unrestricted access to contraception; Roe v. Wade (1973), which legalized abortion; and Carey v. Population Services International (1977), which made it legal for doctors and pharmacists to distribute contraceptives to minors.

Sanger died on September 6, 1966, about a year after the Supreme Court decided on Griswold v. Connecticut. The next day, Alaska Senator Ernest Gruening spoke about Sanger in Congress. In an address to the president, Gruening said Sanger was "a great woman, a courageous and indomitable person who lived to see one of the most remarkable revolutions of modern times—a revolution which her torch kindled."

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