Voice and Resonance Disorders 81to separate her feelings about her mother from what her mother said and did. By separating the
person from the be hav iors, Betsy was free to feel anger at her mother, which apparently she had
been suppressing and repressing. Betsy immediately stopped seeing her boyfriend but broke off the
relationship carefully, in a way that would not place her in danger. In therapy, Betsy learned a lot
about relationships and eventually became an in de pen dent woman capable of managing her life.
In many ways, Betsy’s emotional growth was precipitated by her loss of voice and the professionals
who treated it.
Case Study 4-5: Litigation Involving Laryngeal Tissue Scarring
From a Kiln Accident
The university and the board of regents, the defendants, took the position that Kendra was
lying or, at the very least, exaggerating her symptoms. Kendra and her family, the plaintiffs, alleged
that her loss of voice and related respiratory conditions were real and possibly fatal. The defendants
held that Kendra had violated university regulations when she entered the fine arts building on a
Saturday and, without supervision, began her pottery assignment. Kendra and her family stated
that she, as a teaching assistant, was issued a building and room key and that it was implied that
she had unlimited access to the kiln and other facilities. The defendants denied liability in the
accident because Kendra, a gradu ate student, should have known that the sawdust she used was
not treated to prevent the f lash fire. The plaintiffs said that the untreated wood was an attractive
nuisance and that the defendants had failed to exercise proper care by not locking it in a secure
place, away from students. The defendants proposed that Kendra was faking and that her attempt
at deception about her voice disorder was typical of her case. More than $1 million in medical bills,
compensation, and damages for pain and suffering were at stake, and the case eventually became
a nasty battle of expert witnesses.
The f lash fire had taken Kendra by surprise. She had pulled the ceramic pot from the kiln and
poured a bucket of sawdust on it, a method used to cool pots to give them a better appearance. This
par tic u lar batch of sawdust was not treated with a special fire retardant to prevent it from bursting
into f lames. When the f lash fire happened, Kendra had ref lexively gasped, inhaling the hot fumes
and allegedly suffering burns to her respiratory tract. The types of respiratory burns she had suffered
are not uncommon in firefighters, and tragically, they can be fatal. In Kendra’s case, allegedly there
was progressive scarring of the sensitive lung tissue. After she was released from the burn unit of the
hospital, she required supplemental oxygen provided by a small blue tube with holes venting it into
her nose. She carried the oxygen bottle everywhere she went. Without it, Kendra could barely walk
from her car to the outpatient waiting room at the hospital. She also complained of lightheadedness
since the kiln accident. This fit young woman, who had previously run marathons, had gained nearly
40 pounds, largely due to her inability to exercise and, according to the doctors, because of the ste-
roids and other medi cations required to prevent further damage to her lungs.
At the trial, the defendants’ expert witness stated that Kendra was exaggerating her symptoms
and faking her voice disorder to increase the damages the jury might award her. The expert sug-
gested that although there was likely damage to her lungs, she still could exhale enough air to
vibrate her vocal cords. He pointed out that persons with severe chronic obstructive pulmonary
diseases, in which the functional volume of air inhaled and exhaled is reduced, are still able to
produce a voice. In the expert’s opinion, there was no physiological reason for Kendra’s inability
to produce a voice and the condition was possibly psychogenic. During cross- examination, his
credentials were examined and he was questioned about how he had reached this conclusion.
The plaintiff ’s expert witness stated that Kendra’s loss of voice was neither an exaggeration
of symptoms nor psychogenic. Large, colorful drawings of the respiratory tract and the vocal
cords were placed in front of the jury. The plaintiff ’s attorney led the expert witness through the