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respiratory and phonatory pro cesses by asking questions about breath support and the myoelastic-
aerodynamic factors associated with voice production. She asked the expert witness to take his
time and to explain the pro cess in words the jurists and judge would understand.
The plaintiff ’s expert witness described how the lungs create pressure below the vocal cords to
blow them apart. The vocal cords would stay apart if it were not for the elasticity of the muscles
in the larynx and air pressure changes that brought them together. The expert demonstrated that
little air pressure was necessary to blow apart the vocal cords and create the suction required to
bring them together. He put two sheets of paper together and blew between them. Because of the
increased velocity of airf low through the constricted part of the sheets, they were sucked together
and began to vibrate. According to the expert, this was a demonstration of Bernoulli’s princi-
ple and an example of how the vocal cords vibrate. The plaintiff ’s expert said he agreed with the
defendant’s assertion that Kendra “prob ably” had enough air support to activate the muscular and
aerodynamic forces necessary to vibrate the vocal cords. In litigation, the distinction between pos-
sibly and prob ably is impor tant.
Conceding that Kendra’s breath support was disrupted but was prob ably enough for the
myoelastic- aerodynamic forces to operate, the plaintiff ’s expert witness explained to the court that
a burn, even a minor one, on the sensitive vocal cord tissue could cause loss of voice. The burned
vocal cords, combined with the changes in breath support, had prob ably caused Kendra to lose her
voice. The expert explained in detail that if the temperature of the gas was high enough to burn
lung tissue, it was likely to be even hotter as it passed through the vocal cords. He opined that
even slight scarring of the sensitive tissue would interfere with vocal cord control and feedback.
He also explained that in therapy the patient could create occasional voicing when alternating the
prephonation and attack stages and stated that over several months he had seen no inconsistencies
in Kendra’s symptoms. Then the plaintiff ’s witness did what the court expected of him: he gave an
educated appraisal of the case and a probable explanation for Kendra’s loss of voice. He stated that
in his expert opinion, Kendra was neither exaggerating nor faking the disorder.
The trial involved several days of testimony from specialists and others. At the end of the
exhausting ordeal, applause and sighs of relief were heard when the jury found for the plaintiff on
all counts. Kendra and her family would receive their just compensation for the accident that took
her voice and livelihood.
Case Study 4-6: Identical Twins With Cleft Lip and Palate
During the ultrasound procedure, the doctor pointed to a vague image and said, “Do you see
the head and body?” The prospective parents nodded, although they really could not tell much
from the picture on the monitor. Then the doctor said, “Oh, look, there’s another one.” The startled
ex pec tant father sat down on the nearest chair while the doctor continued to discuss the images
of the twins. When the doctor left the room, the ex pec tant parents hugged each other and began
planning for the two additions to their family. The pregnancy was relatively normal, but during