“What’s the state of play?”  I tell him that on some days it’s quite strong, on others it’s not.  On a good day and in the shower, I can even manage a scale.  Not, it must be said, a scale that any humanoid with a passing interest in music might recognise as such – but on a distant galaxy, an alien life form might just sit up and take notice. I met up with a friend, Pippa, a few weeks ago at a gig and once we sat down to talk – and I spoke quietly – she remarked that my voice has some resonance to it.  Trying to speak over others – it does not.  I mention this as well, to Mr ENT.

I tell him about cycling to work and climbing three flights of stairs and how this seems to make my voice louder.  By the afternoon, my voice has all but gone.  On occasion it might put in an appearance after sundown – but to all intents and purposes, it’s a lark rather than an owl.

What I cannot do is control it.  I am not in charge.

“When you climb these stairs – do you wheeze?”  No, I do not wheeze.  He thinks for a minute.  “I’ll be honest, your larynx isn’t the easiest to work on.”  So – a voice with a stroppy attitude.  I ask why the needle in the neck, rather than the tube down the throat.  “It’s less risky for you”.  But he does let me know that while it’s better for me it’s not so good for him.

He inspects my voice box with the camera; “it’s not great, I’m afraid”.  He suggests I go back to seeing the voice therapist; “I can keep an eye on you”.  Then it hits me; he’s not going to offer another injection.  I’m stunned; it was not what I expected.  But you said …   It takes me back to May 2010 when the cardio-thoracic surgeon was coming up with all sorts of reasons why he should not remove my tumour.

This was meant to be a routine appointment and it’s becoming anything but.  Annie couldn’t be here and I have to sort this out myself.  I’m still taking in what he’s just said, but I also need to counter it quickly.  When he turns away the moment will be lost.  Patients are always advised to have someone with them for consultations – it’s difficult to process information, particularly disappointing information and at the same time form a challenging response.

Eventually I blurt out “does this mean you’re not going to try again?’  It’s the best I could manage under the circumstances.  He thinks for a minute; “We could do better.”  I can see that he’s trying to convince himself.  He brightens up; “If you’re keen, then why not?”  I sign the consent form; “We’ll be in touch”.

I sit in the car afterwards; if I hadn’t pushed hard I’d have been back to humming through a fat straw in a glass of water[1].  I wonder if I’m kidding myself; that this is a good as it gets.  No; boots straps must be pulled up, loins must be girded.  Onwards and upwards.  I look at the consent form; the times I’ve signed these without reading them.  Under ‘risks’ he’s written ‘wheeze’.