★★★  Inter Act  ★★★ with Declan Costello MA, MBBS,
FRCS (ORL-HNS)

Emma:

So I'm so sorry to pull you out of what must be monstrously busy times, as for everyone but particularly for you. I hope the questions aren't too hard! - I wanted a different take on things, so I hope that's okay?

Declan:

Yes, of course, go ahead - delighted to chat.

Emma:

Thank you. So the first thing I was going to ask you is - do you hum while you work? This came out of a very random conversation that I had. A lot of people do - but in your situation, is that viable, or is that a silly question?

Declan:

I do hum while I work. I guess like a lot of musicians, rather than a running monologue of words in my head, I have a kind of running set of music - and sometimes it is determined by what I've listened to that day. I do hum and I do sing a bit at work - not when I'm with patients who are awake, generally speaking, so not in clinic on the whole. When I'm operating, I will hum and sing.

Emma:

That's very interesting.

Declan:

So it's slightly disconcerting for the theatre staff around me but I do, I do!

Emma:

I know people have mentioned about music in theatre, even played music, so it's interesting that you sing it as well. If it were played, who would choose it? Would it be the patient or would it be you?

Declan:

Well it would depend - if I'm doing a procedure under general anaesthetic, then I would get to choose; but in an operating theatre at any given time, there are probably eight or ten people - so sometimes, it's a bit of a bunfight over the music, of what gets to play. Generally speaking, it is the surgeon who has the final say (!), so I would often get a choice of what I wanted to play. If I'm doing a procedure under local anaesthetic and actually, if the priorities are on keeping the patient calm, then I might offer them an option of what they want to listen to, or I might just choose some Debussy piano favourites or something like that, just to keep things calm.

Emma:

Do you warm up your voice, even on days where you may not be singing in a rehearsal or concert?

Declan:

Well, I would love to say yes, I do - but actually the truth is, I don't. I shouldn't be admitting this but I'm not a great practitioner of what I preach.

Emma:

Lots of people probably aren't!

Declan:

I know. I do sing most days and I'm conscious that if I know I'm going to be singing in a couple of days time, I get myself set up, so to speak, but I'm not as rigorous about warming up my voice as I should be.

Emma:

Just to add in - in a normal day, I presume you'd be vocalizing all day pretty much anyway?

Declan:

Yes, by and large - yesterday, for example, I was in clinic in the morning, in the afternoon and in the evening, so I was speaking pretty much constantly for - I don't know, 12 hours or thereabouts - and I do get vocally tired towards the end of that. So there is a lot of vocalization involved in what I do.

Emma:

There's probably a subconscious balance as well. I found years ago, when I was doing very heavy teaching schedules, I automatically worked out where to ease off and where to put more in, if it was going to be a really long, long, long day. So you have to sort of weigh that up, don't you?

Declan:

Yes, that's right and actually, when I start a long day of clinics, I consciously pace myself. If you start too energetic, then actually you'll be really worn out by six hours in.

Emma:

Which has brought you the greatest self-knowledge: medical training or singing training?

Declan:

I think there is a lot of self-knowledge in both, actually, and I think they have helped each other. I developed self-knowledge of controlling nerves and stress with singing, interestingly, and that has helped in terms of managing my thought processes when I'm operating.

I think there's also a thing about mental rehearsals. So for a performance you're going to do, it's useful, I think, to think through the steps and to think about where the pitfalls might be, so that you're actually prepared for that; and the same thing is very true of an operation as well. I will often think about all the individual steps, think about where things are going to go right; or if things don't go quite to plan, how you're going to modify things - and so the mental rehearsal thing, I think, is very helpful - and that self-awareness, I think, has been very important.

Emma:

That's very interesting. Just taking something else up, while you're talking - would you say there are temperaments that suit what you do? - because I think temperaments for performers are very variable. People go into it and they have monstrous nerves - and still put themselves through it quite a lot - but I imagine for surgery, it's a really specific thing. So you can't really be too far off a fairly steady temperament, would you say, generally, for a surgeon? We hope!

Declan:

Well, yes and no. Surgeons are, you know, very like the rest of the world! Surgeons are a very varied bunch. There are some extremely gung-ho and energetic people, there are some much more diffident and laid-back people. The issue is, when you go into surgery as a career, you're a relatively junior doctor; you're not really thinking about your future self, 20 years hence. The extent of personality types amongst surgeons is very different - between specialties for example: ENT surgeons are fairly well-known for being a relaxed bunch, generally speaking; cardiac surgeons, neurosurgeons, those sorts of guys are much, much more intense - and there is a spectrum in between.

Emma:

What's the riskiest or most unusual singing performance you've been involved in? Maybe not risky perhaps...something where it felt like a mismatch, or perhaps it's just unusual what happened...that kind of thing.

Declan:

I have to say that the socially-distanced singing that we've been doing over this last few weeks, in the latter half of 2020, has felt really weird. Watching The Sixteen, or any of these other choirs, or The BBC Singers, for that matter, putting on fantastic performances - I don't know quite how they do it. I've had some slightly weird experiences over the years. Singing ‘Jesu, Joy of Man's Desiring’ in Welsh was one of the weirder ones - at St. John's - I think that was a tribute to George Guest, at the time.

Emma:

What repertoire is on your singing bucket list?

Declan:

Of the things I haven't sung?

Emma:

Yes.

Declan:

So the thing is, I know that there are things that I ought to sing.

Emma:

Why ought to?

Declan:

Well, until last year, I hadn't done Beethoven's Ninth Symphony and I'm not an enormous fan of listening to Beethoven but I thought that, at some stage in my life, I ought to do it - and I did it and it was fine. I think equally, people absolutely rave about the ‘Missa Solemnis’, so I feel that I ought to do it. It's not necessarily on my bucket list, I wouldn't say.

I have to say I've been very fortunate with having sung pretty much all of the music that I would possibly want to sing. I'd love to do the whole ‘Christmas Oratorio’ and, left to my own devices, I'd sing all of the Bach cantatas. I've been lucky enough to sing over the years with the Oxford Bach Soloists and I've done a number of cantatas with them - but to sing all of them would be quite something.

Emma:

This maybe ties in slightly with the question about during surgery - but what music do you listen to, to lift your spirits and/or to wind down?

Declan:

When listening to music, I actively have to tell myself to listen to something other than J. S. Bach because I think, left to my own devices, I would probably just listen to Bach. It doesn't take very much to encourage me to listen to the ‘Christmas Oratorio’ in the run-up to Christmas, the ‘Passions’ in the run-up to Easter, the cantatas for the rest of the year. I think it depends very much on what sort of mood I am in. I've got sort of travel music, if I'm on a long plane journey - actually, I find the Bach ‘Cello Suites’ relaxing to listen to. If I'm running and I'm listening to music, I listen to something completely different - I usually listen to rock or pop music.

Emma:

Do you have a favourite piece and is it vocal or instrumental? It's really impossible to say to people, have they got one favourite piece - and it's a bit of a weird question - but it's probably going to be Bach, from what you're saying.

Declan:

Yes I think so and I think it would probably be the ‘St. Matthew Passion’.

Emma:

What have been the best and worst aspects of 2020 for you?

Declan:

Gosh, well I guess the best aspect for me of this year has been that moment in the middle of August when, there having been huge restrictions on singing for all that time, then suddenly, the clouds parted and the Department for Digital, Culture, Media and Sport allowed singing to go ahead again, which was quite a moment - and it was great to know that the research that we had done had really fed directly into that. It was a palpable sense of relief and joy at the fact that people could go back to singing, so that was probably the best moment.

I guess the worst moment is like a lot of these things - the fear and the anxiety and the anticipation of there being something awful about to hit you was probably the worst aspect of it; you know, thinking back to March 2020, when we were looking at Italy and the fact that they were absolutely deluged, swamped completely, couldn't cope, patients dying on gurneys in corridors and this sort of thing and actually, we really were worried that that was going to happen to us - so that moment of anxiety and stress and fear I think amongst all the medical community was pretty horrid.

Emma:

You mentioned the research and I think there was a site you could link to, earlier in the year; I did find it at one point, where you referred to the #OneVoiceCampaign - is that still happening?

Declan:

Well I'm not directly involved in #OneVoiceCampaign, that's Sam Evans. I did do an interview for Sam, while we were in the middle of the maelstrom of all the research at that time. The #OneVoiceCampaign is very much still going.

Emma:

Ordinarily, if you are singing, does your schedule give you enough time mentally to prepare your mind and voice? I mean, if you have a concert in the middle of a very busy phase and time is short?

Declan:

Yes, the simple answer is probably not enough time. I try to use my time in the car to get myself to where I need to be, if I'm going to be singing. I don't have days of meditation and thought ahead of things to get ready, I just launch into it, by and large.

Emma:

Do you have any advice for younger singers who are currently restricted in their vocal activities? I know, as you said, things have eased a bit - not really enough - and it's a very clamped-down vista for a lot of the people that I am seeing at the moment. They're doing their best and they're using the time in different ways but is there anything of hope that you could suggest they might spend their time doing instead?

Declan:

In terms of direct things relating to using the voice, I think in my clinics at the moment, I'm seeing a lot of singers who are suffering from the effects of trying to sing over Zoom in their bedrooms, or their bathrooms, or whatever else. It's not a natural environment to sing in. Some people are under-singing, some people are over-singing, some people haven't sung for six months and then they're wondering why they can't get back into doing it quite so easily. It's relatively straightforward to work that sort of thing through, so I think 'slow and steady regular practice in the way you would normally do', accepting the fact that the performance environment is not what it could be and not what it should be.

Emma:

Indeed, that's pretty helpful. I did urge people to just make a noise, especially as I have people who live on their own. At the beginning of it, to suddenly be isolated and not speaking or exchanging voice regularly is a very alien thing for a lot of people. So, as you say, little and often is probably great advice.

Declan:

Particularly for older people who are more isolated. If you are into your 70s and 80s; you may be widowed, you're now no longer allowed very much to go out and see people. So all of a sudden, you could find yourself for five days of the week not using your voice at all.

Emma:

That's very true. Actually I have a choir with many members like that and, for some of them, it's a four or five times a week activity, for as much the social interaction as the voice. To have that all taken away instantly was really quite shocking, I think, for a lot of them.

Declan:

Absolutely.

Emma:

Well the final question is - what do you do, to switch off from both singing and medicine - or do you?

Declan:

I do. I run two or three times a week and that's quite nice, mental freewheeling time for me.

Emma:

What sorts of distances?

Declan:

I've got a circuit of five miles that I do a few times a week. I have done a marathon and various half-marathons in the past but I haven't got any plans to do any. So running.

I read a bit but probably not as much as I should. I don't really watch very much TV but I like to zone out to ‘Private Eye’ and ‘Gramophone’ and actually just have my brain work in a completely different way.

Emma:

Fantastic, that's amazing, thank you. That covered everything I wanted to ask you - I'm very grateful for the time.

Declan:

Pleasure, not at all. You're most welcome, nice to talk to you.

I am indebted to Declan for taking the time out needed for this interview. I know that the outcome of his research will be of great interest to singers and non-singers alike - and I am grateful for his snapshot of the life of a singing surgeon!

There are some links below to Declan's web site, the research paper (currently at pre-print) and the #OneVoiceCampaign web site:

Declan's web site

Research paper

#OneVoiceCampaign web site

Return to Emma's Voiceblog

14th. December, 2020