12.2 Specialisation.
In the early fifties physicians were encouraged to become professionally active in the field of disorders of voice, speech, and hearing. For the second half of my tour of active military duty I was stationed at a small air-base where few demands were made on me as to medical services. I could spend most of my time studying phonetics and voice/speech/language pathology. By the time I left the military service in 1955, I had decided on a career as a medical specialist focussing on voice, speech, and hearing problems. The choice became easier when I learned that collegues in Finland (Aatto Sonninen) and Sweden (Björn Fritzell) held positions as precisely such specialists.This field of professional specialisation appealed to me as offering opportunity to study pathology and therapy, and, at the same time, offering scope for my interest in languages and music. It presented an inviting challenge to bring together complementary disciplines, such as linguistics, behavioural sciences and medical sciences.
I felt a strong urge to penetrate into the undiscovered regions of human voice and speech production. It was not at all a vague feeling of 'I would like to know more about this'; I was determined to discover as much as I could, and would not allow myself to be satisfied with meagre results. During four years in the department of medicine at Groningen university I did experimental work in voice physiology under the direction of the excellent medical physicist Jan Willem van den Berg. Eelco Huizinga, my professor of Ear, Nose and Throat diseases, warned me when we parted: Don't let your horizon be narrowed by fanaticism. In retrospect I think that the opposite happened. A strong drive has been necessary to expand the study of speech, voice and language beyond the limits of the Ear, Nose and Throat specialty. It requires some courage and a lot of energy to enter neighbouring territories , and to traverse large mental distances. When I started, linguistics, psychology and medicine were separate worlds, light-years apart. Mental acrobatics were required to reach members on the other side of the abyss. The combined efforts of other ‘trespassers’ like myself have changed this.
Since no formally directed training in my chosen area existed in Holland, I applied for and received a fellowship sponsored by the World Health Organisation. This award enabled me to visit centres offering specialisation in voice and speech pathology and laboratories for scientific research in human communication in France, Austria, Germany, and the Scandinavian countries. In the meantime I had met my wife, Tiete Terpstra, an accomplished speech therapist from Amsterdam. Just before leaving on this journey of exploratory study, we were married. Together, we set out as wandering students. On our return, an appointment awaited me at the University of Utrecht as an associate of Piet Gerlings, professor of diseases of the ear, nose and throat (ENT). My assigned task was to develop a clinical program in voice, speech, and language pathology within the ENT department of the Medical School.
We launched our work in the basement of a new building, with two speech therapists and a part-time psychiatrist. We found that for many of the problems presented by our patients we could offer no solutions. This deficiency was in part caused by the fact that at that time logopedics (speech therapy) was still functioning in a medical framework dating from the 1930s: reforms were over-due. Embarking on this project we experienced exhilarating moments. Theoretical innovation resulted in the discovery of new methods, enabling us to deliver productive work. In cooperation with plastic surgeons and dental specialists we reconsidered the diagnosis and treatment of short palate and cleft palate, and confirmed the notion that the widespread occurrence of habitual mouth-breathing and as well as other abnormal oral habits were the causes of orthodontic as well as speech-articulation problems. We also developed intensive treatment programs for voice disorders and stuttering, an evolution which is still taking place.
12.3 Failed