It has been a little more than a year since Gov. Pete Wilson underwent a minor throat surgery that his doctor expected to heal in about a week.
Today, his condition is much better than it was last May when the governor was forced to remain silent for about two months, sending his nascent presidential campaign into a fatal tailspin. But the voice still has not healed.
Cracks and strains in his speeches still prompt the governor to occasionally offer his audiences an explanation. "Don't worry," he says. "It doesn't hurt me. It only hurts my listeners."
By now, it is evident that the governor's condition could be a permanent annoyance. Most of the time, it is scarcely noticed, aides said. But on days when the governor's schedule is packed with speeches, meetings and interviews, he begins to show the strain.
And to a politician, a voice handicap is a career consideration. Wilson said in an interview recently that he does not know whether his condition will affect any of his future plans, such as his stated interest in another White House bid.
"I don't know that," Wilson said. "There are certain things I can do that can help me. And I think that over time it gets better."
One of the main problems, the 63-year-old governor admits, is that he has been a disobedient patient who often ignores his doctor's orders. The best remedy to help Wilson overcome his condition is voice therapy. But if that is going to work, experts said, it will take a rigorous program and a dedicated student.
Voice specialists said the governor might have to meet with a therapist at least three hours a week for about six months. Then he would have to practice every day. In the process, they said, he would have to learn a new way to speak, relying more on his lungs and less on his vocal cords.
In addition to the time required, experts said, therapy is also a difficult task, especially for an active public speaker. Patients are often told to speak in ways that, at first, might be uncomfortable, said Dr. David M. Alessi, an otolaryngologist at Cedars-Sinai Medical Center in Los Angeles who deals with disorders of the throat.
"It's conceivable" his voice could recover, Alessi said. "But it's very difficult for a politician to do that. He would need to have extensive voice training and periods of vocal rest. . . . If he has scarring on the vocal cord this far out [from surgery], that typically does not go away on its own."
Wilson aides said the governor meets periodically with a voice therapist. But they said he does not keep the visits that his doctor has ordered. "He goes when his busy schedule allows," said Sean Walsh, Wilson's press secretary.
Wilson's surgery came on April 14 last year, barely two weeks after he announced that he was planning a campaign for the White House. Dr. Gerald Berke, the director of neck surgery at UCLA Medical Center, told reporters before the operation that he planned to remove a nodule that had grown on the governor's vocal cord.
Berke compared the nodule to a callus and said it was not uncommon for a professional who uses his voice extensively. At the time, the nodule was causing the governor's voice to squeak or crack during speeches. And it was irritating enough that he often used cough drops.
Berke said the surgery was a minor procedure and that full recovery was expected in about a week. After the operation, Berke said he was required to remove more tissue than he had expected.
In addition, Wilson did not adequately rest his voice immediately after the operation. As a result, it deteriorated to a point where he was forced into silence for two months.
Wilson gave his first speech after the surgery on June 14. Two days later, he held a news conference to dispel rumors that his troubled presidential campaign might fold. The governor eventually abandoned his White House bid in September, blaming his failure on the two months of forced silence.
Recently, Wilson explained his condition in an interview.
"You make sound by exhaling and blowing apart the vocal cords," he said, moving his two index fingers apart. "You blow them apart, and they come back together. The question is, if they are not of the same mass [because] one is diminished [by surgery] . . . then it may be that there is less than perfect closure. That produces some momentary gap . . . and that is what causes the crack" in the voice.
Wilson saw Berke about three weeks ago for a checkup. Walsh said the doctor, who declined to be interviewed, reported that the "vocal cords look as good as he has ever seen."
Still, the doctor recommended that Wilson limit his speeches, spend more time in therapy and refrain from talking in cars, planes or cocktail receptions that require him to speak over background noise.
"Cocktail parties are the worst," Wilson said. "They are absolutely the worst. There is this hum of conversation at about 10 decibels above normal. And if you are going to converse, it's the same thing you experience if you try to talk above a band that's playing."
Walsh said the governor's voice has not forced him to cancel appearances since the first two months when he was ordered to be silent. But he said the staff refrains from scheduling too many speaking appearances in one day.
"He is conscious of the voice," Walsh said. "When he gives a morning and a lunch speech, he will try to limit speaking at a reception in the evening. There are times, though, when there are priority events."
Wilson talks about his voice reluctantly. He treats it like a minor annoyance that he wishes would go unnoticed. And he bristles a bit at the notion that it is any brake on his campaign plans. In fact, he described a busy year of public demands.
"I know exactly what I need to do," he said. "I need to get Bob Dole elected. I need to get the [GOP] legislative ranks built up. And so I intend to spend a lot of time campaigning for other people and for causes. . . . That's what I need to do and that's what I am going to do."