'Dilbert' Cartoonist's Strange Illness

A balding, bespectacled working stiff inexplicably loses his voice — except when speaking in rhyme or pinching his nose.

It may sound like a farcical plot for a popular cartoon satirizing American office culture, but "Dilbert" cartoonist Scott Adams says he recovered less than a week ago from just such an affliction.

"I don't want to give false hope to people who are suffering from the same thing," Adams said, sitting at his drawing tablet in his suburban San Francisco office. "I don't even know if my voice is going to last. Maybe this is an illusion. It came back but in a few days it could go away again forever."

Adams, 49, appears to be a rare example of someone who has largely — but not totally — recovered from spasmodic dysphonia, a mysterious disease in which parts of the brain controlling speech shut down or go haywire. As many as 30,000 Americans are afflicted, typically in their 40s and 50s, experts say.

One of the most peculiar aspects of SD is that victims are typically unable to have intimate conversations in their normal voice. Yet they can speak under different circumstances, such as immediately after sneezing or laughing, or in an exaggerated falsetto or baritone, or while reciting poetry, according to SD support groups.

Patients are often so anxious about their speech that they stop breathing or have heart palpitations. There is no known cure — but many victims have improved their speech by changing tenor or pitch, or doing special breathing and relaxation exercises.

"It's extremely frustrating," said Dr. Krzysztof Izdebski, a voice and speech pathophysiologist in San Francisco who has treated more than 800 people with SD. "People who have this problem are tremendously socially handicapped. They look normal and may even say one or two normal words, but they have facial grimaces and they stutter and people think they're having a stroke. Society is very cruel toward them."

SD may be caused by a chromosomal abnormality that results in spasms of the vocal chords. It may cause spasms in the eyes, arms, legs and mouth. Many victims suffer multiple dystonias, or movement disorders.

Nearly three years ago, Adams developed a tremor in his right pinky whenever he tried to put pen to paper. He turned to a digital drawing tablet and stylus, and the spasms disappeared. Dilbert has been computer-generated ever since.

Then, Adams lost his voice in early 2005 after a bout of bronchitis and laryngitis. He withdrew; the thought of going to the grocery store without saying "hi" or "thank you" was depressing. Being unable to scream "fire!" or "watch out!" terrified him.

A specialist finally diagnosed Adams with SD and he began treatments of the tissue-paralyzing drug botulinum toxin. When injected into the muscles around the larynx, Botox — also used to smooth wrinkles — blocks nerve impulses and reduces spasms.

But the injections generally work for just three months. Side effects include a breathy, inconsistent voice.

Adams, the former Pacific Bell financial analyst whose doodles mocking middle management became one of the country's most popular comic strips, hated the injections.

His only comfort was that he could sing and recite poetry with only minimal gasping and stammering. He recited nursery rhymes every night in hopes of "re-mapping" his brain.

Last weekend, Adams was chanting "Jack Be Nimble" for the umpteenth time when it dawned on him: He wasn't having a stitch of difficulty.

He's been talking ever since — albeit with a raspy, tinny voice.

Adams isn't the first well-known figure to develop the condition. In 1992, public radio host Diane Rehm developed a scratchy cough, and by 1998 she had to take a four-month leave because her speech had become so tortured. Eventually, researchers at Johns Hopkins University diagnosed her with SD.

Rehm's voice still sounds distinctly frail and cracked, but she has maintained a radio career. She said other patients should take comfort in the fact that she, Adams and others have recovered much of their speech.

"I had to work so, so hard to finally get it back and be comfortable with it," Rehm said in a phone interview Thursday. "Sometimes I listen to the early radio interviews I did, and it's hard to believe that that voice is mine."

The protagonist of Adams' comic strip — the bumbling, cubicle-dwelling engineer Dilbert — has long been the artist's alter-ego. While Dilbert hasn't discussed SD in the strip, he and his wry pet, Dogbert, are among the few cartoon characters who lack mouths.

"It's probably a coincidence," Adams said. "But it's a funny one."

By Rachel Konrad