BVA Profiles
Ruth EPpstein (BVA President 2004 - 2005) interviewed by Stephanie Martin
Ruth, your entry in the Royal College of Speech and Language Therapists' Directory says your BA (Hons) in Communication Disorders was awarded by Tel Aviv University, which is not only rather exotic but also a bit of a way from Gray's Inn Road - can you tell me about that journey, how and why you made it?
I was born and grew up in Israel. I graduated from Tel Aviv University medical school with a combined degree in speech therapy and audiology, I came to London for my cousin's wedding when I met a certain Mr Epstein. The rest as they say is history…
I started my professional life in England two years later working in the rural depth of East Sussex driving 60 miles a day down country lanes through herds of cows. Hardly exotic but a wonderful introduction to British country life. We moved to London in the early 80s and I joined the Middlesex Hospital until the merger of ENT services in 1998.
Your worked with one of my heroes, Dr. Frances McCurtin, on a voice research project quite a few years ago, was that the impetus for your research focus or had research been a long-term interest?
I had the pleasure of working with Frances on her xeroradiography PhD project at the Middlesex Hospital. This was second research project I was involved with and my first brush with the vocal tract. My earliest experience in research was in aphasiology with Professor Stan Newman who later became my supervisor and mentor for my own PhD.
Research has always been my passion and an integral part of my clinical work. I believe we all have a responsibility to try and broaden knowledge and expertise. Whether the effectiveness with our clients grows over time, is critically driven by what we put back into our respective fields.
I am always interested in what has motivated an individual to undertake a PhD, which is a fairly gruelling process at the best of times. As far as I remember your children were quite young at the time you were doing yours. What was your motivation?
My PhD came about through the persistent encouragement of several of the ENT consultants I had the privilege of working with at the Middlesex Hospital, including Sir Douglas Ranger, Mr Dick Williams and Mr Garfield Davies. Indeed, it was gruelling. I did it in my spare time and it took seven years marked by many long nights and holiday afternoons spent completing assignments.
While you were working on your PhD Ruth, how did you combine the clinical and research role, did one feed into the other?
The research evolved from the clinical work. I think I have always been what you might call a researching clinician in that I sought the evidence for clinical practice. I am a strong believer in the need to combine clinical expertise with a body of research findings that are valid, reliable and clinically relevant. As a working clinician, I know this is not easy, but I feel it is more possible now even more
than when I started my own PhD in light of the recent call for and discussion of evidence-based practice.
Can you tell readers a little more about that research and the findings?
My PhD focused on the long term impact of botulinum toxin injections on
individuals with adductor spasmodic dysphonia. It examined the psychosocial
changes resulting from the injections and the influence of psychosocial factors on outcome. As a clinician, I was intrigued by the fact that my patients' voice
symptoms improved considerably with botulinum toxin intervention, yet they
remained psychosocially 'handicapped'. The major findings of my study showed
that illness does not predict disability. Another conclusion that emerged from my study is concerning coping. The study confirmed the role of coping as a mediator between disease process and outcome.
Last year you successfully set up a new MSc course at UCL, open to both Otolaryngologists and Speech and Language Therapists. What can you tell us about that, how did it come about and how has the first year gone?
Voice and phonosurgery is a recognised sub specialty in both otolaryngology and speech and language therapy. As such, there has been a growing need for training in this area of specialty. Other reasons for setting the course up were the need for academic research focusing on evidence based health care in voice pathology and Government led initiatives for clinicians to obtain further qualifications in areas of clinical specialty. The MSc/Diploma in Voice Pathology consists of five components: clinical management, research methods and professional skills, instrumentation and acoustics, phonosurgery and a research project. As we received our accreditation only in July last year, we started our first year with three students. This year we have a mixed group of twelve students, both from overseas and from the UK. I hope we can look forward to cross-disciplinary collaboration among voice professionals and excellent research output.
They always say 'ask a busy person …' but in the 'busyness' league you seem to be more engaged than most in a range of different activities - how does it all fit together and do you ever have time off?
I must admit fitting everything in is a juggling act that requires tight diary management combined with efficiency, energy and good humour. At 4 o'clock in the morning I sometimes wonder how successful I am… Conversely, I am surrounded by many colleagues and friends who achieve a healthy balance between work and play. This is what I aspire to.
I mentioned Frances McCurtin as one of my heroes, who has influenced you in your professional life and how?
I have already mentioned several people who have been both mentors and major influence on my thinking and actions. Some others without a doubt are colleagues in the USA like Diane Bless and Dan Boone who have always impressed me with their energy and intellectual generosity in sharing knowledge and experience.
As President of the BVA what do you see as its most important role in the voice arena?
In my opinion, the BVA's basic role should be to empower each of the related disciplines under the common umbrella of 'voice' to add value in their respective areas.
Do you have a number of specific aims for the Association that you would like to fulfil during your year in office?
One of my duties as President is to reflect on our mission statement in term of what has been achieved and how I can make a contribution to moving things forward. My main aims for the organisation are to ensure the BVA plays a lead role in voice related issues in terms of education, protocols and guidelines through interactive communication with professional organisations. An additional and essential aim is to recruit more members. Last but not least is for the BVA to play a more active role in facilitating research in the field of voice.
In terms of your professional life do you have any remaining unfulfilled long-term goals and if so what are they?
For many years I have had an interest in vocal performance measurement. I feel this area of voice is still too qualitative - I would like to contribute to an accelerated approach in this area. Another vision is to launch a multidisciplinary course in performing arts medicine - some of the most fulfilling moments of my
clinical work have been with professional voice users.
What 'voice' legacy would you most like to be remembered for and why?
I am proud to be recognised for my contributions along traditional lines such as the MSc in voice pathology and clinical practice, but also for pushing boundaries in my field, such as my recent appearance at the first 'Human Beatbox' convention as 'Dr Ruth'!