Anaïs Rameau, Assistant Professor of Otolaryngology at Weill Cornell Medical Center
November 4, 2020
Anaïs Rameau, 2020 Class of Young Leaders
Q. You are a laryngeal surgeon, a medical academic, and the CEO of MyophonX, a novel medical device which gives a voice to people with limited phonation capacity. Where did your journey on this professional path begin, and how do you achieve a balance between these roles?
I find voice fascinating in its intimate connection to our identity. It is mesmerizing that, despite the apparent rudimentary structure of vocal folds, each human voice is unique and inimitable. Voice is both tangible and ethereal. It can be recorded and used as a biometric marker, yet it is made up of invisible acoustic waves which can powerfully affect our emotions. Listening to an opera aria can bring us to tears, while a child’s cry is immediately disconcerting (and nowadays some political voices can cause us to cringe).
Treating the human voice both medically and surgically allows me to get a little closer to its mystery. In academia, I have the privilege to dedicate time to research and produce new knowledge about the larynx. There is still so much to discover, from regeneration of damaged tissue to restoration of vocal fold mobility. I also love the convergence of voice and new technologies, and think there are innumerable possibilities in the therapeutic, entrepreneurial and creative realms. MyophonX, a silent speech device, is an embodiment of this convergence. All my endeavors are borne out of curiosity and a passionate drive to innovate for patients.
Q. The notions of “being heard” and “having a voice” are critical elements when we talk about diversity and inclusion in the political, social, medical, and educational landscape of the United States. Is this concept something you think about as you work to restore the ability to communicate in patients with compromised vocal cords?
Absolutely, understanding health disparities in laryngology have been one of my research efforts in the past two years, thanks to the supportive environment of Weill Cornell Medical College, New York Presbyterian, which has made health justice an organizational focus. My role as an academic physician is to improve our knowledge base on health disparities, so we can better address them through policy interventions. The socioeconomic and racial disparities in health outcomes of COVID-19 are hard to ignore, and current events surrounding the killing of George Floyd have brought racial disparities to the fore in NYC and in the country. For instance, one of our recent studies was a comparison of access to specialty surgical care before and immediately after the pandemic started, which we showed led to a decline in diversity in our patient population despite the advent of telehealth, likely due to limited access to the internet or familiarity with tele-services.
Conversely, telehealth also holds the promise of making health services more accessible by lowering costs and overcoming geographical barriers. One of my team’s projects is the development of a freely accessible mobile application for gender-affirming voice therapy for transgender individuals, using evidence-based treatment and standard of care practices. The transgender community is affected by barriers to health services, including voice therapy, at a disproportionately higher rate. Since transgender patients’ voices are closely related to their gender identity and quality of life, novel delivery of gender-affirming voice care would be beneficial to overcome these barriers. Hence, the idea for the open-access app, which we hope to launch in 2021 under the name “Attuned”.
Q. You are a mentor to undergraduates, medical students, residents, and graduate students at Cornell University. What qualities do you find are most important for being an effective leader in your field? What is something you have learned from the students you mentor?
Mentoring is a continual exercise in self-reflection and seeing oneself through the other’s gaze. Though I was brought up by a successful and career-focused mother who never complained about the plight of women in her competitive field, I do see that my gender is not a minor component in my interaction with students. They have a tendency to call me by my first name, which I immediately correct, to remind them of our respective roles and responsibilities. Through role-modeling, I try to inspire them to see all the possibilities, both traditional and unconventional, they have ahead of them. I was once told in a fellowship interview it’d be difficulty to establish myself as an authority in laryngology as a female with a (French) accent. I took the challenge, and today, I can show students that regardless of their physical attributes or social/cultural background, they can strive to be who they want to be in medicine and question the status quo via their unique perspective.
Students equally reward me with their successes and dedication to excellence, and through teaching me about the Generation Z perspective. Besides being more facile with technology, Gen Z is more questioning of norms and given social categories. Students have less fear about expressing their unique identities, seeking disruptive solutions and establishing new social values. I find their boldness inspiring.
Q. Can you describe the challenges you faced as an airway surgical specialist working on the front lines during the onset of COVID-19? What have you seen during this experience that gives you hope for the future health and safety of people living both in the US and around the globe?
As an airway surgical specialist, I was called in early to take care of SARS-CoV-2 infected patients during high risk airway procedure (tracheostomies etc.) at New York Presbyterian. In March, we had so little knowledge compared to today about the virus. PPE was lacking and access to testing very limited. I remember re-using N95s multiple times, and self-isolating from my loved ones, as nasopharyngeal swab testing was not even available to health care staff. It was a dark time. Our normal outpatient services completely stopped, and I could not ensure my regular patients were getting the care they needed.
The amount of solidarity in the clinical and research world was awe inspiring in the Spring. There was an adrenaline rush in the scientific community, we wanted to collectively find immediate solutions for infected patients. I re-read La Peste, and found a model to emulate in the abnegating Dr. Rieux. Despite the interruption of normal services, we all got so busy with helping team efforts in the hospitals and engaging in pandemic research. For instance, we quickly formed a team with colleagues in aerospace engineering at our Cornell University Ithaca campus to create a device for the mitigation of aerosols during airway procedures, and got a grant to support our work. These types of collaboration would be slow to set up in normal times. The scientific community has been incredibly productive in the past few months, and I am hopeful that science will lead to better prevention and treatment of COVID-19.
Q. You spent some time growing up in Paris. What is your relationship with the scientific and medical sector in France, and how do you think being a Young Leader will contribute to these transatlantic ties?
Though I grew up in Paris, I have spent all my adult years in the English-speaking world, and engaging with the French perspective during the Young Leaders Program would help me refine my understanding of present-day France. This could be an opportunity for building academic bridges with French scientists and for learning more about alternative science and research policies. I would also like to share my perspective as a surgical provider at an American academic center. Healthcare continues to be at the heart of political debates in the US, and the paradox of American healthcare can be difficult to comprehend abroad: we have the fanciest medical technologies and research capabilities in the world, yet our health outcomes are mediocre and unequal, and our services extremely onerous in comparison. The effects of the COVID-19 pandemic in the US is an embodiment of this paradox and deserves transatlantic reflection, as we attempt to rethink the way we practice public health and medicine in both countries with the unfolding second wave.