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Focus on Joseph P. Bradley, MD

Joseph P. Bradley, MD, is an otolaryngologist who specializes in voice disorders, laryngotracheal disorders, and swallowing disorders.

He sees patients at:

The Voice and Airway Center—West County, 1020 N. Mason Road, MOB#3, Suite 205, Creve Coeur, MO, 63141.

Please call 314-362-7509 for an appointment.

What happened in the course of schooling to influence you to choose your specialty?

I always thought I would be a neurosurgeon, but then my interest shifted to pediatric hematology oncology during medical school. I had the opportunity for a pathology fellowship the year between my pre-clinical and clinical years of medical school, and it was during my surgical pathology rotation that I was exposed to total laryngectomy specimens and composite resections of the jaw, tongue and floor of the mouth. It was fascinating – I had no idea that the ear, nose, throat (ENT) specialty was so much more than tonsils and ear tubes.

It was during my 3rd year of clinical surgical rotations when I chose to do an ENT rotation. My decision was influenced by former classmates and what I saw in otolaryngology from my year of the pathology fellowship. I fell in love with the ENT specialty -- I liked the fact that otolaryngologists do both medical and surgical sides of the field. There really is no medical counterpart to what we do.

I also have a background in singing and public speaking. So being in the field responsible for helping people communicate was an extra boost for confirming that this is where I was meant to be.

What brought you to Washington University?

My journey with Washington University started in college. I did my undergraduate training here and met my wife -- before I went to the University of Kansas for medical school.

When it was time to apply for residency programs, St. Louis was a great halfway point between where our two families live – she is from Chicago and I’m from south of Kansas City.

After my residency here, I left for the Emory Voice Center for my Laryngology fellowship. Fortunately, there was an opening for a laryngologist (specialist in voice and larynx disorders) back at Washington University. Dr. Richard Chole, who was chairman of the department at the time, spoke with me about I how would fit in – and that is how I ended up returning.

A lot of people would love to end up at Washington University after building a reputation elsewhere. I was fortunate to start my career here -- I can’t ask for a better institution in terms of research and institutional support. St. Louis is a wonderful place to live.

Which aspect of your practice do you find most interesting?

My practice is fairly unique because I’m sub-specialized in treating voice disorders. I also see patients with upper airway and swallowing issues, but my main focus is voice.

I have an incredible spectrum of patients, ranging from the farmer whose voice has given out to professional opera singers in town for a performance.

The field of voice disorders is still relatively young. Otolaryngologists have always been doing laryngology, but the real interest in the sub-specialty of voice began about 25 or 30 years ago. Research has driven many improvements in our procedures.

It’s very rewarding to provide such important quality-of-life service for my patients. Our voice is what defines us as human beings, and we don’t think about it until we don’t have it. Our ability to communicate and to express what we want is really what sets us apart from the rest of the animal world. When you can no longer communicate the way that you used to, it can have a profound effect.

What new developments in your field are you most excited about?

The most exciting developments are the treatments and procedures that can now be performed on patients under local anesthesia as opposed to general anesthesia. By taking many procedures out of the operating room, we are able to do some vocal restoration in less than 20 minutes – as opposed to a hospital outpatient procedure that could take four to six hours.

We can use laser treatments to treat vocal cord warts that are caused by the human papillomavirus, as well as polyps and pre-cancerous lesions on the vocal cords without having to put the patient under general anesthesia.

The more I can do for the patient outside of the operating room to avoid the effects and expense of general anesthetic, the better it is for him or her. Laryngology has been pushing the frontiers of these procedures.

What is one of the most common voice problems you see?

The most common problem I see is a condition called muscle tension dystonia.

Nobody ever really teaches us how to talk or use our voice. We learn how to talk by modeling the people we have around us – our parents and family. The way we produce sound out of our larynx is not always the most optimal or efficient. That is why when someone uses his or her voice in an inappropriate way, it can lead to certain problems.

For example, I see patients who were cheerleaders in high school and did a lot of yelling by squeezing muscles in their neck. This can eventually lead to pain within the neck and the development of nodules and a raspy voice. Our speech and language pathologists work with these patients to change how their voice is being produced.

The second most common problem I see is vocal cord paralyses that can result from surgery in the neck – thyroidectomy surgery, carotid endarterectomy (surgery in the carotid artery), or anterior approaches to spinal surgery. Something happened during surgery to the nerve that controls the vocal cords and the patient may end up with a very breathy voice, making it very challenging for him or her to talk.

A filler material can be injected that gives a patient his or her voice back in 15-20 minutes. It lasts 6-12 months, and gives the vocal cords time to recover. If they don’t recover, I have other treatment options to permanently fix the problem.

Where are you from?

I’m from Nevada, Missouri -- a small town of 8500 people, south of Kansas City. It was a great place to grow up. Certainly nowhere near as many opportunities as my kids now have growing up in a city. But there is something unique about a small town environment where you know a lot of the people; they know your family and the town rallies around itself.

My high school was an excellent high school and I had great science teachers who were very supportive. I’d been planning on going into medicine since I was four years old. My teachers made sure they challenged me enough so that when I got into college, I would be successful enough to get into medical school.

Is there a particular award or achievement that is most gratifying?

I would have to say it’s my Eagle Scout Award. It was something I did all on my own and was my first major achievement. That has always stuck with me.

It’s wonderful for teaching young men to learn how to be a leader among their peers. It’s a good trial and error before you have to get out in the real world. That is why I will always support the Boy Scouts.

What is the best advice you’ve received?

The best advice I ever received was from my grandmother, who said, “Joseph, let other people find out how smart you are – you don’t have to tell them.” Humility is not always the easiest thing to learn. Her advice has helped to keep me more humble over the years. Several times a month, her voice runs in the back of my head.

You said you had a background in voice, what is it?

In college, I sang in the choir at the Newman Center on the campus here at Washington University. In medical school at the University of Kansas I sang in an acapella group– we were the “Doctor’s Notes”.
 

If you weren’t a doctor, what would you like to be doing?

I would be a political science professor. Political science was my undergraduate degree – I loved policy debate and studying politics in college. It was my one last chance to do something completely out of the box before I started my career in medicine.