By April Dembosky, KQED, KFF Health News

When doctors told her they had to remove her tongue and voice box to save her life from the cancer that had invaded her mouth, Sonya Sotinsky sat down with a microphone to record herself saying the things she would never again be able to say.

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“Happy birthday” and “I’m proud of you” topped the phrases she banked for her husband and two daughters, as well as “I’ll be right with you,” intended for customers at the architecture firm she co-owns in Tucson, Arizona.

Thinking about the grandchildren she desperately hoped to see born one day, she also recorded herself reading more than a dozen children’s books, from the Eloise series to Dr. Seuss, to one day play for them at bedtime.

But one of the biggest categories of sound files she banked was a string of curse words and filthy sayings. If the voice is the primary expression of personality, sarcasm and profanity are essential to Sotinsky’s.

“When you can’t use your voice, it is very, very frustrating. Other people project what they think your personality is. I have silently screamed and screamed at there being no scream,” Sotinsky said recently, referring to rudimentary voice technology or writing notes by hand before she chanced upon a modern workaround. “What the literal you-know-what?”

Fighting invasive oral cancer at age 51 forced Sotinsky to confront the existential importance of the human voice. Her unique intonation, cadence, and slight New Jersey accent, she felt, were fingerprints of her identity. And she refused to be silenced.

While her doctors and insurance company saved her life, they showed little interest in saving her voice, she said. So she set out on her own to research and identify the artificial intelligence company that could. It used the recordings Sotinsky had banked of her natural voice to create an exact replica now stored in an app on her phone, allowing her to type and speak once again with a full range of sentiment and sarcasm.

“She got her sass back,” said Sotinsky’s daughter, Ela Fuentevilla, 23. “When we heard her AI voice, we all cried — my sister, my dad, and I. It’s crazy similar.”

‘Your Voice Is Your Identity’

It took close to a year for doctors to detect Sotinsky’s cancer. She complained to her orthodontist and dentist multiple times about jaw pain and a strange sensation under her tongue. Then water began dribbling down her chin when she drank. When the pain got so intense that she could no longer speak at the end of each day, Sotinsky insisted her orthodontist take a closer look.

“A shadow cast over his face. I saw it when he leaned back,” she said, “that look you don’t want to see.”

That’s when she started recording. In the five weeks between her diagnosis and surgery to remove her entire tongue and voice box — in medical terms, a total glossectomy and laryngectomy — she banked as much of her voice as she could manage.

“Your voice is your identity,” said Sue Yom, a radiation oncologist at the University of California-San Francisco, where Sotinsky got treatment. “Communication is not only how we express ourselves and relate to other people, but also how we make sense of the world.”

“When the voice is no longer available, you can’t hear yourself thinking out loud, you can’t hear yourself interacting with other people,” Yom said. “It impacts how your mind works.”

People who lose their voice box, she added, are at higher risk for long-term emotional distress, depression, and physical pain compared with those who retain it after cancer treatment. Close to a third lose their job, and the social isolation can be profound.

Most laryngectomy patients learn to speak again with an electrolarynx, a small battery-operated box held against the throat that produces a monotonic, mechanical voice. But without a tongue to shape her words, Sotinsky knew that wouldn’t work for her.

When Sotinsky had her surgery in January 2022, AI voices were still in their infancy. The best technology she could find yielded a synthetic version of her voice, but it was still flat and robotic, and people strained to understand her.

She got by until mid-2024, when she read about tech companies using generative AI to replicate a person’s full range of natural inflection and emotion.

While companies can now re-create a person’s voice from snippets of old home movies or even a one-minute voicemail, 30 minutes is the sweet spot.

Sotinsky had banked hours reading children’s books aloud.

“Eloise saved my voice,” Sotinsky said.

Now she types what she wants to say into a text-to-speech app on her phone, called Whisper, which translates and broadcasts her AI voice through portable speakers.

Most doctors and speech therapists who work with head-and-neck cancer patients don’t realize AI software can be used this way, Yom said, and with their focus on saving lives they often don’t have the bandwidth to encourage patients to record their voices before they lose them in surgery.

Health insurance companies likewise prioritize treatments that extend life over those that improve its quality — and typically avoid covering new technologies until data proves their actuarial value.

Sotinsky and her daughter spent months wrangling with claims adjusters at Blue Cross Blue Shield of Arizona, but the insurer refused to reimburse Sotinsky for the $3,000 she spent on her initial assistive speaking technology.

“Apparently, having a voice is not considered a medical necessity,” Sotinsky quipped, her AI voice edged with sarcasm.

Sotinsky now pays the $99 monthly fee for her AI voice clone out-of-pocket.

“While health plans cover both routine and lifesaving care, assistive communication devices are typically not covered,” said Teresa Joseph, a spokesperson for Blue Cross Blue Shield of Arizona. “As AI provides opportunities to impact health, we imagine that coverage criteria will evolve nationally.”

Research Might Lead to Insurance Coverage

Sotinsky resolved to use her newfound voice to help others regain theirs. She stepped back from her work in architecture and built a website detailing her voice banking journey — voicebanknow.com. She tells her story at conferences and webinars, including an oncology conference in Denver that Yom organized for 80 scientists.

One doctor who attended, Jennifer De Los Santos, was so inspired by hearing Sotinsky’s voice that she began laying the groundwork for a clinical trial on the impact AI technology has on patients’ communication and quality of life. That type of research could generate the data health insurers need to measure actuarial value — “and therefore justify coverage by insurance,” said De Los Santos, a head-and-neck cancer researcher and professor at Washington University in St. Louis.

Breast cancer survivors faced a similar battle in the 1980s and ’90s, she added. Insurers initially refused to cover the cost of breast reconstruction after a mastectomy, calling the procedure cosmetic and unnecessary.

It took years of patient advocacy and carefully crafted data showing reconstruction had a profound impact on women’s physical and emotional well-being before the federal government mandated insurance coverage in 1998.

Both De Los Santos and Yom said research data on AI voice clones will likely follow a similar path, eventually proving that a fully functioning, natural-sounding voice can lead to not only a better life, but a longer one.

In recent months, Sotinsky’s AI voice literally helped save her life. Her cancer had resurged in her lungs and liver. Her voice allowed her to communicate with her doctors and participate fully in developing the treatment plan. It showed her just how “medically necessary” having a voice is.

She noticed that doctors and nurses took her more seriously. They didn’t tune out the way people often did when she relied on her more robotic, synthesized voice. It seemed they saw her as more fully human.

“If someone can only communicate using a few words at a time, and not elaborate and interface more fully, it’s natural that you can’t detect that they have more depth of thought,” she said. “Being able to dialogue with my care team in a more seamless way is vital.”

While doctors successfully treated her latest round of cancer, Sotinsky, now 55, said she is confronting her odds in a new way, facing the reality that she will likely die much sooner than she wants.

All over again, she realized how crucial her voice is for maintaining perspective on life and a sense of humor in the face of death.

“I tend to forget and think I am fine, when in reality, this is forever now. Emotionally, you start to get cocky again, and this was like, Whoa, b****, we ain’t playing. This cancer is real,” Sotinsky said, typing her next phrase with a mischievous grin.

“Sarcasm is part of my love language.”

This article is from a partnership with KQED and NPR .

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

Amy Lindgren

To search or not to search, that is the (December) question. Job search, that is. Searches for life’s meaning or other deep issues can continue unabated, but candidates may need to decide if job search at year’s end is worthwhile.

It’s understandable that the question would come up. In the old days, it was obvious there were fewer job ads over the holidays. A glance at the Sunday paper told you that, leading to the conclusion that employers weren’t hiring for the month.

Ironically,  this was really a chicken-and-egg situation, at least back then. Puzzled that employers would suddenly need fewer workers, I ran an informal experiment for a few years. Using just the phone book (remember those?) my employees called companies randomly until we had 100 answers to these two questions: Do you currently have openings? If yes, are you advertising those openings?

As it turns out, the non-advertising employers who had openings were holding back because they thought job seekers were on pause for December. Not wanting to waste money on expensive newspaper ads, they limited their outreach. The candidates, meanwhile, assumed that fewer ads meant hiring was shut down in December.

And so a tradition was born of job seekers deciding not to search in the last month of the year while employers chose not to advertise. Even so, not advertising wasn’t (and isn’t) the same as not hiring. Employers who met candidates through other means — including self-introduction — were still open to hiring, a fact that job seekers often missed.

Coming back around then, should candidates search in December? Some indicators have changed, making the decision muddier. For example, you can no longer tell at a glance that advertisements are more or less plentiful at any point in the year. With a significant number of online postings being duplicates across different platforms, and others being “held over” despite having expired, it’s not a statistic us laypeople could easily discern.

All that said, we’ve long known that postings don’t represent the bulk of hiring activity, so they’re not a great indicator of openings at any time.

From my perspective, the answer to the December question is more personal than global. Three arguments for continuing your search full-speed through December might be:

• 1. You need a job, and can’t afford to lose the 10 or 20 days of potential searching a full stop would represent.

• 2. You’re in an industry that uses December to gear up for the new year, such as tax accounting.

• 3. You’re afraid you won’t return to your search if you take a break.

Conversely, arguments for intentionally stopping or slowing your search in December could include:

• 1. You’re burned out and need recovery time from the process.

• 2. You’ll be traveling or dealing with kids on school break, effectively erasing your options for searching.

• 3. You know you’re not going to do the work anyway, so you might as well plan for that reality.

Over the years I’ve pressed for staying in the search, with the understanding that other candidates holding back makes a less crowded field for those who press forward. I still favor that concept, but I’ve also come to see the value of a catch-up month for job seekers, especially if it’s been a long search. In that version, here’s what you might do instead in the month of December:

First, keep your schedule, but shorten it. Suppose you’ve been reserving 9 am to noon, Monday through Friday for job search tasks. Stick with the 9 am start, but end after an hour instead of three. Maintaining the start time will make it easier to pick up the reins again in January.

Next, consider unfinished tasks from your search. Have you been meaning to organize your files or create a networking database? Identify what would make you more efficient and set that up for yourself.

Now, what about your contacts? Are there networking coffees you can organize for December or January? Maybe you want to send holiday wishes to those who have helped you this year.

Finally, what would make you a stronger candidate in January? Consider small things such as updates to your résumé or LinkedIn page, while also reviewing online sessions on Coursera or elsewhere for “universal” topics such as project management. December can be a good time for building knowledge that future employers will appreciate.

Whatever you choose, do set meetings for the first week of January. That will help you start your motor again.

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Amy Lindgren owns a career consulting firm in St. Paul. She can be reached at alindgren@prototypecareerservice.com.

Reports of recent job cuts, especially by tech companies, have spurred speculation about the impact of AI on the workplace: Will the advanced computing technology increasingly replace people on the job?

That was on Kaitlyn McCormick’s mind as she pursued a bachelor’s degree in the information technology field. She is now working toward a master’s in artificial intelligence and machine learning through CSU Global, an online, fully accredited university that’s part of the Colorado State University system.

“If you’re thinking four years or two years of education is going to take you to right where you need to be and you’ll be fine for the next 50 years, that’s not reality,” McCormick said. “If you don’t try to become more relevant, you’re going to be left behind. That’s the cold, dark truth.”

McCormick, who lives in Littleton, has worked in IT for about 16 years and has been a software engineer at Q2 Software Inc. for almost 10 years. The firm had a recent companywide discussion about incorporating AI into its platform. Some employees expressed angst and uncertainty about the prospect.

“It is a fearful moment. I can relate with them on that,” McCormick said.

Even as she pursues a master’s degree in AI and machine learning, McCormick, who is deaf, experiences her own uncertainty. The single mother is working full-time and taking classes as she strives to keep up with the changes.

“Rather than running away, you should embrace it, take advantage of using AI as an assistant,” McCormick said. “The first thing to consider is that AI will always require a human.”

Matthew Brown echoed McCormick’s statement that the computer systems still need human input.

The machines don’t  learn all on their own, said Brown, program director of computer science at CSU Global. “They still have to have data input, they have to have human interaction for those models to be built.”

Artificial intelligence is a set of technologies that allows machines and computer programs to mimic human intelligence through experience, identifying patterns and making decisions based on large volumes of data at a speed beyond what people can do alone. CSU Global describes machine learning as a subfield of AI that helps a system learn more quickly so it can accomplish a particular task.

Brown doesn’t believe “the mantra that AI is taking over the world” and is going to replace people. He said jobs are changing and morphing into something else. People are needed to work with AI to interpret data and results.

“I still have to have people that feed these models data and manage them. The roles are changing, but there’s still the need for people that understand this technology,” Brown said.

He gave an example of a quality engineer in aerospace working on a design for an airplane wing. An engineer might spend days producing a report while AI could review that data and issue a report in less than a day.

“Now the quality engineer can use their time more wisely reviewing the report and come in, looking at the assumptions that the AI engine gave, and make decisions based on that,” Brown said.

However, he expects certain jobs, such as data entry or writing lines of computer code, to change or disappear.

“AI can generate lines of code way faster than anyone could type it out,” Brown said. “So those jobs that are being impacted the most are jobs that are high-touch, redundant work that’s prone to errors because of human input.”

He expects entry-level tech jobs to be affected. People in the industry have told Brown that they’re not looking for interns or entry-level programmers but for people with skills in AI.

“Programs in universities are going to have to rethink what they’re training students to do,” Brown said. “I think everybody’s going to be impacted by it, just about every industry, just about every role. It’s that transformative.”

The global consulting firm Challenger Gray & Christmas released a tally from U.S. employers that said 153,074 jobs were eliminated in October, up 175% from the 55,597 cuts reported in October 2024. The firm said some industries are correcting after the hiring boom during the pandemic, but the reductions also come as companies are adopting AI, costs are rising, and consumer and corporate spending are softening.

Technology led in private-sector job cuts as companies restructure amid AI integration, slower demand and efficiency pressures, Challenger Gray & Christmas said. The industry announced 33,281 reductions, compared with 5,639 in September.

But experts told CNBC in early November that companies could be blaming AI for layoffs that are because of business mistakes and belt-tightening. Peter Cappelli, a professor of management at the Wharton School of the University of Pennsylvania, told CNBC “there’s very little evidence that it cuts jobs anywhere near like the level that we’re talking about.”

In most cases, Cappelli said, AI doesn’t cut head count at all.

About 560 students are enrolled in CSU Global’s online master’s degree program in AI and machine learning. Brown, whose background includes time in the military and work in retail, aerospace and government contracting, said the students are a diverse group. Many are looking to improve their skills or re-enter the job market.

“As an institution, we’ve decided that we need to understand and be a part of AI, making sure that students understand it and can use it efficiently to get the kind of work they want,” Brown said.

None of the Tim Walz failings have been enjoyable to chronicle. Jesse Ventura, Gov. Turnbuckle, was enjoyable to cover, even when he threatened to mow down the media with his state SUV. One time, Rudy Perpich brought an ink-stained lot of us to the attic in the old Irvine Mansion on Summit Avenue to show us a hose he had draining from the roof into a bucket — proof, he said, that the Legislature was treating him cruelly for not dumping millions of dollars into the governor’s mansion.

Those were the days, goofy governors serving a well-oiled state machine.

Walz?

Walz should not be running for a third term. He should resign immediately. He can’t explain the fraud under his watch, except for bromides and boilerplate nonsense and whatever else he can come up with — he speaks at a ridiculously high-speed tempo — to bring Donald Trump into his deflections.

Trump’s indecent playground bullying serves no purpose, but Trump did not allow fraud to happen in Minnesota. This is all on Walz. Too many sources, including a state representative, Marion Rarick, and more than 430 Department of Human Services employees, said that word came down through the chain of the bureaucracy to keep pushing our money out the door even when its final direction had been discovered.

The Walz fraud is now a national story. He can’t hide from it. He can’t continue to pretend that he didn’t know about it. He can’t “aw, shucks” his way out of this because his lame “aw, shucks” posturing has always been an act anyway. He has flirted with the idea that he would be thought a racist if he raised a fuss, so he chose instead to make an entire community “less than” by not expecting them to play by the book, which, of course, is racist itself.

We have been poorly served. Minnesotans are having their eyes opened, especially when they open their property tax statements or really understand the way any size business has been treated by this state. We wonder where we would be if Walz and his incompetent and short-sighted legislative brothers and sisters didn’t blow the $18 billion surplus and then stare out the window, yawning, while another billion was stolen. The indictments keep coming; we don’t even have a final tally yet.

The national commentary tone is embarrassment for Minnesota, that things could get this bad. We actually don’t need the sympathy of the New York Times and the Washington Post, but the sentiment is accurate. We are embarrassed. Every time Walz opens his mouth is embarrassing.

Trump’s outbursts — Somalis have destroyed this state; they haven’t, we have a governor in charge of that — only served to give another platform to the gas-lighting virtuous among us to lecture us about how Somalis are important to the state and are, in fact, our friends and neighbors. The governor, the mayors and the city councils, trembling in fear of appearing racist, are pretty much saying, “it wasn’t their fault they stole the money.” It certainly has nothing to do with racism to say, well, yes, it was.

Ilhan Omar, on CNN just the other day, blamed the fraud on hastily available funding for new programs and there being no guardrails in place. By that pathetic excuse, she might think it’s OK to rob a bank if there is no security guard present.

Omar, a congresswoman, has a soapbox more significant than most of us. I am unaware that she ever denounced the fraud. She has given us boilerplate nonsense from time to time, and, because she is quicker on her feet than Walz, she has never bothered with the bumpkin act. Minnesotans are perfectly willing to be friends and neighbors with all our friends and neighbors, but are Somalis standing with all Minnesotans to condemn the fraud? Has any Somali leader pounded his or her fist on the podium to rail against the theft?

Has Walz?

Joe Soucheray can be reached at jsoucheray@pioneerpress.com. Soucheray’s “Garage Logic” podcast can be heard at garagelogic.com.

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