Most alarming to listeners devoted to his seminal recordings: the state of Mr. Dylan's voice, decades on from its first signs of deterioration. Dr. Lee Akst, director of the Johns Hopkins Voice Center, says it's impossible to diagnose Mr. Dylan without an examination, but that rock singers are especially prone to scarring or other damage to the vocal cords. Such trauma can be cumulative, he says, compounding the risks for the perennially touring singer. What's obvious: Though he never had a conventionally pretty voice—that was part of its power—lately he's been sounding like a scatting Cookie Monster. On stage, he strums an electric guitar and blows on a harmonica but spends more time at an upright organ, vamping.
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